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Navigating the New Requirements for Food Handling on a Budget Norovirus Virions, Image Courtesy of PHIL
Navigating the New Requirements for Food Handling on a Budget
Norovirus Virions, Image Courtesy of PHIL
Provide an overview of the burden of Foodborne Illness (FBI) in the US
and the impact specifically for Highly Susceptible Populations (HSPs) as
well as it’s common causes and how it can be prevented.
Review the new requirements for food handling for ALRs and how to
meet them without breaking the bank – follow along with the
regulations if you like
Cost saving tips to assure personal health, hand hygiene, approved foods, food temperatures and storage, cleaning, and employee training will appear in green throughout.
Facts that explain the why behind each requirement will appear in blue.
The Centers for Disease Control estimates that:
48 million people or 1 in 6 Americans gets sick from foodborneillness every single year
128,000 of those are hospitalized
3,000 die from foodborne diseases each year
Highly Susceptible Population
means persons who are more likely than other people in
the general population to experience foodborne disease
because they are immunocompromised, preschool age
children, or older adults; and they obtain food at a
facility that provides services such as custodial care,
health care, or assisted living, such as a child or adult day
care center, kidney dialysis center, hospital or nursing
home, or nutritional or socialization services such as a
senior center.
Death rates for infectious diarrheal disease are
5X higher in people over 74 years of age than in
the next highest group, children <2, and
15X higher than the rates for younger adults.
Studies attribute this heightened risks, to
several factors: (1) the aging of the GI tract (2)
a higher prevalence of underlying medical
disorders; and (3) malnutrition and a decline in
the immune response.
-Marler Clark, LLP., PS.
0
50
100
150
200
250
300
<1 1-4 5-18 19-40 41-55 56-64 65-80 81-99
Shigella
Salmonella
Listeria
E. coli
Campylobacter
Colorado, 2009-2013
Severe consequences, requiring hospitalization, increase with age for all of the top foodborne illnesses.
In a 10 year study, FDA and CDC determined the 5 primary causes of FBI: Poor Personal Hygiene* Improper Holding Temperature*
▪ (Cold and hot holding, cooling and reheating)
Contaminated Equipment Inadequate Cooking Food from Unsafe Sources
All of the new requirements are based on these 5 factors.
The top 5 causes of FBI from food eaten in the US are: Norovirus 5,461,731 (58%) Salmonella 1,027,561 (11%) Clostridium perfringens 965,958 (10%) Campylobacter 845,024 (9%) Staphylococcus aureus 241,148 (3%)
Other agents don’t cause as many illnesses, but are more likely to lead to hospitalization. Those germs include: Clostridium botulinum, the germ that causes botulism Listeria E coli O157 Vibrio
Researchers have identified >250 foodborne diseases!-CDC
>90%
0%
10%
20%
30%
40%
50%
60%
RFE Institions LTCF
Cross-Cont
Hand Wash
Hygiene
Hot Hold
Cold Hold
Adequate HS
Anyone preparing or serving food is required to
take food safety training and maintain
evidence of completion on site.
Online training such as statefoodsafety.com cost $10 and take roughly two hours to complete. You can print or save a PDF of your certificate right from the site.
Please note this course was designed for restaurants. Sections of this course that talk about commercial equipment do not apply to ALR with less than 20 beds! Focus on the behaviors associated with food safety such as cooling, cooking, reheating, hygiene, handwashing
THIS course is being made into an online training that will be available online, free to take anytime anywhere and tailored to these requirements!!
Staff must be in good health & free of communicable disease while handling, preparing or serving food or handling utensils.
Staff cannot handle, prepare or serve food while experiencing any of the following symptoms:▪ Vomiting, diarrhea, sore throat with fever, jaundice or lesion
containing pus on the hands or wrists
Staff with these symptoms can’t return to handling food until at least 24 hours after symptoms resolve.
Ill employees are a significant factor in large FBI outbreaks
If you only have one person that prepares food, you can serve prepacked foods, serve self service items and use single use utensils until that
person is well enough to return to food handling
When an employee is diagnosed with Norovirus,
Shigella, E. coli, Hepatitis A, Salmonella Typi,
or other bacterial enteric pathogen the person
in charge is required to consult with the
Department before the employee is allowed to
return to handling food or utensils.
