· National Food Safety Issues
· Older Americans Act 2000 Requirements
· Model Food Code
· SUA Standards/Guidelines: Food Handling
· Food Safety Training and Education
· SUA Standards/Guidelines: Food Safety Training
· Food Safety
· SUA Standards/Guidelines: Food Safety
· Food Recalls
· SUA Standards/Guidelines: Food Recall
· Foodborne Illness Outbreaks
· SUA Standards/Guidelines: Foodborne Illness
AND QUALITY IMPROVEMENT
· SUA Standards/Guidelines:
Food Safety Monitoring
- Additional Resources
Food Safety Issues
Food safety and sanitation is an important public health concern.
In the United States, it is estimated that 76 million illnesses,
325,000 hospitalizations, and 5,000 deaths are attributed to foodborne
illness each year. The annual cost of foodborne illness is estimated
to be from $10 to $83 billion (1). For some individuals, foodborne
illness may result in a mild, temporary discomfort. Because older
adults are a highly susceptible population, foodborne illness may
have serious or long-term consequences, and may be life threatening.
Older adults are vulnerable to foodborne illness for several reasons. Some of these include (2):
As part of the aging process, the ability of the immune system
to function at normal levels decreases. A decrease in the level
of disease-fighting cells is a significant factor in making
the average older adult highly susceptible to harmful microorganisms
of the stomach lining and a decrease in stomach acid: The stomach plays an important role in limiting
the number of bacteria that enter the small intestine. During
the natural aging process, an older persons stomach tends to
produce less acid. The decrease or loss of stomach acidity increases
the likelihood of infection if a pathogen is ingested with food
in sense of smell and taste: Many contaminated foods do not smell or
taste bad. However, for foods like spoiled milk, a person who
does not notice "off" odors and flavors is more likely
to eat the food and more likely to become ill.
on their own: For
an older person, preparing meals may pose special challenges.
A widower who has not cooked for himself may not know how to
prepare food safely. A person receiving home-delivered meals
may not be familiar with safe handling and storage practices
for meals and leftovers.
causes of foodborne illness are multifaceted. Some major risk factors
of foodborne illness are related to employee behaviors and preparation
practices in food service establishments. The principle known risk
cooking, such as undercooking raw shell eggs,
from unsafe sources,
personal hygiene, and
(such as, pest and rodent infestation and improper food storage).
There are a number of foodborne disease organisms,
toxins, and chemicals that affect the public’s health. It is important
for SUAs to provide the OANP with general information about new
emerging concerns that relate to foodborne diseases. For example,
Noroviruses are the most common cause of gastroenteritis in the
US. They cause an estimated 23 million cases of acute gastroenteritis
(AGE) annually (3). The Norwalk
virus has received recent attention as a number of outbreaks of
AGE were reported on cruise ships sailing into US ports between
June and December 2002 (3). Since October 2002, several
states have noted an increase in outbreaks of AGE consistent clinically
and epidemiologically, with norovirus infection, particularly in
institutional settings such as nursing homes (CDC, unpublished data,
2002). Although attention has been drawn recently to outbreaks of
norovirus on cruise ships, an estimated 60%-80% of all AGE outbreaks
occur on land, particularly in institutional settings, through nonfoodborne
modes of transmission (4-6). CDC's Emerging Infections Program Foodborne
Diseases Active Surveillance Network (FoodNet) collects data on
about 10 foodborne diseases in nine US sites to quantify and monitor
foodborne illnesses (7). Some other common foodborne infections
are those caused by the bacteria Campylobacter,
coli O157:H7. It is important for SUAs to inform OANPs about
the emergence of these foodborne diseases and provide the necessary
resources to assist OANPs in minimizing the risk of foodborne illness
The following resources provide additional information
on foodborne diseases:Bad Bug Book: http://www.cfsan.fda.gov/~mow/intro.html
of Bacterial and Mycotic Diseases: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/default.htm
The 2001 Model Food Code
(8) released by the Food and Drug Administration (FDA) and the Centers
for Disease Control and Prevention (CDC) of the US Department of
Health and Human Services (DHHS) and the Food Safety and Inspection
Service of the US Department of Agriculture (USDA), provides practical
and science-based guidance for foodservice establishments. The Food
Code (http://www.cfsan.fda.gov/~dms/fc01-toc.html) addresses controls
for risk factors. It established 5 key public health interventions
to protect consumer health:
hands as a vehicle of contamination,
and temperature parameters for controlling pathogens, and
2001 Food Code is a model code, which FDA regularly updates.
It provides a scientifically sound, legal basis for regulating the
retail food market at the state and local level.
