Food Safety

Systems Review

A Handbook Developed by:

Brown – Nicollet
Environmental Health
 1
Introduction

What is the purpose of this manual?

First and foremost, this manual was produced to help food service operators have
a more complete understanding of food safety practices and Active Managerial
Control (AMC).

Active Managerial Control is a comprehensive food safety system. It includes

operators and staff who are knowledgeable about food safety issues, and are
responsible for controlling practices and procedures that contribute to foodborne
illness. This new system offers greater assurance that safe food is served.
This manual can also serve as a guide for learning that which is required of all
Certified Food Protection Managers and Persons-In-Charge at each
establishment.
Most inspections by our agency will be scheduled ahead of time. This will ensure
that the right personnel will be on hand for discussion, and that time can be set
aside for this discussion.

Resources are available on our agency website at

www.co.nicollet.mn.us > County Government drop down > Departments > Brown-Nicollet
Environmental Health

Acronym
s
AMC Active Managerial Control
BNEH Brown-Nicollet Environmental Health
CFPM Certified Food Protection Manager
FBI Foodborne Illness
FS Food Safety
HACCP Hazard Analysis & Critical Control Points
MDH Minnesota Department of Health
PIC Person-In-Charge

Notes...
 2
Table of Contents

Introduction and Acronyms ................................................................................................. 1

Table of Contents ................................................................................................................. 2

Your Restaurant Profile .....................................................................................................3 - 4

The Menu Review ................................................................................................................... 4

Personnel Issues .................................................................................................................5 - 7

Food Preparation and Handling Issues ..................................................................... 8 - 12

Cross Contamination ............................................................................................... 8

Temperatures ............................................................................................................ 9

Hazardous Points ........................................................................................... 10 - 12

Food Requiring Special Handling ........................................................................ 13

Facility Issues ................................................................................................................ 14 - 15

Non-critical Items ................................................................................................................. 15

Emergency Preparedness .................................................................................................. 15

Communications with Environmental Health ................................................................. 16

Requirements ............................................................................................................... 17 – 18

References & Contacts ...................................................................................................... 19

Acknowledgements ............................................................................................................ 19

MDH Food Employee Illness Guidelines ......................................................... Appendix A

Notes...
 3
Your Restaurant Profile

The following questions are designed to help determine aspects of your restaurant
that may differ from other restaurants, and most importantly, what critical food
safety issues are most important.

Schedule
What are your hours of operation? What are your busiest times of the day?
What are your busiest days of the week? What is your busiest times of the year?
When do you place orders? When do you receive orders?

These questions about scheduling and staffing are intended to help you
determine your staffing needs. Having adequate staff will help ensure food
safety is not compromised.

Staff
How many people work in your restaurant? Do you have a lot of turnover?

Is all staff fluent in English? How many CFPM’s are on staff?

Do you have a new employee training program? How many PIC’s are on staff?

Customers
What percent of your customers are local? What percent are tourists?
Do you think you have a lot of repeat business? Do you do much advertising?
Do you offer senior citizen discounts? Do you have a children's menu?

Do you serve a highly susceptible population? Questions about your

customer base can help in determining specific health hazards.
Highly Susceptible Population: persons who are more likely than others in the general
population to experience foodborne illness because they are immunocompromised,
preschool-age children, or older adults.

Notes...
 4 Your Restaurant Profile

Operations
What are your opening procedures? What are your closing procedures?
Do you serve TCS foods? What are the special demands of
catering, banquets, or holidays?
What are your policies on employee What are your hand washing & glove use
Illness? policies?
What are your long-term remodeling plans? Do you have in-service training for staff?

These questions help determine your restaurants individual situation.

They can also help you understand where you hope to be in the future.

The Menu Review

Does the menu change throughout the year?
How many menu items do you use?
What do you consider to be your specialties?
Do you run daily specials?
Do you use prep sheets with written recipes?
How do you handle ready-to-eat food items?
Do you cook items in large volume for several days use?
How do you handle requests for undercooked TCS foods?
Do you have Consumer Advisories in place for undercooked TCS foods?

These questions point out the need for careful controls or

critical control points in the preparation of your menu items.

As part of your Food Safety Systems and Active Managerial Control you may want
to follow handling of menu items from ingredient arrival - through preparation,
cooking and serving - through leftover management and finally service. This
procedure will help ensure you serve your customers safely.

Notes...
 Personnel Issues 5
Personnel issues fall into five basic categories: Training, Employee Health,
Standards, Reinforcement and Hygiene. These are standard business
management topics as well as food safety systems practices.

Training
Three types of training programs can be used. Many restaurants use all three.
 New employee training. All employees must be taught food safety practices as
they are important to long-term restaurant success. At a minimum, new
employees should know all about:
 Handwashing
 How to avoid cross-contamination of menu items
 Proper food and equipment temperatures
 Proper reporting when they are ill
 Current employee training and education programs can be effectively
used to teach any of the above concepts.
 Teaching by example. Managers can act as role model and establish an
attitude of respect for food safety standards and policies.

Employee Health
Every restaurant must have a written policy that conforms to the Food Code
regarding employee illness.
 Employees must not work if they have:
x DIARRHEA
x VOMITING
or have been diagnosed as having:
x Shiga toxin-producing E. coli, Salmonella, Shigella, Hepatitis A, or Norovirus
 All employees must report the above symptoms and/or illness to their manager,
or Person-In-Charge and must also report if they have an open, infected wound
or burn.
 A written Employee Illness Policy is required. An example can be found on our
website.
 All employees must be instructed about and understand this policy.
 All employees must sign an Employee Illness Reporting Agreement.
 Signed Agreements must be kept on file.
 Proper Reporting Posters must be posted on -site.
For more information see the Minnesota Food Employee Illness
Guidelines at the end of the booklet.

