Food Safety Training Preventing Foodborne Illness Welcome to the Knox County Health Department Food Safety Training!

Our goal is that by the end of this training, you will:

1. Recognize the importance of preventing foodborne illness, and 2. Understand how you can prevent foodborne illness. About This Training

A certificate of completion can be earned if you score 70% or higher on the test that follows this training. (This is not an ANSI approved certification.)

• Instructions for the test will be provided at the end of the training.

If you have any questions before, during, or after the training, please contact ? Environmental Health at the Knox County Health Department at (865) 215–5200. About This Training

This training will include sections on: 1. Foodborne Illness About This Training

This training will include sections on: 1. Foodborne Illness 2. The 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils, and Equipment 4. Poor Employee Health & Hygiene 5. Food From Unsafe Sources About This Training

This training will include sections on: 1. Foodborne Illness 2. The 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils, and Equipment 4. Poor Employee Health & Hygiene 5. Food From Unsafe Sources 3. Additional Prevention Measures from the TN Food Service Establishment Rules: 1. Consumer Advisory 2. Date Marking 3. Specialized Processing 4. Manager Certification About This Training

There are questions included throughout this training on slides indicated by the title, “Test Your Knowledge”.

These questions are part of the training. They are not an evaluation, or part of the test for the certificate of completion. Foodborne Illness Foodborne Illness

What is foodborne illness?

Foodborne illness has many names, including: • Food poisoning • Foodborne disease • Foodborne infection Test Your Knowledge

Who can be affected by foodborne illness? (click an option below)

older adults

pregnant women

children

healthy adults

restaurant employees Test Your Knowledge

Who can be affected by foodborne illness? (click an option below)

everyone is at risk for foodborne illness Foodborne Illness

What are the symptoms of foodborne illness?

There are many symptoms of foodborne illness, including: • Chills • Nausea • Vomiting • Diarrhea • Abdominal cramps • Jaundice • Fever • Dizziness Foodborne Illness

What causes foodborne illness?

• Bacteria, • Viruses, • Parasites, • Molds, • Toxins (including chemical toxins, like pesticides), and • Allergens Foodborne Illness

How many people does foodborne illness affect?

• Every year in the U.S., foodborne illness: • Sickens 1 in 6 people (a total of 48 million people) • Hospitalizes 128,000 people • Kills 3,000 people

• Foodborne illness also costs the U.S. an estimated $152 billion every year Foodborne Illness

How are restaurants related to foodborne illness?

In 2013, food prepared in restaurants was related to: • 60% of foodborne illness outbreaks and • 51% of outbreak-associated illness Foodborne Illness

How are restaurants related to foodborne illness?

In Tennessee, restaurants were related to: • Nearly 56% of foodborne illness outbreaks, and • 25% of hospitalizations related to foodborne illness Foodborne Illness

How can foodborne illness be prevented?

Safe food handling practices! (Also known as “food safety”.)

Food safety aims to prevent illness, and protect the health and safety of those eating AND working with food. Foodborne Illness

How can foodborne illness be prevented?

Chance of foodborne illness is lowered by: • Safe food handling practices • Proper cooking and storage • Adequate cleaning and sanitation • All of which you will learn about today! Foodborne Illness

What is the Health Department’s role in preventing foodborne illness?

Environmental Health Specialists (aka, Health Inspectors) with the Knox County Health Department (KCHD) help establishments prevent foodborne illness by: • Serving as a resource for questions and food safety education, and • Conducting inspections to ensure establishments understand proper food safety procedures that will help prevent foodborne illness. Foodborne Illness How do Health Inspectors determine proper food safety procedures?

The current regulations in Tennessee for food safety are the TN Food Service Establishment Rules. This is what: • KCHD inspections are based on, and • What this training is based on 5 Major Risk Factors for Foodborne Illness 5 Major Risk Factors for Foodborne Illness

• There are five major risk factors that lead to the majority of foodborne illness from food service establishments.

• It is important to learn these risk factors and know how you can prevent them from causing foodborne illness. The 5 Major Risk Factors for Foodborne Illness are:

1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils, and Equipment 4. Poor Employee Health & Hygiene 5. Food From Unsafe Sources Risk Factor 1: Improper Holding & Cooling Risk Factor 1: Improper Holding & Cooling

Why are holding and cooling procedures important?

• Bacteria that cause foodborne illness grow rapidly in foods when they are between 41°F and 135°F. Risk Factor 1: Improper Holding & Cooling

Why are holding and cooling procedures important?

• Bacteria that cause foodborne illness grow rapidly in foods when they are between 41°F and 135°F. ! • This temperature range is called the temperature danger zone. Risk Factor 1: Improper Holding & Cooling

Why are holding and cooling procedures important?

• Proper heating and cooling procedures reduce the time a food is in the temperature danger zone (between 41°F and 135°F.) ! • This prevents growth of bacteria, preventing foodborne illness. Risk Factor 1: Improper Holding & Cooling

Time/Temperature Control for Safety (TCS) Foods

• Certain foods have conditions that are ideal for the growth of bacteria that cause foodborne illness

• These foods are called Time/Temperature Control for Safety Foods, or TCS Foods Risk Factor 1: Improper Holding & Cooling

Time/Temperature Control for Safety (TCS) Foods

TCS foods include: • Meat, fish, poultry, seafood • Sprouts (alfalfa and bean) • Eggs and dairy products • Cut melons • Cooked vegetables • Garlic or herbs bottled in oil • Tofu • Sliced tomatoes • Cooked rice, beans, pasta and • Cut leafy greens potatoes Risk Factor 1: Improper Holding & Cooling

Proper Holding & Cooling

To keep TCS Foods safe and out of the temperature danger zone, proper procedures should be followed for:

1. Cooling food 2. Holding hot food (soups, cooked rice, etc.) 3. Holding cold food (cut fruit, tuna salad, etc.) Risk Factor 1: Improper Holding & Cooling

Cooling Food 135°F

TCS Foods must be cooled from 135°F to 41°F or below within six hours 6 hours 41°F Risk Factor 1: Improper Holding & Cooling

There are two important cooling stages: 135°F STAGE 1: Reduce the temperature from 135°F 2 hours to 70°F or below within two hours 70°F

41°F Risk Factor 1: Improper Holding & Cooling

There are two important cooling stages: 135°F STAGE 1: Reduce the temperature from 135°F 2 hours to 70°F or below within two hours. 70°F STAGE 2: Reduce the temperature from 70°F to 41°F or below within the next four hours. 4 hours 41°F

Note: Foods prepared from ambient temperatures must be cooled to below 41°F or below within four hours of preparation. Risk Factor 1: Improper Holding & Cooling

How can you be sure foods are cooled properly?

