Begin Within



14414519621500Region 1 Standard Operating Guidelines (SOG) Food and Water Safety and SecurityOBJECTIVE: To Ensure Safe Drinking Water and Food Supplies.Drinking water and food safety may be a public health issue when there is: a loss of power for more than two hours; a loss of potable water; a threat of chemical or biological contamination during a flood, fire, or other natural or man-made disaster. SPECIAL CONSIDERATIONS:Water emergencies involving community water departments require close cooperation between the Water Department, the Department of Environmental Protection (DEP), the Department of Public Health (DPH)) and the Board of Health (BOH). Even one confirmed foodborne illness must be reported as soon as possible to DPH. Depending on the nature of the food/water emergency, there may be a need to dispense medication at an Emergency Dispensing Site (EDS SOG) and Public Information is the BOH’s most important tool (PIO SOGCONCEPT OF OPERATIONS: This guide assumes continuous pre-event planning and is NOT a substitute for any Plan, Laws, Regulations or Official Forms. It:Assumes that Local Public Health (LPH) officials follow the National Incident Management System (NIMS) and Incident Command System (ICS).References emergency response plans such as the Comprehensive Emergency Management Plans (CEMP); Public Health All-Hazards plans Continuity of Operations Plans (COOP), and other SOGs. Expects that Public Health will play either a lead or supporting role, depending on the scope of the event. LPH may be the Incident Commander (IC) or be asked by the IC or his designee to:Assess the Public Health situationContact public and private partners who work with LPHProvide information and Risk Communications (Public Information) to the public and respondersInspect facilities to ensure compliance with minimum environmental and health safety standards.Provide sampling, testing and interpretation Investigate diseasesRecommend rationing standardsAssist with volunteer managementAdvise on Individuals Requiring Additional Assistance and those with Access and Functional NeedsInstructions: Page one is a table of contents (TOC). Each item in the TOC points to a section with a checklist of Food and Water considerations, including.Initial Response Actions: procedures common to all incidents and addresses incident response procedures such as assessing the situation, establishing command and control and connecting with response partners. Operations: Many public health emergencies include multiple issues such as safe food, water, air, housing, disease prevention, public information, etc. Consider consulting multiple SOGs. Recovery: may be the longest phase of the Incident, requiring the most LPH resources. Community partner organizations are essential to ensure recovery and return to normal. ? Check Boxes: Use the check boxes to track action items considered or acted upon. In the Resource/Assigned Column find and add resources: items, plans, people. Starred Items are critical tasks that should always be considered in any large scale Emergency/IncidentGrey shaded areas indicate/suggest risk communication activities14414516637000Region 1 Standard Operating Guidelines (SOG) Food and Water Safety and Security TABLE of CONTENTSInitial Response ActionsBegin Within1.1 Initial Assessment of the Event0 – 3 hours1.2 Contact Response Partners and Maintain Communications.25 – 3 hours1.3 Establish Command and Control.50 – 2 hours1.4 Implement Risk Communications1 – 3 hours1.5 Review Emergency Plans2 – 8 hours1.6 Assess Logistical Needs/Resources 2 – 8 hours1.7 Document All Expenditures and Response Actions2 - ongoingOperations: Food and Water Emergency ResponseBegin Within2.1 Provide advice to Incident Commander and First Responders1hr - ongoing2.2 Contact Public Water Supplies, Food Establishments, Institutions, Homes1hr – 2 hours2.3 Monitor and Ensure Safe Food/Water2hr - ongoingProvide Risk Communications 2hr - ongoing2.5 Conduct disease surveillance/investigations3hr - ongoing2.6 Use Local Board of Health authority to issue orders and obtain information3hr - ongoingRecoveryComplete Within3.1 Lift Board of Health OrdersAs appropriate3.2 Support Recovery; work with VOAD (Voluntary Organizations Active in Disasters)Ongoing3.3 Support debris management operations; return to new normalOngoing3.4 Submit forms and documents for expenditures and other data30 days3.5 Complete After Action Report and Improvement Plan30 daysOperations Quick Overview: Food and Water safety is a primary responsibility of the BOH. Information and education are the primary tools for ensuring food and water safety. After assessing the situation:Begin Risk Communications immediately; coordinate with the Joint Information System (JIS) Document and log all actions, resources and expensesMaintain communications with the Incident Commander; Emergency Operation Center & response partnersConsider a Public Health Emergency Response Team (ERT) to plan for multiple operational periods (COOP )Monitor and ensure safe Food and WaterMonitor donated food and public/spontaneous Volunteer Feeding Operations and Points of Distribution (POD)Maintain disease surveillance system in cooperation with the hospitals, health care providers and DPHInitial Response Actions1.1 Initial Assessment of the EventResources/Notes FORMCHECKBOX Assess the scope of the public health threat: verify that it is an emergency (or potential emergency) requiring immediate responseICS Form 201 Incident Briefing Form FORMCHECKBOX Contact Immediate Response Partners:Emergency Management DirectorChief Elected Officials (CEO)Public Health NurseOthers as appropriate FORMCHECKBOX Determine who is able to respond, when, confirm contact info.BOH Call Down List; BOH COOP FORMCHECKBOX Call the state epidemiologist: 617-983-6800, if DPH aid needed24/7 call line to DPH Epi on duty FORMCHECKBOX Summarize the event:Disease agent or risk factors: symptoms, incubation, transmission, treatmentWhere/when exposure occurred or is likely to occur:Source of exposure: natural, accidental, terroristWho is at riskScope: How many individuals/communities/areas are involved Protective Actions: What can people do to protect themselves?More Information: agent, exposure pathways and treatment Key Issues: Loss of Power/Water, Food/Water Contamination, Disease fact sheets DPH surveillance manualDrug