Notes...
 6 Personnel Issues continued
Standards
Managers must firmly establish standard behaviors to minimize food safety risks.
Some examples of these standards are:
➥ Wash hands as directed ➥ Practice proper illness reporting ➥ No eating, drinking, or smoking in the kitchen
➥ No touching of face or hair while preparing or serving food ➥ Take every customer complaint seriously

Reinforcement
Reinforce safe practices through:
Example “Do as I do (and as I say)”
Encouragement Compliment employees who are doing things right!
Discipline Correct employees who are doing things wrong.

Hygiene

Do your employees know how to properly wash their

hands?

Do your employees know when to wash their hands?

Do your employees know why it is important to wash

their hands?

How do you verify or make sure that each employee can

answer the three questions above?

Notes...
 7
Personnel Issues continued

Handwashing
HOW to wash:
Food employees must wash their hands and exposed portions of their arms using
soap and water and vigorously rubbing together the surfaces of their lathered
hands and arms for at least 20 seconds. Employees must pay particular attention to
the areas underneath the fingernails and between the fingers. After rinsing with
clean water, hands must be dried thoroughly using individual-use paper towels or a
heated air/air knife hand drying device. Handwashing posters must be posted at
each handwashing sink that an employee might use.
WHEN to wash:
After touching body parts (including face and hair)
After using the restroom
After coughing, sneezing, blowing nose
After smoking, eating, or drinking
After handling dirty dishes & equipment
Before beginning food prep
During food prep as often as necessary to prevent cross contamination
When switching between working with raw foods and working with ready-to-
eat foods
After doing anything that could contaminate the hands (including handling
money)

*The Food Code requires a double handwash - once in the restroom and
then again in the kitchen before resuming work!
WHY wash?
Proper Handwashing is the single most important action to prevent foodborne illness.
Other employee hygiene issues:
Proper use of gloves
Hair restraints
Clean uniforms and/or work clothes
Proper use of aprons (not for hand-wiping)
Proper handling of cuts and burns (cover with bandages & gloves)

Notes...
 8 Food Handling & Preparation Issues
Cross-Contamination
Cross Contamination is the transfer of harmful substances or micro-organisms to
food by:
1. hands that either: weren't properly washed or
touched raw foods, then touched cooked or ready-to-eat foods.
2. food contact surfaces that aren't clean and sanitized. Fruits & Vegs
Cooked meats
Prevention of cross contamination is part of a safe food system. Raw meats
Proper Storage of foods to prevent cross contamination includes (see above diagram ↑):
Cooler Stacking: Store foods in this order (top to bottom) to
avoid dripping on the foods on lower shelves.
Dry Storage: Do not store food, food service items or equipment under or
near pipes or toxic substances.
Do not store food, food service items, or equipment directly
on the floor - it must be at least six inches above floor level.

Ice: Ice that will be used in drinks must not be touched by hands,
bottles, glasses, etc. An ice scoop must be used;
NO product can be cooled in ice that is to be used
for beverages.

Sanitization of utensils and work surfaces to prevent cross-contamination includes:

▪ Storing all wiping cloths for clean-up of work surfaces and tables in a sanitizing
solution at proper concentration (see below)
▪ Dishes, utensils, and cookware used to prepare or serve foods must be washed,
rinsed, properly sanitized, and air-dried.

Sanitizer Strength: Contact Time:

Chlorine must be 50-100 ppm 10 seconds
Iodine must be over 12.5 ppm 30 seconds
Quaternary Ammonium must be 200 ppm - 400 ppm 30 seconds

Recording sanitizer strengths is part of a safe food system and Active Managerial Control.
If a sanitizer level is found to be inadequate during the recording process, the problem must
be corrected. Sanitizer strength must be recorded on a Sanitizer Chart.

Notes...
 Food Handling & Preparation Issues 9
Temperatures
For years, a general rule of thumb has been:

 Keep hot foods hot and cold foods cold!

 Heat cold foods that you want to be hot, quickly.
 Properly cool hot foods that you want to be cold.
This means that there is to be no thawing of frozen foods on the counter, and no
allowing of hot foods to become room temperature before refrigerating them! It
also means that foods may not be heated in a steam table, because it is a “hot
holding” unit, and cannot be used to heat up cold foods or leftovers.

Critical Temperatures
Final Cooked Temps:
Leftovers 1650F
Poultry, Pasta & Stuffed Meats 1650F
Microwaved Food 1650F
Ground Meats 1550F
Steak/Eggs 1450F

Hot Holding Temperature: Above 1350F

Keep foods out of

Danger Zone 410F - 1350F the Danger Zone!

Cold Temps: Foods in Dry Storage 500F - 700F

Cold foods ≤410F
Frozen Foods ≤ 00 F

☛The regular use of Hot and Cold Holding Temperature logs is required and is
part of Active Managerial Control.

Cooling: Foods must be cooled from 1350F to 700F within two hours, and from 700F to
410F within and additional four hours. The use of a Safe Cooling
Chart is required to monitor this process and must be used.

Reheating: Reheating must be done rapidly to a temperature of 165 0F within two

hours. The internal temperature must stay at 1650F for at least 15
seconds.

