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Forms > 05 Dietary Services (96 docs)

05 Dietary Services (96 docs)

Free Forms, caregiving nursing forms, policies, Licensing, Training, Management, Elder Care, Assisted Living, Alzheimer's, ALF

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Documents in 05 Dietary Services (96 docs) (96)

Normal work shift hours and general job duties for the morning cook.

Excerpt:
5:30	SET UP, FOOD PREP, CREATE DAILY LIST, TURN ON OVEN
	MAKE BISCUITS, MUFFINS, BREAD
	BREAKFAST FOOD PREP
6:15	PUT STOCK AWAY IF DELIVERED
6:45	COOK BREAKFAST,... A.M. Cook Duty List
Form to report any concerns a staff member may have anonymously. Anonymous Concern Communication
A menu for a week. Blank Menu
A form to help track dietary operations during a shift at a care facility. Residential Care, Skilled Nursing Care and Assisted Living Care Dietary Services Department. Care Facility Dietary Shift Report
This form is used to report exposure to any pathogens, such as blood. Care Facility Exposure Report Form
Form of what needs to be cleaned after each use. Clean After Each Use
What needs to be cleaned every month. Cleaning Kitchen Monthly Schedule
What needs to be cleaned each week. Cleaning Kitchen Weekly Schedule
What needs to be cleaned daily. Daily Cleaning Report
A menu form used to plan the menu for the day. Daily Menu Form
Menu plan for the day for the kitchen to use. Daily Menu Form - Kitchen Use
Form used to document a resident's eating habits. Type of food (regular, chopped, puree) and areas that may cause problems, such as loose dentures, chewing difficulties and other areas to monitor. Dietary Care Plan for Community Based and Home Care
A form used by the Dietary Department to plan goals. Dietary Department Goals and Plans
Blank form for safety rules. Dietary Department Safety Rules
A blank form for dietary duties. Dietary Duty List
Supervisor, and or Manager duty pledge for dietary program. Dietary Manager Pledge and Acceptance
Blank order form. Dietary Order Blank
Order form for coffee, tea, and spices. Dietary Order Coffee, Tea, Spices
A order form for dairy items. Dietary Order Dairy
Order form for fresh produce. Dietary Order Fresh Produce
General Ordering Form for Dietary Supplies. Dietary Order General
An order form for the general things needed. Dietary Order General Supplies
Order form for the lighting in the kitchen. Dietary Order Lighting
Order form for shopping at a local market. Dietary Order Local Market
Order form to order meats. Dietary Order Meat, Poultry, Pork, and Fish
Order form for soda. Dietary Order Soda
A form to plan out the menus for the month. Dietary Service Menu
An audit to be performed by the Administrator or Owner to assist them in following proper policies and procedures in the Dietary Department to help make sure their food service meets state and federal laws and regulations. Great form for community based care facilities, assisted living and residential care homes. Dietary Service Monthly Audit
Blank schedule for staff. Dietary Staff Schedule
A list of required training procedures for new staff. Dietary Training Check Off List
Doctors orders regarding a resident's diet. Doctors Dietary Order Blank
Form developed to evaluate an employee's documentation skills. Documentation Skills Evaluation - Dietary
Form to put drink choices on. Drink Choices Breakfast-Master List
Master list of the dinner drink choices. Drink Choices Dinner- Master List
Master list of the drink choices for the midday. Drink Choices Midday-Master List
This form is used to list foods and keep an inventory of foods on hand for emergencies.

Excerpt:
Below is a list of emergency foods and products you may want to have on hand in quantities large enough to feed your residents (and staff) for two weeks to a month.  Other emergency food supplies can be purchased from the local military surplus store.
Be sure to pay attention to the shelf life, replace with fresh stock before expiration, and use product on next menu. Emergency Food List Form
Communication and suggestion form used by employee's regarding unsafe conditions and/or occupational health concerns. Employee Safety Communication and Suggestion Form
Record of the foods a resident is allergic to. Food Allergy Plan
Master list for disliked meat. Food Dislikes - Beef, Pork, Fish - Master List
Master list for breakfast items. Food Dislikes - Cereal, Breads, Grains - Master List
Master list for fruits that are not liked. Food Dislikes - Fruit- Master List
List of disliked poulty, eggs, and dairy. Food Dislikes - Poultry, Eggs, Dairy - Master List
Master list for salad dislikes. Food Dislikes - Salad - Master List
Master list for disliked vegetables. Food Dislikes - Vegetables - Master List
An addendum to the admission agreement between resident and care facility regarding food service. Food Service Agreement - Addendum for Community Based Home Care
Form used to audit the dietary department of a care facility. Food Service Audit
A form used by residents to request food substitutes prior to meals. Food Substitute Request Form
This form is used to report and document any hazardous situation. Hazard Report Form
Form designed to place an advertising an employment opportunity. Help Wanted Advertisement Form
Form for injury prevention plan. IIPP Master List Dietary Service
A form developed by the ProvidersWeb used by the instructor of the in-service to document training on safety, resident care plans, and class attendee's in Nursing Home, Residential Care and Assisted Living Facilities. In-Service Training Report (Form)
Description of the job duties and responsibilities of the Dietary Manager and/or Supervisor of a care facility. 

Excerpt:
Purpose of This Position:
~Make the resident happy with their diet. To ensure quality food is delivered to the residents, in a manner that is clean, safe, and healthy.
~Prevent food-borne illness, and cross-contamination.
~Recruit, supervise, train, continually educate, discipline if need be, the dietary staff.... Job Description - Dietary Manager - Supervisor
Description of the job duties and responsibilities of the dishwasher in a care facility.  

