CHAPTER DIVISION OF PUBLIC HEALTH; BUREAU OF ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH AND SANITATION STANDARDS

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1 CHAPTER DIVISION OF PUBLIC HEALTH; BUREAU OF ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH AND SANITATION STANDARDS SUBCHAPTER GENERAL PROVISIONS Part 001 General Provisions Authority Purpose and Findings Purpose Binding [Reserved] Definitions Part 100 Sanitary Permits Sanitary Permits Required Display of Sanitary Permits Compliance with CNMI and Federal Law Pre-operation Inspections Required Compliance with Act and Regulations Form and Charges for Permit and Annual Renewal Fees Transfer of Permit Forbidden Part 200 Inspection Pre-operation Inspections Inspection Frequency Inspection for Permit Renewal Additional Inspections Access to Premises and Due Notice Denial of Access Suspension of Sanitary Permit Part 300 Inspection Reports; Demerit Values; Demerit Scores Inspection Reports Demerit Values Demerit Scores; Grades Failing Grade; Imminent Health Hazard Closure Notice Part 400 Inspection Reports Content of Inspection Reports Service of Inspection Reports Part 500 Timely Correction of Violations of Critical Control Points Corrective Actions Time Allowed for Corrective Action Extensions of Compliance Period Re-grading After Corrective Action Verification and Documentation of Correction Part 600 Suspension and Revocation of Permit Imminent Health Hazard; Suspension and Closure Suspension; Notice and Hearing Revocation; Notice and Hearing

2 Judicial Review of Decisions Reinstatement of Permit Revoked Permit May Not Be Reinstated No New Permit Closing Notification of Commissioner of Public Safety Notice Posted of Closure Inspection Report Public Information Part 700 Penalties and Fines for Violations Penalties Hearings on Fines Part 800 Ceasing Operations and Reporting Notification of Imminent Health Hazard Unaffected Areas Resumption of Operations Part 900 Infectious Disease Control Employees Carrying Communicable Diseases Employees with Other Health Problems Employees with Food or Water Borne Illness Tattoo or Body Piercing Shops; Employees with Blood Borne Illnesses Procedures When Infection Is Suspected Part 1000 Miscellaneous Provisions Severability Appendix A Bureau of Environmental Health Fee Schedule Subchapter Authority: 1 CMC 2603 and 2605; 3 CMC Subchapter History: Amdts Adopted 39 Com. Reg (Feb. 28, 2017); Amdts Proposed 36 Com. Reg (July 28, 2014); Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: PL 1-8, tit. 1, ch. 12, codified as amended at 1 CMC , created the Department of Public Health and Environmental Services (DPHES) within the Commonwealth government. See 1 CMC CMC 2603(a) grants the Department the power and duty to maintain and improve health and sanitary conditions in the CNMI. 1 CMC 2605 directs the Department to adopt rules and regulations regarding those matters over which it has jurisdiction. Executive Order 94-3 (effective August 23, 1994) reorganized the Commonwealth government executive branch, changed agency names and official titles, and effected numerous other revisions. According to Executive Order : Section 105. Department of Public Health. The Department of Public Health and Environmental Services is re-designated the Department of Public Health. The full text of Executive Order 94-3 is set forth in the commission comment to 1 CMC PL (effective Apr. 26, 2001), the Commonwealth Environmental Health and Sanitation Act of 2000, codified at 3 CMC , revised the Commonwealth statutes related to environmental health and sanitation. PL repealed former 3 CMC and enacted new sanitation provisions. 3 CMC 2122 requires a sanitary permit to operate enumerated establishments. 3 CMC 2123 directs the Secretary of

3 Public Health to promulgate rules and regulations required to ensure the sanitary operation of listed establishments. The 1999 Food Handlers Rules and Regulations contained General Provisions applicable to the Bureau of Environmental Health s Environmental Health and Sanitation Standards codified in this chapter. The 2003 amendments also contained general provisions applicable to this entire chapter. Although the Department of Public Health did not specifically repeal the 1999 General Provisions, the 2003 General Provisions duplicate the definitions included in the 1999 promulgation. The Commission has retained the 1999 Purpose and Findings provision. See Public Law (effective Jan. 15, 2010), the Commonwealth Healthcare Corporation Act of 2008, codified at 3 CMC 2801 et seq., established the Commonwealth Healthcare Corporation, which assumed the duties of the Department of Public Health as of January 15, Part General Provisions Authority The regulations throughout this chapter implement the provisions of the Commonwealth Environmental Health and Sanitation Act of 2000, PL or 3 CMC 2121, et seq. (hereinafter the Act). The Act authorizes the Secretary of the Department of Public Health to establish, propose or adopt rules and regulations governing public health and sanitation practices in the Commonwealth of the Northern Mariana Islands ( CNMI ). In addition, 1 CMC 2603 and 2605 authorize the Secretary to promulgate regulations to protect the health of residents of the CNMI. Modified, 1 CMC 3806(d). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Purpose and Findings (a) The Division of Public Health, Department of Public Health is promulgating the rules and regulations in this chapter in accordance with the provisions of 1 CMC 2605 and 3 CMC The purpose of these rules and regulations is to establish procedures and protocols for the operation of the Bureau of Environmental Health. In particular it provides for health and sanitation standards for businesses handling food for human consumption; health and hygiene standards for clinics, beauty salons, massage parlors and other establishments; safety and sanitation standards for high density living environments such as hotels and apartments; and control of vector of disease. By promulgating these rules and regulations the Division of Public Health intends to establish minimum health standards to protect the life, health, safety, and welfare of the general public in the CNMI. (b) The Division of Public Health is concerned about the transmission of communicable diseases in the CNMI, which already has high rates of illnesses such as salmonella, shigella, campylobacter, food poisoning, and tuberculosis. Unclean business establishments, unclean living conditions and overcrowding, infected food handlers, and uncontrolled vectors of disease all potentially spread these illnesses in the community. The Division of Public Health has found that infected people who show little outward appearance of being ill transmit many of these

4 diseases. As a result, a wide range of food-borne infections and other communicable diseases may be unknowingly transmitted to customers and the general public. The Division of Public Health has thus concluded that an effective means of controlling the spread of specific diseases is to monitor business establishments and living environments and screen likely carriers of these diseases annually. Modified, 1 CMC 3806(d), (f). History: Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The original paragraphs were not designated. The Commission designated subsections (a) and (b). The 1999 Food Handlers Rules and Regulations contained General Provisions applicable to the Bureau of Environmental Health s Environmental Health and Sanitation Standards codified in this chapter. The 2003 amendments also contained general provisions applicable to this entire chapter. Although the Department of Public Health did not specifically repeal the 1999 General Provisions, the 2003 General Provisions duplicate the definitions included in the 1999 promulgation. The Commission has retained the 1999 Purpose and Findings provision in this section Purpose The rules and regulations in this subchapter shall be known as the Environmental Health and Sanitation Standards and may be listed as such and will be hereinafter referred to as* * See Commission Comment. Modified, 1 CMC 3806(d). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: *Commonwealth Register volume 25, number 6, pages and mistakenly reprint earlier pages in the volume from another regulatory program. As a result, two pages of the regulations codified in this chapter are missing from the Commonwealth Register, including the conclusion of this section. See 25 Com. Reg. at (July 15, 2003) Binding [Reserved.]* * See Commission Comment. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: *Commonwealth Register volume 25, number 6, pages and mistakenly reprint earlier pages in the volume from another regulatory program. As a result, two pages of the regulations codified in this chapter are missing from the Commonwealth Register, including this section. See 25 Com. Reg. at (July 15, 2003) Definitions

5 (a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* [Reserved.]* (n) Compliance. Shall mean an act of adherence or compliance with rules, regulations, procedures, or policies established by the regulations in this subchapter. (o) Corrosive-resistant Material. Shall mean materials that maintain their original characteristic under prolonged influence of normal use of cleaning compounds, or contact with sanitizing solutions, and other conditions of use within the establishment that may be reasonably expected during normal use. (p) Critical control point means a fundamental element or process or procedure that must be carried out in a specific controlled manner to ensure that the overall process or procedure does not create an unacceptable health risk or produce any byproduct that creates an unacceptable health risk. (q) Delegated Authority. Shall mean the authority delegated by the Secretary of Public Health to the Deputy Secretary for Public Health to act on his/her behalf enforcing public health and sanitation rules and regulations, and all other policies, procedures, and the provisions of the regulations in this subchapter. (r) Dental Clinic. Shall mean an establishment where the examination, removing,

6 crowning, and filling of teeth are provided. (s) Department. Shall mean the Department of Public Health, Commonwealth of the Northern Mariana Islands. (t) Deputy Secretary. Shall mean the Deputy Secretary for Public Health. (u) Division. Shall mean the Division of Public Health, the Department of Public Health, Commonwealth of the Northern Mariana Islands. (v) Duly authorized representative means the Deputy Secretary for Public Health Administration, the Medical Director of Public Health, the Environmental Health Office, or Environmental Health Inspector, as designated by the Secretary. (w) Easily Cleanable Surfaces. Shall mean surfaces that are readily accessible and made of such material and so fabricated that food residue and other soil may be effectively removed by normal cleaning methods. (x) Employee. Shall mean the health permit holder, individuals having supervisory or management duties and any other person working in a food service establishment or any other establishment covered by the regulations in this subchapter. (y) Establishments. Shall mean any buildings, structures, places, or homes, whether being used for any purpose or not, that are hereby governed by the regulations in this subchapter. (z) Equipment. Shall mean stoves, ovens, ranges, hoods, slicers, mixers, water heaters, meat blocks, tables, counters, refrigerators, sinks, dishwashing machines, steam tables, and similar items other than utensils, used in the operation of a food service establishment, and it shall also mean devices, equipment, or implements used or utilized for handling, preparing, storing of drugs or cosmetics, or any equipment incidental to the handling, preparing, or storing of drugs or cosmetics and shall include those devices, equipment, or implements used in the operations of acupuncture clinic, dental clinic, optical clinic, health clinic, barber & beauty shops, massage parlors and in tattoo shops. (aa) Fair or Public Exhibits. Shall mean a festival at which articles, products, wares, etc., are displayed for competitive exhibition, advertising, sales or distribution, where foods or drinks are offered for sale, and where amusement of various kinds may be offered. (bb) Food Contact Surfaces. Shall mean those surfaces of equipment and utensils with which food normally comes in contact, and those surfaces from which food may drain, drip, or splash back onto surfaces normally in contact with food. (cc) Food Handler Certificate. Shall mean a certification by the Secretary of the Department of Public Health or Deputy Secretary for Public Health Administration to an applicant food handler after completing a physical examination and/or health screening for communicable or foodborne diseases and found to be free of these diseases and upon successfully completing a

7 food handlers seminar conducted or sanctioned by the Bureau of Environmental Health. (dd) Food Handler. Shall mean any person who handles food or drinks in a place where food or drinks are stored, prepared, or sold for public consumption. It also means all persons who are hired to work in homes, hotels, school kitchens, or cafeterias, concession stands, cafeterias, snack bars, restaurants, or any eating and drinking establishments were* the duties require the handling of cooking utensils, food, or drinks for public consumption. * So in original. (ee) Food Processing Establishment. Shall mean a commercial establishment in which food or drinks are processed, manufactured, or packaged for human consumption, such as: soy bean processing units, water and ice processing plants, hot pepper processing plants, bean sprouts processing plants, and other food or drinks processing plants. The term does not include a food service establishment, retail food outlets, or commissary operation. (ff) Food Retail/Wholesale Establishment. Shall mean an establishment where food and drinks are stored, kept, displayed, whether raw or cooked, and sold individually or in bulk commodity. (gg) Food Service Establishment. Shall mean any place where food is prepared and provided in individual servings, regardless whether consumption is on or off the site, and shall also include delicatessen type operation that prepares sandwiches, or other food in individual servings for public consumption. The term does not include private homes or churches or other religious, philanthropic, civic, social, political, or educational nature, which handle food or drinks for distribution to its members without charge. (hh) Food Transportation. Shall mean the use of any conveyance to transport food or drinks from one place to another, and shall include automobiles, truck, carts, and dollies or any means of transporting food or drinks from one place to another. This term does not include mobile food units, such as; hot dog carts, snack trucks, or other similar means of ready-to-eat food delivery vehicles. (ii) Food. Shall mean consumable products that contain vitamins, proteins, or nutrients for the human body including water or beverages, beef, poultry, pork, fish, crustacean, pastries, confectioneries, vegetables and fruits, or any other consumable product or ingredient used or intended for use or for sale in whole or in part for human consumption. (jj) Foodborne illness means an illness resulting from the ingestion of food or drink. (kk) Funeral establishment means any place used for such activities as are incident, convenient, or related to the preparation and arrangements for the funeral, transportation, burial, cremation, or other disposition of dead human bodies. (ll) Health Certificate. Shall mean a certification issued by the Secretary of the Department of Public Health or a licensed physician in private practice to a person who has been found to be