Fact Sheets – on line FORMCHECKBOX Gather StatisticsNumber exposed Number likely to be exposed Number hospitalized – connect with hospital infection control/ERNumber treated / given prophylaxis (preventative treatment) FORMCHECKBOX Assess/Monitor impacted population; population health needsFood Establishments and their Emergency PlansPublic Water Supplies (PWS) and their Emergency PlansPrivate Water Supplies/WellsAll Public Feeding/Distribution CentersDisease Surveillance System (MAVEN)Housing Health and Safety and Indoor Air QualityPublic Building Health and Safety and Indoor Air QualityOutdoor Air Quality FORMCHECKBOX Assess language needs; Interpreter resources; functional needsIRAA SOG/CEMP Annex FORMCHECKBOX Estimate how long the situation will last: days, weeks, unknownCheck COOP plansBegin Risk Communication ActivitiesMedia ResourcesBegin Risk Communications immediately; coordinate with the Joint Information System (JIS) for the emergencyThis establishes the BOH as a source of credible information FORMCHECKBOX Develop and Send Initial Public Messages (holding messages)Use outgoing 911, media, 211, web, This is an evolving emergency…ICS Media Call Intake Form –PIO SOGWe have activated our emergency plan…Templates, prewritten message and press release forms found in:Emergency PlansPIO Toolkit, PIO SOGLocal officials are investigating the situationThis is what we know right now. Stay informed and follow official instructionsWe will get back to you in 2 hours FORMCHECKBOX Activate the BOH emergency public information systemREPC Regional Plans FORMCHECKBOX Establish situational awareness with neighboring jurisdictions FORMCHECKBOX Consider using Social Media to maintain contact with the Public1.2 Contact Response Partners; Maintain CommunicationsResources/Notes FORMCHECKBOX Inform the Emergency Management Director(EMD); Chief Elected Official(CEO), BOH, PIO, EOC and other early notification officialsMay also contact DPW, Water/Sewer Suppliers, Food Establishments FORMCHECKBOX Notification: Contact other relevant response partners: maintain communications; Situational Awareness; understand the emergency.GETS (Government Emergency Telecommunications Services) cards (must pre-enroll) – grabs free lines FORMCHECKBOX Call Internal Contacts: Assemble the Emergency Response TeamUse HAMs, phones, radios, etc. Board of Health staff and membersInternal Emergency Contact ListsPublic Health Nurse (may be a Visiting Nurse Association – VNA)Emergency Management Director (EMD)Public Health Pocket CardsMayor/Selectboard/Town ManagerPublic Information OfficerHHAN, email, out-going 911Water Department; police and others as needed FORMCHECKBOX Call External Contacts as appropriatePhone, satellite phones, email, HAMsMutual Aid Partners such as neighboring BOHRadio, HAM radios Neighboring jurisdictionsHospital(s) (capacity, situational awareness, communications)Department of Public Health (DPH)(617) 983-6800 EPI on callDepartment of Environmental Protection (DEP)(888) 304-1133 Spill HotLineDistrict Health Officer(617) 839-3237 Charlie Kaniecki DPH Emergency Preparedness Bureau(617) 647-0343 (pager)DPH Regional Hospital Coordinator(617)438-1466Interpreter Strike Team LeaderMA Registry of Interpreters for DeafMEMA (Western Region)(413) 821-1500USDA (800) 535-4555Mass Dept of Agricultural Resources (MDAR)413-548-1900; agr/Public Health Emergency Preparedness CoalitionRegional (Local) Emergency Planning Committee (REPC/LEPC)Medical Reserve Corps (MRC) Community Emergency Response Team (CERT) American Red Cross (ARC) Worcester, MA 01606978-537-3339Pioneer Valley: 413-737-4306Greater Westfield: 413-562-9684Berkshire County: 413-442-1506Salvation Army (Voluntary Organization Active in Disaster-VOAD)(617) 542-5420salvationarmy-SchoolsElder ServicesCommunity Based Organization (CBO) partners, including Faith basedSheriff’s DepartmentBerkshire 413-445-4559Franklin 413-774-4014Hampden 413-858-0132Hampshire 413-584-59111.3 Establish Command and ControlResources/Notes FORMCHECKBOX Clarify Incident Command Structure and Chain of CommandBOH may be the lead; provide supportIncident Commander (IC) identified and communications establishedCEMPConsider Unified Command (UC) for a food and water emergencyBOH Emergency PlansIncident Command Post (ICP) set upEmergency Operations Center (EOC) activated if neededEDS planAssess need for Joint Information System (JIS) or Center (JIC)Consider the need for an Area Command for regional emergencies FORMCHECKBOX Clarify Incident Command Roles ICS 203: Organization AssignmentsPIOs (Incident PIO; Agency/Dept. PIO, Other Jurisdiction PIO)PIO Job Action Sheet/Check ListSafety Officer (May be combined with Security)ICS 206: Responder Medical PlanSecurity Section Chief/Security Branch Director (Law Enforcement)Liaison Officer (Connects with other agencies/organizations)Functional Needs Officer (to coordinate IRAA Functional Needs)Individuals Requiring Additional Assistance Operations Section Chief – depends on the type of emergencyPlanning Section Chief (situational awareness; next operational periodFinance and Administration Section Chief (Expenses;procurement)Contact Chief Financial Officer (CFO)Logistics Section Chief (Deals with resources) FORMCHECKBOX Respond to designated command location: Emergency Operation Center (EOC) or Incident Command Post (ICP)EOC Location and Phone FORMCHECKBOX Receive situation awareness report from the emergency Management Director (EMD) or Incident Commander (IC)ICS 201: Incident Briefing ReportICS 202 Incident Objectives FORMCHECKBOX Ongoing Activities throughout the IncidentContinue notification attempts until successful. Follow up on all actions taken to ensure their completionReceive situation awareness report from the Emergency Management Director (EMD) or (IC)Help the EMD/IC develop the Incident Action Plan (IAP)Document/log all response activities and financial expenditures1.4 Implement Risk Communications /Public Information PlanResources/Notes FORMCHECKBOX Risk Communication Roles, Positions, LocationsHampshire PIO Tool Kit – on lineDesignate a Public Health Incident Public Information Officer (PIO) CEMP and Risk Communication PlansPublic Health PIO should be in constant contact with other PIOsIncident Commander approves all communications/messagesJoint information Center or System (JIC/JIS) (virtual or physical) established as