nebraska state unit on aging: senior center manual …dhhs.ne.gov/medicaid/aging/documents/senior...

Nebraska State Unit On Aging: Senior Center Manual Template

SENIOR CENTER NAME

Table of ContentsIntroduction..........................................................................................................5

Center History......................................................................................................6

Governance and Policy.....................................................................................7

Organizational Structure..............................................................................7

Documents Maintained On-Site.................................................................7

Conflict of Interest Policy.............................................................................8

Confidentiality Policy.....................................................................................9

Staff Volunteers Participants........................................................................10

Staffing.............................................................................................................10

Staff Training..................................................................................................10

Home Delivered Meal Staff Training......................................................11

Equal Employment Opportunity...............................................................11

Anti-Harassment...........................................................................................12

Ethical Conduct..............................................................................................12

Standard of Behavior...................................................................................12

Center Prayer Policy.....................................................................................12

Participant Grievance Procedure.............................................................13

Finance.................................................................................................................14

Contribution Policies....................................................................................14

Use of Tickets.................................................................................................15

In-Kind Contributions...................................................................................15

Fiscal Management......................................................................................15

Monitoring...........................................................................................................17

Center Evaluation Procedures..................................................................17

Areas of Evaluation:.....................................................................................17

Marketing.............................................................................................................18

Targeted Demographic...............................................................................18

Programs and Activities..............................................................................18

Promotional Techniques.............................................................................19

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Monthly Newsletter......................................................................................20

Press Releases...............................................................................................20

Facility Use and Standards............................................................................21

Hours of Operation.......................................................................................21

Emergency Closings and Late Openings..............................................21

Physical Facility.............................................................................................21

Site:................................................................................................................21

Restrooms:..................................................................................................22

Emergency Requirements.........................................................................22

Accident Procedures....................................................................................23

Food Poisoning Procedures.......................................................................23

Gratuities.........................................................................................................24

Selling and Soliciting at the Center........................................................24

Political Activities allowed at the Center..............................................24

Children in the Center.................................................................................24

Animals in the Center..................................................................................24

Alcohol and Drugs.........................................................................................24

Weapon Policy................................................................................................24

Parking..............................................................................................................25

Posting Requirements.................................................................................25

Food Service.......................................................................................................26

Eligibility Criteria...........................................................................................26

Title III C-1 (Congregate Meals)...........................................................26

Title III C-2 (Home Delivered Meals)...................................................26

Dietary Recommended Intake Requirements.....................................26

Meal Standards..............................................................................................26

Menu Approval Process...............................................................................27

Menu Planning Guidelines..........................................................................27

Site Prepared Food Procurement............................................................28

Catered Food Procurement.......................................................................28

Donated Foods...............................................................................................29

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Food Storage..................................................................................................29

Food Preparation...........................................................................................29

Temperatures.................................................................................................30

Congregate:................................................................................................30

Salad Bar:....................................................................................................30

Home Delivered:.......................................................................................30

Emergency Meal Delivery..........................................................................31

Sanitation........................................................................................................31

Leftover Food.................................................................................................31

Removing Food from the Center.............................................................32

Congregate and Home Delivered Meals...................................................33

Congregate Meal Program Guidelines...................................................33

Meal Signature Policies...............................................................................33

Home Delivered Meal Program Guidelines..........................................33

Home Delivered Meal Packaging.............................................................34

Delivery of Home Delivered Meals..........................................................34

Multipurpose Programs and Activities.......................................................36

Multipurpose Guidelines.............................................................................36

Health Promotion:.....................................................................................36

Exercise:.......................................................................................................36

Social and Recreation:............................................................................36

Multipurpose Services.................................................................................36

Transportation Program Guidelines........................................................37

Transportation Standards..........................................................................37

Definitions...........................................................................................................40

Forms....................................................................................................................41

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Introduction This template was created in order to give our Nebraska Area Agencies on Aging and Senior Centers an example of a manual format they can use at their own discretion in creation of Senior Center Manuals.This template is designed to provide examples of content to assist the Agencies and Centers to make their own manual that fits each of their unique needs and requirements. This is meant to be used as a guide in creating your own Senior Center Manual and should not be considered an official mandate.We recognize that each Area Agency on Aging and Senior Center will have different needs and resources. We created this template with flexibility in mind. If a section does not fit your needs, feel free to use what works, or expand on other sections to better cover the programs you have. Much of the information included is based on industry standards, regulations, and statutes. Please review Federal, State, and Local regulations and statutes prior to customizing this manual for your Center.

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Center History Insert local background on the Center.

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Governance and Policy Organizational StructureThe governance of the Center shall be established by written documents. This includes By-laws that establish roles, responsibilities, and the organizational structure of the Center. Federal, state, and local statutes, regulations and policies should be considered when writing governing documents. The Center shall have a written statement of its purpose and goals. These should be based on the needs of the seniors in the area that the Center supports and have measurable outcomes whenever possible. The Center’s governing bodies, staff and participants will develop the Center’s goals and objectives. The planning process should include self-monitoring of goals and objectives.The planning process should involve budget preparations that anticipate the resources needed to reach the Center’s purposes and goals. The budget will be prepared by administrative staff with input from program staff, participants, and governing committees. The Center’s activities and services will dictate the resources required for the budget. The financial planning, management, record keeping and reporting, of the Center’s management staff, should be overseen by the governing board. The governing board should ensure that adequate insurance is provided for the Center.Effective operation management policy should contain the following:1. Employee and volunteer recruitment, hiring, probation and dismissal policies.2. Holidays, vacation, leave and other benefits.3. Employee and participant grievance and disciplinary actions.4. Staff development, training and performance evaluation procedures.5. Mandatory reporting policy and procedures.6. Communication channels for staff and participant input to management.7. An affirmative action policy.

