BOS SR 003 4-8-15 ABRIDGE VERSION.PDF
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-Abridged Version for Purpose of Setting the Hearing- Report to the Board of Supervisors Prepared by the Maricopa County Environmental Services Department Board of Health (BOH) Meeting Date: January 26, 2015 Board of Supervisors Hearing Date: April 8, 2015 Case #/Title: ES-2014-003/Food Service Worker Certification Supervisor Districts: All Districts Applicant: Maricopa County Environmental Services Department (Department) Request: Approve proposed revision to Maricopa County Environmental Health Code (MCEHC) Chapter VII – to align the MCEHC with A.R.S. § 11-269.12. This statute allows for food service worker (FSW) training and certification by accredited entities, and the requirement to accept other Arizona counties certificate or identification card. Support/Opposition: To date, the Department has received written comments from 222 stakeholders via the EROP website and other means: 209 expressed support, ten expressed opposition and three stated their opinion as “other.” The Department provides email responses to all written comments received and where applicable, stakeholders were also provided MCEHC proposal clarifications and/or the statutory requirements outlined in A.R.S. § 11-269.12. Stakeholder Meetings Stakeholder meetings were held on September 22, 2014, October 7, 2014 and December 4, 2014. On September 22, 2014, seven stakeholders attended and no verbal or written support or opposition was expressed for the proposed revision. On October 7, 2014, six stakeholders attended; three provided support, two provided opposition and one did not provide support or opposition. On December 4, 2014, seven stakeholders attended. One provided verbal and written support on behalf of the National Restaurant Association. Three provided verbal opposition on behalf of SFS Page 1 of 8 and two of the three provided written opposition as well. The remaining three attendees did not provide support or opposition. Also, an opposing comment was submitted in writing for an individual not at the December meeting. Opposing and Supportive Views Opposing stakeholders are concerned with the potential of decreased control in the quality of FSW training provided and the prevention of fraud. Their concerns also included recommendations to require: a secure database for all course providers submittal of training documents to the Department the continuance of FSW card issuance/fee collection placement of the Maricopa County seal on certificates fulfillment of the current contract with SFS to remain the sole source provider of the Department’s FSW card program. Supportive stakeholders stated the proposed revision provides increased flexibility in employee food safety training. Their written comments indicate FSW training flexibility may also provide: food establishments the ability to utilize quality training programs that are accepted in other states better compliance while retaining the regulation intent of employees trained on food safety knowledge the opportunity to create more affordable and convenient training options increased competition among approved training providers and the ability to choose the trainer. Many of these stakeholders support both a FSW certificate to serve as training documentation and the Department’s proposal of eliminating the FSW card requirement. Some stakeholders viewed the $5 FSW card cost as an extra unnecessary expense and the card as an inconvenience for employees to obtain at a Department office after successful test completion. Thus far, the Department has received over 94% support for this proposed revision. In accordance with the 2013 FDA Food Code, Maricopa County food establishment employees must demonstrate food safety knowledge; actual knowledge application is evaluated during Department inspections instead of by a card or certificate. Page 2 of 8 BOH Meetings At the October 27, 2014 BOH meeting, the Department presented written comments from 217 stakeholders received via the Enhanced Regulatory Outreach Program (EROP) website and other means: 207 expressed support, 7 opposed and 3 stated their opinion as “other”. Contracted vendor SFS representatives, Mr. Vernon Stout and Dr. Christine Lewis provided statements at the BOH meeting. Mr. Stout noted that SFS is the current provider for the Department’s FSW card program and is concerned about the proposed MCEHC revision due to the impact on the SFS contract with the Department. Mr. Stout emphasized that SFS has invested significant resources into fulfilling the contract requirements. Dr. Lewis expressed concerns about the proposed revision due to the potential threat to public safety and interference with the current SFS contract. After SFS provided their comments, the