Navigating the New Requirements for Food Handling on a Budget. Norovirus Virions, Image Courtesy of PHIL

Transcription

1 Navigating the New Requirements for Food Handling on a Budget Norovirus Virions, Image Courtesy of PHIL

2 Provide an overview of the burden of Foodborne Illness (FBI) in the US and the impact specifically for Highly Susceptible Populations (HSPs) as well as it s common causes and how it can be prevented. Review the new requirements for food handling for ALRs and how to meet them without breaking the bank follow along with the regulations if you like Cost saving tips to assure personal health, hand hygiene, approved foods, food temperatures and storage, cleaning, and employee training will appear in green throughout. Facts that explain the why behind each requirement will appear in blue.

3 The Centers for Disease Control estimates that: 48 million people or 1 in 6 Americans gets sick from foodborne illness every single year 128,000 of those are hospitalized 3,000 die from foodborne diseases each year

4 Highly Susceptible Population means persons who are more likely than other people in the general population to experience foodborne disease because they are immunocompromised, preschool age children, or older adults; and they obtain food at a facility that provides services such as custodial care, health care, or assisted living, such as a child or adult day care center, kidney dialysis center, hospital or nursing home, or nutritional or socialization services such as a senior center.

5

6 Death rates for infectious diarrheal disease are 5X higher in people over 74 years of age than in the next highest group, children <2, and 15X higher than the rates for younger adults. Studies attribute this heightened risks, to several factors: (1) the aging of the GI tract (2) a higher prevalence of underlying medical disorders; and (3) malnutrition and a decline in the immune response. -Marler Clark, LLP., PS.

7 < Severe consequences, requiring hospitalization, increase with age for all of the top foodborne illnesses. Shigella Salmonella Listeria E. coli Campylobacter Colorado,

8

9 In a 10 year study, FDA and CDC determined the 5 primary causes of FBI: Poor Personal Hygiene* Improper Holding Temperature* (Cold and hot holding, cooling and reheating) Contaminated Equipment Inadequate Cooking Food from Unsafe Sources All of the new requirements are based on these 5 factors.

10 The top 5 causes of FBI from food eaten in the US are: Norovirus 5,461,731 (58%) Salmonella 1,027,561 (11%) Clostridium perfringens 965,958 (10%) Campylobacter 845,024 (9%) Staphylococcus aureus 241,148 (3%) >90% Other agents don t cause as many illnesses, but are more likely to lead to hospitalization. Those germs include: Clostridium botulinum, the germ that causes botulism Listeria E coli O157 Vibrio Researchers have identified >250 foodborne diseases! -CDC

11 60% 50% 40% 30% 20% 10% Cross-Cont Hand Wash Hygiene Hot Hold Cold Hold Adequate HS 0% RFE Institions LTCF

12 Anyone preparing or serving food is required to take food safety training and maintain evidence of completion on site. Online training such as statefoodsafety.com cost $10 and take roughly two hours to complete. You can print or save a PDF of your certificate right from the site. Please note this course was designed for restaurants. Sections of this course that talk about commercial equipment do not apply to ALR with less than 20 beds! Focus on the behaviors associated with food safety such as cooling, cooking, reheating, hygiene, handwashing THIS course is being made into an online training that will be available online, free to take anytime anywhere and tailored to these requirements!!

13 Staff must be in good health & free of communicable disease while handling, preparing or serving food or handling utensils. Staff cannot handle, prepare or serve food while experiencing any of the following symptoms: Vomiting, diarrhea, sore throat with fever, jaundice or lesion containing pus on the hands or wrists Staff with these symptoms can t return to handling food until at least 24 hours after symptoms resolve. Ill employees are a significant factor in large FBI outbreaks If you only have one person that prepares food, you can serve prepacked foods, serve self service items and use single use utensils until that person is well enough to return to food handling

14 When an employee is diagnosed with Norovirus, Shigella, E. coli, Hepatitis A, Salmonella Typi, or other bacterial enteric pathogen the person in charge is required to consult with the Department before the employee is allowed to return to handling food or utensils. These are serious illnesses that can easily spread through food. Keeping anyone diagnosed with these conditions from handling food is your best defense against a devastating outbreak and resulting liability for causing preventable severe illness, hospitalizations and deaths.