135°F Check the temperature of the food with a calibrated thermometer during the two cooling stages to make sure: 2 hours 1. After two hours of cooling from 135°F or above, the food will 70°F reach 70° F, and

41°F Risk Factor 1: Improper Holding & Cooling

How can you be sure foods are cooled properly?

135°F Check the temperature of the food with a calibrated thermometer during the two cooling stages to make sure:

1. After two hours of cooling from 135°F or above, the food will 6 reach 70° F, and hours 2. After six total hours of cooling from 135°F or above, the food will reach 41° F or below. 41°F

Note: Temperature logs are recommended Risk Factor 1: Improper Holding & Cooling

Why use a calibrated thermometer?

• Calibrating a thermometer makes sure it is reading temperatures correctly. • Correct temperatures are key for making sure food remains safe when: • Cooking, • Storing, • Cooling, and • Holding Risk Factor 1: Improper Holding & Cooling How should you calibrate a thermometer?

There are two ways to calibrate a thermometer:

1. With Ice water: 32° F • Fill a container with ice, then add water until the container is full. • Completely submerge the sensing area of the thermometer for 30 seconds. • The thermometer should read 32° F. If it doesn’t, adjust the thermometer until it reads 32° F. Risk Factor 1: Improper Holding & Cooling How should you calibrate a thermometer?

2. With boiling water • Boil clean tap water in a large pot. 212° F • Completely submerge the sensing area of the thermometer for 30 seconds. • The thermometer should read 212° F. If it doesn’t, adjust the thermometer until it reads 212° F. Risk Factor 1: Improper Holding & Cooling

There are several ways you can help foods cool faster:

• Use shallow containers to reduce the volume • Change the type of container (metal containers cool faster than plastic) • Make smaller portions (put into several smaller containers or cut large portions of meat into smaller pieces) • Put containers in ice baths • Put ice wands in the container • Add ice as an ingredient Test Your Knowledge

Proper cooling occurs in two stages. In the first stage, the food temperature must be reduced from 135°F to 70°F or below in how many hours? (click an option below)

1 2 4 6 Test Your Knowledge

Proper cooling occurs in two stages. In the first stage, the food temperature must be reduced from 135°F to 70°F or below in how many hours? (click an option below) 1 ✓2 4 6 In the first stage of cooling, foods should reach 70°F or below in two hours. Test Your Knowledge

Proper cooling occurs in two stages. In the second stage, the food temperature must be reduced from 70°F to 41°F or below in how many hours? (click an option below)

1 2 4 6 Test Your Knowledge

Proper cooling occurs in two stages. In the second stage, the food temperature must be reduced from 70°F to 41°F or below in how many hours? (click an option below) 1 2 ✓4 6 In the second stage of cooling, foods should reach 41°F or below in four hours. Risk Factor 1: Improper Holding & Cooling

Holding Hot & Cold Food

When holding TCS food, you can keep food safe by either using: 1. Temperature (outside of the temperature danger zone), or 2. Time (held no more than four hours, then thrown out)

This prevents the growth of bacteria that cause foodborne illness. Risk Factor 1: Improper Holding & Cooling

Using Time Instead of Temperature This is called using “time as a public health control”

To use time to keep food safe: 1. Written procedures stating the foods using time must be prepared in advance 2. Food must be marked to indicate the time that it is taken out of temperature control 3. Food not served within four hours* must be DISCARDED *If initial food temperature is at or below 41° F and does not exceed 70° F during holding, the food may be held for six hours before being discarded. Risk Factor 1: Improper Holding & Cooling

Using Proper Temperatures to Keep Food Safe

When using temperature to keep food safe, foods must stay out of the: Risk Factor 1: Improper Holding & Cooling

Using Proper Temperatures to Keep Food Safe

When using temperature to keep food safe, foods must stay out of the: ! Temperature Danger Zone (41°F to 135°F) Risk Factor 1: Improper Holding & Cooling

Using Proper Temperatures to Keep Food Safe

To keep hot foods safe, they must stay: HOT at 135°F or above* !

*Unless using time instead of temperature Risk Factor 1: Improper Holding & Cooling

Using Proper Temperatures to Keep Food Safe

To keep hot foods safe, they must stay: HOT at 135°F or above* !

*Unless using time instead of temperature Risk Factor 1: Improper Holding & Cooling

Using Proper Temperatures to Keep Food Safe

To keep cold foods safe, they must stay: COLD at 41°F or below* !

*Unless using time instead of temperature Risk Factor 1: Improper Holding & Cooling

Using Proper Temperatures to Keep Food Safe

To keep cold foods safe, they must stay: COLD at 41°F or below* !

*Unless using time instead of temperature Test Your Knowledge

Which of the following is true when using time as a public health control? (click an option below)

written procedures must be in place food must be marked with the time it was taken out of temperature control

food must be served within 4 hours, then discarded after 4 hours

all of the above Test Your Knowledge

Which of the following is true when using time as a public health control? (click an option below)

written procedures must be in place All three options are true, and should be food must be marked with the time it was taken out of temperature control followed to prevent foodborne illness. food must be served within 4 hours, then discarded after 4 hours

allall of of the the aboveabove Test Your Knowledge

Unless your establishment is using time as a public health control, when holding hot foods, the food must stay at or above: (click an option below)

200° F 135° F 41° F 32° F Test Your Knowledge

Unless your establishment is using time as a public health control, when holding hot foods, the food must stay at or above: (click an option below) 200° F 135✓° F 41° F 32° F Hot foods should be held at or above 135° F. Test Your Knowledge

Unless your establishment is using time as a public health control, when holding cold foods, the food must stay at or below: (click an option below)

200° F 135° F 41° F 32° F Test Your Knowledge

Unless your establishment is using time as a public health control, when holding cold foods, the food must stay at or below: (click an option below) 200° F 135° F 41✓° F 32° F Cold foods should be held at or below 41° F. 5 Major Foodborne Illness Risk Factors:

1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources Risk Factor 2: Inadequate Cooking Risk Factor 2: Inadequate Cooking

Why is adequate cooking important?

Cooking is the only food preparation step that can actually kill bacteria. Risk Factor 2: Inadequate Cooking

What is “adequate” cooking?

• Adequate cooking means cooking a food to its correct temperature for at least 15 seconds. • This makes sure the foodborne illness-causing bacteria in the food are killed. Risk Factor 2: Inadequate Cooking

What is “adequate” cooking?

