Download - Nutrition Training - AgingFlorida.net
N O V E M B E R 7 , 2 0 1 8
Nutrition TrainingPresented By: Carole Mackey, Kristina Melling,
Abbie Walters, & Angela Brito
Agenda
Introductions Reporting & Record Keeping Review of Updated Handbook
& Recent NOIs Reminders Best Practices Food Safety Dietary Guidelines Questions & Answers
Reporting Reminders and Record Keeping
Dietician Approved Menus Due on the 15th of each month. Please send all reports to
Please note that all menus must be signed and approved by the providers contracted dietician at least 4 weeks before implementation.
The approving dietician's signature and date must be on every page of the posted menu.
Reporting Reminders and Record Keeping
Menu Substitutions
Due on the 15th of each month
The documentation must include: date of the substitution, the substitution made, the reason for the substitution, and the signature of the employee authorizing the substitution.
Reporting Reminders and Record Keeping
Nutrition Education Documentation Due on the 15th of each month Written documentation of Nutrition Education should include:
date of presentation, name and title of presenter, lesson plan or curriculum, length of presentation and sign in sheets.
Each episode of Nutrition Education must be at least 15 minutes in length.
The documentation requirement for materials delivered to HDM clients shall include the date of distribution, copy of distributed material, and number of clients receiving the information.
Nutrition education should be developed by RD.
Reporting Reminders and Record Keeping
Temperature Logs Due on the 15th of each month Documentation must include: Time menu items delivered,
each menu item and serving size, temperature of each potentially hazardous menu items must be taken:
When the food is received by the nutrition site; If there is more than 30 minutes between when the food is
received at the meal site and when it is served, then a temperature of each food item must document again at the time the meal is served and if a provider prepares the meal on site, then temperature must be taken and recorded when the food is leaving the production area.
Reporting Reminders and Record Keeping
If food was not at temperature requirements, clearly document what was done (reheat meal in microwave for 60 seconds, etc.). Document at what temperature the food was served.
Food grade probe-type thermometers must be used; other thermometers such as infrared thermometers cannot be used to take food temperatures. Thermometers must be correctly calibrated at least weekly, to ensure accuracy. Also, they must be cleaned and sanitized between uses.
Reporting Reminders and Record Keeping
Nutrition Program Compliance Review (NPCR) Due quarterly (April, July, October, & January 15th) Complete this form quarterly at each meal site. It must be
completed once per year by: 1) A nutrition consultant (registered dietician) and 2) A nutrition program service provider’s administrative staff member. And twice per year the form should be completed by the meal site manager or designee.
If any items are out of compliance, be sure to send follow up documentation that the issue was addressed and resolved.
Reporting to SCC
As conducted: Food Safety Training (minimum of 1x per year staff &
volunteers). Training must be developed by RD. Advisory Council Documentation (minimum of 2x per year) Media Releases
Verification RD Requirements are met: Copies of RD license (at least annually) Contract Agreement with RD (at least annually) These items are collected in the annual Service Provider
Application
Annual Contract and Monitoring Report for Food Service Vendor
FROZEN HOME DELIVERED MEALS
When delivered to the client, the temperature should be 20˚ F or frozen solid.
DOEA Form 217 must be used to evaluate client’s ability to: Follow written directions on label Heat the meal Has freezer space to store up to 7 frozen meals Has working equipment (freezer, microwave, or oven)
Form 217 is to be kept in client’s file.
2018 DOEA Programs & Services Handbook
Food service vendor requirements (Ch. 4, pp. 160-164) “The food service vendor must not have had any
Temporary or permanent closures, Administrative Complaints regarding food safety, or 10 or more high priority/significant findings on sanitation
inspections within the past 12 months,beginning July 1, 2018”
Notify provider immediately of any closures or Administrative Complaints regarding food safety
Notify provider within 24 hours of any sanitation inspections Provide a written plan of correction for any high priority or
significant findings on sanitation inspections
2018 DOEA Programs & Services Handbook
Provider RD requirements (Ch. 4, p. 113) Monitor, at least annually, every food service vendor’s
sanitation inspection reports Review corrective action plans of food service vendors for all
significant or high priority findings on sanitation inspection reports
2018 DOEA Programs & Services Handbook
Access to Food Service VendorSanitation Inspection Reportson DBPR Website GA Food Service – St. Pete Facility
myfloridalicense.com/inspectionDates.asp?SID=&id=2236139 GA Food Service – Fort Myers Facility
myfloridalicense.com/inspectionDates.asp?SID=&id=2195442 Metz Culinary Management – Sarasota Facility
myfloridalicense.com/inspectionDates.asp?SID=&id=6881343
2018 DOEA Programs & Services Handbook
Expiration Dates All ready-to-eat (or drink) foods must have an
expiration, use-by, sell-by, or best-by date andbe received before the date occurs (Ch. 4, p. 146)
Food that has passed its expiration date, use-by date, sell-by date, or best-by date cannot be served to clients (Ch. 4, p. 147)
Policies and procedures shall be developed and implemented to address instances when milk is received without an expiration date or past the expiration, sell-by, best-by, or use-by date (Ch. 4, p. 136)
If milk is received frozen, the milk must be scheduled to be consumed prior to the expiration date (Ch. 4, p. 179)
2018 DOEA Programs & Services Handbook
When there is a break in service at a congregate meal site, the provider must notify and receive approval from SCC for the site to resume services and billing (Ch. 4, p. 104)
LTC clients receiving C1 (Ch. 4, p. 157 & p. 176)
REMINDERS
Make sure meal site managers are following menu serving size if serving food.