The 2001 Food Code is neither federal law nor federal
regulation and does not preempt state and local food law.
It and its predecessor have been written so that it is easy
to adopt at state and local levels. Through the years, state and local jurisdictions
have adopted some of the model food code.
A list of jurisdictions that have adopted the 2001 Food
Code is available at http://www.cfsan.fda.gov
under Federal/State Food Programs-Retail Food Safety References.
safety is a priority action area of Healthy People 2010.
Priority action areas include: reducing infections caused by foodborne
pathogens, reducing outbreaks of foodborne illness, and improving
food employee behaviors and food preparation practices that directly
relate to foodborne illnesses in retail food establishments (9).
FDA, USDA, US Environmental Protection Agency, and CDC maintain
a collaborative website on national food safety programs at: http://vm.cfsan.fda.gov/~dms/fs-toc.html.
It contains a variety of government-generated information on food
safety for the food industry and food consumers. The website www.FoodSafety.gov is the
“gateway” to government food safety information. Medline Plus also
provides access to current food safety information: http://www.nlm.nih.gov/medlineplus/foodsafety.html
OAA emphasizes the importance of food safety and sanitation in nutrition
projects. It requires them to comply with state or local laws regarding
the safe and sanitary handling of food, equipment, and supplies.
SUAs are encouraged to use the 2001 Model Food
Code and the objectives in Healthy People 2010 as reference
documents to assist in developing policies and procedures that comply
with state and local food laws.
It is important that SUAs examine the food safety and sanitation
requirements in their current policies and procedures and take the
necessary steps to ensure that OANPs comply with their state and
local food law. It is equally important for OANPs to ensure
that their caterers and vendors comply with state and local food
than review 56 different state and territory food laws as well as
hundreds of local regulations and ordinances, this chapter reviews
the provisions in the 2001 Food Code upon which many state
and local jurisdictions base their food statutes, regulations, and
ordinances. The chapter
addresses the following:
Management and Personnel,
Compliance and Enforcement.
Older Americans Act 2000 Requirements
ensure that the project ---
encourages providers to enter into contracts that limit the
amount of time meals must spend in transit before they are consumed.
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.
MANAGEMENT AND PERSONNEL
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
with the state and local food codes,
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
Providing a safe place to
equipment in good operating order,
Publishing rules for good
Training employees in proper
food safety principles
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.
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
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
Cleanliness (Part 2-3) and Hygienic Practices (Part
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
Sample SUA Food
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.
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
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.
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.
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.
signs shall be posted in each toilet room directing employees
that they shall wash hands with soap before returning to
Training and Education
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.
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).
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.
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
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
Food Protection Professional (CFPP)
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
Certified Professional Food Manager (NCPFM)
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
Food Safety Manager
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.
Safety Information and Training Resources for Professionals
number of food safety and sanitation training resources are
available. Below are several websites that provide training
Office of Regulatory Affairs
Training & Human Resource Development:
Illness Education Information Center:
Provides a multiplicity of food safety education information
Illness Education Information Center:
Provides links to information on distance learning, on-line
courses and curriculums.
resources are also available in languages other than English.
A few sources are listed below:
Safety Foreign Language Materials
Food Safety Training Materials in Foreign
National Food Service Management Institute: Food Safety Mini
Safety Information and Material for Consumers/OANP Participants
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.
and materials for consumers and older adults include:
|Sample SUA Food
Safety Training Standards/Guidelines
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).
instruct clients or their caregivers on the following safe
practices for handling delivered food, as they may apply:
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.
1. Clean: Wash hands and surfaces often
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
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
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
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
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
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.
sauces, soups and gravy to a boil when reheating. Heat other
leftovers thoroughly to 165°F.
4. Chill: Refrigerate promptly
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
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
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.
Health Services Agency-County of Santa Cruz Environmental Health
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.
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.
Keep foods in cold-holding tables, commercial refrigerated display cases,
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.
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
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
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.
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
Sample SUA Food
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.
following shall not be used:
prepared or canned in the home,
which are bulging, dented, leaking, rusty or which spurt liquid
an off odor, and
show signs of mold.
following may be used:
other food contributions shall be cleared, prior to serving,
with Local County Sanitarian or the Department’s consulting
Registered Dietitian or Nutritionist.
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
All food and non-food
items shall be clearly labeled so that their contents are
All chemicals and cleaning
supplies shall be stored in an area separate from food.