• Different foods contain different types of bacteria, which are killed at different temperatures. • This means that different foods have different minimum cooking temperatures to make sure their bacteria are killed. Risk Factor 2: Inadequate Cooking

Foods that Must be Cooked to 165°F

The foods that must be cooked to 165°F for 15 at least seconds are: • Poultry • Stuffed foods or stuffing • Raw animal foods cooked in a microwave • Reheated Time/Temperature Control for Safety Food (TCS) for hot holding Risk Factor 2: Inadequate Cooking

Foods that Must be Cooked to 155°F

The foods that must be cooked to 155°F for 15 at least seconds are: • Hamburger • Sausage • Injected meats • Eggs (for hot holding) Risk Factor 2: Inadequate Cooking

Foods that Must be Cooked to 145°F

The foods that must be cooked to 145°F for 15 at least seconds are: • Pork • Eggs (for immediate service) • Fish • Shrimp • Whole intact meats Risk Factor 2: Inadequate Cooking

What is “adequate” cooking?

• Remember, the correct cooking temperature depends on the type of food.

• For all foods, be sure to always use a calibrated thermometer to verify temperatures.

Note: Temperature logs are recommended Test Your Knowledge

Poultry, stuffed foods or stuffing, and raw animal foods cooked in a microwave must be cooked to what minimum temperature for at least 15 seconds? (click an option below)

145°F 155°F 165°F Test Your Knowledge

Poultry, stuffed foods or stuffing, and raw animal foods cooked in a microwave must be cooked to what minimum temperature for at least 15 seconds? (click an option below)

145°F 155°F 165°F

Poultry, stuffed foods or stuffing, casseroles, and raw animal foods cooked in a microwave must be cooked to 165°F or higher for at least 15 seconds. Test Your Knowledge

Hamburger, sausage, injected meats, and eggs (for hot holding) must be cooked to what minimum temperature for at least 15 seconds? (click an option below)

145°F 155°F 165°F Test Your Knowledge

Hamburger, sausage, injected meats, and eggs (for hot holding) must be cooked to what minimum temperature for at least 15 seconds? (click an option below)

145°F 155°F 165°F

Hamburger, sausage, injected meats, and eggs (for hot holding) must be cooked to 155°F or higher for at least 15 seconds. Test Your Knowledge

Eggs (for immediate service), fish, shrimp, whole intact meats, pork must be cooked to what minimum temperature for at least 15 seconds? (click an option below)

145°F 155°F 165°F Test Your Knowledge

Eggs (for immediate service), fish, shrimp, whole intact meats, pork must be cooked to what minimum temperature for at least 15 seconds? (click an option below)

145°F 155°F 165°F

Eggs (for immediate service), fish, shrimp, whole intact meats, pork must be cooked to 145°F or higher for at least 15 seconds. 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources Risk Factor 3: Contaminated Food, Utensils and Equipment Risk Factor 3: Contaminated Food, Utensils and Equipment

What is contamination?

• Food can become contaminated when it comes into contact with dirty or contaminated food contact surfaces, or another contaminated food. • This is also called cross-contamination.

It is important to prevent contamination because it can lead to foodborne illness. Risk Factor 3: Contaminated Food, Utensils and Equipment

What are the food contact surfaces that can transfer contaminants to food?

Anything that is contaminated and may later come into contact with food can be a source of cross-contamination, including: • Hands and gloves • Knives and cutting boards • Storage and serving containers • Improperly washed/sanitized surfaces, utensils, and equipment Risk Factor 3: Contaminated Food, Utensils and Equipment

How can you prevent cross contamination?

There are several ways you can prevent cross contamination, including: • Washing hands after handling raw meat, fish, or poultry • Preparing raw meat and poultry in an area away from other foods • Using a separate cutting board for raw meat and poultry • Thoroughly washing, rinsing, and sanitizing ALL food contact surfaces that touch raw meat and poultry Test Your Knowledge

Would this prevent cross contamination?

(Raw meat being thawed in a ware washing sink while dishes are being washed.) Test Your Knowledge

Would this prevent cross contamination?

No. • Raw meat can contain bacteria that causes foodborne illness. • Leaving raw meat in an area where dishes are cleaned could result in bacteria being transferred to clean dishes, and ultimately lead to foodborne illness. (Raw meat being thawed in a ware washing sink while dishes are being washed.) Test Your Knowledge

Would this prevent cross contamination?

(Cutting board and knife being used at the same time for raw chicken and vegetables to be served raw.) Test Your Knowledge

Would this prevent cross contamination?

No. • Raw chicken can contain bacteria that causes foodborne illness. • The chicken can transfer this bacteria to the cutting board and knife, which can then transfer it to the vegetables.

(Cutting board and knife being used at the same time for raw chicken and vegetables to be served raw.) Risk Factor 3: Contaminated Food, Utensils and Equipment

Can cross-contamination occur while food is stored?

Contamination can occur if pieces or juices from raw meat or poultry fall into other foods when stored. To prevent this, always: • Store raw meat below other foods in the refrigerator, and • Store foods with lower cooking temperatures above foods with higher cooking temperatures Test Your Knowledge

Would this prevent cross contamination?

(Raw meat stored over vegetables) Test Your Knowledge

Would this prevent cross contamination?

No. • Juices or small parts of the meat could drop onto the vegetables, transferring bacteria that may cause foodborne illness. • Since the vegetables may not be cooked to a temperature high enough to kill the bacteria in raw meat, or could even be served raw, this could cause foodborne illness. (Raw meat stored over vegetables) Risk Factor 3: Contaminated Food, Utensils and Equipment

How can you prevent contamination?

Washing, rinsing, and sanitizing is key to prevent contamination.

prevent wash rinse sanitize foodborne illness Risk Factor 3: Contaminated Food, Utensils and Equipment

How can you prevent contamination?

Always wash, rinse, and sanitize utensils and equipment: • Between uses for raw and ready-to-eat foods, • When dirty or contaminated, and • At least every four hours if used continuously at room temperature. prevent wash rinse sanitize foodborne illness Risk Factor 3: Contaminated Food, Utensils and Equipment

What is proper sanitizing?

There are two methods of sanitizing that can be used to effectively sanitize utensils and equipment: 1. Hot water 2. Chemical • Chlorine or quaternary ammonia solution can be used for chemical sanitizing Risk Factor 3: Contaminated Food, Utensils and Equipment

How can hot water be used to sanitize?

When using hot water sanitizing for manual washing and sanitizing: 1. Water must be at least 171°F for at least 30 seconds, and 2. Dishes must reach 160°F by immersion in the 171°F water.

When using a machine for washing and sanitizing, water must reach: • 165°F for a stationary rack, single temperature machine • 180°F for all other machines Risk Factor 3: Contaminated Food, Utensils and Equipment

Chemical Sanitizing

For both types of chemical sanitizing, dishes and utensils are immersed in the chemical solution for a specific amount of time.

