Long-Term Care, Skilled Nursing, and Adult Day Programs
For any questions or concerns regarding SPOT, please contact COVIDOB@acgov.org.
NEW! Step One: Complete the Exposure Survey.
Step Two: Complete the SPOT Intake Form using the instructions below for new users or returning users.
New Users
A. Open the link below to fill out and submit a SPOT Intake Form.
SPOT Intake Form (ENGLISH) | SPOT Intake Form (SPANISH)
Returning Users
A. Login to your SPOT account.
SPOT Login Site
B. Visit "View Locations and Exposures"
C. Select the location.
D. Select "Report New Exposure"
E. Fill out the SPOT Intake Form
Select “No, I will provide this information later once the Health Department has confirmed the information.” at the bottom of the SPOT Intake Form
Note: While the completion of the application is the first step of reporting, you will still need to submit case information via SPOT Bulk Upload once you receive access to be fully compliant.
The Alameda County Public Health Department will review your form and email you with the next steps. A response should be expected within the same or following business day.
Step Three: Download and fill out the LTCF SPOT Bulk Upload Template (blue columns are required to be completed). Then log into your SPOT account and go to “Bulk Upload” section. Complete the fields and upload the completed document in this section as shown below.
Note: While contact tracing may be part of your outbreak response, you do not need to report close contact information to Alameda County Public Health.
Step Four: New COVID-19 case related to the outbreak should be reported via LTCF SPOT Bulk Upload Template. Do not include previously reported cases when reporting additional cases.
*For facilities reporting their first outbreak or need immediate assistance, email COVIDOB@acgov.org Monday-Friday 8:30 AM to 5:00 PM.
All Other Settings (businesses, schools, acute care, etc.)
Step One: Open the link below to fill out and submit a SPOT Intake Form.
Note: While the completion of the application is the first step of reporting, you will still need to submit case information once you receive access to be fully compliant.
Step Two: Once you have submitted your request, the Alameda County COVID Investigations and Prevention Unit (CIPU) will review your form and email you with the next steps. A response should be expected within the same or following business day.
For first time users, a SPOT account registration email will be sent to you.
Using SPOT to Report COVID-19 Cases
Step One: Refer to the instructions in the email you received from the Alameda County CIPU. Please complete all required information for positive COVID-19 cases associated with the outbreak.
Step Two: Each additional COVID-19 case related to the exposure should be reported through SPOT.
ACPHD encourages all facilities to stay up to date on guidance for their specific settings. While ACPHD continues to support settings who are experiencing outbreaks, we are unable to work individually with all facilities. However, we will continue to share resources by email when we receive an outbreak report. In addition, if your setting is detecting unusual COVID illnesses such as more severe illness (e.g. hospitalizations or deaths), a more rapid spread of infections (e.g. having 1 case then 20), or cases with unusual symptoms (e.g. other than typical for COVID), please reach out to COVIDOB@acgov.org
Case Reporting for Health Care Providers
Submit Confidential Morbidity Reports (CMRs) within 24 hours on patients with SARS-CoV-2 infection that have been hospitalized or have died. Providers should continue to report Multi-System Inflammatory Syndromes in Children (MIS-C).
- Fax to 510-273-3944 or send by secure email to COVIDreport@acgov.org.
Laboratories must continue to report positive and negative results via Electronic Laboratory Reporting (ELR) or by fax within 24 hours.
Reporting Threshold for Long-Term Care Facilities
Must report the following within one (1) working day to the Alameda County Public Health Department per CDPH AFL 23-08, Title 17 California Code of Regulations (CCR) sections 2500
Please use the following reporting thresholds from CORHA/CSTE:
- ≥2 cases of probable1 or confirmed COVID-19 among residents identified within 7 days
OR
- ≥2 cases of suspect3, probable1 or confirmed COVID-19 among HCP4 AND ≥1 case of probable or confirmed COVID-19 among residents, with epi-linkage2/5,
OR
- ≥3 cases of acute illness compatible with COVID-19 among residents with onset within a 72h period
1 Probable case is defined as a person meeting presumptive laboratory evidence. Presumptive laboratory evidence includes the detection of SARSCoV-2 specific antigen in a clinical or post-mortem specimen using a diagnostic test performed by a CLIA-certified provider (includes those tests performed under a CLIA certificate of waiver).
2 Epi-linkage among patients or residents is defined as overlap on the same unit or ward, or other patient care location (e.g., radiology suite), or having the potential to have been cared for by common HCP within a 7-day time period of each other. Determining epi-linkages requires judgment and may include weighing evidence whether or not patients had a common source of exposure.
3 Suspect case is defined as a person meeting supportive laboratory evidence OR meeting vital records criteria with no confirmatory or presumptive laboratory evidence for SARS-CoV-2. Supportive laboratory evidence includes the detection of SARS-CoV-2 specific antigen by immunocytochemistry OR detection of SARS-CoV-2 RNA or specific antigen using a test performed without CLIA oversight.
4 Healthcare Personnel (HCP), defined by CDC, include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel)(6). Facilities should prioritize investigations of cases in HCPs whose duties require them to have close contact with patients or visitors. Healthcare facility infection prevention or occupational health personnel should, wherever feasible, interview HCP with COVID-19 to identify likely sources of exposure and assess whether there are epi-linkages with other HCP or patient cases.
5 Epi-linkage among HCP is defined as having the potential to have been within 6 ft for 15 minutes or longer while working in the facility during the 7 days prior to the onset of symptoms; for example, worked on the same unit during the same shift, and no more likely sources of exposure identified outside the facility. Determining epi-linkages requires judgment and may include weighing evidence whether or not transmission took place in the facility, accounting for likely sources of exposure outside the facility.
