Manager Consent and Interview

Attachment 4: EHS-Net Listeria Retail Deli Study-Manager Informed Consent and Interview

Public reporting burden for this collection of information is estimated to average 22 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: CDC/ATSDR Information Collection Review Office, MS D-74; 1600 Clifton Road NE, Atlanta, Ga. 30333; ATTN: PRA (0920-0792)

INFORMED CONSENT ESTABLISHMENT ID:__________

Let me give you a little background on why I am here and what we are going to be doing. I am working with __________________ (state/local health department) on a research project designed to help us better understand retail delis’ food safety policies and practices. Your retail deli was chosen at random to be in this project. Participation in this study is voluntary. You can choose to stop at any time. If you do not want to be part of the study or if you change your mind later, nothing will happen to you.

Having said that, I need to let you know that if at any time during my visit I see something that is an imminent health hazard, such as no power or water, or sewage on the floor, I will need to stop the study and report the problem to the local agency that is responsible for inspecting your grocery store.

For the next 22 minutes, I am going to ask you some questions about this retail deli’s food safety policies and practices. Following your interview, I’m going to ask you to take a short, 10 minute survey on food safety. If any of the questions make you uncomfortable, you can choose not to answer them. The information I collect today will be combined with information from other retail delis in various states and analyzed. Your name and your retail establishment’s name will not be recorded on the data collection form, nor will they be included in any reports.

The information you provide will be valuable in helping us understand the difficult issues retail delis face, so we ask you to be as open and honest as possible.

After our interview, I’d like to talk to one of your deli workers for about 10 minutes, if possible. It can be a worker of your choosing. However, it needs to be someone who uses and cleans the deli slicers and can speak English fairly well.

I’d also like to take some time to observe your deli’s environment and your employees as they work. This will take about an hour and a half to two hours, but it will not interfere with your work or your employees’ work. I will stay out of the way and will not talk with your employees much or at all.

Do you have any questions? If you have any questions at a later time or would like a summary of the study’s findings, you can contact: (Local Contact Name). (If have card) My information is on this card. We expect to have all of the data summarized in about 12 months.

Note to data collectors: Read each interview question aloud and mark the appropriate response. Texts that should be read aloud are bolded, while those that should not be read aloud are not bolded.

ESTABLISHMENT DEMOGRAPHIC / CLASSIFICATION

I’d like to ask you some questions about this deli. Please be as open and honest as possible. Keep in mind that some of the questions will have more than one answer choice. The first few questions are general questions about the deli.

1. Is this an independent establishment or a chain establishment?

 Independent  Chain  Refused

2. What is your busiest day of the week in terms of the number of customers served by the deli?

 Monday  Tuesday Wednesday  Thursday

 Friday  Saturday  Sunday  Unsure  Refused

3. Approximately how many customers are served by the deli on your busiest day?

__________ customers (Enter number of customers)  Unsure  Refused

4. What is your slowest day of the week in terms of customers served by the deli?

 Monday  Tuesday Wednesday  Thursday

 Friday  Saturday  Sunday  Unsure  Refused

5. Approximately how many customers are served by the deli on your slowest day?

________­­___ customers (Enter number of customers)  Unsure  Refused

6. How long is a typical work shift?

________­­___ hours (Enter number of hours)  Unsure  Refused

7. How many work shifts are there in the deli per day?

________­­___ shifts (Enter number of shifts)  Unsure  Refused

8. On average, how many employees, per shift, work in the deli?

8a. 1^st shift (opening-10am): __________ employees (Enter number of employees)

 Unsure  Refused

8b. 2^nd shift (10am-2pm): __________ employees (Enter number of employees)

 Unsure  Refused

8c. 3^rd shift (2pm-6pm): __________ employees (Enter number of employees)

 Unsure  Refused

8d. 4^th shift (6pm-closing): __________ employees (Enter number of employees)

 Unsure  Refused

9. How old is this building? ______­­__years _________months (Enter years and months)

__________years (Enter estimated year)

 Unsure Refused

DELI MANAGER DEMOGRAPHIC

The next few questions are about you, the deli manager.

