Date: 12/28/16

Care Connection for Aging Services

NUTRITION POLICIES

PURPOSE

This manual is designed to help you understand and meet the standards of operation for a food service establishment serving the elderly.

SCOPE

Care Connection for Aging Services provides nutrition services to eligible persons age 60 years or over. Approximately 500,000 meals per year will be served to eligible recipients under the Congregate and Home Delivered Meals Programs. Services provided shall meet the standards as outlined in the Older Americans Act, Nutrition Service Standards of the Department of Health and Senior Services and the Missouri Department of Health and Senior Services Rule governing food service sanitation.

RESPONSIBILITIES

It is the responsibility of all Care Connection for Aging Services employees to abide by all policies outlined in this manual.

RECORD KEEPING

Meal Count

Accurate meal counts shall be kept at the center. The Head Cook shall be responsible for keeping an accurate “meal count” for each meal. The total number of meals served (hot, breakfast, supper, frozen, etc) shall be recorded daily. The Head Cook shall match this record to the total meals summary as entered in NAPIS by the Center Coordinator/Home Delivered Meal Data Coordinator at the end of each week. The Center Coordinator /Home Delivered Meal Data Coordinator will be responsible for keeping sign-in sheets on file for a minimum of five years.

Accurate meal counts for satellite centers shall be kept by the head cook of the host kitchen. Meal counts shall be recorded daily on form K513.

Perpetual Inventory Records

1. A perpetual inventory system shall be maintained at each center as required in the Nutrition Service Standards. The Head Cook shall be responsible for overseeing that a perpetual inventory record be kept for all food items at the center. This system shall be kept current at all times at the center during working hours. This inventory shall reflect both receipts and disbursements of food. The inventory records should not be taken home by the Head Cook.

2. The record shall be divided into categories such as frozen foods, dry goods, etc. USDA commodity food items shall be documented in a like manner. These

1 inventory items shall be clearly designated as USDA and shall not be totaled with other stock of like items. This inventory should be kept on file at the center for a minimum of three years.

3. Following is a listing of divisions and headings to be used in establishing the perpetual inventory.

a. Frozen 1. Vegetables 2. Fruits/Juices 3. Meats Beef Chicken/Turkey Fish Pork

4. Breads/Pasta 5. Dairy

b. Canned 1. Vegetables 2. Fruits/Juices 3. Soups 4. Meats

c. Dry Goods 1. Flours/Sugars Graham Cracker Crumbs Meals Oats Biscuit Mix 2. Cake/Dessert Mixes 3. Jell-O/Pudding Mixes 4. Gravies/Cheese Sources/Bases 5. Baking Supplies Pan Spray Yeast Soda Baking Powder Corn Starch Shortening/Oil Food Coloring Cocoa Chocolate Chips 6. Pasta/Rice/Dry Beans 7. Miscellaneous Dry Milk Crackers Salt/Seasonings Cereal Marshmallows 2 Vanilla Coconut Nuts Dehydrated Onion Molasses Peanut Butter Vinegar Raisins Worcestershire Sauce

d. Condiments/Beverages 1. Ketchup 2. Mustard 3. Jelly/DX Jelly 4. Mayo 5. Relish 6. Pickles 7. Salad Dressings 8. Lemon Juice 9. Bacon Bits 10. Picante Sauce 11. BBQ Sauce 12. Coffee 13. Tea 14. Sweet’n Low 15. p/c Sugar Packets 16. p/c Creamer Packets

e. Dairy 1. Margarine 2. Cheese 3. Milk 4. Eggs

Physical Food Inventory

A monthly physical inventory shall be conducted on the last working day of each month. The Head Cook shall be responsible for conducting a monthly physical inventory of all items on hand. The physical inventory figures shall be noted in the perpetual inventory, and any discrepancies appropriately documented. These records shall be kept on file at the center level for a minimum of three years. The Nutritionist or Regional Services Director shall be responsible for verifying the amounts reported in the physical inventory on a monthly basis.

HOME DELIVERED MEAL AND SATELLITE MEAL SERVICE

Safety of Home Delivered Meals

1. The temperatures of meals delivered to home bound participants shall be over 140 degrees for hot foods and under 41 degrees for cold food. The

3 cooks, manager, and meal delivery personnel shall work jointly to assure that these standards are maintained.

2. The following precautions must be taken to insure adequate temperatures:

a. A thermometer shall be used to check the temperature of food on the range or oven. Hot foods shall be 165 to 185 degrees prior to placing in a preheated steam table for packaging.

b. A thermometer shall be used to check the temperature of cold foods to insure the temperature is 41 degrees or below. Foods may be placed in the freezer for a short period if necessary to achieve the proper temperature. Staff and volunteers shall be trained to package meals quickly using an assembly line system and good sanitation procedures.

c. Carriers used in transporting must always be pre-heated and pre- chilled before packing.

