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Medical CDM : Certified Dietary Manager Exam

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CDM test Format | CDM Course Contents | CDM Course Outline | CDM test Syllabus | CDM test Objectives

- Management of Foodservice
- Sanitation & Food Safety
- Nutrition & Medical Nutrition Therapy
- Human Resource Management
- Career Skills

- Utilize the systems approach to procure, produce, and serve food to all customers.
- Provide a safe and sanitary environment for employees.
- Utilize appropriate supervisory management techniques.
- Provide appropriate quality nutritional care for the client.
- Meet all licensing and regulatory agency standards.
- Utilize business, marketing, and public relation skills to Strengthen foodservice and nutrition to peers, patients, and community.
- Constantly strive for improved performance as a Dietary Manager.
- Participate in the professional activities of the Association of Nutrition & Foodservice Professionals.

Critical Thinking Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
=> Access data, references, patient education materials, consumer and other information from credible sources.
=> Perform nutrition screening and identify clients or patients to be referred to a registered dietitian nutritionist.
=> Evaluate information to determine if it is consistent with accepted scientific evidence. Problem Solving Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
=> Participate in quality improvement and customer satisfaction activities to Strengthen delivery of nutrition services.
=> Modify recipes and menus for acceptability and affordability that accommodate the cultural diversity and health status of various populations, groups and individuals.
Interpersonal Behavioral and Social Skills
The ability to show cultural competence in interactions with clients, colleagues and staff.
=> Demonstrate an understanding of cultural competence/sensitivity.
=> Show cultural competence in interactions with clients, colleagues and staff.
=> Implement interventions to effect change and enhance wellness in diverse individuals and groups.
Oral and Written Communication 1. The ability to listen to and understand information and ideas presented through spoken words and sentences.
2. The ability to communicate information and ideas in
=> Prepare and deliver sound food and nutrition presentations to a target audience.
=> Provide nutrition and lifestyle education to well populations.
=> Promote health improvement, food safety, wellness and disease speaking so others will understand.
3. The ability to read and understand information and ideas presented in writing.
4. The ability to communicate information and ideas in writing so others will understand. prevention for the general population.
=> Develop nutrition education materials for disease prevention and health improvement that are culturally and age appropriate and designed for the educational level of the audience.
Active Listening Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
Physical activities Performing physical activities that require considerable use of your arms and legs and moving your whole body, such as climbing, lifting, balancing, walking, stooping, and handling of materials.
=> Demonstrate sufficient upperbody strength and manual dexterity to operate and clean household and institutional equipment required for food preparation and food.
=> Travel to clinical sites and have mobility within and around the sites.
Activities may involve standing, sitting, stooping and be in hot and cold facilities.
=> Demonstrate the ability to exert maximum muscle force to lift, push, pull, or carry objects such as food supplies, small equipment and delivery of meals.
=> Sensing
=> Visual
=> Hearing
=> Taste
=> Smell
1. The ability to see details at close range (within a few feet of the observer).
2. The ability to taste and smell to determine acceptability of foods and supplements.
3. The ability to hear spoken words.
=> Demonstrate sufficient vision, smell and taste to evaluate the appearance, aroma, and flavor of food.
=> Demonstrate sufficient vision to observe compliance with food sanitation and safety codes.
Professional Attributes Practicing professional skills required in entry-level positions.
=> Attend scheduled classes, labs and supervised practices and be present for examination and testing. Be prepared for class.
=> Maintain professional demeanor in class and during supervised practice.
=> Maintain personal hygiene and dress code policies.

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Medical certification

overseas Masks, worry and a pretend Certification: group of workers at CSL Plasma Say circumstances at Donation facilities Aren’t protected | CDM Free PDF and PDF Download

ProPublica is a nonprofit newsroom that investigates abuses of energy. register to get hold of their largest reviews as soon as they’re published.

Heather Steadman, a nurse at a CSL Plasma donation center near Pittsburgh, become about to enter a tiny closed-door room to manage an test when the doctor exceeded her a masks in a translucent wrapper labeled KN95. The folded white masks, seen in the back of chinese characters, become all her company was proposing to supply protection to her from COVID-19.