10. Approximately how long have you worked in the retail food industry? By retail food industry, I am referring to any deli, restaurant, or commercial establishment that serves food to the public such as a grocery store.

__________years _________months (Enter years and months)

 Unsure  Refused

11. Approximately how long have you been employed as the Person-In-Charge (the PIC) or deli manager here? __________ years _________months (Enter years and months)

 Unsure  Refused

12. What duties or responsibilities are included in your position as PIC or deli manager? (Check all that apply)

 Owner/partner

 Cook/chef/food preparer  Supervising workers that are responsible for preparing food

 Supervising workers that are responsible for cleaning equipment

 Training employees on work duties and responsibilities

 Training employees on proper food safety practices

 Other (Describe): ­­­­____________________________________

 Refused

FOOD HANDLING PRACTICES AND POLICIES

Now I’d like to ask you some general questions about this deli’s food handling practices. If the question refers to something your deli doesn’t do, just let me know. When I ask questions about chubs, I am referring to large chunks of deli meat that are sliced upon the customer’s request.

13. On average, how many chubs of deli meat do you sell per week?

__________chubs (Enter number of chubs)  Unsure  Refused

14. What is the shortest amount of time a chub is opened before it is all sold?

__________days (Enter number of days)  Unsure  Refused

15. What is the longest amount of time a chub is opened before it is all sold?

__________days (Enter number of days)  Unsure  Refused

16. Regardless of type, what is the maximum number of days you can hold an opened chub according to the deli’s policy?

__________days (Enter number of days)  Unsure  Refused

 There is no deli policy.

 Other (Describe):_______________________________________________________

17. Is there a record keeping method in place for keeping up with the dates of these opened

chubs?

 Yes  Unsure

 No  Refused

18. On average, how long are chubs stored in the freezer before they are placed in the

refrigerator to thaw?

__________days (Enter number of days)  Unsure  Refused

 Other (Describe):________________________________________________________

19. On average, how long are chubs stored in the refrigerator before they are placed in the

deli case to be sold?

__________days (Enter number of days)  Unsure  Refused

 Other (Describe):________________________________________________________

20. What do you do with deli products that have reached their sell-by dates? By deli

products, I mean foods that are prepared and sold in the deli as ready-to-eat foods

which include deli meats, deli cheeses, and deli salads. (Check all that apply)

 Throw away or discard

 Use in some combination products such as deli salads, sandwiches, wraps, and

soups

 Other (Describe):___________________­­­­­­­­­­­________­­­_________________

 Unsure

 Refused

21. When is a deli product discarded or thrown away? (Check all that apply)

 On the sell-by date

 __________days before the sell-by date (Enter number of days)

 __________ days after the sell-by date (Enter number of days)

 Product is not discarded or thrown away.

 Other (Describe):__________________________________________________

 Unsure

 Refused

22. When are deli products used to make other combination products? By combination

products, I mean foods that are prepared using one or more deli products. Examples

of combination products are deli salads, sandwiches, wraps, and soups. (Check all that

apply)

 On an as needed basis

 On the sell-by date

 __________days before the sell-by date (Enter number of days)

 __________ days after the sell-by date (Enter number of days)

 Deli product is not used in other combination products. (Go to Q23)

 Other (Describe):_______________________________________________________

 Unsure (Go to Q23)

 Refused (Go to Q23)

22a. What types of combination products are made with these deli products?

(Check all that apply)

 Cold deli salads (e.g., turkey, tuna, and chicken)

 Sandwiches (e.g., subs, pinwheels, and wraps)

 Soups

 Other (Describe):___________________­­­­­­­­­­­________­­­________________

 Unsure

 Refused

Now I’d like to ask you some general questions about this deli’s policies, or standard operating procedures regarding food safety. In instances when I refer to written policies, I am talking about guidelines or rules that are physically located in the deli and are accessible to all employees. Please be as open and honest as possible as we are not looking for specific right or wrong answers to these questions.

