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Sections Covered in this exam s

Domain 1. NUTRITION - 20%
A. Gather Nutrition Data
1. Document nutrition information in medical records

a. chart in medical records
b. enter data using a computer (e.g. Electronic Medical Record)
c. use nutrition information

2. Interview for nutrition related information

a. ask appropriate nutrition questions of clients (e.g.- allergies- preferences)
b. gather client information from relevant sources (e.g.- caregivers- interdisciplinary teams)
c. recognize nonverbal responses and communication cues
d. record information gathered
e. use ethical and confidentiality principles and practices
f. identify food customs and preferences (e.g.- race- culture- religion- age)

3. Obtain routine nutrition screening data

a. use established guidelines to distinguish between routine and at risk clients
b. gather client data from relevant sources (e.g. medical record- referrals- interviews)
c. complete client forms (e.g.- MDS)
d. comply with federal regulations related to evaluating client status and care
e. calculate nutrient intake
f. document relevant nutrition related information (e.g.- laboratory values- BMI)

4. Identify nutrition problems and client rights

a. verify information to ensure accuracy
b. review documentation for nutrition care follow up
c. honor client rights (e.g.- HIPAA)

B. Apply Nutrition Data
1. Modify diet plans

a. develop menus
b. implement nutrition plan into meals/foods to be served
c. respect client needs and food habits
d. use nutrition analysis data to modify menus for:

(1) calories- carbohydrates- proteins- fats- and minerals
(2) fiber content- texture- or feeding needs
(3) medical or other personal condition (including allergies)
(4) racial- cultural- age- and religious differences

2. Implement the written diet orders

a. recognize medical and nutrition terminology
b. provide nutrition that reflects the written diet order
c. include client input on diet prescribed by the provider
d. recognize appropriateness of diet order for diagnosis
e. explain importance of adhering to written diet orders

3. Apply standard nutrition care

a. review clients nutritional needs using evidence based guidelines
b. assess nutrition content of foods
c. identify sources to consult to assist in implementing nutrition care plans (e.g.- IDT)

4. Review effectiveness of the nutrition care plan

5. Manage special nourishments and supplemental feedings according to the written diet order

a. identify clients who need nourishments or supplemental feeding
b. identify appropriate supplemental products
c. monitor the delivery of nourishments and supplements
d. audit the acceptance of nourishments or supplements

C. Provide Nutrition Education
1. Assist clients with food selection based on written diet order

a. review dietary requirements of client
b. determine clients knowledge and needs
c. suggest acceptable food substitutes based on client preferences
d. verify substitutes in terms of availability and facility practices

2. Use nutrition education materials

a. develop a plan for nutrition education
b. select educational materials and resources
c. use resource materials and equipment in teaching

Domain 2. FOODSERVICE - 21%
A. Ensure Effectiveness of Standardized Recipes
1. Identify elements of a standardized recipe (e.g.- yield- ingredients)
2. Compute portions using food charts/references
3. Develop cooking procedures- including HACCP guidelines
4. Calculate cost and nutrition content of standardized recipes
5. Evaluate client acceptance of new recipes

B. Specify Standards and Procedures for Preparing Food
1. Develop food quality control standards- (e.g.- appearance- temperature- acceptance)
2. Implement procedures to monitor food production
3. Develop procedures for monitoring food waste

C. Supervise the Production and Distribution of Food
1. Define procedures for type of food service
2. Monitor adherence to delivery schedules and procedures
3. Keep records for monitoring and accountability
4. Calculate efficiency (time- cost) of foodservice system
5. Define schedules for foodservice production
6. Define production needs for special event food preparation
7. Forecast menus- recipes- diet census- preparation/production sheets- tally sheets- and retail needs

D. Monitor Meal Service
1. Verify

a. diet accuracy
b. portion size (quantity)
c. temperature
d. texture
e. presentation (color- shape)
f. quality

2. Assure compliance of meals served as posted

E. Implement Continuous Quality Improvement Procedures for Foodservice Department (e.g.- QAPI)
1. Define objectives and standards for foodservice
2. Monitor quality indicators
3. Implement necessary procedural changes
4. Interpret data for reports
5. Implement auditing tool to determine the effectiveness of quality indicators (e.g.- food acceptance survey- plate waste study)
6. Analyze data to make recommendations