8 free of any parasitic or pathogenic germ and found to be free of any communicable diseases as herein defined in this subchapter. (mm) Health clinic means a building, room, place, or establishment where physical and health examinations, health consultations, or the care or treatment of sick and/or injured people is provided or made available outside a hospital, and shall include optical clinics, acupuncture clinics, dental clinics, chiropractic clinics, and any other establishment other than a hospital where health care is provided. (nn) Health inspector or inspector means an individual duly authorized by the Secretary of Health to represent the Division of Public Health, Bureau of Environmental Health during a sanitary inspection, investigation, or other public environmental health related duty. (oo) Hermetically Sealed Container. Shall mean a container designed and intended to be secure against the entry of micro-organism and to maintain the commercial sterility of its content. (pp) Hotel, motel, or room accommodation means any structure or any portion of any structure, including any lodging house, rooming house, dormitory, health spa, studio hotel, hotel, motel, or private club containing four or more guest rooms and intended to provide overnight accommodations or accommodations by the hour for pay, whether monetary or in-kind. The term hotel, motel, or room accommodation shall not include any penal institution, hospital, clinic, nursing home, school, laboratory, or childcare facility. (qq) Imminent health hazard means a significant threat or danger to the health, safety and welfare of the public that is considered to exist when there is evidence sufficient to show that a product, practice, circumstance, or event creates a situation that requires immediate correction or cessation of operation to prevent harm or injury to persons in the community based on: (1) The extent of the potential harm or injury; and (2) The nature, severity, and duration of anticipated harm or injury. (rr) Kitchenware. Shall mean all multi-use utensils other than table-wares. (ss) Laundry & Dry Cleaning Establishment. Shall mean an establishment where clothes and linens are laundered and dried, or where laundering and drying machines are provided for commercial use. (tt) Management Food Sanitation Training Certificate. Shall mean a certification issued by the Secretary of the Department of Public Health or his/her authorized representative to management personnel of food or drink establishment after successfully completing management food sanitation examination or a management food sanitation seminar conducted by the Bureau of Environmental Health or other entities, and as sanctioned by the Department of Public Health. (uu) Massage parlor means, any building, room, place, or establishment occupied and used for the purpose of using any method of applying pressure or friction against, or stroking, kneading, rubbing, tapping, pounding, vibrating, or stimulating the external part of the body with

9 the hands or feet, or with the aid of any apparatus or appliance, with or without such supplementary aids such as rubbing alcohol, ointments, liniments, antiseptics, oil, powders, creams, lotions, or similar preparations. Massage parlor shall not include a regularly licensed and established hospital, health clinic or dispensary that provides non-medical and non-surgical manipulative exercises practiced upon the human body manually or otherwise by a health care provider with or without the use of therapeutic, electrical, mechanical, or bathing devices. (vv) Mobile Food Unit. Shall mean a vehicle-mounted food service establishment designed to be readily movable, and/or dispenses food for public consumption and includes ready-to-eat food delivery vehicles, whether private or establishment owned. (ww) Optometry Clinic. Shall mean an establishment where the examination of eyes is provided, or where optical lenses are manufactured or sold. (xx) Packaged. Shall mean bottled, canned, cartooned*, securely wrapped, or vacuum packed, or any food or drink substance that comes in a packaged form. * So in original. (yy) Penal institution means any jail, detention center, prison, detention camp, juvenile detention home or cottages, or other facility operated by the CNMI government and used as a holding facility, jail, or residential custodial facility. Penal institution shall not include hospitals or childcare facilities. (zz) Person means an individual, association, corporation, partnership, other legal entity, government, or governmental subdivision or agency. (aaa) Person in charge means the individual present in a place of employment who is the apparent supervisor of the business establishment and of the employees at the time of inspection, or in the event no designated supervisor is present, then any employee working at the place of employment. (bbb) Potentially Hazardous Food. Shall mean any food that consists in whole or in part of milk or milk product, eggs, meat, poultry, fish, shellfish, edible crustacea, or other ingredients including synthetic ingredients in a form capable of supporting rapid and progressive growth of infectious or toxigenic micro-organism. (ccc) Premises. Shall mean the areas of any structures, buildings, or appurtenances, whether for private habitation, business or any use of any structures, buildings, or appurtenances, and shall include vacant or abandoned homes, vacant lots, construction sites, junk yards, open fields, utility corridors, storm drains, private and public parks, vessels, and any other areas whether for private or public use. (ddd) Provisions. Shall mean the provisions in this subchapter, or the Act, established or adopted and enforced by the Department of Public Health.

10 (eee) Pushcart. Shall mean a non-self-propelled vehicle limited to serving non-potentially hazardous food or commissary-wrapped food maintained at proper temperatures, or limited to the preparation and serving of hot dogs, sandwiches, and/or beverages. (fff) Reconstituted. Shall mean dehydrated food products recombined with water or other liquids. (ggg) Regulations. Shall mean the rules and regulations in this subchapter, or other regulations established and enforced in the Commonwealth of the Northern Mariana Islands. (hhh) Restroom facility means a room(s) equipped with a water closet or toilet and/or hand washing facility that meets Department of Public Works Building and Safety Code standards for employee and public usage that is clean, well maintained, in good repair, and adequately stocked with liquid soap and dispensers, toilet tissue and disposable towels or equipped with hot air hand dryer(s). (iii) Room Accommodation. Shall mean a place for resting, sleeping, relaxing, or sheltering in exchange for fee. It also means hotels, motels, apartments, lodging houses, boarding houses, staff houses, or other types of room accommodations where a fee is imposed for sleeping, relaxing, sheltering or resting. (jjj) Safe Material. Shall mean articles manufactured from or composed of materials that may not reasonably be expected to result, directly or indirectly, in their becoming a component or otherwise affecting the characteristic of any food. (kkk) Sanitary Permit. Shall mean an authorization issued by the Secretary of the Department of Public Health or his duly authorized representative, to any person or persons who has met the requirements of the regulations in this subchapter and is authorized to operate a business establishment as herein defined in these regulations. (lll) Sanitation. Shall mean the practice of maintaining cleanliness. (mmm) Sanitization or sanitize. Shall mean the effective bactericidal treatment by a process that provides enough accumulation heat or concentration of chemicals for enough time to reduce the bacterial count, including pathogens, to a safe level on utensils and equipment. (nnn) School means any establishment, public or private, for the care and education of students from kindergarten through grade twelve and any college or university or educational institution of higher learning. (ooo) Sealed. Shall mean free of cracks or other openings that permit the entry or passage of moisture, water, air, or other elements not commonly found inside of packaged food items. (ppp) Secretary means the Secretary of the Department of Public Health or his/her duly authorized representative.

11 (qqq) Single Service Articles. Shall mean cups, containers, lids, or closures, plates, knives, forks, spoons, straws, peddles, placements, napkins, dollies, wrappings, toothpicks, and all similar items which are wholly or in part made from paper, paperboard, molded pulp, foil, wood, plastic, synthetic, or other readily destructible materials and which are intended by the manufacturers and generally recognized by the public as for one usage only, and then discarded. (rrr) Storage. Shall mean an enclosed place, area, or room where food or drinks, or equipment are kept or stored. (sss) Swimming pool means any artificial structure, basin or tank constructed of impervious materials used or intended to be used for swimming, diving, wading, recreational bathing, or as a hot tub, whirlpool, or jacuzzi by the general public, whether for a fee or free of charge, or by the customers, clients, guests or employees of any person, including, but not limited to, a commercial pool, community pool, a pool at a hotel, motel, resort, private or public club, private or public school, gymnasium, or health establishment. The term swimming pool shall not include private residential swimming pools located on private residential property and under the direct control of the owner or lessee(s), and used only by the owner or lessee(s), their family, and their guests. (ttt) Tableware. Shall mean multi-use eating and drinking utensils. (uuu) Tattoo and/or body piercing shop means any premises where patrons can have the human epidermis punctured and stained with ink or other pigment leaving a permanent design or picture, or pierced for adornment with jewelry or studs. (vvv) Temporary food service means a food establishment that operates for a period of no more than thirty consecutive days in conjunction with a single event or celebration. (www) Valid. Shall mean current, updated, or still enforceable by means of applications of time and date, or period designated to act as valid or current. (xxx) Vector means any organism capable of transmitting the causative agent of human disease or capable of producing human discomfort or injury, including mosquitoes, flies, fleas, cockroaches, or other insects and ticks, mice, or rats. (yyy) Vector borne illness means an illness transmitted through a vector. (zzz) Vending Machine. Shall mean any self-service device which upon insertion of a coin, coins, tokens, or by other similar means, dispenses unit serving of food, either in bulk or in packages, including tobacco products. (aaaa) Vendors. Shall mean the selling of food and/or drinks from stands, machines, pushcarts, or any other means, and shall include road-side vendors, fund-raising activities, or any temporary or permanent food or drinks vending activities. (bbbb) Vermin. Shall mean rodents, flies, cockroaches, mosquitoes, or other insects that may

12 carry diseases. (cccc) Vessels. Shall mean air-going or sea-going means of transportation of commerce, for leisure or for other purposes. (dddd) Violation. Shall means the act of breaking, disobeying, or not complying with the rules, regulations, or policies established in the regulations in this subchapter. (eeee) Ware Washing. Shall mean the cleaning and sanitization of food contact surfaces of all equipment and utensils. (ffff) Waterborne illness means an illness resulting from submersion in, ingestion, or aspiration of contaminated water. (gggg) Wholesome. Shall mean in sound condition, clean, free from adulteration, and otherwise suitable for use as human food. Modified, 1 CMC 3806(d), (e), (f), (g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: *Commonwealth Register volume 25, number 6, pages and mistakenly reprint earlier pages in the volume from another regulatory program. As a result, two pages of the regulations codified in this chapter are missing from the Commonwealth Register, including subsections (a) through (m) of this section. See 25 Com. Reg. at (July 15, 2003). The Commission inserted quotation marks around terms defined. The Commission inserted commas after the words crowning in subsection (r), preparing and parlors in subsection (z), prepared, restaurants, and food in subsection (dd), outlets in section (ee), carts and trucks in subsection (hh), convenient and cremation in subsection (kk), clinics in subsection (mm), safety in subsection (qq), place and mechanical in subsection (uu), sandwiches in subsection (eee), air in subsection (ooo), tokens in subsection (zzz), pushcarts in subsection (aaaa), disobeying and regulations in subsection (dddd), In subsection (w), the Commission changed remove to removed and in subsection (oo), the Commission changed contained to container to correct manifest errors. In subsection (bbb), the Commission changed consist to consists to correct a manifest error. In subsections (bbb) and (ppp), the Commission inserted the final periods. In subsection (ddd), the Commission changed a colon to a period to maintain consistent punctuation in this section. The 1999 Food Handlers Rules and Regulations contained General Provisions applicable to the Bureau of Environmental Health s Environmental Health and Sanitation Standards codified in this chapter. The 2003 amendments also contained general provisions applicable to this entire chapter. Although the Department of Public Health did not specifically repeal the 1999 General Provisions, the 2003 General Provisions duplicate the definitions included in the 1999 promulgation and, therefore, the Commission has not retained the 1999 definitions. See 20 Com. Reg. at (Oct. 15, 1998). Part Sanitary Permits Sanitary Permits Required It shall be unlawful for any person to operate or open the following business without a valid and current sanitary permit for such establishment or activity:

13 (a) Funeral establishments, crematoriums, and cemeteries; (b) Any establishment or activity involving food or drink service, temporary food service, food retail, wholesale and transportation operations, pushcarts, caterers, or motor vehicle food vendors; (c) Food manufacturing, processing, packaging, importation, distribution, and warehousing facilities; (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) Barber shops and beauty parlors; Ice, water, and other beverage bottling plants and distributors thereof; Tattoo and/or body piercing shops; Massage parlors, bathing houses, spas, and gymnasiums; Health-clinics and convalescent homes; Schools and other child-care facilities; Penal institutions; Hotels, motels, and other room accommodations; Vector control and sanitation of aircraft, ships, and commercial premises; Swimming pools and water parks. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title. The Commission inserted commas after the words crematoriums in subsection (a), spas in subsection (g), and ships in subsection (l) pursuant to 1 CMC 3806(g) Display of Sanitary Permits Each establishment s current sanitary permit shall be displayed at all times in a conspicuous place on the premises so that it may be readily viewed by members of the public. Modified, 1 CMC 3806(g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission changed establishments to establishment s to correct a manifest error.

14 Compliance with CNMI and Federal Law Only persons who comply with the Act and the regulations in this subchapter shall be entitled to receive and retain such permit. Permit issuance and approval by the Secretary does not relieve the applicant from the obligation and responsibility of obtaining all necessary and required CNMI and/or federal government permits. Modified, 1 CMC 3806(d), (f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Pre-operation Inspections Required Before any person shall commence to operate or open for business any establishment or activity listed above, where a sanitary permit is required, he or she shall complete an application requesting a pre-operation inspection by a health inspector. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Compliance with Act and Regulations The health inspector shall inspect the location to determine whether such business or establishment satisfies the sanitation and environmental health standards established by the Act and the regulations in this subchapter. If the application is for a temporary food service establishment, then it shall also include the beginning and ending dates of the proposed operation. Modified, 1 CMC 3806(d), (f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Form and Charges for Permit and Annual Renewal The Secretary shall prescribe the form of the permit. All sanitary permits issued under this Act and regulations promulgated there under shall terminate and be renewable annually on the anniversary of the date of application. No refunds shall be made on the unused portions of the permit or upon applications that have been denied.

