Food Safety & Sanitation

Older Americans Act 2000 Requirements

SECTION 339 Nutrition

(2) ensure that the project ---

(C) encourages providers to enter into contracts that limit the amount of time meals must spend in transit before they are consumed.

(F) comply with applicable provisions of State or local laws regarding the safe and sanitary handling of food, equipment, and supplies used in the storage, preparation, service, and delivery of meals to an older individual.

B. MANAGEMENT AND PERSONNEL

Management’s primary responsible is to provide safe food to consumers. All levels in the network, whether at a state, AAA, or local provider level, have a management function of assuring safe food in the OANP. To ensure food safety, management has the responsibility and duty of demonstrating knowledge of foodborne disease prevention and implementing Hazard Analysis Critical Control Point (HACCP) principles and requirements of the Model Food Code. Other important responsibilities referenced the Model Food Code include:

Complying with the state and local food codes,
Minimizing liability issues,
Dealing with crises, such as food recalls, food illness outbreaks, equipment breakdowns, and other emergencies,
Ensuring personnel follow appropriate food safety and hygiene practices,
Being a certified food handler,
Providing a safe place to work,
Keeping equipment in good operating order,
Publishing rules for good safety, and
Training employees in proper food safety principles

Food safety is achieved in a foodservice establishment when both employees and management properly perform their duties. Below are additional examples of management responsibilities from the 2001 Model Food Code and SUA policies and procedures.

2001 Model Food Code

Supervision (Part 2-1):

It is recommended that the supervision of the foodservice establishment shall be designated to management or an individual in charge who has the responsibility and duty of ensuring that personnel follow appropriate food safety and hygiene practices. Management or person(s) in charge shall also demonstrate knowledge of foodborne disease prevention, application of the Hazard Analysis Critical Control Point principles, and the requirements of the Model Food Code.

Employee Health (Part 2-2):

Management or person in charge shall require foodservice personnel (applicants to whom a conditional offer of employment is made and current foodservice employees) to report information about their health and activities as they relate to diseases that are transmissible through food.

Personal Cleanliness (Part 2-3) and Hygienic Practices (Part 2-4) :

Good hygienic practices are important to ensuring that food is not contaminated with bacteria, foreign objects or chemicals. It is important that all foodservice workers maintain a high standard of personal hygiene and cleanliness. Some hygienic practices that every foodservice worker should follow include: frequent hand-washing, personal hygiene, hair restraints, wearing appropriate attire (clean clothes, aprons, closed-toe shoes) and limited jewelry, keeping fingernails trimmed, filed, and maintained, abstaining from smoking, chewing gum and other unhygienic practices in food handling areas, and covering all wounds on hands or arms.

Sample SUA Food Handling Standards/Guidelines

California

All food handlers and servers shall be free of communicable disease. If an employee or volunteer is believed ill or a carrier of a communicable disease, she/he shall be restricted from performing food preparation and service activities. Clearance from a physician may be requested by the provider prior to permitting the employee to return to work.
All food handlers and servers shall wear clean, washable clothing, close-toed protective footwear, and hairnets, caps, or other suitable hair coverings to prevent contamination of foods, beverages and/or utensils.
All food handlers and servers are prohibited from using tobacco in any form while preparing, handling, or serving food or beverages. Tobacco shall not be used in any form in any room or space used primarily for the preparation or storage of food. Projects shall post and maintain “No Smoking” signs in such rooms or places.
All food handlers and servers shall use tongs or other implements while serving food. If hand contact with the food is unavoidable, disposable hand coverings shall be worn.
All food handlers and servers shall thoroughly wash their hands prior to beginning work, after using the toilet and every time hands are soiled.
Hand washing facilities in good repair and equipped with hot and cold running water shall be provided for employees within or adjacent to the food preparation area.
A permanently installed detergent or soap dispenser and single use paper towels or hot air blowers shall be provided at or adjacent to all hand washing facilities.
Legible signs shall be posted in each toilet room directing employees that they shall wash hands with soap before returning to work.

