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(1) Generally. The food service department shall be under the supervision of a person skilled in the selection, handling, preparation and serving of food and the supervision and management of food handlers. There shall be a sufficient number of cooks, dishwashers and maids to properly prepare three (3) well-balanced meals daily.
(2) Clothing, etc. It is mandatory that all cooks and food handlers wear clean garments (uniforms are desirable) and hair nets or clean caps, and keep their hands and fingernails clean at all times.
(3) Education and Instruction. Adequate instructions for employees in acceptable and sanitary food handling practices are required. Educational material and services are available from the department.
(4) Standards and Inspections. All institutions caring for six (6) or more persons shall comply with grade A standards established by the county board of health in its regulations for eating and drinking establishments. All institutions shall be inspected regularly by the department as to the cleanliness of food and food containers and as to the protection of food from spoilage.
(b) Physical facilities.
(1) Generally. There are seven (7) major phases of work including: Receiving of food and supplies, storage, preliminary preparation, cooking, serving, return of soiled dishes and dishwashing, and garbage disposal. All or part of these units may be provided in the main kitchen.
a. The food service department shall be located in the main building or an attached building. It is recommended that it be located on the ground floor. If the food service rooms are located below the ground floor, adequate light and ventilation shall be provided by windows.
b. To facilitate receiving food supplies and the disposal of waste, a convenient outside entrance shall be planned.
c. No toilet rooms or sleeping rooms shall open directly into any kitchen or ward serving pantry.
(3) Space. Space requirement varies from twelve (12) square feet to as much as thirty (30) square feet per bed depending upon the type of patient served.
a. There shall be an aisle of at least three (3) feet between working areas, and wider is desirable if the aisle is used as a passageway.
b. Ceiling height shall be at least eight (8) feet, and higher is desirable.
a. The amount of storage space needed is dependent upon frequency of deliveries. It is recommended that its location be within easy access to the receiving area and the kitchen.
b. The storeroom shall be cool, well ventilated and fitted with metal shelving, metal bins or covered galvanized cans for storage of staple foods.
c. All supplies shall be stored off the floor and away from the wall so as to allow for cleaning. All precautions shall be taken against the invasion of rodents and insects, the seepage of dust and water leakage or other sources of contamination. Care shall be exercised in the rotation of stored foods so that the sold stock is used first.
a. Where delivery is on a bi-weekly basis, a space of one and one-half (1 1/2) to two (2) cubic feet per person, including personnel, is required. Size would have to be adjusted to other schedules of delivery.
b. Where separate refrigeration can be provided, recommended temperatures for storing perishable foods are: thirty-two (32) degrees to thirty-eight (38) degrees Fahrenheit for meats, forty (40) degrees Fahrenheit for dairy products and forty-five (45) to fifty (50) degrees Fahrenheit for fruits and vegetables. If it is impracticable to provide separate refrigeration, the temperature shall be maintained at forty (40) degrees Fahrenheit or less.
(c) Preparing and serving food.
(1) Normal Diet.
a. A well-balanced diet of good quality food, correctly prepared and sufficient in quantity to meet the nutritional needs of the patients shall be served three (3) times daily. This shall include for each day:
1. Three (3) cups of milk per person.
2. Two (2) servings of fruit (one citrus).
3. One (1) to two (2) servings of meat, poultry or fish.
4. A minimum of four (4) eggs weekly.
5. Two (2) tablespoons of butter or fortified margarine.
6. Cereals or bread (whole wheat or enriched) every meal.
7. Potatoes once a day.
8. Two (2) servings of vegetables (one (1) leafy green or yellow), in addition to potatoes.
9. Simple desserts (stewed or canned fruit, custard or pudding, ice cream, etc.)
b. The method of serving food shall be such that the food reaches the patient in good condition. Hot foods should be served hot; cold foods should be served cold.
c. Special attention shall be given to the texture of food given patients without dentures or with poor dentures because of their difficulty of mastication.
d. A time schedule for service of meals to patients and personnel shall be established, and it is recommended that meals be served approximately five (5) hours apart but it shall not be longer than fourteen (14) hours from the evening meal until breakfast.