Over a virtually 20-year profession, she’d worn licensed respirators in intensive care instruments and cared for patients death from respiratory ailment. That evening in late June, she was about to lean into the face of a stranger, checking his throat and peering into his eyes, guarded handiest with the aid of a mask of questionable origin.

“there were simply crimson flags far and wide it,” she spoke of of the masks, which company information exhibit became marketed to personnel as just as good because the vaunted American-made N95 respirator at stopping the spread of the coronavirus.

She stared at the medical professional incredulously, then marched to a nearby storage hutch. She plunged her hand into a blue box of fifty or so masks, then two extra bins, like a child frantically scrounging through cereal packing containers for a magic ring.

From each, she pulled out a sheet of paper, hoping for proof that the masks had been cleared as beneficial by means of the U.S. government — from the federal food and Drug Administration, maybe, or the national Institute for Occupational defense and health, NIOSH, which certifies N95s that may filter ninety five% of particles.

as a substitute, she examine aloud the primary line of English: “no longer for medical goal.”

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Steadman, 41, had been in a standoff with her organization for months over insufficient own protective equipment. She’d long gone on go away in April, urgent CSL to provide first rate masks. She’d complained, devoid of success, to the federal Occupational defense and fitness Administration, which is supposed to ensure secure offices. different CSL personnel across the nation had made identical complaints. Ten weeks later, even though her complaints had been pushed aside, she lower back since the company mentioned laborers now had access to medical-grade masks.

CSL, a leader in the international plasma business, says it was adhering to federal guidelines to protect entrance-line worker's as it equipped a huge national push — recommended by using President Donald Trump — to cozy blood plasma donations from recovered COVID-19 patients. The FDA had authorized emergency use of convalescent plasma remedy as a remedy for the severely unwell, regardless of an absence of scientific proof that it saves lives.

Steadman and different blood plasma people feared a new stage of chance as donors got here in from the highway and attested that that they had been symptom-free for 14 days. the workers knew what the reviews referred to: individuals looking to be paid in change for being stuck with a needle usually tend to conceal sickness than those devoid of economic incentive.

“These don't seem to be people that are going to inform me that they’re sick,” Steadman told me.

This, on accurate of the movements circulate of non-COVID-19 donors coming in for $forty a draw, in general bad americans in high-chance agencies, equivalent to these working “basic” jobs where infections can spread wildly. A plasma donation comprises repeated and extended contact with body of workers — in the reception area, in waiting rooms, all over real tests in closed areas and when blood is drawn.

The enterprise referred to it turned into following all federal guidelines, however no agency had quantified the hazards posed to laborers like Steadman as a result of stepped-up plasma donations. Steadman had considered the various experiences of counterfeit masks making their solution to hospitals, endangering nurses and medical doctors. instead of face what she saw as “approaching danger,” Steadman informed CSL she wouldn’t return unless she had assurances the enterprise changed into providing safe masks. She also filed another OSHA grievance.

After weeks of awaiting regulators to behave, she contacted ProPublica. She despatched correspondence, CSL working towards materials, inner social media posts and samples of three masks from CSL’s stockpile. She’d spent hours making an attempt to song the masks’ origins, to look if her colleagues had been thoroughly protected, and not one of the chinese KN95s provided have been on the time on the FDA’s licensed record of masks which are roughly similar to U.S.-permitted N95s.

“They literally bought some off Amazon,” she pointed out, regarding facts the business gave to OSHA.

Her story presents a glimpse into the confusion, anxiousness and fear wrought by using lax govt oversight of the coronavirus mask market, the place extreme demand and low provide bred graft and fraud and left some entrance-line health care workers reliant on face coverings that could or could no longer work.

I’d spent the closing six months delving into the murky world of PPE, monitoring overseas companies and middlemen, and documenting rate gouging and questionable contracts. All of it unfolded in opposition t a backdrop of complicated and evolving suggestions from the federal govt.

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Are you a public medical expert, medical company, elected reputable, affected person or other COVID-19 expert? support be certain their journalism is accountable and concentrated on the correct concerns.

note: in case you Strengthen emergency warning indications for COVID-19, such as problem respiratory or bluish lips, get medical attention automatically. The CDC has greater suggestions on what to do if you're ill.

When Steadman and some other CSL workers agreed to talk, I obtained in my car and made the windy 4-hour power to the strip mall in McKeesport, Pennsylvania, the place they labored.

