Nutrition

Food Service

Gads Hill Center provides nutritious meals for children furnished under contract by a licensed caterer, Open Kitchens, at our directly-operated sites. Food is delivered directly from the caterer's kitchen to Gads Hill Center and is portioned and served by Gads Hill Center staff. Each Head Start partner site has made similar arrangements with a caterer or provided the appropriate facilities to cook on-site.

A staff person possessing a Food Service/Sanitation certificate will be on the premises whenever program food is being served to children. Food shall be stored, prepared, and handled per the Food Service Sanitation code and other regulations of the Department of Health, the City of Chicago, and the State of Illinois. Only food identified on the menu will be served to children as a meal component. Menus are designed by the caterer or partner site in collaboration with program staff and are approved by a licensed dietician or nutritionist.

The food temperature shall be maintained to ensure food safety and avoid foodborne illness. Thermometers in the refrigerator shall be monitored continuously to ensure that cold foods are maintained below 40o. Additionally, food service staff will measure the temperature of food upon arrival from the caterer and recheck this temperature before service to ensure that hot foods are maintained at 140o. Potentially hazardous and perishable food will be refrigerated immediately upon arrival.

Nutrition Food Assessments and Accommodations

Guidance:

1. During enrollment, staff will complete a Child Nutrition Intake Assessment and work with families to identify any special dietary needs for a child while at the program.

2. Each child's height and weight will be completed on each child twice per year. If the Body Mass Index (BMI) for children 3 and older is at or above the 95th percentile or at or below the 5th percentile, a referral to the medical provider or Nutrition Consultant will be recommended to the parent/guardian.

3. For a child with a disability, any special meal or dietary accommodation must be documented by a Dietary Restriction and Substitution Statement signed by an authorized professional as specified by USDA CACFP. Any dietary modifications that are required for children with disabilities will be made as soon as appropriate documentation has been submitted.

4. For a child without a disability, dietary requests that are not medically necessary will be accommodated if USDA CACFP meal patterns can still be met, the requested item(s) do not exceed more than 10% of the usual cost, and the requested item is readily available where supplies are usually purchased. The Nutrition Coordinator must approve all substitutions.

5. Requests for fluid milk substitutes require only a parent signature when the alternate milk selected is approved by USDA CACFP as a product that meets nutrient standards for non-dairy beverages. The written request must identify the special dietary need that restricts the diet of the child.

6. Head Start staff will refer children with nutrition-related disabilities ,food allergies/special diets to the Nutrition Coordinator for review. Children with conditions such as celiac disease, phenylketonuria, diabetes, severe food allergy (anaphylaxis) or any other medically necessary modification will also be referred to the Health and Safety manager for review. The Nutrition Consultant and/or Disabilities Coordinator will be utilized as necessary and appropriate. An individualized Nutrition and Feeding Care Plan will be developed.

7. Any special diets, food allergies or intolerances will be clearly posted for Head Start staff.

8. The Health & Safety manager will coordinate with other specialists and staff members to ensure individualization of meals and snacks.

9. Community nutritional issues are included on the agenda and discussed at the Health Advisory Committee meeting.

Breast Feeding and Nutrition

Human milk, as an exclusive food, is best suited to meet the entire nutritional needs of an infant from birth until six months of age. In addition to nutrition, breastfeeding supports optimal health and development. Human milk is also the best source of milk for infants for at least the first twelve months of age and, thereafter, for as long as mutually desired by mother and child. Breastfeeding protects infants from many acute and chronic diseases and has advantages for the mother. Early Head Start Centers will encourage, provide arrangements for, and support breastfeeding.

Guidance: Program staff will:

1. Talk with families about breastfeeding, offer accurate information to help families make informed choices, and support families in the feeding decisions that make the most sense for them. 2. Provide a programming environment that welcomes breastfeeding.

3. Provide a designated space for mothers wanting to breastfeed their infants privately.

4. Ensure that refrigerator and freezer space is made available for labeled, pumped human milk as needed. The Nutrition Coordinator will train the staff on the benefits of breastfeeding and techniques for handling and storing human milk.