(2) Therapeutic or Special Diets. Therapeutic diets shall be provided as ordered by the patient's physician as part of the course of treatment of the patient. Therapeutic or special diets as ordered by physicians shall be posted in the kitchen.
a. Menus shall be planned and written one (1) week in advance in order to insure variety and an adequate diet. This help to plan kitchen work efficiently and to facilitate marketing. A copy of menus shall be posted in the kitchen.
b. Menus showing food actually served each day shall be recorded and kept on file. Nursing and care homes with five (5) beds or less are excepted from his requirements.
(4) Distribution of Food.
a. A satisfactory method of food distribution shall be provided. In institutions of more than one (1) story, where more than six (6) patients above the first floor receive bedside tray service, a dumbwaiter or elevator or ward serving pantries shall be provided.
b. Cracked and chipped china shall not be used.
(5) Domestic Animals. Domestic animals are not permitted in any place where food is prepared or served.
(d) Dining rooms.
(1) Lighting an Ventilation. Dining rooms shall be well lighted and ventilated.
(2) Location. It is recommended that dining rooms be located adjacent to the kitchen in order to facilitate the serving of food.
(3) Space, etc. Dining areas shall be adequate for both patients and personnel. Twelve (12) square feet per person is recommended whether dining room or cafeteria service is used. When wheel chair patients are fed in the dining room, greater floor space per person will be necessary. The kitchen shall not be used as a dining room for patients or personnel.
(e) Milk supply.
(1) Source. The source of supply and distribution shall be approved by the state department of health or local authority. Pasteurized milk shall be used.
(2) Storage. Milk must be stored in tightly-covered containers.
(f) Ice. Ice that is used in direct contact with food and drink shall be obtained from sanitary sources and handled in a sanitary manner.
(g) Cleansing of food containers.
(1) Generally. Centralized dishwashing is advocated, even with decentralized food service, because it limits noise on floors, lessens the number of employees required and allows for better control of breakage, and supervision of operation.
(2) Separate Room. A separate room for dishwashing is desirable. It should be compact, light and airy.
(3) Location of Dishwashing Unit. The dishwashing unit may be directly adjacent to the dining room; however, in locating the unit care shall be taken so that the service of soiled dishes will not interfere with the routing of service.
a. Provision of a three-compartment sink or a dishwashing machine in the dishwashing unit is mandatory. Nursing and care homes with five (5) beds or less may use a two-compartment sink with a spray rinse.
b. The dishwashing unit shall also include tables for soiled and clean dishes, storage cupboards and trucks for transporting dishes to and from the unit. If dishwashing is decentralized, provision of a three-compartment sink and tables or a dishwashing machine in each serving pantry is mandatory.
a. All food containers shall, following the last preceding use, be washed until visibly clean in warm water containing an ample quantity of soap or alkaline cleanser.
b. After cleaning, all food containers shall be rinsed with clear running water or immersed in a suitable receptacle containing clear water.
c. All food containers, after cleaning and rinsing, shall be disinfected by one of the following procedures:
1. Immersion in water at a temperature of not less than one hundred eighty (180) degrees Fahrenheit for not less than one (1) minute, or
2. Immersion in a solution containing not less than one hundred (100) parts per million available chlorine for one (1) minute and allowed to drain on a wire or corrugated metal rack.
d. After cleaning, rinsing and disinfecting, the food containers shall be stored in such a manner as not to become contaminated before reuse.
e. The wiping of food containers after washing, rinsing and disinfecting is prohibited.
f. The results obtained with dishwashing machines shall be equal to those obtained by the method outlined above.
(h) Facilities for personnel.
(1) Handwashing Facilities. It is mandatory that handwashing facilities be provided in all kitchens, ward serving pantries and washrooms used by food handlers. They shall be equipped with an adequate supply of soap, disposable towels, and hot and cold running water. The use of the common towel is prohibited. Hands shall not be washed in sinks where food is prepared.
(2) Lockers. Lockers or cloakrooms for personnel shall be provided and wraps shall not be hung in the kitchen area.
(3) Rest Rooms. Rest rooms shall be provided for personnel. (Mont. Co. Code 1965, § 89-44; 1980 L.M.C., ch. 27, § 1.)
Cross reference-Eating and drinking establishments, Ch. 15.