Department stated their interest in consideration of stakeholder input while meeting the changes required by Arizona Revised Statute. A motion to recommend continuance of the proposed revision into the standard EROP process was made by Ms. Halley, seconded by Mr. Steill and the motion passed unanimously. At the January 26, 2015 BOH meeting, the Department presented written comments from 222 stakeholders via the EROP website and other means: 209 expressed support, ten expressed opposition and three stated their opinion as “other.” Mr. David Matthew, a National Restaurant Association representative, provided verbal support for the changes to Chapter VII of the MCEHC. The National Restaurant Association believes the proposed changes allowing food service worker (FSW) training and certification by accredited agencies and other Arizona counties are a positive step forward in continuing to promote food safety in Maricopa County. Mr. Vernon Stout, a SFS representative, provided verbal opposition for the proposed changes. He believes the feedback provided to the BOH through the EROP process is skewed as most recent data came from members of the Restaurant Association through canned responses. Mr. Stout urged BOH members not to enact the proposed change as it does not protect the public as well as the currently implemented rule. Motion to recommend submission for Case ES-2014-003/Food Service Worker Certification to the BOS’ for approval was made by Mr. Don Cassano, seconded by Dr. Michael Mills; BOH members unanimously passed the motion. Page 3 of 8 Department Recommendation: Staff recommends the BOS approve the proposed revisions to the MCEHC BOH Recommendation: Approve per Department recommended language. Executive Summary: During the 51st Legislature, 2nd Regular Session Representative T. J. Shope (R-Dist.8) introduced HB 2436 Food Handler Training; Courses; Certification, amending state statutes related to county food handler trainings and certificates. HB 2436 was signed into law by Governor Jan Brewer on April 23, 2014 and became effective on July 24, 2014 as A.R.S. § 11-269-12. A.R.S. § 11-269-12 states that if a county requires food handler training and certificates for employees in the food service industry, the food handler certificate training course must meet the American Society for Testing and Materials (ASTM) Standard E2659-09 and other statutory topics. A food handler certificate training course may be offered by any means available, including an online course, it must be completed within the time period required by the county and the certificate must be renewed as required by the county. Upon completion of an accredited food handler certificate training course, the county shall issue any certificate or identification card required by the county, to a person who demonstrates successful completion of the course. A.R.S. § 11- 269-12 also states that a county-issued food handler certificate or identification card is valid in any county that requires a certificate or identification card and prohibits the county from limiting the number of times a person may attempt to complete a food handler certificate training course. Finally, A.R.S. § 11-269-12 asserts that if a county government that provides food service has an in-house food service training program, a certificate by that county training program is valid for food service that is provided for that county’s facilities or operations. Food handler certificate training courses that are created by the county or approved by the county (or both) before July 24, 2014 that do not meet the ASTM standards are considered to be accredited. In the bill sponsor’s own words, the intent of this legislation “was to make food handler training courses more readily available to restaurants and workers and, importantly, to allow more choice as to entities that could offer such courses throughout Arizona…as long as a course is accredited per the standards Page 4 of 8 contained in other parts of the bill, regardless of which entity offers the training, a county shall issue the proper certificate or card to anyone completing such a course” (Shope letter to Deputy County Attorney Dan Brenden, dated June13, 2014). Department FSW Training/Card Implementation Efforts Since A.R.S. § 11-269.12 went into effect, the procedures followed by the Department for FSW training and FSW cards are: The Department issues a FSW card to any individual who presents a valid FSW certificate from any ASTM accredited third party FSW training program. To obtain the FSW card, the individual must present the certificate at one of the Department’s five regional office locations, along with the appropriate proof of lawful presence (e.g. valid AZ driver’s license). The individual is then issued a FSW card with their photo. Kiosks