Notes...
 10 Food Handling & Preparation
Critical Control Points
Issues
Consider the progress of food through your establishment - from the time you order
it until the customer leaves your restaurant after a good meal. Hazard Analysis of
Critical Control Points (HACCP) leads us to look at each menu item and to
develop two lists:
1. A list of what can go wrong, and
2. A list of actions we can take when something does go wrong
There are basically nine areas of food preparation:
Planning
Purchasing
Storing
Preparing
Cooking Holding Cooking
Holding
Reheating
Serving
Serving

Planning
Planning for your menu is an important economic aspect of your operation
and care must be taken to understand the needs of your establishment.

Purchasing
Your food safety system begins by choosing reliable suppliers who meet
federal, state and local standards. Look for suppliers with the following qualities:
▪ Properly refrigerated delivery trucks ▪ Trained Employees ▪ Accommodate your delivery schedule
▪ Allow you to inspect deliveries ▪ Respond to your needs
Storage
There are three general methods for minimizing the hazards associated with storage.
1. Prevent Cross Contamination.
2. Use the FIFO Method. FIFO=First In - First Out. Pick a date to write on each package
of food (such as the expiration date, or the date received). Put new supplies
behind old ones, so that the older packages are used first. Then regularly check the
expiration dates. Use proper date making procedures.
3. Measure and record temperatures. Use a Temperature Log daily to monitor, record
and verify that all coolers and freezers are holding food at proper temperatures.

Notes...
 Food Handling & Preparation Issues
11
Preparation & Cooking
Hazards involved with preparation and cooking include four critical areas.
1. Cleaning and Sanitization
▪ Wash fruits and vegetables in the sink designated for food prep only!
▪ As always, prevent cross contamination - be sure that cutting boards and
knives are sanitized between uses and between food products. Use color
coded cutting boards so that raw and cooked products are kept separate.
2. Thawing food
▪ In a refrigerator
▪ Under cool running water (700F or less) in a sanitized sink
▪ As part of the cooking process
▪ In a microwave just prior to final cooking
3. Cooking
▪ Use recipes with cooking times and internal temperature limits written into the
recipe.
▪ Measure final temperatures with a thermometer which is sanitized after
each use.
4. Microwaving
▪ Stir or rotate product during cooking

Cold Holding

Keeping items in a salad bar under 410F can be tricky! It is essential that all staff
understand the hazards of salad bar operations. Temperatures must be taken and
recorded every two hours.
☛ Salad bars must be properly set up. Foods in individual containers must be
filled so that the highest level of food is below the refrigerated level.
☛ Never mix new food with old food.
☛ If the salad bar is used for both lunch and dinner, it should be taken down
after lunch and reset for the dinner service.
☛ Salad bars must be properly constructed and maintained.

Hot Holding
Keeping hot foods hot during food service hours requires constant monitoring.
Temperatures of food items in the steam table and in approved hot holding
equipment should be taken and recorded every two hours.

*Domestic crockpots are not allowed *Foods should be stirred frequently

*Never mix new food with old food

Notes...
 12
Food Handling & Preparation
Issues
Serving
Proper employee hygiene and proper serving equipment (scoops, tongs, etc.)
will minimize hazards associated with serving.

Cooling
Improper cooling procedures can be one of the most common causes of
foodborne illness in establishments!
▪ Food must be cooled from 1350F to 700F within two hours, and then from 700F
to 410F within four hours (for a total of six hours).
▪ When cooling from 1350F to 700F, any time under the required two hours
can be added to the time you take to cool from 700F to 410F. For example, if
you can cool from 1350F to 700F within 0.5 hours, you can take the 1.5 extra
hours and add them to the 4 hours you have to cool from 700F to 410F, for a
total of 5.5 hours to get from 700F to 410F.

The following steps are mandatory - they must be understood and followed precisely by
all staff.
1. Large items or batches of food must first be cut or divided into smaller sections.
2. The smaller sections must be placed in pre-chilled stainless steel pans.
- Thick foods like chili or stew should have a depth of no more than 2 inches.
- Thinner foods like soup may be 3 inches deep.
3. The pans of leftovers can be placed in larger pans of ice and refrigerated.
4. The food in the pans must be stirred as it cools. An ice paddle can be used.
5. When cool, the pans may be placed on the upper shelves of a refrigerator, far
enough apart that air can circulate around them. They may be covered
when the ingredient temperature measures 410F or below.
6. Record the cooling times on a Safe Cooling Chart for each menu item and
add these times to your recipes.
Reheating
The reheating of foods is another critical step. Monitoring and recording temperatures is
required. These steps must be followed precisely or the food must be discarded.
1. Cooking ranges, ovens, and microwaves must be used to reheat food:
- All previously cooked foods must be reheated to 165 0F within two hours for at
least 15 seconds.
2. Food may then be transferred to hot holding equipment.

Reheating times for each type of food should be recorded and added to each recipe.

Notes...
 13
Food Handling & Preparation Issues
Food Requiring Special Handling
- Eggs - - Game Meats -
 Use pasteurized eggs in all recipes in  Cook field dressed game to 165°F
which eggs can’t be cooked to 145°F for at least 15 seconds.
or higher, such as mousses,
 Cook commercially-dressed game
meringues, egg nog, or sauces.
to 155°F for at least 15 seconds.
 Use pasteurized eggs in all recipes
served to the elderly, ill, infants, and - Hamburger & Other Ground Meats -
pregnant women (highly
 All ground meats must be cooked
susceptible population).
to 155°F for at least 15 seconds.
 Recipes using ground meats must
- Salads & Sandwiches - include temperature measurement
and times.
 Always prepare pasta, meat,
egg, and fish salads less than 24
hours before service.
- Batters & Breadings -
 Chill all ingredients to 41°F or below  Batters made with eggs are
before assembling the recipe. potentially hazardous. If possible, use
commercially made battered and
 Wash all fruits and vegetables. breaded items.
 If you make your own breadings and
batters, follow these instructions
- Stuffings - precisely:
 Cook stuffing separately to 165°F. ~ use pasteurized eggs
~ refrigerate all ingredients
 Cook stuffed meats, fish, pasta, and ~ make small batches
poultry to an internal temperature of ~ fry small batches
165°F or higher for at least 15 seconds. ~ record cooking times and add
to recipes
~ do not reuse batter in which
foods have been dipped.