These are serious illnesses that can easily spread through food. Keeping anyone diagnosed with these conditions from handling food is your best defense against a devastating outbreak and resulting liability for causing
preventable severe illness, hospitalizations and deaths.
Food handlers, cooks and servers must properly wash their
hands using the following procedure:
Wash using warm (100⁰F to 120⁰F) soapy water by vigorously
scrubbing all surfaces of the hands and wrists for at least 20
seconds. Rinse hands clean. Thoroughly dry hands with a
disposable paper towel. Use the paper towel to turn off sink
faucets before disposing.
Your kitchen sink can serve as your hand sink and can be used for washing dishes and produce as long as it’s cleaned and sanitized
between uses.
Before:
leaving the restroom, and again before returning to
food or beverage preparation, or dishwashing;
handling or putting on single use gloves for food
handling and between removing soiled gloves and
putting on new, clean gloves.
After: coughing, sneezing, using a tissue, smoking or eating; touching the hair, face or body; handling soiled dishes or utensils; feeding or caring for residents; caring for pets or other animals; and engaging in any activities that contaminate the
hands, handling garbage, mopping, working with chemicals and other cleaning activities.
When switching between handling raw animal foods and ready-to-eat foods and as often as necessary to remove contamination and prevent cross contamination when changing tasks.
Employees must: have good hygienic practices and wear clean clothing, smock or
uniform while handling food or utensils. are prohibited from using common towels to wipe or dry their
hands, single use paper towels are ideal! not eat or smoke in areas used for food preparation or storage.
Drinking in these areas is allowed with enclosed containers. not touch their faces, hair or other body surfaces while handling
food. not taste food during preparation with a utensil that is not clean
and sanitized. The same utensil must be washed, rinsed and sanitized before it is reused.
Utensils used to dispense food must have handles that are kept out of food and ice
33% of outbreaks are attributed to poor personal hygiene
Good handwashing protects your residents and your staff from sick days and lost wages.
Ready-to-eat foods cannot be handled
with bare hands.
Instead gloves or utensils must be
used to handle, prepare and serve
these foods.
Ready-to-eat foods include cold cuts,
produce, breads, garnishes, fruit and
even ice. Eliminating bare hand contact with ready-to-eat foods is the most effective means of control NOROVIRUS, an illness that spreads rapidly through food and from person to person quickly making everyone exposed sick.
Handwashing provides a
2 log reduction in viral particles
(vp) = 10,000,000,000
Ungloved hands can transfer
1,000,000,000 vp
It only takes 1-10 vp to cause
illness
Handwashing isn’t enough!
Gloves or utensils are required
every time you handle ready-to-
eat foods.
Gloves must be used in a manner that prevents
contamination of food and food contact surfaces.
Gloves are to be changed whenever switching from
handling raw animal foods to ready-to-eat foods and
whenever else gloved hands become contaminated.
When gloves are changed, hands must be washed.
Deli tissues and utensils can be used for many foods reducing the number of gloves needed.
All foods, including raw ingredients and prepared foods, must come from approved, licensed or registered sources or food manufacturers.
Produce can be obtained from other sources, including grown in your own garden, as long as good agricultural practices are used.
Easy to follow best practices for safely growing and harvesting your own vegetables can be found on our website. Food Safety for Vegetable Gardens -Tips for School, Child Care and Long Term Care Facilities
Click on Food Safety then Food Safety for Gardens
https://www.colorado.gov/cdphe/DEHS
Grow Produce Safely
Foods that cannot be served ready-to-eat:
Raw animal foods (e.g., raw fish, shellfish, steak tartare)
Partially cooked animal foods (e.g., poached fish, soft cooked/boiled
eggs*, rare burger)
Raw milk
Raw seed sprouts
Juice that is not pasteurized under a HACCP plan unless it is squeezed
to order on site
Pasteurized eggs can be ordered by large suppliers or can be requested at local grocers, they cost slightly more than other eggs but are only needed for eggs you undercook.