needed for a regional or multi-agency eventPIO Job Action SheetSpokesperson(s) chosen (not usually the PIO)Trusted Source; PIO Check listSubject matter experts (SME) identifiedMedia Intake Form – PIO SOGLocation for press briefing establishedEDS communication plansPublic Information Officer Job Action Sheets (JAS)PIO Job Action Sheets (JAS)Public Information Officer ChecklistsRegion 1 PIO SOGMedia Contact Lists, Including Functional/Access Needs MediaMedia Contact Lists; Mass211 FORMCHECKBOX Review/Revise the Risk Communication Plan/Media Policies with the EMD, PIO, CEO, JIS/JIC, based on the Incident Action Plan Risk Communication Plan Communications Plan (ICS 205) FORMCHECKBOX Determine the essential messages/ public information FORMCHECKBOX Situational Awareness FORMCHECKBOX Flood Water risks: flooded wells/septic; roads; food contamination FORMCHECKBOX Power Outage risks: set frig/freezer colder; pack with ice FORMCHECKBOX Loss of drinking water: store water in clean containers FORMCHECKBOX Cook and cool food in advance FORMCHECKBOX Disease/injury prevention FORMCHECKBOX When/where to seek medical advice/ treatment FORMCHECKBOX Universal accommodations for access/ functional needs FORMCHECKBOX Sources of safe food and water FORMCHECKBOX Agricultural AdvisoriesDisease and injury fact sheetsFunctional and Access Needs communication plan.Interpreter Strike Team FORMCHECKBOX Determine how you will notify the publicSlower Methods: FORMCHECKBOX Newspapers FORMCHECKBOX Printed handouts FORMCHECKBOX Websites FORMCHECKBOX TV; descriptive TV FORMCHECKBOX Simultaneous interpretation (live & internet/video relay)Faster Methods: FORMCHECKBOX Outgoing 911 FORMCHECKBOX Social Media FORMCHECKBOX Radio FORMCHECKBOX Hotlines FORMCHECKBOX Mass 211 FORMCHECKBOX FORMCHECKBOX Sources of more information FORMCHECKBOX Websites FORMCHECKBOX Hotlines FORMCHECKBOX Mass 211 FORMCHECKBOX Local media FORMCHECKBOX Twitter FORMCHECKBOX Facebook FORMCHECKBOX Draft messages appropriate to media used and public reachedMultiple languages and formatsPress/media releasesUpdated frequentlyVolunteer/donation opportunities FORMCHECKBOX Brief Incident Spokesperson(s)3 key messagesMessage Map Worksheet –PIO SOG FORMCHECKBOX Monitor public reaction and establish methods for public interaction/information exchangeMedia Contacts: General and Functional and Access Needs FORMCHECKBOX Hotlines FORMCHECKBOX Mass 211 FORMCHECKBOX Email FORMCHECKBOX Social MediaIssuing messages on Social Media facilitates monitory of Social Media FORMCHECKBOX Issue Public Information, Warnings, NotificationsCoordinate messages with FORMCHECKBOX Other jurisdictions FORMCHECKBOX DPH/MEMA/DEP/DMH FORMCHECKBOX ARC FORMCHECKBOX Interpreter Strike Team FORMCHECKBOX Functional and Access Needs AgenciesICS 223: Health and Safety MessageC-MIST strategies and plansRespond to media enquiriesICS Media Enquiry FormHold press alerts and conferences as neededICS 306: Press ReleaseBrief spokespersons on key messages (Not usually the PIOs)ICS 223 – Health & Safety MessageEnsure Incident Commander approval of all information releases1.5 Review Emergency Plans, Policies and ProceduresResources/Notes FORMCHECKBOX Review Public Health Legal Authority and PlansReview Continuity of Operation (COOP)Boil and do not use ordersStanding orders (local and/or State)Authority to close buildings/businesses/schoolsLiability issues Legal Council should be consulted FORMCHECKBOX Review Public Water Supplies Emergency Plans FORMCHECKBOX Review Food Establishment Emergency PlansFood Establishment Emergency Plans FORMCHECKBOX Review Emergency Dispensing Site Plans if appropriateEDS Plans and EDS SOG FORMCHECKBOX Review IT/Data Management Systems and Protocols FORMCHECKBOX Assist IC with development of the Incident Action Plan (IAP) Incident Action Plan FORMCHECKBOX Use ICS EDS formsIncident Objectives (ICS 202)Division/Group Assignments (ICS 204Organizational Assignment (ICS 203)Incident Map (ICS 225)Communications Plan (ICS 205), Medical Plan (ICS 206)1.6 Assess Logistical Needs/Resources (What is needed?)Resources/NotesBegin tracking expenses and staff/volunteer timeCheck with Finance for forms FORMCHECKBOX Medical Supplies; Personal Protective Equipment for Responders FORMCHECKBOX Other SuppliesForms and information sheetsPH Inventory ListMarkers and Sign BoardsEDS suppliesComputers, printersCrowd control devicesEDS supplies FORMCHECKBOX Functional and Access Needs TranslatorsBehavior Health StaffMRC/DMHSigns/forms in multiple languagesEDS supplies FORMCHECKBOX Staffing Needs Organizational Assignment List (ICS 203)Number of staff/volunteers neededDivision/Group Assignment List (ICS 204)Number of shiftsCredentialing requirements, especially for unaffiliated volunteersBreak area and food / water FORMCHECKBOX Communication Resource NeedsRisk Communication (See Risk Communication Logistics Below)Tactical Communications: Radios, Phones, Internet, HAM FORMCHECKBOX Type and content of needed educational materials/methods FORMCHECKBOX Set-up a Medical Material Tracking and Reporting System if needed FORMCHECKBOX Required forms, documentation, paperworkRisk Communication Logistical (people/supplies) Needs Resources/NotesComputer; Power and Extension CordsWireless RouterMultiple phone linesFax, printer, scannerPaper, pens, clipboardsMicrophone, CameraTV and Radio accessConsider using HAM radiosTables and chairsInternet: Website, Email, Social MediaMessage MapsPre-written messages1.7 Document All Expenditures and Response ActionsResources/NotesTrack/document all expenses and staff/volunteer timeResponsible Parties may be liable for all documented expenditures FORMCHECKBOX Establish contact with Finance/Administration Section Chief and obtain reporting formsThis is likely to be a Municipal Procurement/Finance Official FORMCHECKBOX Establish contact with Logistics/Planning Section Chiefs FORMCHECKBOX Review MOUs and MAA FORMCHECKBOX Assign a person to be responsible for data collection FORMCHECKBOX Track all Equipment/Resource Requests/AllocationsWork with LogisticsName of Equipment/Resource RequestedHourly Rate EstablishedPerson RequestingRole of person requestingTasks needed forWhere neededDate/time neededFollow up FORMCHECKBOX Track all Staff/Volunteer Time and OvertimeNameTime InTime OutTasks/Assignments FORMCHECKBOX Track all Illness or Injuries related to the Response FORMCHECKBOX