Manager Interview

Form Approved

Attachment 5- NVEAIS Manager Interview OMB No. 0920-xxxx

Exp. Date xx/xx/20xx

Public reporting burden for this collection of information is estimated to average 20 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-xxxx)

Only bold text is to be read aloud.

Establishment – General

1. Date the manager interview was conducted: _____/_____/________

Read aloud: I’d like to ask you some questions about this establishment. Please be as open and honest as possible. The first few questions focus on the establishment in general. Please make your best estimate if you do not know the exact number for the following questions.

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

• Independent

• Chain

• Unsure

• Refused

3. Approximately how many meals are served here daily? ______________

4. What is the establishment’s busiest day, in terms of number of meals served?

• Monday

• Tuesday

• Wednesday

• Thursday

• Friday

• Saturday

• Sunday

• Refused

5. Are any foods prepared or partially prepared at a commissary or other location?

• Yes

• No

• Unsure

• Refused

6. Other than daily specials, when was the last time food items were added to your menu(s)?

• No changes to menu items have occurred

• In the last WEEK

• In the last MONTH

• More than a month ago

• Unsure

• Refused

7. Where does the establishment purchase or acquire its food? (Select all that apply, probe for additional responses.)

• General Distributor / Wholesaler

• Corporate distributor

• Grocery Store / Supermarket / Warehouse store

• Farmer’s Market

• Other restaurant

• Non-regulated entity

• Other (describe) ____________________________________

• Unsure

• Refused

Kitchen Manager

Read aloud: The next few questions focus on kitchen managers. As I read the following questions please keep in mind that we are asking about managers who have control over the kitchen area or back of the house.

8. In total how long have you worked as a kitchen manager?

• Less than 6 months

  • 6 months-less than a year

  • 1 year – less than 2 years

  • 2 years – less than 4 years

  • 4 years – less than 6 years

  • 6 years – less than 8 years

  • 8 years – less than 10 years

  • 10 or more years

  • Refused

9. Approximately how long have you been employed as a kitchen manager in this establishment?

• Less than 6 months

  • 6 months-less than a year

  • 1 year – less than 2 years

  • 2 years – less than 4 years

  • 4 years – less than 6 years

  • 6 years – less than 8 years

  • 8 years – less than 10 years

  • 10 or more years

  • Refused

10. How many kitchen managers, including you, are currently employed in this establishment? If you aren’t sure, use your best guess.

• Number of managers: ______________

• Unsure

• Refused

11. What language(s) do you and other managers in this establishment speak fluently? (Check all that apply)

• English

• Spanish

• French

• Chinese (any dialect)

• Japanese

• Other

12. What languages do you and other managers speak at work? (Check all that apply)

• English

• Spanish

• French

• Chinese (any dialect)

• Japanese

• Other

13. In your opinion, how well do you communicate verbally with your food workers, very well, somewhat well or not well at all?

 Not well at all

 Somewhat well

 Very well

 Unsure/Don’t know

Read aloud: The next few questions ask about kitchen manager food safety training and certification.

14. Do any kitchen managers receive food safety training? This training can be a course or a class, or it can be training that occurs on the job.

• Yes

• No If No, skip to #15

• Unsure If Unsure, skip to #15

• Refused If Refused, skip to #15

1. How many kitchen managers have had food safety training? If you aren’t sure, use your best guess.

• Number of managers:___________________

• Unsure

• Refused

2. What type of food safety training do kitchen managers (you) received? Is it on the job or a class or a course taken somewhere other than work, or both of these types? (Check all that apply)

• On the job training (any sort of training conducted by the establishment or corporate office. It might entail posting instructions or material in the establishment, viewing videos, computer-based training taken in the establishment or sending employees to a corporate kitchen for training.)

• A class / course taken at a university, community college, or culinary school or other educational institution (A class or course refers to any training conducted by a university, community college, culinary school, health department or similar entity.)

Read aloud: The next few questions ask about kitchen manager food safety certification, where you receive a certificate upon completion of the training course.

15. Does this establishment require that kitchen managers have a food safety certification?

• Yes

• No

• Unsure

• Refused

16. Are any kitchen managers, including you, food safety certified?

• Yes

• No If No, skip to Food Workers Read Aloud

• Unsure If Unsure, skip to Food Workers Read Aloud

• Refused If Refused, skip to Food Workers Read Aloud

1. How many kitchen managers in this establishment, including yourself, are food safety certified through either ServSafe®, National Registry of Food Safety Professionals / Environmental Health Testing or Thomson Prometric? If you aren’t sure, use your best guess.