15 History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Fees Fees for the issuance of sanitary permits, the duplication of sanitary permits, inspections, compliance education and consultation, and other activities provided for under this Act are as set forth on the attached Department of Public Health, Bureau of Environmental Health Fee Schedule [Appendix A]. Any other charges shall be established by posting in the offices of the Bureau. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Transfer of Permit Forbidden It shall be unlawful to transfer a permit to another person or to another location or to post it on or use it in any way in connection with any other premises other than that for which it was issued. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Part Inspection Pre-operation Inspections Before a sanitary permit is issued, a health inspector shall conduct one or more pre-operation inspections to verify that: (a) The applicant has been issued a business license by the Department of Commerce to conduct the particular business for which the sanitary permit is being requested; (b) The applicant has obtained a certificate of occupancy from the Department of Public Works after establishing that the building and equipment, as defined in the Building and Safety Code at 7 CMC 7122, are in compliance with law; and (c) The applicant s establishment is sanitary and complies with the requirements of the Act and the regulations in this subchapter. Modified, 1 CMC 3806(f), (g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: In subsection (c), the Commission inserted the final period Inspection Frequency

16 (a) Once a sanitary permit has been granted to an applicant, a health inspector shall conduct an inspection of the establishment at least once every six months thereafter unless otherwise provided below. (b) Except as provided under additional inspections below, at such time that an establishment receives a grade A on three consecutive inspections, inspections of the establishment shall be reduced to one per year until such time that the establishment receives a grade B or lower on an inspection. After receiving a grade B or lower, the establishment shall be subject to inspections once every six months until such time that the establishment again qualifies for the reduced number of inspections under this section. Modified, 1 CMC 3806(e), (f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Inspection for Permit Renewal The health inspector shall inspect an establishment before issuing an annual renewal of the sanitary permit. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Additional Inspections Additional inspections shall be prioritized, and may be conducted more frequently than once every six months based on consideration of the following: (a) Past performance on an inspection, which uncovered adverse public health conditions and nonconformance with critical control points; (b) The risk of potential hazards unique to the specific type of business conducted, including the extent of potential hazard to the public; (c) The number of people who may be affected should an imminent health hazard occur, and whether the population served is a highly susceptible population to the potential hazard; and (d) Complaints received by the Secretary concerning the establishments operation or sanitary condition that may present an unacceptable health risk. Modified, 1 CMC 3806(e), (f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003).

17 Access to Premises and Due Notice After the health inspector presents official credentials and provides notice of intent to inspect the establishment or premises during the hours of operation or other reasonable time, the person in charge shall permit the health inspector access, either in the company of an employee or otherwise, to all persons employed by, and to all parts of the establishment or premises, and shall permit examination and copying of any and all records, to insure compliance with this Act and the regulations promulgated there under. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Denial of Access If the person in charge denies access to the health inspector, the health inspector shall inform the person in charge that: (a) The holder of a sanitary permit is required to allow access to health inspectors as specified under the Act; and (b) Access to the establishment or premises is a condition of maintaining a sanitary permit to operate an establishment. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Suspension of Sanitary Permit If, after the health inspector presents this information, the person in charge is still unwilling to grant access to the establishment or premises, the health inspector shall schedule a hearing within ten working days to suspend the sanitary permit on the basis of being unable to conduct an inspection. The health inspector shall note in the inspection report the details surrounding the person in charge s refusal to grant access to the establishment or premises. Modified, 1 CMC 3806(e), (f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title. Part Inspection Reports; Demerit Values; Demerit Scores

18 Inspection Reports Whenever the health inspector makes an inspection and discovers that any provision of the Act or regulations has been violated, he shall record his findings on an inspection report form for the permit holder or person in charge. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section titles in part Demerit Values For each violation of a critical control point, a demerit value shall be assigned. Upon completion of an inspection, the health inspector shall total the demerit point values for all requirements in violation, such total becoming the grade for the establishment. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Demerit Scores; Grades Grades shall be based on the following demerit scores: (a) (b) (c) Grade A - An establishment having a score of not more than ten demerits. Grade B - An establishment having a score of more than ten, but not more than twenty. Grade C - An establishment having a score of more than twenty, but not more than thirty. Modified, 1 CMC 3806(e). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Failing Grade; Imminent Health Hazard An establishment with a score of more than thirty demerits shall be considered an imminent health hazard and shall not be granted a sanitary permit, or in the case of a renewal, shall be subject to immediate suspension and closure. Modified, 1 CMC 3806(e). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15,

19 2003) Closure Notice Immediately following such a grading during an inspection, the health inspector shall post a closure notice placard in an obvious location at the front door of the establishment to alert the public. Anyone other than the Secretary or a health inspector is prohibited from removing this placard. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Part Inspection Reports Content of Inspection Reports Whenever a health inspector makes an inspection, he shall notify the permit holder or person in charge of such violations by means of an inspection report. In such notification, the health inspector shall: (a) Set forth the specific violations found, together with the demerit score of the establishment; (b) Establish a specific and reasonable period of time for correction of the violations found; (c) State that failure to correct any deficiencies in accordance with the provisions of any applicable laws, rules, or regulations may result in suspension of the permit; (d) State that an opportunity for appeal from any inspection findings will be provided if a written request for a hearing is filed with the Secretary within the period of time established for notice of corrections; and (e) Request that the person in charge sign an acknowledgment of receipt of the inspection report. However, failure or refusal to sign receipt of the inspection report shall not relieve the permit holder or person in charge from the obligation to correct the violations noted in the inspection report within the specified time frame. Modified, 1 CMC 3806(f), (g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: In subsection (b), the Commission changed the final period to a semi-colon to ensure consistent punctuation. The Commission inserted a comma after the word rules in subsection (c) pursuant to 1 CMC 3806(g).

20 Service of Inspection Reports Inspection reports provided for under this Act shall be deemed to have been properly served when a copy of the inspection report form or other notice has been delivered personally to the permit holder or person in charge, or such inspection report has been sent by registered or certified mail return receipt requested, to the last known address of the permit holder. The permit holder or person in charge shall be required to maintain copies of the inspection report forms at the establishment for a period of seven years. The Secretary shall also maintain files of the inspection report and proof of service. Modified, 1 CMC 3806(e). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Part Timely Correction of Violations of Critical Control Points Corrective Actions A permit holder who has received a demerit score of more than ten points shall correct a violation of a critical control point and implement corrective actions within a reasonable time period as specified in the inspection report, or as provided below. Modified, 1 CMC 3806(e). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Time Allowed for Corrective Action Considering the nature of the potential health risk involved and the complexity of the corrective action needed, a permit holder may avoid suspension of the sanitary permit, if the permit holder can make corrections or repairs within the following time frames and the deficiencies do not constitute an imminent health hazard which would require immediate suspension and closure: (a) Five working days for deficiencies that involve general cleaning and easily resolvable critical control point violations; (b) Fifteen working days for deficiencies or violations that require more man-hours due to the scope of work, including but not limited to minor building repairs and the purchase of necessary equipment; (c) Thirty working days for deficiencies requiring the purchase of equipment or materials necessary for remodeling that may not be found on island, but must be requested from an offisland supplier or contractor.

21 Modified, 1 CMC 3806(e). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Extensions of Compliance Period The Secretary may but is not required to agree to an extension of the compliance period if: (a) The permit holder provides in writing sufficient evidence that the specified time frame with which to comply is not feasible due to insurmountable circumstances and agrees to an alternative date; (b) No imminent health hazard would result from the delay; and (c) The reasons are deemed justified by the Secretary. However, a second request for an extension will be cause for suspension of the sanitary permit. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Re-grading After Corrective Action The applicant or person in charge of any establishment or premises that received a low grade may at any time make a written request for an inspection for the purpose of re-grading the establishment after corrective action has been completed. Upon receipt of a written request, which includes a signed statement from the person in charge that the initial inspection report s corrective actions have been carried out, a health inspector will schedule an inspection, for a fee, within ten working days of receipt at the Bureau of Environmental Health Office. Modified, 1 CMC 3806(e), (f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Verification and Documentation of Correction (a) At the next inspection, after a health inspector advised an establishment or person to make a correction of a violation of a critical control point or deviation, the health inspector shall enter the specifics about the previous violation and information about the corrective action on the inspection report. (b) After receiving notification that the permit holder has corrected a violation of a critical

22 control point, or at the end of the specified period of time for correction, the health inspector shall verify correction of the violation through inspection, document the information on an inspection report, and enter the report in Bureau of Environmental Health records. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Part Suspension and Revocation of Permit Imminent Health Hazard; Suspension and Closure The Secretary may suspend a sanitary permit without prior hearing thereby immediately closing the establishment if a violation is of a nature so as to constitute an imminent health hazard. Suspension without prior hearing may be imposed for such time until the violation is corrected, or may be imposed pending a hearing. Notice of suspension and closure shall be provided to the permit holder or person in charge prior to the suspension and closure taking effect. Hearings requested following the suspension of a permit without prior hearing should be scheduled as soon as possible, but not later than five business days from the date of closure. Hearings shall be conducted in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.]. Modified, 1 CMC 3806(e), (g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission changed Procedures to Procedure to correct a manifest error. The Commission created the section title Suspension; Notice and Hearing A sanitary permit may be suspended by the Secretary upon a finding that the permit holder or a person in his employ or under his suspension or control has continuously violated the requirements of this Act or the regulations promulgated there under, although such violations do not constitute an imminent health hazard; or if the establishment has failed to pay fees assessed against it for violations of the Act or the regulations promulgated there under; or if the establishment has in any way continuously disregarded the Secretary s efforts to satisfy the requirements of the Act or the regulations in this subchapter. The Secretary shall provide notice of intent to suspend a sanitary permit by giving written notice thereof to the holder, in which case, the permit holder shall have ten calendar days within which to request a hearing. Suspension may be imposed for such time until the violation is corrected or may be imposed as a penalty for repeated violations, in which case, it shall not exceed six months. Hearings shall be conducted in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.]. Modified, 1 CMC 3806(d), (e), (g).

23 History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission changed Procedures to Procedure to correct a manifest error. The Commission created the section title Revocation; Notice and Hearing Revocation of a permit may occur after a permit holder has had his permit suspended on two separate occasions, but continues to violate the requirements of the Act or the regulations promulgated there under, or if the establishment has resumed operations after being closed by the Secretary. The Secretary shall provide notice of intent to revoke a sanitary permit by giving written notice thereof to the permit holder, in which case the permit holder shall have ten calendar days within which to request a hearing. A hearing for revocation of the sanitary permit shall be conducted in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.]. Modified, 1 CMC 3806(e), (g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission changed Procedures to Procedure to correct a manifest error. The Commission created the section title Judicial Review of Decisions Following a hearing, a judicial review of the Secretary s decision may be held in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.]. Pending final determination upon such judicial review, it shall be discretionary with the court to stay the enforcement of the order of suspension or revocation upon the furnishing of adequate bond. Modified, 1 CMC 3806(f), (g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission changed Procedures to Procedure to correct a manifest error. The Commission created the section title Reinstatement of Permit When the holder of a permit believes he has corrected a condition upon his premises or some other violation for which his permit has been suspended, he may write a letter to the Secretary for reinstatement of the permit. The Secretary, upon receipt of such letter, shall schedule an inspection of the premises within five working days. If the findings of this inspection show that the violation has been corrected, the Secretary shall reinstate the permit where suspension was imposed until such time that the violations were corrected. If suspension of the permit was

24 imposed for reasons other than the need to take corrective action, the suspension will remain in effect through the period specified for suspension. Modified, 1 CMC 3806(e). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Revoked Permit May Not Be Reinstated A permit is no longer valid and may not be reinstated when it has been revoked, except upon order of the court. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) No New Permit No person whose permit has been revoked shall be eligible to obtain a new permit for a period of one year. Modified, 1 CMC 3806(e). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Closing The Secretary shall effect the closing of any establishment or activity whose permit has been suspended or revoked. Upon the request of the Secretary, the Commissioner of the Department of Public Safety shall provide police personnel to enforce such closing. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Notification of Commissioner of Public Safety The Secretary shall notify the Commissioner of Public Safety of any suspension or revocation of a permit and the Commissioner of Public Safety shall assure that the suspended or revoked permit holder shall not resume operation until reinstated by the Secretary. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Notice Posted of Closure Whenever any establishment requiring a permit is closed by the Secretary, the health inspector

25 shall post a notice, easily visible to the public, stating that said establishment is closed by order of the Secretary for violations of this Act or the regulations promulgated there under. No person other than the Secretary or the health inspector shall remove, deface, destroy, or conceal such notice. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission inserted a comma after the word destroy pursuant to 1 CMC 3806(g) Inspection Report Public Information The inspection report shall be considered a public document and the Secretary shall make it available for inspection and copying as provided by law. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Part Penalties and Fines for Violations Penalties Those permit holders found violating the requirements of the Act or the regulations in this subchapter shall, upon issuance of notice to the permit holder or person in charge by the Secretary, be fined and penalized in the following manner: (a) First Offense: The permit holder shall receive a warning letter. (b) Second Offense: A fine of up to $ (c) Subsequent Offenses: The permit holder shall be subject to a fine of up to $1, for each subsequent offense. Modified, 1 CMC 3806(d). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Hearings on Fines A permit holder who has received notice of imposition of a fine shall have ten calendar days from the date of service of the notice to request a hearing. Hearings shall be conducted in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.].

