California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 8 - Intermediate Care Facilities for the Developmentally Disabled › Article 3 - Services › Section 76363 - Food and Nutrition Services-Food Service

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The food and nutrition needs of clients
				  shall be met in accordance with the "Dietary Reference Intakes: The Essential
				  Guide to Nutrient Requirements" (2006) adopted by the National Research Council
				  of the National Academy of Sciences, Institute of Medicine, hereby incorporated
				  by reference, and adjusted for age, sex, activity, and disability through a
				  nourishing, balanced diet unless contraindicated by medical needs.
(b) Food services shall include:
(1) Not less than 3 meals shall be served
				  daily, with not less than a 10 hours' span between the first meal and the last
				  meal of the day, and not more than a 14 hours' span between the third meal and
				  the first meal of the following day.
(2) Mealtimes comparable to those of similar
				  age groups existing in the community.
(3) Nourishment or between meal snacks shall
				  be provided as required by the dietary plan. Bedtime nourishments shall be
				  offered to all clients unless countermanded by the interdisciplinary team,
				  attending physician or the dietitian.
(4) Client food preferences shall be adhered
				  to as much as possible and substitutes for all food refused shall be from
				  appropriate food groups. Condiments such as salt, pepper or sugar shall be
				  provided at each meal unless countermanded by the physician's diet order or by
				  decision of the interdisciplinary team responsible for the client's
				  program.
(5) All clients shall eat
				  in dining rooms, except where contraindicated for health reasons, or by
				  decision of the interdisciplinary team responsible for the client's program.
				  Table service shall be provided for all clients who can eat at a table,
				  including clients in wheelchairs. Dining areas shall be equipped with tables,
				  chairs, eating utensils and dishes designed to meet the developmental needs of
				  each client.
(6) When food is
				  provided by an outside commercial food service, all requirements shall be met.
				  The facility shall maintain a written plan, space, equipment and food supplies
				  to provide clients food service in emergencies.
(7) Food shall be prepared by methods that
				  conserve nutritive value, flavor and appearance. Food shall be served
				  attractively at appropriate temperatures and in a form to meet individual
				  needs.
(8) Denial of a
				  nutritionally adequate diet shall not be used as a punishment.
(9) Dining rooms shall be supervised and
				  staffed for self-help dining procedures, and to assure that each client
				  receives an adequate amount of food.
(10) Clients shall be provided with
				  systematic training to develop appropriate eating skills, utilizing adaptive
				  equipment where it serves the developmental process.
(11) Direct-care staff shall be trained in
				  and shall utilize proper feeding techniques. Clients shall eat in an upright
				  position unless medically contraindicated.
(12) Clients shall be encouraged and assisted
				  in feeding themselves whenever possible. Clients shall be permitted to eat in a
				  manner consistent with their developmental needs. Whenever self-feeding is not
				  possible, clients shall be provided assistance in eating.