Must report the following within one (1) working day to the Alameda County Public Health Department per CDSS Title 22, section 80061:
Please use the following reporting thresholds from CORHA/CSTE:
- ≥2 cases of probable1 or confirmed COVID-19 among residents identified within 7 days
OR
- ≥2 cases of suspect3, probable1 or confirmed COVID-19 among HCP4 AND ≥1 case of probable or confirmed COVID-19 among residents, with epi-linkage2/5,
OR
- ≥3 cases of acute illness compatible with COVID-19 among residents with onset within a 72h period
1 Probable case is defined as a person meeting presumptive laboratory evidence. Presumptive laboratory evidence includes the detection of SARSCoV-2 specific antigen in a clinical or post-mortem specimen using a diagnostic test performed by a CLIA-certified provider (includes those tests performed under a CLIA certificate of waiver).
2 Epi-linkage among patients or residents is defined as overlap on the same unit or ward, or other patient care location (e.g., radiology suite), or having the potential to have been cared for by common HCP within a 7-day time period of each other. Determining epi-linkages requires judgment and may include weighing evidence whether or not patients had a common source of exposure.
3 Suspect case is defined as a person meeting supportive laboratory evidence OR meeting vital records criteria with no confirmatory or presumptive laboratory evidence for SARS-CoV-2. Supportive laboratory evidence includes the detection of SARS-CoV-2 specific antigen by immunocytochemistry OR detection of SARS-CoV-2 RNA or specific antigen using a test performed without CLIA oversight.
4 Healthcare Personnel (HCP), defined by CDC, include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, contractual staff not employed by the healthcare facility, and persons not directly involved in patient care, but who could be exposed to infectious agents that can be transmitted in the healthcare setting (e.g., clerical, dietary, environmental services, laundry, security, engineering and facilities management, administrative, billing, and volunteer personnel)(6). Facilities should prioritize investigations of cases in HCPs whose duties require them to have close contact with patients or visitors. Healthcare facility infection prevention or occupational health personnel should, wherever feasible, interview HCP with COVID-19 to identify likely sources of exposure and assess whether there are epi-linkages with other HCP or patient cases.
5 Epi-linkage among HCP is defined as having the potential to have been within 6 ft for 15 minutes or longer while working in the facility during the 7 days prior to the onset of symptoms; for example, worked on the same unit during the same shift, and no more likely sources of exposure identified outside the facility. Determining epi-linkages requires judgment and may include weighing evidence whether or not transmission took place in the facility, accounting for likely sources of exposure outside the facility.
- Outbreak Definition: At least three suspected, probable, or confirmed COVID-19 cases within a 7-day period among epidemiologically linked residents and/or staff
- “Epidemiologically-linked cases” include persons with close contact with a confirmed or probable case of COVID-19 disease; OR a member of a risk cohort as defined by public health authorities during an outbreak.
- A "risk cohort" includes persons with potential for shared exposure with the case(s) through a shared defined physical space. Examples include but are not limited to persons in the same: dining room, activity room, visiting area, Physical Therapy room.
- CDPH Guidance for Isolation and Quarantine for definition of "close contact."
Reporting Threshold for Health Care Facilities
Acute Care Facilities should refer to CORHA/CSTE for reporting thresholds to public health. Please see link here.
Please see AFL-23-08 for Requirements to Report Outbreaks and Unusual Infectious Disease Occurrences
Please refer to How to Report an Outbreak: All Other Settings (businesses, schools, acute care, etc.)
Outpatient health facilities, including dialysis facilities, emergency departments, urgent care, primary care, and dental offices must report the following to Alameda County Public Health Department per CDPH General Outbreak Reporting Guidance
- At least three COVID-19 cases within a 7-day period among people who are epidemiologically linked in the setting, and are not known to be close contacts of each other in any other case investigation.
Reporting Threshold for Non-Healthcare Settings
The Isolation & Quarantine Hotel closed permanently at the end of February 2023. Facilities should have a plan to safely isolate and/or quarantine all residents on-site as needed. Please refer to our Guide for On-site Isolation & Quarantine for Unlicensed Group Living Settings. If you require assistance, please email COVIDOB@acgov.org
Congregate living facilities such as homeless shelters, residential treatment facilities, transitional housing facilities, room and board, group homes, and residential congregate living for youth must report the following to Alameda County Public Health Department per local reporting thresholds:
- 5 or more COVID-19 cases within a 7-day period in residents and/or staff.
- 3 COVID-19 cases within a 7-day period in an inmate, corrections staff and/or contracted staff.
Reporting thresholds:
| Setting | Number of Cases (e.g. the number of cases that need to be reported) |
| Elementary schools or schools with stable classrooms | 5 or more positive COVID-19 cases within a 7-day period in an individual classroom |
| Secondary schools or schools with students that change classrooms frequently | 15 percent or more of a grade has tested positive for COVID-19 within a 7-day period |
| Child care programs | 5 or more positive COVID-19 cases within a 7-day period
|
As of January 1, 2023, general workplaces are no longer required to report outbreaks (three or more COVID-19 cases among employees in an "exposed group" within a 7-day period) to their local health jurisdiction. AB 685 is no longer in effect and general workplaces should instead refer to AB 2693 and the Cal/OSHA Reporting Requirements FAQ for the most up-to-date COVID-19 case reporting and recording requirements. Reporting requirements for specific special settings are unchanged.
Covered employers must continue to comply with the COVID-19 Non-Emergency Temporary Standards, for Cal/OSHA reporting requirements. Please visit: https://www.dir.ca.gov/dosh/coronavirus/.
Please refer to How to Report an Outbreak: All Other Settings (businesses, schools, acute care, etc.).