Opened packages of foods,
such as sugar, flour and noodles shall be stored in tightly
closed containers and clearly labeled on the main part of
Refrigerators and freezers
shall be kept clean and in good repair.
All refrigerators shall
maintain a maximum temperature of 40°F.
All freezers shall maintain
a maximum temperature of 0°F.
An accurate and readily
visible thermometer shall be installed in all refrigerators
storage systems shall ensure a “First-In, First-Out”
use of foods. All foods stored in freezers shall be
dated and labeled.
AAA reserves the right to inspect such foods to determine
compliance with the specifications and to reject any food
not meeting such specifications.
containers or other appropriate materials that are easily
cleaned and sanitized each day must be used to maintain
acceptable temperatures during the transport of bulk
foods to serving centers, and for home delivered meals
on delivery routes.
containers or other appropriate materials that are easily
cleaned and sanitized each day must be used to maintain
acceptable temperatures during the transport of bulk foods
to serving congregate dining centers, and for home delivered
meals on delivery routes.
food shall be packaged and transported in a manner to
protect against potential contamination including dust,
insects, rodents, unclean equipment and utensils, and
Foods purchased for
use in the nutrition program shall be of good quality
and shall be obtained from sources, which conform to
federal, state and local regulatory standards.
food carrier must be tightly closed after each meal is
the time of packaging of home‑delivered meals to
the receipt by participants, hot food shall be kept at
140°F or above, and cold foods at 40°F or below (edited).
Frozen meals shall
be maintained in a frozen state during delivery. When
the meal has completely thawed, it shall not be refrozen for later use.
All meals must be
individually portioned. Cold and hot foods must be packed
in separate insulated food carriers with tight fitting
lids and transported immediately.
food with the exception of fresh fruit and milk shall
be taken from the congregate meal site after it has
providers shall have a written policy posted regarding
the removal of food from the congregate meal site.
All food transported to sites which becomes “leftover,”
except unopened prepacked food, must be properly disposed
of at the meal site or the main food preparation site
in compliance with local Health Department regulations.
AAAs shall develop policies and procedures to minimize
leftover meals to 1.5% or less.
Leftovers (which should be minimal) shall be offered
to all participants as second helpings at those congregate
settings which do not have on site cooking facilities
or methods to preserve leftover food to meet the nutritional
standards for later consumption (approved by the local
The AAA shall cause to have placed at each nutrition
site, in a location that is easily visible to patrons,
a disclaimer which shall state: “For Your Safety: Food
removed from the center must be kept hot or refrigerated
promptly. We cannot be responsible for illness or problems
caused by improperly handled food.” No food shall be
taken from the site by staff.
All OANPs need to pay attention to food product recalls
and be familiar with the appropriate steps for handling food
recalls. A food recall is a voluntary action by a food manufacturer
or distributor to protect the public from products that may
cause health problems and even death. The type of food product determines which federal
agency is responsible for regulation (14). The USDA Food Safety and Inspection Service (FSIS)
inspects and regulates meat and poultry products, as well
as pasteurized egg products (eggs that have been removed from
their shells for further processing) produced in federally
inspected plants. The FDA
all other food products,
vegetables, dairy, fish, grains, and nuts. FDA is responsible for
ensuring that foods are safe, wholesome, and correctly labeled.
However, because FSIS is the primary agency for USDA commodity
foods, it is the liaison agency in all recalls of USDA commodity
foods including those regulated by the FDA.
The FDA has guidelines for companies to follow with respect to their
voluntary removal or correction of marketed violated products
under the Agency's jurisdiction. These guidelines are published
21 of the Code of Federal Regulations, Part 7.
FDA expects companies to take full responsibility for
product recalls, including follow-up checks to assure that
recalls are successful. FDA's role under the guidelines
is to monitor company recalls and assess the adequacy of a
firm's action. After a recall is completed, FDA makes
sure that the product is destroyed or suitably reconditioned
and investigates why the product was defective.
a food product is recalled, FSIS and FDA are responsible for
a recall classification based on the health risk to consumers.
A recall classification is always listed in the recall notification.
FSIS and FDA use a code to help consumers know the seriousness
of the effects of consuming the product. The following is
a list of definitions of the classification of a food recall:
Class I: A health hazard situation with a reasonable probability that consuming
the product will cause serious health problems or death.
Class II: A health hazard situation with a remote probability of health problems
from consuming the product.
Handling Food Product Recalls
is recommended that SUAs and/or AAAs implement policies and
procedures that include information on responding to a Food
Recall Notice. OANPs should be aware of the standard food
recall procedures in their state. Important procedures to
Completing a food recall action
Identifying the recalled food
Counting the recalled product
Identifying where and how to segregate
the recalled food product.
