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FAQs for COVID-19 Health Order C19-07y

Page last updated on October 21, 2021

Background

On June 15, 2021, the California Blueprint for a Safer Economy was terminated, however statewide COVID-19 guidance continues for some settings. The San Francisco Health Officer's declaration of a health emergency arising from the pandemic continues to be in effect, and the main health order governing the emergency remains in place. This document answers FAQs about the current version of the health order..

Revision history:

October 21, 2021 corrected editing errors.

October 14, 2021 to clarifiy new masking guidelines in the updated Health Order.

September 30, 2021:

Explains the vaccination requirements (September 30, 2021) for employees working in covered high-risk settings.

Clarifies vaccination requirements for profession basketball players or others performing in large or mega indoor events.

September 23, 2021:

Clarifies proof of vaccination for participants in out-of-school time (OST) youth programs.
Updated link to the list of vaccines approved by WHO.
Clarifies enforcement of vaccination requirement for children turning twelve.
Clarifies exemptions and enforcement of new requirement of vaccinations verification.
The highly contagious Delta Variant has made it necessary to restore the indoor masking requirement.
New requirement of vaccination verification for patrons and staff in certain indoor public settings.
Vaccination requirements for personnel in high-risk settings extended to cover other health care providers.
Updates the vaccine mandate deadline, for personnel working in high-risk settings, to September 30, 2021 (instead of September 15, 2021).
How to deal with patrons who cannot get vaccinated due to a disability or religious belief.

1. What does the Safer Return Together Health Order do?

The Safer Return Together Health Order lifts most pandemic requirements. More specifically, it lifts capacity limits and physical distancing requirements for most businesses and activities. It also allows businesses, schools, and other activities to fully resume.

The order still has some requirements to specific situations. The purpose of these restrictions is to protect our communities and save lives by:

Increasing vaccine coverage to the greatest extent possible
Limiting the transmission risk of COVID-19
Containing any potential COVID-19 outbreaks
Aligning in general with the guidance issued by the CDC and the State relating to COVID-19 except in limited instances where local conditions require more restrictive measures

The order applies these additional measures to certain settings with vulnerable populations or where there is a high risk of COVID-19 transmission to ensure the health and safety of all in that setting.

Vaccination

2. Who should get vaccinated?

Every eligible individual living, working and visiting San Francisco is strongly urged to get vaccinated as soon as they are able. This is especially important for people at risk for severe illness with COVID-19 and people who live or work with unvaccinated older adults and unvaccinated individuals with health risks.

3. Why is the City requiring proof of vaccination to go inside certain businesses?

San Francisco’s Health Officer is taking this step to protect against the continued spread of the highly contagious Delta variant, to safeguard against likely future variants and to help ensure the continued safe reopening of schools and businesses. Vaccines are safe, effective and widely available. They are the best means of protection against COVID-19 and its known variants. They are an especially important tool to protect those not eligible to be vaccinated, like children under 12, as well as more vulnerable populations, such as people with compromised immune systems.

4. How do you show that you’ve been vaccinated?

There are several ways to do so. Acceptable methods of proof include:

Original, copy, or electronic photo of the CDC vaccination card (or similar documentation issued by another foreign governmental jurisdiction)
documentation from a healthcare provider
personal digital COVID-19 vaccine record issued by the State of California available by going to https://myvaccinerecord.cdph.ca.gov
personal digital COVID-19 vaccine record issued by another State, local, or foreign governmental jurisdictions
personal digital COVID-19 vaccine record issued by an approved private company

Businesses subject to this new requirement must cross-check proof of vaccination against each patron’s photo identification.

A written self-attestation or declaration of vaccination status is not acceptable as a form of proof.

5. I live in Canada and got the AstraZeneca vaccine. Does my Canadian vaccination card satisfy the proof of vaccination requirement even though AstraZeneca's vaccine wasn't approved by the FDA?

Yes, as long as you are fully vaccinated. Full vaccination means you completed the entire recommended series of vaccination (usually one or two doses) with a vaccine authorized to prevent COVID-19 by the FDA or by the World Health Organization. A vaccination card similar to a CDC vaccination record card issued by a foreign governmental jurisdiction is an acceptable form of proof of vaccination. Lists of FDA-authorized vaccines and WHO-authorized vaccines are available.

6. Is proof of vaccination required to enter all businesses in San Francisco?

No. The proof of vaccination requirement applies to two main categories of indoor businesses: (1) those that serve food and drink, like bars, restaurants, clubs, theaters and entertainment venues; and (2) indoor gyms, yoga studios and other fitness establishments. These both are types of indoor businesses that by their nature create situations where the virus could spread more easily. This is because people must take off their masks to eat and drink, and because exercise accelerates breathing. Vaccination requirements also apply to patrons and staff at large indoor events with 1,000 people or more because so many people will be gathered together in an indoor space.

7. Can I provide results from a negative COVID-19 test in place of proof of vaccination?

No. But for a limited period of time you may be able to provide a negative test to attend indoor events with more than 1,000 people. This only applies where tickets were sold before August 12 for events happening before September 15. The test result must be negative for the virus that causes COVID-19 within the prior 72 hours. Both nucleic acid (including polymerase chain reaction (PCR)) and antigen tests are acceptable.

8. When does this take effect?

The new vaccination verification requirements for patrons of bars, restaurants, clubs, theaters, entertainment venues, gyms and other covered businesses will take effect at 12:01 a.m. on Friday, August 20.

