Nutrition Training - AgingFlorida.net

N O V E M B E R 7 , 2 0 1 8

Nutrition TrainingPresented By: Carole Mackey, Kristina Melling,

Abbie Walters, & Angela Brito

Agenda

Introductions Reporting & Record Keeping Review of Updated Handbook

& Recent NOIs Reminders Best Practices Food Safety Dietary Guidelines Questions & Answers

Reporting Reminders and Record Keeping

Dietician Approved Menus Due on the 15th of each month. Please send all reports to

[email protected]

Please note that all menus must be signed and approved by the providers contracted dietician at least 4 weeks before implementation.

The approving dietician's signature and date must be on every page of the posted menu.

mailto:OAAreports@


Menu Substitutions

Due on the 15th of each month

The documentation must include: date of the substitution, the substitution made, the reason for the substitution, and the signature of the employee authorizing the substitution.


Nutrition Education Documentation Due on the 15th of each month Written documentation of Nutrition Education should include:

date of presentation, name and title of presenter, lesson plan or curriculum, length of presentation and sign in sheets.

Each episode of Nutrition Education must be at least 15 minutes in length.

The documentation requirement for materials delivered to HDM clients shall include the date of distribution, copy of distributed material, and number of clients receiving the information.

Nutrition education should be developed by RD.


Temperature Logs Due on the 15th of each month Documentation must include: Time menu items delivered,

each menu item and serving size, temperature of each potentially hazardous menu items must be taken:

When the food is received by the nutrition site; If there is more than 30 minutes between when the food is

received at the meal site and when it is served, then a temperature of each food item must document again at the time the meal is served and if a provider prepares the meal on site, then temperature must be taken and recorded when the food is leaving the production area.


If food was not at temperature requirements, clearly document what was done (reheat meal in microwave for 60 seconds, etc.). Document at what temperature the food was served.

Food grade probe-type thermometers must be used; other thermometers such as infrared thermometers cannot be used to take food temperatures. Thermometers must be correctly calibrated at least weekly, to ensure accuracy. Also, they must be cleaned and sanitized between uses.


Nutrition Program Compliance Review (NPCR) Due quarterly (April, July, October, & January 15th) Complete this form quarterly at each meal site. It must be

completed once per year by: 1) A nutrition consultant (registered dietician) and 2) A nutrition program service provider’s administrative staff member. And twice per year the form should be completed by the meal site manager or designee.

If any items are out of compliance, be sure to send follow up documentation that the issue was addressed and resolved.

Reporting to SCC

As conducted: Food Safety Training (minimum of 1x per year staff &

volunteers). Training must be developed by RD. Advisory Council Documentation (minimum of 2x per year) Media Releases

Verification RD Requirements are met: Copies of RD license (at least annually) Contract Agreement with RD (at least annually) These items are collected in the annual Service Provider

Application

Annual Contract and Monitoring Report for Food Service Vendor

FROZEN HOME DELIVERED MEALS

When delivered to the client, the temperature should be 20˚ F or frozen solid.

DOEA Form 217 must be used to evaluate client’s ability to: Follow written directions on label Heat the meal Has freezer space to store up to 7 frozen meals Has working equipment (freezer, microwave, or oven)

Form 217 is to be kept in client’s file.

2018 DOEA Programs & Services Handbook

Food service vendor requirements (Ch. 4, pp. 160-164) “The food service vendor must not have had any

Temporary or permanent closures, Administrative Complaints regarding food safety, or 10 or more high priority/significant findings on sanitation

inspections within the past 12 months,beginning July 1, 2018”

Notify provider immediately of any closures or Administrative Complaints regarding food safety

Notify provider within 24 hours of any sanitation inspections Provide a written plan of correction for any high priority or

significant findings on sanitation inspections


Provider RD requirements (Ch. 4, p. 113) Monitor, at least annually, every food service vendor’s

sanitation inspection reports Review corrective action plans of food service vendors for all

significant or high priority findings on sanitation inspection reports


Access to Food Service VendorSanitation Inspection Reportson DBPR Website GA Food Service – St. Pete Facility

myfloridalicense.com/inspectionDates.asp?SID=&id=2236139 GA Food Service – Fort Myers Facility

myfloridalicense.com/inspectionDates.asp?SID=&id=2195442 Metz Culinary Management – Sarasota Facility

myfloridalicense.com/inspectionDates.asp?SID=&id=6881343


Expiration Dates All ready-to-eat (or drink) foods must have an

expiration, use-by, sell-by, or best-by date andbe received before the date occurs (Ch. 4, p. 146)

Food that has passed its expiration date, use-by date, sell-by date, or best-by date cannot be served to clients (Ch. 4, p. 147)

Policies and procedures shall be developed and implemented to address instances when milk is received without an expiration date or past the expiration, sell-by, best-by, or use-by date (Ch. 4, p. 136)

If milk is received frozen, the milk must be scheduled to be consumed prior to the expiration date (Ch. 4, p. 179)


When there is a break in service at a congregate meal site, the provider must notify and receive approval from SCC for the site to resume services and billing (Ch. 4, p. 104)

LTC clients receiving C1 (Ch. 4, p. 157 & p. 176)

REMINDERS

Make sure meal site managers are following menu serving size if serving food.