Notes...
 14
Facility Issues
These facility devices are also important to a safe food system:

Thermometers
* Control of temperature is one of the most important aspects of food safety. All food
service employees need to be able to use food thermometers. Thermometers must
be accurate and calibrated regularly.
* Thermometers should be washed, rinsed, sanitized, and air dried between uses.
* Thermometers should be inserted so that the sensing area is in the center of the
food. After 15 seconds, the temperature should be recorded.
* A small diameter probe thermometer is required if you serving thin foods, such as
meat patties, fish patties, eggs, etc.
Dishwashers
 Mechanical dishwashers must be in good working order so that all dishes
are sanitized.
 Hot water units must be monitored daily, using temperature-sensing test strips
(e.g. Thermolabels®). Use of a temperature-sensing test strip must be recorded
regularly on Sanitizer Chart.
 Sanitizer strength in chemical units must be monitored and recorded daily. Use
test strips to monitor sanitizer concentration.
 If three compartment sinks are used, the sanitizer must be monitored and
recorded daily on a Sanitizer Chart.

Food Contact Surfaces

* Must be easy to clean, smooth, non-absorbent
* Must be washed, rinsed, and sanitized
▪ after each use ▪ whenever your work is interrupted
▪ every time you switch foods ▪ every four hours of use
* All slicers, milkshake machines, and grills must be cleaned & sanitized according to
manufacturer’s instructions.
* Sanitizer strength for food contact surfaces must be recorded daily on a Sanitizer
Chart.

Notes...
 Other Facility Concerns 15
➥Utilities - including water supply, electricity, natural gas, plumbing, and sewage
disposal must be code-compliant.

➥Lighting and ventilation must be in compliance with mechanical and building codes.

➥Fire prevention systems must be in compliance with fire codes.

➥Garbage, recycling, solid waste, and hazardous waste storage and disposal must be safe,
sanitary, and legal.
➥Cleaning, sanitizing, and maintenance of facilities and equipment must be regularly
scheduled.
➥An Integrated Pest Management system must be in place, with emphasis on prevention.
Procedures for controlling pests, should prevention techniques fail, must be documented.

Other Items
During the inspection, items that are important, but not critical to food safety may be
noted. Correction of all violations should be a priority for restaurant management.
Correction will lead to a better managed establishment. And these small improvements
will contribute to an overall feeling of orderliness, health and safety.

Emergency Preparedness
Important to each and every establishment is an Emergency Preparedness Plan. All
restaurants need to have procedures and plans in place to cover the following types of
emergency situations:
🔌Short-term and long-term power failures 🔥Floods and fires

𐰩 Customer safety in severe weather 💦 Contamination of water supply

It is important that all staff know exactly what steps to take when an emergency occurs.
Review/Revise Emergency Contact Information for Emergency Services Providers
annually. 

Notes...
 16 Communication with Environmental Health
Health
507-934-7089 📞 507-934-7089 📞 507-934-7089

Reporting Responsibilities & Requirements

You must call BNEH if an employee reports:
x Vomiting
x Diarrhea
or has been diagnosed with:
x Salmonella
x Shigella
x Shiga toxin-producing E. Coli
x Hepatitis A
x Norovirus
x other enteric bacterial, viral, or parasitic
pathogens

This call can be made to the office anytime, you must leave a message.
Contact 507-934-7096 within 24 hours to report employee illness and report immediately
if a customer reports that
they have become ill after eating at your restaurant.

507-934-7089 📞 507-934-7089 📞 507-934-7089

*You must also call BNEH if you are selling or remodeling your restaurant, or if you are
building a new establishment. This requirement also covers leasing or
ownership/partnership changes. It is important for liability determinations that your license
paperwork accurately reflects ownership information. If you fail to notify BNEH about
remodeling or equipment additions, and these unapproved facility changes later need to
be modified to conform to the Food Code requirements, you will not only be in violation of
state law, you will incur extra expenses.

*You must also call BNEH if your CFPM leaves, to arrange to have another
person certified.

*We would also encourage you to call us whenever you have a question, have
a problem, or have a good idea!

Notes...
 x
17
Requirements
Paperwork
These must be posted:
➥Temperature Charts
➥P e r s o n - I n - C h a r g e P o s t e r
➥Food Service License (and it must be accurate for your current
operation)
➥Minnesota Clean Indoor Air Act signs/No Smoking signs
➥Employee Illness and Customer Complaint Reporting Poster
➥Certified Food Protection Manager License
➥H a n d w a s h i n g P o s t e r s

These must be available:

➥Sanitizer Logs
➥Temperature Logs
➥Safe Cooling Charts

➥Employee Illness Logs/Reporting Policy/Reporting Agreements
➥Customer Complaint Logs
➥Cleanup procedures for Vomit and Fecal Events

Staffing
Management Staff
☛ Each restaurant must have at least one Certified Food Protection Manager
☛ Each restaurant must have at least one Person-In-Charge on the premises
at all times. This will often be the Certified Food Protection Manager, but may
also be other knowledgeable staff designated and trained as a Person-In-
Charge.