The new requirement also means that affected businesses must use their best efforts to determine the vaccination status of their staff before 12:01 a.m. on Friday, August 20. The vaccination requirement for staff will take effect at 12:01 a.m. on Wednesday, October 13.

The changed vaccination verification requirements for indoor mega-events and the new vaccination verification requirements for large indoor events will take effect on August 20. This is subject to a limited exception for events where any tickets or reservations were sold before August 12 and that occur before September 15. Large events and mega-events that are covered by that exemption must still comply with the requirements for proof of vaccination or negative testing that currently apply to mega-events.

Covered Businesses

9. Do I need to show proof of vaccination to go inside a grocery store? What about to go inside a drug store? How about entering an indoor shopping mall?

No. Proof of vaccination is not required for patrons to enter these indoor retail spaces unless food or drink are being served and consumed inside. With limited exceptions, all persons two years of age and older are required to wear a well-fitted mask when inside these and other public indoor spaces. Businesses that operate food courts in indoor shopping centers with seated dining are required to obtain proof of vaccination before patrons enter the food court unless they have removed all the seating.

10. Is proof of vaccination required in a cafeteria or gym within an office space that is not open to members of the public?

No, not at this time. Offices or other businesses that offer cafeteria services or that have gyms that are not open to members of the public are not required to comply with the new vaccination verification requirement. If these cafeteria or gym facilities are open to members of the public, businesses must comply with the August 20, 2021 vaccination verification deadline for all persons entering these facilities.

11. Is proof of vaccination required in a hotel gym? What about a gym used exclusively by collegiate athletes or private members?

Yes. Proof of vaccination is required in gyms in hotels, gyms used by collegiate athletes, and gyms with private memberships. Offices or businesses hosting a gym that is open only to employees are not required to comply with the proof of vaccination requirement.

12. Is proof of vaccination required at institutions of higher education hosting indoor physical education classes? What about indoor culinary classes?

Yes, proof of vaccination is required before entering indoor physical education classes and intercollegiate sports where participants will be engaged in exercise involving elevated breathing. Indoor culinary classes that involve eating or drinking are also subject to the proof of vaccination requirement.

13. Are organizations providing shelter, food, or other necessities of life to people experiencing homelessness or food or shelter insecurity required to obtain verification of vaccination from clients or patrons?

Generally, no. Government agencies and other entities operating shelters or similar facilities that house or provide meals or other necessities of life to individuals experiencing homelessness or who have food or shelter insecurity may offer those services to those who are unvaccinated, although everyone is strongly urged to become fully vaccinated as soon as possible. Staff members of these entities are still subject to ascertainment (providing vaccination status) and proof of vaccination requirements. With limited exceptions, all persons two years of age and older are required to wear a well-fitted mask when inside these and other public indoor spaces.

14. Are museums and galleries covered by the vaccine mandate?

The proof of vaccination requirement only applies if 1,000 or more patrons will be present in an individual gallery or other enclosed space at the same time. Museums and galleries are encouraged to ensure that patrons move through exhibits and avoid gathering in large groups for extended periods of time. For each gallery space or room in which patrons gather museums and galleries are also encouraged to implement at least one of the ventilation strategies approved by SFDPH. But in areas where food or drinks are served and consumed (e.g., a restaurant or café within a museum), proof of vaccination for patrons and implementation of at least one ventilation strategy are required regardless of the number of people present in the space. With limited exceptions, all persons 2 years old and older are required to wear a well-fitted mask when inside galleries, museums, and other similar public indoor spaces.

15. For events being held in a hotel, museum, or other event space, who is responsible for obtaining proof of vaccination? The hotel/venue, or the event organizer? Do they have to verify before entering the venue space or the hotel?

It is the responsibility of both the operator of the host venue and the event organizer to ensure that proof of vaccination requirements are met. Proof of vaccination must be obtained before patrons enter any venue space that is subject to the proof of vaccination requirement. For example, if a hotel is hosting a gathering of over 1,000 people in a large ball room, proof of vaccination should be obtained before patrons enter the ballroom.

16. My venue holds 1,500 people. Do I need to submit a health plan to DPH for each planned event, or can I submit one plan for all planned events at my place of business?

You are only required to submit one health plan per venue as long as it covers all the different kinds of planned events in that venue that are subject to the proof of vaccination requirement. That plan must be submitted at least 10 days before the first covered event.

17. Does a house of worship need to require proof of vaccination at an indoor wedding reception or other gathering where food or drinks are being served?

Yes. The proof of vaccination requirement applies to indoor gatherings of all sizes hosted by houses of worship where food or drink are being served, such as a wedding reception. For clarity, proof of vaccination is not required where food or drink are served indoors briefly only as part of a religious ceremony (e.g., communion or kiddush).

18. Is a tent or other outdoor structure considered an indoor or outdoor space?

Guidance on whether a structure is considered outdoors or indoors, is available.

Proof of vaccination requirements apply to all indoor spaces where food or drink are being served, where people are engaged in exercise that accelerates breathing, or where groups of more than 1,000 people are gathered.

19. If a landlord has tenants that are businesses covered by the proof of vaccination requirements, does the landlord have an obligation to enforce the vaccination mandate?

Both landlords and tenants are responsible for ensuring that proof of vaccination requirements are met. If a tenant is violating a health order and won’t stop, then upon being notified by the City, a property owner must exercise its rights under the lease to stop the property from being a public nuisance.

20. Do I have to be fully vaccinated to attend a large or mega indoor gathering such as a Warriors basketball game or a concert at the Chase Center? Do children under 12 need to be tested before entering these events?