23. Does this deli have a written policy concerning hand washing?

 Yes  Unsure

 No  Refused

24. Regardless whether it’s written or not, does the hand washing policy address any of the

following topics? (Read bolded answer choices aloud and check all that apply)

 Frequency of hand washing

 Hand washing before and after performance of work-related tasks

 Hand washing before and after handling specific food products

 Hand washing between glove changes

 Hand washing after using the restroom

 Other (Describe): _____________________________________________

 Unsure

 Refused

25. Does this deli have a written policy concerning disposable glove use?

 Yes  Unsure

 No  Refused

26. Regardless whether it’s written or not, does the glove policy address any of the

following topics? (Read bolded answer choices aloud and check all that apply)

 When gloves should be worn by workers

 How often gloves should be changed

 Changing gloves when performing different tasks

 Changing gloves when handling different food products

 Other (Describe): _____________________________________________

 Unsure

 Refused

27. Does the glove policy require you to wear gloves every time you handle ready-to-eat

foods? Ready-to-eat foods are those that do not require further cooking or heating for

safe consumption such as deli meats, deli cheeses, rotisserie chicken, vegetables, deli

salads, and fruits.

 Yes  Unsure

 No  Refused

CLEANING AND SANITIZING PRACTICES AND POLICY

Now I’d like to ask you some general questions regarding this deli’s cleaning and sanitizing policies.

28. Does this deli have a written policy concerning sanitizing solution preparation?

 Yes  Unsure

 No  Refused

29. How is the sanitizing solution prepared? (Check all that apply)

 Purchased from a retailer/vendor then diluted according to manufacturer’s instruction

 Purchased from a retailer/vendor then diluted according to establishment’s instruction

 Purchased from a retailer/vendor then used without further preparation

 Prepared in-house from common household-strength products

 Other (Describe):________________________________________________

 Unsure

 Refused

30. What sanitizing solutions are currently in use in this deli? (Check all that apply)

 Quaternary ammonia  No sanitizing solutions are in use (Go to Q32)

 Peracetic acid  Soaps/detergent

 Iodophors  Water only

 Chlorine  Other (Describe): __________________

 Unsure  Refused

31. When is the sanitizing solution changed? (Check all that apply)

 When the water appears dirty  Unsure

 When the water changes color  Refused

 Every ___________ hours (Enter number of hours)

 At the beginning of each shift

 At the end of each shift

 On an as needed basis

 Other (Describe):_____________________________________________

32. Does this deli have a written policy on how to store wet wiping cloths while they are in-

use?

 Yes  Refused

 No  Unsure

33. How are wet wiping cloths stored while they are in-use? (Check all that apply)

 In a sanitizing solution

 In a soap and water solution

 In water

 Not stored in any solution (e.g., on counter)

 Other solution (Describe):_________________________________________

 N/A: Do not use wet wiping cloths

 Unsure

 Refused

In some of the following questions, I am going to ask you how often certain items are cleaned. It may be that not every item gets cleaned. If that is the case, please just say so.

34. Does this deli have a written policy for cleaning the deli floor?

 Yes  Unsure

 No  Refused

35. How often is your deli floor cleaned? (Check all that apply)

 Every __________ days (Enter number of days)  Unsure

 At the beginning of each day/when the deli opens  Refused

 At the end of each day/when the deli closes

 Weekly

 Never (Go to Q36)

 Other (Describe):____________________________________________

35a. How do you clean the deli floor? (Check all that apply)

 Use a low pressure dispensing system, no chemicals (e.g., garden hose)

 Use a low pressure dispensing system, with chemicals

 Use a high pressure dispensing system, no chemicals (e.g., hose with pistol

grip nozzle)

 Use a high pressure dispensing system, with chemicals

 Other (Describe):______________________________________________

 Unsure

 Refused

36. Does this deli have a written policy for cleaning the deli floor drains?

 Yes  Unsure

 No  Refused

37. How often do you clean the deli floor drains? (Check all that apply)

 Every __________ days (Enter number of days)  Unsure

 At the beginning of each day/when the deli opens  Refused

 At the end of each day/when the deli closes

 Weekly

 Never (Go to Q38)

 Other (Describe):_____________________________________________

 N/A: No deli floor drains (Go to Q38)

37a. What, if any, agents or chemicals are used to clean the deli floor drains? (Check all that apply)