Food Safety Training and Education

Providing OANP staff and participants with information and educational materials for food safety is important in reducing the risk of food-borne illness. Because there are large numbers of volunteers who work in OANP dining centers and who deliver meals to homes, providing them with food safety training is important. It is recommended that either SUAs or AAAs indicate in their policies and procedures that OANP providers, including caterers, train staff in food safety and that this recommendation be included in any service contract.

The 1995 National Evaluation of the OANP found about 36% of SUAs reporting state certification for food service sanitation in their state. The Evaluation also found that sanitation and food safety training was mandatory for different program personnel in a number of states. Such training was most frequently mandatory for food service aides, site managers, and nutrition project directors. Thirty-three percent of the SUAs reported that training was not mandatory at the project or site levels (10).

Training of OANP staff and volunteers is an important component to ensure food safety. Managers and/or supervisors must assume a primary responsibility for food safety and sanitation training in a food establishment. Some SUAs require training for all program personnel. For example, food service managers and other staff members may be required to complete a course provided by their local Health Department to be certified as a “Food Handler.” Certification of specific food service personnel is often required by the State Health Department.

Foodservice Certification Courses

Below are some programs that provide certification for food protection managers. For certification requirements, contact the local regulatory agency. A list of State health agencies can be found at: www.fda.gov/oca/sthealth.htm

ServSafe®
A comprehensive food safety education and training program developed by the Educational Foundation of the National Restaurant Association that is widely recognized by many federal, state and local jurisdictions. The program combines thorough training in all areas of food safety. The ServSafe® certificate verifies that an individual has successfully passed the ServSafe® Food Protection Manager Certification Examination. www.edfound.org

Certified Food Protection Professional (CFPP)
The Dietary Managers Association's CFPP credential is geared toward the foodservice professional. Options for the food protection course are a 16-hour classroom food safety training course, independent study via print materials, or independent online study. www.dmaonline.org

National Certified Professional Food Manager (NCPFM)
Experior AssessmentsTM administers the NCPFM exam, which tests knowledge, skills, and abilities related to food protection, and the ability to organize and supervise employees within the work environment. The NCPFM exam is appropriate for site supervisors, managers, or first line supervisors in establishments that prepare and serve food. www.experioronline.com

Certified Food Safety Manager
This certification, offered by the National Registry of Food Safety Professionals, Inc., serves the foodservice industry, regulatory agencies, and academia. The Food Safety Manager Certification Examination is designed to be used with any food safety training program available on the market. www.nrfsp.com

Food Safety Information and Training Resources for Professionals

A number of food safety and sanitation training resources are available. Below are several websites that provide training information:

Office of Regulatory Affairs Training & Human Resource Development:
http://www.fda.gov/ora/training/course_ora.html

Foodborne Illness Education Information Center: Provides a multiplicity of food safety education information and materials.
http://www.nal.usda.gov/foodborne/index.html

Foodborne Illness Education Information Center: Provides links to information on distance learning, on-line courses and curriculums.
http://www.nal.usda.gov/foodborne/fbindex/032.htm

Many resources are also available in languages other than English. A few sources are listed below:

Food Safety Foreign Language Materials
http://www.nal.usda.gov/foodborne/fbindex/037.htm

Food Safety Training Materials in Foreign Languages
http://peaches.nal.usda.gov/foodborne/fbidb/forlang.asp

The National Food Service Management Institute: Food Safety Mini Posters:
http://www.nfsmi.org/Information/postindx.htm

Food Safety Information and Material for Consumers/OANP Participants

Food safety education for OANP participants, especially those receiving home delivered meals, helps prevent foodborne illness. Studies show that home-delivered meal participants often save food from their meals to eat later in the day (11-13). Most home-delivered meal participants do not consume their meal immediately upon delivery (13). Therefore, it is important that OANPs educate participants and their caregivers about proper storage and heating of meals not immediately consumed and/or if portions of the meal are saved to eat later in the day. Dining center participants should also be educated about the risks associated with taking food out from the dining site.

