Food-Service-Manual-for-Health-Care-Institutions

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Food Service Manual for Health Care Institutions 418 • Food Safety and Inspection Service • Meat and Poultry Hot Line • Ednet: e-mail • International Classification of Diseases, 9th revision (ICD-9) • Food Safety Educator • National Environmental Health Association • National Restaurant Association Education Foundation • National Science Foundation International Surveys by Governing Agencies A health care food service department may be surveyed by the JCAHO, state licensing agencies, county public health departments, and other agencies. The agency surveyors follow standards that have been established under federal and state laws or by various state, county, and municipal agencies. The purpose of these surveys is to protect the health of the public by preventing or correcting unhealthy sanitation practices. Health Inspections Environmental health specialists monitor the conditions of individual establishments to determine whether they are in compliance with state and local laws. These specialists may be called sanitarians. It is the responsibility of the food service manager to be aware of the purpose and function of the local registered sanitarians who conduct the inspection. It is also the food service manager’s responsibility to secure copies of rules and regulations concerning the inspection, to follow the rules and ensure that food service employees adhere to the rules. Performing selfaudits and surveys should be routine, and when a deficiency is found, action needs to be taken to correct it. Self-audits help maintain a safe and sanitary department. Self-audits also help to be prepared for a visit from the health inspector, state surveyor, or JCAHO It is also the responsibility of the food service manager to be available to answer questions, tour the facility with the inspector, and have all necessary records well documented. When a violation is cited, a report will be given to the food service manager with a date when the violation must be corrected. Fines and possible closure of the department can result when warnings are not taken seriously. If the food service manager does not understand the violation or needs more information about the problem, he or she should ask the inspector for additional resources. The health inspectors are looking for what is on the checklist (which may vary from state to state). The following are among the categories that will be looked at and checked: • Food. From an approved source, free of spoilage; no home-processed foods; no dented or damaged cans; original container properly labeled • Food protection. PHFs meet temperature requirements; food properly thawed; thermometers provided; handling of food minimized; food protected during storage, preparation, display, and transportation • Personnel. With infections restricted, hands are washed, uniforms are clean, and hair restraints are used • Food equipment and utensils. Dish-washing facilities provided with accurate thermometers; pressure gauge and chemical test kit; clean equipment and utensils properly stored and handled to prevent contamination; food contact surfaces of cutting boards, meat slicers, can openers, work counters, and the like washed, rinsed, and sanitized; and surfaces free of abrasives and detergents • Safety. Fire extinguishers proper and sufficient, exits are well lighted, electrical wiring is in good repair, and gas appliances are properly installed and maintained
• Plumbing. Properly installed and maintained, there is no cross-connection between potable and waste water, and backflow devices are in place • Insect, rodent, animal control. No insects, rodents, or other animals are present; outer openings are protected; and pest control management is in place • Garbage and refuse disposal. Garbage containers are sanitarily maintained and covered, and outside area is maintained and clean • Toilets and hand-washing facilities. Hand-washing sinks are accessible; hand sinks are provided with soap and single-service towels; toilet rooms are clean and in good repair; doors are self-closing; trash receptacles are available • Other. Toxic cleaning agents are stored away from food preparation and utensil-washing area; toxics are labeled; the premise is clean and maintained; there are no unnecessary articles; cleaning maintenance equipment is properly stored; only authorized personnel have access • Lighting, ventilation, floors, walls, and ceiling. Meet all applicable codes • Water. Safe; hot and cold water are under pressure • License. Current and properly displayed; food management certification is valid Health, Hygiene, and Clean Work Habits Food Safety, Sanitation, and Hazard Analysis Critical Control Points Providing safe and sanitary food service obviously relies on the employment of healthy workers who are thoroughly trained in safe food-handling procedures, practice good personal hygiene, and perform their duties without undue fatigue. Humans can trace many cases of food-borne illness to contamination, so the ongoing training and supervision of food service employees should stress good health, careful personal grooming, and good work habits. All food service employees