Storing Breast Milk

Proper storage and handling of breast milk and infant formula are necessary to prevent spoilage, minimize bacterial growth, and ensure that each infant receives his or her own mother’s milk or the correct brand of formula.

Guidance:

1. Home visitors and other staff work with parents to find safe methods for storing and handling of breast milk and infant formula in both home and program environments, and for transporting breast milk as needed.

2. Staff and parents work together to ensure that all breast milk and formula are dated, clearly labeled with the child’s name, and used only for the intended child.

3. All bottles of breast milk and formula are refrigerated at 39’F or lower until immediately before feeding, and any contents remaining after feeding, are discarded immediately.

4. Unused breast milk will be discarded after 72 hours, if refrigerated, or after three months if frozen. The formula should be mixed before each use and stored according to the manufacturer’s directions.

5. Once frozen breast milk is thawed, it is used within 24 hours. Previously frozen breast milk, once thawed, is never to be refrozen.

6. Frozen breast milk and the formula are thawed in running, warm water, or in the refrigerator.

7. To avoid spoilage, avoid warming bottles of formula or breast milk at room temperature. If breast milk or formula is to be warmed, bottles may be placed in warm pans of water at no more than 120 degrees Fahrenheit for no more than five minutes. After warming, the bottle is shaken well, and the temperature is tested on the preparer’s wrist before feeding.

8. Breast milk or formula bottles are never to be warmed in a microwave. Microwaves heat unevenly and may cause severe burning.

Handling Ready-to-Eat Food

Despite proper hand washing, all contamination may not be removed from hands, therefore bare hands contact with ready-to-eat food will be avoided as prescribed by the FDA Food Code (2013).

Guidance:

The following items will be considered ready-to-eat foods and may not be handled with bare hands: Prepared fresh fruits and vegetables served raw Salads and salad ingredients Cooked meats, cold meats and sandwiches Bread, toast, rolls, and baked goods Ice Any food that will not be thoroughly cooked or reheated after it is prepared Acceptable alternatives to bare hands would be: deli paper spatula tongs single-use gloves fork or spoon scoops napkin

Food Handling and Sanitation

Food Preparation and Handling Food will be prepared with a minimum of handling, with suitable utensils, and on surfaces that have been cleaned, rinsed, and sanitized prior to use to prevent cross-contamination. Unless produce is labeled “ready to eat”, “washed”, or “triple washed”, it should be washed under running water before cutting and serving. Tops of canned items will be washed before opening. Potentially hazardous foods must be thawed under refrigeration at a temperature of 410 F or lower, submerged under running water at 700 F or lower, and in a microwave only when food is cooked immediately afterward, or as a part of conventional cooking. Potentially hazardous foods must be kept at an internal temperature below 410 F or above 1350 F during the holding period. The temperature of all potentially hazardous foods will be recorded on the daily Production Record. Food that is prepared off-site will be transported in insulated containers that keep hot and cold foods at safe temperatures. Food temperatures will be taken and recorded before service. During transportation, food, and food utensils will be transported in covered containers or completely wrapped

Food Storage and Monitoring

All non-food items will be stored separately from food items. Chemical and cleaning solutions will be stored separately from paper/disposable meal service items. All chemical and cleaning supplies will be clearly labeled. All food not stored in the product container or package in which it was originally obtained, is stored in a sealed container that is labeled and dated. Thermometers will be present in each refrigerator, cooler, and freezer and monitored and recorded daily to ensure that refrigeration temperatures are between 320-410 F and freezer temperatures are at 00 F or colder. This will include classroom refrigerators. Store rooms, storage areas, freezers, and refrigerators should be organized with inventory recording in mind and in an orderly manner. Food and non-food supplies will be used on a first-in/first-out basis. A physical inventory of food and non-food items will be recorded on a monthly basis.

Food Service and Illness

The Centers for Disease Control and Prevention (CDC) estimates approximately 20 percent of foodborne illness outbreaks are caused by ill food service employees working with food. For this reason, all food establishments should have an employee illness policy for food service personnel. To prevent foodborne illness outbreaks, employees with any of the following symptoms or conditions shall report such to their supervisor and abstain from any food handling, preparation, or serving: vomiting, diarrhea, fever, jaundice, sore throat with fever, lesions containing pus on hands, wrists or other exposed portions of the body All staff should be free from illness for 24 hours before returning to work.