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Documents Maintained On-SiteThe following documents should be kept on file and maintained by the organization: 1. The Charter of the Center. 2. The By-laws of the Center 3. A member list of the Center’s governing entity and advisory entity. The list should include individuals’ names and contact information. 4. Organizational chart. 5. The Policy and Procedures Manual. 6. The Center’s vision, mission, purpose and organizational structure. 7. A description of each of the Center’s programs and services. 8. The current approved budget. 9. A current audit. 10. Job descriptions for each of the Center’s positions. 11. Job applications and resumes for all personnel. 12. The Center’s most current evaluations, including participant satisfaction surveys.13. The Center’s disaster plan.These documents should be reviewed annually and revised as needed.Conflict of Interest Policy1. In all conflicts of interest, the interested parties must make a full disclosure, by notice in writing, to the full Board of Directors, including but not limited to the following situations:

a) A Board member who is related to another Board or staff member by blood, marriage or domestic partnership.

b) A supervisory staff member who is related to another staff member whom they supervise.

c) A Board member, their organization, or staff member of an organization who stands to benefit from a Center transaction, that receives payment from the Center for any subcontract, goods or services other than as part of their regular job responsibilities or as reimbursement for reasonable expenses incurred as provided in the By-laws and Board policy.

d) A Board or staff member who is also a member of the governing body of a contributor to the Center.

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e) A volunteer who meets any of the situations or criteria listed above while working on behalf of the Center.

2. Following a full disclosure, the Board of Directors shall determine whether a conflict of interest exists. The Board will then vote to authorize or reject the transaction. The Board will then take any other action deemed necessary to address the conflict and protect the Center’s best interests. The Board vote shall be a majority vote.3. A temporary leave of absence from all Board activities is required for any Board or Committee members who are formally considering employment with the Center until the position is filled. The Board member’s elected term will not be extended because of the leave. The temporary leave of absence, indicating the time period of the leave, must be submitted to the Secretary of the Center or the Center’s office. The Center will inform the Chair of the Board. The request will be brought to the board for action. The official minutes will show any request and action.4. Anyone in a position to make decisions involving the spending of the Center’s resources who also stands to benefit from that decision, must disclose that conflict as soon as it arises. They cannot participate in any final decisions.5. This policy shall be given to all Board members, staff or other key stakeholders. Each Board member, officer and staff member shall sign and date the policy at the beginning of their term of service or employment and each year thereafter. Failure to sign does not nullify the policy.Confidentiality PolicyAll information supplied by the participants of the Center to the staff, contracted employees, volunteers and interns, must be treated as confidential information. Unless there is a clear need and right to know, the information should not be revealed to any unauthorized person, including other staff. Staff, volunteers, participants and any other involved persons may face discipline up to and including termination for breaching confidentiality by releasing information to unauthorized individuals.

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Staff Volunteers ParticipantsStaffing1. The Center must employ adequate staff to assure satisfactory performance of all programs and activities provided. 2. The Center’s size and scope of services will determine the number and type (full-time or part-time) of staff required. The Center should have a Director.3. If the Center has a significant number of participants who do not speak English, bilingual staff must be available. 4. The Center should provide opportunities for volunteers to assist in daily operations. These volunteers should be made up of seniors, students and community members.5. A volunteer coordinator should be designated to recruit, provide meaningful and accessible volunteer opportunities, and provide initial and ongoing training. 6. Written job descriptions should be available for all staff and volunteer positions. 7. Employees and volunteers should have three references contacted before hiring, two of which are from persons they are not related to. Contact with references must be kept on file. Staff Training1. The Center must provide orientation and ongoing training for all volunteers and staff. Training areas include: Congregate Meals, Home Delivered Meals and Multipurpose Program services. Training sessions should be documented and a training schedule should be developed annually.2. All cooks should possess proper competencies and skills through experience, training or certification. It is recommended that all cooks obtain a Food Manager’s certification. Continuing education should include attending seminars, food shows and workshops.3. Health Department certification requirements for staff and facility must be in compliance. Any individuals that work directly with food should obtain a Food Handler's permit. The Center is responsible for providing training on all applicable food service requirements. 4. Staff and volunteers should attend training sessions offered by other organizations whenever feasible and appropriate.5. Staff and volunteers should receive comprehensive training during orientation and be provided ongoing training year round.

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Supervisors should utilize a variety of methods to obtain appropriate training, including outsourced trainings by other organizations, videos and other educational media, staff meeting training and individual study modules. 6. All food handlers should complete a food safety and sanitation course within one month of employment. 7. There should be at least one staff present at the Center who has successfully completed a Certified Food Manager course. Home Delivered Meal Staff Training1. To ensure the safety and well-being of participants, particular care should be exercised when training home delivery staff and volunteers. Staff and volunteers that deliver meals shall be at least eighteen (18) years of age. Volunteers under 18 may assist with the delivery process if accompanied and assisted by a Center designated volunteer or staff person. 2. It is recommended that volunteers completing community service hours that are court-ordered, or are the result of any type of disciplinary action, must never ride on any home delivered meal route, nor have any access to home delivered meal records and participant information. 3. Home delivered meal training should include the following:

a) Participant medical emergency response. b) Appropriate homebound participant and caregiver

interactions. c) Methods to detect changes in participant functioning or

status.d) Homebound participant social needs.e) Participant changes in physical or mental status reporting. f) Barriers to service delivery reporting methods.