Yes.

Beginning August 20, 2021, patrons age 12 and up must show proof of vaccination to enter large or mega indoor gatherings such as the Chase Center for a basketball game or concert. Based on current health conditions, these facilities must not allow unvaccinated people 12 and over to enter indoor areas regardless of the reason they are unvaccinated, except for the limited purposes provided under the health order. Due to the nature of many indoor events (such as a live concert), facilities may not be able to offer unvaccinated patrons safe and feasible options that facilitate live access to services consistent with the health order requirements.

Children under 12 may attend these events but under State rules are required to show proof of a negative COVID-19 test before entering an indoor event of 1,000 or more people. See further information on California's testing requirements at these events. There is also a narrow, time-limited exception for events where any tickets or reservations were sold before August 12, 2021 and that occur before September 15. Events that are covered by that exemption must still comply with the requirements for proof of vaccination or negative testing that currently apply to mega-events.

Covered Personnel

21. Which workers must get vaccinated?

Proof of vaccination will be required for anyone who routinely works in a high-risk setting and for anyone who works in indoor businesses where the virus could spread more easily.

Employees who routinely work in a high risk-setting such as acute care hospitals, skilled nursing facilities, residential care facilities for the elderly, homeless shelters and jails is required to be fully vaccinated by September 30, 2021.

Employees working in the other businesses that include those that serve food and drink, fitness establishments, and recreation facilities where there may be elevated breathing will need to verify that they are fully vaccinated by October 13, 2021.

The October 13, 2021 deadline also applies to (1) workers who are not permanently stationed in high-risk settings but who enter the high-risk setting in the course of their duties on an intermittent or occasional basis; (2) personnel in adult daycare facilities, adult day programs licensed by the California Department of Social Services (CDSS), and dental offices; (3) home health care workers and pharmacists; and (4) all staff who routinely work onsite of a covered business. Additionally, the health order does not prohibit any other businesses or government entities from requiring their employees to get vaccinated or provide verification of their vaccination status.

22. Are any employees exempt from this vaccination requirement?

There are limited exemptions to vaccination requirements such as religious beliefs and qualifying medical reasons. In order to claim an exemption, employees must submit a declination form to their employer. Unvaccinated exempt people who work in high risk settings will be required to wear a well-fitted mask (except while actively eating or drinking). Alternatively, non-vented N95 mask, supplied by the high-risk setting upon request, is strongly encouraged. They must also get tested for COVID-19 at least once a week using either a nucleic acid or an antigen test.

23. If an employee who works in a covered high-risk setting receives their final vaccine shot on (or within two weeks before) September 30, 2021, are they prohibited from entering the high-risk setting for two weeks after that shot until they meet the definition of fully vaccinated, or can they mask and test in that interim two-week period?

Any employee who works in a high-risk setting and completed an FDA authorized or approved COVID-19 vaccine regimen (either one dose of a single-dose regimen or the second dose of a two-dose regimen) may immediately enter and work in the high-risk setting if during the two weeks following their final vaccine dose the employee:

is tested for COVID-19 at least once a week (and at least twice a week if the high-risk setting is a general acute care hospital, skilled nursing facility, or intermediate care facility) using either a nucleic acid (including polymerase chain reaction (PCR)) or antigen test

AND

wears a face covering at all times in the high-risk setting in compliance with the State Public Health Officer Order of July 26, 2021.

So, for example, if an employee in a high-risk setting receives a second shot of the Pfizer-BioNTech vaccine on September 29, 2021, that individual could continue to enter the facility to work in the facility through October 13, 2021 if that employee meets the masking and testing requirements; after October 13 that employee would be fully vaccinated and would not be subject to these additional testing and masking provisions of the Order. An employer could still require additional safety measures, and any masking requirements that apply under state or local rules to fully vaccinated employees in such settings would apply.

24. Are professional basketball players or others performing in large or mega indoor events subject to the City’s vaccine mandate, regardless of whether those individuals claim a medical or religious exemption?

At large and mega indoor events, all patrons age 12 and older must be vaccinated at this time. Under the current Safer Return Together Order, those patrons who do not provide proof of full vaccination cannot enter indoor areas regardless of the reason they are unvaccinated. And they cannot test out of this requirement even if they have a medical or religious exemption. At this time, this same rule applies to professional basketball players and other performers employed by the business, government entity or other organization hosting a large or mega indoor event (“home players”). To perform at those events in San Francisco, home players must be fully vaccinated by October 13.

In contrast to home players, players or other performers who are not employed by the host of the event (“visiting players”) are excepted from the vaccine verification requirements. But under the Safer Return Together Order those visiting performers or players are strongly urged to be fully vaccinated before performing or playing. And they are required to meet under the Order a number of specific health requirements. Specifically, they must remain at least six feet from members of the public at all times during the event, provide a proof of a negative COVID-19 test taken within 48 hours of the event, and wear a well-fitted mask at all times except while actively performing or playing. Also, unvaccinated visiting performers or players cannot enter the indoor sections of restaurants, bars, or cafes located within the event venue, except as required for them to perform or play.