15

16 Food handlers, cooks and servers must properly wash their hands using the following procedure: Wash using warm (100⁰F to 120⁰F) soapy water by vigorously scrubbing all surfaces of the hands and wrists for at least 20 seconds. Rinse hands clean. Thoroughly dry hands with a disposable paper towel. Use the paper towel to turn off sink faucets before disposing. Your kitchen sink can serve as your hand sink and can be used for washing dishes and produce as long as it s cleaned and sanitized between uses.

17 Before: leaving the restroom, and again before returning to food or beverage preparation, or dishwashing; handling or putting on single use gloves for food handling and between removing soiled gloves and putting on new, clean gloves.

18 After: coughing, sneezing, using a tissue, smoking or eating; touching the hair, face or body; handling soiled dishes or utensils; feeding or caring for residents; caring for pets or other animals; and engaging in any activities that contaminate the hands, handling garbage, mopping, working with chemicals and other cleaning activities. When switching between handling raw animal foods and ready-to-eat foods and as often as necessary to remove contamination and prevent cross contamination when changing tasks.

19 Employees must: have good hygienic practices and wear clean clothing, smock or uniform while handling food or utensils. are prohibited from using common towels to wipe or dry their hands, single use paper towels are ideal! not eat or smoke in areas used for food preparation or storage. Drinking in these areas is allowed with enclosed containers. not touch their faces, hair or other body surfaces while handling food. not taste food during preparation with a utensil that is not clean and sanitized. The same utensil must be washed, rinsed and sanitized before it is reused. Utensils used to dispense food must have handles that are kept out of food and ice 33% of outbreaks are attributed to poor personal hygiene Good handwashing protects your residents and your staff from sick days and lost wages.

20 Ready-to-eat foods cannot be handled with bare hands. Instead gloves or utensils must be used to handle, prepare and serve these foods. Ready-to-eat foods include cold cuts, produce, breads, garnishes, fruit and even ice. Eliminating bare hand contact with ready-to-eat foods is the most effective means of control NOROVIRUS, an illness that spreads rapidly through food and from person to person quickly making everyone exposed sick.

21 Handwashing provides a 2 log reduction in viral particles (vp) = 10,000,000,000 Ungloved hands can transfer 1,000,000,000 vp It only takes 1-10 vp to cause illness Handwashing isn t enough! Gloves or utensils are required every time you handle ready-toeat foods.

22

23 Gloves must be used in a manner that prevents contamination of food and food contact surfaces. Gloves are to be changed whenever switching from handling raw animal foods to ready-to-eat foods and whenever else gloved hands become contaminated. When gloves are changed, hands must be washed. Deli tissues and utensils can be used for many foods reducing the number of gloves needed.

24 All foods, including raw ingredients and prepared foods, must come from approved, licensed or registered sources or food manufacturers. Produce can be obtained from other sources, including grown in your own garden, as long as good agricultural practices are used. Easy to follow best practices for safely growing and harvesting your own vegetables can be found on our website. Food Safety for Vegetable Gardens -Tips for School, Child Care and Long Term Care Facilities

25 Grow Produce Safely Click on Food Safety then Food Safety for Gardens

26 Foods that cannot be served ready-to-eat: Raw animal foods (e.g., raw fish, shellfish, steak tartare) Partially cooked animal foods (e.g., poached fish, soft cooked/boiled eggs*, rare burger) Raw milk Raw seed sprouts Juice that is not pasteurized under a HACCP plan unless it is squeezed to order on site Pasteurized eggs can be ordered by large suppliers or can be requested at local grocers, they cost slightly more than other eggs but are only needed for eggs you undercook. These requirements do not preclude residents from consuming foods they acquire themselves or from loved ones.