26 Modified, 1 CMC 3806(e), (g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission changed Procedures to Procedure to correct a manifest error. The Commission created the section title. Part Ceasing Operations and Reporting Notification of Imminent Health Hazard A permit holder shall immediately discontinue operations and notify a health inspector if an imminent health hazard may exist because of an emergency such as a fire, flood, extended interruption of electrical or water service, sewage backup, misuse of poisonous or toxic materials, onset of an apparent food borne, waterborne, vector borne illness or communicable disease outbreak, gross unsanitary occurrence or condition, or other circumstance that may endanger public health. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Unaffected Areas A permit holder need not discontinue operations in an area of an establishment that is unaffected by the imminent health hazard. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission created the section title Resumption of Operations If operations are discontinued as specified above or otherwise according to law, the permit holder shall obtain approval from a health inspector before resuming operations. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Part Infectious Disease Control Employees Carrying Communicable Diseases

27 No person managing an establishment identified above, that due to the nature of the services offered, poses a direct mode for disease transmission to the general public, shall permit an employee to work knowing or having reason to know that such employee has a communicable disease or is a carrier of such disease that would readily spread to the patrons of the establishment and the general public. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: With the exception of , the Commission created the section titles in part Employees with Other Health Problems No person managing an establishment identified above shall allow an employee or employee applicant with any form of head or body lice, scabies, or infected with an active viral disease, such as chicken pox, measles, mumps, or tuberculosis, or afflicted with an unprotected pustular lesion on the hands, wrists, or exposed portions of the body, to work in their establishment. No employee or employee applicant shall work in such establishment knowing himself to have or having reason to believe that he has any of the diseases set forth above or is a carrier of any such disease. Modified, 1 CMC 3806(f). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Employees with Food or Water Borne Illness No person managing any food or drink service, or handling, establishment shall permit an employee or employee applicant to work in an area of the establishment where there would be a danger of disease transmission, knowing or having reason to know that such employee has a food borne or waterborne illness or is a carrier of such illness. No employee shall work in such an area of an establishment knowing him to have or having reason to believe that he has a food borne or waterborne illness or is a carrier of any such illness. If the manager or a person in charge suspects that any employee has a food borne or waterborne illness or is a carrier of such illness, he shall notify the Secretary immediately. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Tattoo or Body Piercing Shops; Employees with Blood Borne Illnesses No person managing a tattoo and/or body piercing shop shall permit a tattoo or body piercing artist or applicant to work in an area of the establishment where there would be danger of disease transmission, knowing or having reason to know that such employee has a blood borne illness or is a carrier of such illness. No tattoo or body piercing artist or applicant shall work in such an area of an establishment knowing himself to have or having reason to believe that he has a blood borne illness or is a carrier of any such illness. If the manager or a person in charge suspects that

28 any employee has a blood borne illness or is a carrier of such illness, he shall notify the Secretary immediately. History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003) Procedures When Infection Is Suspected When suspicion arises as to the possibility of transmission of infection from an employee or employee applicant, the Secretary is authorized to require: (a) The immediate exclusion of the employee from all activity within the specific establishment for which transmission of a food borne, waterborne, or blood borne illness or communicable disease is possible due to the nature of the services offered; (b) The immediate closing of the establishment until no further danger of illness or communicable disease outbreak exists; (c) Medical examination of the employee and/or his fellow employees, with such laboratory examinations as may be indicated. Modified, 1 CMC 3806(g). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: In subsection (a), the Commission changed the final period to a semi-colon to ensure consistent punctuation. Part Miscellaneous Provisions Severability If any provision of the regulations in this subchapter or the application of any provision of these regulations to any person or circumstance should be held invalid by a court of competent jurisdiction, the remainder of these regulations or the application of its provisions to person or circumstances other than those to which it is held invalid shall not be affected hereby. Modified, 1 CMC 3806(d). History: Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003).

29 Appendix A Department of Public Health Bureau of Environmental Health Fee Schedule Section Category Description Rate 101 Immunization Program Certificates & Fees School Health Certificate $ Immunization Summary $ Immunization Shot Card $ Health Evaluation $5 102 Snack Bar, Restaurant, Night Club, Employee Cafeteria Fixed establishment vending food/drink or transporter, or entertainment establishment, beauty, room rentals, etc Restaurant / Fast Food $ Snack Bars $ Café / Coffee $ Canteen $ Kitchenette $ Cafeteria (Employee) $ Bars / Tavern $ Karaoke Lounge $ Night Club $ Retail Outlets Fixed establishment dispensing directly to customer Mom & Pop Store Establishment no larger than 190 sq. feet in size Mini Marts Between 190 and 240 sq. ft. $ Super Market Larger than 240 sq. ft. $ Convenient Store Larger than 240 sq. ft. $ Sale of Cosmetics (Gift Specialty establishment vending beauty Shop) products 104 Fixed or mobile roadside or temporary event sale Outdoor BBQ Stand Stand-alone structure, equipped with waste disposal, running water, refrigeration, and preparation area Sale of Refreshment Sale of processed prepackaged food, soup, $90 salad, and beverages Produce Vendors Sale of raw vegetables $ Fish Vendors Sale of freshly caught seafood $ Fish & Produce Vendors Sale of fresh (within 24 hrs. harvest) vegetable $90 & seafood Delivery Vehicle Transport food/drink vehicle $90 $90 $90 $90

30 104.7 Snack Mobile Mobile snack vehicle vending processed, $90 prepackaged food directly to customer 105 Sheltering Room accommodation ranges from house rental (single room) to large hotel operation Hotels-Small 1 50 rooms $ Hotels-Medium rooms $ Hotels-Large 101+ rooms $ Motel 1 40 rooms $ Staff Housing-Small 1 10 rooms $ Staff Housing-Medium rooms $ Staff Housing-Large 21+ rooms $ Dormitory-Boarding House Per building $ House Room Rental Each single rental unit/house $ Bulk Storage / Processing Plant Meat or other Food Meat processing / manufacture of food $140 Processing Plant Water Botting Plant Water / ice processing plant $ Bakery Other manufactured food (bakery) $ Retail / Wholesale Storage Storage warehouse separated location from the $140 vending site Wholesale-Storage Facility Dry/cold $ Beautification Shop Bodily services provided from fixed building Barber Shop $ Beauty Shop $ Barber Shop / Beauty Shop $ Massage Parlor $ Sauna / Spa / Swimming $90 Pool Facial / Manicure / Pedicure $ School, Health Centers, Pharmaceutical Drugs, and Devices Outlets & Public Facility Schools Private or public operated pre, grade, middie, high, and post highschool $ Daycare Center Pre-school center $ Sanitariums Health Clinic Private and public operated health centers $ Dental Clinic $ Pharmaceutical & Devices Outlets dispensing over the counter and $140 Outlet prescription drugs and/or medical devices Optical Clinic $ Other BEH Permits, Issuance of new, renew, duplicate, or

31 110.4 BEH Administrative Research or Fieldwork Verification Modified, 1 CMC 3806(f), (g). Certificates Issuance and temporary permits or certificates Penalties Food Handlers Certificate Completes PE & FST $ Temporary Food Handlers Certificate Completes FST and awaiting PE results $ Duplicate Food Handlers New replacement certificate $15 Certificate Duplicate Sanitary Permit 50% of permit fee Onsite Food Handlers Minimum of 10 $250, $250 Training additional $25 per person Verification of Required requestor to submit to BEH office $90 Unwholesome Food Disposal inventory listing of proposed disposal per hour Ship Clearance Commercial cargo vessel $ Deratting Certificate Inspection of potential vector on vessel $ Cruise Ship Clearance 1 or 4 food/drink outlets for guest with $595 employee cafeteria Cruise Ship Cruise ship with <4 or more food/drink $30 outlets, each outlet would pay additional $30 per outlet Noncompliant Establishment Resuming ceased operation $ New Fees and Enforcement New promulgated fees for existing service Penalties Translation Language interpreter (non-english speaker) $30 contracted by BEH office to moderate/facilitate 1 time communication/training. Minimum of 10 participants Expired Sanitary Permit 50% (half price) plus the cost of permit for the 1 st month (after 10 days grace period); subsequent months will be full price of permit per month Follow-up Inspection Estabishment management request re- $90 inspection to validate corrective actions taken Administrative cost to validate and authenticate request information from key CHCC offices, from files, or fieldwork verification History: Amdts Adopted 39 Com. Reg (Feb. 28, 2017); Amdts Proposed 36 Com. Reg (July 28, 2014); Amdts Adopted 25 Com. Reg (Aug. 22, 2003); Amdts Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission changed directing to directly in line 103 and Wholesome to Wholesale in line pursuant to 1 CMC 3806(g). $50

32 A similar table is found at Part 400 of subsection It is unclear whether the Department intended this table to replace the the one located in

33 SUBCHAPTER CEMETERIES AND MORTUARIES RULES AND REGULATIONS Part 001 General Provisions Definitions Part 100 Sanitary Permitting Procedures for Funeral Establishments, Crematoria, and Cemeteries Sanitary Permitting Requirements Branch Office Sanitary Permits Sanitary Permit Application and Fees Sanitary Permit Renewals Display of Sanitary Permits Change of Ownership, Operation, or Location Part 200 Burial Arrangements, Permit Application, and Fees Burial Arrangements Burial Permit Application Fees Burial Permit Records Part 300 Infection Control Responsibilities Prevention Plans Universal Precautions Waste Management Protective Clothing and Laundry Employee Health Precautions Public Health Precautions Part 400 Funeral Service Operational Requirements Preserving and Storage of Human Remains Embalming Requirements Transport Requirements Within the CNMI Transport Requirements Into or Outside of the CNMI Funeral Establishment Operational and Sanitary Requirements Crematorium Operational and Sanitary Requirements Part 500 Disposition and Exhumation of Human Remains General Disposition Disposition of Abandoned Remains Exhumation Procedures Cemetery Operational Requirements Part 600 Sanitary Inspections Pre-operation Inspection Inspection Frequency Inspection for Permit Renewal Additional Inspections Access to Premises and Due Notice Inspection Reports; Demerit Values; Demerit Scores Content of Inspection Reports Service of Inspection Reports Timely Correction of Violations of Critical Control Points Re-grading After Corrective Action

34 Verification and Documentation of Correction Part 700 Suspension, Revocation of Sanitary Permit Suspension and Revocation of Permit Reinstatement of Permit Revoked Permit May Not Be Reinstated No New Permit Closing Notification of Commissioner of Public Safety Notice Posted of Closure Inspection Report Public Information Penalties and Fines for Violations of the Act Ceasing Operations and Reporting Resumption of Operations Part 800 Miscellaneous Provisions Severability Repeal Clause References Schedule A Appendix A Burial Permit Appendix B On Island Burial Transit Certificate Appendix C Off Island Burial Transit Certificate Appendix D Authorization to Embalm or Cremate Appendix E Cremation Certificate Appendix F Exhumation Permit Appendix G Funeral Establishment, Crematorium, and Cemetery Inspection Report Form Subchapter Authority: 1 CMC 2603 and 2605; 3 CMC 2123(a)(1); 3 CMC Subchapter History: Amdts Adopted 25 Com. Reg (July 15, 2003); Amdts Adopted 24 Com. Reg (Dec. 27, 2002); Amdts Proposed 24 Com. Reg (Oct. 30, 2002); Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) (repealing the June 1984 Public Cemetery Rules and Regulations). Commission Comment: PL 1-8, tit. 1, ch. 12, codified as amended at 1 CMC , created the Department of Public Health and Environmental Services (DPHES) within the Commonwealth government. See 1 CMC CMC 2603(g) grants the Department the power and duty to administer public cemeteries. 1 CMC 2605 directs the Department to adopt rules and regulations regarding those matters over which it has jurisdiction, including interments and dead bodies, disinterments of dead human bodies, and cemeteries and burial grounds. See 1 CMC 2605(f), (g), and (h). Executive Order 94-3 (effective August 23, 1994) reorganized the Commonwealth government executive branch, changed agency names and official titles, and effected numerous other revisions. According to Executive Order : Section 105. Department of Public Health. The Department of Public Health and Environmental Services is re-designated the Department of Public Health. The full text of Executive Order 94-3 is set forth in the commission comment to 1 CMC PL 3-45 (effective Feb. 11, 1983), formerly codified at 3 CMC , originally addressed public cemeteries in the CNMI. 3 CMC 2614 made DPHES responsible for the management, care, operation maintenance and administration of public cemeteries. 3 CMC 2615 authorized DPHES to promulgate regulations to govern

35 burials and public cemeteries in the CNMI. PL (effective Jan. 25, 2000), the Public Cemetery Act of 1999, codified at 3 CMC , repealed PL See PL PL , codified at 3 CMC 2624, authorizes the Department of Public Health to administer and manage public cemeteries and authorizes regulations for burial permits, fees, and exhumation. PL (effective Apr. 26, 2001), the Commonwealth Environmental Health and Sanitation Act of 2000, codified at 3 CMC , revised the Commonwealth statutes related to environmental health and sanitation. PL repealed former 3 CMC and enacted new sanitation provisions. PL ( 2122), 3 CMC 2122, requires a sanitary permit to operate enumerated establishments, including funeral establishments, crematoriums, and cemeteries. PL ( 2123), 3 CMC 2123, directs the Secretary of Public Health to promulgate rules and regulations required to ensure the sanitary operation of listed establishments. In 1984, pursuant to PL (formerly 3 CMC 2615), the Department of Public Health and Environmental Services promulgated Operation, Management and Maintenance of Public Cemeteries Rules and Regulations. The history of these regulations is as follows: Adopted 6 Com. Reg (June 15, 1984); Proposed 5 Com. Reg (May 27, 1983). The February 2002 Cemeteries and Mortuaries Rules and Regulations repealed the June 1984 regulations in their entirety. See Cemeteries and Mortuaries Rules and Regulations 8.13, 24 Com. Reg. at (Sept. 24, 2001), codified at NMIAC Public Law (effective Jan. 15, 2010), the Commonwealth Healthcare Corporation Act of 2008, codified at 3 CMC 2801 et seq., established the Commonwealth Healthcare Corporation, which assumed the duties of the Department of Public Health as of January 15, Part General Provisions Definitions Whenever used in the rules and regulations in this subchapter, the following terms shall have the meaning set forth below: (a) Alternative container means an unfinished wood box or other non-metal receptacle or enclosure resistant to leakage or spillage, without ornamentation or a fixed interior lining, which is designed for the encasement of human remains and which is made of fiberboard, pressedwood, composition materials (with or without an outside covering) or like materials used to transport human remains to their final disposition. (b) BEH means the Bureau of Environmental Health within the Department of Public Health. (c) Board means the CNMI Medical Profession Licensing Board. (d) Body parts : (1) Body parts means limbs or other human anatomy that are removed from a person or human remains for medical purposes during treatment, medical procedures, surgery, biopsy, autopsy, or medical research; or human bodies or any portion of bodies that have been donated to science for medical research purposes. (2) Preserved body parts means a body part(s) that has been placed into a preservative,

36 such as but not limited to formaldehyde, which due to its hazardous nature requires special handling to prevent human exposure. (e) Burial permit means the authority granted by BEH to release human remains, not including historical human remains, for burial. (f) Burial plot means a parcel of land or lot used for interment of human remains in a cemetery. (g) Casket means a rigid container resistant to leakage or spillage, which is designed for the encasement of human remains and which is usually ornamented and lined with fabric. (h) Columbarium means a structure or room, or other space in a building or structure of durable or lasting fireproof construction, containing niches, used or intended to be used, as an interment site to contain cremated human remains. (i) CNMI means the Commonwealth of the Northern Mariana Islands. (j) Coved means a curved piece of molding placed where the juncture of the wall and floor meet that is used to prevent dirt or grime from settling in this space by providing a smooth curved surface that may be cleaned easily. (k) CHC means the Commonwealth Health Center. (l) Communicable disease means a disease caused by an infectious agent or the toxic product produced by an infectious agent that can be transmitted directly or indirectly from one individual to another. (m) Cradle-to-grave manifest means the documented chain of custody records kept by generators of bio-hazardous or hazardous waste, which includes information about the amount and type of waste accumulated, the date of generation, and the names of all individuals handling the waste from point of generation to the waste s final disposal. (n) Cremated remains means all human remains recovered after the completion of the cremation, which may possibly include the residue of any foreign matter including casket material, clothing, or eyeglasses, that was cremated with the human remains. (o) Cremation means a procedure whereby a dead human body or body parts shall be reduced by direct flame to residue that includes bone fragments, which may then be pulverized to coarse powdery consistency. (p) Crematorium means a fixed place, establishment, or premises licensed to do business as a crematorium that is devoted to the activities which are incident, convenient, or related to the care, preparation and arrangement, financial and otherwise, for the cremation of human dead bodies and including, but not limited to, a suitable room with all instruments and supplies used for the cremation services.