Equipment for Home Delivered Meals and Satellite Meals

1. Insulated carriers shall be used to deliver home bound meals. The cook and Coordinator, and County Services Director shall be responsible for securing and maintaining enough suitable carriers for home bound delivery. All equipment used in transporting foods shall have smooth easily cleanable surfaces. The Head Cook shall be responsible for seeing that carriers are cleaned and sanitized daily.

2. Two or more insulated carriers must be used for delivering the meals. Cold foods must be packed together in a carrier, including salads. Hot foods must be packed together in a separate carrier. The cold food carrier should have a frozen unit to help retain cold temperatures. The hot food carrier should have an additional source of heat to help maintain hot temperatures.

Delivery of Home Bound Meals

1. The Center Coordinator, Home Delivery Meal Coordinator, Head Cook and Meal Delivery persons shall work together to insure that meal completion times and route schedules meet this standard.

2. Documentation of the temperatures and time for last delivery for home bound meals will be the responsibility of the Head Cooks and the Meal Delivery persons. Temperatures and time of last delivery of home bound meals shall be recorded at least once a month on the approved agency form (see Form #M213). The cook shall provide a sample meal to be used for checking temperatures. The meal delivery person should be trained in the correct technique for taking and recording temperatures. The time at the last stop shall be noted on the form in addition to the temperature of the designated test meal. Hot food must be delivered to the service 4 recipient within 3 hours following the end of preparation time, and must arrive at a temperature of at least 120 degrees.

MENU PLANNING

Cycle Menus

Standardized menus shall be developed for the noon meal, and breakfast sack meals and supper sack meal.

1. A twenty to twenty-eight (20-28) day proposed cycle menu shall be developed to be repeated for a two (2) or three (3) month period using the approved menu form (see Form #M201). In developing the menu, suggestions shall be solicited from service recipients regarding menu choices. Menus may be reviewed by the local Board Committee for changes appropriate to their center’s activity schedule such as the monthly birthday celebration or other special events. Any changes shall be submitted to the certified nutritionist for final approval prior to the serving date. The Head Cook shall be responsible for obtaining the necessary approval prior to printing the menus in the newspaper, newsletter, etc. A final copy of all menus as served shall be sent to the central office monthly.

2. Each meal shall contain at least one-third (1/3) of the current recommended dietary allowances (RDA) established by the National Policy and Resource Center on Nutrition and Aging.

3. Standardized recipes shall be used to assure quality and quantity. Approved sources for recipes include the cookbook Food for 50 and/or the Care Connection Cookbook.

Meal Pattern

1. The lunch menus shall follow the meal pattern set forth below:

a. 3 oz. cooked edible meat or meat equivalent

b. 1 cup serving fruits and/or vegetables (2 -½ cup servings or 3 -1/3 cup servings to equal 1 cup)

c. 1 serving bread or bread alternate

d. 1 teaspoon butter or margarine

e. ½ cup serving dessert

f. 1 cup milk or equivalent

5 Variations from Accepted Portion Sizes

At the expressed wish of the participant, a menu item can be omitted from the plate served to that participant. Also at the expressed wish of the participant, a reduced portion size can be served to that participant. Center staff may wish to post an attractive, large print, easy-to-read sign in the serving area indicating that menu items can be reduced or omitted at the request of the participant.

Posting of Official Menu Form

The approved menu form provided by the Department of Health and Senior Services will be the official record of menus and portion sizes. The Head Cook shall be responsible for having the approved menu form posted in a highly visible location in the kitchen.

Menu Substitutions

Menu substitutions shall be made in accordance with the following procedures:

1. Whenever possible menu substitutions shall be approved in advance by the central office.

2. Emergency substitutions shall be made by the Head Cook following accepted nutritional standards.

3. All menu substitutions shall be recorded on the appropriate substitution form (see Form #K514) and one copy forwarded to the central office. One copy shall be kept at the center for one year.

Donated Food

1. Only fresh foods may be accepted as donations from individuals, groups or organizations. Fresh food is defined as garden vegetables and fruits in season, any frozen items that have been processed at a USDA inspected facility, and any meat, fresh or frozen, from a USDA inspected facility. This includes fresh bakery items from a commercial bakery.

2. Under no circumstances may the following food items be accepted: home canned foods, foods prepared elsewhere, and farm butchered meats.

3. Donated food items may be substituted into the regular menus only where appropriate. The policy and documentation regarding substitutions to the menu is applicable to donated food items. The Head Cook shall be responsible for inspecting and accepting donated foods and completing necessary documentation and approvals. 6 4. No food shall be accepted from anonymous sources.