The car parking zone of the Olympia looking middle may well be artfully rendered in pencil and pastel and slapped on a postcard labeled “Poverty, americaA.” There’s a payday personal loan keep, a dollar Tree, a hire-A-middle, a shuttered Payless ShoeSource and within the corner, the glowing crimson sign of CSL Plasma.

With unemployment at near-record highs, CSL had made donating plasma a good looking option and mobilized laborers nationwide to recruit new donors. In McKeesport, it provided a $100 cash bonus to donors who might show they’d as soon as proven high-quality for COVID-19 and advertised that general donors could make about $seven-hundred month-to-month.

As FDA Hypes, OSHA Chills

CSL has greater than 260 U.S. plasma donation centers with plans to open dozens more next year. primarily based in Australia, the business is proud of a heritage that spans from its early use of plasma to beat diphtheria a century ago to assisting Strengthen the swine flu vaccine a decade ago. With $2.2 billion in earnings final yr, CSL gave out a listing dividend to U.S. shareholders.

Its company seems poised to get even more advantageous.

An alliance of analysis associations, plasma banks and drug agencies promotes donations through “The battle Is In Us” campaign, pitched on-line and on television by using stars similar to Dwayne “The Rock” Johnson and Helen Mirren who urge COVID-19 survivors to visit plasma facilities including CSL’s. The Trump administration has praised the initiative and refers donors to the alliance.

considering that the pandemic’s early days, the administration has been pushing plasma donations and cleared the style for a restrained examine to look if treatments of concentrated antibodies, derived from the serum surrounding the blood cells of COVID-19 survivors, could help others recuperate.

In late August, the FDA opened the door for frequent use of convalescent plasma therapy, citing a look at that kinda sorta confirmed the capabilities upsides of the treatment outweighed the hazards. In doing so, FDA Commissioner Stephen Hahn claimed that the medicine may have saved 35 out of 100 sufferers, an announcement he later recanted after scientists called it a gross exaggeration. nevertheless, Alex Azar, secretary of the U.S. branch of fitness and Human capabilities, referred to as the approval of convalescent plasma remedy a “milestone success in President Trump’s efforts to shop lives from COVID-19.”

This pushed CSL into excessive apparatus.

Weeks earlier, CSL constrained CEO Paul Perreault had made the case for the business-led race to get antibody-weighted down plasma in a roundtable appearance with Trump and different federal officials on the American red go headquarters in Washington.

“We need plasma. They want plasma donors. They need them anyplace they are,” Perreault informed Trump.

President Donald Trump visits an American red pass plasma donation middle in July 2020. (Doug Mills/The ny instances by the use of AP photograph)

apart from the president’s aid, the business had also enlisted exact pharmaceutical lobbyists to press the price of plasma remedy in Washington.

but many unknowns remained. Trump’s administration skipped the tedious — and, scientists say, crucial — step of a randomized controlled examine, comparing consequences of patients who obtained plasma remedy with those who didn’t. And while federal organizations stressed out that plasma donation facilities should stay open all over the pandemic to preserve the nation’s blood deliver flowing, employee safety went largely unmentioned.

Tom Inglesby, a director at Johns Hopkins’ center for fitness security, talked about the risk to people in plasma donation facilities depends on the spread in each and every neighborhood. The greater possibility, he said, may now not be the individuals who have recovered from COVID-19 however all the other donors who are being let in without prior screening to a place where infections can spread comfortably.

“If I had been working during this classification of facility, i want to have an N95 masks,” Inglesby stated.

“You’d should name these people health care authorities, for sure. They’re drawing blood.”

for the reason that March, OSHA has obtained about a dozen COVID-19-connected workplace protection complaints from CSL worker's in Pennsylvania, Indiana, Michigan, Minnesota and Texas. Half were about insufficient PPE equivalent to masks, the leisure about fear the business wasn’t imposing public health guidelines.

In late may also, for example, a Houston employee stated that a workforce member confirmed advantageous and “six people working near the infected person were quarantined,” based on OSHA statistics.

“other body of workers contributors are being sent out to work at different areas,” that criticism stated, “exacerbating the spread.”

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Anthony Farina, CSL’s spokesman, observed OSHA has assessed no penalties based on these complaints.

