D.C. Mun. Regs. tit. 22, r. 22-B3504
Each CRFPID shall ensure that each person residing there has access to food at any time, unless there is a restriction based upon assessment, approved by a physician and justified in the person's ISP.
Each CRFPID shall offer each person a nourishing, well-balanced diet in accordance with dietary guidelines established by the United States Department of Agriculture.
Menus shall be developed with consideration of average portion sizes for menu items, person preferences, shall be developed on a weekly basis, shall provide a variety of food choices at each meal, and shall be available to persons during mealtimes and otherwise. Each menu shall vary from week to week and adjusted for seasonal changes. Menus shall be available for each person's review. Mealtime protocols containing personal dietary needs shall not be displayed publicly.
If a person requires a modified diet, it shall be prescribed by a physician and documented in the person's ISP. A "modified diet" is any diet that requires specialized or restricted textures, restricted or increased calories or any other therapeutic restrictions or use of dietary supplements.
A recommendation by a licensed dietitian for a modified diet shall be reviewed by a physician within five (5) business days, and shall be implemented only if ordered. If the diet is to be modified based on a medical emergency, the modification must be approved by a physician order within twenty-four (24) hours.
Any modified diet shall be planned, prepared, and served by staff members who have received instruction and training on modified diets from a licensed dietitian. Subsequent training can be conducted by a licensed health professional trained by a licensed dietitian.
Modified diets shall be reviewed at least quarterly by a dietitian, and as necessary according to any change in the person's condition. The review shall ensure that each diet provides adequate nutrition.
All food and drink shall be free from spoilage, contamination and debris.
The CRFPID shall offer at least three (3) meals per day that are nutritious and suited to the needs and choice of each person, along with the availability of nutritious snacks at the times of a person's choosing. The meals shall be offered at reasonable times as follows:
A person shall not be required to eat at the three regularly scheduled meal times. Any variation from the requirements of Subsection 3504.9 shall be documented in the person's record.
Each CRFPID shall be responsible for ensuring that meals served away from the CRFPID are suited to the dietary needs of the person as indicated in his or her ISP.
No person may be denied a meal as a form of punishment.
Each CRFPID shall provide table service for all persons who can and want to eat at a table, including persons in wheelchairs. The dining room shall have tables and chairs sufficient in number to seat all persons residing in the home who utilize the dining room.
Each CRFPID shall equip dining areas with tables, chairs, eating utensils, and dishes designed to meet the needs of each person.
Persons, as needed, shall be provided training to develop eating skills and to use special eating equipment and utensils if such training is indicated in the ISP.
Each CRFPID shall train the staff in the use of proper mealtime protocols and how to assist persons who require special mealtime protocols or utensils.
Each CRFPID shall ensure that all direct care staff who prepare, cook or serve food are trained in the storage, preparation and serving of food, the cleaning and care of equipment, and food preparation in order to maintain sanitary conditions at all times.
Training in food storage and preparation, serving of food, and cleaning and care of equipment shall be done by a certified food manager in accordance with Title 25-A DCMR, Food and Food Operations.
There shall be at least a three (3) day supply of perishable food and a five (5) day supply of nonperishable food in the CRFPID based on the menus for both regular and modified diets.
Dry or staple food items shall be stored at least twelve (12) inches above the floor in a room not subject to sewage or waste water backflow, or contamination by condensation, leakage, rodents or vermin.
Each CRFPID shall have and utilize effective procedures for cleaning all equipment and work areas used in the preparation and serving of foods.
Dishes, eating utensils and cooking equipment shall be cleaned after each meal, appropriately dried and stored to maintain their sanitary condition.
Hot and cold water, soap, and towels shall be provided in or adjacent to food preparation areas for hand washing.
Each CRFPID shall serve meals at temperatures in accordance with Title 25-A DCMR, Food and Food Operations. If a person requires mealtime assistance, food shall be maintained at serving temperature until assistance is provided. Food that is not promptly consumed shall be refrigerated, if necessary, and reheated.
Food requiring refrigeration shall be maintained at temperatures in accordance with Title 25-A DCMR, Food and Food Operations, until preparation for consumption or, if appropriate, for consumption while cold.
Frozen foods shall be maintained frozen in accordance with Title 25-A DCMR, Food and Food Operations until preparation for consumption or, if appropriate, for consumption while frozen.
Foods that must be cooked to safe temperatures (including but not limited to raw animal, seafood or plant foods) before consumption, shall be heated and reheated to the temperatures in accordance with Title 25-A DCMR, Food and Food Operations.
D.C. Mun. Regs. tit. 22, r. 22-B3504