are also provided at the Department’s regional offices where individuals can take an online course and exam to obtain the certificate. The online course at these kiosks is offered through StateFoodSafety.com (SFS). The Department accepts valid FSW certificates or identification cards issued by another county within Arizona. An individual possessing a valid certificate/identification card from another Arizona county does not need to obtain an additional card from Maricopa County. The Department issues Limited Use FSW Cards to individuals with disabilities that meet the requirements outlined in the MCEHC, Chapter VII. The Department issues fee-waived FSW cards to individuals working under a Board of Health (BOH) fee waiver who have fulfilled the training requirements. The Department currently conducts the training required for these cards. Department Research Completing due diligence prior to recommending the proposed MCEHC revision, the Department researched whether or not each jurisdiction in California requires a locally-issued FSW card. California’s Health and Safety Code contains requirements similar to A.R.S. § 11-269.12. Specifically, the California Code allows FSW cards to be recognized throughout the state, with the exception of jurisdictions with existing FSW programs that took effect prior to January 1, 2009. Page 5 of 8 There are three California counties that qualify for this exemption based on having an existing FSW program prior to January 1, 2009. Each of these county programs maintains their own requirements and methods for obtaining FSW training and certification. San Diego County San Diego County accepts either a valid FSW card issued by a county-authorized food handler training school, or a County FSW test administered by the current food safety manager who has passed a state approved food safety certification exam. Riverside County Riverside County accepts only SFS online FSW class/testing or testing at one of their County offices. San Bernardino County San Bernardino County accepts only County-issued FSW cards, which can be obtained online via SFS. There were four other jurisdictions benchmarked which are listed below. None of the jurisdictions require a locally-issued FSW card in addition to the American National Standards Institute (ANSI)/ASTM accredited certificate described in the California Health and Safety Code. Do you require a How do you ensure Jurisdiction card in addition How are the ANSI/ASTM the ANSI/ASTM to the ANSI/ASTM certificates audited? certificates are valid? certificate? Audits generally occur By ensuring the during inspections when company is on the list Santa Clara an establishment has a of approved food County No history of non-compliance handler training and/or in response to a programs (ANSI- food-borne illness accredited). report/investigation. City of Pasadena No - - During routine inspections By looking for the Los Angeles the inspectors verify each ANSI accreditation County No employee has a certificate on the printed from an ANSI accredited certificate. program. City of San No - - Francisco Current Contract with SFS to Provide FSW Training At the request of the Department, the Office of Procurement Services (OPS) issued a solicitation for FSW training in November 2012, (Serial 12149-RFP, Food Service Worker Online Training, Testing and Classroom Training Provider (SFS Contract)) which Page 6 of 8 was awarded by the Board of Supervisors (BOS) on June 5, 2013 to SFS of Orem, Utah. The SFS contract’s base term is from June 5, 2013 through June 30, 2016. A copy of the SFS contract is attached and the contractor’s responsibilities are specifically defined in Exhibit B, Scope of Work. OPS received a letter dated October 18, 2014, (Included in the attached Report to BOH dated October 27, 2014) from Mr. Richard L. Hill who is the legal representative of SFS. In his letter, Mr. Hill states that by adopting and implementing the proposed rule to the MCEHC, which permits individuals to obtain training from providers other than SFS, would result in significant financial damages to his client, SFS. Mr. Hill alleges that adoption of this rule would reduce the number of individuals trained under this contract by 91%. Mr. Hill also takes the position that adopting and implementing the proposed rule would be a violation of both the United States Constitution and the Arizona State Constitution, which both prohibit the adoption of laws “… that impair contractual rights” by no longer recognizing SFS as the exclusive provider of FSW training in Maricopa County through the base term of the existing SFS contract. OPS, in consultation with the Maricopa County Attorney’s Office, reviewed and responded to Mr. Hill’s October 18, 2014 letter on October 30, 2014 (letter attached). A brief summary of the