Include begin and end times on nutrition education documentation.

Inform your contract manager by email of any planned meal site closures.

All food service staff and volunteers must receive annual training by a RD, or competent Certified Food Protection Manager under the direction of the RD, on the prevention of foodborne illness. Staff and volunteers must be trained prior to assuming food

service assignments.

Best Practices

Food Waste Food Quality Food Preparation Advisory Council Meetings

ACL Innovation Grants

Food Safety

Review Date 2/11 G-1504

• Foodborne illness• Food contamination• Personal hygiene• Preparing, cooking, and serving

foods• Receiving and storing foods• Cleaning and sanitizing

Areas of Discussion

Foodborne Illness

Microorganisms

• The major cause of a foodborne illness

• You cannot feel, see, or taste

• Very quick to multiply in potentially hazardous foods

• Most of the foods we eat contain one or more type of microorganism

Potentially Hazardous Foods

Foods capable of supporting the rapid and progressive growth of harmful microorganisms: Milk, milk products Shelled eggs Sprouts, raw seeds Melons Soy-protein foods Corn, rice, potatoes, peas

Fish Shellfish Meat—beef, pork, lamb Poultry Cooked rice, beans, other

heat-treated plant foods

How Do Microorganisms Grow?

FAT TOM• Food (potentially hazardous foods)• Acid (pH slightly acidic or neutral)• Temperature (danger zone: 41˚F−140˚F)• Time (less than 4 hours)• Oxygen (presence of)• Moisture (water helps growth)

Foodborne Illness

• Caused by bacteria:— Salmonellosis— Shigellosis— Vibrio gastroenteritis— Hemorrhagic colitis— Staphylococcal gastroenteritis— Botulism

• Caused by virus:— Hepatitis A

Food Contamination

Cross Contamination

• A food service worker handling the food contact area of a plate or glass

• An employee preparing cooked food where raw food was placed without properly cleaning and sanitizing the area first

Types of Hazardous Substances

Physical: Hair, bandages, dirt, metal items, and fingernails

Biological: Bacteria, viruses, parasites, and toxins

Chemical: Cleaning products, toxic metal residue, and pesticides

Ways Food Can Become Contaminated

Poor personal hygiene: Leading cause of foodborne illnesses Improper hand washing Dirty work clothes

Temperature and time abuse: 41˚F−140˚F is the danger zone No more than 4 hours in the danger zone

Cleaning and sanitizing

Personal Hygiene

Basics of Good Hygiene

• Good personal grooming• Clean clothes• Proper use of aprons• Hair restraints• No jewelry• Trimmed and clean fingernails

Serving Food Properly

Hold plates by the bottom or at the edge:

Never touch the food-contact surface

Hold cups by bottom or handle:

Never put fingers on the rim of the glass

Never put fingers inside the glass

Hold silverware by the handle:

Never touch the food-contact surface

Serving Food Properly (cont’d)

Use long-handled utensils, such as tongs or scoops,

for one food only

Never allow your hands to come in contact with the

food

Scoop ice with proper utensil, not a cup

Restrictions From Work

If you or a worker is experiencing:• Sore throat• Runny nose• Diarrhea• Fever• Vomiting

BEST PRACTICE IS TO GO HOME

Proper Hand Washing

Rinse hands in warm water (about 105˚F)

Apply hand soap

Scrub hands and exposed arms for 20 seconds—do not forget between fingers and under rings

Rinse hands

Use a single-serve towel or air dryer

Apply hand sanitizer (optional)

Proper Hand Washing (cont’d)

Never wash your hands in a prep sink or dish-

washing sink

Wash hands in a designated hand-washing station

Do not substitute hand sanitizer for proper hand

washing, but you can use hand sanitizer after hand

washing

When to Wash Hands

After using the bathroom After touching bare body parts After coughing, sneezing, or using tissues After eating, drinking, or smoking After handling soiled equipment or utensils After food preparation After clearing table or dishes After removing or disposing of trash

Proper Use of Gloves

Gloves can contaminate as well; do not rely on

gloves to feel you are safe

Change gloves:

After completing a task and beginning a new task

If they become dirty

After handing raw meat, poultry, or fish

Before handling ready-to-eat or cooked food

Proper Care of Cuts, Burns, Sores, Infections

Report to supervisor

Cover with a clean, dry bandage

May need reassignment to nonfood contact duties

Wash each time you put on a new bandage

Preparing, Cooking, and Serving Foods

Temperature Danger Zone

41˚F−140 ˚ F

Must either cook or store below 41˚F within 4

hours

Temperature Danger Zone (cont’d)