27 Unlike most bacteria, Listeria can grow and multiply in foods inside the refrigerator at 41⁰F and below. At least 90% of LM cases occur in highly susceptible populations. - CDC The best mechanism to control bacteria is to control the time refrigerated foods are stored. -Image Courtesy PHIL

28 Potentially hazardous foods that are not cooked, especially: Lunch meats* Deli salads made in-house Soft cheeses It is strongly recommended, but not required, that lunch meats, hot dogs, and cold cuts be cooked or heated before service to highly susceptible populations.

29 Date marking is required to control for Listeria monocytogenes (LM) Keeping foods too long increases the risk of LM Ready-to-eat, refrigerated foods not used within 24 hours must be labeled for use or discard 7 days after opening/preparation This does not apply to commercially prepared condiments and dressings. You can use any means you like to date mark foods as long as it consistent and easy to understand.

30 Food Whole roasts (beef, lamb, pork) Beef steaks Eggs**, pork, lamb, fish Ground beef, fish, pork, lamb, veal Poultry (ground or whole), stuffed meats Temperatures 135 F 145 F 145 F 155 F 165 F **Pasteurized eggs can be cooked to order and do not need to reach 145 F before being served. Analog food thermometers typically cost <$10 and can be easily recalibrated using ice water and used for years to come.

31

32 Prepare glass of ICE & WATER. Place thermometer in ICE & WATER. Wait until needle stops moving. Does the temperature read 32 F? No Yes Thermometers should be calibrated often. Once a week is sufficient and anytime they have been dropped or seem to be off. Adjust the dial, while leaving the stem in the water, by holding the nut underneath securely & turning the face to read 32 F. Thermometer is calibrated correctly.

33 How fast can bacteria multiply? At room temperature, just ONE bacterium in food can grow to 2,097,152 bacteria In just 7 hours! Salmonella typhimurium - courtesy of CDC s PHIL Under ideal conditions, bacteria multiply rapidly, in fact they multiple exponentially.

34 Potentially hazardous foods are foods with ideal conditions for bacterial growth including: Protein Moisture ph Time Temperature (41 F to 135F ) These are food that require temperature control to assure they are safe. We will spend the next section talking about these foods. Potentially hazardous foods (PHF) Foods that need refrigeration

35 Temperature ( F) 160 F 140 F 120 F 100 F 80 F Rapid bacteria growth 60 F 40 F 20 F Bacteria multiple rapidly when PHF are between 135 F and 41 F. Keeping foods at proper temperatures improves their quality and shelf life while assuring safety.

36 Potentially Hazardous Foods must be maintained at the proper temperatures at all times prior to being served. PHF that are stored cold must be held at or below 41⁰F. Potentially Hazardous Foods that are stored hot must be held at or above 135⁰F. When foods are being prepared, cooled or reheated, they must not be held below 135⁰F or above 41⁰F for extended time to control the growth of harmful bacteria. You can use the same food thermometers that you use to test cooking temperatures to test holding temperatures, simply clean the probe first. While efforts should be made to maintain temperatures during receipt, storage, preparation and service, the temperature requirements only apply to foods before they are served to residents.

37 Potentially hazardous foods that are reheated from room temperature, such as opening a can or from cold storage before hot holding must be heated rapidly within 2 hours to 165 F Rapid reheating can be accomplished on a stove top, in an oven, microwave or another approved reheating device Rapid reheating can be done easily in the standard kitchen equipment you likely already have. To verify you are reaching 165 F within 2 hours, you can use the same analog thermometer we discussed earlier.