“CSL Plasma has cooperated right away with all requests for tips, and has automatically shared documentation of their defense practices in region to avoid publicity. The business also investigated the allegations and reviewed their applicable necessities to ascertain compliance with acceptable OSHA COVID-19 suggestions,” his remark spoke of.

All but three of those instances had been closed.

Debbie Berkowitz, a former top OSHA reputable in the Obama administration, stated Steadman’s journey is a part of a larger trend. “OSHA has decided now not to implement the legislations and has abandoned its mission,” she spoke of. “workers are on their personal.”

The company has acquired greater than 33,000 COVID-19-related complaints, in line with OSHA records. more than two-thirds of those are closed. very nearly 9,000 complaints had been about PPE at work.

She became certainly involved about a company presentation that advised CSL workers that KN95s, accredited beneath chinese language requirements, had been just as good as N95s, accepted through U.S. scientists.

presenting questionable chinese masks “and sort of implying to people that here is like an N95 — it is absolutely deceiving and bad since it gives these people a false feel of security,” Berkowitz said.

Afraid at Work

The angst among CSL people began in March, when company advice stated that “a masks does not accurately offer protection to fit individuals from an an infection of coronavirus.” In fairness, this become across the time U.S. Surgeon well-known Jerome Adams despatched out a tweet he’d later recant:

“critically people- stop buying MASKS! They are not useful in preventing standard public from catching #Coronavirus”

CSL employees, including managers, described an internal tracker on the business’s community displaying tons of of personnel took leave from March through September as a result of they were either uncovered to COVID-19, in poor health or afraid. None of those laborers have been able to share uncooked records. CSL didn't at once respond.

Steadman shared emails that trace at challenge sweeping via CSL as employee absences shuttered whole facilities.

March 17: “due to workforce disease, the Hillsboro [Florida] 126 core will lengthen opening …”

March 27: “Little Rock [Arkansas] 234 is closed as a result of staffing considerations.”

March 30: “... Peoria [Arizona] closed for the day as a result of staffing concerns.”

The enterprise shared on-line presentations outlining evolving pandemic instructions. On April 10, it instructed employees that N95 respirators conveniently filtered out airborne contaminants. but the business wasn’t presenting them and mask use was voluntary.

Later correspondence suggests masks were not required since the business had no OSHA-accredited respiratory program, which comprises practising on a way to wear them and fit testing to ensure proper use.

That week, Steadman lodged her first criticism to management, took leave and complained to OSHA.

“I endured to work in decent faith, despite surely believing that imminent danger exists,” she wrote in a lengthy letter to CSL management. “despite the fact, the policy for ‘recovered donors’ is a chance i am not willing to take.”

The drumbeat of personnel absences indicated she turned into no longer alone in her worry.

April 17: “Taylor 240 [Pennsylvania] briefly closed due to staffing concerns.”

On may also four, soon after the FDA gave emergency use authorization to import masks from 80 little-well-known chinese producers, the company announced it wasn’t distributing those gold-usual N95s. It became instead providing chinese language KN95s. And 10 days later, a presentation advised employees there turned into “little or no difference in certification necessities between a N95 and KN95.”

however company facts display the three manufacturers of KN95s CSL bought and dispensed have been now not on the FDA’s list of chinese masks that are roughly comparable to N95s and correct for health care workers. And all three used earloops, which may also be less comfortable than those that wrap around the head.

The circulate to distribute chinese KN95s didn’t halt the continuing group of workers considerations.

June 21: “... home [Pennsylvania] unable to open due to staffing.”

meanwhile, CSL continued to aggressively recruit donors who had recovered from COVID-19, with worker's posting flyers and placing signals across the nation, in response to interior social media posts, a few of which display people improperly donning KN95s.

Weeks passed, so Steadman referred to as OSHA. She was instructed to file a new grievance. Too a lot time had handed. So she did.

In early July, OSHA advised the business that regulators wouldn’t investigate Steadman’s updated criticism, deferring to CSL to look into it.

CSL reported to OSHA that its investigation had discovered no problem. A July 15 follow-up from corporate headquarters in Boca Raton, Florida, gave particulars about CSL’s masks, together with photographs and a snapshot of hundreds apparently purchased through Amazon. in line with CSL, the masks were sourced by the Utah-based clinical machine company HemaSource. Executives at HemaSource did not reply to messages from ProPublica.

