Cal. Code Regs. Tit. 22, § 70273 - Dietetic Service General Requirements
(a) The dietetic service shall provide food
of the quality and quantity to meet the patient's needs in accordance with
physicians' orders and, to the extent medically possible, to meet the
Recommended Daily Dietary Allowances, 1974 Edition, adopted by the Food and
Nutrition Board of the National Research Council of the National Academy of
Sciences, 2107 Constitution Avenue, Washington, DC 20418, and the following:
(1) Not less than three meals shall be served
daily.
(2) Not more than 14 hours
shall elapse between the evening meal and breakfast of the following
day.
(3) Nourishment or between
meal feedings shall be provided as required by the diet prescription and shall
be offered to all patients unless counterordered by the physician.
(4) Patient food preferences shall be
respected as much as possible and substitutes shall be offered through use of a
selective menu or substitutes from appropriate food groups.
(5) When food is provided by an outside food
service, all applicable requirements herein set forth shall be met. The
hospital shall maintain adequate space, equipment and staple food supplies to
provide patient food service in emergencies.
(b) Policies and procedures shall be
developed and maintained in consultation with representatives of the medical
staff, nursing staff and administration to govern the provision of dietetic
services. Policies shall be approved by the medical staff, administration and
governing body. Procedures shall be approved by the medical staff and
administration.
(c) The
responsibility and the accountability of the dietetic service to the medical
staff and administration shall be defined.
(d) A current diet manual approved by the
dietitian and the medical staff shall be used as the basis for diet orders and
for planning modified diets. Copies of the diet manual shall be available at
each nursing station and in the dietetic service area.
(e) Therapeutic diets shall be provided as
prescribed by a person lawfully authorized to give such an order and shall be
planned, prepared and served with supervision and/or consultation from the
dietitian. Persons responsible for therapeutic diets shall have sufficient
knowledge of food values to make appropriate substitutions when
necessary.
(f) A current profile
card shall be maintained for each patient indicating diet, likes, dislikes and
other pertinent information concerning the patient's dietary needs.
(g) Menus.
(1) Menus for regular and routine modified
diets shall be written at least one week in advance, dated and posted in the
kitchen at least three days in advance.
(2) If any meal served varies from the
planned menu, the change shall be noted in writing on the posted menu in the
kitchen.
(3) Menus shall provide a
variety of foods in adequate amounts at each meal.
(4) Menus should be planned with
consideration for cultural and religious background and food habits of
patients.
(5) A copy of the menu as
served shall be kept on file for at least 30 days.
(6) Records of food purchased shall be kept
available for one year.
(7)
Standardized recipes, adjusted to appropriate yield, shall be maintained and
used in food preparation.
(h) Food shall be prepared by methods which
conserve nutritive value, flavor and appearance. Food shall be served
attractively at appropriate temperatures and in a form to meet individual
needs.
(i) Nutritional Care.
(1) Nutritional care shall be integrated in
the patient care plan.
(2)
Observations and information pertinent to dietetic treatment shall be recorded
in patient's medical records by the dietitian.
(3) Pertinent dietary records shall be
included in patient's transfer discharge record to ensure continuity of
nutritional care.
(j)
In-service training shall be provided for all dietetic service personnel and a
record of subject areas covered, date and duration of each session and
attendance lists shall be maintained.
(k) Food Storage.
(1) Food storage areas shall be clean at all
times.
(2) Dry or staple items
shall be stored at least 30 cm (12 inches) above the floor, in a ventilated
room, not subject to sewage or waste water backflow, or contamination by
condensation, leakage, rodents or vermin.
(3) All readily perishable foods or beverages
capable of supporting rapid and progressive growth of microorganisms which can
cause food infections or food intoxication shall be maintained at temperatures
of 7°C (45°F) or below, or at 60°C (140°F) or above, at all
times, except during necessary periods of preparation and service. Frozen food
shall be stored at -18°C (0°F) or below.
(4) There shall be a reliable thermometer in
each refrigerator and in storerooms used for perishable food.
(5) Pesticides, other toxic substances and
drugs shall not be stored in the kitchen area or in storerooms for food and/or
food preparation equipment and utensils.
(6) Soaps, detergents, cleaning compounds or
similar substances shall not be stored in food storerooms or food storage
areas.
(l) Sanitation.
(1) All kitchens and kitchen areas shall be
kept clean, free from litter and rubbish and protected from rodents, roaches,
flies and other insects.
(2) All
utensils, counters, shelves and equipment shall be kept clean, maintained in
good repair and shall be free from breaks, corrosions, open seams, cracks and
chipped areas.
(3) Plasticware,
china and glassware that is unsightly, unsanitary or hazardous because of
chips, cracks or loss of glaze shall be discarded.
(4) Ice which is used in connection with food
or drink shall be from a sanitary source and shall be handled and dispensed in
a sanitary manner.
(5) Kitchen
wastes that are not disposed of by mechanical means shall be kept in leakproof,
nonabsorbent, tightly closed containers and shall be disposed of as frequently
as necessary to prevent a nuisance or unsightliness.
(m) All utensils used for eating, drinking
and in the preparation and serving of food and drink shall be cleaned and
disinfected or discarded after each usage.
(1) Gross food particles shall be removed by
scraping and prerinsing in running water.
(2) The utensils shall be thoroughly washed
in hot water with a minimum temperature of 43°C (110°F), using soap or
detergent, rinsed in hot water to remove soap or detergent and disinfected by
one of the following methods or an equivalent method approved by the
Department:
(A) Immersion for at least two
minutes in clean water at 77°C (180°F).
(B) Immersion for at least 30 seconds in
clean water at 82°C (180°F).
(C) Immersion in water containing
bactericidal chemical as approved by the Department.
(3) After disinfection the utensils shall be
allowed to drain and dry in racks or baskets on nonabsorbent surfaces. Drying
cloths shall not be used.
(4)
Results obtained with dishwashing machines shall be equal to those obtained by
the methods outlined above and all dishwashing machines shall meet the
requirements contained in Standard No. 3 as amended in April 1965 of the
National Sanitation Foundation, P.O. Box 1468, Ann Arbor, MI
48106.
Notes
Note: Authority cited: Sections 208(a) and 1275, Health and Safety Code. Reference: Section 1276, Health and Safety Code.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.