Students may prepare and eat foods in the classroom as part of a learning activity associated with an approved curriculum project.  Use of blenders in classroom food preparation is forbidden.  All appliances, dishes and utensils used for any classroom cooking must be fully sanitized in the cafeteria and run through an UL-approved dishwasher or washed in a cafeteria sanitizing sink.

Teachers and students should be aware of and follow safe food handling practices. If needed, the Child Nutrition program could serve as a resource for information about best practices when handling a variety of foods.

Meals provided by the school cafeteria kitchen should not be further processed (i.e., chopped, blended, pureed, etc.) in the classroom because this area is not permitted for food preparation. Most establishments or operations where food is prepared or served at wholesale or retail for pay must have a valid food handling permit. Therefore, all meal preparation should take place in the cafeteria kitchen with approved equipment and ingredients following a Hazard Analysis Critical Control Point (HACCP) food safety plan. North Carolina General Statute § 130A‐247 and North Carolina Department of Environment and Natural Resources (NCDENR) 15A NCAC 18A .2600 Rules Governing the Sanitation of Food Service Establishments provide detailed information.

The Division of Environmental Health in the North Carolina Department of Environment and Natural Resources has drafted revisions to the 15A NCAC 18A .2400 Rules Governing Sanitation of Public, Privateand Religious Schools. The draft revisions are currently undergoing a fiscal impact assessment. If adopted, the revisions will regulate food preparation practices in the classroom setting. The response to this question will be updated as new information is received.  Contact the local Environmental Health specialist if clarification is needed.

Food safety is the first consideration. Many of the students involved in meal preparation have food allergies or sensitivities. There are regulations for highly susceptible populations and special considerations for juice, pasteurized eggs or egg products, ready-to-eat foods, and tube feedings.

Fresh-squeezed juice can NOT be served.  All juice must be prepackaged and pasteurized or in a commercially sterile, shelf-stable form in a hermetically-sealed container. Juice prepared from concentrate using safe, potable water is allowed as long as safe food handling practices are followed.

Substitute pasteurized eggs or egg products for raw eggs when making recipes calling for lightly cooked eggs. 

All eggs and egg dishes must be cooked to at least 145 degrees F or higher for immediate service or 155 degrees if hot held.

Do NOT serve: raw animal foods (raw fish or shellfish; raw marinated fish; raw beef, poultry, or pork), partially cooked animal foods (lightly cooked fish; rare meat, soft cooked eggs from raw eggs; meringues), raw unpasteurized milk or products made from it, raw seed sprouts.

The same foods that are prohibited or avoided in the school cafeteria kitchens should be avoided in instructional use as well. Consultation with the Child Nutrition Director is encouraged.

If food handling and preparation are part of the student' curriculum then a student can use the microwave as part of a life skills goal.  Environmental health inspects and licenses food preparation and service areas for instructional purposes separately.  The principal of your school should know these rules or how to contact environmental health for consultation.

Competitive foods and beverages may not be sold during the school day until after the last school lunch meal is served and the cafeteria closes for the day. Occupational home economics instructional programs which operate under an approved annual vocational education plan and which involve the preparation and sale of foods to individuals other than students are not in competition with the Child Nutrition program.

Foods and beverages that pass the Child Nutrition cashier at the point of service cannot be returned to the cafeteria serving line for re‐service under any circumstances. These foods and beverages are considered sold to the student; therefore, the student would determine whether to discard or save an item for later personal consumption.

When the student is finished with the meal or snack, most leftover foods should be discarded. There is a significant risk of foodborne illness if potentially hazardous foods are not handled safely and held at proper temperatures. The only exceptions to saving leftovers from the student’s meal or snack would be for non‐potentially hazardous food such as unopened, commercially packaged crackers and whole (uncut) fresh fruit. If these non‐potentially hazardous foods are saved for later consumption, they should be consumed or discarded by the student selecting the original meal or snack and should not be transferred to another person to minimize any intentional or unintentional contamination.

School staff must always follow the dietary instructions on the Medical Statement for Students with Special Nutritional Needs for School Meals that have been prescribed by the licensed physician. It is the responsibility of the classroom teacher in consultation with the parent or guardian, school nurse, and school administrators to determine if foods from unapproved or uninspected sources may be served in the classroom. Students with special dietary needs may have weakened immune systems and be more highly susceptible to foodborne illness, especially from raw foods.

