Attachment 9 - NEARS Manager Interview
Form Approved
	CDC
	estimates the average public reporting burden for this collection of
	information as 20 minutes per response, including the time for
	reviewing instructions, searching existing data/information sources,
	gathering and maintaining the data/information needed, and
	completing and reviewing the collection of information. An agency
	may not conduct or sponsor, and a person is not required to respond
	to a collection of information unless it displays a currently valid
	OMB control number. Send comments regarding this burden estimate or
	any other aspect of this collection of information, including
	suggestions for reducing this burden, to: CDC/ATSDR Information
	Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta,
	Georgia 30333; ATTN: PRA (0920-0980)
	
	 
	Public
	reporting burden for this collection of information is estimated to
	average 20 minutes per response, including the time for reviewing
	instructions, searching existing data sources, gathering and
	maintaining the data needed, and completing and reviewing the
	collection of information. An agency may not conduct or sponsor, and
	a person is not required to respond to, a collection of information
	unless it displays a currently valid OMB control number. Send
	comments regarding this burden estimate or any other aspect of this
	collection of information, including suggestions for reducing this
	burden, to: CDC/ATSDR Information Collection Review Office, MS D-74;
	1600 Clifton Road NE, Atlanta, Ga. 30333; ATTN: PRA (0920-0980) 
 
	
Part III- Manager interview: Conduct an establishment manager interview after an establishment has been identified for an environmental assessment. This form provides a semi-structured interview; you can probe for more information as needed. Read bold text aloud. Do not read answer choices aloud unless they are bolded. Do not read the Unsure or Refused answer choices.
1a. How long was the interview? Number of minutes: _____________
1b. Date the manager interview was initiated (MM/DD/YYYY): / /
READ ALOUD: I’d like to ask you some questions about this establishment. Please be as open and honest as possible. The first few questions focus on the establishment in general. For these questions, please make your best estimate if you do not know the exact answer.
 
Is this an independent establishment or a chain establishment?
 Independent  Unsure
 Chain  Refused
Approximately how many meals are served here daily? Meals could be estimated using number of customers served or ticket orders. #_____  Unsure Refused
What is the establishment’s busiest day, in terms of number of meals served?
|  Monday |  Friday |  Unsure | 
|  Tuesday |  Saturday |  Refused | 
|  Wednesday |  Sunday | 
				 | 
|  Thursday | 
				 | 
				 | 
Are any foods prepared or partially prepared at a commissary or other location?
 Yes  Unsure
 No  Refused
Other than daily specials, when was the last time food items were added to your menu(s)?
|  No changes to menu items have occurred | More than a month ago | 
|  In the last WEEK |  Unsure | 
|  In the last MONTH |  Refused | 
	READ
	ALOUD:
	The
	next
	few
	questions
	focus
	on
	kitchen
	managers.
	As
	I
	read
	the
	following
	questions,
	please
	keep
	in
	mind
	that
	we
	are
	asking
	about
	managers
	who
	have
	control
	over
	the
	kitchen
	area
	or
	back
	of
	the
	house. 
Approximately how long have you been employed as a kitchen manager in this establishment?
Length:  Unsure Refused
Approximately how long have you worked as a kitchen manager?
Length:  Unsure Refused
How many kitchen managers, including you, are currently employed in this establishment? If you aren’t sure, use your best guess.
Number of kitchen managers: ____  Unsure Refused
	READ
	ALOUD:
	The
	next
	few
	questions
	focus
	on
	the
	language-related
	knowledge
	and
	skills
	of
	all
	kitchen
	managers
	in
	your
	establishment.
	Please
	think
	about
	your
	language
	abilities
	and
	those
	of
	other
	kitchen
	managers
	in
	this
	establishment. 
	For
	these
	questions,
	fluent
	means
	able
	to
	clearly,
	easily,
	and
	readily
	understand
	and
	communicate
	verbal
	messages
	in
	the
	language
	specified.
	If
	a
	manager
	is
	bilingual
	or
	trilingual
	please
	tell
	me
	all
	languages
	he
	or
	she
	speaks
	fluently.
	For
	these questions, please
	make
	your
	best
	estimate
	if
	you
	do
	not
	know
	the
	exact
	answer. 
What language(s) do you and other managers in this establishment speak fluently? (Check ll that apply)
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What languages do you and other managers speak at work? (Check all that apply)
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In your opinion, how well do you communicate verbally with your food workers: not well at well, somewhat well, or very well?
 Not well at all  Somewhat well  very well
 Unsure  Refused
READ ALOUD: The next few questions ask about kitchen manager food safety training and certification.
 
