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San Francisco Health Network
COVID-19

Best Practices for Outdoor Personal Services

Below is the web/accessbible version of Exhibit A from Health Officer Directive No. 2020-23 issued on September 1, 2020, regarding Best Practices for Personal Services Outdoors

In addition to preparing, posting, and implementing the Social Distancing Protocol required by Section 4.d and Appendix A of Health Officer Order No. C19-07h (the "Social Distancing Protocol"), each Covered Personal Service Provider that operates in the City must comply with each requirement listed below and prepare a Health and Safety Plan.

See also Outdoor Personal Services Guidance   中文 | Русский | Pilipino | Español | Tiếng Việt

 

Requirements:

  1. Section 1 – General Requirements for All Covered Personal Service Providers:

    1. All services must be provided entirely outdoors. Services that cannot be safely performed outdoors or that would require a customer to have to enter an establishment are not permitted at this time. Services that may not be performed at this time include: electrology, tattooing, piercing, microblading, permanent make-up, and other forms of body art that are invasive and require a controlled hygienic environment.
    2. All services provided outdoors must be approved by the applicable licensing agencies, such as the California Board of Barbering and Cosmetology and the San Francisco Department of Public Health ("SFDPH").
    3. Service Providers regulated by the California Board of Barbering and Cosmetology must comply with state guidance and regulations, including any regulations that limit the location where outdoor services may be performed.
    4. Consistent with the limitations under the State Health Order, Health Officer Order No. C19-07h (the "Stay-Safer-at-Home Order"), and guidance from SFDPH, Covered Service Providers that are permitted to operate outdoors may, subject to any applicable permit requirements, conduct their operations under a tent, canopy, or other sun or weather shelter, but only as long as no more than one side is closed, allowing sufficient outdoor air movement. Also the number and composition of barriers used for outdoor services must allow the free flow of air in the breathing zone.
    5. Develop a plan and implement daily COVID-19 symptom self-verifications for all Personnel as required by the Social Distancing Protocol.
    6. Confirm with customers before they arrive for their appointment that they are symptom- free. Customers who are feeling ill or who have exhibited symptoms of COVID-19 within 24 hours of their scheduled appointment must cancel or reschedule their appointment. In such cases, customers must not be charged a cancellation fee or other financial penalty.
    7. Consider implementing digital forms or questionnaires to allow customers to complete all paperwork electronically before their appointment.
    8. Conduct screening of all customers upon arrival. Customers who do not pass the screening must be refused service and their appointment should be rescheduled or canceled.
    9. Require Personnel to wear Face Coverings as provided in Health Order No. C19-12c issued on July 22, 2020, and any future amendment to that order (the "Face Covering Order"). Covered Personal Service Providers must wear their Face Coverings at all times while in the presence of customers and other Personnel.
    10. Customers must wear a Face Covering at all times except when they are otherwise exempt from doing so under the Face Covering Order. Covered Personal Service Providers must not provide services that require the customer to remove their Face Covering at any time during the service.
    11. Covered Personal Service Providers may not offer customers food or drink of any kind, and customers must not eat or drink while they are receiving a service.
    12. Covered Personal Service Providers must develop a plan and implement sanitization requirements that exceed usual professional requirements and standards, including:

      1. Comply with any existing or COVID-19 specific health-related regulatory requirements, such as those required by Cal/OSHA, the California Board of Barbering and Cosmetology, California Health and Safety Code, and the San Francisco Health and Safety Code.
      2. Instruct all Personnel to wash their hands frequently with soap and water for at least 20 seconds and to wash hands or use hand sanitizer (provided by the Covered Personal Service Provider) before and after touching high-touch surfaces.
      3. Disinfect station counters, rolling carts, drawers, hand mirrors, tools, and other surfaces between each customer.
      4. All single use items, such as disposable wax collars, cotton, neck strips, and applicators, must be used once and immediately thrown away in a container with a lid.
      5. All appliances at work stations and treatment areas must be properly disinfected between each customer, as follows:

        1. Clean and disinfect shears by removing all visible debris, clean with soap and water, and wipe or spray with an EPA-registered disinfectant that demonstrates bactericidal, fungicidal, and virucidal activity and is approved for COVID-19.
        2. Clean and disinfect all other non-porous, non-electrical tools by removing all visible debris, cleaning with soap and water, drying the tools, and then completely immersing them in an EPA registered disinfectant. Tools must be sprayed or submerged and left to set for the full amount of time required by the disinfectant's manufacturer. Immersed items, like combs or brushes, must be removed at the end of contact time, rinsed, and dried with a paper towel or clean, freshly laundered towel.
        3. Clean all electrical tools, such as clippers and LED lamps by removing all visible debris and disinfecting with an EPA-registered disinfectant spray or wipe that demonstrates bactericidal, fungicidal, and virucidal activity and is approved for COVID-19. Follow with an EPA-registered disinfectant spray or wipe for the full contact time as noted by the manufacturer's directions. Use caution when using a spray and be sure your device is unplugged and do not spray into the motor. Consider use of wipeable covers for electronics. If no manufacturer guidance is available, use of alcohol-based wipes or sprays containing at least 60% alcohol to disinfect touch screens. Dry surfaces thoroughly to avoid pooling of liquids.
      6. Clean and disinfect all handles, hoses, spray nozzles, and other equipment between customers. Chairs, headrests, and other items must also be thoroughly cleaned and sanitized between each use. Where appropriate, consider adding a paper cover, sheet, or clean towel that can be easily disposed of or cleaned for use between customers. Since porous surfaces such as fabric chair seats cannot be easily disinfected, consider covering with a plastic or disposable liner and cleaning or disposing of the liner after each customer.
      7. Where linens are used, even if the customer does not get under them, the linens must still be removed for laundering and the bed or table properly disinfected before each use by a customer. All dirty linens, including towels, sheets, blankets, smocks, and reusable capes, must be placed in a closed container and not used again until properly laundered either by a commercial laundering service or a laundering process that includes immersion in water of at least 160 degrees Fahrenheit for at least 25 minutes. Store all clean linens in a clean, covered place. Ensure Personnel who handle dirty linens or laundry wear gloves and a Face Covering.
  2. Section 2 – Additional Requirements for Establishments that Provide Personal Services:

    1. Establishments offering services outside must consider the risks associated with local streets, sidewalks, traffic, pedestrians, and bicyclists. Establishments and Covered Personal Service Providers must take all reasonable and feasible efforts to reduce customer and Personnel exposure to traffic and bike lanes, minimize blocking visibility of other travelers (whether vehicle, pedestrian, or bicyclist), and minimize or eliminate potential blockages of passageways, including ADA-compliant public access to sidewalks. Covered Personal Service Providers must comply with state and local laws, regulations, and permitting requirements (e.g., ADA access and compliance with applicable zoning), including the placement of outdoor shelters and service stations.
    2. Establishments offering outdoor services must address the potential hazards that result from moving personal services outside, including: (1) ensuring use of electrical devices and extension cords in compliance with Cal/OSHA's Guide to Electrical Safety; and (2) ensuring there are no tripping hazards from cords or other equipment.
    3. All waste, including waste water and hair clippings, must be disposed of safely and as required by state and local regulations.
    4. The establishment must comply with the Cal/OSHA standards for heat illness prevention for outdoor workers, including an effective heat illness prevention plan with written procedures.
    5. The layout of the outdoor establishment must allow for proper social distancing. For example, chairs and work stations must be arranged to ensure at least six feet of space between customers. Establishments should consider additional divider shields or other impermeable barriers where appropriate and feasible.
    6. Advise customers who are receiving services that they must remain outside of the establishment, and may enter the establishment only to access: (1) a bathroom or (2) an outdoor space that is only accessible by traveling through the establishment. This restriction does not apply to customers who are patronizing other aspects of the establishment (e.g., purchasing personal care products) subject to the Social Distancing Protocol, and applicable industry-specific directives.
    7. Instruct all Personnel and customers to maintain at least six-foot distance from others except as necessary to perform a personal service otherwise permitted by this Directive or when momentarily necessary to facilitate or accept payment and hand off items or deliver goods. If the Covered Personal Service Provider cannot ensure maintenance of a six-foot distance within the facility between Personnel, such as by moving work stations or spreading Personnel out, then it must reduce the number of Personnel permitted in the facility at any given time accordingly.
    8. If all or part of a Covered Personal Service Provider's establishment has been vacant or dormant during the Stay-Safer-At-Home Order, then the Covered Personal Service Provider must ensure plumbing is functioning and that pipes are flushed before use. The San Francisco PUC provides guidance for flushing and preparing water systems at:sfwater.org/flushingguidance.
    9. If the establishment uses pedestal fans or hard mounted fans, the Covered Personal Service Provider must adjust the direction of fans to minimize air from fans blowing from one customer's space to another's space.
    10. Evaluate the facility to determine the number of people (including customers and Personnel) who may safely fit in the outdoor service area at any time while ensuring adherence to Social Distancing Requirements under this Directive and the Stay-Safer-At- Home Order. Educate Personnel about capacity limits and require them to enforce limits by, for example, spacing out customer appointments.
    11. Develop a plan and implement additional sanitization requirements, including:

