Food Service Module I:

Management of Food Service Personnel

CRD 2.11/CRD 4.1
1. Analyze the job of one food service employee and critique existing job description.
WHO: DIETETIC TECHNICIAN (DT)
WHAT: Analyze and critique existing job description
WHERE: Womack Army Medical Center, Nutrition Care Division
HOW: Analyzing the current job description. Identify duties not listed that are routinely performed. Identify
duties in the job description that are rarely or never performed. Update terms. Compare the factors that
determine pay grade with current Office of Personnel Management (OPM)1 guidelines to see if the job still
safely lies within the pay grade limitations. Review the Academy of Nutrition and Dietetics recommendations
concerning dietetic technicians scope of practice and compare to DTs current job duties.
WHY: Making suggestions for changes to the current job description will help the NCD recruit and hire the
best dietetic technician candidates when they have a job opening. It will also help possible candidates decide
if the job is something they are qualified for, want to do, are able to do, and if they will get paid adequately for
duties performed.
CLASSIFICATION:
Dietetic Technician is considered a non-supervisory position. For a proper classification of a non-supervisory
job, the position description should define clearly the major duties that will be assigned and required, how
those jobs will be accomplished, and the amount of responsibility needed to do the job. By reading the job
description, applicants should be able to discern the qualification requirements. Specialized requirements not
readily apparent in the description should be specifically mentioned and supported by the described duties.
The current job description for a dietetic technician is below in Figure 1. The black text depicts the current
text, and the red text depicts modifications made by me to the job description.
FACTORS:
The OPM uses factors to determine the General Schedule pay grade (GS).2 General Schedule is the broadest
subdivision of the classification system covered by Title 5. It includes a range of levels of difficulty and
responsibility for covered positions from grades GS 1 to GS 15. The total points calculated from 9 factors will
categorize the job GS 1-15.1 I looked at the OPM criteria and then chose a category based on what, in my
opinion, best fit with the job description. Instead of including all factors, I included the ones below in which I
believe there is likely justification to change if the new version of the job description is accepted, or alter if the
old version is continued.

Factor 2: SUPERVISORY CONTROLS

Currently listed as Factor 2-3 (275 points)Factor 2-3 states: The supervisor makes assignments by defining objectives, priorities, and deadlines and
assists the employee with unusual situations that do not have clear precedents. The employee plans and
carries out the successive steps and handles problems and deviations in the work assignments in accordance
with instructions, policies, previous training, or accepted practices in the occupation. Completed work is
usually evaluated for technical soundness, appropriateness, and conformity to policy and requirements. The
methods used in arriving at the end results are not usually reviewed in detail.2
The following paragraph is from the current job description and describes a higher level of responsibility than
factor 2-3 covers. In fact, in my recommendation this paragraph will be removed because what it requires
would overstep a dietetic technicians scope of practice.3 Therapeutic diet ordering by RDs has only recently
been allowed in certain hospitals.
Independently plans and carries out work without prompting from supervisor. Independently plans
the patients diet menu, monitoring the patients progress, modifies standard and non-standard
modified diet menus for patients from knowledge of diets, reference manuals, and information on
patients dietary history card. Determines proper diet from generally stated prescriptions which cover
such aspects of diet caloric levels and carbohydrate distribution. Calculates and modifies non-standard
diets. Orders and modifies a variety of test diets as necessary. Orders nutritional supplements.
In my opinion, if the job description is not altered, the factor should increase to 2-4 (450 points).
Factor 2-4 states: The supervisor sets the overall objectives and resources available. The employee and
supervisor, in consultation, develop deadlines, projects, and work to be done. The employee, having
developed expertise in the line of work, is responsible for planning and carrying out the assignment, resolving
most of the conflicts that arise, coordinating the work with others as necessary, and interpreting policy on
own initiative in terms of established objectives. In some assignments, the employee also determines the
approach to be taken and the methodology to be used. The employee keeps the supervisor informed of
progress and potentially controversial matters. Completed work is reviewed only from an overall standpoint in
terms of feasibility, compatibility with other work, or effectiveness in meeting requirements or expected
results.2
Factor 7: PURPOSE OF CONTACTS
Currently listed as factor 7-2 (50 points)Factor 7-2 states: The purpose is to plan, coordinate, or advise on work efforts, or to resolve operating
problems by influencing or motivating individuals or groups who are working toward mutual goals and who
have basically cooperative attitudes.2
After changes to job description are given, I would lower this point value to a factor of 7-1 (20 points).
Factor 7-1 states: The purpose is to obtain, clarify, or give facts or information regardless of the nature of
those facts; i.e., the facts or information may range from easily understood to highly technical. 2 The dietetic
technician should provide a brief explanation of prescribed diet. Unless properly trained all questions outside
of those needed in order to complete the required nutritional screening should be directed to a registered
dietitian. Dietetic technicians should not counsel or give diet prescriptions. They should not provide
justification for current diet prescription unless they are given permission to do so.