Hand Washing

Hand hygiene is the most important way to reduce the spread of infection. Many studies have shown that improperly cleansed hands are the primary carriers of infections. Deficiencies in hand hygiene have contributed to many outbreaks of diarrhea among children and caregivers/teachers in childcare centers. Proper hand washing is the best prevention against food-borne illnesses and other diseases. Unwashed or poorly washed hands can transfer harmful bacteria from your hands to those you are feeding.

Guidance:

Children and staff members should wash their hands using the following method:

a. Check to be sure a clean, disposable paper (or single-use cloth) towel is available;

b. Turn on warm water, between 60°F and 120°F, to a comfortable temperature;

c. Moisten hands with water and apply soap to hands;

. Rub hands together vigorously until a soapy lather appears, hands are out of the water stream, and continue for at least twenty seconds (sing Happy Birthday silently twice). Rub areas between fingers, around nail beds, under fingernails, jewelry, and the back of hands.

e. Rinse hands under running water, between 60°F and 120°F, until they are free of soap and dirt. Leave the water running while drying hands;

f. Dry hands with clean, disposable paper or single-use cloth towel;

g. If taps do not shut off automatically, turn taps off with a disposable paper or single-use cloth towel;

h. Throw the disposable paper towel into a lined trash container; place single-use cloth towels in the laundry hamper; or hang individually labeled cloth towels to dry.

When running water is unavailable or impractical, the use of alcohol-based hand sanitizer is an alternative to traditional handwashing with soap and water by children over twenty-four months of age and adults on hands that are not visibly soiled. A single pump of alcohol-based sanitizer should be dispensed. Hands should be rubbed together, distributing sanitizer to all hand and finger surfaces and hands should be permitted to air dry.

GHC Requires that hand washing occurs upon arrival for the day, after breaks, or when moving from one child care group to another, before and after food preparation, handling, serving (including setting tables), eating, or feeding a child, before and after diapering, before and after administering medications, before and after water play, after handling/removing trash, after smoking, eating or drinking, after coughing, sneezing, using a tissue, or any other potential exposure to blood or body fluids, after using the toilet or helping a child use a toilet. Also, after touching or handling any animal, after sand or outdoor play situations or times that children and staff should perform hand hygiene should be posted in all food preparation, hand hygiene, diapering, and toileting areas. Caregivers/teachers should provide assistance with handwashing at a sink for infants who can be safely cradled in one arm and for children who can stand but not wash their hands independently. A child who can stand should use a child-height sink or stand on a safety step at a height at which the child’s hands can hang freely under the running water. After assisting the child with handwashing, the staff member should wash his or her own hands.

Nutrition for Infants and Toddlers

Infants and toddlers require appropriate nutritional needs for their development, nourishment, and school readiness. Caregivers and families should work together to develop infant feeding plans for each infant. Feeding schedules, formula vs. breast milk, types and amounts of food provided, the introduction of new foods, meal patterns, food intolerances and preferences, voiding patterns, and developmental changes should be shared between parents and caregivers regularly.

Guidance:

1. Infants are held while being fed and are not laid down to sleep with a bottle or propped up.

2. Infants are fed “on demand” or “on cue” to the extent possible, as indicated by age, in appropriate amounts, and at appropriate intervals, as required by USDA CACFP guidelines.

3. Information is shared between parents and staff regularly on the following: a. feeding schedules b. amounts and types of foods serving c. breast milk or formula and/or baby food used d. meals patterns e. new foods introduced by parents f. food intolerances and preferences g. voiding patterns h. observations related to developmental changes in feeding and nutrition

4. A variety of food is served which broadens each child’s food experience. Food is served in developmentally appropriate forms. A tracking sheet within the child’s file will be utilized to track which foods a child has been introduced to and any intolerances or preferences.

5. Breast milk and formula are handled and stored properly. See Handling and Storage of Breast Milk and Formula Policy.

6. On hot days, infants receiving human milk in a bottle are given additional human milk, and those receiving formula mixed with water are given additional formula mixed with water.

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