Additional Food Resources

Code Reference: FDA Food Code 2-501.11

A food establishment shall have written procedures for employees to follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the food establishment. The procedures shall address the specific actions employees must take to minimize the spread of contamination and the exposure of employees, consumers, food, and surfaces to vomitus or fecal matter. 

Having a written plan for clean up can help reduce the likelihood that food may become contaminated and that others may become ill because of the incident.

According to the CDC, Norovirus is the leading cause of foodborne disease outbreaks in the United States. Consumers are at risk of contracting Norovirus illness from direct exposure to vomit or from exposure to airborne Norovirus from vomit. Additionally, exposed food employees are also at risk of contracting Norovirus illness and can subsequently transfer the virus to ready-to-eat food items served to consumers. 

Effective clean up of vomit and fecal matter in a food establishment should be handled differently from routine cleaning procedures. It should involve a stricter cleaning and disinfecting process. Some chemicals that are usually used for sanitizing food-contact surfaces and disinfecting countertops and floors, such as certain quaternary ammonium compounds, may not be effective against Norovirus.

A written clean-up and response procedure should address situations where a food employee or other individual becomes physically ill in areas where food may be prepared, stored or served. Once an episode has occurred, timely, effective clean-up is imperative.

When developing a written plan that addresses cleaning and disinfection of a vomitus and/or diarrheal contamination event, a food establishment should have specific directions for cleanup that are specific to their facility and should answer:

1. When will a clean-up plan will be implemented?
2. What cleaning supplies and personal protective equipment are needed? (Disposable items are best.)
3. Who should clean up an incident? (This should not be someone directly involved in food prep or service.)
4. How will surfaced that may have become contaminated be cleaned and disinfected? (Bleach solutions are recommended, and items that cannot be bleached should be steam cleaned.)
5. What will be done with open or exposed food and food equipment?
6. How will employees be trained on the proper use of personal protective equipment and the procedures to follow in containing, cleaning, and disinfecting a contaminated area?
7. How will the affected area be blocked off and contained to minimize the exposure of employees, customers and others in the facility to the surfaces or food that may have become contaminated? (It is recommended that a 25-foot radius of the incident be cleaned and sanitized).
8. What procedures are in place for employee hygiene and disposal of personal protective equipment and discharges, including airborne particles? (Include procedures in the event that an employee comes in direct contact with infected discharges.)
9. How will an effective employee health policy and effective clean-up procedures help minimize the risk of disease transmission in your facility?

Code References: lowa Administrative Code 481.31.1(2), FDA Food Code 2-102.12(A)

What is the Certified Food Protection Manager (CFPM) requirement?

The person in charge shall be a certified food protection manager who has shown proficiency of required information through passing a test that is part of an accredited program.

Code 2-102.12(A) does not apply to certain types of food establishments deemed by the
regulatory authority to pose minimal risk of causing, or contributing to, foodborne illness based on the nature of the operation and extent of food preparation. Exceptions to this Code are found in Iowa Administrative Code 481-31.1(2)

Exceptions

For the purposes of section 2-102.12(A) of the 2017 Food Code with Supplement, the food establishment may employ a single certified food protection manager who is not present at the food establishment during all hours of operation, as long as the following requirements are met:

• 1. The individual who is a certified food protection manager has supervisory and management responsibility and the authority to direct and control food preparation and service at the food establishment;
• 2. The person in charge demonstrates knowledge as prescribed in section 2-102.11 of the 2017 Food Code with Supplement; and
• 3. The person in charge demonstrates active managerial control of food safety by complying with section 2-103.11 of the 2017 Food Code with Supplement.
  • a. A food establishment that, upon inspection, is found to be in violation of section 2-102.11 or 2-103.11 of the 2017 Food Code with Supplement will have six months to ensure that any individual designated as the person in charge is a certified food protection manager.