Special Diets

1. Special menus where feasible and appropriate shall be provided to meet the particular dietary needs arising from the health requirements, religious requirements, or ethnic background of participants.

2. At a minimum, minor modifications shall be made for the Heart Healthy diet:

a. To reduce calories, baked or broiled meat entrees may be provided. Fresh or juice packed fruits, two percent (2%) or skim milk and vegetables with no fat seasoning shall be provided. A Heart Healthy diet dessert alternative shall be offered daily.

b. To reduce sodium, salt shall be reduced to one-half (1/2) the amount indicated in baked goods recipes; salt-free seasonings used in cooked foods; low sodium entrée choice offered if a high sodium vegetable choice offered if a high sodium vegetable is on the regular menu (example: sauerkraut).

c. To reduce fat and cholesterol, a baked, broiled, or boiled meat entrée may be offered, (except that no liver and no egg yolks shall be served as entrees), skimmed milk, and polyunsaturated margarine in cooking and for table use may be provided.

d. Have available as an alternative to the regular entrée a chef’s salad. The chef’s salad shall be served with the option of a low/reduced calorie dressing and shall consist, at a minimum, of the following: 1 ½ cups lettuce 1 cup combination of any other fresh vegetables 1 hard cooked egg 1 oz. meat. 1 oz. cheese

The chef’s salad shall be offered with the other meal components i.e. bread/crackers, margarine, milk and dessert.

3. Special menus (Heart Healthy) shall be prepared by the agency nutritionist using the Missouri Diet Manual in consultation with a dietitian. Persons responsible for the service of these special diets shall be trained to make appropriate substitutions based on food values.

7 4. All standard and special diet menus shall be recorded on the official agency form approved by The Department of Health and Senior Services. The Head Cook shall be responsible for posting copies of all standard and special diet menus in the kitchen area.

Interruptions to the Menu Cycle

In the case of an interruption of meal service due to inclement weather or other emergency, use the pre-planned menu whenever possible. If the center is closed on the 9th and services resume on the 10th, use the menu scheduled for the 9th and drop the 10th. Continue on the regular menu cycle as posted for the 11th and proceed in like manner for the remainder of the cycle.

Unsweetened Fruit/Dessert

At all times fresh, sugar free, or lite-syrup packed fruit should be available for participant selection in place of the regular dessert items. The Head Cook is responsible for having fruit available daily. Center staff may wish to post an attractive, easy-to-read sign at the serving line explaining that unsweetened fruit is available.

Frozen Meals

1. Frozen meals may be prepared for individuals needing additional meal support during the time when the center is closed. Multiple frozen meals may also be delivered to geographically isolated individuals

2. Frozen meals shall conform to the same meal pattern as outlined in Section 51-6-B, and shall contain at least one-third (1/3 of the R.D.A.'s established by the National Policy and Resource Center on Nutrition and Aging.

3. A commercial freezer must be available for preparing and freezing the frozen meals Foods included should be fresh, high quality items that will not deteriorate during the freezing/rethermalizing process. Trays must be covered and labeled using the agency approved label tray and plastic. All meals must be placed in the freezer in a single layer until solidly frozen.

4. Frozen meals shall be rotated in the freezer to insure quality. No frozen meal may be kept on site for more than two (2) months.

SANITATION REQUIREMENTS

Sanitizing Utensils

All dishes, pots, pans and utensils shall be washed and sanitized properly according to the Department of Health and Senior Services Rules Governing Health and Sanitation.

8 1. Cleaning and sanitizing may be done in a commercial type dish machine in water temperatures of 140 degrees F. for washing and 180 degrees F. for sanitizing. The temperature shall be monitored twice weekly and recorded to assure accurate temperatures are being maintained. These temperatures shall be recorded by the dish machine operator on the appropriate form (see Form #K515) and will be maintained on file by the Head Cook for a minimum of six months.

2. Cleaning and sanitizing may be done in a commercial type dish machine in water temperatures of 120 degrees F. for washing when chemicals are added for sanitation purposes to the rinse water. The chemical sanitizing rinse water temperature shall not be less than 75 degrees F. and the chemicals shall be automatically dispensed. A test kit or other device that accurately measures the parts per million (PPM) concentration of the solution shall be available and used on a daily basis. The dish machine operator shall be trained to check the chemical concentration prior to using the machine each day.