Do any kitchen managers receive food safety training? This training can be a course or a class, or it can be training that occurs on the job.
Yes  Unsure Skip to next Read Aloud
No Skip to next read Aloud  Refused Skip to next Read Aloud
13a. How many kitchen managers have had food safety training? If you aren’t sure, use your best guess.
Number of managers: _______  Unsure
 Refused
13b. What type of food safety training do kitchen managers (you) receive? Is it on the job or a class or a course taken somewhere other than work, or both of these types? (Check all that apply)
On the job training (any training conducted by the establishment or corporate office. It might entail posting instructions or material in the establishment, viewing videos, computer-based training taken in the establishment or sending employees to a corporate kitchen for training.)
A class/course taken at a university, community college, or culinary school or other educational institution (any training conducted by a university, community college, culinary school, health department or similar entity.)
A course/class that leads to taking an exam from an ANSI accredited program (such as ServSafe, National Registry of Food Safety Professionals, Prometric,360 Training, or AboveTraining/StateFoodSafety.com).
READ ALOUD: The next few questions ask about kitchen manager food safety certification, where you receive a certificate upon completion of the training course.
 
14. Does this establishment require that kitchen managers have a food safety certification?
 Yes  Unsure
 No  Refused
15. Are any kitchen managers, including you, food safety certified?
Yes  Unsure Skip to next Read Aloud
No Skip to next Read Aloud  Refused Skip to next Read Aloud
15a. How many kitchen managers in this establishment, including yourself, are food safety certified by an ANSI accredited program such as ServSafe National Registry of Food Safety Professionals Prometric, or 360Training, or AboveTraining/StateFoodSafety.com? If you aren’t sure, use your best guess.
Number of managers: _______  Unsure  Refused
15b. How often is a certified kitchen manager present during hours of operation?
 All of the time  Most of the time  Some of the time  Rarely  None of the time
	READ
	ALOUD:
	The
	next
	set
	of
	questions
	focuses
	on
	food
	workers,
	and
	by
	food
	workers
	I
	mean
	employees,
	excluding
	managers,
	who
	work
	in
	the
	kitchen.
	This
	does
	not
	include
	staff
	who
	have
	no
	food
	handling
	responsibilities
	or
	who
	have
	very
	limited
	food
	contact
	such
	as
	adding
	garnish
	or
	condiments
	to
	a
	plate. 
	
	 
16. How many food workers do you have? If you do not know the exact number, an estimate will be fine.
 Number of food workers: _______ If 0, skip to the Read Aloud before #17
 Unsure Skip to the Read Aloud before #17  Refused Skip to the Read Aloud before #17
16a. What language(s) do food workers in this establishment speak fluently? (Check all that apply)
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16b.What languages do food workers speak at work? (Check all that apply)
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READ ALOUD: The next few questions focus on food safety training and certification among food workers, excluding managers.
 
16c.Do any food workers receive food safety training? This training can be a course or a class, or it can be training that occurs on the job.
 Yes  Unsure Skip to next Read Aloud
 No Skip to next Read Aloud  Refused Skip to next Read Aloud
16c1. How many food workers have had food safety training? Please make your best estimate if you do not know the exact number.
 Number of food workers with training:______  Unsure  Refused
16c2. What type of food safety training do food workers receive? Is it on the job or a class or course taken somewhere other than work, or both of these types? (Check all that apply)
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	READ
	ALOUD:
	
	Now
	I’m
	going
	to
	ask
	you
	some
	questions
	about
	policies
	you
	have
	in
	this
	establishment.
	Food
	safety
	policies
	can
	be
	informal,
	verbal
	and
	part
	of
	on-the-job
	or
	other
	establishment
	training
	or
	they
	may
	be
	formal,
	written
	documents
	that
	state
	the
	policy. 
17. Does this establishment have a cleaning policy or schedule for
| 17a. cutting boards? |  Yes  No  Unsure  Refused  NA | 
| 17b. food slicers? |  Yes  No  Unsure  Refused  NA | 
| 17c. food preparation tables? |  Yes  No  Unsure  Refused  NA | 
| 17d. after a worker or customer vomits and/or has diarrhea in the establishment? |  Yes  No  Unsure  Refused  NA | 
| 17e. frequently touched customer surfaces like menus, tables, and condiments? |  Yes  No  Unsure  Refused  NA | 
If none of the answers to 17a-17e are Yes, skip to #18.
17f. If they have any of these policies: Are any of these policies written?
 Yes  Unsure Skip to #18
 No Skip to #18  Refused Skip to #18
17f11. Which ones? (Check all that apply)
 Cutting boards  After vomiting/diarrheal incident
 Food slicers  Frequently touched customer surfaces
 Food preparation tables
18. Does this establishment have a policy for disposable glove use?
 Yes  Unsure Skip to next Read Aloud
 No Skip to next Read Aloud  Refused Skip to next Read Aloud
18a. If there is a glove use policy: Does the glove policy require that food workers wear gloves:
| 18a1. when they have cuts or other injuries? |  Yes  No  Unsure  Refused | 
| 18a2. when handling ready-to-eat foods? |  Yes  No  Unsure  Refused  NA | 
| 18a3. when handling raw meat or poultry? |  Yes  No  Unsure  Refused  NA | 
| 18a4. at all times while working in the kitchen? |  Yes  No  Unsure  Refused | 
18b. If there is a glove use policy: Is the policy written?
 Yes  Unsure
 No  Refused
READ ALOUD: The next few questions refer to actual food temperatures, not the ambient temperatures where food is stored. The questions refer to temperatures taken using some type of thermometer.
 