38 Foods must be cooled actively and as quickly as possible to minimize the time in the danger zone. Foods cooled from room temperature, such as opening a can or preparing foods from room temperature, must be cooled to 41 F within 4 hours. Following cooking or removal from hot holding, foods must be cooled from 135 F to 70 F within 2 hours and from 70 F to 41 F within 4 additional hours. Begin cooling when hot foods reach 135 F on their own, then use shallow uncovered containers, ice as an ingredient, ice baths, your freezer or a combination to cool food quickly to 41 F. Cooling foods quickly not only assures safety, it also improves the quality and shelf life of foods.

39 Temperature ( F) Passive Cooling Rapid Cooling Hours This graph shows temperatures of food that is rapidly cooled compared with the same food that is passively cooled. The rapidly cooled food is in the DANGER ZONE for much less time, shortening the opportunity for bacteria to multiple and assuring safer food.

40 While you prepare food at room temperatures, you are not required to maintain the temperature above 135 F or below 41F, instead finish preparing each item within 2 hours and return the food to hot holding or cold holding until it is served. You have 4 hours to get prepared foods below 41F after they are prepared at room temperature.

41 Frozen foods must be thawed using one of the following safe techniques: Under refrigeration Under cool running water between F In a microwave oven As part of the cooking process Thawing on a counter at room temperature can allow portions of the food to remain above 41 F for an extended period of time, allowing bacteria to multiply. Keeping foods out of the danger zone shortens bacteria s opportunity to reach dangerous levels and assures safer food.

42 The requirements for assisted living residences with under 20 beds were written to allow for safe food handling in a typical home or domestic setting. The requirements are your road map to assure safe food for your residents with no need to buy expensive new equipment as long as your home refrigerator keeps foods 41 F and a means to cook and hold foods above 165 F.

43 Food contact surfaces must be washed, rinsed and sanitized before use and at least every 4 hour of continual use. Sanitizer must be approved for use as a no-rinse food contact sanitizer and registered with EPA and used in accordance with labeled instructions. 1 Teaspoon Inexpensive household bleach can be used to make a sanitizing solutions. Use 1 teaspoon per gallon of water to create the proper concentration of 100 ppm chlorine. You can make this same solution in a spray bottle or similar container that can last for up to a week and be used to sanitize counter tops and other food contact surfaces.

44 There should be no need to install new expensive plumbing fixtures. Your kitchen sink is adequate for handwashing, dish washing, thawing and preparing food as long as it works, has hot and cold water and is washed, rinsed and sanitized in between uses.

45 Dishes, utensils and cookware must be washed using one of these methods: In a single or multiple compartment sink using dish detergent, rinsed clean, then submerged in an approved sanitizer, or Washed in a domestic or commercial dish machine with wash water that reaches 155 F or is equipped with a chemical sanitizing cycle. Inexpensive household bleach can be used to sanitize dishes, simply follow the labeled instructions for sanitizing. Check you dishwasher users manual to determine if it reaches 155 F during the wash cycle. The temperature can be verified by your surveyor using a special device.

46 Mop water can be filled using a bath tub, utility sink or any sink with a quick release hose attachment. Mop water can be dumped in a toilet, bathtub, or utility sink. There is no need for a dedicated mop sink for filling or dumping mop water. In fact there is no requirement for frequent mopping! Having a means to mop is important in the event you need to clean up after someone that becomes ill. A quick release hose attachment can be found at your local hardware store and costs under $10. It allows you to remove an attached hose right after filling a mop bucket so that you can use the sink for something else.

47 Monitoring food temperatures is best practice and assures malfunctioning refrigerators don t go unnoticed, required cook temperatures are reached and foods are cooled and reheated rapidly. However, there is no requirement to log temperatures, but as you are getting used to the habit it might help keep you aware of potential problems, avoid illnesses and survey citations.

48 Available 8:30 am 5:00 pm Monday - Friday Call (303) and press option 3 your question to: cdphe_iepu@state.co.us therese.pilonetti@state.co.us