SANITATION: KEEP CALM AND FOLLOW THE RULES!

Transcription

1 SANITATION: KEEP CALM AND FOLLOW THE RULES! JULIE HALFPOP RDN, LD MARTIN BROS. DISTRIBUTING TODAY WE WILL DISCUSS OBJECTIVES: 1. UNDERSTAND THE REGULATIONS REGARDING FOOD SAFETY AND SANITATION. 2. DISCUSS COMMON CITATIONS AND WAYS THAT THEY CAN BE AVOIDED. 3. UNDERSTAND THE IMPORTANCE OF EDUCATING STAFF AND INCORPORATING A CULTURE OF SERVICE. 1

2 F800 F801 F802 F803 F804 F805 F806 F807 F808 F809 F810 F811 F812 F813 F814 NEW F TAGS FOOD & NUTRITION SERVICES PROVIDED DIET MEETS NEEDS OF EACH RESIDENT QUALIFIED DIETARY STAFF SUFFICIENT DIETARY SUPPORT PERSONNEL MENUS MEET RES NEEDS/PREP IN ADVANCE/FOLLOWED NUTRITIVE VALUE/APPEAR, PALATABLE/PREFER TEMP FOOD IN FORM TO MEET INDIVIDUAL NEEDS RESIDENT ALLERGIES, PREFERENCES AND SUBSTITUTES DRINKS AVAIL TO MEET NEEDS/PREFERENCES/HYDRATION THERAPEUTIC DIET PRESCRIBED BY PHYSICIAN FREQUENCY OF MEALS/SNACKS AT BEDTIME ASSISTIVE DEVICES EATING EQUIPMENT/UTENSILS FEEDING ASST TRAINING/SUPERVISION/RESIDENT FOOD PROCUREMENT, STORE/PREPARE/SERVE SANITARY PERSONAL FOOD POLICY DISPOSE GARBAGE & REFUSE PROPERLY COMMON DEFICIENT PRACTICES 1. FOOD HANDLING/SANITATION CONCERNS 2. NOT FOLLOWING THE PLANNED MENUS 3. ADEQUATE ROUTINE CLEANING *SANDRA FRAHAM, IDHCC CONFERENCE 4/6/18 2

3 KEY AREAS TO SERVING SAFE FOOD 1. EDUCATION & TRAINING 2. PERSONAL HYGIENE AND EXCLUSION OF ILL EMPLOYEES 3. MEETING FOOD TEMPERATURE REQUIREMENTS FOR COOKING, HOLDING, COOLING & STORING FOOD 4. MONITORING OF EXPECTED PRACTICES *SANDRA FRAHAM, IDHCC CONFERENCE 4/6/18 RESOURCES 3

4 DINING OBSERVATION 1. DOES STAFF DISTRIBUTE AND SERVE FOOD UNDER SANITARY CONDITIONS? (F812) 2. DID THE FACILITY PROVIDE A SAFE, SANITARY, AND COMFORTABLE ENVIRONMENT AND HELP PREVENT THE DEVELOPMENT AND TRANSMISSION OF COMMUNICABLE DISEASES AND INFECTIONS? (F880) *SURVEYORS ARE NOW REQUIRED TO OBSERVE THE FIRST MEAL UPON ENTRANCE INTO THE FACILITY. EACH SURVEY TEAM MEMBER WILL BE ASSIGNED A DINING AREA. IF THERE ARE FEWER SURVEYORS THAN DINING AREAS, OBSERVE THE DINING AREAS WITH THE MOST DEPENDENT RESIDENTS. SOME EXAMPLES OF FRONT OF THE HOUSE CITATIONS STAFF SCRAPED FOOD OFF PLATE WITH THUMB DIETARY STAFF TOUCHED FOOD AND NON-FOOD ITEMS WITH GLOVED HANDS STAFF TOUCHED READY-TO-EAT FOODS WITH BARE HANDS WATER MUGS REFILLED IN UNSANITARY MANNER KITCHEN STAFF FAILED TO WASH HANDS OR CHANGE GLOVES BETWEEN TASKS OF DIRTY AND CLEAN IN THE DINING ROOM DIETARY AIDE CLEARED SOILED DISHES AND FAILED TO WASH HANDS PRIOR TO RETURNING TO SERVING OTHER RESIDENTS 4

