Food Employee Or Conditional Employee Reporting Agreement - Franklin County Public Health

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Employee Health Policy
Franklin County Public Health
280 East Broad Street
Food Safety Program
Columbus, Ohio 43215-4562
(614) 525-3160
Franklin County
Public Health
Food Employee or Conditional Employee Reporting Agreement
The purpose of this agreement is to inform food employees and conditional employees (potential employee to
whom a job offer is made) of their responsibilities to notify the Person in Charge (PIC) when they experience
any of the listed conditions so that the PIC can take action to prevent the transmission of foodborne illness. A
food employee or conditional employee must report information such as the date when illness symptoms or an
illness first started, or of an illness diagnosis with no symptoms.
I AGREE TO REPORT TO THE PERSON IN CHARGE:
Any of the following symptoms, either while at work or outside of work, including the date that the symptoms
first started:
1. Diarrhea
2. Vomiting
3. Jaundice (yellowing of the eyes or skin)
4. Sore throat with fever
5. A lesion containing pus such as a boil or open infected wound on the hands, wrists, exposed portions of
the arms or other parts of the body (unless the lesion is protected by disposable gloves or a dry, tight
fitting bandage).
If a health care provider has diagnosed me with any of the illnesses listed below, the PIC must notify
Franklin County Public Health when a food employee is diagnosed with any of these illnesses or
conditions:
A.) Any of the following illnesses:
1. Campylobacter
2. Cryptosporidium
3. Cyclospora
4. Entamoeba histolytica
5. Shiga toxin-producing Escherichia coli (STEC)
6. Giardia
7. Hepatitis A
8. Norovirus
9. Salmonella spp.
10. Salmonella Typhi
11. Shigella
12. Vibrio cholera
13. Yersinia
B.) An illness that was diagnosed by a health care provider, within the past three months due to Salmonella
typhi (without having received antibiotic therapy).
Rev. 1/2016
1

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