Resources and materials for consumers and older adults include:

Food Safety Publications:
www.fsis.usda.gov/oa/pubs/consumerpubs.htm
The Foodkeeper: A Consumer Guide to Food Quality and Safe Handling http://www.fmi.org/consumer/foodkeeper/foodkeeper.pdf

Food Safety Education and Consumer Information
http://www.fsis.usda.gov/OA/consedu.htm
To Your Health! Food Safety for Seniors
http://www.foodsafety.gov/~fsg/sr2.html
Seniors and Food Safety. Preventing Foodborne Illness
http://vm.cfsan.fda.gov/~dms/seniors.html
Seniors Need Wisdom on Food Safety
http://www.fsis.usda.gov/OA/pubs/seniors.htm

Sample SUA Food Safety Training Standards/Guidelines

California

Quarterly in-service training shall be provided for all paid and volunteer food service personnel, including home-delivered meal personnel.
At least two of the quarterly in-service training sessions shall include the prevention of foodborne illness and all food service personnel as defined in Subsection 147.5c. shall attend.
Prevention of foodborne illness training shall include the principles of Hazard Analysis Critical Control Point (HACCP).

Connecticut

Appropriately instruct clients or their caregivers on the following safe practices for handling delivered food, as they may apply:
- to eat hot food within 1 hour of delivery.
- to eat cold foods immediately or place them in the refrigerator.
- to eat fast chilled meals within 3 days of delivery and to store them at 40 °F or less (edited).
- to eat frozen meals within 1 month of delivery and to store them at 10°F or less.
- to have an accurate thermometer in their refrigerator if they store fast chilled meals, and one in their freezer if they store frozen meals.

C. FOOD

Food Safety

Inadequate food temperature controls are common factors contributing to foodborne illness. Unless food is properly handled when purchased, stored, prepared, and served, contamination may occur. Proper food handling practices help prevent foodborne illness. Written guidelines should reflect the type of foodservice operations in place. There are different requirements to prepare and serve hot meals at dining centers and to the homebound than for meals prepared and delivered from a central kitchen. Likewise, the preparation and/or service of frozen meals require specific procedures. Regardless of the type of congregate or home delivered meal prepared and/or served, a critical element in maintaining food safety is to cook foods to appropriate temperatures and to keep perishable food products out of the temperature danger zone (between 41°F and 140°F).

Food and other products such as utensils and dinnerware must be packaged and delivered in a manner that prevents contamination and maintains proper food temperatures. State of the art food carrier and transport systems can safely deliver cold and hot food items and/or meals at proper temperatures within acceptable time frames. Protecting food from contamination is dependent upon the development of suitable standards and procedures and ensuring that these guidelines are followed. The Partnership for Food Safety Education's Fight BAC!^®, formed in 1997, is a public-private coalition dedicated to educating the public about safe food handling to help reduce foodborne illness. Members represent industry, government (including USDA, FDA, CDC) and consumer groups, as well as alliances with corporate America. Below are four steps (verbatim) for keeping food safe developed for the Fight BAC!^® campaign (http://www.fightbac.org/foursteps.cfm). The website has many other resources and links. Also refer to Chapter 3 in the Model Food Code for additional guidance.

Step 1. Clean: Wash hands and surfaces often

According to food safety experts, bacteria can spread throughout the kitchen and get on to cutting boards, knives, sponges and counter tops. Here's how to Fight BAC:

Wash hands in hot soapy water before preparing food and after using the bathroom, changing diapers and handling pets. For best results, consumers should use warm water to moisten their hands and then apply soap and rub their hands together for 20 seconds before rinsing thoroughly. Twenty seconds is the same amount of time it takes to sing two choruses of Happy Birthday. After hands are washed, they should be dried with a paper towel or with an air hand-drying device.
Wash cutting boards, knives, utensils and counter tops in hot soapy water after preparing each food item and before going on to the next one.
Use plastic or other non-porous cutting boards. Cutting boards should be run through the dishwasher or washed in hot soapy water after use.
Consider using paper towels to clean up kitchen surfaces. Or, if using cloth towels, consumers should wash them often in the hot cycle of the washing machine.