Placing warning labels on the
segregated food product.
Notifying site staff not to use
the segregated food product.
Counting the amount of the recalled
food product used.
Accounting for the entire recalled
food product by consolidating counts for product used
and product in inventory.
Obtaining information needed for
public communications: whether the product was served, to
whom it was served, and date served
The following are some resources regarding handling
a food product recall:
Consumer Information and Education:
Sample SUA Food
Product Recall Standards/Guidelines
designated individual at the Contractor's corporate offices
will maintain a current vendor listing for food purchases
made at the corporate or the local level. Information
will be readily available for identifying the product
lines purchased by manufacturer, brand, and item number.
Contractor shall require, as a condition of purchase,
that all vendors (food brokers, wholesalers, distributors,
manufacturers, etc.) immediately alert the Contractor
in the event that notification of a food recall is received
from a manufacturer, the Health Department, or other governmental
receiving notification of a food recall, the Contractor
will take the necessary steps to determine if the recalled
product was a brand and item purchased for meals served
in the State of Alabama. In that event, the Commission
and the appointed representative of the Commission will
be immediately advised of the potential problem. The Contractor
will also (a) check purchasing records to determine which
production units, if any, received the recalled lot numbers
and the date and amounts received (b) check production
unit records to determine the recent history for serving
the recalled product line and (c) check all storage, production,
and service areas to locate any recalled products. The
Commission will be advised of these determinations. If
a recalled product has been or may have been served within
the State of Alabama, the Commission will advise the Area
Agencies on Aging of the potential problem and will consult
with officials at the Alabama State Department of Public
Health to determine the appropriate course of action.
If the product recall results in meals or portions of
meals not being served or injury to persons consuming
the contaminated food, the Contractor will bear the loss
and will be liable for all damages.
from the Foodborne-Disease Outbreak Surveillance System (15)
indicate that the most commonly reported factors that contributed
to foodborne disease between 1993-1997 were improper holding
temperature and inadequate cooking of food. The annual number
of outbreaks reported ranged from 477 to 653. Objectives 10-1
and 10-2 in Healthy People 2010 aim at reducing the
number of foodborne illness cases and foodborne illness outbreaks
by 50% respectively.
foodborne illness outbreak is when a group of people consumes
the same contaminated food and two or more of them come down
with the same illness. This may occur when a group eats the same contaminated
meal together at a foodservice establishment, or it may occur
among a group of people who do not know each other, but who
all happen to buy and eat the same contaminated food from
a grocery store or restaurant. Usually a number of factors
contribute to a foodborne illness outbreak. Many are local
in nature. For example, a food item can become easily contaminated
when it is inadequately cooked or when it is left out at room
temperature for many hours. Foodborne illness outbreaks are
often recognized when a group of people realizes that they
all became ill after a common meal, and someone calls the
local health department.
For example, a common local outbreak might occur after
eating a catered meal at a reception or a meal at an understaffed
restaurant on a particularly busy day. Cases of foodborne
illness can either be confirmed through laboratory analysis
of the patients’ stools or remain “probable or suspect.” Reports
of outbreaks to local health departments usually come from
individuals who are ill or health care providers and hospitals.
Local health departments investigate reported outbreaks and
report the results to the state Department of Health, which
subsequently reports them to the US Centers for Disease Control
and Prevention (CDC). The CDC: Foodborne Infections provides
up-to-date information about foodborne infection on their
is important for SUAs to provide AAAs and OANPs with the appropriate
guidance on responding to foodborne illness outbreaks. While
there have been instances of foodborne illnesses associated
with the OANP, the reported incidence of such outbreaks has
been relatively low. The 1995 National Evaluation found that
among the 400 AAAs surveyed (which represent 60% of the AAAs
in the country), there were only six incidents of illness
associated with the OANP in the past three years. The AAAs
reported that 175 older persons became ill from these six
incidents. Meat and poultry products were associated with
the reported food-borne illnesses (10).
If a foodborne disease outbreak occurs in an OANP,
the impact can be devastating for the program and its participants.
The following are some examples from the Idaho
Food Safety & Sanitation Manual
on what to do if a foodborne disease outbreak takes place:
Staff and/or volunteers
should direct all calls and/or complaints from a customer
claiming that they became sick from a food and/or beverage
they consumed to the manager or person in charge immediately.
