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November

2006

Reducing Foodborne Illness


Risk Factors in Food Service
and Retail Establishments

1
Introduction
Agency initiative to
provide information
about risk factors
insufficiently controlled
in:
Institutions
Restaurants
Retail food

2
Introduction

To remind operators and


regulators about safe practices
used to control risk factors.

3
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.

4
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, delis, meat and poultry, seafood
and produce) facility types.

5
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

9
Recommendations

Operators
Provide
Procedures
Staff training

Monitoring

Corrective action

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Recommendations

Hospitals and Nursing Homes


Cool foods from 135F to 70 F in 2
hours and then to 41F in a total of 6
hours.
Hold Potentially Hazardous Foods
(PHF) /Time-Temperature Control For
Safety (TCS) Food cold at 41F or
below

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Recommendations
Hospitals and Nursing Homes
Hold hot food at 135F 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 41F; and
after 4 days if held at 45F

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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 135F or above
Pre-heat steam table, soup warmers,

etc. before adding food


Reheat leftovers quickly to 165F (in

less than 2 hours)


Reheat commercially prepared foods

in intact packages to 135F

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Recommendations

Elementary Schools
Holding, Time and Temperature
Keep cold foods at 41F or colder
Provide all hot and cold holding units with
thermometers
Cool hot foods from 135F to 70 in 2
hours and then to 41F in a total of 6
hours
Cool foods made from room temperature
ingredients (canned tuna, bean salad,
etc.) to 41F in 4 hours

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Recommendations

Elementary Schools
Datemark 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 41F
Discard after 4 days if held at 45F

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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
ImproperHolding, 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
ImproperHolding, 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 establishments 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
Verifyhand 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 facilitys
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 Service
Establish solution for long term
control
Maintain an open dialog with

operators
Understand the operation

procedures and employee training


programs

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Summary

Restaurants
Full Service
Implement standard operating
procedures (SOPs) 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 41F

Discard after 4 days if held at 45F

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Recommendations

Fast Food
Holding, Time and Temperature
Ensure foods that require refrigeration
are maintained at 41F or below
Maintain hot food at 135F or above

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Recommendations
Fast Food

Date Marking

Hard Cooked Eggs

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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 41F
Discard after 4 days if held at 45F

Hold food that requires refrigeration cold at

41F 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


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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 41 F or below in storage

and while on display


Keep frozen food frozen

Keep hot food at 135F 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

manufacturers 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 41F 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 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 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 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
Storeseafood 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 41 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 41 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 41F 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 41F 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
Maintainfood 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 Retail Food Protection Team


Food Specialists Center for Food Safety and
Applied Nutrition
Food & Drug Administration
College Park, MD
PH: 301-436-2350
Email:
Bedwards@cfsan.fda.gov

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