37 (q) Critical control points means a fundamental element of a process or procedure that must be carried out in a specific controlled manner to ensure that the overall process or procedure does not create an unacceptable health risk or produce an byproduct that creates an unacceptable health risk. (r) Crypt means an above ground chamber in a mausoleum of sufficient size to contain human remains. (s) Death certificate means a document reporting the death of a human being that has been duly attested to by a licensed physician, filed with the CNMI s Recorder s Office, and copies submitted to the Office of Vital and Health Statistics within the Department of Public Health. (t) (u) (v) Department or DPH means the Department of Public Health. DLNR means the Department of Lands and Natural Resources. DPW means the Department of Public Works. (w) Embalmer means any person licensed by the Board and engaged, or holding him or herself out as engaged in the practice, science, or profession of embalming. (x) Embalming means the practice, science or profession of preserving, disinfecting, and preparing a dead human body for burial or transport by injection of an embalming fluid both arterially and into the body cavities. (y) Exhumation means the removal of human remains from a burial site for the purpose of transferring the remains to another burial site or for performing investigative procedures authorized by CNMI authorities. (z) Funeral means a period following death in which there are religious services or other rites or ceremonies with the human remains of the deceased present. (aa) Funeral director means any person engaged, or holding himself or herself out as engaged in the practice or profession of funeral service, or with a title intending to imply or designate him or her as a funeral director or undertaker. (bb) Funeral director of record means the funeral director registered with BEH as the person in charge of a funeral establishment, crematorium, or cemetery. (cc) Funeral establishment means a fixed place, establishment, or premises licensed to do business as a funeral establishment and operated by a funeral director of record that is devoted to funeral services and the activities which are incident, convenient, or related to the care, preparation and arrangement, financial and otherwise, for the funeral, transportation and burial, or other disposition of human remains and including, but not limited to, a suitable room with all instruments and supplies used for the storage and/or preparation of dead human bodies for burial

38 or other disposition. (dd) Funeral merchandise means those items that are normally presented for sale as part of the funeral establishment operation on a for-profit basis. These items include but are not limited to caskets, alternative containers, burial clothing, burial vaults, urns, and grave markers. (ee) Funeral service means: (1) Conducting funeral ceremonies; or (2) Providing cremation services; or (3) Making the arrangements for disposition of human remains, excluding historic human remains, that may include but not limited to dressing or adorning the body. (ff) Historical burial site means the site at which historical human remains are placed or buried. (gg) Historical human remains means the lifeless remains of a human being that died during or prior to the end of World War II (1945) and is not interred in a public cemetery. (hh) Human remains means the lifeless remains of a human being that died after (ii) Imminent health hazard means a significant threat or danger to the health, safety, and welfare of the public that is considered to exist when there is evidence sufficient to show that the product, practice, circumstance, or event creates a situation that requires immediate correction or cessation of operation to prevent harm or injury to persons in the community based on: (1) The extent of the potential harm or injury; and (2) The nature, severity, and duration of anticipated harm or injury. (jj) Interment means the burial of human remains into a cemetery burial plot, burial at sea, or the placement of human remains into a vault, crypt of a mausoleum, or the placement of cremated human remains into a niche of a columbarium. (kk) Intern means any person engaged in learning the science, practice or profession of embalming under the instruction and supervision of an embalmer preceptor duly licensed and registered with the Board. (ll) Mausoleum means an above ground structure or building of durable or lasting construction containing crypts or spaces that are used, or intended to be used, as a finalburial site. (mm) Next of kin means the spouse, children over 18 years of age, parents, or siblings of the deceased, in this order of priority. (nn) Off island burial transit certificate means documentation accompanying human remains, not including historic human remains, entering or leaving the CNMI that contains signatures from persons releasing the remains to the custody of the common carrier(s) transporting the remains, as well as information as to how the human remains were prepared and

39 to which country the human remains shall be released for final disposition. (oo) Office of statistics means the Office of Vital and Health Statistics, Bureau of Health Planning within the Department. (pp) On island burial transit certificate means the documentation accompanying human remains, not including historical human remains, transported within the CNMI containing the signatures of all individuals who accepted custody of said human remains from point of origin on through to final disposition. (qq) Person means an individual, association, corporation, partnership, other legal entity, government, or governmental subdivision or agency. (rr) Private cemetery means a place or area set apart on hallowed ground to serve as the final resting-place for the dead, which is managed by a funeral director of record. This term also includes all facilities located on the site generally associated or found in cemeteries, which may include, but not be limited to, mausoleums, columbaria, parking lots, landscaped areas, a chapel, a house of meditation, or other structures appropriate in a cemetery. (ss) Public cemetery means a place or area set apart to serve as the final resting-place for the dead and managed by a funeral director of record for the CNMI Government or the Office of Veteran Affairs. This term also includes all public facilities located on the site generally associated or found in public cemeteries, which may include, but not be limited to, mausoleums, columbaria, parking lots, landscaped areas, a chapel, a house of meditation, or other structures appropriate in a cemetery. (tt) Responsible person means the person who has accepted responsibility for contacting the proper authorities and professionals to arrange the care, preparation, preservation, transport, or final disposition of human remains. (uu) Sanitary permit means the authority granted by BEH for a physical establishment to be used to conduct funeral services based on the environmentally safe, healthy, and sanitary maintenance and management of operations. (vv) Secretary means the Secretary of the Department or his/her duly authorized representative. (ww) Urn means a canister, box, or sealable container used to enclose cremated human remains. (xx) Vault means a below ground concrete or hollow block chamber of sufficient size to contain human remains. Modified, 1 CMC 3806(d), (f), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

40 Commission Comment: In subsection (ii), the Commission corrected the spelling of the. The Commission inserted commas after the words establishment in subsections (p) and (cc), safety in subsection (ii), practice in subsection (kk), meditation in subsections (rr) and (ss), and healthy in subsection (uu) pursuant to 1 CMC 3806(g). Part Cemeteries Sanitary Permitting Procedures for Funeral Establishments, Crematoria and Sanitary Permitting Requirements (a) No person shall conduct, maintain, manage, or operate a funeral establishment, funeral establishment branch office, crematorium, or cemetery without a valid sanitary permit issued to him or her by BEH. (b) A sanitary permit shall not be required by those persons who solely conduct religious ceremonies, or who dress or adorn human remains, if the deceased did not die from nor was afflicted with a highly communicable disease. (c) A permitted funeral establishment, funeral establishment branch office, crematorium, or cemetery must be distinct and separate from other non-funeral service related activities including, but not limited to private dwellings and other business establishments. (d) No sanitary permit to operate a funeral establishment, funeral establishment branch office, crematorium, or cemetery shall be issued by BEH unless the applicant for the permit has satisfied all of the requirements listed below: (1) Has been issued a certificate of occupancy for all structures from DPW; (2) Holds a valid business license for funeral services; and (3) Employs a licensed embalmer or funeral director registered with BEH who shall be in charge of the funeral establishment, funeral establishment branch office, crematorium, or cemetery as the funeral director of record. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission inserted commas after the words manage in subsection (a) and crematorium in subsection (c) pursuant to 1 CMC 3806(g) Branch Office Sanitary Permits (a) The branch office of a funeral establishment shall have a separate sanitary permit, but shall not be required to employ a separate funeral director of record. (b) One branch office shall be allowed to operate under the funeral establishment permit, and this one branch office may be permitted to operate without a preparation room. Modified, 1 CMC 3806(e), (f).

41 History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Sanitary Permit Application and Fees (a) Sanitary permit applications for a funeral establishment, funeral establishment branch office, crematorium, or cemetery shall be made on forms furnished by BEH which specify what services the establishment shall offer such as storage, preparation, embalming, cremation, interment, and/or ceremonial services. (b) All applications for sanitary permits shall be accompanied by a fee as set forth in the Department s schedule of fees. (c) BEH shall issue a sanitary permit receipt of: to the applicant upon (1) A completed application specifying the funeral director of record; (2) The application fee; and (3) A recommendation to permit the applicant by BEH Health Inspector, as specified in a completed inspection report. (d) Every sanitary permit issued under this section shall specify the name of the establishment as listed on the application and the funeral director(s) of record. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission inserted a comma after the word interment in subsection (a) pursuant to 1 CMC 3806(g) Sanitary Permit Renewals (a) All sanitary permits issued under the provisions of the regulations in this subchapter shall be renewed annually by the holders thereof. (b) The sanitary permit holder shall pay to BEH a yearly renewal fee as set forth in the Department s schedule of fees for each funeral establishment, funeral establishment branch office, crematorium, and cemetery sanitary permit. (c)(1) Applications accompanied by the renewal fee shall be filed with BEH twenty working days prior to the expiration date of the sanitary permit for each year. (2) Applications filed after twenty working days prior to the expiration date of the sanitary permit shall be accompanied by a late fee as set forth in the Department s schedule of fees in addition to the renewal fee cited above. (d) The sanitary permit holder whose establishment continues to operate after the sanitary permit(s) has lapsed shall be penalized as provided in of this subchapter. (e) BEH shall keep a register in which the names of all persons to whom sanitary permits

42 have been issued under this section and the establishments funeral directors of record shall be entered. That register shall be open to public inspection upon request at BEH. Modified, 1 CMC 3806(c), (d), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Display of Sanitary Permits A valid sanitary permit shall be displayed at all times in a conspicuous place in the premises as designated by the Secretary. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Change of Ownership, Operation, or Location (a) A sanitary permit shall be issued to a specific permit holder for a specific location. Any change in management, ownership, or location shall require that a new sanitary permit be obtained by the establishment. Sanitary permits are not transferable or assignable. (b) The permit holder shall give BEH written notice by hand delivery or by certified mail, within ten working days from the date of termination of employment, for any cause, of the funeral director of record for the funeral establishment, branch office, crematorium, or cemetery. (1) The sanitary permit shall expire twenty working days from the date BEH was notified by the permit holder of the termination if no new funeral director is registered with BEH as the funeral director of record. (2) No funeral services shall be conducted at the funeral establishment, branch office, crematorium, or cemetery without a funeral director being registered with BEH as the funeral director of record for that establishment. (c) Any person who inherits any ownership interest in a funeral establishment, branch office, crematorium, or cemetery may continue to conduct the business of that establishment as their ownership interest would allow, contingent upon the following: (1) The person has experience with meeting with families to arrange for the conducting of funeral services; (2) The person files with BEH a statement of change-of-fact concerning that inheritance; and (3) The business is conducted in compliance with all the requirements of the rules and regulations in this subchapter. Modified, 1 CMC 3806(d), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Part Burial Arrangements, Permit Application, and Fees Burial Arrangements

43 (a) Upon an individual being pronounced legally dead by a licensed physician, the next of kin or other responsible person(s) shall be responsible for the following: (1) Obtaining a death certificate from the Department; (2) Arranging the dressing or adorning of human remains of the deceased at a permitted funeral establishment with refrigerated storage facilities or the CHC morgue; and (3)(i) Arranging the transport of the human remains to the place of final disposition given that the deceased did not die from or while afflicted by a communicable disease. (ii) Should the deceased have died as the result of or while afflicted by a communicable disease, arranging for a licensed embalmer, permitted funeral establishment director of record, or medical professional to store, preserve, and transport the human remains to the place of final disposition. (b) If human remains of no historical significance are discovered and reported as unclaimed to the Department, the Secretary shall notify the Department of Public Safety and arrange to have the human remains brought to the CHC morgue for storage in a refrigeration unit until an investigation is completed. The Secretary shall also arrange for the final disposition of the human remains as provided in the Department s Regulations Governing Interments and Dead Bodies [NMIAC, title 140, subchapter 10.4]. (1) The human remains shall not be embalmed, should preservation be necessary, until the police investigation is complete or until the Chief of the Criminal Division of the Office of the Attorney General has noted by written consent that the body may be embalmed. (2) If the deceased was a foreign national, the Secretary shall make every effort to contact the appropriate authorities so that they may make the necessary arrangements for final disposition of the human remains in the country of origin. (3) Should the authority of the country of origin decline acceptance of the human remains, the Secretary shall make the necessary arrangements for final disposition within the CNMI as specified in of this subchapter. (c) All historic human remains shall be reported to the Historical Preservation Office for any and all exhumation, storage, transfer, preparation, and/or final disposition arrangements. Modified, 1 CMC 3806(c), (d), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Burial Permit Application (a) Burial on Land (1) A burial permit (see appendix A), shall be issued for a specific location and shall not be transferable. (2) No person shall be permitted to inter human remains, not including historic human remains, anywhere within the CNMI other than in an approved burial site in a private or public cemetery, or at sea as authorized by the Secretary. (3) The next of kin or other responsible person(s) of the deceased shall apply for a burial permit to inter the human remains within the CNMI, or apply for an off island burial transit certificate with the Department and make arrangements for a common carrier to ship the human