Include begin and end times on nutrition education documentation.
Inform your contract manager by email of any planned meal site closures.
All food service staff and volunteers must receive annual training by a RD, or competent Certified Food Protection Manager under the direction of the RD, on the prevention of foodborne illness. Staff and volunteers must be trained prior to assuming food
service assignments.
Best Practices
Food Waste Food Quality Food Preparation Advisory Council Meetings
ACL Innovation Grants
• Foodborne illness• Food contamination• Personal hygiene• Preparing, cooking, and serving
foods• Receiving and storing foods• Cleaning and sanitizing
Areas of Discussion
Microorganisms
• The major cause of a foodborne illness
• You cannot feel, see, or taste
• Very quick to multiply in potentially hazardous foods
• Most of the foods we eat contain one or more type of microorganism
Potentially Hazardous Foods
Foods capable of supporting the rapid and progressive growth of harmful microorganisms: Milk, milk products Shelled eggs Sprouts, raw seeds Melons Soy-protein foods Corn, rice, potatoes, peas
Fish Shellfish Meat—beef, pork, lamb Poultry Cooked rice, beans, other
heat-treated plant foods
How Do Microorganisms Grow?
FAT TOM• Food (potentially hazardous foods)• Acid (pH slightly acidic or neutral)• Temperature (danger zone: 41˚F−140˚F)• Time (less than 4 hours)• Oxygen (presence of)• Moisture (water helps growth)
Foodborne Illness
• Caused by bacteria:— Salmonellosis— Shigellosis— Vibrio gastroenteritis— Hemorrhagic colitis— Staphylococcal gastroenteritis— Botulism
• Caused by virus:— Hepatitis A
Cross Contamination
• A food service worker handling the food contact area of a plate or glass
• An employee preparing cooked food where raw food was placed without properly cleaning and sanitizing the area first
Types of Hazardous Substances
Physical: Hair, bandages, dirt, metal items, and fingernails
Biological: Bacteria, viruses, parasites, and toxins
Chemical: Cleaning products, toxic metal residue, and pesticides
Ways Food Can Become Contaminated
Poor personal hygiene: Leading cause of foodborne illnesses Improper hand washing Dirty work clothes
Temperature and time abuse: 41˚F−140˚F is the danger zone No more than 4 hours in the danger zone
Cleaning and sanitizing
Basics of Good Hygiene
• Good personal grooming• Clean clothes• Proper use of aprons• Hair restraints• No jewelry• Trimmed and clean fingernails
Serving Food Properly
Hold plates by the bottom or at the edge:
Never touch the food-contact surface
Hold cups by bottom or handle:
Never put fingers on the rim of the glass
Never put fingers inside the glass
Hold silverware by the handle:
Never touch the food-contact surface
Serving Food Properly (cont’d)
Use long-handled utensils, such as tongs or scoops,
for one food only
Never allow your hands to come in contact with the
food
Scoop ice with proper utensil, not a cup
Restrictions From Work
If you or a worker is experiencing:• Sore throat• Runny nose• Diarrhea• Fever• Vomiting
BEST PRACTICE IS TO GO HOME
Proper Hand Washing
Rinse hands in warm water (about 105˚F)
Apply hand soap
Scrub hands and exposed arms for 20 seconds—do not forget between fingers and under rings
Rinse hands
Use a single-serve towel or air dryer
Apply hand sanitizer (optional)
Proper Hand Washing (cont’d)
Never wash your hands in a prep sink or dish-
washing sink
Wash hands in a designated hand-washing station
Do not substitute hand sanitizer for proper hand
washing, but you can use hand sanitizer after hand
washing
When to Wash Hands
After using the bathroom After touching bare body parts After coughing, sneezing, or using tissues After eating, drinking, or smoking After handling soiled equipment or utensils After food preparation After clearing table or dishes After removing or disposing of trash
Proper Use of Gloves
Gloves can contaminate as well; do not rely on
gloves to feel you are safe
Change gloves:
After completing a task and beginning a new task
If they become dirty
After handing raw meat, poultry, or fish
Before handling ready-to-eat or cooked food
Proper Care of Cuts, Burns, Sores, Infections
Report to supervisor
Cover with a clean, dry bandage
May need reassignment to nonfood contact duties
Wash each time you put on a new bandage
Proper Use of a Thermometer
Clean and sanitize stem of thermometer prior to
each use with alcohol
Insert thermometer into the thickest part of the
food
Do not allow thermometer to touch the base of the
pan
Proper Use of a Thermometer (cont’d)
Wait a minimum of 15 seconds after the needle
stops moving to take the temperature reading
Wipe thermometer stem in between foods
Calibration of a Bimetallic-Stemmed Thermometer
Fill a container with ice and add drinkable water