For the purposes of section 2-102.12(B), the following food establishments are not required to employ a certified food protection manager:

• 1. Food establishments that sell only prepackaged food.
• 2. Temporary or farmers market food establishments.
• 3. Food establishments at which food is not prepared, where customers may purchase beverages and where the service of food is limited to the service of ice, beverages, prepackaged snack foods, popcorn or peanuts and to the reheating of commercially prepared foods for immediate service that do not require assembly, such as frozen pizza or prepackaged sandwiches.
• 4. Food establishments at which food is not prepared, where customers may purchase only commercially-prepared non-time/temperature control for safety foods that are dispensed either unpackaged or packaged and that are intended for off-premises consumption.
  • a. Time frames for compliance with section 2-102.12 of the 2017 Food Code with Supplement, as amended by paragraphs 31.1(2)“a” and “b” are as follows:
    • i. Newly licensed facilities must comply with section 2-102.12 of the 2017 Food Code with Supplement, as amended by paragraphs 31.1(2)“a” and “b,” within six months of licensure.
    • ii. If an individual meeting the requirement of paragraph 31.1(2)“a” leaves employment, the establishment shall meet the requirement of section 2-102.12 of the 2017 Food Code with Supplement, as amended by paragraphs 31.1(2)“a” and “b,” within six months of the individual’s departure.

Why is certification important?

Being a certified food protection manager demonstrates that one has the knowledge, skills and abilities necessary to oversee the safe storage, preparation and sale of food to the public.

Food establishments with certified food managers typically

• Have better food safety practices and behaviors;
• Have fewer instances of foodborne illness; and 
• Are less likely to have serious violations on their inspections.

How to obtain certification

Certification may be obtained by by completeing an ANSI-accredited program and successfully passing an examination. Visit the ANSI-Accreditation website to access the following training:

• 360training.com, Inc.
  • Learn2Serve® Food Protection Manager Certification Program
  • Online food manager course, online exam, or in-person exam proctored by a third-party test center
• Above Training/StateFoodSafety.com
  • State Food Safety Food Manager Certification
  • Online food manager course, online exam, or in-person exam proctored by a third-party test center
  • Courses available in English and Spanish
  • Website and resources available in multiple languages
• National Registry of Food Safety Professionals
  • Food Protection Manager Certification Program
  • Online food manager course, in-person exam at a Pearson Vue testing center
  • International Certified Food Safety Manager courses available
• National Restaurant Association
  • ServSafe® Food Protection Manager Certification Program
  • Online Food Manager course, online exam, or in-person exam proctored by a third-party test center
  • Online classes in multiple languages
  • In person classes and exams offered through the Iowa Restaurant Association and through many county extension offices and ISUExtension.
• Prometric Inc.
  • Food Protection Manager Certification Program
  • Online course, in-person testing at a proctored location
• The Always Safe Food Company
  • Food Protection Manager Certification Program
  • Online course (English), online exam (English or Spanish)

Before beginning, gather the following necessary supplies:

• Equipment to protect yourself (personal protective equipment)
  • Disposable gloves
  • Disposable hair cover
  • Disposable shoe covers
  • Disposable gown
  • Disposable face mask (for use if you need to clean up any bodily fluids or when mixing cleaning/disinfectant products)
• Clean-up Kit
  • Disposable mop (avoid wooden mops)
  • Mop bucket
  • Disposable towels and cloths
  • Trash bags/plastic bags
  • A disinfectant proven to kill Norovirus.

Recommended Disinfectant: Mix a chlorine bleach solution using regular strength unscented bleach and water. Warning: Chlorine bleach may damage some fabrics and surfaces so you should spot test areas before applying the solution.

• Chlorine Bleach solutions should be freshly mixed just before beginning cleaning procedures. Opened containers of bleach can lose effectiveness 30 days after opening.¹
• Water should be approximately 75°F. Water temperatures higher than this can decrease the effectiveness of bleach solutions.
• For hard surfaces (e.g. non-porous surfaces, ceramic, sealed countertops, utensils):
  • Bleach solution should contain 3500 ppm chlorine.
  • Add 16 tablespoons (approximately one cup) bleach regular strength 5-8% bleach (sodium hypochlorite) to one gallon water.
• For porous surfaces (e.g. unsealed concrete or natural stone):
  • Bleach solution should contain 5000 ppm chlorine.
  • Add 25 tablespoons (approximately one and a half cups) bleach regular strength 5–8% bleach (sodium hypochlorite) to one gallon water.
• Consult the product label. Note the concentration of bleach you are using (% Sodium Hypoclorite). This determinnes the amount of bleach you must add to the mixture.
  • If the bleach you are using is more or less concentrated from the concentrations listed above, consult the manufacturer’s instructions for proper mixing directions.
  • You can also use another disinfectant registered as effective against Norovirus by the Environmental Protection Agency (EPA).
• Not all disinfectants shown on the EPA list are approved for use in food facilities.
  • Make sure that product labels contain language which states that they are approved to be used in FDA food facilities AND that the label provides adequate directions for use in these settings.
  • Quaternary ammonia products are less effective.²
  • If you have questions, consult the manufacturer for more information on the approval for use of their product on food contact surfaces and/or in food service facilities.
• Any product that will be used to sanitize food contact surfaces must be FDA approved under 21 CFR 178.1010. Click here for a list of approved chemicals (List G).
• A video to review of cleanup procedures can be viewed on YouTube.

