10-144 C.M.R. ch. 117, § 6 - Environmental Safety

6.1 Environment and Safety. Any Adult Day Services Program must comply with State and local health, fire, safety, building and sanitation laws, ordinances or codes.

6.2 No license to operate an Adult Day Services Program shall be issued or re-issued until the program site has passed inspection by the State Fire Marshal Office and a written report signed by the State Fire Marshal has been provided to the Department.

6.3 Fire Safety Plan. Each program must have a fire safety plan. This plan and any changes in it are to be developed in conjunction with and approved by local or State fire authorities. The plan shall be posted conspicuously in the program area and shall include:

6.3.1 Fire safety measures to be taken;

6.3.2 Location of emergency exits;

6.3.3 Evacuation procedures;

6.3.4 The telephone numbers of police, fire, ambulance, physicians or other individuals to contact in an emergency;

6.3.5 The number and placement of smoke detectors.

6.4 Fire Drills. Drills or rehearsals of the emergency steps to be taken shall be conducted at irregular times of day at least once each month ( 22 M.R.S.A. §8605) .

6.4.1 A record shall be kept on forms approved by the Department showing the date and time of each drill and the evacuation time of the drill. Day services providers shall be knowledgeable about and shall inform and train staff about the use of fire safety equipment. At the time of admission and at least semiannually after admission, consumers shall be informed of emergency procedures.

6.5 Evacuation. If, for any reason, the consumers are evacuated from the program other than a planned fire drill, the administrator or a facility representative shall notify the department at 1-800-383-2441 and the Office of the State Fire Marshall immediately after the consumers are safely evacuated.

6.6 Smoke Detectors.. Smoke detectors shall be functional at all times.

6.7 Water Supply. The water supply shall be adequate, of a safe and sanitary quality and from a source which meets applicable State and local regulations. The following standards shall apply:

6.7.1 Water not piped directly from its source shall be transported, handled, sorted and dispensed in a sanitary manner.

6.7.2 Adequate supplies of hot and cold water shall be provided at all hand washing facilities and where equipment and utensils are washed, unless otherwise approved in writing by the Department.

6.7.3 Water supply systems shall be reviewed and approved according to the Department's Rules Relating to Drinking Water, 10-144 C.M.R. Ch. 231.

6.7.4 A private supply shall be tested annually and a satisfactory result must be obtained.

6.8 Rooms used by consumers. All rooms used by consumers must have adequate light, ventilation and heating and present no hazards to consumer's health and welfare. The program site must be equipped with a heating system capable of maintaining a temperature of at least seventy (70) degrees Fahrenheit throughout the program space area(s). Windows and doors used for ventilation must be effectively screened. The rooms shall be furnished with sufficient comfortable nonfolding chairs, nonfolding tables, rocking and reclining chairs.

6.8.1 The site must have at least two (2) exits remote from one another that are kept clear at all times.

6.9 Providers shall provide telephones that are not pay-phones for consumers' use. Telephones shall be located in areas that provide the maximum amount of privacy possible under the circumstances. Telephone shall have numbers that are listed in local telephone directories and shall provide both inbound and outbound call service. All local calls shall be free of charge for consumers.

6.10 Every part of the building intended for consumer use must meet applicable State and Federal guidelines for handicapped accessibility.

6.11 The program space shall be kept clean and shall be maintained in a condition that ensures the health and safety of consumers. Consumers shall be able to move freely from room to room, with no barriers or hazards impeding free movement.

6.12 Animals kept as pets:

6.12.1 Household pets, except fish in aquariums and service animals (e.g. guide dogs) shall not be permitted in common dining areas during meals.

6.12.2 No animals, except for service animals (e.g., guide dogs) shall be permitted in common food preparation areas.

6.12.3 There shall be proof of rabies vaccinations for household pets. Pets must not present a danger to residents or guests. The facility shall be free of pet odors and waste shall be disposed of regularly.

6.13 Sanitation and Safety

6.13.1 Facility Cleanliness. All reasonable precautions shall be taken in maintaining a safe, sanitary and comfortable living environment. There shall be no evidence of rodent or insect infestation.

6.13.2 Food Safety and Sanitation. Food shall be stored, prepared and served in a safe and sanitary manner, including at a minimum:

6.13.2.1 Kitchen and food preparation areas shall be located away from possible food contamination sources;

6.13.2.2 Kitchen and food preparation areas shall be clean and food stored so as to be free from spoilage and contamination;

6.13.2.3 All equipment, dishes, glassware and cooking utensils shall be in good repair.

6.14 Dishwashing. Both manual and mechanical dishwashing methods must comply with local and state health and sanitation laws, ordinances or codes.

