Quiz 3 Flashcards
List and explain the four major types of Operations
Conventional
Commissary
Assembly/Serve
Ready Prepared (Cook/Chill)
Ready-prepared 3 main steps
Cook/Chill
Storage
Re-thermalized and serve
At the same location (separation between cooking and serving)
Advantages/Disadvantages of cook/chill
Advantages would be: requires less skilled workers and less daily labor
Disadvantages: more expensive equipment and more storage required
Commissary (Central Production Kitchen)
Meals at one centralized kitchen, then sent out to somewhere else (stored chilled, hot, or frozen)
Assembly/Serve
Meals are fully assembled and sent to the service buyer (kitchen-less kitchen) will be frozen meals
List and explain the two types of chilling methods
Blast chilling (cold air circulates around the pan)
Tumble chilling (packed food submerged in water)
- pump/fill station or tumble chiller
- label and FIFO
- 32-38 degrees F… 41-50 should be used in 12 hours, discard if reaches above 50
HACCP plans must address
CCP’s and Sanitation
The 5 CCP’s in Cook/Chill
Cooking
Bagging ( at > 135 F)
Chilling ( 135 to 70 F in 2 hours then from 70 to 41 F in no more than 6 hours!!!)
Holding ( refrigerate immediately when it reaches 41 F)
Reheating (165 for 15 seconds in two hours after taking out of fridge)
Ways to rethermalize
re-therm carts
microwaves
combi ovens
Keep warm in trays
Advantages to Cook/Chill
Less labor induced
More laid-back work environment
Reduced waste
Menu flexibility
Time management
What two organizations require an “all hazards” approach to assess risk for patients, staff, and visitors during a
disaster or emergency.
CMS (Centers for Medicare and Medicaid services)
Joint Commission
What two steps does the CMS require for disaster preparedness plans?
risk assessment and emergency plan
- develop the policies and procedures and review it once a year for any revisions
What are fluid requirements and how many days on hand for food?
1 gallon/person/day
3-10 days ( 4 )
The bottom line to disaster preparedness…
Food services need to develop risk management plans to deal
with disasters and emergencies that pose a threat to their
area
Risk Management Process steps
Assess - what could happen?
Evaluate -which incidents are more serious?
Manage - develop the risk management plan and emergency procedures/policies
Monitor/Review - something happens…how can we improve?
What to do in loss of power?
Cook all perishables (in walk-in) immediately
- affects CCP’s and food safety temps and ability to cook if gas is needed
Have a contract with refrigerated trucks that run on diesel
What about water? For a disaster situation
You loose the ability to clean, handwash, restrooms, tea and coffee machines, dishwashers…
- you can use a water dispenser with a built in filter and a portable handwashing dispenser
What about a fire situation
- need proper training ( who to call, how to use a fire extinguisher, how to put out grease/electric fires/paper fires)
- do you need an alternate kitchen if a fire occurs? Commissary system? Need an alternate menu now?
What is a skeleton staff?
Staff might go from 70% to 50% to 25%…how can you still operate under these conditions (for pandemic situations)
- keep healthy people healthy
- PPE, sanitation, distancing, masks, etc
- self-service into service areas
Internet outage issues?
- Issues with charting
- Patient meal documentation
- Printing out tickets
- Meal Ticket Printing
How do healthcare facilities continue to
provide nutritionally adequate meals and
water during a disaster/emergency? (Steps)
- Develop emergency meal plans ( select vs non-select)
- Develop policies and procedures for these emergencies (Communication plan for employees
Alternate sources of energy
How food will be distributed among the facility
* Centralized
* Decentralized
Alternate sources of handwashing and dishwashing – use of all
disposable products - Set up standing orders with vendors
- Have emergency supplies on hand
- DOH = Inventory Value / (COGS/Days in period)
Clinical RDN deals with
- MNT for sheltered
individuals - Food Supplies
- Liquid Nourishments
Supplies - ## Tube Feeding Supplies
Food service roles
Serve safe food, have adequate supplies and water, create the menus,
Community roles
Work in a Command Center or Emergency Operations Center
* Give shelter assistance
* Participate in a Planning Committee
– State
– Community
– Red Cross
Describe scum
- often from boiling over
- Scum is the solid layer that often forms
on the surface of milk during heating. - Made up of milk proteins (casein) and
fat molecules - heat a lower temperature
- stir occasionally or cover with a lid to prevent scum formation
- Beating the milk with a rotary beater
to form a foam layer will also help
prevent scum from forming
Describe milk boiling over
- when heated too fast and too hot
Pressure builds up beneath the layer of
scum thus preventing the pressure
from being released as steam. - Use a low heat when heating milk to
prevent boiling over.