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1. Which of the following is NOT one of the five symptoms a food employee must report to the person in charge?

California law and the FDA Food Code list five reportable symptoms: vomiting, diarrhea, jaundice, sore throat with fever, and an open or infected wound containing pus that is not properly covered. A mild headache by itself is not on that list.

2. A cook calls in and tells the manager she vomited twice last night. When may she safely return to handling food?

An employee excluded for vomiting or diarrhea may return only after being symptom-free for at least 24 hours without the help of medication that masks symptoms. Feeling better, eating a meal, or waiting only 12 hours is not enough under the Retail Food Code.

3. Which group of pathogens makes up the "Big 6" foodborne illnesses that a food employee must report?

The FDA Food Code and California law require employees to report diagnosis or exposure to six specific pathogens: Norovirus, Hepatitis A, Shigella spp., Shiga-toxin producing E. coli (STEC), Salmonella Typhi, and nontyphoidal Salmonella, which was added in 2017.

4. A server arrives at work with yellowing of the eyes and skin. What must the person in charge do?

Jaundice is a reportable symptom often linked to Hepatitis A. The Retail Food Code requires full EXCLUSION (not just restriction) from the facility and notification to the regulatory authority. The employee cannot return until cleared by the health department.

5. An employee has a small infected cut on her hand that is leaking pus. Which action complies with the California Retail Food Code?

A wound with pus must be covered with an impermeable (water-resistant) bandage AND a single-use glove or finger cot. A fabric bandage or paper towel is not impermeable and is not enough. Sanitizer is not designed for skin and does not cover the wound.

6. When a food employee is diagnosed with one of the Big 6 illnesses, who is the person in charge required to notify?

California law and the FDA Food Code require the Person in Charge to immediately notify the local health department (the regulatory authority) when an employee is diagnosed with Norovirus, Hepatitis A, Shigella, STEC, Salmonella Typhi, or nontyphoidal Salmonella. This protects the public and lets the health department investigate possible exposure.

7. A dishwasher reports a sore throat with a fever of 101°F. The facility does NOT serve a highly susceptible population. What is the correct action?

Sore throat WITH fever generally requires RESTRICTION (not full exclusion) in facilities that do not serve highly susceptible populations. The employee can still perform tasks that do not involve food or food-contact surfaces. In facilities serving the elderly, young children, or the immunocompromised, exclusion is required.

8. Which of the following is the food employee's own legal duty under California's reporting rule?

The employee's legal duty is to report immediately to the person in charge any of the five reportable symptoms, a diagnosed Big 6 illness, exposure to an outbreak, or living with someone who has a Big 6 illness. Waiting, self-diagnosing, or hiding the illness violates the Retail Food Code and puts customers at risk.

9. Which population is considered "highly susceptible" and triggers stricter exclusion rules?

The FDA Food Code defines a Highly Susceptible Population (HSP) as people who are more likely than the general public to be severely affected by foodborne illness: preschool-age children, older adults in nursing homes or assisted-living, and immunocompromised individuals (such as those with cancer or HIV). Facilities serving HSPs must EXCLUDE, not just restrict, employees with sore throat and fever.

10. A cook was excluded after being diagnosed with Salmonella. What does he need before he can return to work?

An employee diagnosed with any Big 6 illness may not return until the regulatory authority (local health department) and/or a licensed medical practitioner provides medical clearance, often after follow-up testing. The 24-hour symptom-free rule alone applies to vomiting/diarrhea WITHOUT a Big 6 diagnosis.

11. According to the CDC, which of the following is one of the most common contributing factors to foodborne illness outbreaks in restaurants?

CDC outbreak investigations repeatedly identify ill food workers, especially those with Norovirus, as a leading contributing factor in restaurant outbreaks. Other common factors include improper time and temperature control, cross-contamination, contaminated equipment, and food from an unsafe source.