Track Relocations/Reallocations FORMCHECKBOX Work with Medical providers/Hospitals to create common Medical Tracking protocols FORMCHECKBOX Establish a system for tracking/managing donationsWork with Logistics/Planning FORMCHECKBOX Continually submit required forms, documentation, paperworkOperations: Food and Water Emergency Response2.1 Provide Advice to Incident Commander; First RespondersResources/NotesMaintain communications with the Incident Commander; Emergency Operation Center; response partnersConsider a Public Health Emergency Response Team (ERT) to plan for multiple operational periods (COOP) FORMCHECKBOX Monitor the Situation and Identify and Report Risks. Consider:Power outages at Food Establishments/PWSEnvironmental and toxic materials hazards and spillsRisks/Protective Actions: Source, Transmission, MitigationDisease and injury informationPersonal Protective Equipment (PPE) Sampling/Testing needs and proceduresSanitization ProtocolsDamage to food supplies: fresh, frozen, dried, cannedDrinking Water contamination, including private wellsDrinking Water distribution must be from an approved source and delivered in food safe containersAgricultural Risks due to contaminationDebris and Waste ManagementConsider contacting all Food Establishments (FE) to establish communications and to alert them to the need for an Emergency PlanConsider triaging FE. National Chains often have robust Emergency Plans and Procedures. Spontaneous Feeding Operations may require the most oversight. FORMCHECKBOX Provide:Technical Assistance, Advise, ContactsEquipment/Supplies2.2 Contact PWS, Food Establishments, Institutions, HomesResources/NotesMonitor and ensure safe Food and Water FORMCHECKBOX Public Water Supplies (PWS):Emergency Action Plans (EAC)Contamination (chemical, bacterial, radiation, viral, particulates)System Issues: cross Connections, power loss, staffing issues, system damage, leaks Liaison with DEPStatus of notifications to water usersIssue boil, do not drink, do not use, other water use ordersNote: While PWS are primarily a DEP responsibility, the BOH has coordinate powers to ensure safe water supplies. FORMCHECKBOX Private Well Issues:Ground water contamination from spills and floodingSurface water contamination; spills, flooding, pollution Alternative potable water supplies identifiedIssue boil, do not drink and do not use orders FORMCHECKBOX On-Site Septic Systems Issues:Do not use when floodedPower loss for pump or I/A systemsSpread lime to cover sewage spills FORMCHECKBOX Emergency Plans for Food Establishments (schools, institutions, camps, Long Term Care (LTC): How will the FE Continuity of Operations Plan (COOP) and Emergency PlansKnowledgeable Person in Charge on each shiftWorkforce reductions and protectionAlternative Potable Water SupplyAlternative refrigeration (generators, dry ice)Solid Waste and Sewage managementReduced menu Emergency Action PlansAlternative hand and ware washing protocolsUse of disposables as alternativesHeat, hot water, cooking, ventilation, lightingClosing; Re-opening, Inspections required – Call firstFood temperatures: discard after 4 hours @ 40 F – 140FContamination Assessment: fire, flooding, radiation, freezing, heat, chemicals, bacterial, viral, toxins, Fitness of Food: Sorting, condemnation, disposalDonations of Food: must meet Safe Food StandardsSee: BCBOHA Food Establishment Emergency Plan - State and Federal Food Code Guidance for Emergency Action Planning for Retail Food Establishmentsdph Food Establishment Inspection Form 2.3 Monitor and Ensure Safe Food and WaterResources/NotesMonitor Safe Food/Water, including all public food and water preparation/points of distribution FORMCHECKBOX Conduct inspections, sampling and monitoringMonitor for disease outbreaksSanitary Surveys and AssessmentsProvide Environmental Health Inspections for mass shelters, feeding, & care; First Responder feeding stations, Points of Distribution for food, water or iceSampling, Testing and interpreting results FORMCHECKBOX Determine Appropriate Types of Food Service:Pre-prepared, packaged mealsCatering services with appropriate resources/skillsPermitted/licensed mobile Kitchen with experienced/licensed volunteers(Red Cross, Salvation Army, Kiwanis)Church, community group, volunteers with a knowledgeable Person-in-Charge (PIC) operating an emergency mobile commissary as a BOH permitted Temporary Food Establishment FORMCHECKBOX Monitor Bulk Drinking Water/Ice Distribution:Drinking water/ice must be from an approved/tested source.Drinking water should only be transported/distributed in food safe containers that have been properly disinfected and have no galvanized metals or other toxic materials. Remember ice can be contaminated with bacteria and other contaminants Monitor Donated Food and Volunteer Feeding OperationsTriage feeding operations to ID higher risk operationsRequest that Responders report temporary food operationsDonations of food: Log all food donations; must meet Safe Food Standards and be from known/commercial/approved sourcesAll donated food must be prepared in an approved kitchen with a safe water potable water supplyPerson in Charge (PIC) must have a current food safety (ServeSafe) certification; demonstrate knowledge of food safetyExamples of Spontaneous Feeding Operations include church dinners; community centers; volunteer outdoor kitchens.Chains and Food Establishments with strong Emergency Action Plans may need less support during an emergency. FORMCHECKBOX Monitor Safe Food Handling Practices: When in doubt, throw it outGood lighting and ventilation when preparing or cooking foodControlled access to food preparation/storage areasFood Prep Area: clean and sanitize often 5-6% unscented bleach)Reduced menus: offer fewer potentially hazardous foods (PHF - items that need refrigeration)Use thermometers to monitor temperatures or time logs as the control (4 hours and throw out)Food holding: log time/temperatures on hot/cold foodsHot/cold food holding: above 140 F. / below 40 F.Re-heat ONCE in 2 hours to 165 F.Discard food after 4 hours out of temperature controlRefrigeration (or generators, ice, dry ice)Hand-wash station (must label) with pump soap and paper towels a MUST + use disposable gloves (non-latex) for RTE foodsWash, rinse and sanitize (sanitizing tablets or chlorine drops) all utensils and food work servicesFood Storage: secure