County’s position regarding SFS’s contract is that while the contract remains valid for the remaining base term of the agreement, it is a requirements contract as defined in Paragraph 6.6.1 of the SFS contract. Further, SFS knowingly entered into this contract and acknowledged that as a requirements contract, the County was not obligated to make any minimum or maximum purchases and therefore adoption of the rule would not affect the existing agreement. On November 17, 2014, OPS received a faxed copy of a letter from Mr. Hill dated November 17, 2014, (letter attached) with a hard copy subsequently received via FedEx on November 18, 2014. In that letter, Mr. Hill reiterates his position that adoption of the proposed rule to the MCEHC would result in the County breaching their agreement with SFS and requested adoption of the proposed rule be delayed until expiration of the current SFS contract. Since OPS had previously responded to Mr. Hill’s contractual issue, they did not provide an additional response. The Department provided receipt acknowledgement of the letter, which is included in this report. Page 7 of 8 A.R.S. § 11-269.12 allows additional means by which a FSW may complete training and obtain certificates and identification cards. A FSW who obtains a valid FSW certificate from SFS will continue to be approved documentation of training. At this time, the Department’s intent is to continue contracted services with SFS; however, the following may also serve as documentation of training: a valid food employee certificate, or identification card, issued by another county within the State of Arizona; or a valid food employee certificate of successful completion of a food handler training course given by the Department; or a valid food employee certificate of successful completion of a third party food handler training course that meets all State of Arizona statutory requirements, including compliance with the ASTM Standard E2659-09. SFS MCEHC Language Suggestion The Department did receive a written comment from SFS representative Vernon Stout which included recommended language (Included in the October 27 BOH Report) for the proposed revision. The Department did not incorporate this suggested language because it is in conflict with A.R.S. § 11- 269.12; this statute is broad with respect to training and does not limit training to be in accordance with a sole provider or a specific contract. The Department understands some opposition to the elimination of the FSW cards exists; however, the proposal is in line with the currently adopted 2013 FDA Food Code, which emphasizes the role of the Person in Charge regarding training and Active Managerial Control within a food establishment. The Department has referred all SFS contract related documents and comments to the Maricopa County Attorney’s Office and the Office of Procurement Services. Presented by: Steven J. Goode, REHS, Director Attachments: Report to BOH 1/26/15 (542 pages) Presentation – Stakeholder Workshop 12/4/14 – (3 Pages) Minutes – Stakeholder Workshop 12/4/14 – (11 Pages) Report to BOH 10/27/14 (475 Pages) Addendum to the BOS (3 Pages) Stakeholder input and responses received after the BOH meeting 1/26/15 (2 Pages) Page 8 of 8 MARICOPA COUNTY ENVIRONMENTAL HEALTH CODE CHAPTER VII FOOD SERVICE WORKERS EMPLOYEES/CERTIFIED FOOD PROTECTION MANAGERS REGULATION 1. Definitions a. “Food Service Manager” “CERTIFIED FOOD PROTECTION MANAGER” means any person who supervises/trains a food EMPLOYEE service worker(s) to follow all food safety regulations (Chapter VII and Chapter VIII). The manager shall be a full time employee of the individually permitted food establishment where employed. b. “Food Service Manager Card” “CERTIFIED FOOD PROTECTION MANAGER CARD” means a document issued by the Department certifying that an individual has fulfilled the requirements to work as a Food Service Manager CERTIFIED FOOD PROTECTION MANAGER. c. “Food Service Worker” “FOOD EMPLOYEE” SHALL HAVE THE SAME MEANING AS ARS §11-269.12 FOOD HANDLER, AND means any person who handles, prepares, serves, sells or gives away food for consumption by persons other than his or her immediate family, or who handles utensils and equipment appurtenant thereto. The term does not include persons in establishments regulated under this code who handle food or drink exclusively in closed crates, cartons, packages, bottles or similar containers in which no portion of the food or drink is exposed to contamination through such handling. d. “Food Service Worker Card” means a document issued by the Department certifying that an individual has fulfilled the requirements to work as a food service worker. D e. “Limited Use Food EMPLOYEE CERTIFICATE Card” means a document issued by the Department certifying that an individual with