• Number of managers: __________

• Unsure

• Refused

Food Workers

Read aloud: The next set of questions focuses on food workers, and by food workers I mean employees, excluding managers, who work in the kitchen. This does not include staff who have no food handling responsibilities or who have very limited food contact such as adding garnish or condiments to a plate.

17. How many food workers do you have? If you do not know the exact number, then an estimate will be fine.

• Number of workers: ___________ If 0 then skip to # 21

• Unsure

• Refused

18. What language(s) do food workers in this establishment speak fluently? (Check all that apply)

• English

• Spanish

• French

• Chinese (any dialect)

• Japanese

• Other

19. What languages do food workers speak at work? (Check all that apply)

• English

• Spanish

• French

• Chinese (any dialect)

• Japanese

• Other

Read aloud: The next few questions focus on food safety training and certification among food workers, excluding managers, and food worker sick leave policies.

20. Do any food workers receive food safety training? This training can be a course or a class, or it can be training that occurs on the job.

• Yes

• No If No, skip to #21

• Unsure If Unsure, skip to #21

• Refused If Refused, skip to #21

1. How many food workers have had food safety training? Please make your best estimate if you do not know the exact number.

• Number of workers: __________

• Unsure

• Refused

2. What type of food safety training do food workers receive? Is it on the job or a class or a course taken somewhere other than work, or both of these types? (Check all that apply)

• On the job training (any sort of training conducted by the establishment or corporate office. It might entail posting instructions or material in the establishment, viewing videos, computer-based training taken in the establishment or sending employees to a corporate kitchen for training.)

• A class / course taken at a university, community college, or culinary school or other educational institution (A class or course refers to any training conducted by a university, community college, culinary school, health department or similar entity.)

Policy

Read aloud: Now I’m going to ask you some questions about policies you have in this establishment.

21. Does this establishment have a cleaning policy or schedule for the kitchen floor?

• Yes

• No If No, skip to #22

• Unsure If Unsure, skip to #22

• Refused If Refused, skip to #22

1. Is this policy written?

• Yes

• No

• Unsure

• Refused

22. Does this establishment have a cleaning policy or schedule for the refrigerator units, such as a walk-in or reach-in?

• Yes

• No If No, skip to #23

• N/A If N/A, skip to #23

• Unsure If Unsure, skip to #23

• Refused If Refused, skip to #23

1. Is this policy written?

• Yes

• No

• Unsure

• Refused

23. Does this establishment have a cleaning policy or schedule for the cutting boards?

• Yes

• No If No, skip to #24

• N/A If N/A, skip to #24

• Unsure If Unsure, skip to #24

• Refused If Refused, skip to #24

1. Is this policy written?

• Yes

• No

• Unsure

• Refused

24. Does this establishment have a cleaning policy or schedule for the food slicers?

• Yes

• No If No, skip to #25

• N/A If N/A, skip to #25

• Unsure If Unsure, skip to #25

• Refused If Refused, skip to #25

1. Is this policy written?

• Yes

• No

• Unsure

• Refused

25. Does this establishment have a cleaning policy or schedule for the food preparation tables?

• Yes

• No If No, skip to #26

• N/A If N/A, skip to #26

• Unsure If Unsure, skip to #26

• Refused If Refused, skip to #26

1. Is this policy written?

• Yes

• No

• Unsure

• Refused

26. Does this establishment have a policy concerning disposable glove use?

• Yes

• No If No, skip to #28

• Unsure If Unsure, skip to #28

• Refused If Refused, skip to #28

1. Is this policy written?

• Yes

• No

• Unsure

• Refused

27. Does the glove policy require that food workers wear gloves:

1. …at all times while working in the kitchen?

• Yes If Yes, skip to #28

• No

• Unsure

• Refused

2. …when handling ready-to-eat foods?

• Yes

• No

• Unsure

• Refused

3. …when handling raw meat or poultry?

• Yes

• No

• Unsure

• NA

• Refused

4. …when they have cuts or other skin injuries?

• Yes

• No

• Unsure

• Refuse

Read aloud: The next few questions refer to actual food temperatures, not the ambient temperatures where food is stored. The questions refer to temperatures taken using some type of thermometer.