12. A line cook tells the manager that his roommate was just diagnosed with Hepatitis A. What is the correct response?

California law requires employees to report not only their own diagnoses but also exposure: living with or having close contact with someone who has a Big 6 illness. The person in charge must report this to the health authority, which will decide whether the employee should be excluded, tested, or vaccinated.

13. According to the CDC, what is the single most common cause of foodborne illness outbreaks in the United States and the pathogen most often linked to sick food workers?

CDC surveillance data consistently identify Norovirus as the leading cause of foodborne illness in the U.S. It spreads very easily through the fecal-oral route, even from tiny amounts of vomit or stool, which is why an infected food worker who handles ready-to-eat food can sicken many customers. Norovirus symptoms (vomiting, watery diarrhea) usually start 12 to 48 hours after exposure.

14. A food handler diagnosed with Shiga-toxin producing E. coli (STEC), such as O157:H7, may transmit a severe complication if he returns to work too early. Which complication is most associated with STEC?

Shiga-toxin producing E. coli, including O157:H7, can cause severe bloody diarrhea that progresses in some patients (especially young children) to hemolytic uremic syndrome (HUS), which can lead to kidney failure. Because of this serious complication, STEC is one of the Big 6 illnesses, and an infected employee must be excluded until cleared by the health authority.

15. A line cook tells the PIC she has a sore throat with a fever of 101°F. The restaurant does NOT serve a highly susceptible population. Under the FDA Food Code, what is the correct action?

Under FDA Food Code §2-201, a sore throat with fever is a reportable symptom. In facilities that do NOT serve a highly susceptible population, the worker is RESTRICTED — she may stay in the building but cannot work with food, food-contact surfaces, or single-use items. Exclusion is only required when a highly susceptible population (HSP) is served.

16. Which of the following best describes a 'Highly Susceptible Population' (HSP) under the FDA Food Code?

A Highly Susceptible Population (HSP) is a group more likely to suffer serious illness from foodborne pathogens because of age or weakened immunity. Examples include nursing home residents, hospital patients, immunocompromised individuals, preschool-age children in custodial care, and pregnant women in such facilities. HSP settings trigger STRICTER rules — for example, sore throat with fever requires exclusion, not just restriction.

17. A dishwasher had vomiting and diarrhea overnight. He feels normal in the morning and has not taken any anti-nausea medication. Under the FDA Food Code, when may he return to food-handling duties?

FDA Food Code §2-201 requires that an employee with vomiting or diarrhea be EXCLUDED until they have been symptom-free for at least 24 hours without using symptom-suppressing medication. Medication can mask symptoms while the worker is still shedding pathogens, so a chemically suppressed worker is still considered ill.

18. A server reports yellowing of the skin and eyes (jaundice) that started two days ago. What is the correct exclusion period before she may return to food work?

Jaundice is a Big 6 reportable symptom strongly associated with Hepatitis A. The FDA Food Code requires that a food employee with jaundice be excluded until at least 7 days have passed since jaundice first appeared AND the regulatory authority or a medical practitioner approves return. If Hepatitis A is confirmed, additional medical clearance is required.

19. Why is Hepatitis A a particularly dangerous foodborne illness for restaurants to manage?

Hepatitis A virus has an incubation period of 15-50 days (average ~28). An infected food worker can shed the virus through stool for weeks before jaundice appears, contaminating ready-to-eat foods unnoticed. Because Hep A is vaccine-preventable, CDC recommends vaccination for food handlers, especially after a known exposure or outbreak.

20. A line cook cuts his finger while slicing onions. The wound is small but bleeding. Which step is the correct way to allow him to keep working?

An open cut on the hand must be cleaned, covered with an IMPERMEABLE (waterproof) bandage, and then enclosed by a single-use glove or finger cot. This double barrier prevents both blood and bacteria from contacting food. A wound on other parts of the body must be covered with an impermeable cover plus clothing. If the wound is infected or pus-filled, the employee must be excluded from food work.