44 remains to a destination outside of the CNMI for final disposition. (4) To prevent the possibility of disease transmission, no person shall be permitted to inter human remains without embalming or cremation if the deceased died as a result of or while afflicted by the plague, cholera, smallpox, epidemic typhus fever, yellow fever, louse-borne relapsing fever, or any other highly contagious communicable disease. Exceptions shall be allowed in those cases where the condition of the body precludes embalming. (5) A burial permit shall not be required: (i) Should a person wish to keep cremated human remains in perpetuity without interment in a niche of a columbarium or other burial site; or (ii) Should a person wish to scatter cremated human remains if the cremated remains are first removed from their container. The container may then by* kept by said person or properly disposed. (6) Should the burial permit applicant wish to inter human remains in a burial plot, niche, vault, or crypt within a cemetery in the CNMI, the permit shall only be granted if: (i) The applicant completes a burial permit form accompanied by the burial permit fee(s); (ii) The original death certificate is filed with the CNMI Recorder s Office and copies submitted to the Office of Statistics and BEH; (iii) Arrangements have been made to prepare, store, or preserve the human remains for burial with an on island burial transit certificate; (iv) A burial plot has been acquired in a private cemetery, or if the burial is to be in a public cemetery, the burial plot fee has been paid and the location approved by DLNR, or the Office of Veteran Affairs; and (v) The cemetery holds a valid sanitary permit. (b) Burial at Sea A permit for burial at sea shall only be granted if: (1) The applicant completes a burial permit form accompanied by the burial permit fee(s); (2) The original death certificate is filed with the CNMI Recorder s Office and copies submitted to the Office of Statistics and BEH; (3) Arrangements have been made to prepare, store, or preserve the human remains for burial with an on island burial transit certificate; and (4) The human remains are taken by boat from any harbor, or by air, for burial at sea at a point not less than three miles from the nearest shoreline. * So in original. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission inserted commas after the word store in subsections (a)(6)(iii) and (b)(3) pursuant to 1 CMC 3806(g) Fees Applications for the burial permit shall be made on forms furnished by the Department accompanied by an application fee of fifty dollars.

45 Modified, 1 CMC 3806(e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Burial Permit Records The original copy of the burial permit shall be given to the applicant for submission to the funeral director of record who has been hired to arrange the interment of the deceased. One copy shall be kept in BEH s files for five years and a second copy shall be submitted to the Office of Statistics by BEH. Modified, 1 CMC 3806(e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Part Infection Control Responsibilities The funeral director of record of a funeral establishment with embalming facilities, or of a crematorium shall have an infection control program. The program shall comply with the requirements of this part of this subchapter. Modified, 1 CMC 3806(d), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Prevention Plans (a) Funeral directors, embalmers, and funeral establishment employees shall comply with the Occupational Safety and Health Administration s (OSHA) Bloodborne Pathogen Standards to Prevent Occupational and Public Exposure to Bloodborne Pathogens. (b) The establishment funeral director(s) of record shall be responsible for ensuring that employees comply with OSHA requirements including, but not limited to: (1) A written exposure control plan, which contains policies and detailed procedures for the safe and effective management of accidents and infectious waste with contingencies for emergencies, e.g., spills, needle sticks, waste bag ruptures, equipment failures, etc.; (2) Appropriate staff training in personal safety equipment usage, universal precautions, proper waste disposal, first aid, etc.; (3) Providing engineering controls, e.g., fume hoods, ventilation systems, etc.; (4) Work practice controls, such as prohibiting the recapping of used needles, promoting frequent hand washing and changing of gowns or aprons, etc.; (5) Adoption of universal precautions; (6) Availability of personal protective equipment, gloves, and clothing; (7) Hepatitis B vaccinations for all employees working with human remains; and (8) Following an established protocol for evaluation in the event that an exposure occurs.

46 Modified, 1 CMC 3806(f), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: In subsection (a), the Commission moved the final period inside of the closing quotation mark Universal Precautions (a) All equipment, refuse receptacles, and work surfaces shall be cleaned and decontaminated after direct contact with blood or other potentially infectious materials, and on a regular daily cleaning schedule. (b) Contaminated work surfaces shall be decontaminated with a disinfectant used according to manufacturer s recommendations and on the following occasions: (1) After completion of procedures; (2) Immediately or as soon as feasible when surfaces are overtly contaminated; (3) After any spill of blood or other potentially infectious materials; and (4) At the end of each work shift. (c) Broken glassware, reusable blades, knives, needles, or other sharp objects that are contaminated with blood or other potentially infectious materials shall be: (1) Properly disposed of in a closing, puncture resistant, leak proof container that is marked with the universal biological hazards symbol or color coded and is readily accessible to the work area; and (2) Sterilized, incinerated, or subject to chemical disinfecting according to manufacturer s recommendations prior to disposal. (d) Broken glassware, reusable blades, knives, needles, or other sharp objects ( sharps ) that are contaminated with blood or other potentially infectious materials shall: (1) Not be picked up directly with the hands, but handled using a brush and dustpan or forceps; and (2) Not be stored or processed in a manner that requires employees or hired maintenance staff to reach by hand into containers where sharps have been placed. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission inserted commas after the word needs in subsections (c) and (d) pursuant to 1 CMC 3806(g) Waste Management (a) A sufficient number of leak proof and clearly marked appropriate waste containers with lids (where necessary), shall be readily available to prevent any and all waste from overflowing in such a manner as to risk employee exposure or to create a harborage for vermin.

47 (b) Waste storage containers shall be stored in an area with access limited to personnel authorized to handle waste disposal. (c) All hazardous waste, including but not limited to formaldehyde, ethanol, or other preservatives, shall be segregated, and stored away from all other wastes and: (1) If disposed of on site, disposal methods shall meet DEQ environmental standards; and (2) If to be disposed of off site, such waste shall only be handled and transported for final disposal by a DEQ registered hazardous waste transporter. (d) All infectious waste, blood products, body parts, and fluids, pathological waste, contaminated broken glassware, reusable blades, knives, needles or other sharp objects, and contaminated body parts shall be considered regulated medical waste and segregated from all other waste at the point of generation. (e) The funeral director of record shall keep an account of the number of containers of waste produced, as well as the type of waste produced. (f) All regulated medical waste shall be collected by a DEQ permitted bio-hazardous waste transporter and destroyed by incineration in a DEQ permitted incinerator. The transporter shall sign receipt of the waste in the facility s cradle-to-grave manifest. A copy of the manifest shall be kept by the funeral director of record in the establishment s records. (g) Pathological waste shall be incinerated, sterilized, or disinfected. Sterilized or disinfected material may be finely ground and flushed into a drain leading to a wastewater disposal system approved by DEQ. (h) Contaminated body parts shall be sterilized, incinerated or undergo chemical disinfecting according to manufacturer s recommendations prior to disposal. (i) Regulated medical waste shall be placed in a non-soluble plastic bag, which is clearly marked with the universal biological hazards symbol, or if applicable into plastic autoclaveable bags, which shall: (1) Be tightly closed when full so as to contain the waste completely for transport; (2) Not be compacted; (3) Be of sufficient number and of an appropriate thickness to prevent spillage or rupture throughout storage, transport, and disposal; (4) Be sterilized by autoclaving or incineration; and (5) Be transported in leak proof rigid or semi-rigid portable containment systems or carts, or vehicle compartments clearly marked with the universal biological hazard symbol and handled in a manner that shall minimize rupturing, spillage and dissemination or aerosolization during transport. (j) Reusable carts, bins, or other containment systems shall be cleaned after each use and disinfected daily when in use.

48 (k) The establishment shall be in compliance with applicable sections of CNMI laws and regulations governing the generation, transportation, storage, treatment, management, and disposal of regulated medical, hazardous and bio-hazardous waste. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission inserted commas after the words transport in subsection (i)(3), bins in subsection (j), and management in subsection (k) pursuant to 1 CMC 3806(g) Protective Clothing and Laundry (a) Contaminated laundry or reusable protective clothing shall not be handled directly, but handled using disposable gloves, and as little as possible. (b) Contaminated laundry shall be bagged in plastic or placed in a marked or color-coded container in a designated location. (c) Contaminated linens, sheets, smocks, or gowns shall not be used for more than one work period without being sanitized and laundered. (d) Contaminated laundry and reusable protective clothing shall be washed separately from other laundry and autoclaved observing universal precautions. History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission inserted a comma after the word smocks pursuant to 1 CMC 3806(g) Employee Health Precautions (a) Employees shall be required to report to the person in charge, information about their health and activities as they relate to illnesses or diseases that are transmissible through general close contact. (b) An employee shall report the information in a manner that allows the person in charge to prevent the likelihood of disease transmission, including: (1) The date of onset of an infestation or illness as specified in this section; and (2) The return to work date or date when treatment shall be complete or when the employee shall no longer be contagious (see schedule A [ ]). (c) If the employee is diagnosed with: (1) Head lice, he or she may return to work twenty four hours after treatment is completed; (2) Body lice, he or she may return to work twenty four hours after treatment is completed; (3) Scabies, he or she may return to work twenty four hours after treatment is started; (4) A viral childhood disease such as: (i) Chicken pox, he or she shall abstain from work after exposure, and may return to work after all vesicles have become dry;

49 (ii) Rubella, he or she may return to work seven days after onset of rash; (iii) Measles, he or she shall abstain from work after exposure, and may return to work four days after the onset of rash; or (iv) Mumps, he or she may return to work nine days after the onset of swelling. (5) Active tuberculosis (TB), he or she may return to work upon notification by DPH s Center for Tuberculosis and Lung Disease; or (6) Cholera, he or she may return to work upon his or her attending physician s recommendation. (d) An employee shall also report information should he or she have any of the following symptoms, which may indicate presence of disease identified in subsection (c) above: (1) Itching, general skin or scalp irritation; (2) Chills and fever; (3) Nausea; or (4) Persistent cough. (e) An employee shall also report information should he or she have a pustular lesion such as a boil or infected wound that is open or draining and is: (1) On the hands or wrists, unless an impermeable cover such as a finger cot or stall protects the lesion and a single use glove is worn over the impermeable cover; (2) On exposed portions of the arms, unless the lesion is protected by an impermeable cover; or (3) On other parts of the body, unless the lesion is covered by a dry, durable tight-fitting bandage. (f) An employee shall also report information should they meet one or more of the following high-risk conditions: (1) He or she is suspected of causing, or being exposed to, a confirmed outbreak caused by Pediculus humanus capitis, P. humanus humanus, P. humanus corporis, Borrelia recurrentis, Pthirus pubis infestation, viruses associated with childhood illnesses, or by Mycobacterium tuberculosis or Vibrio cholera, including an outbreak within a school or at a social setting because the employee: (i) Shared clothing, towels, or other items that may come into direct contact with hair or skin of a person who is infested with the parasite that caused the outbreak or who is suspected of being a carrier of the parasite; or (ii) Is not immune to the illness by previous exposure and had spent a considerable amount of time with a person who is ill with the pathogen that caused the outbreak or who is suspected of being a carrier of the pathogenic agent; (2) If he or she are not immune and live in the same household as a person who is diagnosed with a viral childhood illness, has an active case of TB, or cholera; or (3) If he or she are not immune and live in the same household as a person who attends or works in a setting where there is a confirmed outbreak of a viral childhood illness, active cases of TB, or cholera. (g) The person in charge shall exclude an employee from working in a funeral establishment, funeral establishment branch office, or crematorium during the period of contagion if the

50 employee is diagnosed with an active case of head or body lice, scabies, a viral childhood illness, TB, or cholera. (h) The person in charge may remove an exclusion due to an active case of head or body lice, scabies, a viral childhood illness, TB, or cholera if: (1) The person excluded provides the person in charge written medical documentation from a licensed physician that specifies that the excluded person may work in an unrestricted capacity in the establishment because the person is free of the pathogenic agent(s) of concern or is not contagious as demonstrated through medical examination or laboratory testing, or by compliance with the return to work dates as specified in (b) and (c). (i) An employee shall, in a manner specified in (b), report to the person in charge the information specified in (b) through (e) and comply with exclusions and restrictions that are specified in (g). Modified, 1 CMC 3806(c), (d), (e), (f), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: In subsection (e), the Commission changed has to have to correct a manifest error. In subsection (f)(1)(ii), the Commission changed the final period to a semicolon. In subsection (i), the original crossreferences incorrectly cited 4.5, codified at The Commission corrected the references Public Health Precautions (a) The human remains of any person who died as the result of, or while afflicted by, the plague, cholera, smallpox, epidemic typhus fever, yellow fever, or louse-borne relapsing fever, or other term indicating a highly contagious or communicable disease shall be embalmed, except in those cases where the condition of the body precludes embalming, or cremated prior to holding ceremonial funeral services, shipping on a common carrier, or conducting the final interment. (b) Attendance at a public funeral for any person who has died as the result of the plague, cholera, smallpox, epidemic typhoid, yellow fever, louse-borne relapsing fever or other term indicating such disease shall be restricted to those persons who are not in the quarantinable stage of the disease as determined by the Secretary. Modified, 1 CMC 3806(g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: In subsection (a), the Commission changed whom to who to correct a manifest error. Part Funeral Service Operational Requirements Preserving and Storage of Human Remains (a) Once human remains have been received by the CHC morgue or a funeral director from the burial permit holder, the remains shall be stored in a properly designed refrigeration unit