Procedure

• Wash your hands.
• Put on personal protective equipment (change if any item becomes soiled).
• Clean.
  • Begin with clean equipment and clean supplies.
    • Make sure that cleaning supplies are clean.
    • Begin with a fresh cleaning solution in a spray bottle so that the cleaner solution doesn’t become contaminated.
    • If you use a mop and bucket to clean the floor, the mop head should be thrown away and the mop equipment (including handles, mop bucket and wheels, etc.) should be disinfected when finished. Mop equipment can hold bacteria and viruses and can contaminate already-cleaned surfaces.
    • Do not use wooden mops. Some are not sealed and cannot be disinfected properly.
  • Cleaners (also known as detergents) remove dirt and germs off surfaces so they can be rinsed away with water. Cleaning is important as you must make sure dust and dirt are removed from surfaces before disinfecting or the disinfectant will not be effective.
  • Visible vomit or diarrhea should be absorbed with a paper towel or other commercial absorbent material such as kitty litter, and discarded prior to disinfection.
• Disinfect.
  • Disinfectants are chemical products that destroy or inactivate germs and prevent them from growing. Disinfectants have no effect on dirt, soil, or dust so surfaces MUST be cleaned (as described above) before they are disinfected.
    • Apply disinfectant to all surfaces in the room, paying close attention to frequently-touched areas.
    • Change cloth when soiled.
    • Make sure to allow the disinfectant to remain in contact with the surface it is applied to for the appropriate amount of time (this is referred to as “contact time”). Use the manufacturer’s guidelines to determine what the appropriate contact time is.
    • Bleach solutions typically need at least 5 minutes of contact time.
    • If the disinfectant dries before the appropriate contact time has passed, you should reapply disinfectant to that area.
• Rinse food contact surfaces.
  • Before use, rinse all food contact surfaces with hot potable water (water that is safe for drinking) and soap after the appropriate contact time has passed.
  • If surfaces are not rinsed, levels of the disinfectant that are left behind may make people sick. 
• Air dry.
  • Allow all surfaces to air dry. Do not use towels to dry any surfaces as they may recontaminate equipment.
• When finished, remove all personal protective equipment and place in a trash bag. Immediately dispose of trash by the most direct route that does not pass through food preparation areas.
• Wash your hands thoroughly with soap and water immediately after disposing of trash.
  • Hand sanitizers may not be effective against Norovirus and should not be used as a substitute for hand washing.
• Contact your inspector for final approval of Noroclean procedures before reopening to the public. 
  • Contact information for inspectors by county can be found online.

Important Notes

• Work from clean to dirty surfaces.
  • Always begin cleaning in the least dirty areas and clean toward the known, dirtier areas.
  • If you are cleaning up any bodily fluids (such as vomit), you should clean from the edges of the spill toward the center.
  • Bathrooms should be cleaned last.
• Clean from top to bottom.
  • Carpets and floors should be cleaned last.
  • Carpets should be cleaned with a chemical disinfectant that is effective against Norovirus and then carpets should be steam-cleaned at 158°F for five minutes or 212°F for one minute for complete inactivation.
• Use the proper cleaning agent.
  • You can find a list of approved products on the EPA website.
• Separate clean from dirty.
  • Do not place dirty items with, above, or close to clean items.
• Launder dirty linens/clothing.
  • Items containing bodily fluids (such as vomit) that need to be laundered should be double-bagged.
  • Handle laundry carefully and avoid shaking it as this can spread the virus.
  • Launder with hot water in a laundry detergent effective against Norovirus (see the above link) for the longest available cycle length. Laundry should then be machine dried

Resources

• “Clean Up and Disinfection for Norovirus” (Downloadable posters in English and Spanish.) Disinfect for Health – Water Quality and Health Council
• “Norovirus for Food Handlers” – Centers for Disease Control and Prevention (CDC) – Several resources are available for download at the bottom of the page. 