5 SOME EXAMPLES OF FRONT OF THE HOUSE CITATIONS IMPROPER USE OF GLOVES, TOUCHED OTHER ITEMS THAN FOOD WHEN SERVING MEALS DINING STAFF DONNED GLOVES WITHOUT WASHING HANDS DURING NOON MEAL DIETARY STAFF CARRIED RESIDENT'S PLATED FOOD FROM KITCHEN TO THE DINING AREA PASSING THOUGH A COMMON HALL AND FAILED TO COVER THE FOOD DURING TRANSPORT STAFF DID NOT WASH HANDS AFTER HUGGING A RESIDENT AND WENT BACK TO SERVING FOOD *HOW MANY OF THESE INVOLVED HANDWASHING AND GLOVING?? FIRST IMPRESSION? 5

6 92% OF CUSTOMERS SAY CLEANLINESS MATTERS WHETHER THEY WILL BE BACK AGAIN 6

7 A CASE FOR CLEANLINESS 88% WONDER ABOUT THE FOOD SAFETY IF THE RESTROOMS ARE NOT CLEAN 95% AGREE THAT CLEANLINESS CAN ELEVATE GOOD BUSINESS 92% AGREE THAT IF THE SURROUNDINGS ARE CLEAN, THEY WILL TELL THEIR FRIENDS 74% ARE LIKELY TO OVERLOOK SLOW SERVICE IF THE BUSINESS IS NOTABLY CLEAN 73% SAY THAT A SMELLY BATHROOM IS WORSE THAN RECEIVING THE WRONG ORDER P & G Professional ISU Safe Food 7

8 GRACIOUS SERVICE 8

9 OTHER FRONT OF HOUSE CONSIDERATIONS 12% OF FOOD WORKERS SAID THEY WORKED WHEN THEY WERE SICK WITH VOMITING OR DIARRHEA NATIONAL CENTER FOR ENVIRONMENTAL HEALTH RECOMMENDATIONS: POLICIES THAT REQUIRE FOOD WORKERS TO TELL MANAGERS WHEN THEY ARE SICK SCHEDULES THAT EASE THE PRESSURE TO WORK SUCH AS ON-CALL WORKERS MORE RESEARCH EXPERIENCED MANAGERS (4 OR MORE YEARS) LED TO FEWER WORKERS WORKING SICK THE LINK BETWEEN PAID SICK LEAVE & WORKING WHILE SICK 9

10 DOES STAFF DISTRIBUTE AND SERVE FOOD UNDER SANITARY CONDITIONS? 10

11 HANDWASHING EDUCATION 11

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15 SAFEEGGS.COM 15

16 SANITIZE SURFACES WIPE DOWN SURFACES, SEATS, MENUS WITH A DAMP CLOTH AND DISINFECTANT TABLECLOTHS NEED TO BE SWAPPED OUT BETWEEN USES 16

17 KITCHEN OBSERVATION 1. DURING THE INITIAL BRIEF TOUR, ARE FOODS STORED AND/OR PREPARED UNDER SANITARY CONDITIONS? (F812) 2. DURING THE INITIAL BRIEF TOUR, DOES THE FACILITY HANDLE, PREPARE, AND DISTRIBUTE FOOD IN A MANNER THAT PREVENTS FOODBORNE ILLNESS TO THE RESIDENTS? (F880) 3. IS THE FOOD STORED AT THE APPROPRIATE TEMPERATURES? (F812) 4. DURING FOLLOW UP VISITS TO THE KITCHEN, ARE FOODS STORED UNDER SANITARY CONDITIONS? (F812) 8. WAS FOOD PROCURED FROM APPROVED OR SATISFACTORY SOURCES AND WAS FOOD STORED, PREPARED, DISTRIBUTED AND SERVED IN ACCORDANCE WITH PROFESSIONAL STANDARDS FOR FOOD SERVICE SAFETY? (F812) KITCHEN OBSERVATION, CONTINUED 10. DURING FOLLOW UP VISITS TO THE KITCHEN, DOES THE FACILITY HANDLE, PREPARE, AND DISTRIBUTE FOOD IN A MANNER THAT PREVENTS FOODBORNE ILLNESS TO THE RESIDENTS? (F880) 11. WERE DISHES AND UTENSILS CLEANED AND STORED UNDER SANITARY CONDITIONS? (F812) 12. IS THE FOOD PREPARATION EQUIPMENT CLEAN? (F812) 16. ARE SNACK/NOURISHMENT REFRIGERATORS ON THE UNIT MAINTAINED WITH PROPER TEMPERATURE AND FOOD ITEMS ARE DATED AND LABELED SO AS TO PREVENT THE POTENTIAL FOR FOODBORNE ILLNESS? (F812) 17