51 unless they are embalmed (see (c)), cremated, or interred within twenty four hours, as witnessed by the funeral director s signature on an on island burial transit certificate. (b) Due to the CNMI s subtropical climate, should the burial permit holder wish to hold an open casket viewing of the deceased during a funeral ceremony, the permit holder, or if retained, the funeral director of record, shall ensure that the human remains are stored or preserved, and interred in one of the following manners: (1) Embalmed before the viewing and subsequently interred or cremated within forty eight hours; (2) If not embalmed before the viewing, held no longer than ten hours with the casket open after which time the casket shall be closed and the body shall be returned to refrigerated storage, or interred, or cremated within twenty four hours; or (3) Refrigerated for the duration of the viewing, then returned to refrigerated storage, or interred or cremated within twenty four hours. Modified, 1 CMC 3806(c), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Embalming Requirements (a) No person shall embalm human remains unless licensed by the Board as an embalmer or registered with a permitted funeral establishment as an intern under the direct supervision of another licensed embalmer. (b) No human remains shall be embalmed if the death is subject to investigation by autopsy, but such remains shall be stored in a properly designed refrigeration unit. (c) Embalmed human remains shall be interred at a burial site or niche within a mausoleum, or cremated within forty eight hours after death. (d) Human remains shall be embalmed according to the Federal Trade Commission, Funeral Industry Practices, and the arteries and body cavities of the remains shall be injected with an embalming fluid of at least the equivalent of ten percent of the body weight. Modified, 1 CMC 3806(e), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: In subsection (d), the Commission moved the comma after Practices inside of the closing quotation mark Transport Requirements Within the CNMI (a) General Preparation for Transport (1) The human remains of any person who died as the result of, or while afflicted by, the plague, cholera, smallpox, epidemic typhus fever, yellow fever, louse-borne relapsing fever, or other term for these diseases indicating a highly contagious or communicable disease shall be

52 embalmed if the condition of the body permits, or cremated prior to disposition. (2) No person within the CNMI other than a funeral director, licensed medical professional, or emergency medical technician shall transport from one house, building or other structure to another, unembalmed human remains of any deceased individual who died from, or while afflicted by, a highly communicable disease that poses an imminent health hazard. The next of kin or other responsible person(s) of the deceased shall contact a permitted funeral establishment, crematorium, or licensed medical facility to arrange transport of the deceased to another location. (b) Casket Rentals for Transport Purposes (1) Human remains transported within the CNMI shall be enclosed in a strong, sealed outer case to prevent seepage of body fluids to the outside. (2) When caskets are made available to rent for transport or on any other temporary basis to save burial expenses, the following provisions shall apply: (i) Said caskets shall be manufactured specifically for multi-use purposes and advertised as such; (ii) No casket manufactured for a single use shall be used more than once; and (iii) Funeral directors shall inform the next of kin or other responsible person(s) of its previous use and obtain written authorization from them acknowledging the fact that the funeral merchandise provided has been previously used in whole or in part. (c) Transport Documentation for Within CNMI (1) An on island burial transit certificate shall be prepared by the funeral director, licensed medical professional, or emergency medical technician who receives human remains from the next of kin or other responsible person(s) prior to releasing the human remains to the custody of the transporter. (2) The on island burial transit certificate shall contain the following information (see appendix B): (i) Name of the deceased and official date of death; (ii) An indication whether or not a communicable disease is suspected or known to have afflicted the deceased; (iii) The name of the person who initially releases the human remains for transport, to pronounce the body legally dead, for preparation, or disposition, and every person thereafter who accepts the human remains for transport, to pronounce the body legally dead, for preparation, or disposition; (iv) The place where the deceased was originally located, and any place thereafter where the human remains were stored, from the time of death to the time of final disposition; (v) The name of the funeral director accepting the human remains for final disposition; and (vi) The specific location and date of final disposition. Modified, 1 CMC 3806(f), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: In subsection (a)(1), the Commission changed whom to who to correct a manifest error Transport Requirements Into or Outside of the CNMI

53 (a) Preparation for Transport (1) The human remains of any person whom died as the result of, or while afflicted by, the plague, cholera, smallpox, epidemic typhus fever, yellow fever, louse-borne relapsing fever, or other term for these diseases indicating a highly contagious or communicable disease shall be embalmed if the condition of the body permits, or cremated prior to shipping on a common carrier. (2) No person shall transport into the CNMI human remains, not including historic human remains, unless the human remains were handled in one of the following manners: (i) Embalmed according to the Federal Trade Commission, Funeral Industry Practices ; or (ii) Cremated to prevent any possible threat of disease transmission. (3) No person shall transport out of the CNMI human remains, not including historic human remains, unless the human remains were handled in one of the following manners: (i) Embalmed according to the Federal Trade Commission, Funeral Industry Practices ; (ii) Cremated to prevent any possible threat of disease transmission; or (iii) The next of kin or other responsible person(s) of the deceased has obtained a waiver from both the common carrier shipping the human remains and the governing authority of the state or country that shall accept the human remains for final disposition. The waiver shall also clearly state that embalming or cremation is not required for the human remains to be released and accepted in the state or country of their final intended destination. (b) Casket Rentals for Transport Purposes (1) The human remains transported into or out of the CNMI shall be enclosed in a strong, sealed outer case to prevent seepage of body fluids to the outside. (2) When caskets are made available to rent for transport or on any other temporary basis to save burial expenses, the following provisions shall apply: (i) Said caskets shall be manufactured specifically for multi-use purposes and advertised as such; (ii) No casket manufactured for a single use shall be used more than once; and (iii) Funeral directors shall inform the next of kin or other responsible person(s) of its previous use and obtain written authorization from them acknowledging the fact that the funeral merchandise provided has been previously used in whole or in part. (3) The original on island burial transit certificate, and if applicable the burial permit, shall be kept by the funeral director of record and a copy submitted to the Office of Statistics and BEH where it shall be kept on file for at least five years. (c) Transport Documentation to Ship Into or Outside of the CNMI (1) Human remains shipped into the CNMI shall include a valid state or country burial transit certificate designating the preservation methods used or waiver thereof. (2) A burial transit certificate issued under the law of another State, which accompanies human remains brought into the CNMI for final disposition, shall be authority for final disposition of the human remains in the CNMI. (3) An off island burial transit certificate shall be prepared for the shipment of human remains outside of the CNMI. The funeral director, licensed medical professional, or emergency medical technician shall prepare the documentation before receiving human remains from the next of kin or other responsible person(s) and subsequently releasing the human remains to the custody of the common carrier.

54 (4) The off island burial transit certificate shall contain the following information (see appendix C): (i) Name of the deceased and official date of death; (ii) An indication that the human remains pose no public health hazard accompanied by a waver* from the common carrier and the country of final disposition; (iii) The name of the person who initially releases the human remains, and the person(s) accepting the human remains to pronounce death, to prepare the remains for transport, and any person thereafter who accepts custody of the human remains until they are released to the common carrier; (iv) The place where the deceased was prepared for transport; (v) The name of the common carrier that will transport the body outside of the CNMI; and (vi) The common carrier s signed authorization to transport the human remains and the date of transport. (5) The original off island burial transit certificate shall accompany the human remains during transit to the country of final disposition, and copies shall be submitted to the Office of Statistics and BEH. * So in original. Modified, 1 CMC 3806(e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Funeral Establishment Operational and Sanitary Requirements (a) Documentation (1) Should the human remains, not including historical human remains, need to be embalmed, the funeral establishment funeral director of record shall also complete an authorization to embalm or cremate and submit copies to the Office of Statistics and BEH. (2) An authorization to embalm or cremate shall contain the following information (see appendix D): (i) Name and signature of the next of kin or responsible person(s) who authorizes embalming; (ii) Relationship of that person to the deceased; (iii) Date that authorization was given; and (iv) Name of the person receiving authorization to embalm on behalf of the funeral establishment or crematorium. (b) Operational Requirements (1) Each funeral establishment that is constructed or extensively remodeled shall obtain a valid certificate of occupancy from DPW verifying that the renovated structure complies with the provisions of the Building Safety Code and the Department of Public Safety s fire and safety standards, before applying for a sanitary permit or permit renewal. Should a funeral establishment be operating out of a preexisting structure that was converted into a funeral establishment, the person in charge shall also obtain a valid certificate of occupancy from DPW prior to applying for a sanitary permit. (2) Any funeral establishment that comes into possession of cremated human remains,

55 whether or not it performed the cremation in its crematorium, shall retain the remains until they are delivered, placed, or shipped pursuant to the instructions of the person(s) entitled to custody or control of the cremated remains. (c) Sanitary Requirements (1) The funeral establishment shall be maintained in good repair and operated in a safe, healthy, and sanitary manner to prevent any potential harm from befalling the establishment s personnel or the public. (2) Each funeral establishment that is used for the care and preparation of human remains for burial, storage, or transportation, as well as for visitation and ceremonial funeral services, shall have two structurally separate rooms. One shall be used for the care, preparation, and custody of the human remains, and a separate room shall be used for confidential funeral arrangement conferences and ceremonies. (3) Both the preparation room and the conference room shall: (i) Be kept in good repair, clean and maintained in such a manner as to present no potential hazards to the health, safety, or welfare of the employees or the public; (ii) Be adequately lighted throughout all the rooms to avoid accidents due to poor visibility and to make dirt and debris easily visible to ensure thorough cleaning each day; (iii) Be adequately ventilated at all times to eliminate odor and supply a frequent air exchange; (iv) Have readily assessable toilet and hand washing facilities provided with tissue, liquid soap, soap dispensers and disposable towels or hot air hand dryer(s) for employees and the public; (v) Have readily available running drinking water provided in adequate quantities to ensure that toilet facilities work properly at all times and that the facility is cleaned at least daily and more frequently as required to maintain a sanitary environment; (vi) Be connected to the Commonwealth Utility Corporation s sewer system or have a DEQ permitted individual wastewater disposal system; (vii) Be maintained in good repair and free of trash or garbage accumulation by the provision of an adequate number of appropriate refuse containers. The general refuse containers shall be kept in a convenient location, and shall not act as a harborage for insects, rodents, or other vermin; (viii) Have a contract with a DEQ permitted bio-hazardous waste transporter for regulated medical waste pickup; and (ix) As a safety measure, have a stocked first aid kit readily available for responding to minor medical incidences such as fainting, distress, or other minor ailments that may occur during daily operations or ceremonial services. (4) Preparation Room (i) Access doors to the preparation room shall be self closing and the floor shall be sealed with tile, cement, or other nonabsorbent flooring that is easily cleanable. Floor and wall junctures shall be coved and have gaps no wider than a 1 mm (1/32 ). The floor shall also be equipped with a floor drain and shall be graded towards the drain for easy rinsing and cleaning. (ii) A ducted exhaust air ventilation system shall be provided. This system shall create directional airflow that draws air into the work area through the entryway. The exhaust air shall not be re-circulated to any other area of the building, shall be discharged to the outside, and shall be dispersed away from occupied areas and air intakes. The system shall be operational and

56 maintained in good repair at all times. (iii) The room shall be fully equipped with industry approved instruments and equipment such as embalming tables, hoppers, sinks, etc., designed for the express purpose of preparing and embalming human remains for burial, transportation, or other disposition, which shall be well maintained in a clean and sanitary condition. (iv) All preparation and embalming instruments and equipment shall be made of nonabsorbent easily cleanable material, which shall be properly cleaned and sterilized between each use. (v)(a) Sterilization shall be performed using an autoclave, sterilizer, or sanitizing solution used according to the manufacturer s recommendations between each use. (B) Sterilized equipment and utensils shall be stored in a designated location separated from used or soiled equipment and utensils. (vi) The preparation room shall be devoted to activities related to the preparation of human remains, storage, or embalming and for no other purpose. (vii) The room s storage facilities shall be secure from access by all unauthorized persons. (viii) No food or drink shall be allowed within the preparation room at any time. (ix) An eye wash station, first aid kit, and hand washing facilities shall be readily available to employees. (x) No person shall be permitted in the preparation room during the course of preparation or embalming except employees of the funeral establishment, next of kin or other responsible person(s) of the deceased, and/or persons authorized by the next of kin or other responsible person(s) of the deceased. (d) The funeral establishment grounds shall be: (1) Maintained free of trash and garbage accumulation by the provision of an adequate number of refuse containers. The refuse containers shall be equipped with tight fitting lids, kept in a convenient location, and not act as a harborage for insects, rodents or other vermin; and (2) Well maintained in that vegetation is cut frequently to prevent overgrowth, which may act as a harborage for insects, rodents, or other vermin. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission corrected the spelling of the word its in subsection (b)(2) pursuant to 1 CMC 3806(g). The Commission inserted commas after the words placed in subsection (b)(2), storage in subsection (c)(2), safety in subsection (c)(3)(i), rodents in subsections (c)(3)(vii) and (d)(2), and distress in subsection (c)(3)(ix) pursuant to 1 CMC 3806(g) Crematorium Operational and Sanitary Requirements (a) Documentation (1) Should the human remains, not including historical human remains, need to be cremated, the funeral establishment or crematorium funeral director of record shall complete an authorization to embalm or cremate and submit copies to the Office of Statistics and BEH. (2) An authorization to embalm or cremate shall contain the following information (see appendix D):

