Professional

Food Manager
Certification
Training
Version 4.0

Food
Safety

Center for
Public Health Education

Developed by the NSF Center for Public Health Education

 v

Table of Contents
Chapter 1 – Introduction to Food Safety . . . . . . . . . . . . . . . . . . . .1
1.1 Introduction to Foodborne Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
1.1.1 People at Risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
1.1.2 Potentially Hazardous Foods (Time Temperaature Control for Safety
Food) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
1.1.3 Five Risk Factors for Foodborne Illness . . . . . . . . . . . . . . . . . . . . .5
1.1.4 How to Ensure Food Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
1.2 Rights and Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
1.2.1 Consumer Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
1.2.2 Management Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . .7
1.2.3 Person in Charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Chapter 2 – Hazards and Sources of Contamination . . . . . . . . . .19
2.1 Food Safety Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
2.2 Physical Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
2.3 Chemical Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
2.3.1 Food Allergies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
2.4 Biological Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
2.4.1 Intoxication vs. Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
2.4.2 Bacteria and FAT TOM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
2.4.3 Viruses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
2.4.4 Parasites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
2.4.5 Fungi, Molds and Yeasts . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
2.4.6 Biological Toxins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Chapter 3 – Employee Health and Personal Hygiene . . . . . . . . . .41
3.1 Employee Health and Hygiene . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
3.2 Diseases Not Spread Through Food . . . . . . . . . . . . . . . . . . . . . . . . .45
3.3 Proper Handwashing Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
3.4 Gloves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
3.5 Clothing, Hair Restraints, Jewelry . . . . . . . . . . . . . . . . . . . . . . . . . . .48
Chapter 4 – Safe Food Handling . . . . . . . . . . . . . . . . . . . . . . . . .59

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4.1 Receiving, Storage and FIFO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

4.2 Minimum Cooking Temperatures . . . . . . . . . . . . . . . . . . . . . . . . . . .64
4.3 Thermometer Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67
4.4 Holding Temperatures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
4.4.1 Hot Holding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
4.4.2 Cold Holding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71
4.4.3 Using Time as a Public Health Control for Food Safety . . . . . . . . .72
4.5 Cooling Foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
4.6 Thawing Foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76
4.7 Freezing to Control Parasites in Fish . . . . . . . . . . . . . . . . . . . . . . . . .77
4.8 Date Marking Requirements for Ready-To-Eat Potentially Hazardous
Food (Time/Temperature Control for Safety Food) . . . . . . . . . . . . . . .78
4.9 Cross Contamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
4.10 Checking Product Temperatures . . . . . . . . . . . . . . . . . . . . . . . . . . .82
4.11 Returned Food and Re-Service of Food . . . . . . . . . . . . . . . . . . . . . .83
Chapter 5 – Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93
5.1 Food Equipment, Cleaning and Sanitizing . . . . . . . . . . . . . . . . . . . .94
5.2 Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94
5.3 Sanitizing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97
5.4 In-Place Cleaning and Sanitizing . . . . . . . . . . . . . . . . . . . . . . . . . . .99
5.5 Chemical Usage and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100
5.6 Types of Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101
5.6.1 Refrigeration Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
5.6.2 Cooking Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103
5.6.3 Manual Warewashing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104
5.6.4 Warewashing Machines . . . . . . . . . . . . . . . . . . . . . . . . . . . .105
5.7 Storage of Clean Utensils and Equipment . . . . . . . . . . . . . . . . . . . .106
5.8 Cleaning and Maintenance Schedules . . . . . . . . . . . . . . . . . . . . . .106
Chapter 6 – Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
6.1 Facility Layout, Design and Construction . . . . . . . . . . . . . . . . . . . . .118
6.1.1 Floors, Walls, and Ceilings . . . . . . . . . . . . . . . . . . . . . . . . . .118
6.1.2 Lighting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
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6.2 Handwashing Sinks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120