a disability has fulfilled the requirements to perform specific low public health risk activities. E. "PERSON IN CHARGE" MEANS THE INDIVIDUAL PRESENT AT A FOOD ESTABLISHMENT WHO IS RESPONSIBLE FOR THE OPERATION AT THE TIME OF INSPECTION. F. “FEE WAIVED FOOD EMPLOYEE CERTIFICATE” MEANS A DOCUMENT ISSUED BY THE DEPARTMENT CERTIFYING THAT AN INDIVIDUAL WORKING UNDER A MARICOPA COUNTY BOARD OF 7-1 HEALTH FEE WAIVER HAS FULFILLED THE TRAINING REQUIREMENTS. REGULATION 2. Display of Food Service Worker/Manager Cards PERSON IN CHARGE AND CERTIFIED FOOD PROTECTION MANAGER Each food establishment shall maintain on its premises a separate file containing the food service worker cards and food service manager cards for each food service worker and food service manager. This file shall be accessible to the Environmental Health Officer for review upon request. A. THE PERSON IN CHARGE OF A FOOD ESTABLISHMENT SHALL ENSURE FOOD EMPLOYEE(S) ARE TRAINED ON FOODBORNE DISEASE PREVENTION IN ACCORDANCE WITH CHAPTER VIII, SECTION 2 OF THE MARICOPA COUNTY ENVIRONMENTAL HEALTH CODE, WITHIN 30 DAYS OF PERFORMING ANY FOOD EMPLOYEE ACTIVITY. B. THE PERSON IN CHARGE OF A TEMPORARY FOOD ESTABLISHMENT, SEASONAL FOOD ESTABLISHMENT, OR SPECIAL EVENT FOOD ESTABLISHMENT SHALL ENSURE FOOD EMPLOYEE(S) ARE TRAINED ON FOODBORNE DISEASE PREVENTION IN ACCORDANCE WITH CHAPTER VIII, SECTION 2 OF THE MARICOPA COUNTY ENVIRONMENTAL HEALTH CODE, PRIOR TO THE START OF THE EVENT. C. A VALID FOOD EMPLOYEE CERTIFICATE OR IDENTIFICATION CARD AS DESCRIBED IN REGULATION 4 OF THIS CHAPTER, MAY SERVE AS DOCUMENTATION OF TRAINING. D. EACH FOOD ESTABLISHMENT SHALL MAINTAIN ON ITS PREMISES A SEPARATE FILE CONTAINING FOOD EMPLOYEE TRAINING DOCUMENTATION. E. EACH FOOD ESTABLISHMENT SHALL HAVE AT LEAST ONE (1) CERTIFIED FOOD PROTECTION MANAGER ON STAFF, WHO IS EITHER PHYSICALLY PRESENT OR AVAILABLE BY ELECTRONIC OR TELEPHONIC MEANS WHENEVER THE FOOD ESTABLISHMENT IS IN OPERATION. F. EACH FOOD ESTABLISHMENT SHALL REPLACE THE CERTIFIED FOOD PROTECTION MANAGER WITHIN NINETY (90) DAYS OF SEPARATION. G. A CERTIFIED FOOD PROTECTION MANAGER SHALL OBTAIN A CERTIFIED FOOD PROTECTION MANAGER CARD FROM THE 7-2 DEPARTMENT AFTER SUCCESSFUL COMPLETION OF A TEST FROM A FOOD PROTECTION MANAGER CERTIFICATION PROGRAM AS DESCRIBED IN THE 2013 FDA FOOD CODE, § 2-102.20. A CERTIFIED FOOD PROTECTION MANAGER CARD SHALL EXPIRE FIVE (5) YEARS FROM THE DATE OF SUCCESSFUL COMPLETION OF A CERTIFIED FOOD PROTECTION MANAGER TEST. REGULATION 3 Limited Use Food Service Worker Cards FOOD EMPLOYEE CERTIFICATES The Department may issue a Limited Use card when requested to reasonably accommodate a person with a disability. THE DEPARTMENT MAY ISSUE THE FOLLOWING FOOD EMPLOYEE CERTIFICATES: A. A LIMITED USE FOOD EMPLOYEE CERTIFICATE MAY BE ISSUED TO REASONABLY ACCOMMODATE A PERSON WITH A DISABILITY. a.1. A person with a Limited Use Food EMPLOYEE Service Worker CERTIFICATE Card shall be under direct supervision of the food establishment’s CERTIFIED Food Service PROTECTION Manager at all times when handling food or food contact surfaces. b.2. The food establishment’s CERTIFIED Food Service PROTECTION Manager shall be responsible for all Limited Use Food EMPLOYEE Service Worker CERTIFICATE Card applicants, and for requesting a Department onsite visit to have the Department officially document any training and to witness the applicant's associated functions and duties assigned by the CERTIFIED Food Service PROTECTION Manager. c.3. Upon Department approval, the applicant will receive written authorization to have a Limited Use Food EMPLOYEE Service Worker Card CERTIFICATE. issued at the Department’s offices with proof of lawful presence in accordance with Arizona State Statute (A.R.S.§41-1080). d. The Limited Use Food Service Worker Card shall expire three years from the date of issue and the fee is the same as listed in Chapter I of this code for Food Service Worker Cards. e. Applicants may have a Limited Use Food Service Worker Card reissued by following Paragraphs 1. a. through d. 3. of this Regulation 3.A. 7-3 B. A FEE WAIVED FOOD EMPLOYEE CERTIFICATE MAY BE ISSUED TO: 1. A FOOD EMPLOYEE FOR WHICH MARICOPA COUNTY BOARD OF HEALTH HAS WAIVED PAYMENT OF ASSOCIATED FEES DUE TO THEIR CHARITABLE OR NONPROFIT STATUS. 