Equal Employment OpportunityThe Center will provide an equal opportunity for all employees in compliance with applicable state, local and federal laws and without regard to non-work-related factors such as race, color, religion, creed, sex, national origin, age, disability, citizenship, marital status, status as a veteran of the Armed Forces and sexual orientation.Anti-HarassmentIn a commitment to a healthy work environment, the Center must be free of any form of harassment, including sexual harassment based on gender, pregnancy, childbirth, or related medical

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conditions, as well as harassment based on race, color, creed, national origin, ancestry or citizenship, age, physical or mental disability, marital status, genetic history, sexual orientation or any other categories protected by law. Unlawful harassment of employees by managers, supervisors or coworkers will not tolerated. Harassment by employees or non-employees with whom its employees have a business, service or professional relationship, will not be tolerated. The Center will also protect employees from harassment by non-employees in the workplace. Ethical ConductUse of intoxicating beverages or illegal drugs on the job or on the premises, unsatisfactory or unprofessional conduct, or insubordination at any time on the part of the staff, could be grounds for dismissal. All conduct violations will be discussed and evaluated by the Director for further action.Standard of BehaviorInappropriate, abusive or improper behavior could result in removal from the Center, suspension or termination of the privilege of attending. All conduct violations will be discussed and evaluated by the Director for further action.1. Anyone who appears to be under the influence of alcohol or illegal drugs while in or around the Center will be required to leave. Transportation will be arranged.2. Abusive or defamatory language, threats or physical violence will not be tolerated. 3. Participants within the Center are expected to have good personal hygiene and proper manner of dress. 4. Participants attending the Center should be able to function independently within the Center with the use of adapted equipment as needed. Center Prayer PolicyThis policy affects any program or service supported by federal and state funds.The Center should post a notice identifying that participants have a free choice to be involved in participant led prayer. The Center will not encourage, discourage, sponsor, lead or organize participant prayer preceding an event or activity.Denominations or requests for a moment of silence for personal reflection should not be discouraged.


Participant Grievance Procedure1. Participant grievances should first be discussed with the Center Director.2. The time, place and nature of the complaint should be recorded.3. The Center Director will attempt to satisfy the grievance. 4. If the participant is not satisfied, the participant may, in writing, submit the grievance to the Chairman of the Center Board.5. The Chairman will attempt to satisfy the grievance.6. If the participant is not satisfied, the participant may, in writing, submit their grievance to the Executive Director of the AAA. At the discretion of the Executive Director, the Center Director and Chairman will be brought into the meeting.7. The Executive Director will either uphold or reverse the decision reached at the local level. The Executive Director will inform the grievance participants by holding a conference with the participant, the Center Director, and the Chairman. Documentation will be kept on file.8. If any party is dissatisfied with solutions proposed by the Executive Director, the party may appeal the decision, in writing, to the Executive Committee of the AAA Governing Board.9. The Executive Committee will consider and weigh the facts of the grievance. If necessary, the Executive Committee will call any of the parties involved to clarify or elaborate further. The Executive Committee will then discuss the complaint and sustain or refute the Executive Director’s solution. The decision of the Executive Committee is final.


Finance Contribution Policies1. The Center will develop a suggested voluntary contribution for meals. The policy of the Center and its governing board determine the suggested voluntary contribution rate. Contribution rates should include eligible participants and non-eligible participants.2. The non-eligible meal rate should cover the entire cost of preparing and serving the meal.3. An opportunity for congregate and home delivered meal participants to make a voluntary and confidential contribution will be provided. 4. To provide the privacy needed for participants, the contribution box shall have a barrier protecting the declaration or non-declaration of contributions. For confidentiality reasons, contribution boxes should be away from the front desk.5. Participant contributions should be recorded as program income (revenue) in the budget. Contribution revenues must be reported and used for the specific service program from which it was received. 6. Participants should be encouraged to contribute whatever they can, whether it is higher or lower than the suggested amount. Participants’ inability or unwillingness to contribute must not exclude them from services.7. Center volunteers should be offered the opportunity to contribute. 8. Participants should be periodically reminded of the value of contributions to services and programs.9. Written contribution procedures should be given to home delivered meal participants.10. Suggested contribution posters should be posted at strategic locations throughout the Center. Locations should include on or near the sign-in desk and on the contribution box. 11. Confidential methods to make contributions must be provided for participants. The Center will ensure that participants will not be pressured to contribute by staff, volunteers or other participants. 12. Receipts for contributions will be provided upon request from participants. Individual participant records and contribution habits of participants must not be maintained by the Center.


13. The non-eligible meal rate of the congregate meal will be charged to all guests and staff who eat lunch at the Center. The non-eligible meal price should be posted on or near the sign-in desk.Use of TicketsTickets may be used in place of daily contributions. Tickets must not have a set value associated with them or a dollar value printed on them. The Center must provide procedures to allow participants wanting a ticket to make a voluntary contribution without volunteers having access or knowledge of the amount of the contribution.In-Kind Contributions1. Any In-Kind Contribution may be counted if the contribution item is one the Center would have purchased. 2. The estimated value of the contribution should be fair and reasonable. If the value of the contribution is in doubt, it is better to under-value an item rather than over-value. 3. Examples include: rent, furniture, recreational supplies, flowers, paper, food products and lawn services.4. The known or estimated dollar amount of In-Kind Contributions should be reported on monthly fiscal reports. 5. Minimum wage will be used when crediting volunteer service hours. 6. Volunteer service can be credited for a higher value if the volunteer possesses the required qualifications in the skill or profession, and actually performs that specific type of skill during the volunteer’s work.7. Volunteer time should be considered In-Kind Contributions when being recorded.8. Third party donated services include: chore, homemaker, trips used for transportation or assisted transportation, etc.Fiscal Management1. It is recommended that cash contributions should be counted, recorded and deposited on a daily basis. 2. Procedures should be in place to keep congregate and home delivered meal program contributions separate. 3. After each service, contributions should be counted by two (2) people simultaneously, recorded and signed off on. Numbered receipts should be used for daily and mailed collections.