Position description: Dietetic Technician GS-0640-05

MAJOR DUTIES:
Performs a variety of technical duties in support of the provision of medical nutrition therapy. Assists the dietitian in carrying out the
dietary functions involved in the assessment, planning, implementation, and evaluation of the nutritional needs for varying
severities of illness in short- and long-term patients ranging in age from pediatric to geriatric.
Interviews and screens patients, (Repetitive, see next paragraph) modifies a variety of both standard and nonstandard diets, (the
word modification should be used with caution and only within the prescribed diet order) Coordinates nutrition care activities with
nursing services, counsels and (Nutrition counseling should be performed by a RD) instruct patients regarding basic nutrition
concepts and menus. Obtains diet orders from ward nurses checking with nurses at each station for accuracy. Communicates with
patient and nursing staff regarding diet changes; hold, late, or early trays, tests, and any other situations that are pertinent to
coordinating nutrition care activities. Receives written and/or telephone menu requests from the patient using a room service
menu. Makes changes based on admissions, discharges, and changes in diet prescriptions. Records this information electronically
and changes diet roster.
- Performs nutrition risk screen by: (1) interviewing patients to determine dietary tolerances, current intake, and eating difficulties
(2) obtaining pertinent information recorded in the patient medical record related to nutrition risk (height, weight, diagnosis, diet
order, pertinent lab values and potential medications that may case drug-nutrient interactions), and (3) determining determine level
of nutrition risk based on above parameters and appropriately referring refer patients requiring intervention to a clinical dietitian.
Answer patient's questions and relays relay unusual comments and concerns to the dietitian. Answers questions on potential
food/drug interactions. Provides instructions to patients on appropriate diet. (Assuming they know what the appropriate diet is and
what it entails. Some DTs with experience and an education in nutrition can likely provide good instruction, however until
comments and suggestions have been approved by the RD, dietetic technicians should use caution in dispensing nutrition advice, or
instruction). Encounters are documented in the patient medical record. 30%
- Visits patients daily to assist with selection of room service menu and collect patient satisfaction surveys. Provides instructions to
patients on menu selection and procedures, basic nutrition concepts, and ways to make required dietary alterations. Answers
questions and instructs patients concerning basic modified diets and nutritionally balanced diets. Informs ambulatory patients
concerning methods of obtaining food in the dining hall and suggests selections to assure nutritional balance. In some cases,
distributes selective menus to patients. (Dietetic technicians should demonstrate knowledge of what constitutes each diet
modification before making suggestions. For example, a patient on a heart healthy diet wants to substitute his salad for a soup, can
he do this? How much sodium does the soup have?) 20%
- Answers telephone during meal hours allowing patients to select menu choices from a room service menu. Independently plans
and carries out work without prompting from supervisor. Independently plans the patients diet menu, monitoring the patients
progress, modifies standard and non-standard modified diet menus for patients from knowledge of diets, reference manuals, and
information on patients dietary history card. Determines proper diet from generally stated prescriptions which cover such aspects
of diet caloric levels and carbohydrate distribution. Calculates and modifies non-standard diets. Orders and modifies a variety of test
diets as necessary. Orders nutritional supplements. (I believe this paragraph overstates a DTs role. Independently planning a diet
would mean that a MD did not have to provide a dietary prescription. Orders test diets as necessary is certainly beyond a DTs scope
of practice. Ordering nutritional supplements can be determined on a case by case basis. Does the DT know if the diabetic patient
can have an Ensure with their current diet? They would have to take into consideration how much carbohydrates the patient is
already consuming, and if it was going to be used as their sole source of nutrition or not.). A better way of putting it may be: Assists
patients to select appropriate food choices for their diet order, monitoring the patients progress, modifies within the prescribed
standard and nonstandard diet menus for patients from knowledge of diets, reference manuals, and information on patients dietary
history and nutrition screening information concerning food tolerances, dietary restrictions, and preferences. (I think this statement
has a better use of the term modification. If a DT is aware of a gluten intolerance or a milk allergy they should make proper
modifications to the patients diet within the dietary prescription provided by their physician) Utilizes knowledge of calorie values,
chemical composition, consistency, and suitability of foods. Determines proper diet from generally stated prescriptions which cover
such aspects of diet caloric levels and carbohydrate distribution. Calculates and modifies nonstandard diets. (Repetitive) Know that
standard modified diets include liquid, diabetic, low calorie, fat restricted, and salt restricted diets and nonstandard modified diets
include renal diets, protein restricted, and protein/salt restricted diets. Test diets include high fat. 40%
- Checks diet roster for each meal and makes necessary diet changes and ensures patients have had a meal delivered. Assembles
menus for patient tray service and cooks. Notifies PTS of "new" meals, cancellations, or other changes occurring. Updates clinical
dietetics records by adding dietary history records for new patients including such data as patient's name, date, and diet order,
combination of restrictions, and pattern menu. Evaluates and makes diet changes in context of patient's height and weight.

-Participates in the Quality Improvement Program by conducting Patient Satisfaction Surveys and monitoring trays. Administers
patient satisfaction surveys to patients on a weekly basis. Resolves complaints associated with food service.
- Monitors preparation of patient trays assembled in the PTS area. Verifies portion size by weight, Measures temperatures;
approves substitutions or modifications for tray dependent upon prescribed diet, patient's menu and availability of food items; and
checks sanitation techniques and appearance of plates.
- Assists hospital staff in training dietetic interns, military food service specialists, reservists, red cross volunteers, and newly
assigned. Assists the dietitian in the outpatient clinic by coordinating and organizing the setup of the classes; ensuring patient signins; explaining such things as weight reduction/diabetic-exchange lists to outpatients; and answering basic questions on follow-up
clinical days. (This is usually performed by the medical assistant, but a dietetic technician trained in this area would be helpful)
st

- Provides dietary instructions to patient prior to discharge on a variety of diets to include feeding during the 1 year, high fiber,
cardiac, weight loss and drug/nutrient interactions. 10%
Performs other duties as assigned.
Factor 1. Knowledge Required by the Position - Level 1-3, 350 Points
Knowledge of medical terminology and current medical nutrition therapy guidelines for a variety of medical conditions in order to
perform nutrition risk screening, interpret diet orders, and provide patient nutrition education to individuals and groups.
Skill in interviewing patients to gather appropriate information to assess nutrition risk (i.e., allergies, high blood pressure, etc.),
educational needs, and individual food preferences.
Knowledge of a variety of standard and nonstandard modified diets and test diets and ability to modify such diets.
Knowledge of nutrition and dietetics in order to plan standard, nonstandard, modified, or specialized individual menus for patients
of all age groups based on knowledge of nutritional values, texture, composition, consistency, patients dietary history, tolerances,
restrictions, and preferences and explain diets to patients and/or answer diet related questions by patients and/or health care staff.
Knowledge of basic food composition of diets in order to review and correct patients menus for compliance with their patients
prescribed diet while adjusting for individual preferences and allergies.
Knowledge of, and ability to, instruct the patient and family concerning diet and general nutrition.
Skill in translating diet prescriptions into modified diet menus.
Knowledge of, and skill to, present nutrition care information during outpatient and in-service education classes.
Skill in oral and written communication.
Ability to utilize a computer terminal with standardized programs to process information in an automated format.
Factor 2. Supervisory Controls - Level 2-3, 275 Points
Works under limited supervision with responsibility for daily monitoring and assessing the nutritional care of patients in assigned
wards. Independently plans and carries out work without prompting from supervisor. Dietitian is usually available to assist with
unusual situations that do not have clear precedents. The physician's diet prescription is expressed in general terms. The incumbent
plans the patients diet menu, monitors the patient's progress, modifying the patient's diet menu as needed and instructing the
patient in proper diet to follow. Cases include patients with a variety of serious conditions including morbid obesity, hypoglycemia,
hyperglycemia, pancreatitis, heart disease, bulimia, anorexia, hypertension, etc. Only the most unusual special diets are referred to
the supervisor for advice and guidance. Work is reviewed for conformance to physicians diet prescription and operating and diet
manuals.
Factor 3. Guidelines - Level 3-2, 125 Points
Guidelines include the physician's diet prescription which is provided for each patient, and operating and understanding the diet
manuals of the agency, the hospital, and the dietary service. The diet manual contains standard diet plans. Translates the diet