The following information should be obtained from the
address and telephone number of person calling;
became ill and what were their symptoms;
the illness diagnosed by a physician (get physician's
name if diagnosed);
foods and/or drinks were consumed;
was the day and time the food was consumed;
was the person who served or provided the food,
information that may seem important at the time.
the information down. Include the date and time the
person called. Inform the caller that the complaint
will be investigated immediately, and the management
will call back within a specified period of time.
information needs to be promptly evaluated and a decision
made on the likelihood that an outbreak has occurred.
There are no clear cut guidelines. The best rule of
thumb is to consider that a foodborne disease outbreak
may have occurred when two or more persons experience
a similar illness, usually gastrointestinal, after eating
a common food.
giving the matter proper consideration and the management
has reason to believe that a foodborne disease outbreak
may have occurred, the following contacts are important:
Contact your local health department immediately.
Attorney. Advise your attorney of the situation
and the action taken. Although your attorney will
most likely recommend that you cooperate fully with
the health department, he or she may want to be
included in the investigation to ensure that the
rights of all concerned are properly respected.
Insurance Agent. Depending on the nature and the
extent of the outbreak, your insurance company may
become involved. It is advisable to inform your
agent at the beginning of an official investigation.
an official foodborne disease outbreak investigation
has begun, the management needs to be aware of the following
health department activities:
Investigating a foodborne disease outbreak is a
lot like detective work. Health department staff
will be asking a lot of questions, not only of food
establishment employees, but also of people who
allegedly have become ill. Two fundamental questions
need to be answered:
What food caused the illness; and
What went wrong to cause the illness
the Disease. Depending on the nature of the foodborne
disease outbreak, preventing additional cases is paramount.
Such control measures that may need to be implemented
immediately are as follows:
sick employees from food-contact work,
Using alternate food processing or
preparation methods, and/or
Closing the establishment.
Sampling. Collecting food and environmental samples
is an important activity during a foodborne disease
outbreak investigation. Finding or not finding the
suspected organism or agent in a specific food is
significant in determining the cause of the outbreak.
Also, it is not uncommon to obtain stool, vomitus
and/or blood samples from victims and employees.
Embargo. Suspected foods in foodborne disease outbreak
investigations may be placed under embargo until a
determination can be made as to its safety or status.
Such foods will be properly identified, and the food
must remain undisturbed until the embargo is lifted.
Reports. Several reports are generated as a result
of the investigation. A special inspection report
is generally completed during the course of the investigation.
It is similar to a regular inspection but only addresses
conditions relating to the outbreak. Also, case investigation
reports are generated.
Sample SUA Foodborne
of suspected foodborne illness are reported to the local
Health Department and SUA immediately.
D. EQUIPMENT/WATER/PHYSICAL FACILITIES
Contaminated equipment is one of the major causes
of foodborne disease outbreaks. Thus, it is crucial that the
foodservice facility and its equipment are properly maintained,
cleaned, and sanitized to prevent the transmission of foodborne
diseases. Effective cleaning and sanitization of equipment
and utensils serve two primary purposes. They:
Reduce chances for contaminating safe food during processing, preparation,
storage, and service by physically removing soil and bacteria
and other microorganisms; and
Minimize the chances of transmitting disease organisms to the consumer
by achieving bacteriologically safe eating utensils.
The task of choosing equipment designed for sanitation
has been simplified by organizations such as the National
Sanitation Foundation (NSF) International. NSF International
develops and publishes standards for sanitary equipment design.
A clean and sanitary food establishment is a prerequisite
to an effective food-safety program. A routine cleaning program
must be established and monitored.
WATER SUPPLY SYSTEM
Proper sanitary controls for the water supply system
and sewage and liquid waste disposal systems are necessary
in food establishments to prevent the food contamination and
the creation of public health hazards.
Because water is so common in place for food establishments,
its availability, purity, and safety are taken for granted.
The protection of water is provided through compliance with
local and state regulations of public drinking water systems
and plumbing codes. However, hazards through repairs, emergencies,
changes, and/or alterations in the water delivery system and
distribution system within the establishment may occur. Therefore,
the water supply systems in a food establishment also need
special attention and must be monitored to prevent food, equipment,
and supplies from becoming contaminated.
constructed, installed, operated and maintained physical facilities
of a foodservice establishment are important to ensure adequate
food safety and sanitation. Other
key considerations in helping keep food safe include adequate handwashing and toilet facilities and prohibiting
pets and other animals on the premises of the foodservice
establishment. Pests such as insects and rodents can also
pose serious problems for establishments. The greatest danger
from pests comes from their ability to spread disease, including
foodborne illness. Developing policies and procedures to ensure
that the physical facilities of the establishment are maintained
in good repair and implementing a pest management program
will help prevent contamination and pests from infesting foodservice
|Sample SUA Equipment/Water/Physical
following numerated list and comments pertaining to the wash
cycle of food contact surfaces will help supervisors and managers
appreciate why there is a particular order in the process:
Equipment and Utensils Clean Prior to Use. Properly
cleaned and sanitized equipment and utensils should be
bacteriologically safe prior to use. Should contamination
be suspected, the equipment and/or utensils should not
be used, but recleaned and sanitized.
