1. NACCHO Program Standards Mentorship
Self-Assessment

2. Objectives: Define Program Standards Self-Assessment
Review FDA Resource Disk (Retail Food Program Standards)
Conducting the “At 1st Glance” Assessment
Versus
Conducting the “Auditable” Self-Assessment
Standard 2 Self-Assessment Overview

3. Program Standards Self-Assessment (SA)
Internal review by program manager or designee
Determines if the existing retail food safety program meets each of the 9 VNRFRPS
SA is a Requirement of Standard 9
Initial SA conducted within 12 months of enrollment
Conducted every 60 months thereafter
Must use latest version of VNRFRPS
SA updates on individual standards

4. Food Establishment Guides Retail Food Program Standards
FDA Resource Disk
Employee Health
Food Code
Food Defense
Food Establishment Guides
Retail Food Program Standards
2011 Version
Risk Factor Study
Standardization

5. Retail Food Program Standards
Standard 1: Regulatory Foundation
Standard 2: Trained Regulatory Staff
Standard 3: Inspection Program Based on HACCP Principles
Standard 4: Uniform Inspection Program
Standard 5: Foodborne Illness & Food Defense Preparedness & Response
Standard 6: Compliance & Enforcement
Standard 7: Industry & Community Relations
Standard 8: Program Support & Resources
Standard 9: Program Assessment
Administrative Procedures for VNRFRPS

6. The “At 1st Glance” Assessment
Basic level of application of each standard’s requirements to the food program
Not time consuming
Not intended to be verified
No completion of SA documentation/worksheets
Identify those standards that there is the potential to meet
Look for common elements across standards (e.g. IN, OUT, NO, NA inspection form)
Can identify gaps, quick fixes, and short or long-term improvements
Today’s Focus: Standard 2 (Option 1)

7. Standard 2 – Option 1 “At 1st Glance”
Resource Disk – Standard 2
Requirement Summary:
Basic considerations:
LHD’s current retail food protection employee training and continuing education program
Availability of training, continuing education, professional credentials, and standardization records for all employees assigned to the retail food protection program who conduct field inspections
Note: Make sure to review the Clearinghouse Q&A interpretations related to Standard 2

8. Standard 2 - Option 1 “At 1st Glance”
Description of Requirement:
Retail food program staff have the KSAs needed to effectively perform their required duties. Consider how this is/can be determined for following “categories” of staff:
Staff conducting food inspections prior to LHD’s enrollment in Program Standards
Staff new to food safety program after enrollment with some prior experience in food regulatory activities
New employee hired after enrollment with no prior experience
Retail food program staff completion of a prescribed step training and standardization process

9. Standard 2 – Option 1 “At 1st Glance”
Questions to consider:
Can you describe or outline your current training curriculum for staff in the different categories?
How do you determine if staff have KSAs needed to perform their duties well and conduct quality inspections?
Do you have in place a method to determine the training needs of staff?
Can you describe your LHD’s standardization process?
Are records easily accessible to verify training, continuing education, standardization activities, maintenance of credentials, etc.?
Note: Keep other standards in mind as you develop the training curriculum!

10. The “Auditable” Self-Assessment
Extensive application of each standard’s requirements to the food program
Much more time consuming and detailed
Meant to provide sufficient verifiable documentation for subsequent verification audit to be successful
Uses the standard-specific worksheets available on the resource disk
Start with performing the SA for those standards that “At 1st Glance” you meet
Devise improvement plans for unmet standards
Can conduct a SA update at any time you feel a standard has been met

11. The “Auditable” Standard 2 – Option 1 Self-Assessment
You will need for reference:
Resource Disk – Standard 2, Self-Assess Guide
Resource Disk – Clearinghouse Work Group Q & A
Listing of employees currently working in the retail food program, including date of hire/assignment to program
Records of completion of a training curriculum
Records of the assessment of each employees KSAs needed to conduct quality inspections (Standard 4)
Records of standardization and re-standardization
Records of contact hours for continuing education relative to retail food work