prescription into a diet plan based on the information in the diet manual, and on the preferences of the patient. For most situations
determines which diet plan is appropriate. When special diets are required, uses reference material to develop the special diet
which is then reviewed by the supervisor.
Factor 4. Complexity - Level 4-2, 75 Points
Work involves diet preparation, documentation, and counseling educating of patients in basic nutrition. (Again, the degree to which
a DT will educate patients is related to the extent of their knowledge in nutrition and the confidence of the RD in them to make good
recommendations.) The employee selects and/or adjusts standard and modified diets, considering food tolerances and dietary
restrictions of each patient.
Factor 5. Scope and Effect - Level 5-2, 75 Points
The purpose of this work is to provide nutritional care and information to patients consistent with physician's diagnosis and dietary
prescription. The work affects health care, comfort, and attitude of patients.
Factor 6. Personal Contacts - Level 6-2, 25 Points
Contacts are primarily with dietitians, food-service workers, patients, family members, nurses, and other hospital support personnel.
Factor 7. Purpose of Contacts - Level 7-2, 50 Points
Contacts with patients and families are to influence and motivate them to accept and adhere to dietary regimen, explains nutritional
self-care, and provides advice on general health maintenance. Contacts with nursing and medical staff are to coordinate efforts and
explain nutritional care plans.
Factor 8. Physical Demand - Level 8-1, 5 Points
Much of the work is sedentary involving reports preparation, searching for needed information, and preparing nutritional care plans.
There is considerable walking throughout the hospital to visit patients and food service areas.
Factor 9. Work Environment - Level 9-2, 20 Points
Work is performed in a hospital setting and involves exposure to contagious diseases, as well as hazards form noise and equipment
in the food production and service areas.
TOTAL POINTS = 865
Point Range (855-1100) = GS-05
NOTICE TO SUPERVISOR: Assignment to duties other than those above for a period exceeding 30 days constitutes a miss-assignment
and must be corrected immediately by appropriate Operating Official submitting a Request for Personnel Action (RPA), either to
detail, temporarily promote, or to permanently assign employee to the appropriate job. Questions regarding details should be
referred through your supervisor to the CPAC.
SUPERVISORS CERTIFICATION: I certify that this position description is an accurate statement of the duties, knowledge, skills,
abilities, responsibilities, physical and performance requirements of this position and its organizational relationships. The position is
necessary to carry out government functions for which I am responsible. This certification is made with the knowledge that this
information is to be used for statutory purposes relating to appointment and payment of public funds and those false or misleading
statements may constitute violations of such statutes or their implementing regulations.

Figure 1

DIETETIC TECHNICIAN SCOPE OF PRACTICE CONSIDERED:

The Academy of Nutrition and Dietetics position paper Scope of Practice for the Dietetic Technician,
Registered,3 states that organizations and individuals within those organizations must ethically take
responsibility for determining the degree of competency of each individual hired for a specific service.
A DTs function in a clinical setting is to support the RD by providing key oversight and communication dealing
with the delivery of food and nutrition services to patients. The degree of direction and supervision is
determined by the RD. The amount of supervision is based on the complexity of the patients disease and
resulting nutritional needs and the competence of the DT. The RD is ultimately responsible and accountable
to the patient and regulatory overseeing the provision of healthcare.
For this job description it is important to consider state dietitian/nutritionist practice acts, rules and
regulations that define supervision and, if applicable, scope of practice specifications for technical and other
assistive staff. Federal and state rules and regulations for health care facilities and for social service programs
specify that the qualified dietitian must supervise the nutritional aspects of patient care and provide nutrition
assessments and dietary counseling. The wording in the job description must not allude to responsibilities
required that would fall outside of a dietetic technicians scope of practice. The table below (Figure 3) was in
the aforementioned position paper and clearly defines which role a RD and a DT should take in the Nutrition
Care Process.

Figure 2

2. Develop an orientation plan for an employee. Discuss orientation plan with relevant
employee. Based on feedback, alter or adjust plan.

