Dietary Crises Questions and Answers Problem #1: The power goes out and your freezer and refrigerator are not on the emergency generator. Help will not arrive for a day or two. Solution #1: FREEZER: Keep freezer door closed Full freezer should keep food frozen about two days Half full freezer about one day If not full, group packages into igloo Where possible add dry ice Thawing food that has ice crystals or is 41 F or less can be refrozen When in doubt throw it out Transfer into ice packed chests if power outage is longer than two days or to functioning freezer Vendors have refrigerated trucks if necessary takes approximately 24 hours of notice to obtain one REFRIGERATOR Keep door closed as much as possible Items should be safe if power not out for more than four hours Discard any food greater than 41 F If out longer than four hours arrange for another temporary refrigerator 1
Problem #2: The State Surveyors are in the facility and the cold temperature dish machine is not correctly dispensing sanitizer into the rinse cycle. Or The dish machine stops working all together Solution #2: IF DISPENSING OF SANITIZER NOT WORKING: Call dish machine vendor to come and repair ASAP Manually add the proper amount of sanitizer to the rinse cycle every rinse Test with appropriate test strip to assure correct amount of sanitizer Record method on Dish Machine Temperature Form IF DISH MACHINE IS NOT WORKING AT ALL: Wash dishes in three compartment sinks Wash/Rinse/Sanitize/Record PPM Sanitizer/Air Dry OR Convert to all paper products Problem #3: There are signs of rodent droppings in the kitchen and it is found that the facility is infested with mice Solution #3: Check for holes in walls, ceilings or floor repair Call pesticide company increase visits or change company Call County Health Department regarding correct amount of sanitizer to use Sanitize all areas do not produce food until this is done RD to oversee compliance 2
Problem #4: Several residents at the same time identified with nausea, vomiting and diarrhea. Possible foodborne illness outbreak suspected. Solution #4: 1. Develop a tool to collect and graph facility data: a) Dates of onset b) Duration of illness c) Number of diagnosed cases d) Number of symptomatic cases e) Types of exposures, i.e., residents, staff vendors and outside personnel 2. Work with county environmentalists to determine what cultures will be taken, i.e., food, water, ice 3. Work with the Medical Director to determine what labs and stools are to be taken 3
Jeopardy Questions and Answers Employee Hygiene 10. When should aprons and gloves be removed? When leaving the dietary department and when using the rest room. 20. Describe appropriate dress for a dietary employee. Neat, clean & washable work clothes. Wear clean apron and socks with closed toe shoes. Jewelry limited to wedding ring and post earrings. Wear a name badge at all times. 30. Describe Universal Precautions for dietary when washing dishes. Wash, rinse and sanitize dishes as usual wearing gloves. 40. List 4 times when gloves should be changed. 1. When touching ready to eat foods 2. If there are sores, rashes, cuts, artificial nails, nail polish 3. After 1 task 4. When washing dishes and pots and pans 50. List 6 steps in properly washing your hands 1. Use warm water 110 120 F 2. Apply liquid and build good lather 3. Lather and scrub for 20 seconds 4. Rinse thoroughly 5. Dry hands with paper towel 6. Turn off tap with paper towel 4
Temperature Control 10. Store food in the refrigerator and freezer at what temperatures? Refrigerator 41 F Freezer 0 F or frozen solid 20. What is the preferred temperature for a storeroom and the preferred rotation method? 1. 70 F 2. FIFO 30. What is the preferred thawing method? Thaw in refrigerator Label with pulled date store on bottom shelf. Have a Prep and Pull schedule. 40. What are desirable Trayline temperatures and temperatures at bedside? Trayline: Hot food 135 F (some states 140 F), Cold food 41 F Bedside: Palatable (usually hot food 120 F, Cold food 45 F) 50. List 6 steps in the cool down process of hazardous foods. 1. Transfer to container with depth no greater than 2 inches 2. Label and date 3. Place in refrigerator loosely covered until it reaches 140 F 4. Cool from 140 70 F in 2 hours 5. Cool from 70 41 F in 4 hours 6. Cover lightly and store in refrigerator 5
Food Storage and Preparation 10. What method should be used in tasting food? Two spoon taste method 20. What responsibility does a community have to staff, visitors and families when allowing food to be brought in from outside sources? To teach and help them understand safe food handling practices. Handout suggested. 30. Name 3 forms of contamination. 1. Biological 2. Chemical 3. Physical 40. What should be placed on all food once opened and stored under refrigeration? Use by dates 50. At what temperature should food be reheated to and within what time frame? 165 F within in 2 hours 6
Proper Equipment 10. What must an exposed florescent light have? A shatter guard or shatter resistant bulb 20. How often should the ice making component of the ice machine be sanitized? Bi annually according to manufacture guidelines 30. How many classes are there of Damaged Cans and which class may be used in food preparation? There are 3 classes Class III minor defects may be used in food preparation 40. What common citation was identified by ALFA? Ware Washing not changing water, water nesting and not washing hand between dirty and clean. 50. What is PPE and what is typical PPE? Personal Protection Equipment Rubber gloves, rubber apron and eye protection 7
Sanitizing and Cleaning Procedures 10. What schedule can help sanitation of the dietary department be in compliance? Cleaning schedules 20. List 3 steps in sanitizing a thermometer. 1. Wash in hot soapy water 2. Rinse in clear, clean water 3. Sanitize using single use alcohol swabs 30. How often should sanitation buckets be changed and what test should occur after each change? At least 3 times a day and test with appropriate litmus strips to assure accurate levels of sanitizer. 40. Sanitizing buckets must have appropriate sanitizing solution. What should the bleach level be and what should the quaternary solution be? Bleach 50 100 ppm Quaternary 150 400 ppm or 200 ppm 50. Describe the wash/rinse/sanitize/dry steps for cleaning and sanitizing pots and pans and dishes in 3 compartment sink. 1. Wash with detergent 100 120 F, change water every 30 min 2. Rinse (110 120 F), change water frequently 3. Sanitize test with an appropriate litmus test strips 4. Air dry 8