3. Cleaning and sanitizing may be done manually in a three compartment sink using the following method:

a. Dishware should be scraped and presoaked as necessary. Sinks shall be cleaned prior to use.

b. All items shall be washed thoroughly in hot soapy water in the first compartment.

c. Items shall be rinsed free of detergent and abrasives with clean water in the second compartment.

d. All items shall be sanitized in the third compartment by completely immersing items for at least one (1) minute in a clean solution containing at least fifty (50) parts per million of available chlorine and a water temperature of at least seventy- five (75) degrees F. A test kit or other device that accurately measures the parts per million concentration shall be available and used daily.

e. Wash, rinse and sanitizing solutions shall be changed as frequently as necessary to assure they are clean and maintain the correct concentration.

f. All dishware, pots, pans and utensils shall be allowed to air dry before storing.

g. Hands shall be cleaned prior to handling clean dishes and utensils. Clean dishware and equipment will be stored in an enclosed cabinet or stored converted or inverted to prevent contamination.

9 h. The Head Cook shall be responsible for assuring that all employees and volunteers are trained in the above techniques and that the procedures are followed correctly.

Sanitizing Work Areas

1. All equipment and work areas shall be routinely cleaned and sanitized according to a written schedule. The Head Cook shall be responsible for assigning cleaning jobs and shall post a monthly schedule and oversee compliance. (see Form #K511)

a. Equipment and utensils shall be cleaned and sanitized after each use. Food contact surfaces of all cooking equipment shall be kept free of accumulated deposits of grease, food particles and other debris. The cavities and door seals of microwave ovens shall be cleaned at least once a day.

b. Equipment too large to be sanitized by immersion shall be sanitized by wiping with a chemical sanitizing solution of at least 100 parts per million of available chlorine.

c. Moist cloths or sponges used for cleaning nonfood contact surfaces of equipment such as counters and tabletops shall be clean and rinsed in sanitizing solution between uses and shall be used for no other purpose. These cloths shall be stored in the sanitizing solution between uses.

c. Moist cloths or sponges used for wiping food spills and food contact surfaces or equipment shall be clean and rinsed frequently in the chemical sanitizing solution and shall be used for no other purpose. These cloths shall be stored in the sanitizing solution between uses.

(1) The Head Cook shall be responsible for assuring that kitchen staff and volunteers are trained and comply with the above procedures.

(2) A system with color coded containers and wiping cloths may be used to assist in this process.

Garbage Disposal

1. Disposables shall be discarded by a locally approved sanitary method. Garbage and refuse shall be kept in durable, easily cleanable, insect and rodent proof 10 containers. Garbage containers should not leak or absorb liquids. Refuse containers shall be kept covered after they are filled. Waste containers shall be cleaned daily, inside and out. It is the custodians responsibility to clean the trash containers daily.

2. Outdoor refuse storage containers shall be covered at all times. The storage surface must be made of a smooth, nonabsorbent material, (such as concrete) and shall be sloped to adequately drain.

APPROPRIATE ATTIRE/HYGIENE

Food Service personnel should shower or bathe daily prior to reporting to their work station. Fingernails should be kept short, clean and neatly trimmed. (Nail polish should not be worn). Clean clothing should be worn daily.

Food Service workers should not report to work if they have a cold, flu or any other type of communicable disease.

Appropriate handwashing signs should be posted in all restrooms.

Food service personnel shall be appropriately attired to insure their personal safety and maintain good sanitary standards.

1. Appropriate attire is considered to be:

a. Clean clothing in good repair. Blouses and shirts should have sleeves. Clothing should fit closely to the body to avoid “floating” over open flames.

b. Comfortable, closed-in shoes with non-skid soles.

c. Hair net or other effective hair restraint, that completely covers hair. Men with facial hair will be required to wear a beard cover.

d. No jewelry, other than a plain wedding band with no inset stones.

e. Appropriate undergarments and socks or stockings.

f. Slacks or long pants. (Long skirts for female staff may be allowed to accommodate religious restrictions.)

2. Not acceptable at any time are:

a. Open-toed shoes or sandals, or high-heeled shoes.

b. Nail polish or “fake nails”.

11 c. Dangling earrings, necklaces, bracelets, chains, or rings other than a plain wedding band without inset stones.

d. Shorts, short skirts or capri pants.

e. Dirty, soiled, ragged clothing.

f. Full facial hair will not be allowed unless covered by an effective hair restraint. Small, neatly trimmed mustaches will be acceptable.

g. Poor personal hygiene to include dirty hair, body odor, soiled hands and/or fingernails.

h. Evidence of a communicable disease, open wounds etc.

FOOD PURCHASING/PROCUREMENT

All food purchased for consumption by the center must be purchased by the head cook from a reputable, approved vendor. The Nutritionist provides the Head Cook with the current approved food purveyor and, if applicable, dairy purveyor. All food purchased from local grocery stores must be from Care Connection approved stores where there has been a purchasing account set up by the Care Connection Accounting department. The only exception to this would be donated food.

