1 november 2006 reducing foodborne illness risk factors in food service and retail establishments

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November 2006

Reducing Foodborne Illness Reducing Foodborne Illness Risk Factors in Food Service Risk Factors in Food Service and Retail Establishmentsand Retail Establishments

Reducing Foodborne Illness Reducing Foodborne Illness Risk Factors in Food Service Risk Factors in Food Service and Retail Establishmentsand Retail Establishments

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Agency initiative to provide information about risk factors insufficiently controlled in: Institutions Restaurants Retail food

Introduction

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Introduction

To remind operators and regulators about safe practices used to control risk factors.

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Introduction

The following slides contain “food safety messages” provided for use in foodservice, retail food stores and retail regulatory programs for training, refresher sessions and inspection related activities.

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Introduction These “food safety messages” were adapted

from the findings of the FDA 2004 report on the occurrence of foodborne illness risk factors and those most commonly found to be out of compliance in nine (hospitals, nursing homes, elementary schools, fast food and full service restaurants, deli’s, meat and poultry, seafood and produce) facility types.

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Introduction

These “food safety messages” also include recommendations that were created based on guidance in the FDA Food Code 2005.

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Institutions

Hospitals and Nursing Homes Elementary Schools

Risk factors needing priority attention

Recommendations Summary

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Risk factors needing priority attention

Hospitals and Nursing Home Improper Holding, Time and

Temperature Contaminated Equipment Poor Personal Hygiene

Schools Improper hot and cold holding

Date marking

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Recommendations

Regulators Provide

Policy Technical training Operator guidance Operator compliance evaluation

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Recommendations

Operators Provide

Procedures Staff training Monitoring Corrective action

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Recommendations

Hospitals and Nursing Homes Cool foods from 135°F to 70 °F in 2

hours and then to 41°F in a total of 6 hours.

Hold Potentially Hazardous Foods (PHF) /Time-Temperature Control For Safety (TCS) Food cold at 41°F or below

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Recommendations

Hospitals and Nursing Homes Hold hot food at 135°F or above If held for more than 24 hours, date mark

ready-to-eat, Potentially Hazardous Foods (PHF) /Time-Temperature Control For Safety (TCS) Food

Discard after 7 days if held at 41°F; and after 4 days if held at 45°F

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Recommendations

Hospitals and Nursing Homes Clean and sanitize surfaces, equipment

and utensils Keep raw animal food separate from

ready-to-eat foods Train employees and enforce a good

personal hygiene program Promote hand washing Exclude ill workers

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Recommendations

Elementary Schools Holding, Time and Temperature

Keep hot foods at 135°F or above Pre-heat steam table, soup warmers,

etc. before adding food Reheat leftovers quickly to 165°F (in

less than 2 hours) Reheat commercially prepared foods

in intact packages to 135°F

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Recommendations

Elementary Schools Holding, Time and Temperature

Keep cold foods at 41°F or colder Provide all hot and cold holding units with

thermometers Cool hot foods from 135°F to 70° in 2

hours and then to 41°F in a total of 6 hours

Cool foods made from room temperature ingredients (canned tuna, bean salad, etc.) to 41°F in 4 hours

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Recommendations

Elementary Schools Date mark ready-to-eat, Potentially

Hazardous Food (PHF) /Time-Temperature Control For Safety (TCS) Food

If prepared on-site and held more than 24 hours

If commercially processed, date mark when opened

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Recommendations

Elementary Schools Date mark ready-to-eat, Potentially

Hazardous Food (PHF) /Time-Temperature Control For Safety (TCS) Food

Discard after 7 days if held at 41°F Discard after 4 days if held at 45°F

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Summary

Institutional Food Service Review impact areas Practice safe procedures Provide training Monitor compliance Adhere to safe practices like those in

the 2005 FDA Food Code

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Restaurants

Full Service Risk factors needing priority

attention Recommendations Summary

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Risk factors needing priority attention

Full Service Improper Holding, Time and

Temperature Improper cooling Potentially Hazardous

Food (PHF) / Time-Temperature Control for Safety (TCS) Food

Poor Personal Hygiene Improper hand washing

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Risk factors needing priority attention

Full Service Improper Holding, Time and

Temperature Improper Cooling

• Failure to cool food properly is unsafe and can allow bacteria to grow

• Poor cooling practices in your establishment can lead to foodborne illness for your customers

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Risk factors needing priority attention

Full Service Poor Personal Hygiene

Improper Hand washing• Failure to wash hands properly is unsafe and

can contribute to the spread of viruses• Poor hand washing practices in your

establishment can lead to customer illness• Improper hand washing is a leading risk factor

for foodborne illness commonly found to be out of control

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Recommendations for Operators