6.3 Chemicals and Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
6.4 Waste Management Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . .122
6.5 Pests and Pest Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123
6.5.1 Flies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123
6.5.2 Cockroaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124
6.5.3 Rodents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125
6.5.4 Integrated Pest Management . . . . . . . . . . . . . . . . . . . . . . . . . .126
6.6 Potable and Non-potable Water . . . . . . . . . . . . . . . . . . . . . . . . . .127
6.7 Cross Connection Control and Backflow Prevention . . . . . . . . . . . . .128
6.8 Imminent Health Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .129
Chapter 7 - Hazard Analysis Critical Control Points (HACCP) . . .139
7.1 What is HACCP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .140
7.2 Food Safety Hazards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141
7.3 The Seven Principles of HACCP . . . . . . . . . . . . . . . . . . . . . . . . . . .142
7.3.1 Conduct a Hazard Analysis . . . . . . . . . . . . . . . . . . . . . . . . . .144
7.3.2 Identify Critical Control Points . . . . . . . . . . . . . . . . . . . . . . . . .144
7.3.3 Establish Critical Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145
7.3.4 Monitor Critical Control Points . . . . . . . . . . . . . . . . . . . . . . . . .146
7.3.5 Establish Corrective Actions . . . . . . . . . . . . . . . . . . . . . . . . . .147
7.3.6 Validation and Verification . . . . . . . . . . . . . . . . . . . . . . . . . . .148
7.3.7 Recordkeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Appendix A – Bacteria, Viruses and Parasites Tables . . . . . . . .157
Appendix B – Training Your Employees . . . . . . . . . . . . . . . . . . .163
Appendix C – Response to Foodborne Disease Outbreaks . . . . .167
Glossary of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177
Web Sites and Publications on Food Safety . . . . . . . . . . . . . . . .179
Recognized Exam Providers . . . . . . . . . . . . . . . . . . . . . . . . . . .183
Chapter Quiz Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
FDA Forms (Inspection, Health Screening, HACCP) . . . . . . . . . . . . . . . .187
Posters (Cooking Temperatures and Handwashing) . . . . . . . . . . . . . . . . .193

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About This Book

• This course is designed for best presentation when delivered in conjunction with the NSF
HealthGuard™ Training CD-Rom available from NSF for NSF recognized trainers.
• NSF encourages trainers who want to use this course to apply to be an NSF recognized
trainer by completing the trainer application form at www.nsf.org/cphe.
• This course can be taught in 8–16 hours, depending upon the local training requirements.
The training can be delivered as full day sessions or divided into blocks that fit into work
schedules.
• This course will prepare food managers for any of the CFP recognized food manager
exams including Thompson Prometric, and the National Registry of Food Safety
Professionals exams. Exam ordering information can be found at the back of this book.
• NSF International can customize the contents or presentation of this book to meet your
organization’s specific training needs.
• Additional training materials and formats, including self-paced CD-ROM training materials
and NSF HealthGuard® online training are available from NSF.
• This book reflects the 2005 Food Code. A summary of changes can be found at
http://vm.cfsan.fda.gov. The major changes of interest are:
• Updated to reflect the new form for potentially hazardous food (potentially haz-
ardous food (time) temperature control for safer food)
• Revised to identify non-potentially hazardous (TCS)
• New section on returned food and re-service of food
• New section on using time as a public health control for food safety
• New section on date marking
• New section on freezing to control parasites in fish
• Addition of Norovirus to list of diagnosed diseases from which the employee must
disclose to the person-in-charge of the establishment
• Reflects the new term hand antiseptic to replace hand sanitizer
• Adds option on shellstock identification
• Please verify that your local authority has adopted the latest Food Code.