and off the floor if possibleSafe Ice/Drinks (treat drink tubs with 1 tsp. bleach/5-8 gallons)Be aware of Food Embargoes/Fitness of FoodMonitor for contamination: chemical, bacterial, radiation, viral, particulate matterFollow all Boil and other water use OrdersSolid Waste management (trash, garbage, medical waste) at least 3 times per day to prevent pestsMay sanitize with unscented bleach.Wear protective gloves; don’t mix with other chemicals like ammoniaFreezing will NOT disinfect water.Sanitize flooded surfaces: 1 cup bleach in 5 gallonsSanitizing Food Surfaces: 1 Tablespoon bleach per gallon of clean water. At least 1 minute of contact time.Food Washing: 8 drops of bleach per gallon of clean water – at least 1 minute contact time. 2.4 Provide Risk Communications; Public Information WarningResources/NotesAt-risk and functional needs individualsIndividuals with compromised immune systemsWater use orders, advisories, alternate sourcesDisease risks and informationWater filtering and disinfection proceduresAgricultural Advisories; Wildlife Warnings; Pest WarningsClosings and embargoesCross contamination warnings: Food, water, animals, peoplePerishables: contaminated, suspect, temperaturesSee PIO SOG Conduct Disease Surveillance/InvestigationsResources/NotesMaintain disease surveillance system in cooperation with the hospitals, health care providers; DPH; EMS FORMCHECKBOX Coordinate with the Public Health Nurse (or VNA)Monitor MAVENContact/coordinate with Hospitals (Infection Control); DPH, EMSWaterborne: Typhoid, cholera, dysentery, infectious hepatitis, giardia, cryptosporidium, E. coliFoodborne: hepatitis A, salmonella, listeria, campylobacter, staphylococcus toxin, botulism toxin (Clostridium)MDPH - Guide to Surveillance, Reporting and Control section 3 and 4 of related disease chapter2.6 Use BOH Authority to Issue Orders and Obtain InformationResources/NotesBoil, Do Not Drink, and Do Not Use ordersDPH Guidance and OrdersClosings, embargos, condemnation, disposal FORMCHECKBOX Establish Emergency Dispensing Site (EDS) if neededEDS SOG FORMCHECKBOX Ongoing ActivitiesContinue monitor the situation and develop action plans ICS 215 Operational PlanningICS Forms completedContinue to monitor personnel/staffingICS 211 Check In ListMonitor and report all ExpensesDocument all response activitiesFollow Up on Actions Taken: ensure all actions completed; close loopsPlan for extended operationsRisk CommunicationsResources/Notes FORMCHECKBOX Continue to develop Media Messages as conditions changeUpdate and inform the public of risks and prevention strategiesConsider animal and agricultural needs as well FORMCHECKBOX Monitor Social Media to keep ahead of rumors FORMCHECKBOX Maintain communication with other Responders and jurisdictions to ensure that messages are consistent, timely and accurateRecoveryRecoveryResources/Notes3.1 Lift orders that are no longer needed3.2 Support Recovery; work with VOAD (Voluntary Organizations) FORMCHECKBOX Inspect and Clean all facilities and return them to normal operations FORMCHECKBOX Return to normal operations: Food Establishments; PWS , Homes3.3 Support debris and waste management; Environmental CleanupCoordinate with DEP; FEMA FORMCHECKBOX Disposal of solid/medical wastes coordinated with DPH/DEP/BOH FORMCHECKBOX Lime areas near homes with flooded septic systems3.4 Submit forms for emergency expenditures and other dataICS 221: Demobilization Checkout FORMCHECKBOX Work with Accounting to comply with FEMA; other re-imbursement3.5 After Action Report with Improvement Plan and revise plans HSEEP After Action Report templateRisk CommunicationsResources/Notes FORMCHECKBOX Continue to develop Media Message as conditions change:Update and inform the publicMethods of reporting illnesses; symptomsReported suspected foodborne to BOHSources of additional information and helpMass211Volunteer opportunities, including spontaneous unaffiliated vol.(SUV) CERT, MRC, ARC, VOAD, MAResponds FORMCHECKBOX Monitor Social Media and other Jurisdictions to ensure accuracyAcronyms: Functions:AARAfter Action Report Written to document/ improve emergency response actionsARCAmerican Red CrossVoluntary agency providing sheltering/feeding supportBOHBoard of HealthLocal agency with coordinate powers with the State DPHCBOCommunity Based OrganizationIncludes Faith and voluntary organizations and businessesCEOChief Elected Official Selectmen, Mayors, and others responsible for a communityCEMPComprehensive Emergency Management PlanEach community has a detailed plan for emergenciesCERCCrisis + Emergency Risk CommunicationsPlan that outlines Risk Communications during emergenciesCERTCommunity Emergency Response Team Trained Citizen Core volunteersCOOPContinuity of Operations PlanBackup plans/strategies for people, roles, facilities, resourcesCORICriminal Offender Record InformationBackground check required by most volunteer organizationsDEPDepartment of Environmental ProtectionState agency responsible for clear air, water and soilDPHDepartment of Public HealthState Agency responsible for public health and safetyEACEmergency Action PlanPre-event, all hazards plans for an agency or organizationEDSEmergency Dispensing SitePublic mass prevention/treatment medical materialsEMDEmergency Management Director Appointed by CEO; plans /supports emergencies; operates EOCEOCEmergency Operations Center Supports Emergency response; coordinates emergency resourcesERTEmergency Response TeamCoordinated team to cover multiple operational periods/tasksESFEmergency Support Function15 Federally designated emergency response functions/areasFEFood EstablishmentServes retail food to the public: free or paid; needs BOH permitFEMAFederal Emergency Management AgencyFederally designated emergency response organizationFNSSFunctional Needs Support ServicesAdditional services for individuals with functional/access needsHAMSAmateur Radio OperatorsLicensed, non-paid radio operatorsICIncident CommanderPerson in charge of an Incident; usually most qualifiedICPIncident Command PostLocation near the Incident used to coordinate operationsICSIncident Command SystemFederal emergency response system; Minimum ICS 100/700 IPImprovement PlanPlan outlines needed improvements, person to implement; timeIRAAIndividuals Requiring Additional AssistanceFunctional and Access Needs: At-Risk; Elderly; Poor; etc.JASJob Action SheetCheck