12. The “Auditable” Standard 2 – Option 1 Self-Assessment
Five elements for training and standardization:
Completion of FDA ORA-U online food curriculum courses (“Pre”-Requisite) – done prior to release
(a) Completion of minimum 25 joint field training inspections with verification that employee has demonstrated KSAs and has ability to conduct independent inspections, AND (b) Completion of the LHD’s field training plan/curriculum
(a) Completion of minimum 25 independent inspections, AND (b) Completion of FDA ORA-U online food curriculum courses (“Post”-Release)
Completion of process similar to FDA Standardization procedures within 18 months of hire/assignment to food program
Completion of 20 contact hours of continuing food safety education every 36 months, part of maintenance of standardization

13. The “Auditable” Standard 2 – Option 1 Self-Assessment
You will need to evaluate each Standard 2 criteria based on Self-Assess Guide:
Criteria 1(a): Verification of Employee Training Records
Standard 2: Self-Assessment Worksheet ; or
LHD’s employee training records; or
Other type of summary record
Criteria 1(b): Confirmation of Pre-Requisite Training Curriculum
LHD’s listing of food program employees at time of SA with date of hire/assignment, and
Records of course completion

14. Complete Standard 2 Self-Assessment Form Employee Training Records
Criteria
Jurisdiction’s
Self Assessment
Auditor’s
Verification
YES NO
Self-Assessor’s
General Comments
If NO, Auditor is to specify why criterion is not met
1. Employee Training Records
a. The jurisdiction maintains a written training record for each employee that includes the date of hire or assignment to the agency’s retail food protection program.
     
b. The jurisdiction’s written training record provides documentation that each employee has completed the Standard #2 pre-requisite (“Pre”) training curriculum PRIOR to conducting independent retail food or foodservice inspections.

15. The “Auditable” Standard 2 – Option 1 Self-Assessment
Criteria 2(a): Staff Completion of 25 Joint Field Training Inspections
Standard 2: Self-Assessment Worksheet ; or
LHD’s listing of food program employees at time of SA with date of hire/assignment; and
Records of 25 joint field training inspections or affidavits of completion of required inspections
Criteria 2(b): Staff Completion of a Field Training Process
Written documentation of field training plan similar to CFP Field Training Manual

16. Complete Standard 2 Self-Assessment Form Initial Field Training
Criteria
Jurisdiction’s
Self Assessment
Auditor’s
Verification
YES NO
Self-Assessor’s
General Comments
If NO, Auditor is to specify why criterion is not met
2. Initial Field Training
a. The jurisdiction maintains a written training record that provides confirmation that each employee completed a minimum of 25 joint field training inspections of retail food and/or foodservice establishments (if less than 25 joint field training inspections are performed, written documentation on file that FSIO has successfully demonstrated all required inspection competencies) PRIOR to conducting independent retail food or foodservice inspections
     
b. The jurisdiction maintains a written training record that provides confirmation that each employee successfully completed a field training process similar to that contain in the CFP Field Training Manual provided in Appendix B-2, Standard 2, PRIOR to conducting independent inspections of retail food and/or foodservice establishments.

17. The “Auditable” Standard 2 – Option 1 Self-Assessment
Criteria 3(a): Staff Completion of 25 Independent Inspections
Standard 2: Self-Assessment Worksheet ; or
LHD’s listing of food program employees at time of SA with date of hire/assignment; and
Records of 25 independent inspections or affidavits of completion of required inspections
Criteria 3(b): Staff Completion of Post Curriculum Training
Records of course completion

18. If NO, Auditor is to specify why criterion is not met
Complete Standard 2 Self-Assessment Form Independent Inspections/Completion of ALL Curriculum Requirements
Criteria
Jurisdiction’s
Self Assessment
Auditor’s
Verification
YES NO
Self-Assessor’s
General Comments
If NO, Auditor is to specify why criterion is not met
3. Independent Inspections / Completion of ALL Curriculum Requirements
a. The jurisdiction maintains a written training record that provides confirmation that each employee completed a minimum of 25 independent retail food and/or foodservice inspections PRIOR to field standardization.
     
b. The jurisdiction written training record provides documentation that each employee has completed ALL aspects of the Standard #2 training curriculum (“Pre”) and (“Post”) courses PRIOR to field standardization.