Step 2. Separate: Don't cross-contaminate

Cross-contamination is how bacteria spread from one food product to another. This is especially true for raw meat, poultry and seafood. Experts caution to keep these foods and their juices away from ready-to-eat foods. Here's how consumers can Fight BAC!:

Separate raw meat, poultry and seafood from other food in the grocery-shopping cart.
Store raw meat, poultry and seafood on the bottom shelf of the refrigerator so juices don’t drip onto other foods.
If possible, use one cutting board for raw meat products and another for salads and other foods that are ready to be eaten.
Always wash cutting boards, knives and other utensils with hot soapy water after they come in contact with raw meat, poultry and seafood.
Never place cooked food on a plate which previously held raw meat, poultry or seafood

Step 3. Cook: Cook to Proper Temperatures

Food safety experts agree that foods are properly cooked when they are heated for a long enough time and at a high enough temperature to kill the harmful bacteria that cause foodborne illness. The best way to Fight BAC is to:

Use a meat thermometer, which measures the internal temperature of cooked meat and poultry, to make sure that the meat is cooked all the way through.
Cook roasts and steaks to at least 145°F. Whole poultry should be cooked to 180°F for doneness.
Cook ground meat, where bacteria can spread during grinding, to at least 160°F. Information from the Centers for Disease Control and Prevention (CDC) links eating undercooked, pink ground beef with a higher risk of illness. If a thermometer is not available, do not eat ground beef that is still pink inside.
Cook eggs until the yolk and white are firm, not runny. Don't use recipes in which eggs remain raw or only partially cooked.
Cook fish until it is opaque and flakes easily with a fork.
Make sure there are no cold spots in food (where bacteria can survive) when cooking in a microwave oven. For best results, cover food, stir and rotate for even cooking. If there is no turntable, rotate the dish by hand once or twice during cooking.
Bring sauces, soups and gravy to a boil when reheating. Heat other leftovers thoroughly to 165°F.

Step 4. Chill: Refrigerate promptly

Food safety experts advise consumers to refrigerate foods quickly because cold temperatures keep most harmful bacteria from growing and multiplying. So, public health officials recommend setting the refrigerator at 40°F and the freezer unit at 0°F and occasionally checking these temperatures with an appliance thermometer. Then, Americans can Fight BAC by following these steps:

Refrigerate or freeze perishables, prepared food and leftovers within two hours.
Never defrost (or marinate) food on the kitchen counter. Use the refrigerator, cold running water or the microwave.
Divide large amounts of leftovers into small, shallow containers for quick cooling in the refrigerator.
With poultry and other stuffed meats, remove the stuffing and refrigerate it in a separate container.
Don't pack the refrigerator. Cool air must circulate to keep food safe.

Other Guidelines include:

From Health Services Agency-County of Santa Cruz Environmental Health Services.
Available at: http://www.co.santa-cruz.ca.us/eh/consumer/food/holding_temperatures.pdf

Correct holding temperature

Keep hot foods hot and cold foods cold.
Hot foods keep at 140° F or above.
Cold foods refrigerate at 41° F or below.
Use a calibrated probe thermometer to check internal food temperatures.

Holding hot foods

Transfer hot foods directly to an oven, steam table, or other holding unit. Do not heat foods in a steam or holding unit.
Reheat leftover foods to 165° F prior to placing in a holding unit. If possible, avoid cooking foods more than one day ahead of time.
Stir foods at frequent intervals to evenly distribute heat. Keep a cover on foods to help maintain temperatures.Break the chain of possible food contamination.
Never combine an old batch of food with a new batch. Check the temperature of the foods on a frequent and regular basis. Use a clean and sanitized thermometer.
Don’t rely solely on the thermostat gauges of the holding equipment. They may not accurately indicate the internal temperature of the food.

Holding cold foods

Keep foods in cold-holding tables, commercial refrigerated display cases, and refrigerators.
Keep food in salad bars and display units, set the food containers in ice to keep them below 41° F.
Keep a cover on foods held in cold holding units to help maintain temperatures.
Check the temperature of the foods on a frequent and regular basis. Use a clean, sanitized thermometer.