      1. Instruct Personnel that they are responsible for keeping their workspaces clean and sanitized. Each Covered Personal Service Provider must clean and properly sanitize their workspace at the end of each shift.
      2. Ensure Personnel have access to cleaning supplies so that they can clean surfaces as needed on their own when custodial staff is not available.
      3. Clean and disinfect high touch surfaces in common areas routinely throughout the day and otherwise in accordance with the Social Distancing Protocol. Common areas include, but are not limited to the following area: lobbies, lounge or seating areas, entry ways, hallways, bathrooms, changing areas, elevators, and stairwells. Clean and disinfect all high touch surfaces and devices found in common areas such as door handles, railings, faucets, toilets, elevator buttons, coat hooks, hangers, furniture, computers, telephones and other devices that are touched by people throughout the day.
      4. Discontinue the use of shared food and beverage equipment in breakrooms (including shared coffee brewers).
      5. Equip the reception area and all workstations with proper sanitation products, including hand sanitizer and sanitizing wipes.
      6. Disinfect station counters, rolling carts, drawers, hand mirrors, tools, and other surfaces between use for each customer.
    12. Where feasible, prohibit Personnel from sharing equipment, such as phones, tables, or computers. Any furniture, tools or equipment that must be used by more than one individual must be sanitized in a manner that complies with the requirements contained in the Social Distancing Protocol. If Personnel must share a workspace, such as on alternating shifts, then the location must be sanitized in a manner that complies with the requirements contained in the Social Distancing Protocol after each use.
    13. If Personnel or a member of the public refuses to comply with the Face Covering Order or other provision of this Directive, then the Covered Personal Service Provider must refuse service to the individual and request that the individual leave the facility.
    14. Implement safety measures for customers, including:

      1. Covered Personal Service Providers must suspend walk-in customers at this time. Stagger appointments to reduce reception congestion and ensure adequate time for proper cleaning and sanitation between each customer visit.
      2. Encourage customers to bring and use their own Face Coverings. Covered Personal Service Providers must provide customers with Face Coverings if they do not have one or refuse service to those who arrive without a Face Covering and who are not otherwise exempt from wearing one under the Face Covering Order.
      3. Prohibit customers from bringing additional people with them to their appointment. If the person receiving the service is a minor, they may bring an adult guardian, or if the person receiving the treatment is disabled they may bring an adult care provider. Covered Personal Service Providers may consider allowing adult customers to bring their minor children if they have no other childcare options. Anyone entering the outdoor service area or establishment must be screened for symptoms of COVID-19 and must be included when determining whether the facility has reached its capacity limit.
      4. If feasible, implement virtual check-in technology to ensure that Personnel are notified when a customer arrives.
      5. Prohibit customers from congregating in the reception area or elsewhere in the outdoor establishment. Ask customers to wait outside with their Face Covering on or in their cars before their appointments.
      6. Service providers must not see multiple customers at once (e.g., while one customer's hair is drying, another receives a haircut). Services for one customer must be completed before a new customer is seen by the same worker.
      7. Remove and prohibit the use of open product samples.
      8. Consider removing items (e.g., throw pillows, fabric-lined chairs, seat cushions, magazines) with surfaces that cannot be cleaned properly.
      9. Have a hard-surfaced, non-porous chair or large hard-surfaced or plastic basket or paper bag for clients to put their clothes on or in.
  3. Section 3 – Additional Requirements Specific to Barbering and Cosmetology Establishments:

    1. Customers receiving barbering or other hair care services must wear Face Coverings that attach with ear-loops to avoid interfering with services.
    2. Provide a clean smock or cape for each customer.
    3. Establishments providing outdoor services must cease the following services: all chemical hair services, including, but not limited to, permanent waving, relaxing, bleaching, tinting, coloring, dyeing and straightening; shampooing; and electrolysis.
    4. Consider temporarily eliminating services that require lengthy blow-drying.
    5. Ensure that all loose hair is swept or vacuumed as quickly as reasonably possible to avoid improper dispersal of hair.
  4. Section 4 – Additional Requirements Specific to Esthetician and Skin Care Services:

    1. Treatment tables or chairs must be covered with either clean treatment table paper, a clean towel, or a clean sheet before each use. After use, do not shake the dirty laundry. Place used linens in a lined, lidded receptacle positioned outside the treatment space to minimize the possibility of dispersing virus in the air.
    2. Covered Personal Service Providers must wear disposable gloves at all times during the service and while cleaning or disinfecting implements and surfaces between each client session.
    3. Before leaving the treatment area, Covered Personal Service Providers must remove and dispose of gloves, apply hand sanitizer or wash hands with soap and water, and use a previously readied disposable barrier, such as a paper towel or sanitizer wipe, to open and close the treatment room door while leaving the room.
    4. When wax pots are running low and new wax needs to be added, empty any remaining wax and clean and disinfect the wax pot before refilling with new wax. Single use applicators must be disposed of immediately after use in a lined trash bin. The trash bin should have a lid and should be lined with a disposable plastic bag.
  5. Section 5 – Additional Requirements Specific to Nail Salons:

    1. Disposable gloves must be worn throughout the entire service and while performing cleaning and disinfection of all implements and surfaces after each client. Once cleaning is finished, remove and dispose of gloves and apply proper hand sanitizer or wash hands with soap and water. Gloves must be changed between each customer.
    2. Pedicures done outside may only be conducted in portable tubs/bowls. The tubs/bowls must be disinfected between each use, with the disinfection occurring inside the nail salon, not in the temporary outdoor setting.
    3. Nail salons should use disposable supplies whenever possible. Any non-disposable supplies must be fully disinfected between customers according to the California Board of Barbering and Cosmetology guidelines.
    4. All single use items, such as cardboard files, sand-bands for drills and buffers, disposable sandals, toe separators, and applicators, must be used once and immediately thrown away in a lined, lidded trash can.

    5. To reduce the number of touchpoints, remove the nail polish displays. In the absence of a nail polish display, use a color palette, which is to be cleaned and disinfected after each client use. If the nail polish display cannot be removed, prohibit customers from handling the nail bottles. Nail polishes should be cleaned and disinfected before being returned to the display.
    6. Consider whether it is feasible to install a plastic partition between the worker and client with ample space cut out where hands or feet can be slid underneath to conduct the manicure or pedicure.
    7. Allow only one manicurist to work at each station and do not allow clients to get multiple services at the same time, such as a manicure and pedicure, because of the inability to provide for adequate physical distancing between Personnel performing those services.
  6. Section 6 – Additional Requirements Specific to Massage Services (Non-Healthcare Setting):

    1. Require customers to wash their hands for at least 20 seconds or use hand sanitizer at the beginning of any treatment.
    2. Consider alterations to the treatment table setup to support the required cleaning and disinfecting protocols. These alterations could include using disposable face cradle covers and/or protecting the table, table warmers, bolsters, and other items with washable barriers like plastic covers that can be easily cleaned or pillowcases that can be removed and replaced between each client. Barriers are not a substitution for the required cleaning and disinfecting protocols.
    3. Clean linens must be stored outside of the treatment area.
    4. Consider providing any hand treatments as the last part of the service to minimize the spread of virus particles that may remain on the hands. Alternately, Covered Personal Service Providers should wash their hands for at least 20 seconds or use hand sanitizer before and after performing hand treatments.
    5. Covered Personal Service Providers must wash their hands for at least 20 seconds with soap and water or use hand sanitizer immediately upon finishing massage services.