What: Orientation plan

Who: Civilian patient tray services (PTS) worker
When: First day of work
How: Patient will receive a New Employee Orientation Folder on their first day. In the folder will be
requirements the employee must do in order to be fully in-processed. A master checklist will have all
requirements listed with a corresponding department supervisor signature to confirm that the step is
complete. If a form needs to be filled out, or a computer training course completed, a copy of that form or a
copy of the course completion certificate will also be placed in the employee folder.
Why: To adequately orient the employee to the hospital and nutrition care division along with all rules and
regulations imposed by both. To ensure all documents are in order and all vaccinations, background checks,
etc. have been completed. To introduce the employee to supervisors and other workers that can assist with
training and provide assistance when needed. To ensure understanding of all equipment associated with job
position, to ensure understanding of physical requirements of position, to ensure document compliance with
hospital and department accreditation standards.
A time frame for expected time of completion would be helpful. Phone numbers to different departments in
order to schedule computer training classes and certifications would facilitate better in-processing time
management. Actions to be completed could be broken down into day by day goals.
Under section #11, entitled Discuss Performance Evaluation a notation that refers employee to the
competencies completed checklist may be a beneficial addition. A time frame within this section would
require employees to be responsible for scheduling time to demonstrate competencies with supervisor, and to
get help and feedback where needed. This would show where training efforts could make the most impact
and where supervision is still required. Determinant on skill level, a final competency check out could be
scheduled by employee to demonstrate their readiness to work unsupervised.
The current orientation checklist is below in black text. Alterations have been made in red text.
NEW EMPLOYEE ORIENTATION CHECKLIST
Womack Army Medical Center

INTRODUCTION: This form will be given to all new staff members upon his/her arrival. It should be completed
by the appropriate person as indicated and returned to the department chief. The data will be used for
administrative purposes and to document compliance with hospital and department accreditation standards.
It is protected by the Privacy Act of 1974 and will be kept confidential.
ACTION TO BE
COMPLETED

PERSON
RESPONSIBLE

1. Introductions: (Week 1)
a. Chief and NCOIC, Nutrition Care Division
b. Branch Chief/NCOIC
c. Section employees
d. NCD Staff

Supervisor

2. Tour of Work Area: (Week 1)

Supervisor

DATE
COMPLETED OR SCHEDULED
TO BE COMPLETED
____________
____________
____________
____________

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.

Restrooms/Shower/Locker Rooms
Break & Smoking Area
Supply Section
Admin/Reception Area
Location of Bulletin Boards
Hospital Tour (including clinics & E.R.)
ABC Cart System
Essential Employee Procedures/inclement weather
Procedures for On-the-Job injuries
Patient Call System
Needle Stick Procedures
Location of eye washes systems
Use of telephone system, telephone directories,
paging, on call roster

____________
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____________

3. NCD Organization Chart & Mission Statement (Week 1)

Supervisor

____________

4. Locker Assignment (Week 1)

Section NCOIC

____________

5. Complete Personnel Data Sheet (due within one week)

Office of the Chief

(NCD Secretary)

____________

6. Read NCD SOPs (Week 1)

Employee
a. Safety, Occupational Health and Fire Prevention (NCD SOP 1-13)
b. Infection Control Policy (NCD SOP 1-14)
c. Hazardous Chemicals (NCD 1-16) Location of MSDS Books
d. Performance Improvement (NCD 1-4)
e. Fire Drill Meeting Location (wooded area)
f. Location of Fire Extinguishers/Location of Gas Shut of Valves
g. Location of Safety Manual
h. How to respond to Fire (RACE)
i. Respond to code Red / Exit location /evacuation procedures if ordered
j. Following completion of a-i, a test to evaluate knowledge will be given
7. Information Management (if applicable) (Week 1)
a. AKO Account
b. Computrition Pswrd & Orientation
c. Essentris/CHCS Training and Passwords
d. V and Z Drive Access
e.
f.

Electronic timecard setup

Outlook account

NCOIC Education and Training

Computrition Mgr (907-xxxx)
WAMC INTRANET IMD HELP DESK
WAMC INTRANET IMD HELP DESK

NCD Secretary (907-xxxx )

WAMC INTRANET IMD HELP DESK (907-xxxx)

8. NCD/Hospital Policies & Procedures (Week 1)

Supervisor
a. Hours of work/breaks
b. Procedures for requesting annual & sick leave
c. Medical treatment
d. Security of personal & government property
e. Signed inclement weather policy/designation as essential or
non-essential personnel, strip map of to home if mission essential
f.
Location of supplies
g. Orientation to work area & section SOPs
h. Systems security

____________
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____________
____________

____________
____________
(not necessary)__
(not necessary ___
____________
____________

____________
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i.
j.
k.
l.
m.
n.

Signed parking area/policy

Fire evacuation procedures/exits & extinguisher location/gas shut off valves
Laundry service for special clothing
Use of phone
Grievance procedures
Personal conduct (i.e. theft, intoxicants, grooming, hygiene,
Uniform/dress code, smoking

____________
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____________
____________
____________

9. Training- Consult NCOIC of Education and Training for required training (Week 1)
a. Hospital Orientation
b. Information Assurance course
c. Food Handlers Course
e. HIPPA training
f. Documentation of competence on unit specific equipment
g. Basic lifesaving course and CPR certification

____________

____________

____________
____________
____________
____________

10. Equipment safety and care. Food preparation and safety. (Week 2)
a. Operating and safety procedures for equipment listed on competencies checklist
b. Instructions on cleaning and sanitizing equipment
c. Instruction on how to prepare, store and deliver items on competencies checklist
d. Shown how to set up and disassemble tray line
e. Introduced to food code worksheets and their use
f. Examples of diets. Tour patient wards, including nurses stations
g. Explained patient identifiers

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_____________
_____________
_____________
____________

11. Review job description and shadow patient tray line employees (Week 2) Supervisor
a. Starter position (Week 2, Day 1)
b. Middle position (Week 2, Day 2)
c. Loading position (Week 2, Day 3)

____________
____________
____________

12. Discuss Performance Evaluation (Week 2, Day 4 and 5)

a. Job description/organizational chart
a. Employee will work on tray line and demonstrate ability to work with
progressively limited supervision.
b. Review knowledge of competency requirements with supervisor
*See following checklist
c. Initial demonstration of competency requirements to supervisor
d. Initial counseling, feedback/OER support form
e. Rating scheme/chain of command
f. Discuss frequency and markers of performance appraisals

Supervisor
____________
____________
____________
____________
____________
____________

12. Traininga. Hospital Orientation

b. CPO Supervisors Course
c. Food Handlers Course
d. Location of Credentialing Packet & process for use (Dietitians only)
e. HIPPA training
f. Documentation of competence on unit specific equipment
g. Consult NCOIC of Education and Training for required training
13. Final competency checklist evaluation (Week 3 or as scheduled)
a. Demonstration of competencies
b. Documentation of competence on unit specific equipment

____________
____________
____________
____________
____________
____________
Supervisor
____________
____________

c.