19. Does this establishment have a policy to take the temperature of any incoming food products?
Yes  Unsure
No  Refused
20. Excluding incoming products, does this establishment have a policy to take food temperatures?
 Yes  Unsure
 No  Refused
 
READ ALOUD: Now I’d like to ask you a few questions about worker health policies. Again, I am asking about policies that apply to staff who primarily work with food—not staff who have no or very limited food handling responsibilities.
21. When food workers say they are ill, do you typically ask if they are experiencing certain symptoms?
 Yes  Unsure
 No  Refused
22. Does this establishment have a policy or procedure that requires food workers to tell a manager when they are ill?
 Yes  Unsure Skip to #23
 No Skip to #23  Refused Skip to #23
22a. Is this policy in writing?
 Yes  Unsure
 No  Refused
22b. Does this policy require ill workers to tell managers what their symptoms are?
 Yes  Unsure
 No  Refused
22c. Does this policy specify certain symptoms that ill workers are required to tell managers about?
 Yes  Unsure Skip to #23
 No Skip to #23  Refused Skip to #23
25c1. What are those symptoms? (Check all that apply)
|  Vomiting |  Sore throat with fever | 
|  Diarrhea |  A lesion containing pus (for ex., boil or infected wound) | 
|  Jaundice (yellow eyes or skin) |  Other (Please describe):_____________________________ | 
23. Does this establishment have a policy or procedure to restrict or exclude ill workers from working? By restrict I mean the worker can work, but is not allowed to handle food, and by exclude I mean the worker does not work at all.
 Yes  Unsure Skip to next Read Aloud
 No Skip to next Read Aloud  Refused Skip to next Read Aloud
23a. Is this policy in writing?
 Yes  Unsure
 No  Refused
23b. Does this policy specify the specific symptoms that would prompt excluding or restricting ill workers from working?
 Yes  Unsure Skip to next Read Aloud
 No Skip to next Read Aloud  Refused Skip to next Read Aloud
23b1. What are those symptoms? (Check all that apply)
|  Vomiting |  Sore throat with fever | 
|  Diarrhea |  A lesion containing pus (for ex., boil or infected wound) | 
|  Jaundice (yellow eyes or skin) |  Other (Please describe)_____________________________ | 
READ ALOUD: The next few questions focus on the food worker and manager sick leave policy. As I read the following questions please keep in mind that we are asking about managers who have control over the kitchen area or back of the house and food workers that work in the kitchen.
 
24. Do any kitchen managers (including you) ever get paid when they miss work because they are ill?
 Yes  Unsure Skip to #25
 No Skip to #25  Refused Skip to #25
24a. How many kitchen managers get paid when they miss work because they are ill? Please make your best estimate if you do not know the exact number.
Number of managers::______  Unsure
 Refused
25.Do any food workers ever get paid when work is missed because they are ill?
 Yes  Unsure Skip to #26
 No Skip to #29  Refused Skip to #26
25a. How many food workers get paid when they miss work because they are ill? Please make your best estimate if you do not know the exact number.
Number of workers:______  Unsure
 Refused
26. Have any practices or policies changed since you were first notified about a potential problem in your restaurant?
 Yes  Unsure End interview  Not applicable End interview
 No End interview  Refused End interview
26a. What were those changes?
READ ALOUD: Thank you very much.
 
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Brown, Laura (CDC/DDNID/NCEH/DEHSP) | 
| File Modified | 0000-00-00 | 
| File Created | 2023-08-27 |