© 2006 - NSF International

2 NSF HealthGuard™ Professional Food Manager Certification

1.1 Introduction to
Foodborne Illness
In order to appreciate the value of food sanitation and
food safety, one needs to understand what can happen
when food becomes unsafe. When basic principles of
food sanitation are ignored and unsafe food is served to
the customer, the potential for illness exists. A food-
Foodborne Illness: any borne illness is any infection or illness that is trans-
infection or illness that is ferred to people by the food they eat.
transferred to people by the
food they eat. Recent estimates indicate that foodborne illness is respon-
sible for approximately 76 million illnesses and 5,000
deaths per year in the United States. Roughly
325,000 Americans will require hospitaliza-
tion this year because of something they ate.
It is difficult to accurately determine the total
cost of foodborne illness in terms of medical
costs, reduced productivity, lost wages, and
human suffering. However, most experts agree
that the annual cost of foodborne illness in the
United States is somewhere between 10 and
83 billion dollars.
While the total impact of foodborne illness on the econo-
my is difficult to measure, the cost to an individual food
establishment is usually much more apparent. An estab-
FDA: an agency of the U.S. lishment that is implicated in a foodborne illness investi-
government that regulates the gation can expect a significant loss of customers and
safety of food and drugs and sales, increased insurance premiums, reduced employee
is responsible for developing
morale, loss of reputation within the community, legal
the Model Food Code.
fees if lawsuits are filed, and in some cases, closure
Model Food Code: a set of ordered by the local health department. In the event that
rules and requirements devel- an establishment is proven to have been the source of a
oped by the FDA to ensure
foodborne disease outbreak, the cost to the establishment
food safety.
will be substantially greater.
Foodborne Disease Out-
break: the occurrence of The 2005 FDA Model Food Code defines a
two or more cases of similar foodborne disease outbreak as “the occurrence
illness resulting from the of two or more cases of a similar illness resulting from the
ingestions of a common
food.
 Chapter 1 – Introduction to Food Safety 3

ingestion of a common food.” It

can be very difficult to determine
when a foodborne outbreak has
occurred. There are several rea-
sons for this. It is estimated that
many foodborne illnesses are not
reported. Despite the fact that
foodborne illnesses can some-
times be life-threatening, individu-
als who have milder symptoms
may shrug off the illness as a
“stomach flu” or “24-hour bug.” These people are less
likely to seek medical treatment or report the condition to
their doctor or local health department. Second, many of Microorganism: tiny organ-
the microorganisms that cause foodborne illnesses isms too small to be seen with
the naked eye.
may also be transmitted through drinking water or by
person-to-person contact, making it difficult to determine
if an illness is actually foodborne.

1.1.1 People at Risk

It is possible that several people eating a meal together
may consume the same foodborne pathogen, but only
Pathogen: microorganisms
some of them develop an illness. This is because some that can cause disease.
people are at a higher risk of contracting foodborne ill-
ness than others. Adults are less likely to get a foodborne
illness if they are healthy and in good physical condi-
tion. People with a higher risk for contracting foodborne
illness include young children, the elderly, pregnant
women, individuals taking certain medications, and
those with weakened immune systems. Infants and
Immune System: the part
young children are more susceptible because their of the body that helps to fight
immune systems are not as fully developed as an adult. off disease and resist infec-
Elderly people have a higher risk because the immune tion.
system begins to weaken with age. For individuals in
higher risk categories, the length and severity of a food-
borne illness can be much greater.

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 Chapter 1 – Introduction to Food Safety 11

Summary
 Foodborne illnesses are responsible for approximately 76 million illnesses
and 5,000 deaths in the United States annually.
 Foodborne illness is preventable.
 Young children, the elderly, individuals with weakened immune systems,
pregnant women, and individuals taking certain medications (such as
immunosuppressants and antibiotics) are at higher risk for contracting
foodborne illness.
 Some types of food are more likely to cause a foodborne illness. These
foods are commonly referred to as potentially hazardous foods.
 A ready-to-eat food is one that receives no further washing or cooking
prior to being eaten. Because these foods receive no further washing or
cooking, contamination of these foods will likely be passed directly to the
consumer.
 The five key risk factors that can result in, or contribute to, foodborne ill-
ness are:
• Food held at improper temperature.
• Inadequately cooked or “undercooked” food.
• Contaminated food equipment (cross contamination).
• Food from an unsafe source.
• Poor personal hygiene practices.

 It is the right of the consumer, when purchasing food, to receive a safe

product that will not cause harm or illness.
 The primary responsibility of any food establishment
is to ensure food safety.
 The FDA Model Food Code recommends that the
person in charge be responsible for ensuring compli-
ance with the Food Code, and being a certified food
protection manager or demonstrating knowledge of
food safety.