4. Cash disbursements should not be made out of the daily cash collections.5. All payments should be made by serial numbered checks except for small disbursements that can be taken from the petty cash fund. All checks should have two signatures.6. A petty cash fund should be used for all payments that are not check payments. A fixed amount should be established for the fund and reimbursed periodically to bring the cash up to the authorized amount. Vouchers with serial numbers should be used for petty cash payments. The voucher format should be prepared in ink with spaces for signatures of the payee and authorized official.7. All bank accounts and bank statements should be reconciled monthly. Copies of the reconciliations should be retained.8. Prior to issuing a purchase order or contract, all purchases of goods, services and equipment, should be authorized. Purchase orders with serial numbers should be used.9. Records of received goods and services should be maintained.10. Check payments to vendors, which are submitted for signature, should be supported by proper documentation including: invoices, requisition forms, purchase orders and receiving reports. Petty cash disbursements should be accounted for by signed receipts. 11. To prevent resubmission for future payment of signed checks issued to vendors, supporting documents should be canceled by perforation or stamped Paid.12. Comparative financial statements should be prepared monthly. The statements should provide enough detail to disclose significant variations in any revenue or expense category. If any significant variations are found, they should be investigated and the reasons for them should be determined.13. Records retention schedules should follow the Nebraska Secretary of State, Schedule 156.


Monitoring Center Evaluation ProceduresThe Center should have adequate procedures to self-monitor, evaluate and report on its operation and programs. The program planning process should include the on-going monitoring and assessment of activities and services. Continual monitoring of the entire Center program will be done by (AGENCY).Areas of Evaluation:Operations, programs, activities and services should be evaluated to examine the extent that they:1. Meet the needs of the community.2. Address and are consistent with the Center’s mission.3. Are consistent with Center’s policy & procedures.4. Achieve the stated objectives of each program.5. Provide for the needs and satisfaction of the participants.6. Provide for the safety of participants, staff and volunteers.7. Are adequate for the demand of the community.8. Are accessible to any and all interested participants.9. Do not unnecessarily duplicate an existing program or service.10. Are fiscally efficient.11. Are administered and staffed effectively.12. Are marketed to the community effectively.13. Enhance the visibility and image of the Center throughout the community.14. Ensure that all programs and services are compliant with contracts from all funding sources.15. Ensure that all programs and services are complaint with the Older Americans Act and NAC Title 15.16. Ensure that the Center is in compliance with Federal, State and Local laws.Note: Information resulting from evaluations should be shared with the Board of Directors, staff, volunteers, funding sources, participants and the general public on a regular basis.


MarketingTargeted DemographicThe Center will target the demographic of people age 60 and over, their spouses, caregivers, and people with disabilities. The Center will also target those caring for people over age 60 and anyone from the general community that wishes to serve or support people over age 60.Programs and ActivitiesThe Center strives to prolong successful independence in the community with providing these programs and activities.1. Education Programs2. Trips3. Socials4. Social Services 5. Volunteer Opportunities6. Fitness Facilities and Activities7. Clubs and Groups8. Special Events9. Support Groups10. Physical and Mental Health Screenings11. Handicap Accessible Transportation and Facility12. Medicare Assistance13. Information and Assistance14. Outreach15. Meals on Wheels16. Caregiver Resource Center17. Caregiver Support Group18. Respite Opportunities19. Community InvolvementPromotional Techniques1. The monthly newsletter is the primary tool for marketing services, activities and programs. Local businesses may be allowed to advertise in the newsletter. This could include special feature articles.2. The Center maintains details on all services, contact information, the most recent newsletters, annual reports and more on the website (WEBSITE).


3. A quarterly print or e-newsletter highlighting special events and other efforts at the Center will also be distributed.4. Local press outlets will be utilized to publicize events and programs through press releases.5. The Center will consider using their participants for marketing resources, such as photo opportunities, to help promote special events and fundraisers. Home delivered meal driver stories will also be considered.6. The Center uses email to distribute information.7. A Facebook page will be maintained by the staff in order to share information and updates about the Center.8. Staff should attend functions in the community that provide an opportunity to distribute information and showcase the programs and activities of the Center. This can include volunteer fairs.9. Flyers and brochures will be used to advertise special events and fundraisers.10. Print articles written for publications should be used to highlight what the Center has to offer.11. Promotional materials should be provided to local doctors’ offices, physical therapists and 60+ communities. 12. Staff should promote and attend Annual Health and Wellness Fairs.13. The Center should participate in the charitable events provided by other nonprofit organizations. 14. Other organizations should be allowed to provide support groups at the Center. The groups should be open to participants and the general public.Monthly Newsletter1. Coordinate a date, towards the end of the month, to have the newsletter labeled and mailed.2. Throughout the month collect information on programs and events given by groups and staff. Establish a date when all information needs to be received by. 3. Coordinate the advertising of business pieces in the newsletter 4. Make any final adjustments and have the Director and staff approve. 5. Send the final copy to the publishing company.6. The Director will complete the bulk mail process and take the newsletter to the post office for delivery. The Director will also coordinate sending out mass emails of the newsletter.


Press ReleasesUsing new information from the newsletter each month, update the information for the release and include special events, fundraisers and support groups. Email contacts at least two weeks prior to events and fundraisers.


Facility Use and Standards Hours of OperationThe Center will operate (DAYS OF THE WEEK) during the hours of (HOURS OF THE DAY).The Center will observe the 2017 holidays of:

HOLIDAY 1 HOLIDAY 2 HOLIDAY 3 HOLIDAY 4 HOLIDAY 5 HOLIDAY 6

HOLIDAY 7 HOLIDAY 8 HOLIDAY 9 HOLIDAY

10

HOLIDAY 11

HOLIDAY 12

Emergency Closings and Late OpeningsThe Center will follow the public schools decision on whether to close or change hours due to inclement weather or other emergency conditions. Announcements will be made through local broadcast media and staff will be notified via phone call by the Director.Physical FacilityThe Center’s physical facility must be maintained in accordance with all applicable federal, state, and local health, fire, safety, building, zoning, and sanitation laws, ordinances and codes. This includes the requirements of Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act.Site:1. Facilities must be free of architectural barriers that limit participation.2. All areas of the facility must have adequate lighting. This includes emergency lighting in areas of the facility without sufficient natural light.3. Exits must be clearly marked and kept free of obstacles and obstructions.4. Lighted exit signs must be checked regularly and in proper working order.5. Equipment must be sturdy and appropriate for older individuals, this includes tables and chairs.6. Adequate aisle space between tables must be provided to accommodate persons with walkers, canes, crutches and wheelchairs.