F. Modify Standardized Menus
1. Use nutritional resources (e.g.- tables- charts- diet manuals)
2. Use standard servings and recipes
3. Adhere to regulatory requirements regarding diet needs
4. Develop menu to consider cultural preferences

Domain 3. Personnel and Communications - 19%
A. Define Personnel Needs and Job Functions
1. Conduct personnel needs analysis
2. Conduct task analysis
3. Write job descriptions
4. Write job specifications
5. Assist with development of advertising for positions
6. Update departmental organizational chart

B. Interview- Select- and Orient Employees
1. Comply with fair employment laws and practices
2. Develop interview procedures for department
3. Describe department procedures and policies to applicants
4. Decide on applicants and record data in file
5. Document selection procedures and policies
6. Orient new employees to facility procedures
7. Provide initial job specific training for new employees
8. Verify completion of training and orientation

C. Provide Ongoing Education
1. Provide follow up after orientation
2. Provide in-service training

a. privacy guidelines (e.g.- HIPAA- FERPA)
b. personal hygiene
c. infection control
d. hospitality and customer service
e. physical and occupational safety
f. professional and ethical expectations
g. nutrition issues
h. crisis management
i. other contemporary issues
j. safety and sanitation (e.g.- allergy)

3. Verify completion of training

D. Develop and Maintain Employee Time Schedules and Assignments
1. Identify overall staffing needs (e.g.- calculate full time equivalents)
2. Identify daily tasks
3. Determine capabilities and preferences of employees available
4. Prepare a time schedule
5. Maintain time schedule chart/records
6. Track absence/tardy records in personnel files
7. Develop a work assignment chart
8. Coordinate work assignments

E. Manage Goals and Priorities for Department
1. Develop short term and long term goals for the department
2. Participate in developing policies and procedures (e.g.- hygiene standards for personnel according to the FDA Food Code)
3. Identify expectations to establish priorities
4. Compare department goals against resources available (e.g.- contingency planning)

F. Manage Department Personnel
1. Maintain personnel records
2. Identify personnel management laws and practices (e.g.- union contracts- FMLA- USERRA)
3. Identify promotion and termination criteria
4. Compile documentation for promotion and termination
5. Conduct performance evaluations
6. Recommend salary and wage adjustments
7. Follow disciplinary procedures to correct a problem (e.g.- coaching- performance improvement plan)
8. Ensure employees compliance with procedures (e.g.- safe food preparation practices)

G. Manage Professional Interactions
1. Participate in regulatory agency surveys

a. identify regulatory standards
b. develop an appropriate plan of correction
c. demonstrate professional interaction with surveyors
d. use regulatory agencies as professional resources

2. Participate in meetings outside the department

a. communicate department goals and policies
b. identify methods of communicating with other departments
c. suggest cooperative ways to solve problems
d. participate in state/national professional meetings

3. Communicate client information to other health professionals

a. identify what client information needs to be communicated
b. identify the need for client referrals
c. implement consultant recommendations as appropriate
d. honor client rights and confidentiality

4. Participate in client care conferences

a. prepare for a client care conference
b. participate in a conference to identify client care concerns
c. work with the interdisciplinary team to develop solutions
d. implement goals and approaches with appropriate follow up

5. Manage department meetings

a. post meeting notices and agendas
b. plan meeting facilities
c. meet with key personnel to develop meeting plans
d. conduct meetings (e.g.- resolving conflicts- keeping time)
e. plan follow up actions resulting from meeting (e.g.- minutes)
f. conduct a staff complaint/grievance session

6. Adhere to professional code of conduct/ethics

H. Implement Departmental Changes
1. Identify existing problems and needs
2. Prepare justification for changes
3. Implement the plan of action
4. Evaluate the effectiveness of the changes

Domain 4. Sanitation and Safety - 24%
A. Manage Personnel to Ensure Compliance with Safety and Sanitation Regulations
1. Identify federal safety laws/regulations/guidelines
2. Write cleaning procedures for utensils- equipment- and work areas
3. Evaluate equipment in terms of maintenance needs and costs
4. Inspect all areas of department for sanitary conditions
5. Educate employees in safety and sanitation (e.g.- master cleaning schedule)
6. Interpret OSHA regulations/guidelines (e.g.- SDS- HAZCOM)
7. Enforce employees compliance with safety and sanitation regulations