Notes...
 18
Requirements continued
Certified Food Protection Managers
➥Must take approved course
➥Must pass approved national exam
➥Must apply for and receive State of Minnesota Certified Food Protection Manager
Certificate
➥Is responsible for:
~ Identification of all food safety hazards within the establishment
~ Development and implementation of polices & procedures to prevent food
borne illness.
~ Training other employees on food safety issues and training Persons-In-Charge
about the knowledge required under the Food Code.
~ Direction of food preparation activities and corrective actions as needed to
protect the health of the consumer.
~ Conducting in-house self-inspections on a periodic basis to see that food
safety policies and procedures are followed.

Person-In-Charge
➥The Person-In-Charge must demonstrate knowledge of the:
➥Relationship between foodborne illness prevention & personal hygiene, control
of cross-contamination, and establishment maintenance
➥Prevention of foodborne disease transmission by an ill food employee
➥Symptoms, incubation periods, and modes of transmission for the common
foodborne diseases
➥Hazards in the consumption of raw or undercooked meat, poultry, eggs, & fish
➥Protecting the water source from backflow and cross connections
➥Required temperatures & times for safe cold holding, hot holding, cooling,
cooking, reheating, and transport of TCS foods
➥Relationship between food safety and necessary equipment
➥Procedures for cleaning and sanitizing utensils and other food contact
surfaces
➥Identifying toxic materials and ensuring safe storage, handling, and disposal
➥In addition, the Person-In-Charge:
➥Must ensure that employee handwashing is monitored
➥Must ensure that employees properly cook potentially hazardous foods
➥Must ensure that cooking temperatures are routinely monitored
➥Must ensure that proper methods are used to rapidly cool TCS
foods and monitor cooling times and temperatures
➥Must ensure that proper methods are used to sanitize utensils and equipment
➥Must ensure that ill employees are restricted or excluded as appropriate
➥Must ensure that proper reporting to BNEH takes place as appropriate

Notes...
 19
References

1) Brown, Nicollet, Cottonwood and Watonwan County Regulation

of Food and Beverage Establishment Ordinances, 2019

2) Minnesota Food Code - Minnesota Rules Chapter 4626

3) Food Safety Manual - Brown-Nicollet Environmental Health

4) Minnesota Department of Health Division of Environmental

Health website: http://www.health.state.mn.us/divs/eh/

Acknowledgments
We would like to thank the Nicollet, Brown, Watonwan, and Cottonwood
County Public Health and Sheriff Departments for their continued support and
assistance.

Brown-Nicollet Environmental Health

Staff
Environmental Health Staff:
Jesse Harmon – Director
Ryan Miller – Environmental Health Specialist
Leah Cameron – Administrative Support Specialist

Notes...
Brown-Nicollet Environmental Health
622 South Front Street ● St. Peter, MN 56082
507-934-7089
www.co.nicollet.mn.us
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Reinforce good handwashing and no bare- Acne itself is not transmitted through food, however some of
hand contact with ready-to-eat foods. the bacteria commonly found in areas of acne can cause
Acne foodborne illnesses. Remind foodworkers that they must not
touch acne (or other parts of their bare skin) while working with
food. If they do so, they must wash their hands immediately.

No exclusions or restrictions are required. Bed bugs are not transmitted from person-to-person. They are
not like lice and will not usually travel directly on a person’s
Bed bugs body. Bed bugs are spread between residences and when they
hide and are transported in luggage, furniture, or other items.

Food employees experiencing persistent sneezing, When employee returns to work: reinforce good handwashing;
coughing, or a runny nose that causes discharge emphasize no bare-hand contact with ready-to-eat foods; and
Bronchitis from the eyes, nose, or mouth may not work with discuss employee illness reporting procedure, and the ways ill
exposed food; clean equipment, utensils, or linens; foodworkers can spread illness through food.
or unwrapped single-service or single-use articles.
Exclude food employee from food establishment. Campylobacteriosis is an infectious disease caused by bacteria
Notify local health department or call 1-877-FOOD- of the genus Campylobacter, and may be transmitted through
Campylobacter spp. ILL. Record illness on employee illness log. Health food. Most people who become ill with campylobacteriosis get
department clearance is required before the diarrhea, cramping, abdominal pain, and fever within two to five
(Campylobacteriosis or foodworker may return to work. days after exposure to the organism. The diarrhea may be
Campylobacter bloody and can be accompanied by nausea and vomiting. The
illness typically lasts one week. Foodworkers diagnosed with
enteritis) campylobacteriosis must report their illness to the person-in-
charge.
** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Open wounds on hands or arms must be covered Chickenpox (also known as varicella-zoster) is a viral illness
with an impermeable bandage and a single-use glove that can be prevented by vaccination. It is highly contagious,
Chickenpox
(for hand wounds) before returning to work. Reinforce but not transmitted through food.
(varicella-zoster) good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.

Exclude food employee from food establishment if Ciguatera fish poisoning (or ciguatera) is caused by eating fish
they have symptoms of vomiting/diarrhea. Must be that contain toxins. While ciguatera is a foodborne illness, it
symptom free for at least 24 hours before returning cannot be transmitted from person-to-person. People who have
to work. Record on employee illness log. Notify local ciguatera may experience nausea, vomiting, and neurologic
health department or call 1-877-FOOD-ILL. symptoms such as tingling fingers or toes. Symptoms usually go
Ciguatera Fish away in days or weeks but can last longer.
Poisoning Barracuda, black grouper, blackfin snapper, cubera snapper,
dog snapper, greater amberjack, hogfish, horse-eye jack,
king mackerel, and yellowfin grouper have been known to
carry ciguatoxins.