These requirements do not preclude residents from consuming foods they acquire themselves or from loved ones.
Unlike most bacteria, Listeria can grow and multiply in foods inside the refrigerator at 41⁰F and below.
At least 90% of LM cases occur in highly susceptible populations. -CDC
The best mechanism to control bacteria is to control the time refrigerated foods are stored.
-Image Courtesy PHIL
Potentially hazardous foods that are not cooked,
especially:
Lunch meats*
Deli salads made in-house
Soft cheeses
It is strongly recommended, but not required, that lunch
meats, hot dogs, and cold cuts be cooked or heated before
service to highly susceptible populations.
Date marking is required to control for Listeria
monocytogenes (LM)
▪ Keeping foods too long increases the risk of LM
Ready-to-eat, refrigerated foods not used within
24 hours must be labeled for use or discard 7 days
after opening/preparation
This does not apply to commercially prepared condiments and dressings.
You can use any means you like to date mark foods as long as it consistent and easy to understand.
Food Temperatures
Whole roasts (beef, lamb, pork) 135˚F
Beef steaks 145˚F
Eggs**, pork, lamb, fish 145˚F
Ground beef, fish, pork, lamb, veal 155˚F
Poultry (ground or whole), stuffed meats 165˚F
**Pasteurized eggs can be cooked to order and do not need to reach 145°F before being served.
Analog food thermometers typically cost <$10 and can be easily recalibrated using ice water and used for years to come.
Prepare glass of ICE & WATER.
Place thermometer in ICE & WATER.
Wait until needle stops moving.
Does the temperature read 32°F?
No
Adjust the dial, while leaving the stem in the water, by
holding the nut underneath securely & turning the face to
read 32°F.
Yes
Thermometer is calibrated correctly.
Thermometers should be calibrated often. Once a week is sufficient and anytime they have been dropped or seem to be off.
How fast can bacteria multiply?
At room temperature, just ONE bacterium in
food can grow to…
2,097,152 bacteria
In just 7 hours!
Under ideal conditions, bacteria multiply rapidly, in
fact they multiple exponentially.
Salmonella typhimurium- courtesy of CDC’s PHIL
Potentially hazardous
foods (PHF)
Potentially hazardous foods are foods with ideal conditions for bacterial growth including:
• Protein• Moisture• pH• Time• Temperature (41°F to 135F°)
These are food that require temperature control to assure they are safe. We will spend the next section talking about these foods.
Foods that need
refrigeration
Rapid bacteria growth
Tem
pe
ratu
re (
°F)
160˚F
140˚F
120˚F
100˚F
80˚F
60˚F
40˚F
20˚F
Keeping foods at proper temperatures improves their quality and shelf life while assuring safety.
Bacteria multiple rapidly when PHF are between 135°F and 41°F.
Potentially Hazardous Foods must be maintained at the proper temperatures at all
times prior to being served. PHF that are stored cold must be held at or below
41⁰F.
Potentially Hazardous Foods that are stored hot must be held at or above 135⁰F.
When foods are being prepared, cooled or reheated, they must not be held below
135⁰F or above 41⁰F for extended time to control the growth of harmful bacteria.
You can use the same food thermometers that you use to test cooking temperatures to test holding temperatures, simply clean the probe first.
While efforts should be made to maintain temperatures during receipt, storage, preparation and service, the temperature requirements only apply to foods before they are served to residents.
Potentially hazardous foods that are reheated from
room temperature, such as opening a can or from cold
storage before hot holding must be heated rapidly
within 2 hours to 165°F
Rapid reheating can be accomplished on a stove top, in
an oven, microwave or another approved reheating
device
Rapid reheating can be done easily in the standard kitchen equipment you likely already have. To verify you are reaching 165°F within 2 hours, you can use the same analog thermometer we discussed earlier.
Foods must be cooled actively and as quickly as possible to
minimize the time in the danger zone.
Foods cooled from room temperature, such as opening a can or
preparing foods from room temperature, must be cooled to 41°F
within 4 hours.
Following cooking or removal from hot holding, foods must be
cooled from 135°F to 70°F within 2 hours and from 70°F to 41°F
within 4 additional hours.