7. Wheelchair ramps must be available where needed.8. Floors, steps, ramps and sidewalks must be kept in good condition and free from debris. For temporary hazards such as wet floors, portable hazard signs must be used.9. The facility should be cleaned daily.Restrooms:1. At least one toilet stall must be handicap accessible.2. Bathroom stall locks must be easy to manipulate and in proper working order.3. Participants with disabilities must be able to access soap dispensers, disposable towels or air-drying devices.4. Restrooms must be thoroughly cleaned daily.Emergency Requirements1. The Director must develop written emergency plans for dealing with emergencies, including, but not limited to: heart attack, stroke, medical emergencies, fire, power failure and natural disasters. The Center should consult with local emergency management agencies and other relevant agencies while developing their plans.2. The Center shall be equipped with adequate emergency first aid supplies and equipment.3. A written record of all incidents shall be filed by the Director and kept on file for review whether or not there is apparent injury or property damage.4. Personnel shall be designated and trained as emergency preparedness officers in the Center. The Center must ensure there is always at least one staff present who is certified in Cardiopulmonary Resuscitation (CPR) and First Aid.5. Appropriate individuals to contact in case of an emergency must be included into written emergency procedures. The following shall be posted throughout the Center:

a) Telephone numbers for fire department, police, ambulance, hospital emergency room, local emergency management offices and the Center address. It is strongly recommended that these be located by each phone.

b) Steps to be taken in each type of emergency.c) Location of first aid kits, fire extinguishers and other

emergency supplies.d) Evacuation routes.

6. Written procedures for fire safety shall be developed. This must include instructions for conducting fire drills and the annual


inspection and maintenance of fire extinguishers and smoke detectors.7. Evacuation drills must be held quarterly. Personnel from local emergency agencies do not have to be present. Participants must receive instruction on the closest exits, the designated meeting place and safe evacuation procedures. All staff at the Center should participate. Drills must be documented and kept on file.8. Emergency disaster drills shall be held annually. The Center should request the assistance of local emergency management offices, wherever feasible.9. First aid training for staff and volunteers should include techniques such as cardiopulmonary resuscitation, the Heimlich maneuver and first steps in emergency situations. Training shall be held annually. 10. The Center shall be equipped with adequate emergency first aid supplies and equipment. Accident ProceduresIf there is any evidence of bodily injury, no matter how small, the participant must be checked by a medical doctor. If necessary, the participant shall be taken to the nearest hospital.Document the accident as soon as possible. Be complete, accurate and add as much detail as possible. This information may be needed for litigation purposes. Note: If the participant refuses all attempts to be checked, still document the accident and keep it on file.Food Poisoning ProceduresIn cases where food poisoning is suspected:1. The participant must contact a doctor immediately. If any chance of food poisoning is suspected, ask the participant to have the doctor call the Center.2. Immediately contact and check every person for illness that ate at the Center that day. Notify the Area Agency. If the participants are found to be ill, repeat the first procedure listed above for each participant.3. Immediately make arrangements to collect food samples to be checked by the hospital or laboratory.GratuitiesGratuities for services provided by funds from the Older American’s Act and 15 NAC are discouraged. If Area Agencies on Aging chose to allow gratuities, policies and procedures must be compliant with all applicable law.


Selling and Soliciting at the CenterNo soliciting, selling or vending will be allowed in the Center, either by participants, Center employees or persons outside the organization. The only exception would be in the case of an approved non-profit organization or community project.Political Activities allowed at the CenterThe Center will make the decision of whether to allow politicians to visit their facility for their campaign. If the Center allows one campaign, the Center must allow every campaign that requests speaking time. Participants can establish time limits for speaking and what, if any, materials to be distributed. Children in the CenterChildren must be accompanied by a responsible adult while in the Center. Exceptions may include volunteer program participants who have obtained prior approval from the Director. Animals in the CenterAnimals are prohibited from being brought into the Center. Exceptions may include service dogs, therapeutic animals and animals which are part of a presentation or special event. Alcohol and DrugsThe Center is a drug and alcohol free workplace. The Center prohibits the sale, use or unauthorized possession of alcohol (without a license), illegal drugs, misuse of prescribed, controlled or any other harmful substances on the premises. Employees may be requested to submit to drug or alcohol testing if they appear unfit or unable to perform their duties. Employees found to have drugs or alcohol in their system, or employees who refuse testing, will be subject to disciplinary action up to and including termination.Weapon PolicyCarrying, possessing or using any firearms or other dangerous weapons on the premises of the Center is strictly prohibited.ParkingThe Center parking lot is located (LOCATION RELATIVE TO THE CENTER) and is accessible from (STREET). Handicapped parking is located (LOCATION). If a participant’s car will need to be left in the parking lot after hours, the Director must be notified first. The Center is not responsible for vehicles in the lot.Posting RequirementsThe Center must meet Federal and State posting requirements. The Center shall post the following:


1. Participant Grievance Procedures.2. Emergency Procedures.3. Evacuation Routes.4. Proof of Quarterly Fire Drill.5. Proof of Annual Fire and Building Inspection.6. Proof of Annual Fire Extinguisher Inspection.7. Title VI Civil Rights Notice.8. Equal Employment Opportunity Poster.9. OSHA Safety and Health Poster.10. Fair Labor Standards Act Poster.11. Telephone numbers of fire department, police, physicians, ambulance, hospital, emergency room and local emergency management offices.12. Steps to be taken in each type of emergency.13. Location of First Aid Kits, Fire Extinguishers and other supplies.14. Monthly Calendar of Events.


Food Service Eligibility CriteriaTitle III C-1 (Congregate Meals)

1. Age 60 and over.2. Spouses of individuals age 60 and over.3. Person with Disability residing with eligible participant.4. Person with Disability at Senior Centers located in Housing

Facilities primarily occupied by older individuals.5. Volunteer.