Foodworkers must report their illness to the person-in-charge.

Food employees experiencing persistent sneezing, When employee returns to work: reinforce good handwashing;
Cold/ coughing, or a runny nose that causes discharge emphasize no bare-hand contact with ready-to-eat foods; and
Cough/Sneezing/ from the eyes, nose, or mouth may not work with discuss employee illness reporting procedure, and the ways ill
exposed food; clean equipment, utensils, or linens; foodworkers can spread illness through food.
Runny nose
or unwrapped single-service or single-use articles.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Open wounds on hands or arms must be covered Reinforce good handwashing. Emphasize no bare-hand
Cut, wound, or with an impermeable bandage and a single-use glove contact with ready-to-eat foods. Discuss employee
(for hand wounds) before returning to work. Reinforce illness reporting procedure. Discuss the ways ill
burn good handwashing and emphasize no bare-hand foodworkers can spread illness through food.
contact with ready-to-eat foods.

Exclude food employee from food establishment. Cryptosporidium can be transmitted from an
**Cryptosporidium Notify local health department or call 1-877-FOOD- infected foodworker to customers through food.
ILL. Record illness on employee illness log. Health
parvum Foodworkers diagnosed with cryptosporidiosis must report their
department clearance is required before the
(Cryptosporidiosis) illness to the person-in-charge.
foodworker may return to work.
Exclude food employee from food establishment. Foodworkers with diarrhea are a SEVERE FOOD SAFETY
Employee must be symptom free for at least 24 RISK. Diarrheal illnesses are often highly contagious and
hours before returning to work. Record on employee can be easily transmitted from an infected foodworker to
Diarrhea illness log. customers.

Foodworkers with diarrhea must report their symptoms to the

person-in-charge.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Exclude food employee from food establishment. E. coli is a SEVERE FOOD SAFETY RISK. E. coli is a highly
Notify local health department or call 1-877-FOOD-ILL. contagious foodborne illness and can be easily transmitted
**Shiga toxin-producing Record illness on employee illness log. Health from an infected foodworker to customers.
E.coli department clearance is required before the
foodworker may return to work.

Foodworkers diagnosed with E. Coli must report their illness to

the Person-In-Charge.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
If symptoms include diarrhea or vomiting, exclude Fevers may be caused by a number of conditions. A
food employee from food establishment, Must be foodworker experiencing a fever may not be a food safety
symptom free for at least 24 hours before returning risk, but should be closely monitored for vomiting, diarrhea, or
to work. Record on employee illness log. influenza.

If fever is not accompanied by diarrhea or vomiting, If foodworker experiences these symptoms, they must report
employee may be allowed to work. Reinforce good their symptoms to the person-in-charge and be immediately
Fever excluded from work.
handwashing; emphasize no bare-hand contact with
ready-to-eat foods; and discuss employee illness
reporting procedure and the way ill foodworkers can
spread illness through food.

If fever is accompanied by sore throat or cough,

see “Influenza”.
Exclude food employee from food establishment. Giardia can be transmitted from an infected foodworker
Notify local health department or call 1-877-FOOD- to customers through food.
**Giardia spp. ILL. Record illness on employee illness log. Health
(Giardiasis) department clearance is required before the Foodworkers diagnosed with giardiasis must report their illness
to the person-in-charge.

If symptoms include diarrhea or vomiting, exclude

food employee from food establishment. Must be
Hangover symptom free for at least 24 hours before returning
to work. Record on employee illness log.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
If symptoms include vomiting or diarrhea, exclude Headaches may be caused by a number of conditions. A
food employee from food establishment. Must be foodworker experiencing a headache may not be a food safety
symptom free for at least 24 hours before returning risk, but should be closely monitored for vomiting or diarrhea.
to work. Record on employee illness log.
If foodworker experiences these symptoms, they must report
If headache is not accompanied by vomiting or their symptoms to the person-in-charge and be immediately
Headache excluded from work.
diarrhea, employee may be allowed to work.
Reinforce good handwashing; emphasize no bare-
hand contact with ready-to-eat foods; and discuss
employee illness reporting procedure, and the ways
ill foodworkers can spread illness through food.

No exclusions or restrictions are required. HIV/AIDS attacks the immune system. The HIV/AIDS virus
is transmitted through contact with the blood and body fluids
of someone who is infected.
HIV/AIDS
HIV/AIDS is not considered to be a foodborne pathogen.
Practice routine blood-borne pathogen precautions.

H1N1 Novel See “Influenza.”

Influenza (Swine flu)

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Exclude food employee from food establishment. Hepatitis A is a SEVERE FOOD SAFETY RISK. Hepatitis A is
Notify local health department or call 1-877-FOOD- a highly contagious foodborne illness and can be easily
ILL. Record illness on employee illness log. Health transmitted from an infected foodworker to customers.
department clearance is required before the Yellowing of skin and eyes are common symptoms of
**Hepatitis A foodworker may return to work. hepatitis A.

Foodworkers diagnosed with hepatitis A must report their

illness to the Person-In-Charge.

No exclusions or restrictions are required. Hepatitis B is a serious liver infection. The hepatitis B virus is
transmitted through contact with blood and body fluids of
Hepatitis B someone who is infected. Hepatitis B is not a considered to
be a foodborne pathogen. Practice routine blood-borne
pathogen precautions.

No exclusions or restrictions are required. Hepatitis C is a serious liver infection. The hepatitis C virus is
transmitted through contact with blood and body fluids of
Hepatitis C someone who is infected. Hepatitis C is not considered to be
a foodborne pathogen. Practice routine blood-borne pathogen
precautions.