The reason for the exception is that visiting players are, by definition, present in the venue only occasionally and as a result present a lower risk of transmission because they have fewer contacts with others. Also, they must comply with additional safety measures to reduce the risk. In particular, as mentioned above, visiting players are subject to the requirement that they remain at least six feet from members of the public, at all times. In this way, they are subject to stricter social distancing requirements than those that apply to home players and patrons attending the event. The City’s requirements for visiting players is consistent with New York City’s similar requirements for players or performers at indoor large events. Also, while they are in San Francisco visiting players are subject to the same restrictions that apply to all other patrons of restaurants, bars, gyms and other facilities covered by the vaccination requirements of the Safer Return Together Order. As a result, at this time visiting players who are unvaccinated may not enter any of these covered facilities while they are in San Francisco. Those restrictions apply to residents and visitors alike.

25. I am an employee who works in a high-risk setting. Does the health order allow my employer to ask me for information concerning my request for an exemption on the basis of a disability or sincere religious belief?

The health order prohibits employees from working indoors at high-risk facilities unless they are fully vaccinated. A worker may be able to obtain an exemption from the vaccination requirement, but only if they have a demonstrated disability or sincere religious belief that prevents them from receiving a COVID-19 vaccine and only if the employer can provide the employee with a reasonable accommodation. Nothing in the health order is intended to prevent an employer from engaging in with its employees to determine whether the employee has a qualifying disability or religious belief or to determine whether the employer is able to offer the employee a reasonable accommodation.

26. If I close the indoor seating at my coffee shop or restaurant, does that mean my employees are no longer covered by this order and able to work without providing proof of full vaccination?

Yes. If no food or beverages are served and consumed indoors then the proof of vaccination requirement does not apply to patrons or staff. With limited exceptions, all persons two years of age and older are required to wear a well-fitted mask when inside these and other public indoor spaces including while ordering or picking up food or to use the restroom.

Exemptions and Enforcement

27. Are there exceptions to the vaccination requirement?

Yes, there are limited exceptions for affected businesses:

This requirement does not apply to children under 12 years old.
These businesses may allow patrons to use the outdoor portions of the business without vaccination verification.
These businesses may allow patrons wearing a well-fitted mask to use a restroom indoors without vaccination verification.
Businesses that serve food or drink “to go” may allow individuals wearing a well-fitted mask to order, pick up or pay for food or drink without vaccination verification.

These requirements may also be subject to limited exemptions under state and federal law. But everyone, including children two years and older, must still comply with applicable indoor mask requirements under local and state health rules.

28. If I go out to a restaurant and eat at an outdoor table do I need to show proof of vaccination?

No.

29. I operate a facility subject to the vaccination mandate under the health order. What do I do if an employee requests an accommodation for a sincerely held religious belief? What qualifies as a sincerely held religious belief?

All businesses are encouraged to consult with their own legal counsel before approving or denying an employee's request for an exemption from the vaccination requirement. Each request should be considered on a case-by-case basis, and the following is offered as general guidance only. Under the health order, an employee may be exempt from the COVID-19 vaccine mandate only under specific circumstances. In the case of a claimed religious exemption, the employee must establish that they have a sincere religious belief that prevents them from receiving the vaccine. If they make this showing, the employer must then engage with the employee to determine if the employer can provide a reasonable accommodation in lieu of vaccination.

To qualify for a religious exemption from the health order's vaccination requirement, an employee must demonstrate:

the employee has a sincerely held belief that prohibits them from receiving the vaccination, and
that belief is religious rather than secular or scientific.

Employees may make a request for exemption verbally or in writing. And an employer may request its employee supply additional written information about the claimed belief. The health order also requires employees to state that they are making their request under penalty of perjury.

As to the first step of this test, generally, an employer should assume that an employee seeking a religious exemption does so in good faith, unless there is an objective basis for questioning their sincerity. For example, if the employee only recently adopted the stated belief or the employee has previously received other vaccinations, the employer may inquire as to why the employee now has a different position.

As to the second step of the test, the fact that an employee claims that their belief is religious is not determinative. When an employee makes a claim for religious exemption, the employer may attempt to determine whether the belief is, in fact, religious or secular in nature. An employee's political, sociological, personal, or philosophical views do not qualify as religious beliefs that would support an exemption under applicable state or federal law.

The ultimate inquiry is whether the employee has a belief that occupies a place in their life parallel to that filled by God in traditional religions. If an employee's request for an accommodation does not readily demonstrate that their belief is sincere or religious in nature, the employer may make further inquiries, such as:

request additional information about the employee's belief system, the nature and tenets of their asserted beliefs, and how they follow the practice or belief;
review written religious materials describing the belief or practice; and
obtain a supporting statement from a religious leader or another member of their community who is familiar with the employee's belief system.

The following is a non-exhaustive list of beliefs state and federal courts have held are not religious (and therefore, standing alone, do not warrant an exemption):

fear of possible side effects from immunization;
a desire to live a "healthy" or "pure" lifestyle;
opposition to vaccination due to veganism;
a belief that the vaccine will do more harm than good; and
distrust in the government or the science supporting vaccination.

Most organized religions do not prohibit vaccinations. A non-exhaustive list of religious faiths and their stance on vaccination is available.. But, an employee is not required to cite a recognized religion or religious tenet to qualify for an accommodation. As to the COVID-19 vaccine specifically, neither the Pfizer nor Moderna vaccines contain fetal cells. An employee's concerns about the use of fetal cell lines in researching the COVID-19 vaccines may also not qualify as a sincere religious belief since those same cell lines were used to develop many other vaccines, including those for hepatitis A, rubella, and rabies. If the employee has previously received other vaccines without concern, the claimed belief may not be sincere or religious.