Title III C-2 (Home Delivered Meals)1. Age 60 and over.2. Participant’s Spouse.3. Person with Disability residing with eligible participant.4. Person with Disability at Senior Centers located in Housing

Facilities primarily occupied by older individuals.Dietary Recommended Intake RequirementsThe special needs and requirements of the elderly must be considered in menu planning, food selection and meal preparation. Each meal served must contain at least one-third of the current Dietary Recommended Intake as established by the Food and Nutrition Board of the National Academy of Science – National Research Council. Meal Standards

1. 2-3 ounces cooked edible meat or alternate equivalent2. 2 servings (a total of 1 cup) of vegetables3. 1 serving (3/4 cup or 5-6 ounces) of fruit4. 2 ounces whole grain items5. 1 tsp butter/margarine or alternate (if appropriate)6. 8 ounces milk

Menu Approval ProcessOn a regular basis a Registered Dietitian will monitor menus and provide comments and suggestions where appropriate.Menu Planning Guidelines1. Staff is encouraged to conduct formal and informal surveys of participants’ likes and dislikes before planning each menu. Examples include nutrition committees, menu planning sessions, suggestion boxes and written surveys. These surveys should include home delivered meal participants.


2. Menus should provide a variety of color, form, texture, temperature, flavor and cultural customs. Menus should also be low in salt, sugar and fat.3. The Center should utilize volume cookbooks or computer software to assist with planning and providing recipes. Be sure to consider food costs, cooks’ skills and production procedures when finalizing decisions.4. In season fresh fruits and vegetables should be used to provide optimal nutrition and be cost efficient.5. The same flavor should not be repeated too often, in the same meal or the same week. 6. The same food should not be served two days in a row or during the same day two weeks in a row.7. Fried foods should be limited to no more than two (2) times in a six (6) week cycle. 8. Processed meats including: ham, hot dogs, sausages, lunchmeats, chicken, and turkey rolls, should not be served more than three (3) times in a six (6) week cycle. Cheese and meat entrees that are high in fat should be used one (1) time in a six (6) week cycle.9. All mixed green salads should include a variety of lettuces, greens and at least three (3) additional vegetables, amounting to four (4) vegetables in total. Do not serve only iceberg lettuce as a salad. Identify the specific salad vegetables on the menu (i.e., tossed salad with carrots, tomatoes and cucumbers).10. Limit gelatin, yogurt, pudding, frozen desserts, to once (1) weekly. Gelatin must not be served plain. It must contain vegetables, fruit or fruit juice to provide the appropriate nutritional value. Gelatin should be identified on the menu as “Fruited Gelatin.” Do not use the brand name term “Jell-O”.11. Including dessert, meals should not include more than three (3) high carbohydrate items.12. Baked desserts should be limited to one (1) time a week. Nutritious baked desserts include peanut butter and oatmeal raisin cookies, apricot cobbler, pumpkin pie, custard, carrot cake, pineapple upside-down cake, rice crispy squares, lemon pie and strawberry shortcake. Substituting fruit juice for water in the mix or recipe will increase the nutritional value.13. Do not count any variety of chips (potato, corn, tortilla, etc.) as a vegetable or bread serving.


14. Meal presentation should be enhanced by using garnishes such as parsley, kale, a lemon or orange slice, a tomato wedge, a melon slice, etc.15. The approved menu must be posted in each kitchen including any catered kitchens.16. Monthly menus should be posted and distributed to participants one week in advance.17. Menus must be kept on file for audit purposes.Site Prepared Food ProcurementFor on-site food preparation: 1. Price quotes should be collected and compared between vendors every quarter. 2. Product from food deliveries must be checked for accuracy and quality before receiving. 3. Food purchasing procedures must ensure that raw food costs remain at the level established in the contract with the Area Agency. Catered Food ProcurementFor commercially catered meals: 1. A bidding process must be conducted prior to contracting with a caterer. A copy of the subcontract with the caterer must be made available to the (AAA) annually. 2. Temperature checks of all hot and cold foods must be taken and recorded upon delivery. The recommended temperature for hot foods is 165 degrees F or above. The recommended temperature for cold foods 40 degrees F or lower. Temperature checks must be kept on file and reviewed periodically for compliance. 3. Catered hot foods received with temperatures below 140 degrees F must immediately be reheated to 165 degrees F, and only served after the 165 degrees F temperature is reached. Donated FoodsOnly food contributions from an approved source will be accepted, such as grocery stores and food vendors. Food that is grown, prepared or packaged at home is not an approved source. Meat must be federally inspected and milk must be pasteurized and homogenized. Do not accept any food which shows signs of mold or spoilage.Food Storage1. Temperatures in the freezers and refrigerators must be monitored daily with internal thermometers. External integral


digital thermometers are not acceptable. A separate thermometer must be placed inside the unit at a place near the door to ensure acceptable temperatures. Thermometers should be calibrated on a regular basis. 2. Storage temperature standards:

a) Storeroom between 40 degrees F and 70 degrees F b) Refrigerator between 32 degrees F and 40 degrees F c) Freezers 0 degrees F or below

3. Food items must be used in a First in First out (FIFO) rotation based on purchase date. 4. Food items and paper goods must be stored at least 6” off the floor in dry storage, refrigerators and freezers. 5. All chemicals and cleaning equipment must be stored separately from food storage or food preparation equipment and must be labeled. 6. Any program supplies, including arts and crafts, must not be stored in food storage areas. 7. Food removed from their original containers must be labeled and dated. 8. Remove any dented cans. Food Preparation1. Food preparation procedures should prioritize maximizing labor, equipment and time efficiency. 2. Frozen foods should be thawed in the refrigerator, in the microwave or under cold running water. Frozen foods should never be thawed at room temperature.3. When preparing, serving, holding and storing food, preservation of nutrients should be prioritized. 4. The holding time from cooking to service should not exceed two (2) hours.TemperaturesCongregate: 1. Hot food must be held at 140 degrees F and above. Cold foods must be held at 40 degrees and below. If hot food has fallen below 140 degrees F, it should be reheated to a minimum of 165 degrees F before serving.2. Temperatures of all food items must be taken daily and recorded. Checks should be done immediately before the first meal and after the last meal is served. 3. Forms are required to keep on file and available for review.