For chlorine solution: • 25-100 ppm immersion for at least 10 seconds

For quaternary ammonia solution: • 150-400 ppm immersion for at least 30 seconds

Note: Always follow manufacturer instructions when using sanitizing chemicals. Risk Factor 3: Contaminated Food, Utensils and Equipment

After Sanitizing - Drying

Bacteria that cause foodborne illness can grow in water that is trapped between cleaned and sanitized dishes and utensils.

After dishes and utensils are washed, rinsed, and sanitized, make sure they are left to dry in a way that allows air to circulate. Test Your Knowledge

Which of the following immersions is a proper way of sanitizing dishes and utensils? (click an option below)

25-100 ppm chlorine solution for at least 10 seconds

150-400 ppm quaternary ammonia solution for at least 30 seconds

171° F or hotter water for at least 30 seconds

all of the above Test Your Knowledge

Which of the following immersions is a proper way of sanitizing dishes and utensils? (click an option below)

25-100 ppm chlorine solution for at least 10 seconds

150-400 ppm quaternary ammonia solution for at least 30 seconds

171° F or hotter water for at least 30 seconds

All three options are true. allall of of the the aboveabove Any of these three methods can be used to properly sanitize dishes and utensils. Test Your Knowledge

When should food contact surfaces be washed, rinsed, and sanitized? (click an option below)

between raw and ready-to-eat foods

when dirty or contaminated

at least every four hours if used continuously if used at room temperature

all of the above Test Your Knowledge

When should food contact surfaces be washed, rinsed, and sanitized? (click an option below)

between raw and ready-to-eat foods Food contact surfaces when dirty or contaminated should be washed, rinsed, and sanitized at least every four hours if used continuously if used at room temperaturein all three instances.

allall of of the the aboveabove 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources Risk Factor 4: Poor Employee Health & Hygiene Risk Factor 4: Poor Employee Health & Hygiene

Employee Health & Hygiene

• Food workers, even if they look and feel healthy, can spread viruses and bacteria • Only food workers who are healthy and practice good personal hygiene keep harmful germs from getting on food, which prevents foodborne illness Risk Factor 4: Poor Employee Health & Hygiene

Employee Health & Hygiene

Good health and hygiene practices include: 1. Proper handwashing practices 2. No bare-hand contact with ready-to-eat foods 3. Proper illness reporting, for both employees and managers 4. Restricting or excluding sick employees Risk Factor 4: Poor Employee Health & Hygiene

Proper Handwashing

• Handwashing is the most effective way you can prevent spreading bacteria and viruses that cause foodborne illness. • When it comes to handwashing, it is important to understand: • Who • When • Where • and How Risk Factor 4: Poor Employee Health & Hygiene

Proper Handwashing - Who

• All food workers should practice proper handwashing.

• Even if a person looks and feels healthy, they can cause foodborne illness with the viruses and bacteria on their hands. Risk Factor 4: Poor Employee Health & Hygiene

Proper Handwashing - When

• Upon entering the kitchen • After taking a break • Before putting on new gloves • After smoking • Anytime you change tasks • After sneezing, coughing or blowing nose • After using the bathroom • After handling animals or using chemicals • After handling raw meat, fish or poultry • After touching your hair, face, or clothing • After handling garbage or dirty dishes • After eating Risk Factor 4: Poor Employee Health & Hygiene

Proper Handwashing - Where

• Always wash hands in a sink designated for hand washing. • Handwashing sinks should always be clean and in working condition. • Hot water, hand soap, and paper towels should also be available at every hand sink. Risk Factor 4: Poor Employee Health & Hygiene

Proper Handwashing - How

Proper handwashing should last for a total of at least 20 seconds and follow these steps: 1. Wet hands and exposed parts of arms under warm running water 2. Lather soap for at least 10 to 15 seconds on hands (front and back), exposed parts of arms, finger tips, and between fingers 3. Rinse thoroughly under warm running water 4. Dry hands with single-use paper towels or an electric hand dryer 5. Using a paper towel to turn off tap is a good practice (This is recommended to keep bacteria from the tap off of your clean hands) Risk Factor 4: Poor Employee Health & Hygiene

Personal Hygiene

There’s more to good personal hygiene than just handwashing. To help prevent foodborne illness, food workers must also: • Keep hair restrained using a hat, hairnet, beard restraint, etc. • Wear clean outer clothing • Keep fingernails trimmed • Only drink from an approved closed container, with proper handling to prevent cross-contamination in the food prep area Risk Factor 4: Poor Employee Health & Hygiene

Personal Hygiene

To prevent food contamination, it is important that food workers do not: • Wear fingernail polish or artificial fingernails when working with exposed food (unless wearing intact gloves in good repair) • Eat or use tobacco in food prep areas • Wear jewelry (only a plain wedding band is permitted) Artificial fingernails, fingernail polish, tobacco products, and jewelry can fall into food and harm the person who eats it. Risk Factor 4: Poor Employee Health & Hygiene

Bare Hand Contact & Ready-to-Eat Foods

• Bare hand contact with ready-to-eat foods can cause cross contamination, and can spread Hepatitis A and Norovirus.

• It is important to never touch ready-to-eat foods with bare hands to prevent the spread of illness. Risk Factor 4: Poor Employee Health & Hygiene

What are Ready-to-Eat Foods?

• Washed fruits and vegetables served raw • Sandwich meats and cheese • Bread, toast, rolls and baked goods • Garnishes such as lettuce, parsley, lemon wedges and pickles • Ice for consumption • Any food that has been thoroughly cooked and is ready to eat Risk Factor 4: Poor Employee Health & Hygiene

What should be used to handle ready-to-eat foods?

