HAR §11-96-10. Dietetic services

(a) Meals served in the center shall meet the recommended dietary allowances of the Food and Nutrition Board of the National Research Council, and be adjusted for age, sex, activity and disability. (b) A minimum of one meal per day shall be provided in accordance with the following requirements stated. (1) Each client who is in the center for four hours or more shall be served a meal that will supply at least one-third of the National Research Council recommended dietary allowances; (2) Each client who is in the center for eight hours or more shall be served a meal and between meal nourishments that will supply at least half of the National Research Council recommended dietary allowances; (3) Each client who is in the center for periods longer than ten hours shall be served at least two meals and between meal nourishments that will supply at least two-thirds of the National Research Council recommended dietary allowances; and (4) Any client accepted at 7:00 a.m. or earlier shall be served a breakfast, unless it has been determined that the client has received a meal prior to arrival. (c) All diets shall be: 96- (1) Prescribed by the client's physician with a record of the diet as ordered kept on file; (2) Planned, prepared, and served by personnel using the current Hawaii Dietetic Association manual; and (3) Reviewed and adjusted as needed by the dietitian. (d) Therapeutic diets shall be planned by a qualified dietitian, as prescribed by the client's physician. (e) A nutritional assessment and diet plan for each client shall be completed and recorded in the health record by the physician or dietitian. The plan should be incorporated in the overall plan of care and reviewed as necessary. (f) Menus shall be written at least one week in advance and posted in the kitchen. (1) Menus shall provide a sufficient variety of foods served in adequate amounts at each meal, and adjusted for seasonal changes along with clients preferences as much as possible; and (2) A different menu shall be followed for each day of the week. If a cycle menu is used, the cycle menu shall cover a minimum of two weeks. (g) All food shall be procured, stored, prepared, distributed, and served under sanitary conditions. (1) Dry or staple food items shall be stored above the floor in a ventilated room not subject to seepage or waste-water back flow, or contamination by condensation, leakages, rodents, or vermin; and (2) Perishable foods shall be stored at the proper temperature to conserve nutritive values and prevent spoilage. (h) Food shall be served under sanitary conditions, and shall be in a form consistent with the needs of the client and the client's ability to consume it. (1) Food shall be served in a form consistent with the appropriate utensils; (2) Effective procedures to promptly and 96- consistently clean all equipment and work areas shall be enforced; (3) All personnel handling food shall be trained in and observe appropriate personal hygiene practices; (4) Hand washing facilities, including hot and cold water, soap, and paper towels adjacent to the work areas shall be provided; (5) Individuals needing special equipment, implements, or utensils to assist them when eating shall have such items provided by the center; (6) There shall be a sufficient number of competent personnel to fulfill the food and nutrition needs of clients; (7) If the food service is directed by a person other than a qualified dietitian, there shall be consultation by a dietitian; (8) Dietary consultation, training and inservice education shall be appropriate to staff and client needs and shall be documented; and (9) Provision may be made for food service by contract with an outside supplier. The method of transport, storage, preparation, and serving of such food as well as the method of providing prompt appropriate replacement foods in therapeutic diets shall be approved by the director prior to initiating such a service. [Eff ] (Auth: HRS §321-11) (Imp: HRS §321-11)