The United States Food and Drug Administration (FDA), Food Code prohibits the service of unpasteurized fresh fruit juice and raw sprouts to highly susceptible populations. Other raw fruits and vegetables may also carry a high risk of contamination. Therefore, it is recommended that foods from school gardens not be served to students with disabilities who require special dietary accommodations. Fresh fruits and vegetables served in the school cafeteria are obtained either from approved sources that follow a Hazard Analysis Critical Control Point (HACCP) food safety plan or from growers that are certified for Good Agricultural Practices (GAP). School gardens may lack these important safeguards against foodborne illness.

The Child Nutrition Dietitian will keep the final/approved Medical Statement form and disseminate copies to the appropriate school based nurses and other school based staff.

Schools are required by Federal law to implement “Child Find” which requires that students with

suspected disabilities are identified, located, and evaluated. The Dietary Modification Decision‐making Flowchart can provide guidance for this process for students who require dietary modification. Schools have a reasonable length of time to assemble a team to assess student needs and formulate an appropriate accommodation plan such as a 504 Accommodation Plan or an Individualized Education Program (IEP). Based on a review of the available literature, best practice standards suggest up to ten days is sufficient to assess student needs and develop a plan of action. Parents are an excellent source of information regarding foods the student ate prior to being enrolled in school. Parents must be involved

and may have to provide food until the school can make appropriate accommodations.

Most schools would initially defer to the Individuals with Disabilities Education Act (IDEA) and use those Federal funds for an evaluation to determine if the student is eligible for disability services. If not eligible for an IEP, the student may qualify for Section 504 of the Rehabilitation Act of 1973 accommodations. Dietary needs may be identified in either an IEP or a 504 Accommodation Plan. For any dietary modification, a completed and signed Medical Statement must be secured. For students with a disability, the Medical Statement must be signed by a licensed physician. For students without a disability, the Medical Statement must be signed by the licensed physician or a recognized medical authority, which includes a physician assistant or nurse practitioner.

Schools should develop a clear procedure for handling these types of concerns. Schools are required by Federal law to implement “Child Find” which requires that students with suspected disabilities are identified, located, and evaluated. If a parent/guardian tells school personnel that a student needs a modified diet, the school may have reason to suspect the existence of a disability. The school is then responsible for evaluating the student and determining eligibility.

A Licensed Physician or Physician's Assistant or Nurse Practitioner must complete and sign the Medical Statement for Students with Unique Mealtime Needs for School Meals. 

Under no circumstances should school staff interpret, revise or change a diet order.

The LEA has a reasonable amount of time (approximately 10 days determined by the Office of Civil Rights) to procure and provide the training necessary to appropriately fulfill the student's needs based on the Medical Statement form. Until then the school staff is asked to collaborate with the parents in order to determine how the student's dietary needs can be met.  In the meantime the school is not to alter the student's food. The parents will be responsible for providing any foods within the modified diet.

No. All Medical Statements requiring dietary accommodations for students with disabilities must be signed by a Licensed Physician or Physician's Assistant or Nurse Practitioner.

Contact the parent or guardian to discuss the Medical Statement. Clarify with the parent/guardian that each special dietary request must be supported by a completed Medical Statement.The  Medical Statement for Students with Unique Mealtime Needs for School Meals form must be signed by a Licensed Physician or Physician's Assistant or Nurse Practitioner.

Based on a federal mandate from the United States Department of Agriculture (USDA), the N.C.

Department of Public Instruction requires a signed statement when making dietary accommodations for students that includes the child's disability or medical condition, an explanation of why the disability or medical condition restricts the child's diet, the major life activity affected, and the food or foods to be omitted from the child's diet and the food or choice of foods that must be substituted. 

The Medical Statement is designed to collect all information required by USDA when accommodating students with special dietary needs. This information will be used by numerous people involved in the care of the student; therefore, the Medical Statement must be completed to ensure all of the student’s nutritional needs are understood and can be met by school staff. The Medical Statement must be signed by a Licensed Physician or Physician's Assistant or Nurse Practitioner.

An appropriate school official (such as the Child Nutrition administrator or school nurse) must ask the parent/guardian to obtain more written information from the licensed physician concerning the substitutions or modifications the student requires. If difficulties arise in obtaining the needed information, the parent/guardian should be advised of the problem and asked to work with the school to obtain a completed Medical Statement for Students with Unique Mealtime Needs for School Meals. It is important that the family understand that the school is unable to provide food substitutions or modifications without a completed and signed Medical Statement. In some cases, it may be appropriate and helpful for the physician to provide a written referral to a registered dietitian or other qualified professional for instructions regarding dietary substitutions or modifications. For further guidance or referral to a registered dietitian, Child Nutrition administrators may contact their State Agency.