Full Service Implement standard operating procedures for

cooling Pay special attention to large food items

such as turkeys, roasts, soups, sauces, chili, refried beans and rice

Use safe methods that work best for the foods you are cooling: reducing the quantity, using an ice bath and stirring, using commercial equipment like a blast chiller

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Recommendations for Operators

Full Service Implement corrective action procedures

when cooling practices are not followed Make sure employees understand when

to apply corrective action Advise employees of the different options

for corrective action such as discarding or reheating

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Recommendations for Operators

Full Service Document the corrective action and

prevent the problem from reoccurring Avoid the need to cool large batches

by preparing smaller batches Include a cooling step in your recipes

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Recommendations for Operators

Full Service Implement monitoring procedures Monitoring provides a way to identify

when there is loss of control of the cooling process

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Recommendations for Operators

Full Service Monitoring procedures should

include: what you will monitor how you will monitor when and how often who is the person responsible for the

monitoring

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Recommendations for Operators

Full Service Conduct ongoing verification

Verify to ensure that the procedures related to cooling are being carried out properly

• Observe tasks related to cooling and monitoring activities

• Review monitoring records and check frequency, accuracy and consistency

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Recommendation for Operators

Full Service Hand washing

Establish a hand washing standard operating procedure (SOP)

Provide interactive employee training Conduct follow-up training as needed Emphasize the importance of hand washing Evaluate hand sink placement

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Recommendation for Operators

Full Service Hand washing

Keep hands and arms clean, and wash: • during food preparation as often as

necessary to remove soil• when switching between working with

raw food and working with ready-to-eat food

• after touching anything that can contaminate hands

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Recommendation for Operators

Full Service Hand washing

Keep hands and arms clean, and wash: • after touching bare body parts• after using the toilet • after touching soiled equipment or

utensils • before putting on gloves to work with

food

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Recommendations for Operators

Full Service Provide detailed training for employees Train employees in their specific roles

for the success of your food safety program

Give the employees the necessary tools and knowledge needed to be successful

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Recommendations for Regulators

Full Service Maintain an open dialog with operators Understand the establishment’s training

program During inspections include time to

observe hand washing behaviors Target long term behavior change

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Recommendations for Regulators

Full Service Verify hand wash sink use and placement Role model “Good Practices” Take corrective action and conduct training

demonstrations when improper hand washing is observed

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Recommendations for Regulators

Full Service When arranging an inspection

visit: It is important to have an

understanding of a facility’s operation and to consider the processing schedule.

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Recommendations for Regulators

Full Service Establish Inspection Priorities for Cooling

Flex hours to accommodate verification of cooling practices

Take corrective action during inspection

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Recommendations for Regulators

Full ServiceEstablish solution for long term

controlMaintain an open dialog with

operatorsUnderstand the operation

procedures and employee training programs

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Summary

Restaurants Full Service

• Implement standard operating procedures (SOP’s) for hand washing and cooling

• Conduct interactive employee training• Monitor • Verify safe procedures • Take Corrective action

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Restaurants

Fast Food Risk factors that need extra attention Safe Practices Summary

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Risk Factors that need extra attention

Fast Food Improper Holding, Time and

Temperature Poor Personal Hygiene Chemicals

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Recommendations

Fast Food Holding, Time and Temperature

Date mark ready-to-eat, Potentially Hazardous Food (PHF) Time/Temperature Control For Safety (TCS) Food

If prepared on-site and held more than 24 hours

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Recommendations

Fast Food Holding, Time and Temperature

If commercially processed, date mark when opened

Discard after 7 days if held at 41°F Discard after 4 days if held at 45°F

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Recommendations

Fast Food Holding, Time and Temperature

Ensure foods that require refrigeration are maintained at 41°F or below

Maintain hot food at 135°F or above

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Recommendations

Hard Cooked Eggs

Fast FoodDate Marking

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Recommendations Fast Food

Date Marking

Cooked Noodles

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Recommendations

Fast Food Personal Hygiene

Keep hands and arms clean and wash: • during food preparation as often as

necessary to remove soil• when switching between working with

raw food and working with ready-to-eat food

• after touching anything that can contaminate hands

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Recommendations

Fast Food Personal Hygiene

Keep hands and arms clean and wash: • after touching bare body parts• using the toilet • after touching soiled equipment or utensils• before putting on gloves to work with food

