July 2001

Information Bulletin 01-20

Kitchen/Food Service Investigative Tool


The purpose of this information bulletin is to provide a checklist, developed by the Center for Medicare and Medicaid Services (CMS), formerly known as HCFA, Chicago regional office. This document, Additional Surveyor Checklist for Kitchen Sanitation, is an investigative tool that will be utilized by Minnesota survey staff as a part of Kitchen/Food Service Observations- assessment of a facility's food storage, preparation and service. This tool does not supersede any regulatory requirements. The tool will be used when performing Task 5B, federal survey procedures for Long Term Care Facilities - Kitchen/Food Service Observation.

Please see Kitchen/Food Service Observation worksheet, HCFA Form A-804 (PDF) and the Additional Surveyor Checklist for Kitchen Sanitation (PDF), copies of which were sent out with the original mailing.

If you have any questions regarding this Information Bulletin, please contact in writing:

Minnesota Department of Health
Health Regulation Division
Licensing and Certification Program
85 East Seventh Place, Suite 300
PO Box 64900
St. Paul, MN 55164-0900
Telephone: (651) 201-4101

Thursday, February 05, 2015 at 03:44PM