Plan to address any areas that need to be completed or worked on

____________

The following can be completed anytime during the first 2 weeks of in-processing.
14. Occupational Health Screening & Immunization (Complete ASAP)
(Include signature line for verification of immunizations and flu shots)
a. Supervisor verification

Employee

____________
____________

15. Verification of Ft Bragg/WAMC In processing

(Return original to Military PAC/Civilian Personnel Office)

Supervisor

____________

16. Security: ID Security Badge

IMD

____________

This competencies checklist would be a good addition to ensure that the employee has been adequately
trained and knows what areas are still weak and should be addressed.

Competencies Checklist:
Employee:____________________________________

Date of Employment:_____________________

Supervisors Initials when completed:

Initial Review_________________________________
Final Review__________________________________
1.

Can proficiently and safely operate the following equipment:

a. Slicer
b. Coffee Urn
c. Ice Machine
d. Potato Peeler
e. Tray Line
f. Food Carts

2.

Can explain how to clean and sanitize above equipment and well as tables, utensils, and knives

3.

Can explain how to prepare, store, deliver and label the following:
a.
b.
c.
d.
e.
f.

Tube Feedings
Beverages
Nourishments
Cold Foods
Box Lunches
Salads/Desserts

4.

Demonstrate how to assemble and disassemble tray line

5.

Can explain and recognize regular and modified diets and can give examples of their menus

6.

Can explain the Food Code Worksheets and their use.

7.
8.
9.

Can demonstrate working at each station on the tray line.

Can demonstrate how to deliver trays, tray delivery schedule and loading procedures
Can demonstrate proper food handling and proper personal hygiene

10. Has safety shoes

11. Can explain and shows how to use patient identifiers.

Areas to be addressed after initial review:
____________________________________________________________________________________________________________
________________________________________________________________________________________________________
Areas to be addressed after final review:
____________________________________________________________________________________________________________
________________________________________________________________________________________________________

3. Analyze and critique current performance standards for a food service worker. Critique or
conduct a performance appraisal on an employee.
I think this performance appraisal is effective at determining the workers ability to do the requirements of the
job. It assesses their ability to communicate with other employees and with supervisors effectively and work
as a member of a team. It assesses their adherence to rules and regulations and any instances of noncompliance are discussed.
However, I believe it lacks the ability to measure an employees true merit. A place should be added for
comments and observations. Here the rater can record qualitative responses related to an employees
performance. For instance something they feel they have contributed, that is important to the job and
organization, and wasnt measured or accounted for in the current appraisal guidelines.
They can record future long- and short-term goals. They can review past performance evaluations and note
any progress made towards previous goals. This could alert the rater to the level of ambition an employee
possesses. Included also would be any continuing education or training the employee has completed, or wants
to complete, and rewards and achievements.
Current performance standard for patient tray service worker:
PERFORMANCE APPRAISAL GUIDELINES 2011
WG-04 PATIENT TRAY SERVICE WORKER
** After the first grouping of standards I removed the criteria for the rating requirements for the purpose of condensing

the amount of information provided into the most relevant parts.

1) Technical Competence Standards:

Follows procedures IAW SOP 2-17 for PTS stations 1, 2, 3 assisting cooks as needed without delaying the tray line
Reviews and corrects trays for proper diet order, completeness, portion accuracy, and attractiveness IAW SOP 2-17
Prepares and serves proper portions of food items on PTS line IAW NCD SOP 2-17 with direction from supervisor with no more than 3
discrepancies per rating period
Sets up and replenishes PTS steam tables IAW SOP 2-17 with direction from supervisor
Documents food temperatures IAW SOP 2-4 with direction of work leader and supervisor of all held foods on PTS line
Assists cooks in the serving and preparation of simple food items IAW TB Med 530 with direction from supervisor with no more than 3
errors per rating period.
Delivers trays IAW SOP 2-15 to correct ward and pt using the appropriate pt identifiers. If pt was not found, addresses the ward staff. If
pt was transferred, the PTS worker will deliver the tray to appropriate ward when they complete the original task (of delivering to that
specific ward)
Delivers trays IAW SOP 2-15 to wards within 10 minutes of cart completion returning to work area within 10 minutes of tray deliveries.
In addition, when delivering late trays obtain the name of the ward employee on duty who received the meals delivered (in order to
properly track tray delivery)
Delivers late trays within a timely manner, allowing for the tray ticket to sit in the PTS box for no more than 15 minutes. In addition,
when delivering late trays obtain the name of the ward employee on duty who received the meals delivered (in order to properly track
tray delivery).

Properly utilize and rotate stock using first in first out method
Prepares and labels nourishments IAW SOP2-20
Stores nourishments for transport to ward IAW SOP 2-20 with no more than 3 errors per rating period
Uses proper method when washing dishes in dish machine
Uses chemicals properly and safely
Uses proper food handling techniques when handling raw fruits/vegetables
Uses cutting boards properly
Uses proper hand washing techniques
Exercises proper food handling procedures IAW TB MED 530
Reports malfunctioning or unsafe equipment to the supervisor

This section reveals the workers dependency on supervisory direction. Recorded in the added comments section a rater could note the level of
supervisory direction needed. They could recognize the workers advancement from needing constant direction to working mostly independent.
This could identify workers who are ready to move up to supervisory positions.
Comments:_______________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
To receive an EXCELLENCE rating (must meet all):
Achieves and maintains Food Service Sanitation Certification/Training.
Consistently exceeds level (100% +) described in standards
Within the last year identifies and communicated at least three patient tray services problems to supervisor, provides
a viable suggested solution to each problem.
To receive a SUCCESS rating:
Meets standards and performs at level (~90%) described in standards.
To receive a NEEDS IMPROVEMENT rating (any of the following):
Performs at level (~80%) described by standards.
Receives two formal counselings for failure to meet standards during rating period.
To receive a FAIL rating (any of the following):
Fails to perform at level (~70%) described by standards.
Receives three or more formal counselings for failure to meet standards during rating period.