Soiled Equipment and Utensils. During use, equipment
and utensils become soiled and contaminated with bacteria.
Scrapping, Preflushing and Presoaking. Scrapping,
preflushing and presoaking, as necessary, are methods for
removing gross amounts and stubborn soil from equipment
Cleaning. There are two steps in the cleaning
process - washing and rinsing:
Washing, when using proper detergents, cleaners,
chemicals and abrasives, remove the remaining soil from
equipment and utensils. This is a physical and a chemical
process. The soil and bacteria, as well as cleaning compounds,
are suspended in the wash water; and
Rinsing removes most of the suspended soil,
bacteria and cleaning compounds from the equipment and utensils.
Although the equipment and utensils look visibly clean
at this point, they are still contaminated with many bacteria.
Sanitizing. Sanitizing kills the remaining pathogenic
organisms on the equipment and utensils. Sanitization will
occur when certain specific chemical concentrations, temperature
requirements, time requirements and water conditions are
satisfied. These conditions are crucial for effective sanitization.
Therefore, precise measurements of the sanitization process
are made periodically. NO RINSING OR ANY OTHER CLEANING
PROCESS SHOULD TAKE PLACE AFTER THE SANITIZING PROCESS.
Air Drying. The only acceptable method of drying
equipment and utensils is air drying. The use of towels
for drying, polishing or any other purpose re-contaminates
equipment and utensils with bacteria.
Proper Storage and Handling. Proper storage and
handling of cleaned and sanitized equipment and utensils
is very important to prevent recontamination prior to use.
Cleaned and sanitized equipment and utensils must be:
on clean surfaces, and
to minimize contamination of food contact surfaces.
sanitization requires greater controls than hot water sanitization.
The following factors must be considered in order to obtain
effective sanitization by chemical sanitization methods:
of the water;
of the water; and
pH and hardness needs to be determined. Should the water supply
be from a municipal supply, the water company may already
have this information. If not, the water will need to be tested
following table provides information pertaining to minimum
and maximum chemical sanitization requirements for manual
operations (in parts per million - ppm).
specified by manufacturer, see label; hardness 500 ppm or
unless container label specifies a higher pH and/or water hardness
** Quaternary ammonium compounds
chemical sanitizer instructions call for a given amount of
sanitizer per gallon of water. The following are two methods
of determining the amount of water used for sanitization:
a gallon container and pour a gallon of water at a time
into the sink until the water is at a suitable depth;
the following formula:
x length x water depth
= total gallons
(cu. in. in one gallon)
following will serve as an example:
of sink - 24" Width of sink - 24" Depth of sink
x 24 x 16 = 9,216
= 40 gallons
the test kit each time and adjust water amount or sanitizer
amount until proper concentration is obtained.
the first two methods, the same amount of water must be used
each time, unless the amount is recalculated.
problem in measuring the right amount of sanitizing chemical
is the method of measure stated on the label. The following
table provides equivalents of various measurements:
= milliliter tbsp. = tablespoon
tsp. = teaspoon f.o. = fluid ounce
bleach is often used as a sanitizer. When used, only pure
bleach (without additives) is acceptable. The amounts of bleach
(which contains 5.25% sodium hypochlorite) needed to obtain
certain concentrations are as follows:
of bleach/gallon(s) water
1 1/2 teaspoons/4 gallons
1 tablespoon/8 gallons
1 1/2 teaspoons/2 gallons
1 tablespoon/4 gallons
1/4 cup/16 gallons
1/2 teaspoons/1 gallon
1 tablespoon/2 gallons
1/2 cup/16 gallons
1 cup/16 gallons
MANUAL WAREWASHING METHODS
Sink Method (hot water sanitization)
1 Or as specified on the manufacturer's label
2 Immersed for at least 30 seconds
Sink Method (chemical sanitization)
1 Or as specified on the manufacturer's label
2 According to chemical sanitization schedule
a two-compartment sink cleaning method is used, a special
sanitization formulation must be used in both sink compartments.