Open wounds on hands or arms must be covered Impetigo is not a foodborne illness, but a contagious skin
with an impermeable bandage and a single-use glove infection occurring on the nose, arms, and legs, or around
Impetigo (for hand wounds) before returning to work. Reinforce the mouth. Impetigo is spread person-to-person by contact
good handwashing and no bare-hand contact with with fluid from around the sores.
ready-to-eat foods.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Open wounds on hands or arms must be covered
with an impermeable bandage and a single-use glove
Infected wound or
(for hand wounds) before returning to work. Reinforce
pustular boil good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.

Exclude food employee from food establishment if Influenza (seasonal and H1N1 novel) is a respiratory illness
symptoms included diarrhea or vomiting, foodworker caused by a virus. Symptoms include fever (above 100o F),
Influenza must be symptom free for at least 24 hours before cough, sore throat, stuffy nose, and in some cases diarrhea
(Seasonal or returning to work. Record on employee illness log. and vomiting.
H1N1 novel flu) Up-to-date information on all types of influenza is available
at www.state.health.mn.us or www.cdc.gov.

Exclude food employee from food establishment. Jaundice, yellowing of the eyes or skin, is a common
Notify local health department or call 1-877-FOOD- symptom in people infected with hepatitis A.
Jaundice ILL. Record illness on employee illness log. Health
department clearance is required before the Jaundiced foodworkers may be a SEVERE FOOD SAFETY
foodworker may return to work. RISK and must report their symptoms to the person-in-charge.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
No exclusions or restrictions are required. Although head lice do not present a food safety risk, it is still
important to take appropriate precautions to ensure that they
do not spread among workers. Common headsets used for
drive-through windows should not be used by foodworkers
Lice with head lice. Combs and other hair accessories should not
be shared. Clothing should not be shared. Clothing should be
stored in an organized fashion on separate hooks or in
lockers to prevent spread of lice.

Exclude food employee from food establishment. Must Listeriosis is a serious infection caused by eating food
be symptom free for at least 24 hours before returning contaminated with the bacterium Listeria monocytogenes.
to work. Record on employee illness log. Notify local While listeriosis is a foodborne illness, it cannot be
health department or call 1-877-FOOD-ILL. transmitted from person-to-person. The disease mostly
Listeria affects older persons, pregnant women, newborns, and adults
with weakened immune systems.
monocytogenes
(Listeriosis) A person with listeriosis may have fever, muscle aches,
and sometimes nausea or diarrhea.

Foodworkers diagnosed with listeriosis must report their illness

to the person-in-charge.

Exclude food employee from food establishment. Some forms of bacterial meningitis are contagious.
Meningitis, If symptoms include diarrhea or vomiting, foodworker
Symptoms include high fever, headache, stiff neck, nausea,
vomiting, confusion, and sleepiness.
Bacterial must be symptom free for at least 24 hours before
returning to work. Record on employee illness log. Up-to-date information is available at www.cdc.gov.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
No exclusions or restrictions are required. Reinforce good handwashing. Emphasize no bare-hand
Mononucleosis contact with ready-to-eat foods. Discuss employee illness
(mono) reporting procedure and the ways ill foodworkers can
spread illness through food.

Exclude food employee from food establishment if Nausea may be caused by a number of conditions. A
symptoms include diarrhea or vomiting. Must be foodworker experiencing nausea may not be a food safety
symptom free for at least 24 hours before returning risk, but should be closely monitored for vomiting or diarrhea.
to work. Record on employee illness log.
If foodworker experiences these symptoms, they must report
their symptoms to the person-in-charge and be immediately
**Nausea If nausea is not accompanied by diarrhea or excluded from work.
vomiting, allow employee to work. Reinforce good
handwashing; emphasize no bare-hand contact with
ready-to-eat foods; and discuss employee illness
reporting procedure, and the ways ill foodworkers
can spread illness through food.

Exclude food employee from food establishment. Norovirus is a SEVERE FOOD SAFETY RISK. Norovirus is a
Notify local health department or call 1-877-FOOD- highly contagious illness and can be easily transmitted from
ILL. Record illness on employee illness log. Health an infected foodworker to customers.
**Norovirus department clearance is required before the
foodworker may return to work. Foodworkers diagnosed with norovirus must report their illness
to the person-in-charge.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
No exclusions or restrictions are required. Pink eye is an infection or inflammation of the eye. It is highly
contagious but is not transmitted through food. Foodworkers
Pink eye with pink eye must take extra precautions not to touch their
eyes or face, and to wash their hands thoroughly to prevent
spread of pink eye to others.
Food employees experiencing persistent sneezing, When employee returns to work: reinforce good handwashing;
coughing, or a runny nose that causes discharge emphasize no bare-hand contact with ready-to-eat foods;
Pneumonia from the eyes, nose, or mouth may not work with discuss employee illness reporting procedure, and the ways ill
exposed food; clean equipment, utensils, or linens; foodworkers can spread illness through food.
or unwrapped single-service or single-use articles.

If vomiting, exclude from food establishment. Vomiting and nausea are common symptoms of morning
sickness, a side effect of pregnancy. While morning
sickness itself is not a communicable illness, care must be
taken to prevent the contamination of food. Pregnant
foodworkers experiencing ongoing nausea may work in a
Pregnancy food establishment, but must be closely monitored for
symptoms that would indicate a communicable illness.

If foodworker experiences these symptoms, they must report

their illness to the person-in-charge and be immediately
excluded from work.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Open wounds on hands or arms must be covered Ringworm is a fungal infection of the body, scalp or feet.
with an impermeable bandage and a single-use glove Ringworm is transmitted by touching lesions of an
Ringworm (for hand wounds) before returning to work. Reinforce infected person or animal.
good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.

