Approval Signature: Date of Approval: July 7, 2011 Review Date: July 2014

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Operational Directive: Infection Prevention & Control for Food Handling and Preparation Page 1 of 6 Personal Care Home/Long Term Care Facility Infection Prevention and Control Program Operational Directive Infection Prevention & Control for Food Handling and Preparation Approval Signature: Supercedes: Page 1 of 6 Date of Approval: July 7, 2011 Review Date: July 2014 Infection Control in Dietetics March 2002 1.0 PURPOSE: 1.1 Infection prevention & control practices for food handling reduces the possibility of pathogen transmission within the dietary department as well as other areas within the personal care home where food is prepared and handled. This is not an all inclusive document. For further information refer to facility policies/procedures for dietary and food handling regulations. 2.0 OPERATIONAL DIRECTIVE: 2.1 Safe food handling procedures must be followed to minimize or eliminate food contamination and to prevent the growth of potentially infectious organisms. 2.2 Infection prevention &control education for food handling must include frequent and proper hand hygiene, adequate food temperature control, cleaning of food contact surfaces, sanitization and storage of equipment and utensils, proper food storage and preparation. 2.3 The terms of the City of Winnipeg By-Law No. 5160/89 and Manitoba Regulation 339/88R must be implemented. 2.4 A valid permit is issued annually by the City of Winnipeg or Province of Manitoba (depending on jurisdiction). This permit must be displayed in a visible area. 2.5 All dietary staff require a Food Handler Certificate. 2.6 The on-duty person in charge must have their Food Handler Certificate posted in a prominent place in the dietary department.

Operational Directive: Infection Prevention & Control for Food Handling and Preparation Page 2 of 6 2.7 An individual with a valid Food Handler Certificate must be on site at all times during food service operations 3.0 PROCEDURE: 3.1 Food Handling and Storage 3.1.1 Purchase quality food that has been inspected from approved sources. 3.1.2 Food shall be protected from contamination at all times. 3.1.3 Potentially hazardous foods shall be kept hot or cold, as appropriate, at all times. 3.1.4 All food shall be stored in clean insect and rodent - proof covered containers, labeled, and dated. 3.1.5 Containers of food shall be stored a minimum of 16cm off the floor. 3.1.6 Food requiring refrigeration shall be rapidly cooled and kept at a temperature of 5 degrees Celsius (41 degrees Fahrenheit) or below. 3.1.7 Frozen food shall be kept frozen and stored at or below 18 degrees Celsius (0 degrees Fahrenheit). 3.1.8 The internal temperature of potentially hazardous foods requiring hot holding shall be held at 60 degrees Celsius (140 degrees Fahrenheit) or above except during preparation. 3.1.9 All pre-cooked, refrigerated or frozen potentially hazardous food shall be reheated rapidly to a minimum internal temperature of 74 degrees Celsius (165 degrees Fahrenheit) prior to being hot held at 60 degrees Celsius (140 degrees Fahrenheit). 3.1.10 All pre-cooked, refrigerated or frozen potentially hazardous food, referred to as fully out sourced products, received from WRHA Nutrition and Food Services (NFS) shall be reheated to an internal temperature of 70 degrees with a minimum holding time of 8 minutes. (Refer to letter from Manitoba Health Protection Branch- Evaluation Division Bureau of Microbial Hazards dated Wednesday, December 22, 1999). 3.1.11 The first time food is cooked the internal temperature should be 70 degrees Celsius. 3.1.12 Frozen foods should be thawed: in refrigerator units at temperatures not to exceed 5 Celsius(41 degrees Fahrenheit; or under cold potable running water with sufficient water velocity to agitate or float off loose food particles; or as part of the cooking process; or in a microwave oven 3.1.13 Dishes are to be free of chips and cracks.