In a letter the following day, an OSHA broke the information to Steadman.

“CSL Plasma has counseled me that the risks you complained about had been investigated. The business enterprise states that the dangers have been corrected,” area Director Christopher Robinson wrote. “With this tips, OSHA feels the case may also be closed.”

Steadman believed the masks details supplied to OSHA demanded additional inquiry.

“Who’s going to make certain people have safe masks if no longer OSHA?” she said.

Steadman with the KN95 masks given to her with the aid of CSL Plasma. (Nate Smallwood for ProPublica)

She rebutted her employer’s response in a doc that reads like a prosecutor’s show.

“each certificates supplied during this doc is easily identifiable as plagiarized, and suits each criterion from the [Centers for Disease Control and Prevention] and NIOSH on determining counterfeit masks and falsified files,” she wrote on July 19.

right here’s where Steadman descended into the maddening vortex that’s subsumed my reporting these final six months. After the FDA opened the gates for masks from China, later reversing route as junk masks ended up in health care settings, it grew to be fairly dang challenging to tell what turned into what. this is especially true of brands of masks the CDC or a private lab hasn’t established and posted findings about, which is the case right here.

Steadman went down a Google hole, cross-referencing pictures, technical statistics, mannequin numbers and extra. All of CSL’s KN95s have been labeled as now not for scientific use.

One classification of masks related lower back to a chinese diaper enterprise.

one more cargo, apparently from Amazon, came in packages of 4 (sterile masks usually come for my part wrapped). Plus, the “CE” markings claiming they’d handed muster with European regulators have been skewed and positioned in diverse spots masks to mask, as if applied by means of hand with an ink stamp as opposed to specific machinery.

The third classification, the KN95 Steadman become exceeded that disturbing June night, links to a corporation registered with the FDA as ZK-most appropriate, which sells masks accredited by way of chinese regulators for working around dust or filtering polluted air. The chinese brand didn't reply to e-mail requests for remark.

however CSL blanketed a technical facts sheet for these masks in its submission to OSHA that raises questions. The doc purports to demonstrate that SGS, a global company that deploys inspectors to factories to look at various goods for far-flung buyers, had found the ZK-optimal respirator totally effective.

The document appeared extraordinary. The date format was month, day, 12 months: “July 1st, 2015.” That’s an American convention I hadn’t seen on other SGS documents. The inspection additionally seemed to be for a totally distinctive masks mannequin, a so-known as PM2.5 masks designed for industrial use.

I reached out to consultants who had imported and offered legit masks. I also reached out to SGS.

Richie Hecker, director of the scientific deliver enterprise Traction and Scale, offered PPE to big apple metropolis and others. together with his help, ProPublica requested a researcher in China to examine. When the consequences came returned, Hecker noted he wouldn’t purchase these masks because SGS spoke of the file supplied to OSHA become false, a “cut and paste job.”

“here is not an usual SGS document,” SGS also wrote to me. “This doc is consequently of no cost whatsoever and they suggest you no longer to depend on it for any intention.”

Hecker stated phony files are commonplace fare in the PPE market and “the KNs are the dirtiest merchandise in the marketplace.” That’s why reputable chain-of-custody documents connecting the mask in Steadman’s hand to a selected factory are vital.

A technical facts sheet that CSL Plasma submitted to OSHA, which the international inspection firm SGS stated is fake and “of no price whatsoever.” (obtained by means of ProPublica)

after I asked CSL about the false SGS document, a spokesperson mentioned that the company would investigate and that it takes its responsibility to supply accurate suggestions to federal regulators with “utmost seriousness.”

On Sept. 2, just two days after I first requested CSL concerning the ZK-superior masks, its ZKG 9501 KN95 mask looked on the FDA’s listing as allowed below the emergency use authorization. This wasn’t the case prior in my analysis or all the way through the months Steadman refreshed and refreshed the identical web site and sent questions to a couple of govt agencies.