2) Adaptability and Initiative Standards:

Assists in kitchen and dish room during down-time.

Supports, accepts, and implements new departmental policies, changes, procedural changes with a positive attitude.
Contributes to NCD mission and goals by identifying and alerting supervisor of work section problems, and suggests solutions for
improvement.
Requests training to improve competency skills.
Assists in training new personnel by presenting a positive role model.
Informs supervisor upon discovering operational and safety issues related to equipment.
Demonstrates flexibility to change work schedule to adapt for staff shortages and mission changes when needed and requested.

3) Working Relationships/Communications Standards:

Maintain courteous, respectful interactions with all patients, hospital staff, subordinates, and supervisors.
Maintains honesty, integrity, impartiality, and good conduct.
Shows commitment to cust. Service. Responds to complaints and concerns in appropriate & timely manner; communicates instances to
supervisor.
Checks information bulletin board daily and is aware of current posted information.
Works as a team member with other staff and supervisors to accomplish the mission.
Communicates effectively with co-workers and supervisors.
Respectfully listens, supports, and follows team leader guidance.
Participates in beginning/end-of-shift as well as other scheduled shift meetings.
Notifies supervisor before taking scheduled breaks and when returning to duty.
Keeps team leader informed of unusual issues and events as the day progresses

4) Responsibility/Dependability Standards:

Follows hospital guidelines, SOPs, and WAMC and Army regulations and policies:
o Will not remove any item from NCD without approval from Chief, NCD regarding use of government property
o Pay for all food items, except for fountain beverages; eat food in the dining room or break room and only on breaks.
o Reports for duty in appropriate clean, and wrinkle free uniform in accordance with TBMED530; reports for duty in safety shoes,
unless exempted by physicians profile
o Reviews all NCD Patient Tray Service policies once per year
o Adheres to hospital parking policy
Training

o Completes and attends annual training and scheduled in service training courses
o While on duty, attends in services, required meetings as documented by sign-in rosters; arrives to meeting on time.
o Participates in NCD, hospital and external training programs as directed by Chief or NCOIC, P&S.
o Complies with AMEDD emphasis programs (i.e. JC standards, EEO, PI, Sexual Harassment Prevention)
Daily Work
o Ensures and maintains PTS area at ready for service level -by ensuring items are restocked, replenished for following meal
service.
o Completes assigned work within established time frame.
o Uses supplies, equipment and materials wisely to conserve costs and resources.
o Maintains work area in a neat, orderly, safe and sanitary manner.
o Appropriately disposes of all outdated food items and supplements 100% of time per supervisor guidance
o Maintains temperature logs for pots and pans and dishwasher.
o Performs daily cleaning per supervisor guidance
Leave and Attendance
o Appropriately manages leave to ensure there is little to no impact on mission accomplishment.
o Requests use or lose leave prior to 1 July IAW Union Agreement.
o Plans and uses sick and annual leave, giving adequate notice, and IAW policy guidelines
o Demonstrates responsibility by arriving for work on time and leaving on schedule, adhering to scheduled breaks and meal
periods.
o Accepts responsibility for attendance as a Mission-Essential employee

5) Additional Comments:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Development goals:

Achievement of development goals:

Employees comments: (optional)

Performance Evaluation Critique:

At WAMC annual performance reviews are given in November. I observed a registered dietitian give an
annual performance evaluation to a dietetic technician (DT). She began by reviewing the job description with
the DT. She provided time for the DT to discuss any problems she had with the description, or if things should
be edited or added to the description in her opinion. She then read each bullet point to the DT and discussed
her performance related to each. As the employee was rated on her performance she was given an
opportunity to justify or explain any negative marks against her. The dietitian did a wonderful job staying
objective and non-bias in her delivery of the performance review. She was friendly and encouraging but also
factual and businesslike. She listened to the employees complaints but did not justify any remarks, as the
situation had been dealt with and was over.
She went over any training the employee needed to finish, or needed to start. I thought this was helpful for
the employee as it gave her a timeline to accomplish this objective. She had the employee sign a new HIPPA
agreement, and verified her knowledge of what it entailed.
The entire process took a week, as the employee needed time to stop after a series of objectives and go over
them at her desk. I thought this not ideal, as the reviewer could lose her train of thought and forget certain
points she wanted to make. However, the RD kept very good records of their discussions and was able to
effectively deliver the performance evaluation in a way that is going to be beneficial to the employee. This
amount of time is not typical, usually performance evaluations are completed within 30 minutes and I have
since observed several that were completed successfully within this time frame or less.

After the dietitian was done, she had the employee sign the performance evaluation confirming she agreed
and understood everything that had been discussed. She also made a copy for the employee so she could
focus on the things she needed to improve over the next year.

4. Review and critique grievance procedure.

Grievance policies are put into place so that employees are given due process in disciplinary situations.
According to Mary Gregoire4 in Foodservice Organizations, A Managerial and Systems Approach, grievance
procedures usually involve a multi-step process where the employee first requests a review by the next
highest supervisor, if a satisfactory response it not obtained here, a higher level supervisor may be requested.
A grievance committee may be formed if the chain of command is unable to come to a satisfactory outcome.
At WAMC, some employees are unionized. In a union contract, grievance procedures are specified and
include provisions for hearings by an outside arbitrator if that is deemed necessary.
I obtained the union contract agreement between Headquarters, XVIII Airborne Corps, Fort Bragg and
American Federation of Government Employees to review the grievance policy in place for WAMC unionized
workers5. The following are the important points in that agreement:
Purpose- To provide a mutually acceptable method of prompt and equitable resolution of grievances
Communication- Every effort will be made by management officials, the Union and grievant, to settle the
grievance at the lowest possible level and as informally as possible. This article does not wish to hinder in
anyway frequent communication, and it wishes to resolve a grievance at the lowest level.
Format- Grievances must be presented in writing and must set forth the following:
1. The issue giving rise to the grievance
2. Whether a meeting is requested
3. Provisions of law, regulation, or union agreement violated
4. Relief sought
5. Name and duty organization of the grievant.
Time- The aggrieved will have a reasonable amount of official duty time to prepare their grievance, but must
get permission from supervisor before leaving workplace.