B. Manage Purchasing- Receiving- Storage- and Distribution of Food and Supplies Following Established Sanitation and Quality Standard
1. Identify appropriate grades and inspections for food
2. Procure food and water from approved sources
3. Verify the quality and quantity of food supplies and equipment received
4. Check supplier invoices against facility purchase order
5. Recognize the hazards associated with types of food packaging
6. Recognize the signs of contamination upon receipt and in storage
7. Process rejections for unacceptable products
8. Label- date- and monitor food to ensure rotation (FIFO)
9. Prevent environmental contamination of food
10. Maintain security procedures

C. Protect Food in all Phases of Preparation Using HACCP Guidelines
1. Identify potentially hazardous foods and foodborne pathogens and their control
2. Recognize the causes- symptoms- and types of foodborne illnesses including biological- chemical- and physical types
3. Monitor time and temperature to limit growth of or destroy microorganisms
4. Prevent cross contamination of food
5. Identify appropriate techniques for temperature retention
6. Ensure the safe cooling of food
7. Establish critical limits
8. Establish the corrective action to be taken when critical limits are exceeded
9. Establish procedures to identify and monitor critical control points (CCP)
10. Establish effective recordkeeping systems that document HACCP
11. Prepare emergency/disaster procedures necessary to assure a safe food supply
12. Develop a crisis management plan to address an outbreak of foodborne illness

D. Manage Physical Facilities to Ensure Compliance with Safety and Sanitation Guidelines
1. Identify federal safety laws/regulations
2. Conduct routine maintenance inspection of equipment:

a. Identify equipment maintenance requirements from manufacturers manuals
b. Correct equipment malfunctions and potential problems
c. Monitor preventive maintenance schedule and contracts

3. Organize work flow and use of equipment

a. analyze tasks to determine overlapping effort or equipment use
b. plan proper placement and use of equipment
c. simplify work procedures and steps
d. monitor work flow; identify and correct problems
e. assure adequate hand washing sinks- lavatory facilities- and supplies

4. identify appropriate environmental controls for water supply- waste disposal- and ventilation
5. follow an integrated pest management (IPM) system
6. prepare a safety inspection checklist
7. write an inspection report on hazards
8. assure cleaning and sanitation of equipment- utensils- chemicals- and space

Domain 5. Business Operations - 16%
A. Manage a Budget
1. Determine facility needs
2. Compute cost of menus (e.g.- supplements)
3. Conduct a product price comparison study
4. Calculate daily cost PPD (e.g.- food- labor- supplies)
5. Calculate minutes per meal
6. Calculate meals per labor hour
7. Compare genuine costs to budget costs
8. Monitor expenses
9. Prepare an estimate of personnel costs for a foodservice department (e.g.- salary scales and merit raises- benchmarking)

B. Prepare Specifications for Capital Purchases
1. Review capital equipment needs and requirements
2. Evaluate existing capital equipment condition and life expectancy
3. Evaluate options for replacement of capital equipment
4. Write budget justification for new capital equipment
5. Recommend specifications for new capital equipment

C. Plan and Budget for Improvements in the Department Design and Layout
1. Maintain records of suggestions and complaints received
2. Conduct department improvement discussion session with staff
3. Communicate improvement recommendations
4. Evaluate work flow- essential equipment relative to new department designs or construction
5. Research concepts/products related to department facility design
6. Prepare proposals- specifications for new construction or renovation in layout/design changes

D. Assist in the Purchasing Process
1. Identify purchasing policies and procedures of department (e.g.- returns- recalls)
2. Review vendor product/selection (e.g.- group purchasing organizations)
3. Establish purchasing specifications
4. Use the ordering and bidding process
5. Evaluate facility needs- budget restrictions- and products available
6. Evaluate product information
7. Be familiar with computer applications
8. Check inventory to identify purchase needs
9. Complete purchase order requisition forms
10. Maintain inventory records
11. Recognize inventory management practices (e.g.- FIFO- par stock- physical- perpetual)

E. Manage Revenue Generating Services
1. Supervise cash activities and reports
2. Calculate cost to set prices for retail/catering
3. Plan foodservice and menus for retail/catering
4. Estimate price per unit serving for retail/catering
5. Use cost control techniques to balance revenue budget
6. Research- analyze- and/or promote revenue generating opportunities

F. Implement Cost Effective Procedures
1. Recommend cost saving purchasing practices
2. Recommend cost saving department practices
3. Implement cost effective inventory control practices
4. Report variance of genuine costs vs. budget