Fostering the right solutions & connections
for more than 33 years
for more than 33 years
We know what our residents are allergic to; it is written in their charts and diet orders. Now that we have our dining rooms open to our residents’ families and friends, we may get inquiries about them stating an allergen they have. When this happens, we have an obligation to meet their allergen needs and keep them safe.
It has been over a year the latest Food Code issued from the Food and Drug Administration was released December 28, 2022. An additional allergen was added making it the Big-9 allergens: milk, eggs, fish, shellfish, wheat, soy, peanuts, tree-nuts and now adding sesame. In addition, the food code also recommends front line staff, our dietary aids and servers have training and are aware of the Big-9 allergens and what food we serve contains these allergens. Additionally, each one of these staff member must be able to recognize the symptoms if a guest is having an allergic reaction (wheezing, hives, itchy rashes, difficulty breathing). If a family member’s guest does go into anaphylaxis shock we need to know what to do and how to assist with this life threatening situation.
There are over 170 known allergens. The Big-9 represent 90% common in the United States. There are quite a few more allergens including mustard, celery and sulfites, less common and not part of that 90%. 25% of cases where someone has an allergic reaction happens outside the home. For us managing our community means it may happen to us when we have a guest visiting a resident. Training is important and how we train our staff will ultimately determine our success. Management must have a plan in place and process of how to facilitate that plan to ensure everyone will work together when an allergen meal is requested. Designate at least one staff member each meal period who knows every ingredient in all items you serve.
Front of house staff: Don’t take it for granted that all family and guests with an allergen will remember tell you. Have it part of your greeting when your resident’s guest are first seated “is there anyone with a known food allergens or intolerance that I should be aware of?” During your pre-shift meeting, go through the menu and have each server and staff member know what Big-9 allergens are in each item, including daily specials and anything with a “secret” ingredient. It is important that the dining room is cleaned and sanitized before any resident is seated; breadcrumbs which contain wheat and a shrimp shell left on a seat crease, as example, can have a very bad outcome. If a guest does have a know allergen, make it clear when giving the customer’s order to the kitchen and put the dining room manager/supervisor and kitchen on full allergen alert. I talk about and quiz my staff during our daily meetings about allergens, making it fun and giving away awards and small prizes as incentive to keeping my staff knowledgeable. If management shows it is important, the staff will react accordingly.
When preparing and cooking food in the back of the house: Your kitchen needs to know how to handle these requests. If an allergen is transferred to another food item we call it cross-contact. Similar to cross-contamination, however if an allergen were to inadvertently make contact with the allergen free meal, item it can never be served. We can’t “kill” an allergen by cooking it longer or hotter. If we are unsure, we never guess, we look at ingredient lists carefully and never take anything for granted: just because it may appear an item doesn’t contain an allergen, we always verify. I never thought “fish” (anchovies) is in most Cesar dressing and some pre-made desserts use ground tree-nuts which look just like dusted cocoa.
Tools of the trade: When preparing an allergen free food, we use the purple cutting boards, knives and utensils. Make sure all utensils are cleaned and sanitized before use, ensuring our sanitizing buckets are at the correct concentration, wash hands, wear new disposable gloves and put on a clean apron. We use cleaned and sanitized pans, sheet trays, use barriers such as parchment paper and aluminum foil to avoid cross-contact. We have a certain area of the kitchen where we prepare those meals and clearly identify the customer’s allergen meal to the server. To distinguish consider double plating, a special color frill tooth picks or have certain plate cover as to mark that allergen free prepared dish.
If you have a self-service areas: each item needs to be clearly marked and identified with its common name and if it contains any of the Big-9 allergens. Have a person dedicated to the self-service area to answer all questions and to look over the area for customers who may contaminate the food. Perhaps separate all the allergens to a certain location. Ensure each food item has its own serving utensils. Have plenty of plates for return visits and extra serving utensils available if cross-contact were to occur.
In the event of an emergency: If you see a customer having signs of an allergic reaction assist them with their medication (epinephrine) such as an auto injector and, without delay have someone call 911. Keep calm, have them stay seated or even lay down. Never move them or have them walk anywhere, the increased circulation by doing so can be deadly. Stay with the person and do not leave their side until medical help arrives.
We are in business to serve our residents and guest. We love what we do; to make people happy from the food we create. We have many challenges and we plan in advance for them for our success. You are the unsung superheroes and I applaud you for what you do everyday.
About the author
Chef Robert McKeon CDM, CFPP has been in Food Service working in Restaurants, Hotels, Catering, Healthcare foodservice industry and now teaching and certifying in food managing, alcohol and allergen certification. He understands how important training is to be successful with compliance with the regulatory authority, your local health departments. He understands the challenges you face in Food Service and teach and train classes in a fun, interactive way that makes it easy to understand.
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