list of roles and ResponsibilitiesJICJoint Information CenterMay be real or virtual center to coordinate informationJISJoint Information SystemUsually a virtual system to coordinate multiple PIO/CentersLEPCLocal Emergency Planning CommitteeState required multi-discipline group to plan for HazMat spillsLTCLong Term Care FacilityNursing Homes; group homesMARespondsMassachusetts volunteer electronic pre-registration systemMass2112-1-1 line used to provide information; reduces use of 9-1-1MEMAMassachusetts Emergency Management AgencyMassachusetts version of FEMA; provides support/resourcesMRCMedical Reserve CorpsPre-trained, credentialed volunteers; both medical/non-med.NPINon-Pharmaceutical InterventionIncludes strategies such as isolation/quarantine, hand-washingPHFPotentially Hazardous FoodsGenerally foods that require refrigerationPHNPublic Health Nurse Works for the BOH to provide disease surveillance/investigationPICPerson in Charge Knowledge/trained person in charge of a Food EstablishmentPIOPublic Information OfficerDesignated person who manages/plans public informationPHILPublic Health Information Hot LineDesignated number for the Public to ask questions/gain infoPODPoint of DistributionSite where food, water, supplies, medicines are dispensedPPEPersonal Protective EquipmentOften includes N95 face mask/respirator, gloves, glasses, suitsPWSPublic Water Supply Designated/regulated by DEP; serves 25+people /60+ daysREPCRegional Emergency Planning CommitteeRegional LEPC; many are also all hazard planning groupsRTEReady to Eat FoodFoods that require no further preparation to eatSEOCState Emergency Operations CenterState EOC provides 15 ESF support functionsSMESubject Matter Experts Individuals with special knowledge: college professors, doctorsSNSStrategic National StockpileFederal stockpiles of Medical Materials ready to distribute in 24hrs.SUVSpontaneous Unaffiliated Volunteer General public with no special emergency training)SOGStandard Operating GuideCommon operating picture; standard procedures; remindersUCUnified CommandUsed when a response is multi-agencyVOADVoluntary Organization Active in Disaster CBO in emergencies such as Red Cross; Salvation ArmyVNAVisiting Nurse Association Provides home medical care; may function as PHN nurseName: Address:FOOD ESTABLISHMENT INSPECTION REPORT Tel. NameDateType of Operation(s) FORMCHECKBOX Food Service FORMCHECKBOX Retail FORMCHECKBOX Residential Kitchen FORMCHECKBOX Mobile FORMCHECKBOX Temporary FORMCHECKBOX Caterer FORMCHECKBOX Bed & BreakfastPermit No.Type of Inspection FORMCHECKBOX Routine FORMCHECKBOX Re-inspectionPrevious InspectionDate: FORMCHECKBOX Pre-operation FORMCHECKBOX Suspect Illness FORMCHECKBOX General Complaint FORMCHECKBOX HACCP FORMCHECKBOX Other___________AddressRisk LevelTelephoneOwnerHACCP Y/N Person-in-Charge (PIC)TimeIn:Out:InspectorEach violation checked requires an explanation on the narrative page(s) and a citation of specific provisions violated. Violations Related to Foodborne Illness Interventions and Risk Factors (Italics/Red)Anti-Choking Tobacco Allergen Awareness590.009 (E) FORMCHECKBOX 590.009 (F) FORMCHECKBOX 590.009 (G) FORMCHECKBOX Violations marked may pose an imminent health hazard and require immediate corrective action as determined by the Board of Health.FOOD PROTECTION MANAGEMENT FORMCHECKBOX 1. PIC Assigned/Knowledgeable/Duties EMPLOYEE HEALTH FORMCHECKBOX 2. Reporting of Diseases by Food Employee and PIC FORMCHECKBOX 3. Personnel with Infections Restricted/ExcludedFOOD FROM APPROVED SOURCE FORMCHECKBOX 4. Food and Water from Approved Source FORMCHECKBOX 5. Receiving/Condition FORMCHECKBOX 6. Tags/Records/Accuracy of Ingredient Statements FORMCHECKBOX 7. Conformance with Approved Procedures/HACCP PlansPROTECTION FROM CONTAMINATION FORMCHECKBOX 8. Separation/Segregation/Protection FORMCHECKBOX 9. Food Contact Surfaces Cleaning and Sanitizing FORMCHECKBOX 10. Proper Adequate Handwashing FORMCHECKBOX 11. Good Hygienic Practices FORMCHECKBOX 12. Prevention of Contamination from Hands FORMCHECKBOX 13. Handwash Facilities PROTECTION FROM CHEMICALS FORMCHECKBOX 14. Approved Food or Color Additives FORMCHECKBOX 15. Toxic ChemicalsTIME/TEMPERATURE CONTROLS (Potentially Hazardous Foods) FORMCHECKBOX 16. Cooking Temperatures FORMCHECKBOX 17. Reheating FORMCHECKBOX 18. Cooling FORMCHECKBOX 19. Hot and Cold Holding FORMCHECKBOX 20. Time as a Public Health ControlREQUIREMENTS FOR HIGHLY-SUSCEPTIBLE-POPULATIONS (HSP) FORMCHECKBOX 21. Food and Food Preparation for HSPCONSUMER ADVISORY FORMCHECKBOX 22. Posting of Consumer Advisories Number of Violated Provisions Related To Foodborne Illnesses Interventions and Risk Factors (Red Items 1-22): Violations Related to Good Retail Practices (Below Items) Critical (C) violations marked must be corrected immediately or within 10 days as determined by the Board of Health. Non-critical (N) violations must be corrected immediately or within 90 days as determined by the 23. Management and Personnel (FC-2)(590.003)24. Food and Food Protection (FC-3)(590.004)25. Equipment and Utensils (FC-4)(590.005)26. Water, Plumbing and Waste (FC-5)(590.006)27. Physical Facility (FC-6)(590.007)28. Poisonous or Toxic Materials (FC-7)(590.008)29. Special Requirements (590.009) 30. OtherInspector’s Signature:Print:Page___ of___ PagesPICs Signature:Print:Official Order for Correction: Based on an inspection today, the items checked indicate violations of 105 CMR 590.000/federal Food Code. This report, when signed below by a Board of Health member or its agent constitutes an order of the Board of Health. Failure to correct violations cited in this report may result in suspension or revocation of the food establishment permit and cessation of food establishment operations. If aggrieved by this order, you have a right to a hearing. Your request must be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order.Orders and DATE OF RE-INSPECTIONGuidance for Emergency Action Planning for Retail Food Establishments Massachusetts Food Protection Program ASKED QUESTIONS REGARDING BOIL WATER ADVISORIESWhat is the proper way to disinfect my water so that it is safe to drink? The preferred method of treatment is boiling. Boiling water kills harmful bacteria and parasites (freezing will not disinfect water). Bring water to a full rolling boil for at least 1 minute to kill most infectious organisms. For