Operational Directive: Infection Prevention & Control for Food Handling and Preparation Page 3 of 6 3.2 Dietetic Personnel and other food handlers 3.2.1 All food handlers (e.g. recreation staff and residents) and dietary staff must follow Routine Practices. 3.2.2 A high standard of personal hygiene must be maintained to prevent contamination of dishes, utensils, food contact surfaces and food. 3.2.3 All dietary staff shall: 3.2.3.1 Wash their hands and exposed portions of the arms before entering the dietary area and as necessary to keep clean. Perform hand hygiene before starting work, after using the bathroom, after breaks, after coughing or sneezing, after handling raw food and contaminated food surfaces, after removing gloves. 3.2.3.2 Maintain personal cleanliness and practice good hygiene. 3.2.3.3 Wear clean clothes and footwear. 3.2.3.4 Not wear artificial nails/gel nails, have long natural nails greater than ¼ inch or chipped nail polish. 3.2.3.5 Wear effective hair restraints at all times in the dietary area. 3.2.3.6 Report illnesses that may be communicable, particularly those involving, diarrhea, nausea, or vomiting, to occupational health or designate. Dietary staff may be excluded from the food service establishment, if contamination of food or food contact surfaces is likely to occur. 3.2.3.7 Report to the occupational health nurse or designate following a communicable disease before returning to work in the dietary department. 3.3 General Cleanliness 3.3.1 Food and beverages must not be consumed in the kitchen or service areas. 3.3.2 Hand washing/hygiene stations should be easily accessible in the food preparation area, and provided with hot and cold water, soap, disposable towels and alcohol based hand rub if appropriate. Hand-washing stations shall not be used for any other purpose than hand washing. 3.3.3 Frequent and effective hand hygiene must be carried out when working in a food environment. If hands are not visibly soiled alcohol based hand rub may be used.

Operational Directive: Infection Prevention & Control for Food Handling and Preparation Page 4 of 6 3.3.4 Bare hand contact with food should be minimized. Use utensils for food contact whenever possible. If hands must be used for food contact, perform hand hygiene frequently. If disposable gloves are used, change and dispose gloves frequently such as when changing tasks or touching non-food contact surfaces. Hand hygiene shall be performed every time gloves are removed. 3.3.5 Any staff food handlers with open sores on their hands shall report to the occupational health nurse or designate prior to beginning the shift to determine necessary work restrictions. 3.3.6 Cutting blocks, cutting boards, salad bowls, and preparation tables should be hard maple or an equivalent non-absorbent material. No potentially hazardous food shall be served on other wooden boards. 3.3.7 All food contact surfaces shall be cleaned after each use with a facility approved sanitizing solution and cloth. Cloths should be used for no other purpose, and shall be kept in a sanitizing solution when not in use and laundered daily. 3.3.8 Sanitizing solutions must be tested as per manufacturer s recommendations to ensure proper concentration. 3.3.9 Kitchen or food preparation areas shall be clean and free from clutter and garbage. 3.3.10 There shall be an established regular cleaning schedule for the food storage areas to keep the areas clean and minimize the risk of insects and rodents. 3.3.11 Garbage should be kept in durable, easily cleanable, insect and rodent-proof covered containers that do not leak or absorb liquids. 3.4 Dishwashers 3.4.1 Where mechanical dishwashers or glass washers are used in the dietary area: 3.4.1.1 Wash water must be maintained at a temperature of not less than 60 degrees Celsius. 3.4.1.2 Items must be sanitized by rinsing with a solution of at least 50 PPM of available chlorine at a temperature of at least 24 degrees Celsius for at least 20 seconds, or items must be sanitized by rinsing with a solution of at least 12.5 PPM of available iodine with a ph range effective at 24 degrees Celsius, or raising the surface temperature of the items to a temperature of 71 degrees Celsius for at least 10 seconds or utensils or tableware must be treated with any chemical sanitizing agent acceptable to the Medical Officer of Health or Public Health Inspector.