6.15 Plumbing, Water Supply and Sewage Disposal. The facility shall comply with all State and local laws and regulations relating to plumbing, water supply and sewage disposal.

6.16 Poisonous and Toxic Materials. When not in use, poisonous and toxic materials such as cleaning solutions, compounds and other non-food supplies, shall be stored in compartments which are used for no other purpose and which are separated from the food storage and preparation areas, cleaning equipment and utensil storage rooms and medication storage areas. Bactericides and cleaning compounds shall not be stored in the same cabinet or area of the room with insecticides, rodenticides or other poisonous materials. All containers must be properly labeled for identification.

6.17 Dietary Services. For those programs preparing or serving food at the Adult Day Services Program site, the following shall apply:

6.17.1 Adequacy of Diets. The program shall provide each consumer with a nourishing, well-balanced diet that meets one-third of the daily nutritional and special dietary needs of each consumer and that meets the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council, National Academy of Sciences, adjusted for age, sex and activity.

6.17.2 Menus. Menus shall be planned at least a week in advance, shall be posted conspicuously in the food service area and in an area used frequently by the consumers and shall be kept on file for three (3) months. The posted menu shall be in large enough print for all consumers to be able to read easily.

6.17.3 Therapeutic Diets. Therapeutic diets ordered by a duly authorized licensed practitioner are considered treatments and shall be ordered in writing.

6.17.4 Milk and Milk Products. Only pasteurized milk and milk products shall be used. No reconstituted powdered milk or evaporated milk shall be served for drinking. Dry or evaporated milk shall only be used for cooking. Milk served for drinking shall be served in the original container or poured directly into the consumer's glass at mealtime.

6.17.5 Refrigerated Storage. Foods requiring refrigeration shall be cooled to a temperature of forty-one (41) degrees Fahrenheit or below. Eggs shall be refrigerated at all times except when being cooked or served. Ice used for human consumption shall not be used for cooling stored food or food containers. Conspicuous, easily readable thermometers shall be provided for each refrigerator and freezer in the facility. Perishable, refrigerated and frozen food shall be labeled and dated. Frozen food shall be kept frozen at a temperature of zero (0) degrees Fahrenheit or below.

6.17.6 Thawing Potentially Hazardous Foods. Potentially hazardous foods shall be thawed as follows:

6.17.6.1 In refrigerator units at a temperature not to exceed forty-one (41) degrees Fahrenheit; or

6.17.6.2 In a microwave oven, only when the food will be immediately transferred to conventional cooking facilities as part of the continuous cooking process or when the entire uninterrupted cooking process takes place in the microwave oven; or

6.17.6.3 Under potable running water at a temperature of seventy (70) degrees Fahrenheit or below, with sufficient water velocity to agitate and float off loose particles into the overflow; or

6.17.6.4 As part of the continued cooking process.

6.18 Cooking Potentially Hazardous Foods.

6.18.1 Poultry, poultry stuffing, stuffed meats and stuffing containing meat shall be cooked to heat all parts of the food to at least 165 (one hundred sixty-five) degrees Fahrenheit, with no interruption in the cooking process;

6.18.2 Pork and any food containing pork shall be cooked to heat all parts of the food to at least one hundred fifty (150) degrees Fahrenheit;

6.18.3 Rare roast beef and rare beef steak shall be cooked to an internal temperature of at least one hundred thirty (130) degrees Fahrenheit, unless otherwise requested by the consumer;

6.18.4 Potentially hazardous foods that have been cooked and then refrigerated shall be reheated rapidly to one hundred sixty-five (165) degrees Fahrenheit or higher throughout before being served;

6.18.5 Custards, cream fillings or similar products shall be kept at safe temperatures of forty-one (41) degrees Fahrenheit or below, except during necessary periods of preparation and service.

6.18.6 All potentially hazardous foods shall, except when being prepared, be kept at forty-one (41) degrees Fahrenheit or below, except during necessary periods of preparation and service.

6.18.7 All perishable foods shall be stored at such temperature as will protect against spoilage.

6.19 Second-Grade Products Prohibited. Second-grade products, such as unlabeled canned goods, home canned goods, improperly or unsealed containers or packages and outdated foods are prohibited from use.

Notes

10-144 C.M.R. ch. 117, § 6