should observe the following procedures: • All food handlers should undergo a health examination by a physician designated by the organization before beginning employment and at intervals specified by public health agencies or the institution. The medical records of employees should be maintained in a separate file from their personnel file. (A written release may be needed from employee to the food service director to review the health record.) • All food service employees should be clean and well groomed. Clean uniforms and aprons are essential. If employees are permitted to wear street clothes while on duty, the clothing should be made of washable fabric. Appropriate hair restraints (nets, hairpins, and surgical caps) must be worn. • Clean hands and fingernails are a must. Food service employees should thoroughly wash their hands before and after handling food, after smoking, after using the toilet, and after using a handkerchief or tissue. Thorough and frequent hand washing is the best defense in the control of hepatitis A outbreaks. Hand sinks with hot running water must be located at the entrance to the kitchen, production area, or workstation. No other sinks (such as food preparation or three-compartment sinks) should be used for hand washing. FDA Food Code does not include hand-washing procedures. However, the following seven-step, double-hand-wash method is recommended for use by all employees involved in food-handling activities: Step 1: Turn on hot, flowing water (110° to 120°F) and wet hands. (Note: Sufficient pressure and volume of flowing water are important in reducing high levels of organisms such as Shigella dysenteriae.) Step 2: Apply an antibacterial soap to hands and onto fingers in sufficient quantity to produce a good lather. Hands and arms should be lathered up to sleeve or as far up arm as necessary to clean any exposed area. Step 3: Rinse hands in hot (110° to 120°F) flowing water. Step 4: Repeat steps 1 and 2 to ensure that all pathogens have been removed. Step 5: Rinse hands and arms in hot flowing water. 419
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Food Service Manual for Health Care
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Contents Figures, Tables, and Exhib
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Figures Figures, Tables, and Exhibi
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8.3. Excerpt from a Performance Eva
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19.1. Flow of Products in Food Serv
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6.2. Sample Job Description and Job
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Foreword It is truly an honor for m
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Preface The health care environment
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Acknowledgments The following indiv
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Introduction This edition of Food S
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Chapter 14 explains safety, securit
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Part One Management of the Food Ser
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Chapter 2 Leadership: Managing for
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oriented or people oriented and tha
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in an orderly manner, to manage the
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so as to anticipate and plan for fu
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Planning Through planning, the futu
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Reward or punitive power is the str
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• Building a team mind-set • Co
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of these three factors jeopardizes
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McClelland claims that “in some b
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• Define limits of what situation
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who have seen programs, processes,
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Leebov, W., and Scott, G. Health Ca
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Chapter 4 Quality Management A prim
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Figure 4.2. Deming’s PDCA Cycle A
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Move to CQI in Health Care The term
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care. Often these choices conflict.
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Supplier Partnerships A customer or
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analysis. Key benefits to having a
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Exhibit 4.1. Team Documentation For
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Figure 4.3. CQI Flowchart Quality c
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Exhibit 4.2. Inspection Criteria fo
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Once the departmental strategy is w
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Before hiring a consultant, managem
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selected for the issue in question.
