Running head: ROTATION ACTIVITIES 1

Food Service Management: Summary of Rotation Activities

Kacy Shaffer

Fontbonne University
FOOD SERVICE ROTATION ACTIVITIES 2

Staff Relief Summary and Reflection

The final week of this rotation was staff relief for one of the managers who works under

Lisa. I arrived at 5:30am each morning and began by taking temperatures of each refrigerator,

freezer, and warming cabinet throughout the facility as well as the dish machine. I helped count,

record, and deposit the cashiers drawers. I did behavioral audits, tray accuracy audits, and tray

passer audits. There are sheets that have checklists for each of these audits. I also did meal

rounds to check how patients feel about the food and service. I helped lead the daily huddle this

week, where I discussed keeping towels submerged in sanitizer solution, changing the solution

every two hours, and not leaving knives on counter tops. A majority of the time each day was

spent on tray line, supervising the staff and helping when it got busy. I helped set up and take

down a catering and helped fill out a form because a customer found a bug in their salad, which

are both things that managers are responsible for. I sat in on an interview for a dietary worker

opening with the clinical nutrition manager, Kris.

This was a good experience overall. Initially, I thought I would be doing staff relief for

Lisa. This was much easier than I expected. It would have been helpful to get to see more of

what Lisa does. However, it was nice to get to work with employees and help them make

improvements in sanitation and safety practices. Some did not realize the correct way to do it and

others did not think it was necessary. I spent a good amount of time demonstrating and

discussing these things. Several times, I would ask, has this solution been changed in the past

two hours? Often times it would be dirty. I would say, I will go change it for you now, but

remember that it has to be changed once it gets dirty or at least every two hours. They were

appreciative of me changing their solution. I would also clean and sanitize knives I found on
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counter tops, then put them away. It seems that setting this example was helpful to get some of

the staff to start implementing these practices.

Summary of Rotation Activities

1. Lisa gave me access to the policy and procedure manuals for SSM. It was difficult to sort

through and find ones related to nutrition and food service. There were 1,127 items to look

through. They were not the type of policy and procedures to modify. They are on the portal for

all SSM entities.

The ones I found included:

Diet manual - this policy discusses the appropriate use of the diet manual from the Academy of

Nutrition and Dietetics. The manual is available on each entitys intranet and a backup CD is

available in the instance of internet issues. All diet counselling must be in accordance with this

manual. Patient menus and diets must comply with this manual. If a diet does not comply or is

not defined in the manual, it must be notated in the medical record and defined by the clinical

RD and the ordering physician.

Hand hygiene - This discusses when hands should be washed but is directed toward healthcare

professionals. It gives details for the CDC and WHO recommendations. It goes through the

proper method of handwashing. It discusses fingernail length, polish, and artificial nails.

Hepatitis A vaccine for food handlers - food handlers in the dietary departments are required to

receive the hep A vaccine at no cost to the employee.

Monitoring refrigerator temperatures: patient food storage and medication - this one gave details

about specific times and temperatures and what to do if a refrigerator is above or below the

recommended temperature.

5. Meeting for diet office employees, discussing conflict resolution (9/22).

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Monthly meeting for all employees where disaster plans were discussed and two RDs did a

lesson on renal diets (9/27).

Meeting about proper food handling, cleaning and sanitizing food contact surfaces (10/25).

Safety meeting where safety precautions are discussed, like knives, burns, lifting, and personal

protective equipment (10/27).

It was interesting to attend these meetings and see how the topics and priorities compare

to the SSM where I work. The first meeting I attended, which was for diet office employees, was

very different from what I have experienced. The diet office employees were having conflict and

complaining about each other, so Lisa scheduled a meeting to resolve conflict. One of the main

things they were complaining about was the person before them not finishing their work before

they leave. We do not have problems like this at Wentzville. The diet office employees do their

work before they leave. That is just what is expected. At the monthly meeting, the disaster plans

were familiar to me because they were similar to Wentzville. Having an RD talk about renal

diets was new, as we do not see this at the behavioral health facility where I work. It was good

for employees to get an idea about why these diets are important. I participated in the meeting

about proper food handling and sanitation. It was important for employees to hear more about

this topic, although theyve learned it before. Discussing cross contamination may help some be

more mindful about their food handling practices. The safety meeting addressed some recent

safety concerns, including knivese and burns. Two employees were burned during my time there

because they did not follow safety precautions. Several employees were leaving knives on

countertops and walking away from them. Some employees were not using cutting gloves. This

was all addressed. It was good for employees to discuss this so they can start following safety

precautions better.
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8. Position P3

a. This position is responsible for preparing the cold items on the patient tray line. Some

examples include sandwiches, salads, fruits, and pudding. They prepare a batch of cheesecake

parfaits each day. They are responsible for checking the temperature of each of the foods every

two hours. They read tickets as they print out and prepare the items for the patient trays. At the

end of their shift, they stock and clean everything in their area.