areas without power add 8 drops, about ? teaspoon, of unscented household beach per gallon of water. How should I wash my hands during a boil water advisory? Based on the current conditions of the affected public water supplies, vigorous hand washing with soap and your tap water is safe for basic personal hygiene. If you are washing your hands to prepare food, if at all possible, you should use boiled (then cooled) water or bottled water with hand washing soap. Is potentially contaminated water (where Cryptosporidium is not the significant contaminant) safe for washing dishes or clothes? Yes, if you rinse hand-washed dishes for a minute in a bleach solution (1 tablespoon bleach per gallon of water). Allow dishes to completely air dry. Most household dishwashers do not reach the proper temperature to sanitize dishes. It is safe to wash clothes in tap water. Is potentially contaminated water safe for bathing and shaving? The water may be used for showering, baths, shaving and washing, so long as care is taken not to swallow or allow water in eyes or nose or mouth. Children and disabled individuals should have their bath supervised to ensure water is not ingested. The time spent bathing should be minimized. Though the risk of illness is minimal, individuals who have recent surgical wounds, are immunosuppressed, or have a chronic illness may want to consider using bottled or boiled water for cleansing until the advisory is lifted. How should I wash fruit and vegetables and make ice? Fruits and vegetables should be washed with boiled (then cooled water) or bottled water or water sanitized with 8 drops (about ? teaspoon) of unscented household bleach per gallon of water. Ice should be made with boiled water, bottled water or sanitized water. What if I have already consumed potentially contaminated water? Even if someone has consumed potentially contaminated water from either a public water system or a private well before they were aware of the boil water advisory, the likelihood of becoming ill is low. Anyone experiencing symptoms such as diarrhea, nausea, vomiting, abdominal cramps, with or without fever, should seek medical attention. What infectious organisms might be present in contaminated water? Disease transmission from contaminated water occurs principally by ingesting water. The major organisms of concern are protozoa such as Giardia and Cryptosporidium, and bacteria, such as Shigella, E. coli and viruses. These organisms primarily affect the gastrointestinal system, causing diarrhea, abdominal cramps, nausea, and vomiting with or without fever. Most of these illnesses are not usually serious or life threatening except in the elderly, the very young or those who are immune-compromised.Consumer Information on Boil Orders from MA Department of Environmental ProtectionNote: these apply to consumers, not to food establishmentsBoil water orders or advisories are public announcements advising the public that they should boil their tap water for drinking and other human consumption uses like cooking, hand washing, brushing teeth, etc. Boil water orders are preventative?measures issued to protect public health from waterborne infectious agents that?could be?or are known to be present in drinking water. Boil water orders are issued by the MassDEP Drinking Water Program (DWP) when MassDEP DWP determines that the consumers of a particular public water system should take precautionary measures with their tap water.When a boil order or advisory is issued the local public water supplier (PWS) must take appropriate corrective action, continue to monitor its water supply, and notify customers when it has remedied the problem and the boil water order is lifted. The? HYPERLINK "" \t "_blank" PWS should be contacted?for details, and in limited instances, consumers may find more information on their?city or town's web site. For general information on boil water orders consumers may also check the MassDEP or US EPA website and fact sheets on contaminants.Below are general precautions MassDEP recommends you take when a boil water order has been issued for your community.General PrecautionsDISCARD?any ice, juice, formula, stored water and uncooked foods that were prepared with tap water during the period of concern.USE BOILED OR BOTTLED WATER?for drinking, food preparation, mixing baby formula, making ice, washing food, manual utensil and equipment washing, rinsing and sanitizing, brushing teeth or any other activity involving the consumption of water.CHILD CARE CENTERS AND SCHOOLS?should use only bottled or boiled water for mixing infant formula, hand washing, and for mixing sanitizing solutions for diapering areas and surfaces such as tabletops and toys. Adult employees should use a hand sanitizer after washing hands with tap water and soap. Do not use drinking fountains and discontinue the use of water play tables. Follow all guidance provided by the Massachusetts Department of Education (DOE) and/or the Massachusetts Department of Early Education and Care (DEEC).RETAIL FOOD ESTABLISHMENTS?must follow the guidance of the local board of health and the Massachusetts Department of Public Health (MassDPH). Wholesale food manufacturers must follow the guidance of MassDPH. Meat processing plants must follow the guidance of MassDPH and the United States Department of Agriculture.SWIMMING POOLS, HOT TUBS, AND SPAS?that are operated properly, including routine monitoring for adequate disinfection levels, may continue to operate.SHARE THIS INFORMATION?with all other people who drink this water, especially those who may not have received this notice directly (for example, visitors). You can do this by posting this notice in a public place or distributing copies by hand or mail.TRANSLATE THESE PRECAUTIONS?for anyone who does not understand English.Tips for drinking water use during a boil orderThere are two simple and effective methods you can use to treat drinking water for microbiological contaminants (bacteria).Boiling:?Bring the water to a rolling boil for at least 1 minute. Laboratory data show this is adequate to make the water safe for drinking.Disinfecting:?Disinfectant tablets obtained from a wilderness store or pharmacy may be used. In an emergency, liquid chlorine bleach such as CloroxTM?or PurexTM?can be used at a dose of 8 drops (1/8 teaspoon) of bleach to each gallon of water. (Careful