Hawaii Administrative Rules › Title 11 - DEPARTMENT OF HEALTH › Subtitle 1 - GENERAL DEPARTMENTAL PROVISIONS › Chapter 89 - DEVELOPMENTAL DISABILITIES DOMICILIARY HOMES › Section 11-89-19 - Nutrition

Current through June, 2024
(a) Meals shall be well-balanced and
				sufficient in quantity, quality, and variety to meet nutritional requirements
				of residents and shall be in accordance with the national research council of
				the national academy of sciences most current recommended dietary allowance
				(RDA), and adjusted to age, sex, activity, and disability.
(b) All foods shall be procured, stored,
				prepared, and served under sanitary conditions.
(c) Foods shall be selected and prepared to
				meet the food desires and habits of residents as much as possible, provided
				nutritional quality is maintained. One week's menu shall be posted. There shall
				be a minimum of food supplies for three days, which will be adequate for the
				number of people to be served.
(d)
				Foods shall be stored in covered containers.
(e) Refrigerators shall be equipped with an
				appropriate thermometer and temperature shall be maintained at 45°F or
				lower.
(f) Toxic chemicals and
				cleaning agents, such as insecticides, fertilizers, bleaches, and all other
				poisons shall be properly labeled and securely stored apart from any food
				supplies.
(g) All caregivers shall
				wash hands thoroughly before starting work and as often as necessary to remove
				any soil or other contamination and after personal use of bathroom
				facilities.
(h) Water supply shall
				be of a safe," sanitary quality and from an approved source. Hot and cold
				running water under pressure shall be provided in all areas where food is
				prepared and where equipment, utensils, and containers are washed.
(i) A minimum of three meals shall be
				provided at regular intervals in each twenty-four hour period.
(j) There shall not be more than fourteen
				hours between a substantial evening meal and breakfast.
(k) Meals shall be served attractively, in a
				comfortable, pleasant atmosphere in the designated dining area. Eating utensils
				and dishes designed to meet the needs of each resident shall be
				provided.
(l) Special diets shall
				be provided for residents when ordered by a physician. Caregivers who have not
				received special diet training may not accept residents requiring special diets
				until trained by a qualified dietician or nutritionist.
(m) If a resident converts to special diet
				while residing in the facility, the caregiver shall obtain instruction and
				submit menus to a qualified dietician or nutritionist for review within two
				weeks of the order, if not trained in the specific diet required.
(n) Between meal nourishment consistent with
				need shall be offered routinely to all residents.
(o) Special diet orders shall be updated
				every three months by a physician. Verbal orders for special diets shall be
				recorded on the physician order sheet by the caregiver receiving the verbal
				orders and written confirmation by the attending physician shall be obtained at
				the next office visit.
(p)
				Caregivers shall supervise the residents according to their needs for self-help
				procedures, and ensure that each resident receives an adequate amount of
				food.