Place thermometer stem into ice water making
sure it is submerged
Allow 30 seconds from the time the needle stops
moving
Calibration of a Bimetallic-Stemmed Thermometer (cont’d)
Locate adjusting nut and hold securely
Rotate until needle reads 32˚F (do not remove
thermometer from water while adjusting)
Accepting and Rejecting Food Delivery
Use the senses (smell, sight, and touch) when
inspecting a food delivery
Reject food when you notice:
Signs of pests
Ice crystals in box or package of food
Torn, broken, or damaged boxes, packages, or cans
Expiration/use-by date has passed
Dry foods are damp
Storage of Food
FIFO—first in, first out
Store foods in original packaging, whenever
possible
Clearly label all foods with date
Storage of Food (cont’d)
Do not overload shelves or store food on floors or
against walls
Store all foods a minimum of 6ˮ above the floor on
clean shelves or racks
Store food only in protected areas, never in
restrooms or utility rooms
Definitions
Cleaning: Involves the removal of food, residues,
dirt, and grease
Sanitizing: Reduces harmful microorganisms to a
level that is safe through the use of a chemical-
sanitizing solution
Cleaning
Use cleaning agents that remove food, soil, and
stains
Examples: Rinsing dishes, sweeping the floor,
and removing dust from overhead vents
Clean entire kitchen on a regular basis
Sanitizing
Use high heat or chemical sanitizers
Must sanitize anything that comes in contact with
food
Sanitize all dishes, pots and pans, utensils, knives,
and worktables after each use or every 4 hours
Clean and sanitize knives and utensils when
moving from one food item to another
Sanitizing Work Surfaces
Use facility-approved sanitizing solution in spray
bottles
Have test strips available to test sanitizer
concentration
Use clean clothes when sanitizing
Sanitize prep sinks after each use
Preventing Foodborne Illness
Purchase, store, and prepare food carefully
Have thermometers available; keep them
calibrated and use them
Practice good personal hygiene
Clean and sanitize regularly
Education References
National Restaurant Association Educational Foundation. Serve Safe Essentials. 5th ed. Chicago, IL: National Restaurant Association Educational Foundation; 2008.
Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.
Nutrition and Health Are Closely Related
“About half of all American adults—117 million individuals—have one or more preventable chronic diseases, many of which are related to poor eating
and physical activity patterns.”
Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.
The Dietary Guidelines for Americans: What It Is, What It Is Not
Provide evidence-based recommendations about the components of a healthy and nutritionally adequate diet
Focus on disease prevention rather than disease treatment
Inform Federal food, nutrition, and health policies and programs
2015-2020 Dietary Guidelines for Americans:The Guidelines
1. Follow a healthy eating pattern across the lifespan. All food and beverage choices matter. Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease.
2. Focus on variety, nutrient density, and amount. To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.
3. Limit calories from added sugars and saturated fats and reduce sodium intake. Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns.
Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.
2015-2020 Dietary Guidelines for Americans:The Guidelines (cont.)
4. Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices. Consider cultural and personal preferences to make these shifts easier to accomplish and maintain.
5. Support healthy eating patterns for all. Everyone has a role in helping to create and support healthy eating patterns in multiple settings nationwide, from home to school to work to communities.
Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.
Inside Healthy Eating Patterns:Food Groups
“Eating an appropriate mix of foods from the food groups and subgroups—within an appropriate calorie level—is important to
promote health.”
Each food group and subgroup provides an array of nutrients.
Recommended amounts reflect eating patterns associated with positive health outcomes.
Foods from all of the food groups should be eaten in nutrient-dense forms.
Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.
Major Messages from Chapter 2
The U.S. population, across almost every age and sex group, consumes eating patterns that are: low in vegetables, fruits, whole grains, dairy, seafood, and oil high in refined grains, added sugars, saturated fats, sodium, and for some age-sex groups, high in the meats, poultry, and eggs
subgroup.
Young children and older Americans generally are closer to the recommendations than are adolescents and young adults.