Excerpt:
The Positive Features:
~Cleaning can give a person a feeling of accomplishment.
~Helping residents' lives be better.
~Don't have to think much to do the job. Job Description - Dishwasher
Description of job duties and responsibilities of the relief cook in a care facility.  

Excerpt:
The Positive Features:
~Cooking is enjoyable for those that like to cook. 
~Appreciation from the residents and staff.
~Able to suggest recipes for menus.
~Learn about special diets and different food cultures. Job Description - Relief Cook
This is a form used to list job tasks that may be encountered which will place care facility staff at risk of occupational exposure to blood or other potentially infectious materials. Job Exposure Determination - Care Facility Dietary Aide
This is a form used to list job tasks that may be encountered which will place care facility staff at risk of occupational exposure to blood or other potentially infectious materials. Job Exposure Determination - Care Facility Dietary Manager & Cook
A form for information on the dietary appliances. Kitchen Appliance Inventory Form
Form used to document employees reporting to work late. Late Report Form
Form used to list dietary staff that have completed required training programs. List of Designated Dietary Staff
The master list of all the residents dislikes. Master Dislikes Tally List
Form to find out if the menu meets the RDA Audit. Menu RDA-QA Audit
A form for recipes. Menu Recipe (Form)
A calendar type form used to schedule snacks. Monthly Snack Menu (Blank)
Form used to document new staff orientation. New Dietary Staff Orientation
A form used by a community-based care facility to assess a resident's nutritional intake.  List of areas to monitor, medical problems related to eating and nutrition, and common signs of malnutrition. RCFE, ALF, RCF, ARF Nutritional Assessment Form for Community Based Care
This form is used for approval of overtime. Overtime Consent Form
Times and duties of the p.m. cook.

Excerpt:
7:00	SWEEP AND SPOT MOP DINING ROOM AND KITCHEN
 	CLEAN SINKS, WORK AREAS, AND ANY EQUIPMENT USED
 	RE-STOCK TABLE CONDIMENTS
 	REFILL JUICES FOR A.M. COOK
 	SET UP 8:00 SNACK CART
7:30	CLOCK OUT
 	BEFORE LEAVING, PLEASE DO THE FOLLOWING:
 	TURN OFF HOOD FAN, TURN OFF OVENS AND GRIDDLE
 	TURN OFF AND DRAIN DISHWASHER, TURN OFF COFFEE MAKER
 	COMPLETE DIETARY SHIFT REPORT, TAKE SOILED LINEN           BUCKETS TO LAUNDRY
 	LOCK PANTRY DOOR, LOCK INSIDE KITCHEN DOOR P.M. Cook Duty List
An analysis on a meal to determine how much was consumed. Plate Waste Study One Meal Analysis
Random survey of what and how much was eaten. Random Plate Waste Study
Form used to verify that all the required dietary forms and agreements have been completed. Resident Dietary Report for community based care homes and skilled nursing homes
Residents record of what drinks are perfered. Resident Drink Preference
A survey on the food and service to the residents. Resident Food and Service Survey
This Resident Food Consumption Report Form is used to document what food item was mostly eaten by a resident, and what food item was not.  After completion turn into Dietary Supervisor and Facility Manager. Resident Food Consumption Report Form for Residential and Home Based Care
Getting residents to eat isn't always easy.  However, if you don't serve them the food they don't like, that can help.  This check off list contains most food items served in care facilities.  Its easy to flip through the binder containing these dislike lists to find out which residents dislike the food item being served, thus enabling staff to provide a substitute. Resident Food Dislikes Form for Community Based Care
A tally survey to determine whether or not residents like their meals and service. Resident Food Service Survey Tally
A record of resident food substitution. Resident Food Substitution Record
Form to document visitor, date, time and purpose of visit. Resident's Dietary Visitation Records
A seating chart for residents. Seating 1-6 Serving Chart
Seating chart for futher seating. Seating 7-12 Serving Chart
A blank seating chart. Seating Serving Chart
A free checklist to see if a resident is showing signs of dehydration. Signs and Symptoms of Dehydration Checklist
This form is for notifiying care services, and others about the short term changes in a resident's diet.  Form used at residential care, assisted living and nursing homes. Special Diet Notification - Short Term
A form used to help define a resident's special diet plan.  Used by Dietary Managers for assisted living facilities and residential care homes. Special Diet Plan for community based care residents
A form for information on a resident's special diet. Special Diets Master List - Ongoing Diets
A menu form that residents may use to request substitutes at mealtime. Substitute Menu Ordering
Form for food substitution. Substitution Menu (Blank)
Snack menu developed by the National Policy & Resource Center on Nutrition & Aging. Super Snack Rotation
Reduced concentration of sugars in snacks developed by National Policy & Resource Center on Nutrition & Aging. Super Snack Rotation Reduced Concentrated Sugars
Form to request a tray sent to a resident's room, and the reason for it. Tray Service Form
week 1 of a 6 week menu plan. Weekly Menu Sample - Week 1
Week 2 of a 6 week menu plan. Weekly Menu Sample - Week 2
Week 3 of a 6 week menu plan. Weekly Menu Sample - Week 3
Week 4 of a 6 week menu plan. Weekly Menu Sample - Week 4
Week 5 of a 6 week menu plan. Weekly Menu Sample - Week 5
Week 6 of a 6 week menu plan. Weekly Menu Sample - Week 6
A form to document, calls, paperwork, and interactions with residents, staff and the public during a shift. Worktime Report - Dietary
 
   
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