N.J. Admin. Code § 8:43J-10.1

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:43J-10.1 - General requirements for dietary services

(a) Dietary services shall be under the direction of a dietitian who meets the requirements in 8:43J-10.2.

(b) The dietitian shall assess the nutritional status and dietary needs of each child as part of the interdisciplinary plan of care and every 60 days thereafter, or more often, if medically necessary.

1. The assessment shall address the presence of:

i. Food allergies;

ii. Metabolic disorders; and

iii. Any special needs related to feeding.

2. The dietitian shall document the results of each assessment in the child's medical record.

(c) Unless dictated otherwise by the child's interdisciplinary plan of care, the facility shall provide a minimum of one meal per day, as well as nutritionally appropriate snacks.

(d) The facility shall provide special diets and supplemental feedings when ordered by the child's primary health care provider.

(e) The facility shall not accept food provided by the child's parent, unless medically indicated and a current, signed agreement exists between the facility and the child's parent addressing the provision of food from sources other than the facility.

(f) The facility shall serve all food and formula under the supervision of the nursing director.

(g) The dietary service shall comply with N.J.A.C. 8:24.

(h) The facility shall make available a current diet manual to personnel in the facility and, if applicable, to the off-site food provider.

(i) The facility shall ensure that meals are planned, prepared and served in accordance with, but not limited to, the following:

1. Menus shall be prepared with regard for the nutritional and therapeutic needs, cultural backgrounds, food habits and personal food preferences of a child and his or her parent;

2. Written, dated menus shall be planned at least 14 days in advance for all diets.

i. The same menu shall not be used more than once in any continuous seven-day period;

3. Current menus with portion sizes and any changes in menus shall be posted in the food preparation and/or serving area and kept, with changes, on file in the dietary service for at least 30 days;

4. Diets served shall be consistent with the diet manual and shall be served in accordance with physicians' orders;

5. Food shall be prepared by cutting, chopping, grinding, or blending to meet the needs of each child;

6. Nutrients and calories shall be provided for each child, as ordered by a physician, based upon Recommended Dietary Allowances, 10th Edition (1989), incorporated herein by reference, as amended and supplemented, Food and Nutrition Board of the National Academy of Sciences, Commission on Life Sciences, National Research Council, adjusted for age, sex, weight, physical activity, and therapeutic needs of the child;

7. Designated staff shall observe meals refused and/or missed and shall document the name of the child and the meal refused and/or missed;

8. Designated staff shall provide assistance with eating, when necessary;

9. The facility shall provide self-help feeding devices;

10. All meals shall be attractive when served to children;

11. The facility shall maintain a record in the serving area for each child, identifying the child by name, and including diet order, known allergies and other information, such as meal patterns when on a calculated diet;

12. The facility shall ensure that all food served is stored and prepared in accordance with acceptable professional standards and at appropriate temperatures; and

13. The facility shall provide a speech-language pathologist to evaluate and monitor a child's ability to chew and swallow food when ordered by the child's primary health care provider.

(j) If food is prepared off-site, the facility shall have a system to inform the caterer each day of the number and types of meals required and any substitutions;

1. Minimum supplies of food (for example, cereal, peanut butter, tuna, canned fruits and vegetables and juices) shall be maintained in facilities with an off-site food preparation system so that simple meals can be prepared in the event there are last-minute requests or emergency situations.

N.J. Admin. Code § 8:43J-10.1