Exclude food employee from food establishment. Salmonella is a SEVERE FOOD SAFETY RISK. Salmonellosis
Notify local health department or call 1-877-FOOD- is a highly contagious foodborne illness and can be easily
**Salmonella ILL. Record illness on employee illness log. Health transmitted from an infected foodworker to customers.
(Salmonellosis) department clearance is required before the
foodworker may return to work. Foodworkers diagnosed with salmonellosis must report their
illness to the person-in-charge.

Open wounds on hands or arms must be covered Scabies is an infestation caused by tiny mites that burrow and
with an impermeable bandage and a single-use glove lay eggs under the skin. Scabies is transmitted by prolonged,
Scabies (for hand wounds) before returning to work. Reinforce direct skin contact with an infected person.
good handwashing and emphasize no bare-hand
contact with ready-to-eat foods.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Exclude food employee from food establishment if Scombroid fish poisoning, or histamine fish poisoning, is a
they have symptoms of vomiting/diarrhea. Must be syndrome resembling an allergic reaction that occurs after
symptom free for at least 24 hours before returning eating fish contaminated with high levels of histamine.
to work. Record on employee illness log. Notify local While scombroid poisoning is a foodborne illness, it cannot
Scombroid Fish health department or call 1-877-FOOD-ILL.
be transmitted from person-to-person.

Poisoning Symptoms begin within 2 minutes to several hours after eating

(Histamine Poisoning) the fish. The most common symptoms are tingling and burning
sensations around the mouth, facial flushing, sweating,
nausea, vomiting, headache, palpitations, dizziness, and rash.

Foodworkers must report their illness to the person-in-charge.

Exclude food employee from food establishment. The foodworker must be excluded from working in the retail
Notify local health department or call 1-877-FOOD- food establishment and the law requires the manager to
**Shigella spp. ILL. Record illness on employee illness log. Health notify the local health department immediately.
(Shigellosis) department clearance is required before the
foodworker may return to work. Foodworkers diagnosed with shigellosis must report their
illness to the person-in-charge.

Open wounds on hands or arms must be covered Shingles is caused by the chickenpox virus and can cause
with an impermeable bandage and a single-use glove extreme pain, itching and numbness. Shingles may cause
Shingles (for hand wounds) before returning to work. Reinforce clusters of blisters that can spread chickenpox to persons
(varicella-zoster) good handwashing and emphasize no bare-hand who have not yet had the virus.
contact with ready-to-eat foods.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Reinforce good handwashing. Emphasize no bare- If sore throat is accompanied by a cough or fever,
hand contact with ready-to-eat foods. Discuss see “Influenza”.
employee illness reporting procedure and the ways
Sore Throat ill foodworkers can spread illness through food. Also see “Influenza”.

Open wounds on hands or arms must be covered Staphylococcus bacteria can cause serious skin infections
with an impermeable bandage and a single-use which can be transmitted through food and cause serious
Staphylococcus skin glove. Open or draining wounds on other parts of the foodborne illness. Contamination of food can occur if a person
infection (Staph or body must be covered by a dry, durable, tight-fitting with draining lesions on the hands or forearms handles foods
bandage. Situations in which an open or draining or food contact surfaces.
MRSA)
wound cannot be properly and effectively covered
should be addressed with the health department.

Reinforce good handwashing, emphasize no bare- Staphylococcus aureus bacteria can cause serious skin
Streptococcal hand contact with ready-to-eat foods; and discuss infections. The term MRSA refers to a Staphylococcus skin
Infection employee illness reporting procedure, and the ways infection that is resistant to certain antibiotics. Staph skin
ill foodworkers can spread illness through food. infections are not foodborne; however, contamination of
(Strep throat/scarlet
food products with the bacteria can occur and result in food
fever) poisoning.

Food employees experiencing persistent sneezing, Tuberculosis is not transmitted to patrons through food;
coughing, or a runny nose that causes discharge however, like any other work place, infectious food handlers
Tuberculosis
from the eyes, nose, or mouth may not work with may transmit their disease to fellow workers. A worker with
(TB) exposed food; clean equipment, utensils, or linens; active tuberculosis can spread the disease by sneezing or
or unwrapped single-service or single-use articles. coughing, which are tuberculosis’ most common symptoms.

** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Re vision Date: 3/17/2010
 Food Employee Illness Guidelines
Illness Symptoms Action Guidance

Conditions Action / Return-to-Work Criteria for Other Information

Foodworkers
Exclude food employee from food establishment. Foodworkers with vomiting are a SEVERE FOOD SAFETY
Must be symptom free for at least 24 hours before RISK. Illnesses that cause vomiting are often highly
returning to work. Record on employee illness log. contagious and can be easily transmitted from an infected
Vomiting foodworker to customers.

Foodworkers with vomiting must report their symptoms to the

person-in-charge.

No exclusions or restrictions are required. Warts are passed person to person, not through food. Small
numbers of warts are not concerning for foodworkers;
however large numbers of warts on the hands or wrists make
these areas difficult to clean adequately with routine
Warts handwashing. If a food employee has a severe infestation of
warts on the hands or wrists, these areas should be covered
with an impermeable cover, and a single-use disposable
glove should be worn while working with food.

Foodborne Illness Hotline: 1-877-FOOD-ILL (1-877-366- 3455)

3455)
** These illnesses should be recorded on an illness log and/or reported to your local health department.
These guidelines are to be used as a resource only. If you have specific questions, contact MDH or your health department. Revision Date: 3/17/201