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Figure 4.6. Cause-and-Effect Diagra
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not identical. CMS standards vary i
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the concurrent stay using critical
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Garvin, D. A. Managing Quality: The
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Chapter 6 Organization and Time Man
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Figure 6.1. Functional Organization
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Process departmentalization allows
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Characteristics of High-Performance
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outcome. Team building should conce
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necessary to assure that food servi
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Figure 6.4. Organization of a Small
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Figure 6.9. Organization of a Food
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skilled-nursing unit in the hospita
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service operations other than the c
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Distributing Authority Authority, t
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• What types of service does the
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Exhibit 6.1. (continued) Why? Which
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Exhibit 6.2. Sample Job Description
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equires, and the best means of moti
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Calculating FTE Needs Full-time equ
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Exhibit 6.3. Sample Productivity Fo
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Figure 6.10. Example of a Daily Sch
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Figure 6.12. Example of a Work Sche
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Figure 6.13. Example of a Manager
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Figure 6.14. Example of a Food Serv
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Lane, B. Managing People. Sunnyvale
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Chapter 9 Clinical Nutrition Care M
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Planning As already shown, a manage
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• Room service for inpatients and
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Figure 9.2. Organizational Chart—
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among professional staff whose memb
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Designing a Nutrition Services Paym
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Nutrition service professionals can
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Figure 9.4. (continued) Food histor
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Figure 9.6. Goal of Nutrition Scree
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Table 9.3. Physical Signs Indicativ
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• A constant and valuable source
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earlier, the patient may need to be
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• Assessment: what the data mean
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• Gives patients greater protecti
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Chapter 10 Management Information S
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Elements of an MIS In addition to t
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automatically to report all vending
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Usually, systems investigation is t
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Function Function refers to the spe
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located in a relatively clean envir
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Figure 10.2. Sample Purchase Order
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Figure 10.3. (continued) Inventory
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Figure 10.5. Beef Barley Soup, Scra
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Patients’ tray cards can be print
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een entered into the menu, each ite
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Bibliography Alexander, J. Selectin
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Excerpt from Annual Food Service De
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Sample Monthly Operating Statement
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Labor Cost Analysis 334 Figure 11.5
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336 Exhibit 11.6. Example of a Mont
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Part Two Operation of the Food Serv
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352 Exhibit 12.2. Selection of Wast
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354 Exhibit 12.4. Selection of Wast
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Restaurant-Style Health Care Menu f
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Chapter 16 Product Selection Produc
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Figure 16.2. Procurement Subsystem
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The USDA organic seal appears on fo
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Figure 16.5. Grade Stamps and Inspe
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A carcass of good grade is blocky a
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e accomplished by scalping, which p
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Table 16.1. (continued) Meat Descri
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harvesting and processing. This tas
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Poultry Poultry products or domesti
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Weight and Size of Shell Eggs Shell
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Table 16.3. Manufacturing and Inspe
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Eggnog Eggnog contains milk product
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Natural, Processed, and Imitation C
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Table 16.4. Common Cheeses Cheese D
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• Bamboo shoots • Bean sprouts
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Celery Celery, mainly the Pascal va
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Size is another factor that affects
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Fruit and Vegetable Specifications
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Corn, , sunflower, and safflower oi
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Organic Flour Organic flour is from
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Relatively small quantities of wild
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Herbal Tea Herbal teas do not come
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alloy, the result is stainless stee
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Summary Food service purchasers mus
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U.S. Department of Agriculture, Agr
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Chapter 18 Receiving, Storage, and
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Figure 18.1. Receiving System Items
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Merchandise Receipt Receiving, Stor
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Receiving, Storage, and Inventory C
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disposed of promptly. The storeroom
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Issuing of Food and Supplies Receiv
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A perpetual inventory record alone
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Inventory Turnover Slow inventory t
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Figure 18.2. Comparison of Par Stoc
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Receiving procedures must ensure th
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Appendix 19.1 A Culinary Glossary
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Hors d’oeuvre Side dish or relish
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Chapter 20 Distribution and Service
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• What is the best type of servic
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Figure 20.1. Typical Tray Makeup Li
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Tray Delivery Because the point of
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quality. In recent years, food serv
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carrying their filled trays to thei
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plate is not used. Place coffee or
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minimized. The type of meal service
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Standards that should be monitored
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Exhibit 20.2. Sensory Assessment fo
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Herz, M. L. Analysis of Alternative
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Index A ABC method, 603 Absenteeism
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CDC (Centers for Disease Control an
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Delivery of products, 575-576 Deman
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Exit interviews, 239, 240e Exotic v
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described, 461; developing, 461-463
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Horizontal communication tract, 194
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Main-dish salads, 652 Maintenance-m
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Nutrient analysis, 296 Nutrition aw
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PERT (program evaluation and review
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(1993), 4, 203; Federal Employee Po
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Standing operational planning. See
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Waste audit, 349 Waste-handling equ
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