Cold foods: 41˚F or lower

Hot foods*: 140˚F or higher

Proper Use of a Thermometer

Clean and sanitize stem of thermometer prior to

each use with alcohol

Insert thermometer into the thickest part of the

food

Do not allow thermometer to touch the base of the

pan

Proper Use of a Thermometer (cont’d)

Wait a minimum of 15 seconds after the needle

stops moving to take the temperature reading

Wipe thermometer stem in between foods

Calibration of a Bimetallic-Stemmed Thermometer

Fill a container with ice and add drinkable water

Place thermometer stem into ice water making

sure it is submerged

Allow 30 seconds from the time the needle stops

moving

Calibration of a Bimetallic-Stemmed Thermometer (cont’d)

Locate adjusting nut and hold securely

Rotate until needle reads 32˚F (do not remove

thermometer from water while adjusting)

Receiving and Storing Foods

Accepting and Rejecting Food Delivery

Use the senses (smell, sight, and touch) when

inspecting a food delivery

Reject food when you notice:

Signs of pests

Ice crystals in box or package of food

Torn, broken, or damaged boxes, packages, or cans

Expiration/use-by date has passed

Dry foods are damp

Storage of Food

FIFO—first in, first out

Store foods in original packaging, whenever

possible

Clearly label all foods with date

Storage of Food (cont’d)

Do not overload shelves or store food on floors or

against walls

Store all foods a minimum of 6ˮ above the floor on

clean shelves or racks

Store food only in protected areas, never in

restrooms or utility rooms

Cleaning and Sanitizing

Definitions

Cleaning: Involves the removal of food, residues,

dirt, and grease

Sanitizing: Reduces harmful microorganisms to a

level that is safe through the use of a chemical-

sanitizing solution

Use a Three-Step Process

Clean

Rinse

Sanitize

Cleaning

Use cleaning agents that remove food, soil, and

stains

Examples: Rinsing dishes, sweeping the floor,

and removing dust from overhead vents

Clean entire kitchen on a regular basis

Sanitizing

Use high heat or chemical sanitizers

Must sanitize anything that comes in contact with

food

Sanitize all dishes, pots and pans, utensils, knives,

and worktables after each use or every 4 hours

Clean and sanitize knives and utensils when

moving from one food item to another

Sanitizing Work Surfaces

Use facility-approved sanitizing solution in spray

bottles

Have test strips available to test sanitizer

concentration

Use clean clothes when sanitizing

Sanitize prep sinks after each use

Preventing Foodborne Illness

Purchase, store, and prepare food carefully

Have thermometers available; keep them

calibrated and use them

Practice good personal hygiene

Clean and sanitize regularly

Education References

National Restaurant Association Educational Foundation. Serve Safe Essentials. 5th ed. Chicago, IL: National Restaurant Association Educational Foundation; 2008.

DietaryGuidelines.govAdditional Resources:

Health.govChooseMyPlate.gov

Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.

Nutrition and Health Are Closely Related

“About half of all American adults—117 million individuals—have one or more preventable chronic diseases, many of which are related to poor eating

and physical activity patterns.”


The Dietary Guidelines for Americans: What It Is, What It Is Not

Provide evidence-based recommendations about the components of a healthy and nutritionally adequate diet

Focus on disease prevention rather than disease treatment

Inform Federal food, nutrition, and health policies and programs

2015-2020 Dietary Guidelines for Americans:The Guidelines

1. Follow a healthy eating pattern across the lifespan. All food and beverage choices matter. Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease.

2. Focus on variety, nutrient density, and amount. To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.

3. Limit calories from added sugars and saturated fats and reduce sodium intake. Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns.


2015-2020 Dietary Guidelines for Americans:The Guidelines (cont.)

4. Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices. Consider cultural and personal preferences to make these shifts easier to accomplish and maintain.

5. Support healthy eating patterns for all. Everyone has a role in helping to create and support healthy eating patterns in multiple settings nationwide, from home to school to work to communities.


Inside Healthy Eating Patterns:Food Groups

“Eating an appropriate mix of foods from the food groups and subgroups—within an appropriate calorie level—is important to

promote health.”

Each food group and subgroup provides an array of nutrients.

Recommended amounts reflect eating patterns associated with positive health outcomes.

Foods from all of the food groups should be eaten in nutrient-dense forms.


Major Messages from Chapter 2

The U.S. population, across almost every age and sex group, consumes eating patterns that are: low in vegetables, fruits, whole grains, dairy, seafood, and oil high in refined grains, added sugars, saturated fats, sodium, and for some age-sex groups, high in the meats, poultry, and eggs

subgroup.

Young children and older Americans generally are closer to the recommendations than are adolescents and young adults.

Implementing the Guidelines Through MyPlate(Figure 3-2)

Questions & Answers

Nutrition Training - AgingFlorida.net

Documents

Transcript of Nutrition Training - AgingFlorida.net