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12 NSF HealthGuard™ Professional Food Manager Certification

Introduction to Food Safety Activity #1

A potentially hazardous food (PHF) is defined as: one that supports growth of
microorganisms or has been involved in foodborne disease outbreaks.
Which of the following are considered potentially hazardous foods?

______ Cooked Beans ______ Fish

______ Banana ______ Flour

______ Shellfish ______ Garlic in Oil Mixtures

______ Milk ______ Raw Sprouts

______ Peanuts ______ Hot Fudge

______ Shell Eggs ______ Candy Bar

______ Beef ______ Dry Pasta

______ Pork ______ Baked Potato

______ Cooked Rice ______ Peanut Butter

______ Tofu ______ Sliced Melon

______ Poultry ______ Commercial Mayonnaise

______ Boxed Cereal ______ Pretzels

______ Yogurt ______ Fresh Broccoli

______ Mustard ______ Lobster

 Chapter 1 – Introduction to Food Safety 13

Introduction to Food Safety Activity #2

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14 NSF HealthGuard™ Professional Food Manager Certification

Let’s Discuss…
The local health department received a complaint from a
person who believed he contracted “food poisoning”
from eating at a local restaurant a few days earlier. The
customer ate dinner at the restaurant on Monday and
had a chicken caesar salad, a diet soft drink, and did
not order dessert. The following afternoon, he began
experiencing stomach cramps, headache, nausea, fever,
and diarrhea.
Upon inspection of the restaurant, the health inspector
noted that the commercial caesar salad dressing was
being stored in a small refrigerator near the wait station.
The temperature of the dressing was 38°F (3°C).
The inspector found that the chicken used in the salad
was stored in a large container in the front of the walk-in
cooler. The manager explained to the inspector that the
chicken is grilled in large batches each
morning, cut up, and then placed in a
covered container at the front of the
walk-in. Because the chicken is also used
in the chicken alfredo and the chicken teriya-
ki, they usually needed to prepare more after
the lunch rush. The manager explained that
whenever new batches were made, they
were placed in a clean, separate container
and the empty container was taken to the
dishwasher.
At the time of the inspection, the cook happened to
be preparing another batch of chicken. The inspector
checked the temperature of the chicken in the walk-in
refrigerator that was apparently made earlier in the day
and found it to be at 58°F (14°C). He then took a sam-
ple of the chicken and placed it in a sterile plastic bag in
a cooler to take back to the lab. A few minutes later he
noticed the cook dumping a new batch of chicken into
the same container on top of the chicken left over from
 Chapter 1 – Introduction to Food Safety 15

lunch. This new batch of chicken was at 105°F (40°C).

The inspector noted that the cook never checked the tem-
perature of the chicken.
The inspector informed the manager that he believed the
chicken was not being cooled properly and that the new
batch of chicken just placed in the walk-in may have
been contaminated by the old batch to which it was
added. The inspector asked the manager to throw away
the chicken.
1) Is it possible that this customer got sick from
eating the chicken caesar salad?
2) Is it appropriate for the inspector to have the
suspect chicken thrown out?
3) Has the warranty of sale been violated? Why
or why not?

At the lab, analysis of the cooked chicken sample

revealed high levels of salmonella bacteria. Over the next
few days, 14 new cases of foodborne illness were
reported by people who ate at the restau-
rant on either Monday or Tuesday. Of
the 14 new cases, nine ate the chicken
caesar salad, three ate the chicken Alfredo,
and two ate the chicken teriyaki. Two of the people
who became ill were sick enough to require
hospitalization. One was a woman in her
early 70s, and the other was a two-year-old
boy who ate pieces of chicken from his
mother’s plate. Both people who
received medical attention tested
positive for the same strain of salmo-
nella that was found on the chicken.
4) Is there enough proof that the chicken caused
harm? If so, who is responsible?
5) Why do you suppose more people became ill
after eating the chicken caesar salad?

© 2006 - NSF International