An FDA professional advised me that company of mask was approved in accordance with trying out and approvals from the FDA’s European Union counterpart, although the masks CSL disbursed and their packaging lack the CE mark. NIOSH has considered dissimilar cases of counterfeit masks sold using the branding of manufacturers on the checklist. U.S. regulators have not validated the ZK-optimal masks themselves, but any one involved about masks at their place of work is encouraged to send them to NIOSH for trying out, officials observed.

just a few days later, on Sept. 13, CSL provided new documents it stated proved the masks were authentic, including a new testing doc and a letter interestingly from a ZK-optimum manager named “Chensu,” who spoke of the masks had been permitted by means of SGS in any case. There become a mixup with the mask fashions, the letter stated, however the masks were good.

i attempted to authenticate those documents with the manufacturing facility however didn’t hear lower back.

I asked a CSL spokesperson for proof the documents came from the manufacturing unit, perhaps an e mail thread showing a series of custody. The business declined however pointed out, “We assure you that they didn't alter any of the documentation.”

I shared all of this with Steadman, who remains skeptical.

“That Put Me at risk”

employees in McKeesport continue to be on facet as a result of the masks but also CSL guidelines they say are conflicting and unhealthy.

CSL says people are secure since the facilities don’t treat patients who are at the moment in poor health with COVID-19.

Donors receive a blood power, temperature and pulse determine, said Farina, the company spokesman, and COVID-19 survivors “need to supply a doctor’s be aware confirming their prognosis and confirmation that they have got recovered from COVID-19.”

Yet late last month, two worker's were doubtlessly uncovered to a donor who later tested fantastic, based on interior emails and interviews with CSL employees. That donor wasn’t adequately wearing her mask, employees advised me.

concerned for her safety, Steadman is on depart from CSL. (Nate Smallwood for ProPublica)

Samantha Kelly, 30, become told she had contact with this person. She worked the reception desk and spent several minutes pricking the fingers and taking the blood force of stroll-in donors. She pointed out the enterprise refused to inform her when that contact happened, making it impossible to retrace her steps and warn those near her.

Kelly is the primary caregiver for her mom, who has diabetes and a continual inflammatory lung disorder.

“That put me in danger,” she informed me. “That put my family at risk, each person they had are available contact with.”

She’s technically still a CSL employee, on unpaid leave when you consider that Aug. 20, however she talked about she’s now not going returned.

A CSL spokesperson observed the company follows CDC and native instructions on contact tracing however mentioned patient privacy laws restrict what they can inform personnel.

business information exhibit CSL stopped doing temperature readings at the door in June.

CSL personnel say the exams specified by means of CSL’s spokesman turn up lengthy after sufferers enter the centers, every so often after they’ve signed in, talked with body of workers and sat in a waiting room earlier than screening.

finally, CSL personnel don’t have lots but donors’ be aware that they’re no longer sick, personnel say and records exhibit.

This month, a woman who noted she’d recovered from COVID-19 came into the McKeesport office to sell her plasma, based on CSL staff. well after she arrived, a staffer found she was running a fever. She was sent home. personnel are nevertheless rattled.

CSL personnel informed me their need for good PPE become heightened by a accurate coverage exchange. personnel have been instructed they can not ask donors who refuse to wear masks to depart, based on company instructions despatched out in late June.

A slide from a June 25 CSL working towards presentation. (got by means of ProPublica)

Responding to Steadman’s persistence, OSHA reopened its investigation. That inquiry is ongoing, and the company received’t say extra except it’s comprehensive, a spokeswoman noted in an email.

On Sept. 1, the business launched a COVID-19 antibody checking out application in about 30 cities to assist identify extra abilities donors who have recovered from the disease. That identical day, the country wide Institutes of health spoke of there’s no facts to support convalescent plasma therapy as a common medicine for COVID-19.

within the end, I discovered best some answers for Steadman, who remains on go away from CSL. She observed she and her co-people may have averted heartache if the business had with no trouble addressed her questions and located FDA-authorized masks again in might also.

“Why would the company let me flail over right here and let me freak out and make contact with several different organizations if every little thing is just best?” she noted. “Nothing that you just’ve simply informed me convinces me that anybody is sure these masks would supply protection to me from COVID — at all.”

On a fresh warm afternoon, as they talked in front of her parent’s lengthy log cabin home, Steadman changed into donning scrubs even if she hadn’t been to work in weeks. I requested why.

She changed into going to a job reasonable.

Yeganeh Torbati and Mollie Simon contributed reporting.

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