Operational Directive: Infection Prevention & Control for Food Handling and Preparation Page 5 of 6 3.4.1.3 A NSF (National Sanitation Foundation) certified commercial mechanical dishwasher is required for seating capacity of 50 seats or more where reusable utensils or tableware are used. 3.5 Sinks 3.5.1 All sinks and equipment shall be constructed and repaired with safe materials. They should be corrosion resistant and nonabsorbent, smooth, easily cleanable, resistant to denting, buckling, pitting, chipping and crazing, free of breaks or open seams, and free from difficult to clean internal corners and crevices. 3.5.2 All sinks and drainage boards shall be self-draining. 3.5.3 A sink with no fewer than 3 compartments, located in the dietary area shall be used where utensils, tableware or kitchen ware are manually cleaned and sanitized. 3.5.4 Sink compartments shall be large enough to permit the accommodation of the equipment and utensils to be washed and each compartment of the sink shall be supplied with hot and cold potable water. 3.5.5 Where manual cleaning and sanitizing methods are used, all utensils, tableware or kitchenware shall be scraped and prerinsed to remove coarse particles of food, washed in the first sink in a clean hot detergent solution, rinsed in the second sink in clean warm water, sanitized in the third sink, and then air dried. For areas where 3 sinks are not available (i.e.: recreation areas) it is recommended to set 3 plastic bins on the counter. 3.6 Hand Washing Areas 3.6.1 Hand washing areas should be conveniently located in the food preparation area for dietary staff, and shall not be used for any other purpose than hand washing. 3.6.2 Sinks used for food preparation or for washing equipment and utensils shall not be used for hand washing or for disposal of waste water from cleaning operations. 3.6.3 A supply of hand soap shall be available at each hand washing sink. 3.6.4 A dispenser containing a supply of single- use towels shall be conveniently located near a hand washing sink. Shared towels are prohibited. If disposable towels are used, easily cleanable waste receptacles shall be conveniently located at the hand washing facility. 3.6.5 Hand washing sinks, soap dispensers, hand-drying devices, alcohol based hand rub dispensers, and all related fixtures shall be kept clean and in good repair.

Operational Directive: Infection Prevention & Control for Food Handling and Preparation Page 6 of 6 3.7 Toilet Facilities 3.7.1 The toilet rooms in the dietary department shall: Not open directly into any room where food or utensils are handled or stored. Have hand hygiene signs posted in toilet rooms used by staff. 3.7.2 Toilet fixtures shall be kept clean and in good repair. A supply of toilet tissue in a dispenser shall be provided at each toilet at all times. Easily cleanable garbage cans shall be provided for waste materials. Toilet rooms used by women shall have at least one covered waste receptacle. 4.0 REFERENCES: 4.1 Canadian Restaurant and Food Services Association, (September 1993).The sanitation code for Canada s Foodservice Industry 4.2 Manitoba Health Protection Branch- Evaluation Division Bureau of Microbial Hazards dated Wednesday, December 22, 1999 Letter 4.3 The City of Winnipeg By-law No. 5160/89. A by-law of the City of Winnipeg to regulate food service establishments. Accessed October 29, 2010 http://www.winnipeg.ca/clkdmis/docext/viewdoc.asp?docume nttypeid=1&docid=525 4.4 The Public Health Act. Manitoba Regulation 339/88 R. Food and food handling establishment s regulations. Accessed October 27, 2010 http://web2.gov.mb.ca/laws/regs/pdf/p210-339.88r.pdf 4.5 WRHA Policy # 90.00.60 Routine Practices for Reducing the Risk of Infection Transmission Accessed November 2, 2010 http://home.wrha.mb.ca/corp/policy/files/90.00.060.pdf Operational Directives Contact: Betty Taylor, Manager, PCH Infection Prevention & Control PCH Infection Prevention & Control Advisory council Approved for wide distribution (March 4, 2011) Distributed to ICPs & Directors of Care for review & comments (March 8, 2011) with return date March 15, 2011 ) PCH Infection Prevention & Control Advisory Council Approved (March 16, 2011) Directors of Care Approved (June 21, 2011) Executive Directors Approved (July 7,2011)