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 February, 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.