18 INITIAL KITCHEN OBSERVATION AUDIT BACK OF THE HOUSE SANITATION IS FOOD STORED PROPERLY? AT PROPER TEMP? UNDER SANITARY CONDITIONS? 18

19 PROPER FOOD STORAGE SAMPLE CITATIONS: DRY STORAGE ITEMS WERE OPENED, UNDATED AND UNLABELED IN THE ACTIVITY ROOM CUPBOARDS, FROZEN ITEMS WERE EXPIRED AND UNLABELED IN THE ACTIVITY FREEZER. THE NURSING MEDICATION REFRIGERATOR AND THE REHABILITATION REFRIGERATOR HAD UNDATED, EXPIRED, AND UNLABELED FOOD ITEMS OPEN, UNDATED, OUTDATED, UNLABELED AND UNCOVERED FOOD CONTAINERS FOUND IN THE FREEZER AND REFRIGERATORS. 4 THAWED, 4 OUNCE CONTAINERS OF SHAKES DID NOT HAVE A DATE ON THE CONTAINER. THE INSTRUCTIONS ON THE CONTAINERS STATE, "STORE FROZEN, USE THAWED PRODUCT WITHIN 14 DAYS." THERE WERE CONTAINERS OF PUDDING OR FRUIT WITH EXPIRED USE BY DATES IN THE RESIDENT'S REFRIGERATOR. DO ALL YOUR REFRIGERATORS/FREEZERS HAVE THERMOMETERS? SYSTEM FOR MONITORING TEMPERATURES WALLS, CEILINGS, FLOORS, SHELVING AND FANS ARE CLEAN AND IN GOOD REPAIR. PROPER STORAGE TO PREVENT CROSS-CONTAMINATION 19

20 DURING THE INITIAL BRIEF TOUR, DOES THE FACILITY HANDLE, PREPARE, AND DISTRIBUTE FOOD IN A MANNER THAT PREVENTS FOODBORNE ILLNESS TO THE RESIDENTS? 20

21 STAFF D TOUCHED CLEAN DISHES WITHOUT SANITIZING, THEN TOUCHED DIRTY DISHES FOLLOWED BY TOUCHING CLEAN DISHES WITHOUT SANITIZING. STAFF E TOUCHED CLEAN DISHES WITHOUT FIRST SANITIZING HANDS - NO HAND WASHING PERFORMED DIETARY COOK DID NOT WASH HANDS AFTER TOUCHING THE DISHWASHER AND BEFORE PREPARING FOOD ITEMS. 21

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23 ARE DISHES AND UTENSILS CLEANED AND STORED UNDER SANITARY CONDITIONS? 23

24 MORE BACK OF THE HOUSE SANITATION I THOUGHT WE WERE SUPPOSED TO LEAVE SPOONS AND SCOOPS IN THE FOOD, BUT WE WERE JUST CITED FOR LEAVING THEM IN THE CONTAINER! CAN YOU PLEASE CLARIFY?! 24

25 SCOOPS SHOULD NOT BE LEFT IN CONTAINERS AS THIS CAN BE A FORM OF CONTAMINATION IF THE HANDLE TOUCHES THE FOOD, THIS IS A VIOLATION HOWEVER, WHEN ON A TRAY LINE, CAFETERIA, ETC, SPOONS & SCOOPS SHOULD BE LEFT IN THE CONTAINER AVOID THE RAINBOW OF COLORS FAILED TO MAINTAIN CLEAN AND SANITARY KITCHEN EQUIPMENT. OBSERVATION ON 1/22/18 AT 8:50AM REVEALED: FOUR SHELF STAINLESS STEEL SHELVING UNIT HAD A GRAY/BROWNISH DEBRIS HANGING FROM THE SHELVING ABOVE THE POTS AND PANS UNDERNEATH; 4 LEGS OF HOBART STAND UP MIXER HAD DARK BROWN AND WHITE STICKY SUBSTANCE AROUND THEM WITH TWO STAINLESS STEEL BOWLS ON THE SHELF UNDERNEATH; FAN ON WALL ABOVE THE 3 COMPARTMENT SINK HAD A BROWNISH SUBSTANCE ON THE PLASTIC COVERING AND BLADES; WHITE MICROWAVE ON THE LOWER LEVEL HAD A RED/ORANGE STICKY SUBSTANCE ON THE BOTTOM, TOP AND SIDES; 2 DOOR CUPBOARD CONTAINED 1 WHITE AND 3 BLACK COFFEE CARAFES ON A TOWEL WITH BROWN STAINS UNDERNEATH EACH CARAFE; FAN ON TOP OF THE COUNTER, BLOWING AIR ONTO CLEAN DISHES ON A BURGUNDY CART HAD A BROWNISH DEBRIS ON THE PLASTIC COVERING AND BLADES. 25