Salad Bar: 1. Before and after serving is completed, each individual item on a salad bar must have a temperature taken.2. A calibrated handheld thermometer should be used to check each salad bar item. Do not use the refrigerator thermometer for temperature checks. 3. Temperatures must be logged and recorded daily for review.Home Delivered: 1. Temperature checks must be taken before meals are sent on the route. A daily temperature log of these checks must be kept. 2. Hot foods must be maintained at 140 degrees F or above. Cold foods must remain below 40 degrees F. Hot and cold foods must be delivered in separate containers. 3. The transporting equipment, packaging materials and procedures used to deliver meals must be able to maintain hot food temperatures at or above 140 degrees F and cold temperatures at or below 40 degrees F from the time of packing to the time of delivery to the home of the participant. There should be no more than a 4 to 6 degrees drop in temperature per hour.4. Once a month, an extra meal must be sent so temperature checks can be taken of each food item before and at the end of the route. These checks are required to be recorded and kept on file for review.Emergency Meal DeliveryA written emergency and contingency plan for congregate and home delivered meal delivery in case of fire, flood, natural catastrophe or facility problem must be developed and kept on file at the Center. This should include a three-day emergency menu with supplies on hand for implementation. In addition, the Center must continually update the plan to ensure that the plan may be implemented when needed. Sanitation1. All personnel including volunteers are encouraged to wear hairnets, plastic gloves (when handling ready to eat items) and aprons in the kitchen.2. All personnel including volunteers must wash hands thoroughly before preparing food and after every interruption. After preparing raw foods, wash and sanitize all contaminated surfaces before handling other foods.3. Personal items need to be stored away from any areas that handle food or food production.


4. All personnel, including volunteers, are encouraged to wear plastic gloves when wrapping silverware and setting up the dining room.5. Dining room tables must be properly washed and sanitized prior to each meal service. Sanitizers must be changed every 4 hours or sooner and solution strength tested. When not in use, wash cloths must be kept in sanitizing solution.6. All raw fruits and vegetables must be washed before preparation.7. Since handles can contaminate food, utensils must not be left in the food. Scoops must not be left in flour, sugar and other containers.8. Fresh food should not be added to the previous pan for serving, serve the product fully then exchange the pan. Leftover Food1. Food production should result in minimal leftovers. Leftover food should first be offered as second helpings to participants. 2. All catered leftover hot or potentially hazardous foods must be discarded. 3. The only hot foods acceptable as leftovers are vegetables and meats. They should not be re-used as the original product. Most can be used in soups or casseroles (i.e. leftover roast beef may be made into soup; it may not be served again as a roast). Menus should be followed when using leftovers or a menu substitution may be made. 4. Leftover food should be properly stored, sealed and labeled with the name of the food, the date the food was prepared and the date of discard. 5. Leftover food can be stored for no longer than three (3) days in a refrigerator or three (3) months in a freezer. 6. Staff may not take any food from the Center. Removing Food from the CenterThe safety of food after it has been served to a participant and when it has been removed from the Center is the responsibility of the recipient. This activity should be discouraged. Signs must be posted in the dining room stating: "For health reasons, taking out food is not recommended. Doing so is at your own risk."


Congregate and Home Delivered MealsCongregate Meal Program Guidelines1. Congregate meals are intended to be served as a hot meal. For menu variety, cold meals may be occasionally provided. 2. Cooked or prepared food brought by participants that is meant to be a substitution to the congregate meal cannot be brought into the Center. 3. A meal reservation system should be used to provide the cooks with a specific number of meals to prepare. Reservations should be taken at least 24 hours in advance. The Center should prepare some additional servings in case of walk-in participants.4. At least two nutrition education programs must be planned and implemented each quarter. Credible sources must be used. Sessions should be advertised at least four weeks in advance, and documentation of the activity kept on file at the Center. Meal Signature Policies1. Participants must sign for their own meal on each day they receive a meal, this includes all congregate and home delivered meals. Participant signatures substantiate the number of meals that are reported.2. AAA monitors will periodically conduct assessments and or audits of signature sheets.3. If participants are not able to sign their name, a staff or volunteer witness shall write the participant's name on the signature sheet and initial beside the written participant's name.4. Signature sheets must be maintained on file.Home Delivered Meal Program Guidelines1. Home delivered meals shall primarily be served as hot lunch meals. For menu variety cold meals may be provided. Every meal must meet all AAA requirements.2. Proper written information on meal storage and re-heating methods must be given to all participants. 3. Printed nutrition education materials, provided by the Center, shall be sent at least (COUNT) times per quarter to all home delivered meal participants. Whenever possible the literature should be written in the participants’ dominant language.


4. A copy of the Center’s grievance procedure must be given to the home delivered participant at the time of enrollment and as requested. 5. Any complaints received from participants and case managers must be investigated and responded to in writing. Within 14 calendar days of receiving a complaint, copies of the complaint and written responses must be sent to the (AAA). 6. All unusual incidents must be reported within 2 days, in writing, to the (AAA). If 911 emergency assistance is involved, the incident must be reported within 24 hours to an (AAA) staff person. Case managers should be notified immediately regarding any concerns about the participants’ environment, health or well-being.Home Delivered Meal Packaging1. Immediately after being packaged, meals must be loaded into the home delivered meal carriers. 2. An adequate heat source must be available for all hot meal carriers.3. Bread items should be packaged separately from hot foods.4. Cold foods and hot foods must be packed in separate containers. An adequate cold source must be available for all cold meals.5. In order to assist delivery drivers with identifying meals going to participants with special diets, modified diet meals must be clearly labeled. 6. Home delivered meals carriers must be sealed tightly immediately after packaging. 7. A sufficient number of home delivered meal carriers must be maintained. 8. Home delivered meal carriers must be thoroughly cleaned and sanitized daily and maintained in good condition. Delivery of Home Delivered Meals1. Participants’ names, addresses and any special delivery instructions must be logged into a route sheet. The route sheet must be used by the driver. 2. Meals should be delivered to participants within two hours of being packaged in order to maintain food safety. The sequence of deliveries must be designed to minimize the time necessary for all meals to be delivered, while allowing for some interaction as part of a daily welfare check.