Grocery Ordering

1. All food should be purchased through the current contracted purveyor that is selected by a bidding process once every 3 years. a. Any food not purchased in bulk through the contracted purveyor must be purchased through a Care Connection approved local grocery store. 2. The Nutritionist will provide the head cook with the current contracted purveyor and the information needed to be able to order food online through the purveyor’s website. Grocery Stores

1. All food purchased at local grocery stores must be purchased at Care Connection approved grocery stores. 2. Trips to the grocery store are to be kept to one trip per week. a. If more than one trip per week is needed, approval must be granted in writing by email for an emergency trip to the local grocery store by either the Nutritionist or Regional Services Director. i. A copy of this approval email MUST be attached to the PO notifying accounting that the extra trip was approved. b. Grocery store trips should be planned alongside grocery purveyor order to ensure extra trips and food and wasted time are kept to a minimum. 12 c. Failure to follow this policy could result in disciplinary action. Donated Food

1. Only fresh foods may be accepted as donations from individuals,

groups or organizations. Fresh food is defined as garden vegetables and fruits in season, any frozen items that have been processed at a USDA inspected facility, and any meat, fresh or frozen, from a USDA inspected facility. This includes fresh bakery items from a commercial bakery.

2. Under no circumstances may the following food items be accepted:

home canned foods, foods prepared elsewhere, and farm butchered meats.

3. Donated food items may be substituted into the regular menus only where appropriate. The policy and documentation regarding substitutions to the menu is applicable to donated food items. The

Head Cook shall be responsible for inspecting and accepting donated foods and completing necessary documentation and approvals.

4. No food shall be accepted from anonymous sources.

FOOD SAFETY

Food safety standards shall be maintained at all times to insure the welfare of our elderly participants. The Head Cook is responsible for insuring that all such standards are maintained.

Sample Portions

1. A sample of all potentially hazardous foods shall be available for analysis by the Department of Health and Senior Services in case of an outbreak of food borne illness. The Head Cook shall be responsible for collecting a sample portion (approximately 2 TBSP) of each potentially hazardous item prior to serving the meal. Each individual item must be kept separated from contact with other foods. A divided tray or portion cup may used. The portions shall be covered, labeled and dated and kept refrigerated at least 72 hours (three days).

Hazardous Foods

1. Potentially hazardous foods which have been held in hot holding longer than four hours shall be destroyed. Any prepared food that has lost its quality shall be disposed of as well. The Head Cook shall be responsible for overseeing that hazardous foods have been destroyed in an appropriate 13 manner. Potentially hazardous foods that are held in a refrigerator at 41 degrees F. may be kept for seven days. Potentially hazardous food that are held in “home style” refrigerators maintaining temperatures at 45 degrees F. must be discarded after 3 days.

Safe Foods

1. Foods that are usually considered safe to store, such as fruits, vegetables, cake, breads, cookies, ice cream and fruit pies, may be retained for use while quality remains acceptable.

Equipment for Maintaining Food Safety

1. Each center shall maintain the proper equipment necessary to assure correct food temperatures, i.e. hot foods 140 degrees or above, cold foods at 41 degrees or below and frozen foods at 0 degrees or below.

a. The Head Cook shall be responsible for assuring that hot and cold food temperatures are checked daily immediately prior to service. These temperatures shall be recorded on the appropriate form (see Form #K508). These records must be kept on file at the center for a minimum of six months.

b. The Head Cook shall be responsible for overseeing that freezer and refrigerator temperatures are checked and recorded on a daily basis on the appropriate form (see Form #K504). All refrigerator and freezer units shall be equipped with an internal thermometer displayed in an easily accessible area to facilitate this process.

c. Specific equipment required for all centers serving meals is as follows:

(1) A home style or commercial range (2) A home style or commercial refrigerator (3) A hand washing sink in kitchen area (4) A 3-vat sink for dishwashing, or other acceptable method (5) A hot table for serving (6) A cold table or other method of keeping cold food at required temperature during service (7) Insulated carriers for delivery of bulk food

d. Additional equipment required for on-site food preparation is as follows:

(1) A commercial range/oven with an automatic 14 range-hood extinguishing system. (2) Adequate amounts of freezer and refrigeration space, preferably commercial. (3) A 3-vat sink. (4) A commercial dishwasher. (5) A commercial mixer. (6) A commercial slicer.

Storing Potentially Hazardous Foods

1. Leftover potentially hazardous foods shall be cooled as rapidly as possible to avoid the potential of food borne illness. The following procedures must be followed when cooling and storing foods.

a. Food shall be placed no more than 2” deep in a container to facilitate rapid cooling.

b. All items for storage shall be covered, labeled and dated to insure first-in first-out rotation.

c. Food items shall be immediately placed in the refrigerator or freezer for storage. No potentially hazardous foods shall be held at room temperature during the initial “cooling” period.

d. Once potentially hazardous food items have been cooled to 41 degrees or below they may be stored in a container more than 2” deep. Properly cooked and chilled items that have retained their quality may be stored under refrigeration for up to 7 days if held at 41 degrees or less. If refrigeration temperatures are 45 degrees, food items may be held for a maximum of 3 days. The Head Cook shall be responsible for assuring that these guidelines are adhered to by both staff and volunteers serving in the kitchen.