Begin cooling when hot foods reach 135°F on their own, then use shallow uncovered containers, ice as an ingredient, ice baths, your freezer or a
combination to cool food quickly to 41°F.
Cooling foods quickly not only assures safety, it also improves the quality and shelf life of foods.
135
115.5
103.3
9384.3
7770.8
65.761.3 57.6 54.4 51.3 49.7 47.9 46.3 45
135
94.7
69.5
55.547.7
43.4 41
0
20
40
60
80
100
120
140
160
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Passive Cooling Rapid Cooling
Hours
Tem
pe
ratu
re (
°F)
This graph shows temperatures of food that is rapidly cooled compared with the same food that is passively cooled. The rapidly
cooled food is in the DANGER ZONE for much less time, shortening the opportunity for bacteria to multiple and assuring safer food.
While you prepare food at room temperatures,
you are not required to maintain the
temperature above 135°F or below 41F°,
instead finish preparing each item within 2
hours and return the food to hot holding or
cold holding until it is served.
You have 4 hours to get prepared foods below
41F°after they are prepared at room
temperature.
Frozen foods must be thawed using one of the
following safe techniques:
▪ Under refrigeration
▪ Under cool running water between 60-70°F
▪ In a microwave oven
▪ As part of the cooking process
Thawing on a counter at room temperature can allow portions of the food to remain above 41°F for an extended period of time, allowing bacteria to
multiply. Keeping foods out of the danger zone shortens bacteria’s opportunity to reach dangerous levels and assures safer food.
The requirements for assisted living residences with under 20 beds were
written to allow for safe food handling in a typical home or domestic
setting.
The requirements are your road map to assure safe food for your
residents with no need to buy expensive new equipment as long as your
home refrigerator keeps foods 41°F and a means to cook and hold foods
above 165°F.
Food contact surfaces must be
washed, rinsed and sanitized
before use and at least every 4
hour of continual use.
Sanitizer must be approved for use
as a no-rinse food contact
sanitizer and registered with EPA
and used in accordance with
labeled instructions.
Inexpensive household bleach can be used to make a sanitizing solutions. Use 1 teaspoon per gallon of water to create the proper
concentration of 100 ppm chlorine. You can make this same solution in a spray bottle or similar container that can last for up to a week
and be used to sanitize counter tops and other food contact surfaces.
1 Teaspoon
There should be no need to install new expensive plumbing fixtures.
Your kitchen sink is adequate for handwashing, dish washing, thawing
and preparing food as long as it works, has hot and cold water and is
washed, rinsed and sanitized in between uses.
Dishes, utensils and cookware must be washed using
one of these methods:
▪ In a single or multiple compartment sink using dish detergent,
rinsed clean, then submerged in an approved sanitizer, or
▪ Washed in a domestic or commercial dish machine with wash
water that reaches 155°F or is equipped with a chemical
sanitizing cycle.
Inexpensive household bleach can be used to sanitize dishes, simply follow the labeled instructions for sanitizing.
Check you dishwasher users manual to determine if it reaches 155°F during the wash cycle. The temperature can be verified by
your surveyor using a special device.
Mop water can be filled using a bath tub, utility sink or any sink with a quick release hose attachment.
Mop water can be dumped in a toilet, bathtub, or utility sink.
There is no need for a dedicated mop sink for filling or dumping mop water. In fact there is no requirement for frequent mopping! Having a
means to mop is important in the event you need to clean up after someone that becomes ill.
A quick release hose attachment can be found at your local hardware store and costs under $10. It allows you to remove an attached hose
right after filling a mop bucket so that you can use the sink for something else.
Monitoring food temperatures is best practice and assures
malfunctioning refrigerators don’t go unnoticed, required cook
temperatures are reached and foods are cooled and reheated
rapidly.
However, there is no requirement to log temperatures, but as you
are getting used to the habit it might help keep you aware of
potential problems, avoid illnesses and survey citations.
Available 8:30 am – 5:00 pm Monday - Friday
Call (303)692-3645 and press option ‘3’
Email your question to: [email protected]