2. A FOOD EMPLOYEE ENROLLED IN A K-12 CULINARY ARTS SCHOOL PROGRAM OR OTHER SIMILAR CURRICULUM BASED PROGRAMS FOR WHICH MARICOPA COUNTY BOARD OF HEALTH HAS WAIVED PAYMENT OF ASSOCIATED FEES. REGULATION 4. Food Service Manager Training FOOD EMPLOYEE TRAINING DOCUMENTATION a. All food service managers shall obtain a food service manager card by completing a food service manager sanitation test certified by an ANSI accredited organization meeting the Conference for Food Protection accreditation standard. The certificate, diploma, or credential obtained there from shall be presented to the Department for issuance of a food service manager card. A food service manager card shall not be issued until the food service manager card fee established by Chapter I of this code is received by the Department. All food service manager cards issued under this subsection shall expire five (5) years from the date of issue of the certification, diploma, or credential presented. A. FOOD EMPLOYEE TRAINING DOCUMENTATION MAY BE SHOWN BY THE FOLLOWING: 1. A VALID FOOD EMPLOYEE CERTIFICATE, OR IDENTIFICATION CARD, ISSUED BY ANOTHER COUNTY WITHIN THE STATE OF ARIZONA; OR 2. A VALID FOOD EMPLOYEE CERTIFICATE OF SUCCESSFUL COMPLETION OF A FOOD HANDLER TRAINING COURSE GIVEN BY THE DEPARTMENT; OR 3. A VALID FOOD EMPLOYEE CERTIFICATE OF SUCCESSFUL COMPLETION OF A THIRD PARTY FOOD HANDLER TRAINING COURSE THAT MEETS ALL STATE OF ARIZONA STATUTORY REQUIREMENTS, INCLUDING COMPLIANCE WITH THE AMERICAN NATIONAL STANDARDS INSTITUTE/ASTM INTERNATIONAL STANDARD E2659-09. 7-4 B. A CERTIFICATE ISSUED UNDER PARAGRAPHS 2 AND 3 OF REGULATION 4 SHALL EXPIRE THREE (3) YEARS FROM THE DATE OF ISSUE. REGULATION 5. Food Service Worker Training a. Except as specified in paragraph b of this Section, within thirty (30) days of performing any food service worker activity, all food service workers shall obtain a food service worker card by completing a food service worker sanitation course or test given by the Department, or show evidence of having completed a substantially similar course or test sponsored or accredited by the Department. The food service worker exam or class fee established by Chapter I of this code shall be paid prior to the initiation of the test or sanitation course. All food service worker cards issued under this subparagraph shall expire three (3) years from the date of issue. A food service worker card shall not be issued until the food service worker card fee established by Chapter I of this Environmental Health Code is received by the Department. b. Temporary food establishment, seasonal food establishment, and special event food establishment food service workers shall obtain a food service worker card prior to the start of the event. REGULATION 6. Food Service Manager’s Duty a. All food establishment locations shall have at least one (1) certified food service manager on staff, who is either physically present or available by electronic or telephonic means whenever the food establishment is in operation. b. A food service establishment has ninety (90) days to replace a certified food service manager who is no longer employed at the food service establishment location. REGULATION 75. Communicable Disease a. Notwithstanding any other provision in this code, should the Environmental Health Officer reasonably believe that a food EMPLOYEE service worker or CERTIFIED food Service PROTECTION manager may be a carrier of or infected with a communicable disease which can be transmitted to the public, through food, the environmental health officer shall immediately notify the Director of the Maricopa County Department of Public Health, (MCDPH) who may: (1) examine or cause the examination of the food EMPLOYEE service worker, and (2) secure from the food EMPLOYEE service worker or CERTIFIED food Service PROTECTION manager appropriate specimens or fluids of body discharge and cause them to be examined at a laboratory approved 7-5 by the Director of MCDPH or by the Arizona Department Of Health Services. The Environmental Health Officer may exclude from any food service work any food EMPLOYEE service worker or CERTIFIED food Service PROTECTION manager who has or demonstrates any illness or symptoms of a communicable disease that may be transmitted through food from food service work. A person so excluded shall not thereafter engage in food service work until approved by the Director of MCDPH. b. If required by the Director of MCDPH, a food EMPLOYEE service worker or CERTIFIED food Service PROTECTION manager shall furnish such information, submit to physical examination, and submit such specimen for laboratory examination, as the MCDPH Director may require for the purpose of determining freedom from communicable disease. The failure of a food EMPLOYEE service worker or CERTIFIED food Service PROTECTION manager to do so to the satisfaction of the Director of MCDPH, shall be sufficient basis for excluding the food EMPLOYEE service worker or CERTIFIED food Service PROTECTION manager from such occupation. c. No Change REGULATION 86. Exemptions Any food establishment, as defined in Chapter VIII of this code, exclusively serving prepackaged foods that are not potentially hazardous (time/temperature control for safety) foods is exempt from Regulations 4 and 6 2 PARAGRAPH E. of this Chapter. 7-6