` Transporting Prepared Foods in Bulk to Satellite Locations

1. Hot food items transported to another location shall be delivered within three and one-half hours (3-1/2) following the end of the meal preparation. This limit includes the time allotted for packaging the food, transporting to the service area, holding time at the center, packaging meals for home-delivered meal recipients, and transporting the meals to the home.

2. Hot delivered foods shall be at a minimum temperature of 140 degrees and cold foods shall be at a maximum temperature of forty-one (41) degrees Fahrenheit. Food temperatures with minor deviation (5-10 degrees) from 15 these standards will result in the food item being heated or chilled to standards prior to service. In the case of food temperatures with significant deviations from these standards the central office will be notified immediately. A daily record shall be kept of the time of delivery and the temperature of hot and cold food items. Management shall be responsible for maintaining the temperature/time log. It shall be kept on file at the center level for a minimum of six months.

Taking Food Items From the Center

1. Participants are discouraged from taking home any potentially hazardous food items.

2. Left-over food items shall not be given to an employee or recipient to take from the center. It will be the responsibility of center staff to assure that these guidelines are adhered to by employees and participants.

Food Preparation Safety

A minimum of one time per year the Nutritionist must provide and center staff will implement a nutrition education program on the topic of food safety.

1. All menu items shall be prepared and held in such a manner as to conserve nutritive value and food quality. The following standards of preparation and holding shall apply:

a. Standardized recipes, adjusted for appropriate yield, shall be used in menu preparation.

b. Standard measuring cups and spoons will be used in preparing foods.

c. Meats should be cooked at low temperatures to conserve moisture and promote tenderness (300-325 degrees – convection oven; 325-350 degrees – conventional oven).

d. Roasts shall be cooked to the correct internal temperature.

e. Vegetables shall be cooked in minimal amounts of water to conserve nutrients. Vegetables shall be cooked a minimal amount of time to assure retention of color, flavor and texture.

f. Whenever possible, fresh fruits and vegetables will be served with the skin intact. Vegetable peelers 16 will be used when necessary to take the minimal amount of flesh off with the skin.

g. All foods will be heated to the proper temperature before being placed on the steam table. NO FOOD is to be heated on the steam table.

h. Foods will be held above 140 degrees or below 41 degrees as appropriate.

i. Foods will be held on the steam table no longer than 30 minutes before service.

j. Foods on the service line will maintain these temperatures:

Broth/Soup – 150-260 degrees Eggs and recipes containing milk/cheese – 140-160 degrees Other hot foods – 140-160 degrees Cold foods – 35-40 degrees

FOOD HANDLING PROCEDURES

Adequate food handling procedures shall be followed to prevent transmission of bacteria causing food borne illness. The following requirements shall be met to insure that food items are handled in a safe and sanitary manner at all times.

Receiving

1. The Head Cook shall insure that all deliveries are inspected and checked in promptly. Receiving temperatures for all dairy products, including milk, shall be 41 degrees. Receiving temperatures for all refrigerated, processed foods shall be 41 degrees. Receiving temperatures for all refrigerated foods need to be taken, and items found not to be at the correct, safe temperature need to be refused. Items shall be cleaned if necessary and placed in appropriate storage area. Items identified as damaged will not be accepted, i.e. meat, or any frozen food that is thawed or has obviously been thawed and refrozen, (shows excessive ice crystals on the packaging) items with broken packaging thus exposing foodstuffs to the air, soiled produce, and dented or bulging cans.

2. Food service personnel shall follow all applicable fiscal control policies with regard to receiving goods. Invoices shall be clearly marked to indicate condition and quantity of items received. The invoice shall be signed and dated at time of receipt by employee or volunteer so designated.

Storage

17 1. All food items will be stored six (6) inches off the floor and eighteen (18) inches from the ceiling. All food items, both dry and refrigerated, will be dated and rotated to assure first-in first-out usage. Food items shall be stored separately from cleaning supplies and chemicals. Dry food storage areas shall be well ventilated, away from direct sunlight and have a temperature maintained between 50 degrees and 70 degrees Fahrenheit.

2. Open dry goods (floor, sugar, dry beans, etc.) will be stored in clean, air-tight containers. These containers shall be labeled on the side and the top of the container, identifying the food by common name.