CLEANING AND SANITIZATION
processing equipment and some vending equipment that requires
in-place cleaning shall be designed and fabricated so that:
Washing and sanitizing solutions can be circulated
throughout a fixed system using an effective cleaning and
sanitizing procedure, and
Cleaning and sanitizing solutions will contact
all food contact surfaces,
The system is self-draining or capable of being
completely evacuated, and
The procedures utilized result in thorough cleaning
of the equipment,
Equipment used in production-line food processing
shall be cleaned and sanitized according to the following
Each time there is a change in processing between
types of animal products (consider exceptions),
Each time there is a change from raw to ready-to-eat
After substantial interruptions,
Throughout the day as necessary, and
After final use each working day.
improved water system technology, monitoring and regulatory
control, water supplies are safer than ever. However, contamination
does occur as a result of system failure or cross-connections.
Give special attention to the following:
Water Status Notices.
Be alert to public notices that pertain to your water
supply. To ensure a safe water supply for food establishment
operations and for drinking purposes during such notices,
contact your local health department for assistance.
Changes in Water
Be aware of changes in water quality such as taste, odor,
or clarity or changes in water pressure. Such changes
may be an indicator of a possible cross-connection.
Cross-connections. Check your establishment for cross-connections mentioned
to the water system or equipment connected to a water
system must be done only by a licensed plumber
who is familiar with cross-connection prevention.
Handwashing Facilities. Handwashing facilities shall be adequate.
Adequacy pertains to the following design requirements:
with hot and cold or controlled temperature water (90°F
to 105°F) through a mixing valve or combination faucet;
slow-closing or metering faucets shall provide a continuous
flow of water for at least fifteen seconds without reactivating
the faucet; and
mixing valves shall not be used.
addition, handwashing facilities shall be provided with
a continuous supply of:
soap or similar hand cleanser; and
sanitary paper towels; or
continuous towel system supplied with a clean towel; or
heated air hand-drying device.
E. COMPLIANCE AND ENFORCEMENT
The key to food safety is controlling time and temperature
throughout the flow of food, practicing good hygiene, preventing
cross contamination, and purchasing food supplies from approved
suppliers. In addition to being monitored by health inspectors,
it is also important that each foodservice operation inspects
its own facilities.
The number of problems identified by SUAs during site
inspections stresses the importance of meal site sanitation
and food safety monitoring. The 1995 National Evaluation of
the OANP (10) found that about 28% of SUAs reported sanitation
and food safety problems in their last assessments of AAAs or
projects. According to the Evaluation, 73% of SUAs require all
sites, both OANP production and service sites, be inspected.
However, only 18% of SUAs require only sites preparing food
be inspected. Dining centers that serve meals should also be
routinely monitored to ensure the maintenance of appropriate
food temperatures and safe handling practices. It is also important
that vendors and caterers be monitored. Sample Dining
Center and Kitchen
monitoring tools are available from Florida. The National Evaluation
found that only 75% of SUAs require vendor sites to be monitored.
Below is a list of common violations from actual inspections,
along with suggestions for correcting them (16):
#1: Potentially hazardous food at room temperature.
Monitor the receiving area and be sure perishable food deliveries
are reaching refrigerators and freezers promptly. Evaluate whether
delivery times are coordinated with staffing, and make any needed
adjustments. In the kitchen, watch for overzealous employees
who may be removing products for preparation too far in advance.
In serving areas, be sure that cold food is going directly into
cold holding units, and hot food is going directly into hot
serving units — no pans on counters.
#2: Bare hands are contacting food.
Train all employees about the need to use a barrier between
food and hands. The barrier may be a utensil or a clean plastic
glove (changed regularly) or a sheet of deli paper. Then, be
sure that sanitary utensils are available in all areas. Sometimes
it takes planning to match the utensil to the job. Employees
given utensils that are awkward to work with often give up and
use bare hands.
#3: No thermometers in use.
Recognize thermometers as one of the chief controls for keeping
food out of the hazard zone. In cold storage areas without a
built-in thermometer, a hanging thermometer can be secured inside.
Then, check and log the temperature regularly. For food preparation
and holding areas, be sure everyone who needs one has and uses
a calibrated thermometer. In holding, emphasize that cold holding
below 41°F is just as critical as hot holding above 140°F. FDA
researchers noted this year that many foodservice professionals
have done a great job of paying attention to endpoint cooking
temperatures, but are overlooking holding and storage issues
with cold food.
#4: Improper thawing.
