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UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed) <br />Remarks <br />FOOD SERVICE <br />Sanitation Requirements <br />Has the facility been inspected by an external party within the past 12 months to ensure that the food service and <br />equipment meets established health, sanitation, and safety protocols? <br />C Yes C No <br />If 'Yes', Date of Inspection <br />Were any violations identified? <br />C Yes C' No <br />Have those violations been corrected? <br />C Yes C No <br />Was the facility re -inspected to ensure the violations were corrected properly? <br />C Yes C No <br />Adequate and Varied Meals <br />Does the facility provide 3 meals per day? <br />C Yes C No <br />Does the facility provide a minimum of 2 hot meals per day? <br />C Yes C No <br />Does the facility provide meals that are nutritionally adequate and varied, as approved by a dietitian? <br />C Yes C No <br />Does the facility serve meals that match the approved meal menus? <br />C Yes C No <br />Does the facility provide special meals for prisoner religious or medical needs? <br />C Yes C No <br />SAFETY AND SANITATION <br />Fire Safety <br />Are annual fire safety inspections conducted by state or local fire officials? <br />C Yes C No <br />If'Yes', Date of Inspection <br />NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information <br />which is for the sale use of the intended recipient(s) Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended <br />recipient, please contact the sender and destroy all copies of this document Any Protected Health Information contained in this document is to be used <br />only to aid in providing healthcare services to federal prisoners Any other use is a violation of Federal HIPAA Law and/or the Privacy Act and will be <br />reported as such. <br />UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed) <br />Page 15 of 22 <br />Form USM -218 <br />Rev. 07121 <br />