21. Two customers at a deli call the health department within 24 hours saying they got sick with the same symptoms after eating there. The manager learns of this. What is the manager's correct first response?

When two or more people experience the same illness after eating food prepared or served at a facility, it meets the standard CDC/FDA definition of a suspected foodborne outbreak. The Person-in-Charge must immediately notify the local health department, preserve any suspect food and production records, and cooperate fully with the investigation. Concealing evidence is unlawful.

22. A line cook in California refuses to work because she has diarrhea and reports this to her manager. The manager threatens to fire her if she doesn't come in. Which legal protection applies?

California Labor Code §6310 and §6311 prohibit retaliation, including firing, against an employee who reports unsafe conditions to the employer or a government agency, or who refuses to perform hazardous work. Combined with FDA Food Code §2-201 (which makes illness reporting a duty), a food worker who reports symptoms or refuses to handle food while sick is legally protected from retaliation.

23. A baker attended a family wedding where several guests later tested positive for Norovirus. He himself has no symptoms. Under the FDA Food Code, what must he do?

FDA Food Code §2-201 requires food employees to report not only diagnoses and symptoms, but also EXPOSURE to outbreaks of Norovirus, Hepatitis A, Shigella, Shiga-toxin E. coli, Salmonella Typhi, and nontyphoidal Salmonella. Reporting an exposure even without symptoms allows the PIC and health department to monitor and prevent further spread, since some pathogens shed before symptoms appear.

24. Under HACCP principles, where does employee health and illness reporting fit?

Employee health and illness reporting is a PREREQUISITE program — a foundational sanitation/operational practice that must be in place for HACCP to work. CCPs control specific hazards (cooking temperatures, etc.), but if a sick employee contaminates ready-to-eat food, no CCP downstream will catch a virus like Norovirus. Strong health policy is the foundation of food safety.

25. What documentation does the FDA Food Code expect a Person-in-Charge to keep when an employee reports a reportable symptom or diagnosis?

FDA Food Code §2-201 expects the PIC to maintain a written or electronic Employee Health Policy/log documenting symptom and diagnosis reports, exposure reports, dates, and the action taken (restriction, exclusion, return-to-work approval). Health inspectors routinely ask to see these records. Employers should NOT keep private medical charts — only the information needed for food-safety compliance.

26. Which of the following is one of the CDC's top contributing factors to foodborne illness outbreaks in restaurants — and is directly addressed by illness-reporting policies?

CDC investigations consistently list poor personal hygiene by sick food workers among the top contributing factors to foodborne outbreaks, along with improper holding temperatures, contaminated equipment, food from unsafe sources, and inadequate cooking. Mandatory illness reporting and exclusion/restriction policies directly target this factor by keeping ill workers from contaminating food.

27. In addition to the FDA Big 6, which agency's regulations in California require reporting of further communicable diseases such as Listeria and Hepatitis E to public-health authorities?

California Code of Regulations (CCR) Title 17 lists communicable diseases that physicians, laboratories, and certain establishments must report to local health departments. Beyond the FDA Big 6, Title 17 includes additional agents such as Listeria monocytogenes and Hepatitis E. A PIC may not be the direct reporter for diagnosis, but should know that California adds reportable diseases beyond the federal Food Code list.

28. A prep cook is diagnosed with nontyphoidal Salmonella after eating undercooked eggs at home. Which food category is the leading source of this pathogen, and what is the correct return-to-work standard?

Nontyphoidal Salmonella (causing salmonellosis) is most commonly linked to raw or undercooked POULTRY and EGGS, and also raw produce and unpasteurized dairy. It is one of the FDA Big 6: an infected food employee must be EXCLUDED until medically cleared by the regulatory authority or a medical practitioner and free of vomiting/diarrhea for at least 24 hours. Diagnosis-based exclusions require formal clearance, not just self-assessment.