3. Leftovers will be stored in shallow, 2 inch pans or containers to promote rapid cooling. All leftovers will be covered or wrapped, labeled and dated. When refrigerating, no cooked foods shall be stored under raw foods (including milk and eggs). Leftovers shall be kept per instructions in the Storing Potentially Hazardous Foods Section . Leftover food items can be reheated only once, to 165 degrees, for service. Any remaining product will be discarded.

4. Proper food storage temperatures will be maintained. Refrigerators will be kept at 40 degrees or less and freezers will be maintained at 0 degrees. Thermometers will be kept in each refrigerator and each freezer. These temperatures shall be taken daily when first opened and recorded on the appropriate form (see Form #K504). These records must be kept on file at the center for six months.

Preparation

1. Meats will be thawed in the refrigerator or under cold running water. Meats thawed under refrigeration shall not be placed above fresh or cooked foods. Meat shall be thawed on the lower shelves of the refrigerator.

2. Raw fruits and raw vegetables shall be thoroughly washed with clean water before being cooked or served.

3. Foods shall be held at room temperature only as long as required for preparation. All potentially hazardous foods will be kept either hot (above 140 degrees) or cold (below 40 degrees) as appropriate.

4. All food will be handled in such a manner as to minimize manual contact. Personnel will handle ready-to-eat items with appropriate utensils or gloved hand. 18

5. Work surfaces and equipment will be kept clean and sanitized. Cutting boards, slicers and knives will be washed and sanitized in between products, i.e. cutting board will be cleaned and sanitized after cutting poultry and before preparing vegetables. Preparation will be kept separate from sanitation areas, i.e. produce will not be washed in pot sink.

Service

1. All food items will be handled with appropriate utensils or with gloved hand. Appropriate portion control utensils and scales shall be used during meal service.

2. Tableware and flatware will be handled so as to avoid contamination of the eating and drinking surfaces. This policy shall be adhered to both during service and preparation and clean-up of meal.

Personnel

1. All personnel shall wash hands prior to beginning meal preparation and as frequently as necessary throughout their shift. Hands shall be washed after smoking, eating, drinking and using the toilet. Hands shall be washed after handling soiled dishware and prior to handling clean dishes.

2. Food service personnel shall not chew gum, smoke or eat except on break. Employees shall not use tobacco in any form while engaged in food preparation or service, or while in areas used for food storage, washing equipment or utensils, or for preparing food. Employees shall use tobacco only in designated smoking areas in their center.

3. Drinking non-alcoholic beverages will be permitted in kitchen only if beverage container has lid covering the contents at all times.

4. All food service personnel shall be expected to maintain a high degree of personal cleanliness. Employees will be in good health, free of open, draining wounds, sores or rashes, and free of communicable disease.

5. Food service personnel will not perform any act while preparing food that may contaminate the food, i.e. wipe nose, scratch, groom hair, etc. If such an act should occur, hands will be thoroughly washed before resuming duties.

6. The Head Cook and/or management staff shall be responsible for insuring that the above handling procedures are followed by both employees and volunteers. 19

MEAL SERVICE

Equipment

Each center shall maintain an adequate number of portion control serving utensils to meet the needs of the menu cycle. The Head Cook and/or Manager/Director shall be responsible for insuring that kitchens are equipped with portions scales, various sized dishers, and spoodles as appropriate.

Serving Time

The Head Cook is responsible for assuring that food service is available to the participants for a minimum of sixty (60) minutes from the beginning of serving time.

Choice Menus

Menus offered shall follow the proposed cycle menu with choices available for entrees, vegetables, and desserts. Participants (both congregate and home bound) will be allowed to select from those choices, a meal that meets or exceeds the required meal pattern.

Meal Selection

All centers shall have meals available to home-bound participants that will meet their needs for seven days a week if necessary. This can be all hot noon meals or a combination of hot and frozen meals. Further all centers shall have meals available for home-bound participants for a breakfast sack or super sack (or both) in combination with the hot noon meal.

FROZEN MEALS Meals that meet the required menu pattern may be prepared in advance of service and frozen for use as evening meals or for delivery to isolated, rural elders on a weekly basis. All meal components shall be included with any frozen meals delivered, including, bread, butter, dessert and milk.

The following guidelines must be strictly adhered to in the preparation of frozen meals:

1. Only freshly prepared, high quality foods may be frozen. 2. Packaging materials shall be clean and free of tears and/or punctures. 3. Meals may be frozen only in a commercial freezer that maintains temperatures from 0 to 10 degrees F.

4. Meals must be placed in a single layer in the freezer until solidly frozen.

20 5. Foods must be packaged quickly, using safe food handling procedures, and immediately placed in a single layer in the freezer.