The Employee Grievance Process:

Step 1- The grievant or Union representative must submit, in writing, (Figure 3) the grievance to the
Fort Bragg civilian personnel office within 30 calendar days of the occurrence. The employer must hold
a Step 1 meeting with the grievant within 14 days after receipt of the written grievance. A written
decision will offer or deny relief and will be issued within 14 days of the Step 1 meeting. If the
grievance is not resolved a date for a Step 2 meeting will be included with this written document.
Step 2- The employee should submit all relevant information and evidence. This meeting will be within
21 days after the Step 1 meeting. A written decision will be sent through the Union to the aggrieved
within 14 days after the Step 2 meeting. Grievances resulting from formal disciplinary action will be
initiated at Step 2 and must be filed with the civilian personnel office no later than 30 days after the
date of the discipline.

Step 3- If grievant does not accept decision, and wishes to pursue the matter, a written request for a
Step 3 meeting within 14 days after the Step 2 decision must be given. This request may be addressed
to the commander and the commander or their designee may hear the complaint. A meeting will be
held within 14 days of the request. A decision will be given within 14 days of the meeting.
Time Limit After Step 3- If the decision is unsatisfactory to the Union, the grievance may be referred to
arbitration. This must be made within 30 days in writing to the Fort Bragg civilian personnel office
within 30 days after the Step 3 decision.
Accepting the offer of relief- Offers of relief at any step must be received in writing.
Time Limits- Time limits can only be extended by mutual consent of parties. Failure to observe time
limits for any step will result in the grievant or the Union representative to advancing to the next step.
I believe the grievance policy for the workers in the food service department of the Nutrition Care Division is
adequate and fair. I like how it stresses the importance of trying to settle the complaint at the lowest level
possible. This will result in a quicker resolution of the grievance and allow the employee to return to work
satisfied. It will also involve the least amount of people which will preserve man hours and keep employees
focused on their respective jobs.
Womack Army Medical Center also highlights its commitment to solving problems at the lowest possible level.
Posted on the bulletin board in the Nutrition Care Division is a memo entitled Troop Commanders Policy
Letter #2- Open Door Policy. This memo states that the troop commander has an open door policy for anyone
in her command. She asks that the chain of command is utilized first, but if unresolved, an appointment can
be made to see her.
Gregoire, 4 suggests that grievances and disciplinary actions can be reduced by:
1. Having accurate job descriptions
2. Selection of individuals with appropriate qualifications for the job requirements
3. Having effective orientation, training, and performance evaluations
4. Use of good human skills by supervisors4.

Fort Bragg Employee Grievance Form

Figure 3

5. Participate in an employees interview if possible. Discussion.

I participated in the interview process during the hiring of a new dietetic technician. The process of
application to hire is described below:

Interested individuals submit their application for the position in which they are interested.
The most relevant applications are chosen from those received for an interview.
Interview times are scheduled with several individuals from the inquiring department.
A rubric is used to score an applicant on answers provided to interviewers questions.
Scores are averaged for each interviewee and then reported to human resources.
A final decision is made based on scored criteria including interview scores, availability to start, amount
of training needed, and other factors.
Human resources alerts potential hire

For this interview two registered dietitians and the non-commissioned officer in charge (NCOIC) of the diet
office interviewed 3 potential hires. Two interviews were conducted in person and one was over the phone.
A rubric of 21 questions was used and each interviewer asked 7 of those questions. Each response was graded
with a score of 1, 2 or 3. A score of 1 means unacceptable or no, a score of 2 means satisfactory or some, and
a score of 3 means excellent or yes. After each interview the raters discussed the potential strengths and
weaknesses of the interviewee. After all interviews were done, the scores of all 3 raters were averaged for

each interviewee. They were ranked from 1 to 3 and that result was sent to the human resource department
for the next step in the process.
After the first interview, the raters felt like 2 questions were poorly designed and didnt make sense.
However, to be fair, no changes were allowed to the rubric and questions had to be phrased the same to each
interviewee.
I was allowed to sit in on the interview process and used a rubric to score interviewees responses based on
my determination of adequacy. I compared my notes with those of the other raters with similar results.
When averaging all the scores, I found that my final score for each interviewee was close to the other raters.
I have attached a copy of one of my rubrics from that process. (Figure 3)

Figure 3

6. Analyze the organizational structure of the food service organization. Review principles
behind planning work schedules and plan a one-week schedule for the food service
operation taking into account staffing pattern, workload and FTE requirements.
The organizational structure of the Nutrition Care Division is below in Figure 5. The flow chart on right-hand
side shows the structure of the employees related to Food Service and Production.
I spoke with the Cook Forman about how he constructs the schedule for the food service workers. He went
through the process with me and told me several important tips to making a successful schedule. Schedules
cover a 4 week period, or 2 pay periods. A work week is Sunday to Saturday. He tries to plan the schedules as
far out in advance as possible. It is required that every full-time employee is scheduled for a 40 hour week.
Another requirement he must consider is the union agreement which says the 2 days off a week, must be 2
consecutive days.
To begin a new schedule he first copies forward the previous schedule, making sure everyone is accounted for.
He will then try to accommodate all requests for leave. Next he will record the number of workers he projects
he will need for both early and late shifts. He will then schedule an early and late shift supervisor. If the
supervisors are off or on leave, he will schedule a work leader as supervisor for that shift. When he is
determining the number of workers needed, he tries to avoid including a cook supervisor in that number, as
he wants them to supervise, and not have to work on the service line. If he is short staffed then they will be
expected to cook, or prep, as well as supervise. Next, he tries to schedule someone dependable. This is
someone who he knows will show up for work. Again, if he is short on help he will stop services such as the
made-to-order eggs station.
He has learned that on a weekday early shift the least amount of workers he requires is 5, for the late shift he
needs four. On weekends, 3 is the least amount needed for both the early and late shift, but he would prefer
to have at least four.
Below (Figure 4), I have attempted to make a weeks schedule for the food service and production department
at WAMC. I first copied a schedule forward in Excel to make sure I had all employees listed. I then cleared all
the values and attempted to make a schedule based on what the Cook Forman taught me. I then compared
my schedule with the current schedule to see if I did an adequate job determining labor requirements.
Key:
X= Day off
HL= Holiday leave- DFAC closed, employee not charged for a day of leave
LV= Leave
ESL= Early Shift Leader
LSL= Late Shift Leader
R= Regular (40 hour)
E= Early
L= Late