 Chemical sanitizer (Enter name of sanitizer)___________________________

 Tablet sanitizer/Sanitizer ring

 Probiotics

 No chemicals or agents are used

 Other (Describe):______________________________________________

 Unsure

 Refused

38. Does this deli have a written policy for cleaning the deli walls?

 Yes  Unsure

 No  Refused

39. How often are your deli walls cleaned? (Check all that apply)

 Every __________ days (Enter number of days)  Unsure

 At the beginning of each day/when the deli opens  Refused

 At the end of each day/when the deli closes

 Weekly

 Never (Go to Q40)

 Other (Describe):____________________________________________

39a. How do you clean the deli walls? (Check all that apply)

 Use a low pressure dispensing system, no chemicals (e.g., garden hose)

 Use a low pressure dispensing system, with chemicals

 Use a high pressure dispensing system, no chemicals (e.g., hose with pistol grip

nozzle)

 Use a high pressure dispensing system, with chemicals

 Other (Describe):______________________________________________

 Unsure

 Refused

40. Does this deli have a written policy for cleaning the refrigerator units, such

as a walk-in or reach-in?  Yes  Unsure  No  Refused

41. How often are the refrigerator units cleaned? (Check all that apply)

 Every __________days (Enter number of days)  Unsure

 At the beginning of each day/when the deli opens  Refused

 At the end of each day/when the deli closes

 Weekly

 Never

 Other (Describe):_____________________________________________

42. Does this deli have a written policy for discarding or cleaning real or

artificial garnishes used in display cases?

 Yes  Unsure

 No  Refused (Go to Q43)

42a. How often are the real or artificial garnishes discarded or cleaned? (Check all that

apply)

 Every _____­­_____ days (Enter number of days)  Unsure

 At the beginning of each day/when the deli opens  Refused

 At the end of each day/when the deli closes

 Weekly

 Never

 Other (Describe):­­­­­­­­________________________________________________

 N/A: No garnishes used

In some of the remaining questions, I am going to ask you about cleaning activities during a typical work shift. It may be that not every item gets cleaned during a work shift. If that is the case, please just say so.

43. Does this deli have a written policy for cleaning the cutting boards?

 Yes  Unsure

 No  Refused

44. On average, how many times are cutting boards cleaned during a shift?

__________times per shift (Enter number of times)

 Other (Describe):______________________________________________

 N/A: No cutting boards used

 Unsure

 Refused

45. Does this deli have a written policy for fully cleaning the food slicers? When I ask

about slicers being fully cleaned, I am referring to them being disassembled, cleaned

and sanitized, and reassembled for use.

 Yes  Unsure

 No  Refused

46. On average, how many times are food slicers fully cleaned during a shift?

__________­­times per shift (Enter number of times)

 Other (Describe):___­­___________________________________________

 N/A: No food slicers used

 Unsure

 Refused

47. Is one or more of your slicers a HOBART 2000 series?

 Yes  Unsure

 No (Go to Q48)  Refused (Go to Q48)

47a. Have you ever been contacted by HOBART about your slicer?

 Yes  Unsure (Go to Q48)

 No (Go to Q48)  Refused (Go to Q48)

47b. Please describe why your establishment was contacted by HOBART._________________

______________________________________________________________________________________

______________________________________________________________________________________

48. Does this deli have a written policy for cleaning the food prep tables?

 Yes  Unsure

 No  Refused

49. On average, how many times are food prep tables cleaned during a shift?

__________times per shift (Enter number of times)

 Other (Describe):___________________________________________

 N/A: No food prep tables used

 Unsure

 Refused

50. Does this deli have a written policy for cleaning the food scales?

 Yes  Unsure

 No  Refused

51. On average, how many times are food scales cleaned during a shift?

__________­­­times per shift (Enter number of times)

 Other (Describe):___________________________________________

 N/A: No food scales used

 Unsure

 Refused

52. Does this deli have a written policy for cleaning the prep sinks?

 Yes  Unsure

 No  Refused

53. On average, how many times are prep sinks cleaned during a shift?

__________­­­times per shift (Enter number of times)

 Other (Describe):___________________________________________

 N/A: No prep sinks used

 Unsure

 Refused

54. Does this deli have a written policy for cleaning the display cases?

 Yes  Unsure

 No  Refused

55. On average, how many times are the outside areas of the display cases, including the

doors and door handles, cleaned during a shift?