If an employee does have a sincere religious belief that prevents them from receiving the COVID-19 vaccine, the employer must then determine whether it can offer a reasonable accommodation. Employers are not required to accommodate employees if it would cause an undue burden on operations or result in more than a "de minimis" cost to the business. For example, an employer does not have to accommodate an employee's religious beliefs if the accommodation is costly, infringes on other employees' job rights or benefits, compromises workplace safety, decreases workplace efficiency, or requires other employees to do more than their share of potentially hazardous or burdensome work.

In making this determination, an employer may consider whether the employee's job requires them to come into contact with non-employees whose vaccination status could be unknown or who may be ineligible for the COVID-19 vaccine. In such cases, an unvaccinated employee may pose a direct threat of harm to coworkers or non-employees if they remain in the workplace and an accommodation may not be possible.

Whether an employer is able to offer an accommodation depends on the nature of the business and the specific employee's job duties. An employer must engage in an interactive process with its employee to determine whether a reasonable accommodation exists under the particular circumstances. Depending on the employee's job duties and location, reasonable accommodations may include requiring the employee to regularly test for COVID-19 and wear an appropriate face covering, allowing the employee to telework, or transferring the employee to a different position or location.

30. What if my employee claims they have a qualifying medical condition? What types of conditions qualify for an exemption from the vaccination requirement under the health order?

Under the health order, an employee may be exempt from the vaccination requirement if they have a qualifying medical condition. This means that they have a condition or disability recognized by the Federal Drug Administration ("FDA") or Centers for Disease Control and Prevention ("CDC") that prevents them from receiving a COVID-19 vaccination.

A list of recognized conditions that prevent someone from receiving the COVID-19 vaccine is available, and includes:

Documented history of severe allergic reaction to one or more ingredients of all the COVID-19 vaccines available in the U.S.; or
Documented history of severe or immediate-type hypersensitivity allergic reaction to a COVID-19 vaccine, along with a reason why the individual cannot be vaccinated with one of the other available vaccines.

Conditions that do not prevent someone from receiving the COVID-19 vaccine (and which therefore do not qualify an individual for an exemption) include:

Allergic reactions (including severe allergic reactions) not related to vaccines (COVID-19 or other vaccines) or injectable therapies, such as allergic reactions related to food, pet, venom, or environmental allergies, or allergies to oral medications;
Latex, egg, or gelatin allergies; or
Delayed-onset local reaction around the injection site after the first COVID-19 vaccine dose.

If an employee believes they have a qualifying condition, they must provide their employer (or the business where they are working) with a signed statement from a physician, nurse practitioner, or other licensed medical professional practicing under the license of a physician stating that the individual qualifies for the exemption. The statement should not reveal any underlying medical condition or disability. The California Medical Board has announced that licensees who grant an exemption without a legitimate medical reason may be subject to disciplinary action.

31. How should businesses covered by the proof of vaccine requirement, such as restaurants, gyms, or large/mega indoor events manage unvaccinated patrons due to a disability or a religious belief?

Based on current health conditions, businesses covered by the proof of vaccine requirement must not allow unvaccinated people 12 and over to enter indoor areas regardless of the reason they are unvaccinated, except for the limited purposes provided under the health order. For example, in a restaurant setting, a customer may go inside while wearing a well-fitted mask to use the restroom or place an order for take-out. The Health Officer will continue to monitor COVID-19 health conditions and, if conditions allow it, may consider changes to the requirements for access of unvaccinated patrons to services.

Businesses should attempt to determine whether safe and feasible options exist that will allow the customer a way to access services consistent with the health order requirements. Examples of options to access services in an indoor restaurant setting may include offering to:

seat a customer in an outdoor area of the business such as an outdoor dining space;
connect the customer with similar services in the area that host outdoor options; or
provide the customer with take-out.

Examples of options to access services in an indoor gym setting may include offering to:

provide access an outdoor area of the business like an outdoor gym space;
connect the customer with similar services in the area that host outdoor options; or
provide the customer access to virtual services, such as an online fitness class, or other remote access options.

The health order does not require businesses to ask questions about the nature of any person's disability or religious belief. And the health order does not require businesses to investigate the validity of a customer's stated exemption.

Businesses should never attempt to physically engage a combative or violent customer who refuses to comply with staff requests. If a person becomes violent or threatens staff, customers, or others, staff should avoid physical contact and immediately call 911. Businesses may also contact the San Francisco Police Department for assistance with any customer who refuses to follow staff requests to leave the premises.

Businesses must never treat a customer differently based on their race, color, ancestry, national origin, place of birth, sex, age, religion, creed, disability, sexual orientation, gender identity, weight or height. For example, a business cannot scrutinize differently a person's proof of vaccination based on the color of their skin; nor may they refuse to accept a vaccination card because it was issued by a foreign government.

These are general guidelines only. Businesses are encouraged to seek the advice of legal counsel as appropriate in developing policies and procedures around the proof of vaccination requirement.

Different guidelines may apply to employers in relation to proof of vaccination requirements for staff. Employers should refer to guidance issued by the Equal Employment Opportunity Commission (EEOC), as well as guidance from the California Department of Fair Employment and Housing (DFEH).

32. I run a small restaurant or bar. Do I have to hire someone to check proof of vaccination at the door?

No. Although checking patrons before entry is preferred, dining establishments and bars may require proof of vaccination to be shown at the time of patrons’ first in-person interaction with staff (e.g., at the time of ordering) rather than at the entrance to the establishment. These establishments are prohibited from serving any patron dining or drinking indoors who fails to provide this proof. Patrons must wear masks at all times until a restaurant or bar staff member has obtained the required proof of vaccination.