If dietary modifications are required, a completed and signed Medical Statement for Students with Unique Mealtime Needs for School Meals must be secured. The Medical Statement must be signed by a licensed physician. Based on a federal mandate from the United States Department of Agriculture (USDA), the N.C. Department of Public Instruction requires a signed statement when making dietary accommodations for students that includes the child's disability or medical condition, an explanation of why the disability or medical condition restricts the

child's diet, the major life activity affected, and the food or foods to be omitted from the child's diet and the food or choice of foods that must be substituted.

The Medical Statement for Students with Special Nutritional Needs for School Meals has been formatted to include all information required by USDA when accommodating students with special dietary needs. It also includes information needed by the Individualized Education Plan Program (IEP) Team or 504 Accommodation Plan Committee and other professionals involved in developing plans to adequately serve the needs of the student. When a student’s 504 Accommodation Plan or Individualized Education Program (IEP) is being developed, the respective team must include the Child Nutrition administrator in making decisions regarding accommodation of special dietary needs through the Child Nutrition program.

Food anaphylaxis (life‐threatening allergy) is considered a disability. If the student’s allergy does not result in anaphylaxis, it is still recommended to gather as much information as possible to best assist the student; the Medical Statement can assist in obtaining complete details regarding the student’s allergy and any requested dietary accommodations. The Local Education Agency (LEA), Child Nutrition program may make food substitutions, at their discretion, for individual students who do not have a disability, but who are medically certified as having a special medical or dietary need. Such determinations are made by the LEA on a case‐by‐case basis. This provision covers those students who have food intolerances or

allergies but do not have life‐threatening reactions (anaphylactic reactions) when exposed to the food(s) with which they have problems.

Under no circumstances should school staff interpret, revise or change a diet order.

For students without a disability, the Medical Statement for Students with Unique Mealtime Needs for School Meals may be completed and signed by a Licensed Physician or Physician's Assistant or Nurse Practitioner. The Local Education Agency (LEA), Child Nutrition program may make food substitutions, at their discretion, for individual students who do not have a disability, but who are medically certified as having a special medical or dietary need. Such determinations are made by the LEA on a case‐by‐case basis. This provision covers those students who have food intolerances or allergies but do not have life‐threatening reactions (anaphylactic reactions) when exposed to the food(s) to which they have problems.

Under no circumstances should school staff interpret, revise or change a diet order.

A Licensed Physician or Physician's Assistant or Nurse Practitioner must complete and sign the Medical Statement for Students with Unique Mealtime Needs for School Meals.

Local health departments, Federally Qualified Health Centers, hospitals, medical centers or school‐based or school‐linked health centers that have registered dietitians on staff may be able to provide assistance in understanding diet orders, developing and modifying meal plans and menus, acquiring special food and beverage item purchases, and other aspects of feeding students with special needs.

No, a parent or guardian cannot withdraw or modify a written Medical Statement. School staff must adhere to the Medical Statement. If the parent/guardian does not agree with the Medical Statement for Students with Unique Mealtime Needs for School Meals, they may request a new evaluation from a  Licensed Physician or Physician's Assistant or Nurse Practitioner who then may revise the Medical Statement. The school may be responsible for providing the medical evaluation.

Under no circumstances should school staff interpret, revise or change a diet order.

If dietary modifications are required, a completed and signed Medical Statement must be secured. The Medical Statement must be signed by a licensed physician. For a student

without a disability, the Medical Statement must be signed by a Licensed Physician or Physician's Assistant or Nurse Practitioner. Medical Statement for Students with Unique Mealtime Needs for School Meals has been formatted to include all information required

by the United States Department of Agriculture (USDA) when accommodating students with special dietary needs. It also includes information needed by the district or school team and other professionals involved in developing plans to adequately serve the needs of the student.

The United States Department of Agriculture (USDA) requires that the Medical Statement for Students with Unique Mealtime Needs for School Meals reflect the current dietary needs of the students. Some Local Education Agencies (LEAs) may require that this information is updated annually. At a minimum, the Medical Statement must be updated when the needs or condition of the student changes. If Medical Statements are not renewed annually, LEAs should review the document regularly making sure it reflects the current dietary needs of the student.

If the Local Education Agency (LEA), Child Nutrition program is not providing food or beverage for the student, the Child Nutrition administrator will not need a completed  Medical Statement for Students with Unique Mealtime Needs for School Meals.