Practice no bare hand contact when handling ready-to-eat foods

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Recommendations

Fast Food

Single-Use Gloves for Salad Preparation

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Recommendations

Fast Food Chemicals

Ensure that chemicals are clearly labeled

Store chemicals separate from food Use chemicals for the intended use Do not mix any chemical with another

chemical

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Recommendations Fast Food

Chemicals Proper labeling and storage

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Summary Restaurants

Fast Food Review the risk factors that need extra

attention Follow safe practices to ensure proper

Holding, Time and Temperature of Potentially Hazardous Food (PHF) Time/Temperature Control For Safety (TCS) Food

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Summary

Restaurants Fast Food

Wash hands regularly and as needed

Practice no bare hand contact when handling ready-to eat foods

Ensure the proper usage, storage and labeling of all chemicals

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Retail Food Stores

Departments Deli Meat and Poultry Seafood Produce

Risk factors needing extra attention Safe practices Summary

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Risk factors needing extra attention

Deli Departments Improper Holding, Time and Temperature Poor Personal Hygiene Prevention from Contamination

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Recommendations

Deli Departments Holding Time, Temperature

Date mark ready-to-eat, Potentially Hazardous Food (PHF) Time/Temperature Control For Safety Food (TCS).

If prepared on-site and held more than 24 hours

If commercially processed, date mark when opened

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Recommendations

Deli Departments Holding Time, Temperature

Discard after 7 days if held at 41°F Discard after 4 days if held at 45°F Hold food that requires refrigeration cold at

41°F or below

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Recommendations

Deli Departments Personal Hygiene

Make certain that food workers wash their hands properly, adequately and as necessary

• Keep hands and arms clean and wash: • during food preparation as often as necessary

to remove soil• when switching between working with raw food

and working with ready-to-eat food• after touching anything that can contaminate

hands

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Recommendations

Deli Departments Personal Hygiene

Keep hands and arms clean and wash: • after touching bare body parts• using the toilet • after touching soiled equipment or utensils• before putting on gloves to work with food

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Recommendations

Deli Departments Personal Hygiene

• Have hand washing sinks convenient and accessible for use

• Have hand washing sinks stocked with soap, single-use towels or drying device

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Recommendations Deli Departments

Personal Hygiene

Accessible hand wash sink

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Recommendations Deli Departments

Personal Hygiene

Hand wash signage

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Recommendations Deli Departments

Protection from Contamination Avoid Sources of Contamination

Blood from meat Blood from meat

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Recommendations

Deli Departments Protection from Contamination

Be sure that all food contact surfaces are clean and sanitized before use, between use, and as needed

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Summary

Deli Departments Follow safe practices for holding time,

temperature Ensure proper hand washing and that

hand sinks are accessible and fully stocked

Protect food from contamination

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Risk factors needing extra attention

Meat and Poultry Departments Improper time, and temperature Prevention from contamination Poor personal hygiene Chemical

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Recommendations

Meat and Poultry Departments Ensure proper temperatures

Keep food cold for safety and an enhanced shelf life

Maintain food 41º F or below in storage and while on display

Keep frozen food frozen Keep hot food at 135°F or above

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Recommendations

Meat and Poultry Departments Date marking

Label all ready-to-eat foods and food products that are prepared on the premises or that are commercially produced and held for more than 24 hours with a disposal date as described in the FDA Food Code.

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Recommendations

Meat and Poultry Departments Prevention from contamination

Keep all areas clean and sanitized Clean and sanitize food contact surfaces

and utensils frequently

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Recommendations

Meat and Poultry Departments Prevention from contamination

Clean and sanitize all food contact surfaces and equipment especially after changing from poultry to red meat

Watch for buildup beneath cutting table top surfaces and on other equipment

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Recommendations

Meat and Poultry Departments Chemical

Avoid chemical hazards Keep all sanitizers, pesticides and other

chemicals separate from food Identify chemicals with a legible label Use chemicals only as directed by the

manufacturer’s label

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Recommendations

Meat and Poultry Departments Personal Hygiene

Wash your hands frequently and after any change in operations

• Keep hands and arms clean and wash: • during food preparation as often as

necessary to remove soil• when switching between working with raw

food and working with ready-to-eat food• after touching anything that can contaminate

hands

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Recommendations

Personal Hygiene Keep hands and arms clean and wash:

• after touching bare body parts• using the toilet • after touching soiled equipment or utensils• before putting on gloves to work with food

Wear proper attire including hair restraints and protective garment covers such as coats

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Summary

Meat and Poultry Departments Follow the safe practices to

ensure that proper time and temperature is maintained when handling meat and poultry

Take measures to protect food from contamination

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Summary

Meat and Poultry Departments Make sure that employees have good

personal hygiene at all times and wash hands regularly especially in between handling raw poultry and red meat

Make sure that all chemicals are properly stored, labeled and always follow the manufacturers instructions for use

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Risk factors needing extra attention