33. What if a teenager doesn’t have photo ID to cross-check against their proof of vaccination?

Businesses should use best efforts to cross-check minors’ proof of vaccination against some form of identification. For example, if the minor does not have photo ID, a non-photo ID (e.g., school ID) or verification from a parent is sufficient.

34. If my child turns twelve and will now get vaccinated, do they have to stop participating in activities that require proof of vaccination (for example, indoor dining, concerts, sporting events, movies) until they are fully vaccinated?

Children who turn twelve and will get vaccinated may continue to participate in activities that require full vaccination for up to 10 weeks after their twelfth birthday without having to show proof of full vaccination. Beginning ten weeks after their twelfth birthday, they must show proof of full vaccination.

35. Do participants in an out-of-school time (OST) youth program have to show proof of full vaccination to participate?

No. Schools and OST Programs are covered by separate sector-specific directives and are not subject to the vaccination requirements set forth in Appendix B of the Health Order at this time. Participants in these programs—including those that are held in facilities that are open to the public—do not have to show proof of vaccination.

36. Do indoor masking requirements still apply?

Yes, the requirements for everyone two years old and older to wear a well-fitted mask in indoor public spaces remain in effect, with limited exceptions. Updated rules effective October 15, 2021, allow removal of masks in some limited work settings involving stable cohorts, such as offices and work-related vehicle use, when everyone is fully vaccinated (with no children under 12 present and no health or religious exemptions). See the FAQs regarding those situations for more details on when masks can be removed in these work settings.

37. Do people attending an event at a private residence need to show proof of vaccination?

No. Individuals hosting private events in their homes are not subject to the new vaccination verification requirements. They are strongly urged to require all guests age 12 and older to show proof that they are fully vaccinated.

38. Do I have to be fully vaccinated to attend a Giants baseball game?

If you attend a large event that is outdoors such as a Giants game, you are not required to show proof of vaccination before entering the ballpark. But proof of vaccination is required for fans 12 years and older whenever they enter an indoor space within the ballpark. For instance, proof of vaccination would be required before entering an indoor area where any person is eating or drinking, like an indoor dining concession area or bar. Proof of vaccination would also be required before entering into any indoor area where more than 1,000 people are gathering. If you are accessing other indoor spaces (such as pick-up concessions with no eating or drinking, or restrooms) you do not need to present proof of vaccination, but you must still wear a well-fitted mask as required by State and local health orders. Although there is no legal mandate to be fully vaccinated to enter the ballpark, SFDPH strongly recommends that all eligible people get fully vaccinated as soon as possible, especially if they plan to attend large gatherings like Giants

39. What happens if businesses do not comply with the order?

As with all of San Francisco’s health orders since the first Stay at Home Order, the City’s primary goal has been compliance through outreach and education, not punitive action. A violation of this order is considered to be a public nuisance and is punishable by fine, imprisonment, or both. The Department of Public Health is authorized to respond to such public nuisances by issuing Notice(s) of Violation and ordering premises vacated and closed until the owner, tenant, or manager submits a written plan to eliminate all violations and DPH finds that plan satisfactory. But again, the City’s goal is to work to ensure compliance. This is about protecting the health of workers, residents and the broader community.

40. When will these requirements end?

The updates to the order will remain in effect until the Health Officer determines they are no longer needed or that they need to be changed. This will depend on health conditions. As mentioned above, these requirements are intended to address not only the current surge but possible future surges due to other variants and to help ensure the ongoing reopening of schools for in-person instruction. The Health Officer will regularly assess health conditions to determine whether and under what conditions vaccination verification is still necessary.

High Risk Settings

41. What are high-risk settings?

The health order defines high risk settings as: acute care hospitals, skilled nursing facilities, residential care facilities for the elderly, homeless shelters (general shelters, family shelters, transitional age youth shelters, and domestic violence shelters), and jails.

These are care or living settings where many people often are living together. These are often congregate settings, where vulnerable populations reside out of necessity and where the risk of COVID-19 transmission and severe illness or death is high.

42. What steps must be taken at a worksite that is designated a high-risk setting?

By September 30, 2021, employers at high risk settings must:

Find out the vaccination status of all personnel (i.e., staff, contractors, sub-contractors, vendors, volunteers)
Require vaccination for all personnel (except for the exceptions given above)
Require unvaccinated exempt personnel to wear a well-fitted mask at all times
Require unvaccinated exempt personnel to be tested at least once per week

Masking

43. Is masking required again?

Yes. The highly contagious Delta Variant has made it necessary to require masking in indoor public spaces again.

44. Do the new masking rules allow people in ride share vehicles to take off their masks?

No. All public transportation, including Muni or other transit buses, trains, and ferries, as well as other commercial modes of shared transportation such as taxis, limousines, and ride share vehicles, are still subject to mask requirements under federal law and the local health order. This new rule under the local health order allows removal of masks only for motor vehicles used by employees for work or personal motor vehicles used by employees to commute to and from work where everyone in the vehicle is fully vaccinated (no kids under 12, no exemptions from vaccination) and everyone in the vehicle is employed by the same entity. When masks are allowed to be removed in vehicles, the order recommends increasing ventilation when possible by opening windows.