28. Does this establishment have a policy to take the temperature of any incoming food products?

• Yes

• No If No, skip to #29

• Unsure If Unsure, #29

• Refused If Refused, skip to #29

1. Are temperatures of incoming products recorded?

• Yes

• No

• Unsure

• Refused

29. Excluding incoming products, does this establishment have a policy to take food temperatures?

• Yes

• No If No, skip to Health Policies Read Aloud

• Unsure If Unsure, skip to Health Policies Read Aloud

• Refused If Refused, skip to Health Policies Read Aloud

1. Are these food temperatures recorded?

• Yes

• No

• Unsure

• Refused

Read aloud: Now I’d like to ask you a few questions about worker health policies. Again, I am asking about policies that apply to staff who primarily work with food- not staff who have no or very limited food handling responsibilities.

30. Does this establishment have a policy or procedure that requires food workers to tell a manager when they are ill?

• Yes  Unsure If Unsure, skip to #31

• No If No, skip to #31  Refused If Refused, skip to #31

1. Is this policy in writing?

• Yes

• No

• Unsure

• Refused

2. Does this policy require ill workers to tell managers what their symptoms are?

• Yes

• No

• Unsure

• Refused

3. Does this policy specify certain symptoms that ill workers are required to tell managers about?

• Yes

• No If No, skip to #30d

• Unsure If Unsure, skip to #30d

• Refused If Refused, skip to #30d

c1. What are those symptoms? (Check all that apply)

• Vomiting

• Diarrhea

• Jaundice- yellow eyes or skin

• Sore throat with fever

• A lesion containing pus- ex: boil or infected wound that is open or draining

• Other (Please describe) ____________________________________

4. Does this policy apply to kitchen managers as well as food workers? For example, are kitchen managers required to tell their manager or the owner when they are ill?

• Yes

• No

• Unsure

• Refused

31. When food workers say they are ill, do you typically ask if they are experiencing certain symptoms?

• Yes  Unsure If Unsure, skip to #32

• No If No, skip to #32  Refused If Refused, skip to #32

1. What are those symptoms? (Check all that apply)

• Vomiting

• Jaundice-yellow eyes or skin

• Diarrhea

• Sore throat with fever

• A lesion containing pus- ex: boil or infected wound that is open or draining

• Other (Please describe) ____________________________________

32. Does this establishment have a policy or procedure to restrict or exclude ill workers from working? By restrict I mean the worker can work, but is not allowed to handle food, and by exclude I mean the worker does not work at all.

• Yes  Unsure If Unsure, skip to #33

• No If No, skip to #33  Refused If Refused, skip to #33

1. Is this policy in writing?

• Yes

• No

• Unsure

• Refused

2. Does this policy specify the specific symptoms that would prompt excluding or restricting ill workers from working?

• Yes

• No If No, skip to #32c

• Unsure If Unsure, skip to #32c

• Refused If Refused, skip to #32c

b1. What are those symptoms? (Check all that apply)

• Vomiting

• Diarrhea

• Jaundice- yellow eyes or skin

• Sore throat with fever

• A lesion containing pus- ex: boil or infected wound that is open or draining

• Other (Please describe) ____________________________________

3. Does this policy apply to kitchen managers as well as food workers? For example, are ill kitchen managers excluded or restricted from working?

• Yes

• No

• Unsure

• Refused

Read aloud: The next few questions focus on the food worker and manager sick leave policy. As I read the following questions please keep in mind that we are asking about managers who have control over the kitchen area or back of the house and food workers are employees who work in the kitchen.

33. Do any kitchen managers (you) ever get paid when they miss work because they are ill?

• Yes

• No If No, skip to #34

• Unsure If Unsure, skip to #34

• Refused If Refused, skip to #34

1. How many kitchen managers get paid when they miss work because they are ill? Please make your best estimate if you do not know the exact number.

• Number of kitchen managers: ______________

• Unsure

• Refused

34. Do any food workers ever get paid when work is missed because they (you) are ill?

• Yes

• No If No, skip to End of Manager Interview

• Unsure If Unsure, skip to End of Manager Interview

• Refused If Refused, skip to End of Manager Interview

1. How many food workers get paid when they miss work because they are ill? Please make your best estimate if you do not know the exact number.

• Number of food workers: ______________

• Unsure

• Refused

Read aloud: Thank you very much.

End of Manager Interview

Version 1_2013 7