b. We did quantity food production with the cheesecake parfaits. We used a large mixing bowl, a

large whisk, and a #5, 6 ounce disher. They make two bags of the mix every time and just make

more each day or when they notice it is getting low.

c. Scoops are used for portioning servings to the patients. They have a standard scoop size for

each item. The employees are trained on which serving size goes with each item. This seems

effective because the patients are getting the same amount every time.

d. Sanitation procedures are not effective. Surfaces and knives were not properly sanitized

between uses. The plan for improvement is detailed in the quality improvement project.

f. I worked a lot on the tray line. When there is a ticket market priority tray, it is supposed to be

taken up immediately. Often, I would take it up to ensure it got there quickly. I also followed the

tray passer for a day and helped deliver trays to the patients.

Position P2

a. This position makes the soups for the cafeteria. There are three soups or items like chicken and

dumplings or chili each day to choose from. They also check the other recipes that they are

responsible for making each day for the cafeteria. They must take initial temperatures after the

food is cooked, then every two hours. The challenges come with making new recipes that you
FOOD SERVICE ROTATION ACTIVITIES 6

may be unfamiliar with. However, for employees who are good at reading recipes and familiar

with cooking methods, this is not much of a challenge.

b. For the soups, the P2 just makes one recipe, which is a full pot of each soup. The recipes

require cutting boards and knives for chopping, a large pot for cooking, and large spoon for

stirring, a hot well for holding, and a ladle for serving.

c. The portions are determined by the cup size. There is an 8 ounce, 12, ounce, and 16 ounce cup

option for the soups, each with a different price. This is a good way to control portion.

d. Sanitation procedures are not effective. Surfaces and knives were not properly sanitized

between uses. The plan for improvement is detailed in the quality improvement project.

9. I developed a menu special for the fall. They usually rotate different salads like Caesar, cobb,

BBQ chicken, chef, and a vegetarian salad. I got a recipe for a spinach salad with maple

vinaigrette. The link to the recipe is https://www.cookingclassy.com/apple-cranberry-pecan-

spinach-salad-maple-cider-vinaigrette/. I made it vegetarian, omitting the meat from the recipe. It

did very well, almost selling out. I made enough to fill two full size rectangular food pans, which

required me to multiply the recipe by 4.

11. I temped all the items at lunch. There was only one item that was out of range. Some

shredded lettuce in the cold production area of the patient tray line was 41 degrees. After

investigating, I discovered that the refrigerator temperature was at 42 degrees. I let a manager

know. We documented it and did a corrective action. We adjusted the refrigerator temperature

and checked back thirty minutes later. It was then at 38 and the food was at 39. The opening

manager already checks the temperatures of the refrigerators every morning. The employees are

supposed to check the temperatures of their food every two hours. The only plan for

improvement would be to ensure that these things are being done. This would mean having a
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manager checking the temperature logs every two hours. They are already walking around, so it

would not take much extra time to check the logs in each area as there are usually three to four

managers there and each is responsible for an area.

16. At this kitchen, the ordering is done by the evening manager. He goes through and looks at

what they are low on, then takes note of what they need to order. He has an idea of how much of

certain items are usually used between deliveries. He does not keep specific count of previous

orders, other than looking at the ordering sheet on U.S. Foods. For the delivery, there is one

specific employee who is responsible for accepting and putting away the order every Tuesday

and Friday. He was just rehired during my time there, after being at another job for almost a

year. When he came back, he rearranged the refrigerators and the dry storage area. It caused a lot

of conflict, because a lot of the employees liked knowing where certain items are. He is

responsible for marking off items and making sure that everything that was purchased arrives on

the order. All the employees know and are reminded to practice the first in first out method.

When items are stocked, they are put behind the items with more recent expiration dates. Also,

when items arrive, the cold stuff is put away first and dry storage items last. I have helped put

away orders at Wentzville several times, which is a much smaller kitchen than Lake St. Louis.

