Ariz. Admin. Code § 9-10-522

Current through Register Vol. 30, No. 45, November 8, 2024

Section R9-10-522 - Food Services

A. An administrator shall ensure that:

1. The ICF/IID has a license or permit as a food establishment under 9 A.A.C. 8, Article 1;

2. A copy of the ICF/IID's food establishment license or permit is maintained;

3. If the ICF/IID contracts with a food establishment, as established in 9 A.A.C. 8, Article 1, to prepare and deliver food to the ICF/ IID:

a. A copy of the contracted food establishment's license or permit under 9 A.A.C. 8, Article 1 is maintained by the ICF/IID; and

b. The ICF/IID is able to store, refrigerate, and reheat food to meet the dietary needs of a resident;

4. A registered dietitian:

a. Participates as part of an interdisciplinary team for a resident requiring a modified or special diet,

b. Reviews a food menu before the food menu is used to ensure that a resident's nutritional needs are being met,

c. Documents the review of a food menu, and

d. Is available for consultation regarding a resident's nutritional needs; and

5. If a registered dietitian is not employed full-time, an individual is designated as a director of food services who consults with a registered dietitian as often as necessary to ensure that the nutritional needs of a resident are met.

B. A registered dietitian or director of food services shall ensure that:

1. Food is prepared:

a. Using methods that conserve nutritional value, flavor, and appearance; and

b. In a form to meet the needs of a resident such as cut, chopped, ground, pureed, or thickened;

2. A food menu:

a. Is prepared at least one week in advance,

b. Includes the foods to be served on each day,

c. Is conspicuously posted at least one day before the first meal on the food menu will be served,

d. Includes any food substitution no later than the morning of the day of meal service with a food substitution, and

e. Is maintained for at least 60 calendar days after the last day included in the food menu;

3. Meals and snacks for each day are planned and served using the applicable guidelines in http://www.health.gov/dietaryguide-lines/2015.asp;

4. A resident is provided:

a. A diet that meets the resident's nutritional needs as specified in the resident's comprehensive assessment and individual program plan;

b. Food served in sufficient quantities to meet the resident's nutritional needs and at an appropriate temperature;

c. Three meals a day with not more than 14 hours between the evening meal and breakfast, except as provided in subsection (B)(4)(e);

d. The option to have a daily evening snack identified in subsection (B)(4)(e)(ii) or other snack; and

e. The option to extend the time span between the evening meal and breakfast from 14 hours to 16 hours if:

i. A resident group agrees; and

ii. The resident is offered an evening snack that includes meat, fish, eggs, cheese, or other protein, and a serving from either the fruit and vegetable food group or the bread and cereal food group;

5. A resident is provided with food substitutions of similar nutritional value if:

a. The resident refuses to eat the food served, or

b. The resident requests a substitution;

6. Recommendations and preferences are requested from a resident or the resident's representative for meal planning;

7. If food is used as a part of a program to manage a resident's inappropriate behavior:

a. A special diet is included as part of the resident's individual program plan, and

b. The special diet is reviewed and evaluated by a physician and a dietitian to ensure the special diet meets the resident's nutritional needs;

8. Meals are served to residents at tables in a dining area and in a manner that allows the resident to eat from an upright position, unless otherwise specified in the resident's individual program plan or by an attending physician;

9. A resident requiring assistance to eat is provided with assistance that recognizes the resident's nutritional, physical, and social needs, including the use of adaptive eating equipment or utensils;

10. Personnel members supervise meals in dining areas to:

a. Direct a resident's self-help dining procedures,

b. Ensure a resident consumes enough food to meet the resident's nutritional needs, and

c. Ensure that a resident eats in a manner consistent with the resident's developmental level;

11. Tableware, utensils, equipment, and food-contact surfaces are clean and in good repair; and

12. Water is available and accessible to residents.

Ariz. Admin. Code § R9-10-522

Adopted by final rulemaking at 25 A.A.R. 1222, effective 4/25/2019