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27 FOOD FROM OUTSIDE SOURCES Potlucks addressed? Educate families & visitors? Label & dating? Safety of the food such for those on mechanically altered diets? Monitoring? RESIDENT REFRIGERATORS The refrigerator is checked out for safety by our building services department and tagged with date inspected. A temperature log is posted on the front and nursing staff record temps daily. Family is instructed in safe food storage practices and refrigerator is care planned. Housekeeping cleans it weekly but if they find a real mess, family is contacted. If it is till not maintained, family is asked to remove it because it's a safety issue. We follow our policy of 72 hours for leftovers here except beverages which are 7 days then follow shelf life guidelines for other items residents purchase. I go through resident refrigerators once a week and toss things. If I see that something is going to expire soon, I try to give residents a heads up so they can eat it before it gets discarded because they have gotten very angry with dietary staff when their food had been thrown away. Do you have policies for addressing unit refrigerators and storage areas? 27

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29 QAPI IDEAS LACK OF COMPETENCY CRITERIA AND CHECKLISTS/EVALUATION OF STAFF LACK OF TRAINING ON NEW REGULATIONS LACK OF COMPREHENSIVE CLEANING SCHEDULE WITH SPECIFIC STAFF ASSIGNED AND STAFF INITIALING TO DOCUMENT LACK OF MANUFACTURER GUIDELINES FOR CLEANING & SANITIZING ALL EQUIPMENT AND LOG TO ENSURE COMPLIANCE LACK OF LOG OR MONITORING OF RED SANITIZING BUCKETS FOR EFFECTIVE SANITIZER USE STAFF UNSURE OF USE OF 3 COMPARTMENT SINK WHEN DISHMACHINE DOWN ANFP Edge March-April

30 EDUCATIONAL INSPIRATIONS USING GLOGERM TO EMPHASIZE PROPER HANDWASHING GIVE STAFF A COPY OF YOUR SANITATION INSPECTION FORM AND LET THEM BE THE INSPECTORS AND THEN DISCUSS THEIR RESULTS SANITATION BINGO FOOD SAFETY SKILLS FAIR SERVSAFE HAS FOOD SAFETY JEOPARDY HANDWASHING FOR LIFE PERSONALIZE THE LEARNING EXPERIENCE WHAT KNOWLEDGE IS REQUIRED TO PERFORM THE JOB? 30

31 SURVEY PREPAREDNESS QUESTIONS DO YOU USE PASTEURIZED EGGS? CAN YOU SHOW ME YOUR TEMPERATURE LOGS? DO YOU KEEP A TEMPERATURE LOG WHEN COOLING FOODS? HOW DO YOU THAW MEAT? DO YOU SERVE LEFTOVERS? WHAT DO YOU DO IF A RESIDENT COMPLAINS ABOUT THE TEMPERATURE OF A FOOD? WHAT DO YOU DO IF YOU HAVE DIARRHEA, FEVER WITH SORE THROAT, VOMITING AND ARE SCHEDULED TO WORK? HOW MANY SECONDS DO YOU WASH YOUR HANDS FOR? WHAT KIND OF DISHMACHINE DO YOU HAVE? IF YOUR HIGH TEMPERATURE DW READS UNDER 180 DEGREES F WHAT DO YOU DO? 31

32 CREATING A FOOD SAFETY CULTURE MAKE TRAINING FUN LEAD BY EXAMPLE EXPLAIN WHY FOLLOW UP 32