Use one of the approved methods for thawing food: thaw in the
refrigerator, or under cold running water, or in the microwave
(and then begin cooking immediately). What really goes wrong
with thawing? Sometimes it is a matter of last-minute efforts
to get food ready. A reminder to transfer frozen ground beef
to the refrigerator two to three days before it will be cooked
can help a great deal.
#5: Food not protected from dirt.
Check all storage areas to be sure food is at least 6 inches
off the floor. This includes in refrigerators and freezers.
Elevation protects food from dirt as you sweep floors, and also
makes food slightly less accessible to pests. Meanwhile, when
serving and transporting food, be sure all food is covered.
Again, a close look at the tools provided to employees can help.
Do they have to tear off sheets of plastic wrap one-by-one to
cover food? Are there snug-fitting lids available that you could
#6: Employees are eating in preparation and/or service areas.
To change this practice, first establish policies clearly. Then,
monitor all areas and remind employees as needed. It's helpful
to explain the rationale behind this policy: Eating makes your
own hands unclean, and facilitates transfer of pathogens to
the food that others will eat. The irony of this policy is not
to encourage cooks to taste their own food and take responsibility
for ensuring quality. Is there a solution? Some managers set
up a taste panel in a controlled area every day, inviting employees
to taste the food and comment.
#7: Improper dishwashing.
Review dish-machine maintenance plan as recommended by the manufacturer.
Inspectors say they often find heavy lime build-up, clogged
rinse jets, or broken temperature gauges. Each of these violations
is preventable with some attention to maintenance.
#8: Chemical sanitizers not tested.
Whether in the pot and pan sink or in a bucket of solution used
for wiping tables, the concentration of chemical sanitizer must
be correct. Explain to employees that too low a concentration
may not work, and too high a concentration may not be safe.
Also, explain that sanitizing solutions lose their strength
over time. Finally, be sure that test kits are available where
needed, and spend the time to show employees how to use them.
#9: Wiping cloths improperly handled.
Sometimes, an employee will use a cloth for tables to grab a
spill on the floor. Encourage employees to use separate cloths
for separate purposes, and keep wiping cloths in the sanitizing
solution between uses. Of course, cloths should be changed as
they become soiled, and every time you make a fresh solution
#10: Walls, ceiling or floor in disrepair.
Continue to monitor the condition of these surfaces to ensure
integrity is intact. This may mean patching and finishing a
crumbling spot on a wall, or replacing loose or chipped tiles
on a floor. All of this protects food in two ways: It prevents
the physical hazard of having loose construction fragments enter
food, and it ensures that these surfaces are cleanable.
#11: Lighting is not shielded.
Suggestions: Recognize broken glass as another physical hazard
to food. Check to be sure that fixtures are shielded.
#12: Employees are promoting cross contamination.
Cross contamination is the transfer of pathogens from one food
can happen in the refrigerator when an employee places raw meat
above fruit and the drippings contaminate the fruit. It can
happen in the kitchen when a cook slices turkey on the slicer
and then slices roast beef without sanitizing the equipment
in between. It can happen in the serving area when an employee
wearing plastic gloves picks up a hamburger to place it on the
grill, and then picks up deli meat for a sandwich to order —
without changing gloves in between. Explain to employees that
utensils, equipment, gloves, and even hands can all boil down
to a personalized taxi service for harmful bacteria and viruses.
Internal monitoring procedures are critical in ensuring
that appropriate sanitation standards and food handling procedures
are followed. Best practices include the regular monitoring
and documentation of compliance and that corrective actions
are completed appropriately. Participant satisfaction surveys, focus groups, and
other consumer-oriented meal service evaluations on a regular
basis also provide information on program compliance and need
for quality improvement.
Sample SUA Food
Safety Monitoring Standards/Guidelines
temperatures shall be recorded by the name of each specific
food item. Exceptions are bread products, crackers, cake
and fresh fruit. Temperature reports must be kept on file
for three years plus the current year.
checks of hot and cold food must be taken and recorded
at least one time per week on selected routes. The last
meal delivered on the route shall be the one checked to
assure that hot food is delivered at a minimum of 140°F
and cold food is delivered at 40°F or below (edited).
Records of temperatures shall be maintained and kept on
file by the provider.
retention problems involving the entire meal shall be monitored
on a daily basis until the problems are identified and corrected.
problems with individual food items shall be followed
up immediately in order to correct the problems.
nutrition project shall establish a monitoring schedule
that insures that standards are met on all routes.
sample of all food items shall be saved at each food preparation
site at least 72 hours for checking purposes should food‑borne
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