45. Can I take off my mask at work if I am unvaccinated?

Masking in most workplaces is set by rules from Cal/OSHA and Public Health Orders. Consult those rules and your employer for details about the masking requirements in your workplace. Currently a well-fitted mask is required in all indoor work settings including shared motor vehicles, except as allowed under updated rules effective October 15, 2021 for some limited work settings involving stable cohorts, such as offices and work-related vehicle use, when everyone is fully vaccinated (with no children under 12 present and no health or religious exemptions). See the FAQs regarding those situations for more details on when masks can be removed in these office and vehicle settings.

46. Do I have to wear a mask at work if I am fully vaccinated?

Fully vaccinated employees may work without masks outside, but are currently required to wear a well-fitted mask indoors unless alone in a private office or in certain office settings . A business or government entity can require that their employees wear facial coverings in any setting. Updated rules effective October 15, 2021 allow removal of masks in some limited work settings involving stable cohorts, such as offices and work-related vehicle use, when everyone is fully vaccinated (with no children under 12 present and no health or religious exemptions). See the FAQs regarding those situations for more details on when masks can be removed in these work settings.

47. Are there times when I can remove my mask indoors?

 You do not have to remain masked while in a private office or vehicle or while actively eating or drinking. There are other limited exceptions to the masking requirement.

48. Can a business or government office require employees and customers to wear masks?

Businesses or government offices must require that all customers and visitors wear masks indoors to reduce the risk to their workers and others. They should clearly post the business’ or office’s requirements onsite and online and apply them consistently. There are limited situations where wearing a mask is not possible or required, such as while actively eating or drinking, showering or being shaved.

49. Can a business or government office require employees and customers to wear masks?

50. How do the new rules around designating separate spaces (separate office floors or suites, distinct fitness rooms, etc.) work?

The new rule allows businesses and other entities, if they wish to do so and based on their own assessment of any other applicable legal requirements, to designate distinct gathering spaces indoors where masks can be removed when all requirements of the order are met. This is so even if other parts of the business include people who are not fully vaccinated. The general requirements under the revised order include that everyone in the area be fully vaccinated and be part of a stable group of people who work together or gather on a regular basis, that 100% of the people be fully vaccinated, that at least one of the ventilation strategies referred to in the order is used in that area, and that all other requirements for unmasked indoors spaces are met. Access to these spaces must be controlled by the business or entity in some manner to exclude everyone who is not fully vaccinated, including, for example, prohibiting access by children under 12 years old and anyone with a medical or religious exemption. Those areas must be separated by doors, walls, or distance and not have large segments of open ventilation with areas that include people who are not fully vaccinated. And all people must wear a mask when in common areas indoors, such as hallways, lobbies, and elevators where such access is not able to be controlled. It is up to the business or entity to design a system that works for it if it wants to use this option.
By way of example, the following types of indoor spaces could be used to create areas where masks could be removed subject to the minimum requirements under the order:

A two-floor gym that designates the entire upper floor as an area where masks can be removed and prohibits guests, drop-ins, or anyone who is not fully vaccinated from going upstairs;
A separate fitness room (such as a spin room, yoga studio, or similar exercise space) separated by a closed door from the rest of the gym where the room has at least one of the required ventilation strategies in place. It is recommended that rooms where masks are removed do not share ventilation with the rest of the facility;
Half of a floor of an office building where access to that part of the floor is restricted to people who are fully vaccinated—in this scenario, it is consistent with the order for there to be a buffer zone in a long open hallway between an area where masks can be removed and the rest of the floor, even if the hallway does not have a physical barrier or door between the two areas;
A large space in a house of worship for religious services where access to the large space is restricted to people who are fully vaccinated, for example by having a separate, smaller room used for services for people whose vaccination status is not known or where children or people with exemptions are present;

Business and other entities should consult their own legal counsel and other advisors for how to set up such spaces if they wish to pursue this option. The examples listed above do not constitute legal advice to any business or entity.

51. Why don’t the new rules apply if there are children under 12 years old present?

Children under 12 years old are not yet eligible for vaccination. This means that they are at higher risk when indoors with anyone who is not masked, and that is true even if the people without masks are fully vaccinated since infections can occur, though they are less likely with fully vaccinated people. For that reason, for the time being when children under 12 are indoors in these communal or public spaces, everyone must remain masked.

52. How do these rules for removal of masks change when children 5 to11 are eligible to get vaccinated?

The health and vaccination benchmarks for lifting the indoor universal mask mandate will likely be met no later than eight weeks after the FDA grants emergency use authorization for any COVID-19 vaccine children ages 5 to 11. Also, it is currently anticipated that for San Francisco to reach the benchmark of 80% vaccination for the total population children in that age range will need to be fully vaccinated. Full vaccination will take a minimum of five weeks from when children in that age group receive their first dose. So, once children 5 to 11 start to get vaccinated, these interim rules where masks can be removed in some settings where no children under 12 are present will soon likely be replaced with an overall lifting of the indoor universal mask requirements.

53. What safety precautions are in place for situations that allow removal of masks indoors?

For businesses or entities that want to offer an indoor area where masks can be removed, the following minimum safety precautions are required:

All people must be fully vaccinated in the area where masks can be removed and there are no exceptions (that means no children under 12 years old and no people with medical or religious vaccination exemptions);
The people who are allowed to enter the area where masks can be removed must be in a stable group who participate in the work or activity on a regular basis—no guests or other visitors are allowed in that area, even if they are masked or fully vaccinated;
At least one ventilation strategy listed in Section 2 of Appendix A of the order (available online at www.sfdph.org/healthorders) must be used in that area;
If the business or entity has an outbreak (i.e., three or more cases in a rolling 14-day period under Cal/OSHA rules), then it must wait for 30 days after the outbreak before allowing masks to be removed in any area of the business;
Employees are still required to self-monitor for COVID-19 symptoms and should remain home if they are sick with new or unexplained symptoms until they test and otherwise follow the rules on isolation and quarantine, if applicable (go to www.sfdph.org/directives for more information); and
People are still allowed to wear a mask at any time, even in an area where masks can be removed, if they feel more comfortable doing so.