Calibrating a thermometer using the ice method

Immerse the temperature probe at least two inches into a glass of finely crushed ice. Add cold tap water to remove air pockets. Wait at least 30 seconds. The gauge should read 32° F; if not, adjust it accordingly.

“Thermy” developed by the USDA, Food Safety and Inspection Service, is an educational site (http://www.fsis.usda.gov/thermy/). It focuses on cooking temperatures needed to ensure food safety. It discusses the different types of thermometers and why food color does not indicate that the minimum internal temperature has been reached.

Hazard Analysis Critical Control Point (HACCP)

The HACCP system, developed by the FDA, Center for Food Safety and Applied Nutrition, should be applied throughout any foodservice operation. HACCP is a proactive, comprehensive, science-based food safety system that allows operators to continuously monitor their establishments and reduce the risk of foodborne illness. The successful application of HACCP requires the responsibility, commitment, and involvement of management and every employee and volunteer involved in the handling, delivery, and service of congregate and home-delivered meals. Following HACCP guidelines allows for a thorough monitoring of meals that will help ensure food safety. The HACCP system comprises seven principles:

Conduct a hazard analysis. Potential hazards associated with a food and measures to control those hazards are identified. The hazard could be biological, such as a microbe; chemical, such as a toxin; or physical, such as ground glass or metal fragments.
Determine Critical Control Points (CCPs). These are points in a food's production--from its raw state through processing and shipping to consumption by the consumer--at which the potential hazard can be controlled or eliminated. Examples are cooking, cooling, packaging, and metal detection.
Establish critical limits. For a cooked food, for example, this might include setting the minimum cooking temperature and time required to ensure the elimination of any harmful microbes.
Establish monitoring procedures. Such procedures might include determining how and by whom cooking time and temperature should be monitored.
Establish corrective actions when monitoring shows that a critical limit has not been met. For example, reprocessing or disposing of food if the minimum cooking temperature is not met.
Verification procedures to confirm that the system is works. For example, testing time-and-temperature recording devices to verify that a cooking unit is working properly.
Establish record keeping and documentation procedures. This would include records of hazards and their control methods, the monitoring of safety requirements and action taken to correct potential problems. Each of these principles must be backed by sound scientific knowledge: for example, published microbiological studies on time and temperature factors for controlling foodborne pathogens.

To assist foodservice operations in applying HACCP principles a draft document entitled: Managing Food Safety: A HACCP Principles Guide for Operators of Food Service, Retail Food Stores, and Other Food Establishments at the Retail Level is available
http://www.cfsan.fda.gov/~dms/hret-toc.html
http://www.nal.usda.gov/fnic/foodborne/haccp/index.shtml

Sample SUA Food Safety Standards/Guidelines

Arizona

All foods shall be of good quality and shall be obtained from sources which conform to federal, state and local regulatory standards for quality, sanitation, and safety.

The following shall not be used:

Foods prepared or canned in the home,
Cans which are bulging, dented, leaking, rusty or which spurt liquid when opened,
Foods with an off odor, and
Foods which show signs of mold.

The following may be used:

Donated bakery products, and
Donated fruits and vegetables

All other food contributions shall be cleared, prior to serving, with Local County Sanitarian or the Department’s consulting Registered Dietitian or Nutritionist.

California

Food in hermetically sealed containers shall be processed in a licensed establishment. No home-prepared or home-canned food shall be used.
Food from broken containers, unlabeled, rusty, or leaking cans or cans with side seam dents, rim dents, or swells shall not be used.
Adequate and suitable space free from dirt, vermin and contamination or adulteration shall be provided for the storage of food, beverages, and cooking, serving, and eating utensils.
The dry storage area shall be cool, dark, well ventilated, clean, orderly, and free from leakage, insects, rodents, and vermin, or other contamination. It shall have at least 10 foot-candles of light. It is recommended that the temperature of the dry storage area be maintained at 50-70°F.
All foods shall be stored at least 6” above the floor, 18” from the ceiling and away from the wall to permit free circulation of air and prevent contamination.
All food and non-food items shal