3. Delivery routes should be mapped for the most efficient use of time and resources.4. Meal carriers must be kept closed during all times except for meal delivery. 5. Delivery of the meal must be made directly to the participant. If the participant is not home to receive the meal, the meal must be returned to the Center. 6. The delivery driver must assist the participant in opening meal containers as needed or requested. 7. Home delivered meal supervisors are required to accompany the driver(s) on each route at least quarterly. This observation ride would include assisting with the meal delivery process to ensure that the delivery is conducted according to standards. Each route observation should be documented.8. The delivery vehicle must be neat, clean and clear of any trash at all times.


Multipurpose Programs and ActivitiesMultipurpose GuidelinesThe following programs and activities should be provided on a regular basis: Health Promotion:Health Promotion Disease Prevention Programs should focus on programs that specifically promote better health and nutrition for participants. Examples include: lectures, screenings, disease prevention and home safety. Health Promotion Programs must be evidence based.Exercise: Exercise Activities should focus on programs that promote the physical well-being of participants. Exercise classes should be geared to a range of skill levels to encourage greater participation. Social and Recreation:Social and Recreation Activities should focus on structured programs that promote the mental and social well-being of participants. Examples include: classes, crafts, games, parties, trips, etc. Individual activities do not qualify as a structured activity. Overall program variety should include different types of activities chosen from the Health Promotion, Exercise and Social and Recreation programs.Multipurpose ServicesThe Center must offer the following services in conjunction with community agencies and participant volunteers. 1. The Center should maintain a current resource file on services available to seniors. Staff should be familiar with the various application processes for each service. Resource files should contain:

Housing Physical Health Mental Health Transportation Financial Assistance

Legal Services Support Groups Government Programs Residential Repair Food Assistance

Other relevant information should also be maintained on file. 2. Information and Assistance as well as referral services can be offered by:


a) Providing information to participants about relevant services in the community.

b) Linking the participants to needed services. c) Providing follow up as needed.d) Referring to Area Agency on Aging for additional Care

Management services as needed. 3. The development of activities and programs must actively include Center participants. Committees or other planning groups for participants should be developed in order to provide input and assistance with program planning and development. For effective marketing and outreach, a monthly calendar of the programs, services and a current menu should be developed and distributed to participants and community resource centers. 4. Intergenerational programs of mutual benefit should be provided by planning and developing activities with input from all involved age groups and community members. Examples include: tutoring services, parties, celebrations and other community service activities. 5. The Center may be used as a distribution site by food programs, such as pantries.Transportation Program Guidelines1. Transportation services are focused on to and from the Center. Refer participants with additional transportation needs to community resources. 2. Participants should be informed of the suggested contribution and encouraged to contribute towards the cost of the service. Confidential methods for participants to contribute must be established by the Center.3. In order to collect and report the demographic information, each transportation participant must be registered with the Center.4. Records must be regularly reviewed by staff to ensure that only Center participants receive the services.5. The Center must review and set the suggested contribution amounts for transportation services annually. Transportation StandardsThe Center shall comply with the following standards and licensure requirements: 1. The vehicle(s) utilized for transportation must have valid license plates and a minimum coverage of uninsured and underinsured motorists insurance.


2. The vehicle shall be constructed for the purpose of transportation of persons and wheelchair bound riders. All seats must be securely fastened to the body of the vehicle and have seat belts installed. When the vehicle is in operation, all participants must be properly seated and properly using seat belts.3. Individuals providing transportation must be a minimum age of eighteen (18) years and possess a valid operator's license. If Assisted Transportation is provided, drivers must be capable of assisting participants with entering and exiting the vehicle, including securing them within the vehicle. They must carry agency identification.4. Staff and volunteers should be trained in:

a) CPR (Cardiopulmonary Resuscitation), first aid and appropriate response protocol for emergency or urgent situations.

b) Full vehicle equipment and operation training including optional manual over-rides on any equipment.

c) Appropriate methods of interacting with participants and observation techniques to detect changes in health and welfare.

d) Contribution procedures to allow all participants to contribute and ensure confidentiality during the process.

5. Transportation service should be available to eligible participants during regular hours of operation. 6. The highest degree of care is required with the operation of equipment and assistance of participants. Each driver providing Assisted Transportation Services to participants must be able to help participants with getting on and off the vehicle and transferring between their home and the Center. 7. The number of bags or packages that participants may have on board may be limited by the Center. If necessary, assistance with the packages from destination to destination will be given by the driver. 8. Assure that all federal, state, and local laws, regulations, ordinances, licenses and inspections governing vehicles are followed before vehicle service is begun and at all times during service. 9. Maintain all vehicles in good working condition. The Area Agency reserves the right to inspect vehicles prior to and during a contract to ensure their safety, and to immediately remove from the program any vehicle it deems unsafe until necessary


corrections are made. All equipment used must be cleaned regularly and kept clean during service. 10. For the added safety and convince of participants, vans and buses should be equipped with comfortable sized steps, grab bars and seat belt extenders. 11. Each vehicle must be equipped with a working fire extinguisher and stocked first aid kit. 12. Communication equipment for every vehicle used in the program must be provided.13. All drivers should practice good hygiene and are required to be well groomed. Drivers and participants onboard the vehicle are prohibited from smoking, expectorating, eating and drinking alcoholic beverages.


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