Seafood Departments Improper holding, time and

temperature Prevention from contamination Poor personal hygiene Food from unsafe source

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Recommendations

Seafood Departments Holding Time and Temperature

Date mark open containers of commercially-processed , ready-to-eat, Potentially Hazardous Foods (PHF) Time /Temperature Control For Safety Food (TCS) and ready-to-eat, PHF/TCS prepared on site

Maintain cold holding temperatures for PHF/TCS at 41°F or below

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Recommendations

Seafood Departments Holding Time and Temperature

Discard ready-to-eat, PHF/TCS as required for date marking

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Recommendations Seafood Departments

Date Marking

Food Product Date Marked

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Recommendations Seafood Departments

Prevention from Contamination Properly clean and sanitize all food contact

surfaces and utensils

3 compartment sink3 compartment sink

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Recommendations

Seafood Departments Prevention from Contamination

Separate raw animal foods from ready-to-eat foods and from other raw animal

foods

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Recommendations Seafood Departments

Personal Hygiene Wash your hands often, especially after

handling raw animal foods, using the restroom, or handling soiled equipment

Hand washingHand washing

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Recommendations

Seafood Departments Personal Hygiene

Make sure all hand wash sinks are supplied with soap and single use towels or hand drying devices

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Recommendations

Seafood Departments Food from Unsafe Sources

Make sure that all food items are purchased from approved sources such as licensed seafood processors or vendors

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Recommendations

Seafood Departments Food from Unsafe Sources

Keep and maintain shell stock tags for 90 days from the dates of harvest

Shellstock tagShellstock tag

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Recommendations

Seafood Departments Chemical

Make sure all spray bottles or chemical storage containers are properly identified

Keep all cleaners, sanitizers or other chemicals in the seafood department or market properly stored

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Recommendations

Seafood, Seafood Departments Chemical

Make sure to use cleaners or other chemicals as intended

Always read the label for chemical type and instructions for use

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Summary

Seafood Departments Keep seafood at proper temperatures. Use good sanitation practices Wash your hands often

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Summary

Seafood Departments Store seafood properly to prevent

contamination Purchase seafood from approved

sources Maintain shell stock tags

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Risk factors needing extra attention

Produce Departments Improper holding, time and temperature Poor personal hygiene

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Recommendations Produce Departments

Holding, time and temperature Hold Potentially Hazardous Food (PHF)

Time/Temperature Control For Safety (TCS)

Food at 41º or below

Cut melons Sprouts

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Recommendations Produce Departments

Holding, time and temperature Hold Potentially Hazardous Food (PHF)

Time/Temperature Control For Safety (TCS) Food at 41º or below

salad bar

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Recommendations

Produce Departments Holding, time and temperature

Use proper storage to reduce the chances of customers becoming ill after eating foods

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Recommendations

Produce Departments Holding, time and temperature

Pay special attention to cut melon, sprouts, and salad bar items that need refrigeration because microorganisms can grow and multiply easiest in these kinds of foods

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Recommendations

Produce Departments Holding, time and temperature

Check refrigeration on a frequent basis to ensure that it is working properly and holding food at 41°F or below

Chill whole fruits before cutting or slicing Make sure that ice levels are adequate and

checked regularly when using ice to hold cut melon

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Recommendations

Produce Departments Holding, time and temperature

Pre-chill unopened cans or jars of food products that will be served on the salad bar

Make sure that Potentially Hazardous Food (PHF) Time/Temperature Control For Safety (TCS) Food that are displayed on “reduced for quick sale” rack are at held at 41°F or below

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Recommendations

Produce Departments Holding, time and temperature

Use a thermometer and check the temperatures of Potentially Hazardous Food (PHF)/ Time-Temperature Control For Safety (TCS) Food in your produce department

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Recommendations

Produce Departments Personal Hygiene

Make sure to wash your hands before handling produce

Use the designated hand washing sink

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Summary

Produce Departments Maintain food at the proper temperature Wash hands properly and as often as

needed: Refer to Chapter 2 in the 2005 FDA Food 2-3

Personal Cleanliness 2-301.14 When to Wash

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References FDA Report in the Occurrence of Foodborne

Illness Risk Factors in Selected Institutional Food Service, Restaurant and Retail Food Store Facility Types (2004) www.cfsan.fda.gov/~dms/retrsk2.html

Food Code, U.S Public Health Service, Food and Drug Administration, 2005 http://www.cfsan.fda.gov/~dms/fc05-toc.html

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FDA Contacts

FDA Regional

Food Specialists

Retail Food Protection TeamCenter for Food Safety and Applied NutritionFood & Drug AdministrationCollege Park, MDPH: 301-436-2350Email: Bedwards@cfsan.fda.gov