19. The “Auditable” Standard 2 – Option 1 Self-Assessment
Criteria 4(a): Staff Completion of Initial Field Standardization
Standard 2: Self-Assessment Worksheet ; or
LHD’s listing of food program employees at time of SA with date of hire/assignment; and
LHD’s Procedures for Standardization; and
Records of Standardization within 18 months of hire/assignment
Criteria 4(b): Staff Maintenance of Field Standardization
Records of re-standardization every 36 months

20. Complete Standard 2 Self-Assessment Form Field Standardization
Criteria
Jurisdiction’s
Self Assessment
Auditor’s
Verification
YES NO
Self-Assessor’s
General Comments
If NO, Auditor is to specify why criterion is not met
4. Field Standardization
a. The jurisdiction maintains a written training record that provides documentation that each employee successfully completed a Standardization process similar to the ‘FDA Procedures for Standardization’ within 18 months of hire or assignment to the retail food protection program.
     
b. The jurisdiction maintains a written training record that provides documentation that each standardized employee has maintained their standardization by performing a minimum of 4 joint inspections with a “training standard” every 3 years.

21. The “Auditable” Standard 2 – Option 1 Self-Assessment
Criteria 5(a): Staff Obtains 20 Contact Hours of CEUs Every 3 Years
Standard 2: Self-Assessment Worksheet ; or
LHD’s listing of food program employees at time of SA with date of hire/assignment; and
LHD’s Procedures for Standardization; and
Records of contact hours (various methods recognized)

22. If NO, Auditor is to specify why criterion is not met
Complete Standard 2 Self-Assessment Form Continuing Education & Training
Criteria
Jurisdiction’s
Self Assessment
Auditor’s
Verification
YES NO
Self-Assessor’s
General Comments
If NO, Auditor is to specify why criterion is not met
5. Continuing Education and Training
a. The jurisdiction maintains a written training record that provides documentation that each employee conducting retail food and/or foodservice inspections has accumulated 20 hours of continuing education every 36 months after the initial training (18) months is completed.
     

23. Sample Standard 2 Training RecordNo
Employee
Name
Date of Hire or Assignment to the
Retail Food Program
Completion of Training Pre-requisite
(“Pre”)
Curriculum*
(Prior to conducting independent inspections)
Completion of a Minimum 25 Joint Field Training Inspections*
AND
(successful completion of a field training process similar to the CFP Field Training Manual in Appendix B-2)
Completion of a Minimum 25 Independent Inspections
“Post” Curriculum Courses*
(within 18 months of hire or assignment to the
Retail Food Program)
Completion of Field Standardization*
(within 18 months of hire or assignment to the Retail Food Program)
Number of Education
Contact Hours
(Minimum of
20 Contact Hours every
3 years)
Meets the
Standard 2
Criteria
YES or NO 1
      2 3 4 5 6
Ninety percent (90%) of the staff must meet each training element for the Jurisdiction to meet Standard 2 – Trained Regulatory Staff
Based on the documentation from this worksheet, record your findings for each of the items on the Standard 2: Program Self-Assessment and Verification Audit Form

24. At the end of the Standard(s) Self-Assessment….
Completion of reporting forms:
Self Assessment & Verification Audit Form
Identifies who conducted the SA and reports whether or not the jurisdiction meets the standard
Lists each of the criteria for the standard against which the self-assessor will individually mark YES or NO to meeting
Allows the self-assessor to transfer specific details to the verification auditor
FDA National Registry Report and Release Record & Agreement to Publish in National Registry (this is submitted after a SA or SA update)
Updates the FDA’s online listing of the status of jurisdictions enrolled in the VNRFRPS

25. Self Assessment & Verification Audit Form

26. Documentation to Maintain for Verification Audit
Completed Program Self-Assessment & Verification Audit Form
Documentation used to support each of the Standard’s criteria
Copy of LHD’s (or State’s) Standardization Procedures
Staff Training Records

27. Fairfax County’s Employee Training Record Spreadsheet
Review & Discussion

28. Questions