Food Service Workers Schedule: Prepared by Stacy

SUN
7
X

MR. MXXXX

MON
8
R

TUE
9
R

WED
10
R

THU
11
R

FRI
12
R

SAT
13
X

COOK SUPERVISOR E -0430 - 1300 L - 1030 - 1900 R - 0500 - 1330 (ESL) EARLY SHIFT LEADER ( LSL) LATE SHIFT LEADER
MS. WILXXXX (CK SUP)
X
ESL
LSL
LSL
X
ESL
LSL
MR. WXXXXX
MS. MILXXXX

(CK SUP)
(CK SUP)

COOKS EARLY 0430 - 1530

MS. SHIXXXX

ESL
LSL
LATE 0800 - 1900
E

X
ESL

X
ESL

ESL
LSL

R
LSL

ESL
X

MR. POXXXXX
MR. BEXXXXXX

X
X

X
L

X
L

E
L

E
L

E
X

E
X

COOKS E 0500 1330 L 1000 - 1830

MR. JONXXX

MR. CRXXXXX
MS. WHIXX

E
LV

X
LV

X
LV

L
X

E
X

L
LV

L
LV

MS. GAXXXX
COOKS E 0500 1330 L 1000 - 1830

MS. CURXXX
MS. JOXXXX

X
E

E
X

L
X

E
E

L
E

L
E

X
E

L
LV

E
LV

E
LV

X
LV

X
LV

L
X

E
X

X
X
MON
TUE
29
30
L
E
R= 0600 -1430
E
L
X
X
E
L
L
L

L
WED
31
L

E
THU
1
E

L
FRI
2
E

L
SAT
3
X

E
E
X
L

E
L
X
L

L
LV
E
X

X
L
E
X

X
L

E
X

LV
X

LV
L

LV
E

E
L

FOOD SERVICE WORKERS CONTRACT E=0600-1430

MS. MCNEIXXX.
(NCFS)
X

LV

LV

LV

LV

LV

MS. SCOTTXXXXX
MS. CALDWELXXX.

E
L

X
E

X
E

E
X

LV
X

E
L

L
LV

(NCFS)
(NCFS)

MR. SAXXXXX (NCFS)

MS. GXXXX (NCFS)
MS. DAVXXX (NCFS)
WORK LEADER
R=0700 - 1530
MR. WHAXXXX
FOOD SERVICE WORKERS E= 0600 - 1430
MS. BRIGXXXX
MR. AGNEXXX.
MR. WASHIXXXX
MS. MILLSXXXX
MR. JONESXXX.
MR. SAPPXXXX

L
SUN
28
X
L=1030-1900
X
E
LV
L
X
LV

(NCFS)
(NCFS)

MS. THOXXX
MS. HAXXXX

(NCFS)
(NCFS)

LV
LV

LV
L

E
E

LV
LV

LV
X

X
X

X
LV

MS. GIEXXXXX

(NCFS)

LV

LV

LV

LV

LV

DINING FACILITY ATTENDANTS E=0600-1430 L=1030-1900

MR. THXXXX
(NCFS)
X
R

EARLY
LATE

5
5

7
6

7
7

7
7

7
6

7
6

5
5

SANDW. BAR 0600-1430

SUN
28

MON
29

TUE
30

WED
31

THU
1

FRI

MS. BEXXXX
Figure 4

LSL
X

(NCFS)

SAT
2

Organizational Structure for the

Nutrition Care Division

Figure 5

7. In-service for Food Service Employees

Hand washing in-service presented to food service employees on December 12, 2014
I began the presentation by showing a video of bacterial replication. While the video was playing I sprinkled
Glo-Germ on my hands. Glo-Germ is an odorless, colorless powder made of tiny plastic particles the size of
bacteria. Glo-germ glows brightly when exposed to ultraviolet light. After applying the powder adequately to
my hands, I shook the hands of 5 volunteers and then had them shake another persons hand. I then asked
them hold out their hands and used the UV light to show how I had spread germs to the first 5 individuals
and how they had spread it to the person they were in contact with. This activity highlights the fact that while
bacteria are not visible to the human eye, they are still present and easily spread by food service workers. I
had the workers go wash their hands and used the light again to show how important using a good hand
washing technique is. Even though they thought they had washed adequately, areas of Glo-germ were still
visible.

References for Module 1:

1. Introduction to the Position Classification Standards. Office of Personnel Management (OPM). Web site.
www.opm.gov/policy-data-oversight/classification-qualifications/classifying-general-schedulepositions/standards/0600/gs0640.pdf. Revised August 2009. Accessed November 24, 2014.
2. The Classifiers Handbook. Office of Personnel Management (OPM). Web site. www.opm.gov/policy-dataoversight/classification-qualifications/classifying-general-schedule-positions/classifierhandbook.pdf. Revised
August 2009. Accessed November 24, 2014.
3. Academy of Nutrition and Dietetics: Scope of Practice for the Dietetic Technician, Registered. J Acad Nutr Diet.
2013;113(6 Suppl):S46-55.
4. Spears MC, Gregoire MB. Foodservice Organizations, A Managerial and Systems Approach. Prentice Hall; 2007;
536-537.
5. Union contract agreement between Headquarters, XVIII Airborne Corps, Fort Bragg and American Federation of
Government Employees