To prevent contamination, always use a barrier instead of bare hands when handling ready-to-eat foods

• Barriers include: • Tongs • Deli paper • Single-use gloves Risk Factor 4: Poor Employee Health & Hygiene

If you choose gloves, always follow these steps:

1 Wash your hands before putting on gloves. 2 Choose only single-use food service gloves. 3 Change gloves: • When they become damaged, dirty, or contaminated • When changing tasks • After handling dirty utensils or equipment • Between working with raw meat and ready to eat foods 4 After you have finished using a pair of gloves: • dispose of the gloves • and wash your hands Risk Factor 4: Poor Employee Health & Hygiene

If you choose gloves, always follow these steps:

1 Wash your hands before putting on gloves. 2 Choose only single-use food service gloves. 3 Change gloves: • When they become damaged, dirty, or contaminated • When changing tasks • After handling dirty utensils or equipment • Between working with raw meat and ready to eat foods 4 After you have finished using a pair of gloves: • dispose of the gloves REMINDER: • and wash your hands To prevent cross-contamination, never wash or reuse single-use food service gloves. Test Your Knowledge Which of the options below is an example of proper glove use? (click an option below)

when gloves become damaged or contaminated: removing gloves, washing hands, and putting on new gloves

between working with raw meat and ready to eat foods: removing gloves, washing hands, and putting on new gloves throwing away a soiled pair of gloves, instead of washing and reusing them

all of the above are examples are proper glove use Test Your Knowledge Which of the options below is an example of proper glove use? (click an option below)

when gloves become damaged or contaminated: removing gloves, washing hands, and putting on new gloves

between working with raw meat and ready to eat foods: removing gloves, washing hands, and putting on new gloves throwing away a soiled pair of gloves, instead of washing and reusing them All three options are examples of proper all of the above are examples are proper glove use all of the above glove use to ensure you prevent cross- contamination and keep food safe. Risk Factor 4: Poor Employee Health & Hygiene

Employee Illness

• Sick food workers are a leading cause of foodborne illness outbreaks.

• It is up to employees and managers to make sure that sick employees do not spread illnesses. Risk Factor 4: Poor Employee Health & Hygiene

Employee Responsibilities

• Employees are responsible for reporting certain symptoms and illnesses to the person in charge of the establishment • Symptoms employees must report to the person in charge are: • Diarrhea • Vomiting • Jaundice (yellowing of the eyes or skin) • Sore throat with fever • Infected lesion on hands or arms Risk Factor 4: Poor Employee Health & Hygiene

Employee Responsibilities

Diagnosed illnesses employees must report to the person in charge are: • Salmonella • Shigella • E-coli • Hepatitis A • Norovirus Salmonella What you need to know

• Common illness name is Salmonellosis. • Sources: Contaminated eggs, poultry, meat, unpasteurized milk or juice, cheese, contaminated raw fruits and vegetables (alfalfa sprouts, melons), spices and nuts. Also animals, pet food, treats and their environments particularly reptiles, amphibians and birds. • Symptoms usually occur within 12 to 72 hours. • Symptoms include: diarrhea, fever, abdominal cramps and vomiting. • Illness duration: 4 to 7 days. Salmonella How can I prevent it?

• Clean hands with soap and warm water before food handling. • Clean and sanitize surfaces before preparing food on them. • Keep food properly refrigerated prior to cooking. • Cook foods to the proper internal temperature and verify with a calibrated thermometer. • Rapidly cool products after cooking to 41 degrees or below. • Separate raw foods from ready-to-eat foods. • Do not use same utensils for raw and cooked foods. • Avoid cross contamination during storage and preparation of foods. E. coli What you need to know

• Common illness name is E. coli, Hemorrhagic colitis or E. coli O157:H7. • Sources: Undercooked beef (especially hamburger), unpasteurized milk and juice, raw fruits, vegetables such as sprouts, food or water contaminated with feces, and unwashed, contaminated hands. • Symptoms usually occur within 2 to 10 days. • Symptoms include: severe watery diarrhea (often bloody), abdominal cramps and pain, vomiting, loss of appetite, weight loss and little or no fever. Can lead to HUS (hemolytic uremic syndrome) resulting in kidney failure. • Illness duration: 3 to 10 days. E. coli How can I prevent it? • Clean hands with soap and warm water after using the bathroom. • Clean hands with soap and warm water before food handling. • Clean and sanitize all surfaces to include counters, cutting boards and utensils and equipment to be used in food preparation. • Use only pasteurized dairy products and juices. • Cook foods to the proper internal temperature, and verify with a calibrated thermometer. Ground beef should be cooked to an internal temperature of 155. • Separate raw foods from ready-to-eat foods. Do not use the same utensils for raw and cooked foods. • Avoid cross contamination during storage and preparation of foods. • Have a negative stool test for E. coli prior to returning to work. Shigella What you need to know

• Common illness name is shigellosis. • Sources: Raw produce, contaminated drinking water, uncooked and cooked foods that are not reheated after contact by an infected food handler. • Symptoms usually occur within 1 to 3 days but range from 12 hours to one week. • Symptoms include: diarrhea (stools may contain blood and mucus), abdominal cramps, fever, and nausea sometimes with vomiting. • Illness duration: 4 to 7 days. Shigella How can I prevent it?

• Clean hands with soap and warm water after going to the bathroom. • Do not prepare food for others while ill with diarrhea. • If a member of your household has been diagnosed with shigella and you are a food handler gloves must be worn as a precaution while working. If you become symptomatic do not work and contact your physician. • Have a negative stool test for Shigella prior to returning to work. Norovirus What you need to know

• Common illness name is Norwalk virus or viral gastroenteritis. • Sources: Raw produce, contaminated water, shellfish from contaminated waters, uncooked and cooked foods that are not reheated after contact by an infected food handler. • Symptoms usually occur within 12 to 48 hours. • Symptoms include: diarrhea, nausea, vomiting, abdominal cramping, fever and headache. • Illness duration: 12 to 60 hours. Norovirus How can I prevent it?

• Clean hands with soap and warm water after using the bathroom. • Clean hands with soap and warm water before preparing food. • If you are ill with diarrhea or vomiting do not prepare or serve food. • Clean and sanitize all surfaces to include counters, cutting boards, utensils and equipment to be used in food preparation. • Wash fruits and vegetables prior to serving. • Use only shellfish from approved waters. • Food service handlers must avoid bare-hand contact with ready-to-eat- foods. Hepatitis A What you need to know

• Common illness name is Hepatitis A. • Sources: Raw produce, contaminated drinking water, shellfish from contaminated waters, uncooked and cooked foods that are not reheated after contact with infected food handler. • Symptoms usually begin within 28 days (ranges from 15 to 50). • Symptoms include: diarrhea, dark urine, jaundice, flu-like symptoms such as fever, headache, nausea and abdominal pain. • Illness duration: varies from 2 weeks to 3 months. Hepatitis A How can I prevent it?

• Clean hands with soap and warm water after using the bathroom. • Clean hands with soap and warm water before handling food. • Use only shellfish from approved sources which have proper certification. • Wash all produce prior to serving. • Food service handlers must avoid bare-hand contact with ready-to-eat- foods. • Get vaccinated if you at risk for getting Hepatitis A. Hepatitis A How is Hepatitis Spread?

Not washing Sex with infected Eating / Drinking Recreational hands partners contaminated food drug use

Who is at Risk? • People who use recreational drugs • People who are currently homeless or in transient living • Gay or bisexual men Risk Factor 4: Poor Employee Health & Hygiene

Manager Responsibilities

The person in charge at the establishment has a responsibility to restrict or exclude employees with certain symptoms and diagnosed illnesses. • “Restricting” means to limit the activities of a food employee. • “Excluding” means to prevent a person from working as an employee in a food establishment or entering a food establishment as an employee.

