The following food service requirements
(1) Where all food is provided
by the facility arrangements shall be made so that each resident has available
at least three meals per day. Exceptions may be allowed on weekends and
holidays providing the total daily food needs are met. Not more than fifteen
(15) hours shall elapse between the third and first meal.
(2) Where meal service within a facility is
elective, arrangements shall be made to assure availability of an adequate
daily food intake for all residents who, in their admission agreement, elected
meal service. If a resident's condition changes so that he is no longer able to
cook or purchase his own meals, the admission agreement shall be modified and
the resident provided full meal service.
(3) Between-meal nourishment or snacks shall
be made available for all residents unless limited by dietary restrictions
prescribed by a physician.
Meals on the premises shall be served in a designated dining area suitable for
the purpose and residents encouraged to have meals with other residents. Tray
service shall be provided in case of temporary need.
(5) Meals shall consist of an appropriate
variety of foods and shall be planned with consideration for cultural and
religious background and food habits of residents.
In facilities for sixteen (16) persons or
more, menus shall be written at least one week in advance and copies of the
menus as served shall be dated and kept on file for at least 30 days.
Facilities licensed for less than sixteen (16) residents
shall maintain a sample menu in their file. Menus shall be made available for
review by the residents or their designated representatives and the licensing
agency upon request.
Modified diets prescribed by a resident's physician as a medical necessity
shall be provided.
(8) All food
shall be of good quality. Commercial foods shall be approved by appropriate
federal, state and local authorities. Food in damaged containers shall not be
accepted, used or retained.
Procedures which protect the safety, acceptability and nutritive values of food
shall be observed in food storage, preparation and service.
(10) Where indicated, food shall be cut,
chopped or ground to meet individual needs.
(11) Powdered milk shall not be used as a
beverage but may be used in cooking or baking. Raw milk shall not be used. Milk
shall be pasteurized.
upon written approval by the licensing agency, meat, poultry and meat food
products shall be inspected by state or federal authorities. Written evidence
of such inspection shall be available for all products not purchased from
canned foods shall not be used.
(14) If food is prepared off the facility
premises, the preparation source shall meet all applicable requirements for
commercial food services. The facility shall have adequate equipment and staff
to receive and serve the food and for cleanup, and shall maintain adequate
equipment for in-house preparation and service of food in
(15) All persons
engaged in food preparation and service shall observe personal hygiene and food
services sanitation practices which protect the food from
(16) In facilities
licensed for sixteen (16) to forty-nine (49) residents, one person shall be
designated who has primary responsibility for food planning, preparation and
service. This person shall be provided with appropriate training.
(17) In facilities licensed for fifty (50) or
more, and providing three (3) meals per day, a full-time employee qualified by
formal training or experience shall be responsible for the operation of the
food service. If this person is not a nutritionist, a dietitian, or a home
economist, provision shall be made for regular consultation from a person so
qualified. The consultation services shall be provided at appropriate times,
during at least one meal. A written record of the frequency, nature and
duration of the consultant's visits shall be secured from the consultant and
kept on file in the facility.
Sufficient food service personnel shall be employed, trained and their working
hours scheduled to meet the needs of residents.
(19) There shall be one or more dining rooms
or similar areas suitable for serving residents at a meal service, in shifts
where appropriate. The dining areas shall be convenient to the kitchen so that
food may be served quickly and easily and shall be attractive and promote
socialization among the diners.
(20) The ventilating systems in food
preparation areas shall be maintained in working order and shall be operated
when food is being prepared. Food preparation equipment shall be placed to
provide aisles of sufficient width to permit easy movement of personnel, mobile
equipment and supplies.
Freezers of adequate size shall be maintained at a temperature of 0 degree F
(-17.7 degree C), and refrigerators of adequate size shall maintain a maximum
temperature of 40 degree F. (4 degree C). They shall be kept clean and food
stored to enable adequate air circulation to maintain the above
(22) Adequate space
shall be maintained to accommodate equipment, personnel and procedures
necessary for proper cleaning and sanitizing of dishes and other
(23) All readily
perishable foods or beverages capable of supporting rapid and progressive
growth of micro-organisms which can cause food infections or food intoxications
shall be stored in covered containers at appropriate temperatures.
(24) Pesticides and other toxic substances
shall not be stored in food storerooms, kitchen areas, or where kitchen
equipment or utensils are stored.
(25) Soaps, detergents, cleaning compounds or
similar substances shall be stored in areas separate from food
(26) Supplies of
nonperishable foods for a minimum of one week and perishable foods for a
minimum of two days shall be maintained on the premises.
(27) All kitchen areas shall be kept clean
and free of litter, rodents, vermin and insects.
(28) All food shall be protected against
contamination. Contaminated food shall be discarded immediately upon
(29) All equipment,
fixed or mobile, and dishes, shall be kept clean and maintained in good repair
and free of breaks, open seams, cracks or chips.
(30) All utensils used for eating and
drinking and in preparation of food and drink, shall be cleaned and sanitized
after each usage.
utensils shall be disinfected:
(A ) In
facilities using mechanical means, by either maintaining hot water at a minimum
temperature of 170 degree F (77 degree C) at the final rinse cycle of
dishwashing machines, or by disinfecting as specified in (B) below.
(B) In facilities not using mechanical means,
by an alternative comparable method approved by the licensing agency or by the
local health department, such as the addition of a sanitation agent to the
final rinse water.
Equipment of appropriate size and type shall be provided for the storage,
preparation and service of food and for sanitizing utensils and tableware, and
shall be well maintained.
Tableware and tables, dishes, and utensils shall be sufficient in quantity to
serve the residents.
devices shall be provided for self help in eating as needed by