Approved Cleaners and Disinfectants for Norovirus

Cleaners/disinfectants will list, on the original container, what bacteria and viruses they are capable of killing with an appropriate contact time. Approved cleaners/disinfectants will list Norovirus or Norwalk-like virus with a corresponding contact time.

A list of EPA approved cleaners/disinfectants for Norovirus/Norwalk-like virus can be found online. (List G)

Citations

¹OSHA. 2008. OSHA Fact Sheet: Noroviruses. U.S Department of Labor.

²CDC. 2011. Morbidity and Mortality Weekly Report, Vol. 60, No. 3. Updated Norovirus Outbreak Management and Disease Prevention Guidelines.

The 2017 FDA Food Code makes changes to the person-in-charge requirements of a food establishment.

Code Reference: FDA Food Code 2-101.11, 2-102.11, 2-103.11

If your food establishment is found in violation of Code 2-102.11, Demonstration of Knowledge, and/or Code 2-103.11, Duties of the Person in Charge, you must, in addition to implementing procedures to ensure that your facility meets the requirements of the following pertaining to codes 2-101.11, 2-102.11, and 2-103.11, your establishment must, within six months of the date of violation, be required to ensure that any individual designated as the person in charge (at all times) be a certified food protection manager.

Person in Charge (Code 2-101.11)

A person in charge (PIC) shall be designated during all hours of operation. This person should be able to demonstrate knowledge of the food safety principles outlined in the Food Code.

Demonstration of Knowledge (Code 2-102.11)

Knowledge can be demonstrated in one of the following ways:

• Establishment has no critical violations during the current inspection.
• PIC is a certified food protection manager who has shown proficiency of required information by passing a test that is part of an accredited program.
• PIC responds correctly to the inspector's questions as they relate to the specific food operation. Questions will be based on:
  • Application of the requirements of the FDA Food Code
  • Foodborne disease prevention
  • Application of the HACCP principles (if applicable to the establishment)

Duties of the Person in Charge (Code 2-103.11)

• Duties of the PIC should be assigned to the PIC or appropriate employees.
• Employees should be trained how to execute duties.
• Duties should be executed and monitored by PIC.
• An inspector may ask PIC to demonstrate, describe, explain, identify, or relate all of the following items during an inspection as it related to the food operationand execution of the duties of the PIC:
  • Employee training
  • Food allergy awareness
  • Food establishment operations are not conducted in a private home or living quarters
  • Unauthorized personnel in food preparation areas
  • Handwashing practices
  • Bare hand contact procedures
  • Cross-contamination prevention
  • Approved food source
  • Food receiving procedures
  • Flow of food and related food-safety hazards
  • Employee health reporting procedures
  • Personal hygiene requirements
  • Cooking and reheating times and temperatures
  • Cooling times and temperatures
  • Hot and cold holding times and temperatures
  • Date-marking procedures
  • Time as a public health control procedure
  • Consumer advisory requirements
  • Cleaning and sanitizing food-contact surfaces
  • Written procedures and plans, where specified by the Food Code, are maintained and implemented as required

Iowa Administrative Code 481 Chapter 30.2 was updated to add the following definition:

Stand operated by a minor means a stand or other facility operated by a person or persons under the age of 18 at which food is sold directly to consumers that is not time/temperature-controlled for safety, or an alcoholic beverage, and that operates on a temporary or occasional basis on private property with the permission of the owner of the property. 

The definition of a Food Establishment does not include a stand operated by a minor.

A food operation that meets the definition of a stand operated by a minor does not require a license from the Iowa Department of Inspections and Appeals or any local contracted health department, nor is it subject to Iowa food safety regulations.

The legislation also prohibits any other municipality or regulatory authority in Iowa from requiring a license, permit, or fee for a food stand operated by a minor as long as it meets the definition.

A food stand meets the definition of a stand operated by a minor if:

• The stand is fully operated by a person or persons under the age of 18;
• The stand is operating on private property, with permission from the owner of the property;
• The stand is operating on a temporary basis;
• The stand is not selling food that requires time/temperature-control for safe consumption;
• The stand is not selling alcoholic beverages.