This prevents a spread of disease that is transmissible through food. Risk Factor 4: Poor Employee Health & Hygiene

Restricting/Excluding Sick Employees

• The person in charge of the establishment must exclude employees while they have: • Diarrhea, or • Vomiting • Employees can return to work after they have been without symptoms for at least 24 hours, or provides written medical documentation from a medical provider stating the symptom(s) is from a non-infectious condition. Risk Factor 4: Poor Employee Health & Hygiene

Restricting/Excluding Sick Employees

The person in charge of the establishment must restrict or exclude* employees while they have: • E. coli • Salmonella • Shigella • Hepatitis A *Always refer to the Employee Health section of the Tennessee Food Service Establishment Rules when determining if restriction or exclusion is required. Risk Factor 4: Poor Employee Health & Hygiene

Restricting/Excluding Sick Employees

The person in charge of the establishment must also notify the health department when an employee has been diagnosed with: • E. Coli • Salmonella • Shigella • Hepatitis A • Norovirus • Or when an employee is jaundiced Test Your Knowledge

When an employee is ill, which of the following symptoms must be reported to a manager? (click an option below)

diarrhea and vomiting

jaundice

sore throat with fever

infected lesion on hands or arms

all of the above Test Your Knowledge

When an employee is ill, which of the following symptoms must be reported to a manager? (click an option below)

diarrhea and vomiting

jaundice All of these symptoms must be reported to a manager to protect the sore throat with fever health of the employee, their coworkers, and their infected lesion on hands or arms customers. allall of of the the aboveabove 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources Risk Factor 5: Food from Unsafe Sources Risk Factor 5: Food from Unsafe Sources

What is a safe source?

A food source is considered safe if: • A regulatory agency has approved it • The source delivers food to your establishment under proper conditions • Proper procedures are followed for shellfish they sell to you Risk Factor 5: Food from Unsafe Sources

Approved Sources

• An approved source means that a regulatory agency has determined that where the food is produced, prepared, or processed meets the standards required by law. • Any food that will be sold or served to customers must come from an approved source. • Local produce vendors (farmer’s markets, etc.) are allowed. Risk Factor 5: Food from Unsafe Sources

Identifying unsafe food when it is delivered

Inspecting food when it is delivered is another way to ensure the food you serve in your establishment is safe. Be sure to check for: • Spoilage • Opened, rusty or severely damaged packaged or canned foods • Dented cans • Proper temperatures — received frozen must be frozen, cold foods must be 41°F or below.

These are all signs of unsafe food and should not be accepted by your establishment Risk Factor 5: Food from Unsafe Sources

Special Procedures for Shellfish

• To be sure the shellfish (oysters, clams, mussels) your establishment serves is safe, verify the source is listed in the Interstate Certified Shellfish Shippers (ICSS) list, which can be located at www.fda.gov • Identification tags should be attached to the shellfish container • Your establishment must keep shellfish tags for 90 days. Risk Factor 5: Food from Unsafe Sources

Important Components of Shellfish Identification Tags

Dealer name and address Dealer certification number

Harvest date Harvester certification number

Harvest location Bold and capitalized statement that “This tag is required to be attached until container is empty and Type and quantity of shellfish thereafter kept on file for 90 days.” 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources 5 Major Foodborne Illness Risk Factors: 1. Improper Holding & Cooling 2. Inadequate Cooking 3. Contaminated Food, Utensils and Equipment 4. Poor Employee Health and Hygiene 5. Food from Unsafe Sources Additional Prevention Measures in the 2009 Food Code 2009 Food Code

Adoption of the 2009 FDA Food Code

• Effective July 1, 2015 the state of Tennessee implemented new rules governing food service establishments. These rules are based in part on the 2009 FDA Food Code.

• Health inspections in Tennessee, as well as this training, are based on the rules of TN Food Service Establishment Rules. 2009 Food Code

What’s in the new code?

The changes under the new TN Food Service Establishment Rules include requirements for: • Consumer advisory • Date marking • Specialized processing • Parasite destruction • Manager certification/demonstration of knowledge TN Food Service Establishment Rules: Consumer Advisory TN Food Service Establishment Rules: Consumer Advisory

Have you seen notes like these before? TN Food Service Establishment Rules: Consumer Advisory

Have you seen notes like these before?

They’re an example of a consumer advisory. TN Food Service Establishment Rules: Consumer Advisory

What is a consumer advisory?

A consumer advisory is a way to let customers know: 1. Which menu items that contain animal foods that are: • Raw,* • Undercooked*, or • Without otherwise being processed to eliminate pathogens* 2. The increased risk of foodborne illness associated with consuming those items

*Consumer advisories are required for these kinds of foods. TN Food Service Establishment Rules: Consumer Advisory

What does a consumer advisory look like?

1. Disclosure 2. Reminder There are two sections that must be included in a consumer advisory. TN Food Service Establishment Rules: Consumer Advisory

What is the disclosure in a consumer advisory?

The disclosure in a consumer advisory: • Is a written statement, and • Clearly identifies items with animal foods that are, or can be ordered, raw or undercooked TN Food Service Establishment Rules: Consumer Advisory

What is the disclosure in a consumer advisory?

Disclosures must include two parts:

2 1 A description of the food Identification of the foods by asterisking (*) to a footnote stating the items are served raw or undercooked TN Food Service Establishment Rules: Consumer Advisory

What is the reminder in a consumer advisory?

The reminder in a consumer advisory: • Is a written statement, and • Is asterisked to make it clear to the customer which foods the reminder applies to, and • Includes specific wording about the health risk of consuming raw or undercooked animal foods TN Food Service Establishment Rules: Consumer Advisory

What is the reminder in a consumer advisory?

The wording in the reminder must be: • “Consuming raw or undercooked meats, poultry, seafood, shellfish or eggs may increase your risk of foodborne illness.” or • “Consuming raw or undercooked meats, poultry, seafood, shellfish or eggs may increase your risk of foodborne illness, especially if you have certain medical conditions.” or • “Regarding the safety of these items, written information is available upon request.” TN Food Service Establishment Rules: Consumer Advisory

Where should a consumer advisory be?