measurement with a clean dropper or other accurate measuring device is required when using liquid chlorine bleach.) Let stand for at least 30 minutes before use. Read the label to see that the bleach has 5-6% chlorine.Specific ActivitiesWashing DishesYou may use a dishwasher if it has a sanitizing cycle. If it does not have a sanitizing cycle, or you are not sure if it does, you may hand wash dishes and utensils by following these steps:Wash the dishes as you normally would.As a final step, immerse the dishes for at least one minute in lukewarm water to which a teaspoon of bleach per gallon of water has been added.Allow the dishes to completely air dry.You may also use boiled and cooled water or bottled water.Young children should be given sponge baths rather than put in a bathtub where they might ingest the tap water. Adults or children should take care not to swallow water when showering.Brushing your TeethUse only disinfected or boiled water for brushing your teeth.IceIce cubes are not safe unless made with disinfected or boiled water. The freezing process does not kill the bacteria or other microorganisms.Washing Fruit and VegetablesUse only disinfected or boiled water to wash fruits and vegetables that are to be eaten raw.Hand WashingYou should wash your hands with soap and boiled water, or soap with bottled water. If only tap water is available, it is best to use an alcohol-based hand sanitizer after you wash your hands. If neither is possible and your hands have been exposed to germs, such as after using the bathroom, washing with warm tap water and soap and thoroughly drying your hands is much better than not washing them at all. In these instances, try to keep your hands away from your mouth and use a hand sanitizer as soon as possible after you're done.CookingBring water to a rolling boil for 1 minute before adding food.InfantsFor infants use only prepared canned baby formula that is not condensed and does not require added water. Do not use powdered formulas prepared with contaminated water.Houseplants and GardensWater can be used without treatment for watering household plants and garden plants. The exception would be things like strawberries or tomatoes where the water would contact the edible fruit.House PetsThe same precautions taken to protect humans should be applied to pets. Aquatic organisms (e.g. fish) should not be exposed to water containing elevated levels of bacteria. If the organism's water needs to be refreshed, use appropriately boiled or bottled water.Flush All Taps When the Boil Water Order Is LiftedWhen flushing it is important to carefully follow the instructions provided. Flush your household and building water lines including: interior and exterior faucets, showers, water/ice dispensers, water treatment units, etc. Water heaters may need to be flushed to remove any contaminated water. Some types of water treatment devices may need to be disinfected or replaced before being used. Check with the manufacturer for details.Additional ResourcesDrinking Water Safety LookupFind more information about Boil, Do Not Drink & Do Not Use orders in cities and towns in MassachusettsWeb page : Boil Water OrderFrequently asked questions about boil water orders.Web page for Post-Boil-Water OrdersGuidance for flushing water lines following a boil-water order. May 2010.Web page Town/City Web SitesList of Massachusetts town/city web sites, organized alphabetically.Web page Department of Public Health - Guidance for Emergency Action Planning for Retail Food EstablishmentsPractical guidance for retail grocery and food service establishments to plan and respond to emergencies that create the potential for an imminent health hazard.DPH Web Site for Disease Control and Prevention (CDC)Renal Dialysis Units during a Boil Water AdvisoryPractical guidance for dialysis units if a boil water advisory is in effect.CDC Web site Demand in Health Care Facilities during Water Disruption EmergenciesList of uses for which safe water will be required during a water-advisory situation.CDC Web site for Post-Boil-Water OrdersResidents are advised to "flush" their water following the lifting of a boil order in order to clear plumbing of potentially contaminated water. Flushing your household and building water lines includes interior and exterior faucets; showers; water and ice dispensers; water treatment units, etc. Please use the following guidance:Cold Water Faucets:?Run tap water until the water feels cold, one minute or more, before drinking tooth brushing, or using for food preparation.?If you have a single-lever faucet, set it to run the cold water first.Hot Water Faucets:?To clear hot-water pipes and water heater of untreated water, change all faucets to hot water and flush for a minimum of 15 minutes for a typical household 40-gallon hot-water tank, 30 minutes for an 80-gallon hot water tank or larger. Hot water is then safe to use for washing hands, and for hand washing of dishes, pots and pans, etc. Never use water from the "hot" faucet for drinking, cooking, or other internal-consumption purposes.Dishwashers:?After flushing hot water pipes and water heater, run dishwasher empty one time.Humidifiers:?Discard any water used in humidifiers, Continuous Positive Airway Pressure (CPAP), oral, medical or health care devices, and rinse the device with clean water.Food and baby formula:?Discard baby formula and other foods prepared with water on the day or days of the boil order. (If unsure of the dates contact your water department.)Refrigerator water-dispensing machine:?Water dispensers from refrigerators should be flushed by at least one quart of water. If unsure of your dispenser's capacity, refer to manufacturer specifications.Ice cubes:?Automatic ice dispensers should be emptied of ice made during the boil order and run through a 24-hour cycle, discarding the ice to assure purging of the icemaker water supply line. For medical, dental, and food service establishments, please refer to the guidance on the Massachusetts Department of Public Health?website.Due to the flushing of the lines by residents and the flushing of the hydrants, some customers may experience a lack of water pressure and/or discolored water. However, this is an expected result and does not pose an immediate health risk. Contact your l ................
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