54. The new rule allows people to be unmasked in some settings where the employer or entity controls access and verifies 100% full vaccination of everyone in the setting. What if there is only one person who has a religious or medical exemption? Can everyone but the person with the exemption take off their mask but the person with the exemption can still attend but wear a mask?

No. The new rule does not allow for people to remove masks if anyone is present who is unvaccinated, even if they have a religious or medical exemption. If anyone is not fully vaccinated for any reason—whether based on an exemption or because they are not eligible for the vaccine, such as children under 12—then for the time being nobody in that setting—even fully vaccinated people—may remove a mask in that setting unless a different exemption allowed by the Health Order applies (e.g., removing a mask while actively eating or drinking). The reason is to limit mask removal to safer settings where everyone is vaccinated and gathers together regularly to help minimize transmission risk until the benchmarks are met to lift the indoor universal mask mandate.

55. The new rule says that people who enter the facility on an intermittent or occasional basis for short periods of time (e.g., people who deliver goods or packages) do not need to provide proof of Full Vaccination, but must wear a mask. Can someone who is not fully vaccinated go into an area where masks can be removed – for example in a gym to engage in fitness activities – if they only do so for a short amount of time?

No. Anyone engaged in the core aspect of the activity (e.g., office work for the business, fitness, a religious gathering, or an adult class) must be fully vaccinated if they are in the area where masks can be removed, even if they are only there for a few minutes. The exemption for people who are only there for a short period of time is for people who are making quick deliveries and not participating in the core activity, and even so it is recommended that they not enter the area where masks can be removed if it is at all possible for them to avoid entering, and they must be masked for the entire period they are onsite.

56. The new rule says masking will end when cases and hospitalizations are low and vaccination is over 80%. When will that happen?

The Health Officer will make that determination when all three criteria listed in the order are met and will then issue an update to the order. At that time, face covering requirements will be lifted in most indoor public settings, but state and federal requirements may still apply in places like public transit, health care facilities, and schools. And, people are still allowed to wear a mask at any time, even in an area where masks can be removed, if they feel more comfortable doing so.

57. In terms of the 100-person cap, what if an office has 150 employees, but they work as teams smaller than 100? Can an office with over 100 employees divide onto separate floors so each floor is not over 100?

The limit on 100 people for indoor settings without masks is for classes, lectures, and similar gatherings with fixed groups only. There are no size limits for offices, gyms and fitness facilities, or religious gatherings.

58. In terms of the 100-person cap for adult lectures and similar activities, what if a class or group has 150 students but they are grouped in separate rooms with each group being under 100 people?

The class can divide into separate rooms for purposes of ensuring that no room has more than 100 people in it at the same time. The rooms must be separated such that they do not have open air flow between the rooms.

59. In some situations, masks can be removed in college lectures or adult classes under the new rules. Do these new rules apply to high school classes where all students are vaccinated?

No. The new rules do not apply to TK-12 education. There are separate directives and other state rules that apply in those settings.

60. As a fully vaccinated person I am not required to mask when I am outside. Should I carry a mask with me anyways?

If you are certain that you will always stay outside, you do not need to bring a mask. If there is a chance you will go indoors, or need to hop on public transit, bring a mask.

61. Can my business ask its unmasked customers about their vaccination status?

Beginning on August 20, 2021, some categories of indoor businesses, those that serve food and drink, and establishments where customers engage in activity involving elevated breathing (e.g. gyms, recreation facilities, yoga studios, and dance studios), must verify the vaccination status of their customers.

62. How will these changes to the mask order be enforced?

Most San Franciscans have been doing an excellent job when it comes to protecting public health, and we have no reason to believe that will change. San Francisco's priority when it comes to public health orders has always been compliance rather than punishment, so the City's approach has been to first educate people about what the health orders require. If necessary, various City departments, including the Department of Public Health and SFPD, have the authority to issue notices of violation, orders to vacate the premises, or citations for violating health orders.

Other Considerations in the Workplace

63. Is personal health screening still required in the workplace?

Businesses and government offices must continue screening employees for COVID-19 symptoms. This does not require that the screening be performed on-site. You can ask your employees to evaluate their symptoms before arriving at work.

64. Should my business continue to offer outdoor and pick-up / to-go service?

All businesses and governmental entities are urged to continue to offer services and activities outdoors, if it is feasible and legally allowed. COVID-19 transmission risk is much lower outdoors compared to indoors.

65. Does the Safer Return Together Health Order mandate any signage?

All businesses and governmental entities are required to post signage that is easily visible reminding individuals of COVID-19 prevention best practices to reduce transmission, including messages with information about topics such as:

Get vaccinated
Stay home if you’re sick and talk to your doctor
Wear a mask for added protection
Maximize fresh air
Clean your hands

All businesses and governmental entities are required to post signs in employee break rooms or other areas encouraging employees to get vaccinated and informing them how to obtain additional information. These signs are available at sf.gov.

66. Are there special requirements for schools and programs for children and youth?

Yes. There are separate directives covering Schools and Programs for Children and Youth.