A consumer advisory can be included on: • Reminder statements on the menu or deli case • Placards • Table tents • Brochures or pamphlets • Other areas where it can be written and clearly seen by customers Test Your Knowledge

Which of these foods require a consumer advisory? (click an option below)

Milk Poultry Lamb Fish

Eggs Pork Beef Shellfish Test Your Knowledge

Which of these foods require a consumer advisory? (click an option below)

Milk Poultry Lamb Fish

Eggs Pork Beef Shellfish

Any animal food that will be served or sold raw, undercooked, or without otherwise being processed to eliminate pathogens must have a consumer advisory. TN Food Service Establishment Rules: Date Marking TN Food Service Establishment Rules: Date Marking

What is date marking?

• Even foods that are refrigerated can grow bacteria that can cause foodborne illness. • Date marking is a way to identify how old foods are, and when those foods should be discarded to prevent bacteria from causing foodborne illness. TN Food Service Establishment Rules: Date Marking

What foods need to be date marked?

Foods require date marking when they are: • Prepared in house OR commercially, • Refrigerated, • Ready-to-eat, • Held for longer than 24 hours, and • A TCS food. TN Food Service Establishment Rules: Date Marking

What foods need to be date marked?

REMEMBER! TCS foods include: Foods require date marking when they are: • Meat, fish, poultry, seafood • Prepared in house OR commercially, • Eggs & dairy products • Cooked vegetables • Refrigerated, • Tofu • Ready-to-eat, • Cooked rice, beans, pasta and potatoes • Sprouts (alfalfa and bean) • Held for longer than 24 hours, and • Cut melons • A TCS food. • Garlic or herbs bottled in oil • Sliced tomatoes & cut leafy greens TN Food Service Establishment Rules: Date Marking

Are there exceptions to date marking?

Date marking is not required for the following items: • Deli salads • Aged hard cheese • Semi-soft cheeses • Cultured dairy products • Preserved Fish products • Shelf stable dry fermented sausages • Shelf stable salt-cured products TN Food Service Establishment Rules: Date Marking

What should a date mark include?

• A day or date should be clearly written on the food package to indicate when the food should be consumed, sold, or discarded • Other dates may also be listed, but they are not required • The day/date written can be no more than seven (7) days from when the food was prepared (if prepared in house) or opened (if it was commercially prepared) This item was opened Note: If food is not properly dated, it must be used or discarded within 24 hours. on 7/01/16 TN Food Service Establishment Rules: Date Marking

Does freezing a food change its date mark?

• Freezing a food stops the date marking clock, but does not reset it • When a food requiring date marking is frozen, the marking must include: • Use by date, • Freezing date, • Thawing date, and • Preparation date This makes it clear how many of the original seven days have been used. TN Food Service Establishment Rules: Date Marking Example: Freezing & Date Marking

1 The food is prepared and date marked, and is counted as the first of 7 days it is safe to use. TN Food Service Establishment Rules: Date Marking Example: Freezing & Date Marking

2 The food is stored at The food is prepared and date 1 41º F for two days. marked, and is counted as the first of 7 days it is safe to use. TN Food Service Establishment Rules: Date Marking Example: Freezing & Date Marking

The food is frozen at 0º F the next 2 The food is stored at 3 The food is prepared and date day, and since it was not frozen all 1 41º F for two days. marked, and is counted as the day, it counts as one of the 7 days. first of 7 days it is safe to use. TN Food Service Establishment Rules: Date Marking Example: Freezing & Date Marking

The food is frozen at 0º F the next 2 The food is stored at 3 The food is prepared and date day, and since it was not frozen all 1 41º F for two days. marked, and is counted as the day, it counts as one of the 7 days. first of 7 days it is safe to use.

4 The food remains frozen for 3 days. TN Food Service Establishment Rules: Date Marking Example: Freezing & Date Marking

The food is frozen at 0º F the next 2 The food is stored at 3 The food is prepared and date day, and since it was not frozen all 1 41º F for two days. marked, and is counted as the day, it counts as one of the 7 days. first of 7 days it is safe to use.

4 The food remains frozen for 3 days.

5 The food is thawed and stored at 41º F. This counts as one of the 7 days because it is above 0º F for part of the day. TN Food Service Establishment Rules Date Marking Example: Freezing & Date Marking

The food is frozen at 0º F the next 2 The food is stored at 3 The food is prepared and date day, and since it was not frozen all 1 41º F for two days. marked, and is counted as the day, it counts as one of the 7 days. first of 7 days it is safe to use.

4 The food remains frozen for 3 days.

5 The food is thawed and stored at 41º F. This counts as one 6 The food is stored at 41º F and of the 7 days because it is above 0º F for part of the day. discarded at the end of the day. TN Food Service Establishment Rules: Date Marking

How does combining foods affect date marking?

• If different containers of foods are combined, the date of the oldest ingredient becomes the date marked on the package

• For example: If today is Wednesday, and you are mixing salad prepared on Monday with salad prepared on Tuesday, the salad would be labeled as prepared on Monday. Test Your Knowledge

Which of the following food types require date marking? (click an option below)

refrigerated, ready-to-eat TCS foods

TCS foods kept more than 24 hours

TCS foods prepared in house OR commercially prepared

all of the above Test Your Knowledge

Which of the food types require date marking? (click an option below)

refrigerated, ready-to-eat TCS foods

TCS foods kept more than 24 hours

TCS foods prepared in house OR commercially prepared

all of the above Date marking is required for foods that are: • Prepared in house OR commercially, • Refrigerated, • Ready-to-eat, • Held for longer than 24 hours, and • A TCS food Test Your Knowledge

On a date mark, what must the day/date written on the food package indicate? (click an option below)

when the food should be consumed, sold, or discarded

when the food was purchased

when the food package was opened Test Your Knowledge

On a date mark, what must the day/date written on the food package indicate? (click an option below)

A date mark must include the day/date the food must be consumed, sold, or discarded by. The date mark can also include additional dates, but they are not required. Test Your Knowledge

What temperature should date marked foods be stored at? (click an option below)

51° F 45° F 41° F or below or below or below Test Your Knowledge

What temperature should date marked foods be stored at? (click an option below)

51° F 45° F 41° F or below or below or below✓ Date marked foods should always be stored at 41° F or below. TN Food Service Establishment Rules: Specialized Processing TN Food Service Establishment Rules: Specialized Processing

What is specialized processing?

• Some establishments use food additives for preservation or prepare foods in ways that alter the atmosphere in a food package

• To ensure these foods remain safe, a Food Safety Plan (or variance) is required if these types of practices will be used in your establishment TN Food Service Establishment Rules: Specialized Processing

What is specialized processing?

Some specialized processing methods that require a Food Safety Plan (or variance) are: • Smoking for preservation • Curing food • Using food additives, such as vinegar for preservation • Reduced oxygen packaging • Operating a molluscan shellfish life-support system display tank • Sprouting seeds or beans TN Food Service Establishment Rules: Parasite Destruction TN Food Service Establishment Rules: Parasite Destruction

When is parasite destruction needed?