6. Meals must meet the required meal pattern of 3 oz. meat and 2 servings of vegetables (or 1 vegetable and 1 fruit).

7. All meal components placed in the tray must be capable of being reheated at 350 degrees F. within a 30 minute span. Hot foods and cold foods should be plated separately.

8. Bread products, desserts and milk must be packaged separately to be delivered with the meal tray.

9. All meal trays and menu components (i.e. bread, dessert) must be covered and sealed in freezer approved packaging. Agency approved labels must be attached to every meal tray.

10. Meals should be rotated in the freezer to insure that the oldest meals are used first.

11. No frozen meal or meal component shall be kept in the freezer for more than two months.

12. The following items shall NEVER be used in frozen meal trays:

a) Lettuce or other cold vegetable salads b) Previously cooked broccoli, cauliflower, brussel sprouts c) Macaroni and cheese d) Jell-O salads or other gelatin products e) Sandwich fillings with mayo, salad dressing, eggs f) Meringues g) Custards h) Sour cream products

13. A copy of the flyer “Guidelines for Preparing Frozen Meals” shall be posted visibly in every kitchen. The Head Cook shall be responsible for insuring that the guidelines are adhered to at all times.

EMPLOYEE MEAL POLICY

All employees of Care Connection can purchase a noon meal at the center. The cost to employees under age 60 will be $3.50 Employees who are age 60 years or over are eligible participants and may obtain a meal for a contribution. 21

Cooks working in the kitchen are required as a part of the job to taste and sample food items for quality assurance purposes. Cooks actively working in the kitchen area will not be required to pay for food consumed as a part of their normal quality assurance routine. Cooks are required to sign the Nutrition Program Sign- in Sheet, unless they are age 60 years or older.

All employee meals must be eaten in the center. The meal components and portions for employee meals shall be the same as the standard portions as defined by the Nutrition Program Standards, unless the employee requests smaller portions. Under no circumstances shall employees take a meal from the center.

Employee’s relatives and/or friends who are under age 60 must sign the Nutrition Program Sign-in Sheet and pay the full cost of the meal directly to the staff person or volunteer working the desk. The staff person or volunteer must note “paid” by the participant’s name indicating that the full cost of the meal was paid.

Meal cost and age qualification for children will be the decision of the Center Services Board and must be recorded in the minutes and posted in the center.

Serving Line - Implementing the Plan

1. Look in the refrigerators and determine if there are any leftovers (of good enough quality!) to use as extras on the serving line.

2. Plan your placement of items in both the hot and cold tables. Think of appearance and convenience. Put gravy by the potatoes, dressings near the salad, etc.

3. If you have two-sided service on the serving line make sure that all items can easily be reached from both sides – without reaching through to the other side of the buffet. Use half long pans, rather than half square pans to help facilitate this.

4. Make sure there is a space available for each item and use the appropriate size of pan when cooking the item!!

5. There should be no 6” full pans on the line, except in the case of serving soup. Then a ½ (long) 6” pan would be appropriate. A good supply of various size pans allows you the freedom to add more and smaller amounts of items to the buffet as needed.

6. It is imperative that food be batch cooked and served fresh. It is better for patrons to have to wait a moment or two for a fresh pan of an item, rather than serving themselves from a large, half-full pan of over-held product.

22 7. The serving line and/or salad bar needs to be monitored by a food service employee trained in safe operating procedures. (MO Food Code)

8. Be aware of exact portion costs, and feature some lower cost items on the serving line.

9. Use smaller utensils for serving. Instead of 4 oz. spoodles, use 2 oz. The same will be true for ladles and dippers. If possible, without ruining appearance, cut meat portions in half before placing on the line.

10. Condiments should be protected from contamination, by being kept in dispensers that are designed to provide protection, or in individual packages or portions. (MO Food Code)

11. If a patron returns to the serving line, they must get a clean dish, so adequate dishes must be available. (State health regulation)

12. Never mix freshly prepared food items with food that has been sitting on the serving line. As one item runs out, replace the entire pan with a new pan of fresh product. Never mix old and new. (State health regulation)

Serving Line Set Up

How you assemble the serving line is key to the success of the entire operation!!

It must be clean. It must be attractive. It must have a variety of colors.

 Assemble food items so that customers select all of the lower cost items first.

 Put bread, salads, vegetables at the beginning of the serving line. Leave high cost items, such as meats and desserts until the very end. This allows the customer to fill up their plates with less expensive items and reduces the chance that they will load their plates with your very expensive meat items.

 You will need some type of small menu signs to identify the food on the serving line. These are available from several sources, or they can be made on the computer. They must be neat and attractive.

 Portion desserts into individual dessert dishes and have a very visible, (attractive) sign, saying customers are limited to one dessert! Otherwise you are likely to incur problems of over-serving in this area.

 Assign a staff member or a trained volunteer to monitor the serving line.

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