1 2 3 4 5 6 85 "(5) is consistent with the facility's goals and policies; "(6) is distributed and interpreted to all facility personnel; and "(7) complies with State and local regulations. "(c) Whenever appropriate, the following services 7 should be provided "(1) initial and periodic evaluation of the nutritional status of each resident, including "(A) determination of dietary requirements and assessment of intake and adequacy through"(i) dietary interview; "(ii) clinical evaluation; (iii) biochemical assessment; "(B) assessment of food service practices; "(C) assessment of feeding practices, capabilities, and potential; “(2) maintenance of a continuing and periodically reviewed nutrition record for each resident; "(3) incorporation of recommendations drawn from the nutrition evaluation into the total management plans for the resident; "(4) periodic review of implementation of recom mendations and of need for modification; "(5) participation in the continuing interdiscipli 86 nary evaluation of individual residents, for the purposes of initiation, monitoring, and followup of individualized habilitation programs; "(6) provision of dent; "(A) counseling services to the individual resi "(B) reciprocal consultation services with facility staff and students; "(C) counseling service to residents' families or their surrogates; "(D) nutrition education, on a continuing basis, for residents, families or surrogates, staff, and students, and development of such programs in coordination with various education programs within the facility and the community; "(7) coordination of nutrition programs between the facility and the community, including— "(A) development of awareness of available programs in nutrition; "(B) development of needed nutrition pro grams; "(C) encouragement of participation of professionals and students in nutrition programs for the mentally retarded; and "(8) development, coordination, and direction of 87 1 nutrition research, as well as cooperation in interdisci "(1) menu planning; "(2) initiating food orders or requisitions; "(3) establishing specifications for food purchases. and insuring that such specifications are met; 3 4 5 6 7 8 . 9 10 11 12 13 14 15 "(4) storing and handling of food; "(5) food preparation; "(6) food serving; “(7) maintaining sanitary standards in compliance with State and local regulations; and "(8) orientation, training, and supervision of food service personnel. "(e) The food and nutrition needs of residents shall 16 be met in accordance with the recommended dietary allow17 ances of the food and nutrition board of the national research 18 council, adjusted for age, sex, activity, and disability, through a nourishing, well-balanced diet. The total food intake of 20 the resident should be evaluated, including food consumed 21 outside of as well as within the facility. 19 22 "(f) Menus shall be planned to meet the needs of 23 the residents in accordance with subsection (e). Menus shall 24 be written in advance. The daily menu shall be posted in food preparation areas. When changes in the menu are 88 1 necessary, substitutions should be noted and should provide 2 equal nutritive values. Menus shall provide a sufficient va3 riety of foods served in adequate amounts at each meal, 4 and shall be: (1) Different for the same days of each week; 5 (2) Adjusted for seasonal changes. Records of menus as 6 served shall be filed and maintained for at least thirty days. 7 At least a one-week supply of staple foods and a two-day 8 supply of perishable foods shall be maintained on the 9 premises. Records of food purchased for preparation shall 10 be filed and maintained for at least thirty days. A file of 11 tested recipes adjusted to appropriate yield should be 12 maintained. 13 14 15 16 17 18 19 "(g) Foods shall be prepared by methods that- "(1) conserve nutritive value; "(2) enhance flavor; and "(3) enhance appearance. "(h) Food shall be prepared, stored, and distributed in a manner that assures a high quality of sanitation. Effective procedures for cleaning all equipment and work areas shall 20 be followed consistently. Dishwashing and panwashing shall 21 be carried out in compliance with State and local health 22 codes. Handwashing facilities, including hot and cold water, 23 soap, and paper towels, shall be provided adjacent to work 25 "(i) When food is transported, it shall be done in a 1 89 manner that maintains proper temperature, protects the food 2 from contamination and spoilage, and insures the preserva3 tion of nutritive value. Food storage procedures shall meet 4 State and local regulations. Dry or staple food items shall be 5 stored at least twelve inches above the floor, in a ventilated. 6 room not subject to sewage or waste water backflow, or 7 contamination by condensation, leakage, rodents, or vermin. 8 Perishable foods shall be stored at the proper temperatures 9 to preserve nutritive values. Food served to residents and 10 not consumed shall be discarded. 11 "(j) There shall be a sufficient number of competent 12 personnel to fulfill the objectives of the food and nutrition 13 services, including 14 15 16 "(1) nutritionists and/or dietitians; "(2) other food service personnel; "(3) clerical personnel; "(4) depending upon the size and scope of the facility, food and nutrition services shall be directed by one of the following "(A) a dietitian who is eligible for membership in the American Dietetic Association, and preferably eligible for registration by the association, or a nutritionist who has a master's degree in foods, nutrition, or public health nutrition, who is eligible for membership in the American Dietetic Associa |