• Some species of fish contain parasites that can be harmful when eaten. • Parasites are killed during normal cooking, but become a concern when fish are eaten in dishes such as sushi, sashimi, and ceviche, when the fish is : • Raw, • Undercooked, or • Lightly preserved. • Freezing to specified temperatures can kill parasites, allowing these foods to be safe to eat. TN Food Service Establishment Rules: Parasite Destruction

How can parasites be destroyed by freezing?

• To ensure raw or partially cooked fish is safe to eat, it must be: • Frozen at -4°F or below for at least seven days, or • Frozen at -31°F or below until solid and stored at -31° or below for a minimum of 15 hours, or • Frozen at -31°F or below until solid and stored at -4°F or below for a minimum of 24 hours TN Food Service Establishment Rules: Parasite Destruction

Are there exemptions for parasite destruction?

Some species are exempt from this requirement, including: • Molluscan shellfish • Tuna of the species allalunga, albacares (Yellowfin), atlanticus, maccoyii (Bluefin, southern), obesus (Bigeye), or thynnus (Bluefin, northern) • Aquacultured fish, such as salmon if: • Raised in net-pens in open water, or • Raised in land-based ponds or tanks, and • Are fed formula feed that contains no live parasites infective to the aquacultured fish • Fish eggs that have been removed from the skein and rinsed TN Food Service Establishment Rules: Manager Certification TN Food Service Establishment Rules: Manager Certification/Demonstration of Knowledge

What is required of a manager?

• An establishment should always have a designated “person in charge” (PIC) at the establishment. • The PIC is required to have demonstrate appropriate food safety knowledge. • This knowledge can be demonstrated by: • ANSI-approved food safety certification of one employee, • Having an inspection with no priority item violations, or • Correctly answering food safety questions at the time of inspection. TN Food Service Establishment Rules: Manager Certification/Demonstration of Knowledge

What if a manager chooses certification?

• If a manager choose to obtain a certification, it must be from a program using the Conference for Food Protection Standards • You can find a qualified program at the American National Standards Institute’s website, which has a listing of accredited personnel certification programs utilizing the Conference for Food Protection Standards: • https://www.ansica.org/wwwversion2/outside/ALLdirectory Listing.asp?menuID=8&prgID=8&status= TN Food Service Establishment Rules: Manager Certification/Demonstration of Knowledge What if a manager chooses demonstration of knowledge?

If a manager chooses demonstration of knowledge, they must be prepared to*: • Describe the relationship between personal hygiene of a food employee and the prevention of foodborne illness. • Explain the responsibilities, rights, and authorities assigned to the food employees and person in charge. • Explain proper procedures for sanitizing utensils and food contact surfaces of equipment. • Correctly answer additional questions about food safety procedures.

*Manager can be aided by utilizing TN Department of Health Demonstration of Knowledge Fact Sheet or other food safety materials. TN Food Service Establishment Rules: Allergens TN Food Service Establishment Rules: Allergens

What is a food allergen?

• A food allergen is a protein in a food or ingredient which causes sensitivity in some people. • These proteins occur naturally. • When enough of an allergen is eaten, the immune system mistakenly considers it harmful and attacks the food protein. • This can cause an allergic reaction. TN Food Service Establishment Rules: Allergens

The 8 major allergens:

• Milk • Eggs • Peanuts • Tree nuts such as almonds, walnuts and pecans • Soybeans • Wheat • Fish • Shellfish such as crab, lobster, and shrimp TN Food Service Establishment Rules: Allergens

When a guest informs you of a food allergy:

• Take all food allergy requests seriously. Refer the food allergy concern to the PIC or manager. At a minimum, one person per shift should be available to answer questions related to the menu. • Seek clarification from guest and write down guest’s allergy. • Do not guess about ingredients; check labels, packaging and recipes. • Consider the possibility of cross-contact between food items. • Always provide facts so customer can make an informed decision. TN Food Service Establishment Rules: Allergens

Sources of Allergen Cross-Contact: • Uncleaned dining room areas including tables, chairs and trays. • Cooking oils, splatter, and steam from cooking foods. • Allergen-containing foods contacting allergy-free foods. • Food equipment that has not been properly washed, rinsed and sanitized after use such as utensils, cutting boards, bowls, pots, pans and preparation surfaces. • All utensils, cutting boards, bowls, pots, pans and preparation surfaces. • Fryers and grills exposed to foods containing allergens. • Contaminated hands and gloves that have handled potential food allergens. TN Food Service Establishment Rules: Allergens

Good retail practices when handling allergens:

• Dining areas including tables, chairs and trays should be properly cleaned between guests. • Use only fresh ingredients including cooking oil when preparing allergen free meals. • Avoid allergen-containing foods contacting allergy-free foods. • Separate food equipment used in processing foods that contain allergens and ensure equipment is cleaned and sanitized prior to use. This includes all utensils, cutting boards, bowls, pots, pans and preparation surfaces. TN Food Service Establishment Rules: Allergens

Good retail practices when handling allergens(continued):

• Properly wash hands and change gloves after handling potential food allergens. • Clearly mark or otherwise indicate the order for the guest with the identified food allergy. • Check with the chef to make sure you have the right meal prior to serving the guest. Do not allow anyone to add garnishes. Carry the special meal to the table separately. • Check with the guest to make sure they are satisfied with their meal. TN Food Service Establishment Rules: Allergens

Signs and symptoms of a food allergy:

• Symptoms usually develop within an hour or less of eating offending food. • Hives, itching or skin rash. • Swelling of the lips, face, tongue and throat or other parts of the body. • Wheezing, nasal congestion or trouble breathing. • Abdominal pain, diarrhea, nausea or vomiting. • Dizziness, lightheadedness or fainting. TN Food Service Establishment Rules: Allergens

Severe Allergic Reaction: Anaphylaxis

Symptoms experienced can be life-threatening to include: • Swelling of the throat and air passages that makes it difficult to breathe. • Shock, with a severe drop in blood pressure. • Rapid, irregular pulse. • Loss of consciousness. SEEK IMMEDIATE MEDICAL ATTENTION! Congratulations! You have completed this training!

• If you would like to earn a certificate of completion, the you must take and pass the test at the link below. • The passing score required to earn a certificate is 70% or higher. • Feel free to review this training for as long as you like before beginning the test. • Click the link below to take the test: https://www.surveymonkey.com/r/KCHDFoodSafetyTraining • If you have any questions about food safety practices this training, or about the certificate of completion, contact Environmental Health at the Knox County Health Department at (865) 215–5200 Revised August 10, 2018