__________­­­times per shift (Enter number of times)

 Other (Describe):___________________________________________

 N/A: No display cases used (Go to Q56)

 Unsure

 Refused

55a. How often are the inner areas (where ready-to-eat foods are stored) of the display

cases cleaned? (Check all that apply)

 Every __________ days (Enter number of days)  Unsure

 At the beginning of each day/when the deli opens  Refused

 At the end of each day/when the deli closes

 Weekly

 Never

 Other (Describe):___________________________________________

56. Does this deli have a written policy for cleaning knives?

 Yes  Unsure

 No  Refused

57. On average, how many times are the knives cleaned during a shift?

__________­­­times per shift (Enter number of times)

 Other (Describe):__________________________________________

 N/A: No knives used

 Unsure

 Refused

58. What do you do when employees do not follow these policies? (Check all that apply)

 No actions are taken

 Verbal reprimand

 Written reprimand

 Warning of a consequence

 Training is provided

 Other (Describe):_____________________________________________

 Unsure

 Refused

CROSS-CONTAMINATION

59. Are any push carts, U-boats or hand trucks used in the deli also used in other parts of

the retail establishment?

 Yes

 No

 Unsure

 Refused

60. How often are ready-to-eat and raw animal products prepared and processed in the

same area within the deli? By raw animal products, I mean animal products that have

not been cooked such as uncooked seafood, chicken, beef, and pork. (Read bolded

answer choices aloud)

 Never  Sometimes  Usually  Always

 Unsure  Refused

61. How often are ready-to-eat foods and raw animal products stored in the same display case? (Read

bolded answer choices aloud)

 Never  Sometimes  Usually  Always

 Unsure  Refused

62. Are any freezer units dedicated to the storage of deli products only?

 Yes

 No

 Unsure

 Refused

63. Are any refrigerators dedicated to the storage of deli products only?

 Yes

 No

 Unsure

 Refused

64. Do you ever record the temperature of the refrigerators?

 Yes  Unsure (Go to Q65)

 No (Go to Q65)  Refused (Go to Q65)

64a. How often are the temperatures of the refrigerators recorded?

 At the beginning of each shift  Never

 At the end of each shift  Other (Describe):______________________

 Daily  Unsure

 Weekly  Refused

 Monthly

DELI MANAGER FOOD SAFETY TRAINING AND CERTIFICATION

The next few questions are about all Persons-in-Charge (PICs) or deli managers. These are individuals who supervise this deli area.

65. How many Persons-In-Charge (PICs) or deli managers, including you, work in this deli?

__________ deli managers (Enter number of deli managers)

 Unsure  Refused

66. Have you, as the PIC or deli manager, ever been food safety certified? By food safety certified, I mean you have taken a food safety test and been issued a card with an expiration date on it, this program may or may not have involved training.

 Yes  No (Go to Q67) Unsure (Go to Q67)  Refused (Go to Q67)

66a. Do you currently hold a valid food safety manager certificate?

 Yes  No (Go to Q67)  Unsure (Go to Q67)  Refused (Go to Q67)

66b. What organization provided the certificate- ServSafe, National Registry of Food

Safety Professionals, Thomson Prometric, a state or local health department, or

some other organization? (Check all that apply)

 ServSafe

 National Registry of Food Safety Professionals

 Thomson Prometric (known formerly as: Experior Assessments, National

Assessment Institute, Chauncy, Educational Testing Service)

 A state or local health department

 Other (Describe): _____________________________________________

 Unsure

 Refused

67. Does this establishment require PICs or deli managers to be food safety certified?

 Yes  Unsure

 No  Refused

68. Does this establishment require PICs or deli managers to be trained in food safety?

 Yes  Unsure

 No  Refused

Thank you, that’s the end of the interview.

Now I would like for you to answer this short survey; it’s 8 questions and should not take you very long to complete.

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