They have a lot more items and more variety. Seeing the whole process from start to finish was

helpful to see how a kitchen can successfully maintain the items they need. At Wentzville, we

have run out of items frequently in the past. Keeping a close eye on what and how much is being

used is helpful to keep an adequate amount on hand.

17. I met with a lady from HR. I asked her about recruitment and she explained that they have a

recruitment team who works to recruit good employees. She talked about her relationship with

Lisa and how they keep in close contact because Lisa wants to make sure she is following all the
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protocols properly. She said this is helpful for a manager to do so they can stay ahead of any

potential problems. Several employees have been sent to HR for being inappropriate, showing

that the behavior is not tolerated. Performance evaluation is done by mostly looking at

attendance. There are different levels depending on employment status (PRN, part time, and full

time) and how many absences and late arrivals an employee has. Employees also set goals and

have evaluations, but these are not weighted as heavily as attendance. For termination

procedures, employees are given a verbal warning, then a written action, then may be terminated

depending on the problem. Employees sign for each of these actions. For screening, the potential

employees reference is checked. The employee sees an SSM employee health nurse who

performs a drug test and a TB test. All new employees go to an orientation before starting work.

Training is up to the individual departments.

22. The public health sanitation inspector came in while I was present. I was able to see what he

looked at and how things went. I asked and the managers say that there have been no violations

since they have been here. They say that they always get 100. This time, the inspector found

water on the floor in the janitors closet that has the mop sink. They had to get it fixed and re-

inspected. I imagine that this is similar in many kitchens, but there are many things that I realize

would be a violation if the inspector witnessed it. However, when an inspector is present,

everyone pays close attention to what they are doing to make sure they are not making any

violations. I wonder if there is a way to help the employees have this awareness more often. I

attempted this with my quality improvement, but I am sure there are more ideas and better ways

to have success with this. The whole point of the inspection is to make sure that kitchens have

practices that ensure that safe food is served. This cannot work if employees only follow these

practices when they know an inspector is present.

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23. During the safety audit, the biggest problem I noticed was employees leaving knives out on

counters and on carts. This is a serious safety issue and a food safety issue when the knives are

being used all day and not cleaned or sanitized. The safety audit is an entire packet for the whole

kitchen and cafeteria. After I brought the knife problem to my preceptors attention, we

discussed it at huddle and began providing frequent reminders. I would walk around and remind

employees if I saw a knife on a counter unattended at their station. Some of the employees did

not like this. However, I did see improvement throughout the week with people putting covers on

knifes and keeping them out on the counters less.

24. During my staff relief week, it was my responsibility every morning to walk around and

document the temperature of the dish machine and every refrigerator and freezer. The

refrigerators should be between 32 and 40 degrees and the freezers should be zero degrees or

below. There were a couple times that they were outside the temperature range. The grab-and-go

in the caf was at 42 degrees one day. I noticed that it was stocked very full and overcrowded. I

know this sometimes can affect the temperature, so I let a manager know and asked if they had a

par that the employees follow. We do this at Wentzville and sign off on what we stock. The sheet

we have says, do not fill over par so we are aware that it should not be overstocked. The dish

machine should be at least 160 degrees for the wash and 180 for the final rinse. Sometimes the

dish machine takes a few minutes to get to the correct temperature, so it is important to push a

few empty racks through and give it time before beginning the dishes.

25. I located and printed the SDS sheets for all the chemicals they use in the kitchen and put

them in a binder in alphabetical order for the employees to have quick access to. Before this,

they could only access it online. My preceptor wanted to be sure that they have access even if the

computers or internet are not working. The cleaning procedure was for the Oasis multi-quat
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sanitizer from Ecolab. This includes the employees changing the solution every two hours and

washing, rinsing, then sanitizing food contact surfaces. This is detailed in the quality

improvement project.

2B. I conducted meal round on several days. I did this for a few breakfast meals and a few lunch

meals. I went to several different patient care areas, the 2nd, 3rd, and 4th floors. Many of the

patients said that both the tray passers and the ladies on the phones who take their orders were

very polite and helpful. This was a theme each time I did meal rounds. Many people said the

food was good or excellent and that it came in a timely fashion. A few people who had

complaints said the food was bland, and it was noted that these people were on the cardiac diet.

Two people said that the vegetables were not cooked enough. I brought this information back to

the managers. They were not sure whether they should address this issue with the cooks. They

said that there is always going to be someone who complains. In this situation, I would have

done a test tray and ordered a few vegetables to see how they were cooked. If they were not

palatable, I would discuss this with the cook.