Dining Services Seminar

1. Dining Services Seminar Leading Age Oklahoma Wednesday, March 12, 2014 Gaye Rowe, ADN, RN Oklahoma State Dept. of Health LTC Training Division

2. Advocate for Resident Choice in Dining With Cultural Change, the dining experience should be more home-like

3. Home-Like should enhance the Quality of a Resident’s Life

4. Even with Cultural Change, safety is always essential when it comes to food handling and preparation.

5. Infections are a significant source of morbidity and mortality for nursing home residents and account for up to half of all nursing home resident transfers to hospital .Infections result in an estimated 150,000 to 200,000 hospital admissions per year at an estimated cost of $673 million to $2 billion annually.

6. US Depart of Agriculture, Food Safety and Inspection Service The Salmonella Enteritidis Risk Assessment states: Nursing home residents have an increased susceptibility to infectious agents like SE and Have severe complications and death from Salmonellosis

7. Dietary 483.35(i)(2) Sanitary Conditions F371 – The facility must: Store, prepare distribute and serve food under sanitary conditions.

8. Intent of F371 The facility follows proper sanitation and food handling practices to prevent the outbreak of foodborne illness. Safe food handling for the prevention of foodborne illnesses begins when food is received from the vendor and continues throughout the facility’s food handling processes.

9. Danger Zone Temperatures: Above 41° degrees F and Below 135° degrees F Temperatures between 41° and 135° degrees allows the rapid growth of pathogenic microorganisms

10. Danger Zone cont. Foods held in the Danger Zone (41°-135° degrees F) for more than: 4 hrs if prepared from ingredients at ambient temperatures 6 hrs if cooked and cooled (Must be cooled down to 70° within 2 hrs)

11. Critical Control Points CCP’s, If not controlled, might result in food safety hazards Thawing Cooking Cooling Holding Reheating of foods Employee hygienic practices

12. Top 10 Deficiencies – F371 #2 2012 - 2014 Arkansas 45.5% - 40.5% Louisiana 43.4% - 28.9% New Mexico 09.9% - 02.8% Oklahoma 34.0% - 49.7% Texas 30.5% - 38.1% Regionally 33.7% - 37.7% Nationally 34.0% - 35.5%

13. What Is Being Cited? Clean equipment Water pitcher lids not clean Cooking utensils with carbon build-up Placing clean plates for meal on dirty cart Chipped cooking spatulas This could have been an avoidable deficiency

14. What Is Being Cited? Eggs Pooling and scrambling unpasteurized eggs Frying unpasteurized eggs with yolk not solid This could have been an avoidable deficiency

15. What Is Being Cited? Thawing Meat Thawing meat in standing water, not under running water Thawing meat on the counter. This could have been an avoidable deficiency

16. What Is Being Cited? Hair covering Hair exposed at forehead, sides of head, back of head to neck, and beards.

17. What Is Being Cited? Gloves Wearing gloves during meal preparation, but , touching blender, retouching food, opening refrigerator door, opening utensil drawers, touching diet cards etc.. This could have been an avoidable deficiency

18. What Is Being Cited? Food Temperatures Food temperatures not taken or documented at the time of food preparation to ensure the food reaches a required internal temperature for 15 seconds AND not checking cooling down temperatures to make sure food not in theDanger Zone after 4 to 6 hrs This could have been an avoidable deficiency

19. InternalFood Temperatures MonitorFor 15 seconds Poultry – 165° Ground meat/Pasteurized eggs – 155° Fish – 145° Unpasteurized eggs – 145° (whites set/yolks congealed This could have been an avoidable deficiency

20. What Is Being Cited? Food Storage Open food bags/boxes(rice, beans, noodles, cereal, potato chips) Open, uncovered storage bins i.e; sugar, flour Interior refrigerator shelves dirty i.e.;milk, etc. No dates on opened containers, i.e.; pickles, etc. No dates on other containers: meat, pizza slices, pudding, ham salad and no label as to what is in container Pests in kitchen i.e.; roaches

21. What Is Being Cited? Clean Environment Kitchen carts, used to transport foods, with dirty handles Dirt/debris on floor and under shelving Open trash containers, (no covers) Sugar/storage bins with exterior stains Debris in utensil drawers Used gloves left on counter Microwave interior dirty, food splatters

22. What is Being Cited? Clean Environment cont. Dish rags on counter/or stored in bucket with dish soap, not chlorine or sanitizer Not checking sanitizer in 3 compartment sinks Not sanitizing sinks before washing pots Can opener and mixer dirty Oven handles sticky with food build-up This could have been an avoidable deficiency

23. What is Being Cited? Clean Environment cont. Light bulbs above stove and serving area coated with thick, grimy substance Ceiling fan blades coated with grime Baseboards with black greasy buildup Backdoor with knicks, mars, peeling paint Air vents with grime, dust and dirt This could have been an avoidable deficiency

24. What is Being Cited? Clean Environment cont. Ice machine dispenser grimy and dirty Ceiling fan blades coated with grime Baseboards with black greasy buildup Backdoor with nicks, mars, peeling paint Air vents with grime, dust and dirt This could have been an avoidable deficiency

25. What Is Being Cited? Dish Machine Not checking sanitizer in: Dish machine 3 compartment sink Cloth bucket No test strips for low temp dish machines This could have been an avoidable deficiency

26. What Is Being Cited? Storing wet dishes Putting wet dishes in the cabinets Storing wet pots and pans in sinks Storing metal cooking containers wet This could have been an avoidable deficiency

27. Thank You Gaye Rowe, RN 405-271-6868 Extension 56572 Gayer@health.ok.gov