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

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Food Service Manual for Health Care Institutions 426 • When chemicals are used for sanitizing in a single-tank, stationary-rack spray machine and glass washer, the following minimum temperatures should be maintained: wash temperature, 120°F (49°C), and final rinse with chemical sanitizer, 75°F (24°C), or no less than the temperature specified by the machine’s manufacturer. • All dish-washing machines must be thoroughly cleaned after each meal and broken down and thoroughly cleaned after the last meal of the day. • When chemicals are used for sanitizing, they should be of a type approved by the local or state health authority. They should also be automatically dispensed in a high-enough concentration and for a long-enough period to provide effective bactericidal treatment (according to the manufacturer’s specifications). • After sanitization, all equipment and utensils must be air dried. Drain boards of adequate size for handling soiled and clean tableware should be provided. Mobile dish tables can be used for these tasks. Never towel dry dishes. • Temperatures for dish washing and pot washing should be taken each time the machine is used. Temperatures should be recorded on a chart posted in the area. The temperature for wash and rinse should be recorded. Any variance should be noted on the chart, along with the action taken to correct it. • In areas where “hard” water is a problem, the machine should be delimed as needed. Manual Ware Washing The following standards should be observed for manual cleaning and sanitizing: • A sink with at least three compartments must be used for the manual washing, rinsing, and sanitizing of utensils and equipment. The compartments should be large enough to accommodate the largest equipment and utensils. Hot and cold water sources should be provided for each compartment. • Drain boards or easily movable dish tables of adequate size should be provided for handling soiled utensils before washing and cleaning utensils after sanitizing. • Equipment and utensils should be preflushed or prescraped and, when necessary, presoaked to remove gross food particles. (Note: A fourth sink compartment equipped with a garbage disposal is useful for this purpose and could be easily included in plans for facilities being renovated and for new construction.) • Except for fixed equipment and utensils too large to be cleaned in sink compartments, the following work sequence should be followed: Wash equipment and utensils in the first sink compartment at a maintained temperature of not less than 110°F (43°C) with a hot detergent solution that is changed frequently to keep the compartment free from soil and grease. Rinse equipment and utensils with clean 120°F (49°C) water in the second compartment and change the water frequently. Sanitize equipment and utensils in the third compartment, using one of the following four methods: (1) Immerse the equipment and utensils for at least thirty seconds in clean hot water maintained at 120°F (49°C). A heating device is needed to maintain this temperature, and a thermometer should be used to check the temperature frequently. Dish baskets should be used to immerse utensils completely. (2) Immerse the equipment and utensils for at least one minute in a clean solution that contains at least 50 parts per million (ppm) available chlorine as a hypochlorite or iodine or quaternary ammonium and a temperature of at least 75°F (24°C). (3) Immerse the equipment and utensils for at least one minute in a clean solution that contains at least 12.5 ppm available iodine and has a pH no higher than 5.0 and a temperature of at least 75°F (24°C). (4) Immerse the equipment and utensils in a clean solution that contains any other chemical sanitizer approved by local and state health authorities that will provide the equivalent bactericidal effect of a 50-ppm chlorine solution at 75°F (24°C) for one minute. All utensils and equipment should be air dried after sanitizing.
• Equipment that is too large to immerse can be sanitized by treatment with clean steam, provided that the steam can be confined within the equipment. An alternative method is to rinse, spray, or swab the equipment with a chemical sanitizing solution mixed to at least twice the strength required for immersion sanitization. Storing Equipment and Utensils Cleaned and sanitized equipment and utensils must be stored properly to protect against contamination. The following standards should be maintained: • Store them at least six inches above the floor in a dry, clean location in a way that protects them from contamination by splashes and dust. Stationary equipment should also be protected from contamination. • Glasses and cups should be stored in an inverted position. Other utensils should be stored covered or inverted whenever practical. Storage containers for tableware should be designed so that only their handles are presented to the employee or consumer. • Store all pots and pans upside down. • Always air dry utensils before putting them away. • Store items so they can be picked up without touching the food-contact surface. • Do not store in restrooms or other areas where possible contamination may occur. Self-Evaluation of Sanitary Conditions and Practices Ongoing self-evaluation of the food service department’s sanitary conditions and practices is necessary to ensure day-to-day protection of all employees and all customers served. The primary benefit of self-monitoring is that managers and employees remain aware of the advantages of maintaining a safe and sanitary operation and avoiding a serious health hazard. The checklist given above in Health Inspections can be used as a guide for developing a sanitation self-evaluation program. Local health departments also can be consulted on questions concerning food sanitation standards for specific localities. The JCAHO’s dietetic standards include standards for infection control that can be incorporated into the institution’s program. These standards also include certain provisions for the institution’s policies and procedures and for communicating them to all employees. As part of the sanitation evaluation and control program, a department representative usually serves on the facility’s overall infection control committee. The committee also reviews the food service department’s policies and procedures, along with those of every other department in the facility. Pest Control Food Safety, Sanitation, and Hazard Analysis Critical Control Points The most common and dangerous pests likely to invade kitchens are rats, mice, flies, roaches, and ants (Table 13.8). They walk and feed on garbage or other waste matter, thus picking up germs and carrying them on or inside their bodies. Rodents, in particular are great carriers of disease. It is important to protect food against pollution from these pests. By careful control measures, insects and rodents may be eliminated from storage and food service areas. Carelessness will result in the spread of disease and costly spoilage. The best method of control is a clean environment and a pest-control contract with a pest company that sprays and follows up with visits on a monthly basis. It is unwise for food service professionals to use sprays, chemicals, or insecticides around food. A number of chemicals can cause problems. Never use a chemical that is not approved for use in food service operations. Pests may enter the facility despite good housekeeping and control. They come in on customers or in baggage and packages, as well as in supplies from warehouses. This is especially the case with roaches, ants, and flies. 427
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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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