57 (i) Name and signature of the next of kin or responsible person(s) who authorizes cremation; (ii) Relationship of that person to the deceased; (iii) Date that authorization was given; and (iv) Name of the person receiving authorization to cremate on behalf of the funeral establishment or crematorium. (3) The next of kin or other responsible person(s) shall be required to personally identify the human remains prior to cremation and sign the authorization to embalm or cremate. If this is not possible, the human remains shall not be cremated. (4) Cremation within 24 hours of death (i) A cremation certificate (see appendix E), issued by the Secretary shall only be necessary should the burial permit applicant request that a deceased person be cremated within twenty four hours after his or her death, or if the Secretary has established that the deceased died of a contagious or infectious disease that poses an imminent health hazard. (ii) Prior to issuing a cremation certificate, the Secretary shall determine that the cause and manner of death is such that no further examination or judicial inquiry is necessary. Only then may a cremation certificate be granted by the Secretary. (iii) The human remains shall not be cremated by any crematorium until the funeral director of record has received the original cremation certificate from the Secretary. (iv) After the cremation has been performed, the crematorium shall submit copies of the cremation certificate to the Office of Statistics and BEH by hand delivery or certified mail. (v) A cremation of human remains, not including historic human remains, shall not be performed until the necessary documentation and consents are issued pursuant to the rules and regulations in this subchapter. (b) Operational Requirements (1) A crematorium employee shall not accept custody of unidentified human remains. (2) Human remains designated for cremation shall be cremated without unreasonable delay. (3) When the crematorium is unable to cremate the human remains immediately upon accepting custody, the crematorium shall provide a secured refrigerated holding facility that shall comply with of this subchapter and applicable public health laws, and that preserves the dignity of the human remains. (4) Crematorium holding facilities shall be secure from access by all unauthorized persons. (5) Any crematorium which comes into possession of cremated human remains, whether or not it performed the cremation, shall retain the remains until they are delivered, placed, or shipped pursuant to the instructions of the person(s) entitled to custody or control of the cremated remains. (6) A metal, indestructible identifying disk shall be placed in the cremation chamber with the human remains for the purpose of identifying said remains. The name of the crematorium and the business license number shall be imprinted on said disk. (7) The crematorium shall not simultaneously cremate more than one dead body within the same cremation chamber. (8) Upon completion of each cremation, the human remains shall be removed and the chamber shall be cleaned and all recoverable residue of the cremation process shall be removed before each successive set of human remains are inserted. (9) The funeral director shall ensure that all prostheses, bridgework, pacemaker, or other medical device(s) are removed from the remains prior to cremation and these personal affects*

58 are delivered to the next of kin or other responsible person(s). (10) Each urn into which cremated remains are placed shall be made of a durable material, which shall enclose the cremated remains entirely. (11)(i) Cremated remains shall be enclosed in an urn that is packed securely into a box, which has been securely sealed. (ii) Cremated remains shall only be shipped by a method which has an internal tracing system available and which provides a receipt signed by the person accepting delivery. (c) Sanitary Requirements (1) The floor shall be sealed with tile, cement, or other nonabsorbent flooring that is easily cleanable. Floor and wall junctures shall be coved and have gaps no wider than 1 mm (1/32 ). The floor shall also be equipped with a floor drain and shall be graded towards the drain for easy rinsing and cleaning. (2) A ducted exhaust air ventilation system shall be provided. This system shall create directional airflow that draws air into the work area through the entryway. The exhaust air shall not be re-circulated to any other area of the building, shall be discharged to the outside, and shall be dispersed away from occupied areas and air intakes. The system shall be operational and maintained in good repair at all times. (3) The preparation room shall be devoted to activities related to the preparation of human remains, storage, or cremation, and for no other purpose. (4) No food or drink shall be allowed within the preparation or incineration chamber area at any time. (5) No person shall be permitted in the crematory preparation room or incineration chamber area while any human remains are in the area awaiting cremation, or being cremated, or while the cremation remains are being removed from the cremation chamber, except employees of the crematorium, next of kin or other responsible person(s) of the deceased, and/or persons authorized by the next of kin or other responsible person(s) of the deceased. (d) The crematorium grounds shall be: (1) Maintained free from trash and garbage accumulation by the provision of an adequate number of refuse containers. The refuse containers shall be equipped with tight fitting lids, kept in a convenient location, and shall not act as a harborage for insects, rodents, or other vermin; and (2) Well maintained in that vegetation is cut frequently to prevent overgrowth, which may act as a harborage for insects, rodents, or other vermin. * So in original. Modified, 1 CMC 3806(c), (d), (e), (f), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: In subsection (c)(1), the Commission changed a 1 mm to 1 mm to correct a manifest error. The Commission inserted commas after the words placed in subsection (b)(5), pacemaker in subsection (b)(9), and rodents in subsections (d)(1) and (d)(2) pursuant to 1 CMC 3806(g). Part Disposition and Exhumation of Human Remains

59 General Disposition (a) All human remains prepared for final disposition shall be treated in a dignified fashion, and burial or cremation arrangements made in an expedient manner. (b) No human remains, excluding historic human remains, may be interred without a burial permit. (c) Only embalmed human remains may be interred into a crypt of a mausoleum. (d) This section shall not apply to the cremation or interment of various body parts from different human bodies. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Disposition of Abandoned Remains (a) The Secretary may arrange with a funeral establishment or crematorium for unclaimed human remains, excluding historic human remains, to be interred or cremated after said bodies have remained unclaimed for more than two weeks after all reasonable attempts have been made and due diligence exercised to contact the next of kin or other responsible person(s) through a public notice in a newspaper of general circulation to come forth to identify said bodies. (b) Records documenting where unclaimed human remains were interred or cremated shall be maintained by the funeral establishment director of record that provided the funeral services, the Office of Statistics and BEH. (c) This section shall not apply to the cremation or interment of various body parts from different human bodies. Modified, 1 CMC 3806(e). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Exhumation Procedures (a) Exhumation applications for historical human remains should be obtained from the Historical Preservation Office. (b) Exhumation of interred human remains for legal or health related reasons shall only be performed upon obtaining an exhumation permit (see appendix F), from the Department. (c) The Secretary shall only consider an application for exhumation from the following authorities or person(s): (1) A member of the next of kin or other responsible person(s) of the deceased for the intent

60 purpose of relocation to another burial plot, for cremation, or for an investigative autopsy to be performed by a licensed pathologist; or (2) The attending physician of the deceased or the Commissioner of the Department of Public Safety for the specific purpose of conducting an investigative autopsy to be performed by a licensed pathologist; or (3) The Historical Preservation Office for the specific purpose of relocating or conducting an archaeological investigation of historical burial sites, war dead, or historical human remains. (d) Exhumation permits shall include the name of the applicant; if possible, the name of the deceased to be exhumed; location from which the human remains are to be removed; and to where the remains shall be relocated for interment, cremation, or investigative procedures. (e) All applications for an exhumation permit for legal or health related reasons shall be accompanied by a fee as set forth in the Department s Schedule of Fees. (f) Applications for an exhumation permit for legal or health related reasons shall be received by BEH twenty working days prior to the requested date of exhumation. Once received, the Secretary shall have twenty working days to: (1) If possible, confirm the original location of the deceased with the Office of Statistics and the funeral director of record who performed the initial interment or his or her duly authorized agent, or other acting person in charge; (2) If applicable, the Secretary shall contact the private or public cemetery funeral director of record to schedule a date for the exhumation to take place; and (3) Approve the exhumation on the condition that the exhumation poses no public health hazard and that only funeral establishment employees or medical professionals familiar with proper infection control methods as set forth in part 300 of this subchapter perform the exhumation. (g) The funeral director of record or Secretary shall ensure that during an exhumation for legal or health related reasons, all individuals coming into direct contact with exhumed human remains that were not embalmed or cremated, or where preparation of the remains prior to burial is unknown, shall wear disposable protective clothing, eye wear, and masks. This precaution is necessary to prevent possible transmission to those individuals exhuming the human remains if viable pathogens are present. (h) Exhumed human remains, not including historic human remains, shall be placed in a sturdy leak proof container for transport to the new site of disposition, or to where the investigative procedures are to take place. (i) Upon interring the human remains which were exhumed for legal or health related reasons, an on island burial transit certificate, an exhumation permit, and a new burial permit (at no additional fee) shall accompany the remains and be signed by the appropriate custodians. (1) The original documents shall be kept by the funeral director of record or responsible person(s) receiving the human remains for final disposition and kept in the cemetery records for five years. (2) Copies of the on island burial transit certificate and the exhumation permit shall be

61 submitted to the Office of Statistics and BEH. (j) Exhumations of human remains, not including historic human remains, shall be conducted during regular government office hours. Modified, 1 CMC 3806(c), (d), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Cemetery Operational Requirements (a) General Requirements (1) All cemetery grounds are recommended to contain a crematorium, columbarium, and mausoleum(s) to make the best use of available land. Mausoleums or columbaria therein shall be: (i) Designed by an architect familiar with the specific structural requirements for mausoleums and columbaria and who is licensed by the CNMI Board of Professional Licensing; and (ii) Constructed by a construction firm that holds a valid CNMI business license; or (iii) If already constructed, the structure has been permitted by DPW as meeting the requirements of the Building Safety Code. (2) Each burial plot shall be numbered and given a specific burial assignment. (3) The cemetery funeral director of record shall keep a current and accurate map and burial plot record showing the location of each burial plot. An update of these maps shall be provided to the Office of Statistics and BEH annually on the renewal date of the cemetery s sanitary permit. (4)(i) Only one body shall be interred per burial plot except when a waiver provided by the funeral director of record stating that the burial permit applicant of the recently deceased, and the burial permit applicant or responsible person(s) of the previously interred, consent to the multiple use of the burial plot for other family members or loved ones. (ii) Multiple use burial plots shall not be disturbed or exhumed for reuse until a period of at least five years has transpired since a previous burial unless the burial permit applicant also applies for an exhumation permit with the Department. (5) Upon completion of the burial, cemetery personnel shall backfill each burial plot or should the next of kin or other responsible person(s) wish, they shall backfill the burial plot under the supervision of cemetery personnel. (6) Cemetery funeral directors of record shall provide for regular maintenance of the cemetery grounds to control vegetation and ensure accessibility to the cemetery at all times. (7) No permanent plants shall be permitted to be planted directly in the soil of a burial plot in any cemetery although a vase or pot may be installed flush with the ground near the grave marker for the placement of flowers or other plants. (b) Public Cemetery Requirements (1) Public cemetery grounds shall be subdivided into burial plots of such dimension to accommodate one adult, child or infant sized casket for burial. (i) Adult sized burial plots shall be six feet deep and eight feet by four feet in dimension, and provide a space of three feet between other burial plots on each side and six feet between each

62 row. (ii) Child sized burial plots shall be six feet deep and, six feet by four feet in dimension, and provide a space of three feet between other burial plots on each side and six feet between each row. (iii) Infant sized burial plots shall be six feet deep and three feet by three feet in dimension, and provide a space of three feet between other burial plots on each side and six feet between each row. (2) Upon receipt of an application for a burial permit in a public cemetery, BEH shall contact DLNR to ensure that the applicant has been assigned a burial plot. (3) Markers for a burial plot shall be uniform in size and placement and shall have the following dimensions: three inches in height, by a maximum of eighteen inches in length by twelve inches wide and shall be countersunk at least two inches into the ground. No headstones or other improvements are permitted on or adjacent to the burial plot. This will allow for easy mowing maintenance of the burial grounds. (4) Markers for mausoleum crypts, or columbarium niches, within a public cemetery shall be no larger than twelve inches by eighteen inches, made of weather resistant material, and mounted flush beneath the crypt or niche. Modified, 1 CMC 3806(e), (f). History: Amdts Adopted 25 Com. Reg (July 15, 2003); Amdts Adopted 24 Com. Reg (Dec. 27, 2002); Amdts Proposed 24 Com. Reg (Oct. 30, 2002); Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The 2003 amendments deleted former subsection (b)(4) and amended subsection (b)(3). The Commission re-designated former subsection (b)(5) accordingly. The Commission inserted a comma after the word columbarium in subsection (a)(1) pursuant to 1 CMC 3806(g). Part Sanitary Inspections Pre-operation Inspection Before a sanitary permit is issued, a BEH Health Inspector shall conduct one or more preoperation inspections to verify that: (a) The applicant has been issued a business license by the Department of Commerce to conduct the particular business for which the sanitary permit is being requested; (b) The applicant has obtained a certificate of occupancy from the DPW; and (c) The applicant s establishment is sanitary and complies with the requirements of the rules and regulations in this subchapter. Modified, 1 CMC 3806(d), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

63 Inspection Frequency (a) Once a sanitary permit has been granted to an applicant, a BEH Health Inspector shall conduct an inspection of the establishment at least once every six months thereafter unless otherwise provided below. A sample inspection report is attached to the rules and regulations in this subchapter as appendix G. (b) Except as provided in below, at such time that an establishment receives a grade A on three consecutive inspections, inspections of the establishment shall be reduced to one per year until such time that the establishment receives a grade B or lower on an inspection. After receiving a grade B or lower, the establishment shall be subject to inspections once every six months until such time that the establishment again qualifies for the reduced number of inspections under this section. Modified, 1 CMC 3806(c), (d), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Inspection for Permit Renewal The BEH Health Inspector shall physically inspect an establishment before issuing an annual renewal of the sanitary permit. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Additional Inspections Additional inspections shall be prioritized, and may be conducted more frequently than once every six months based on consideration of the following: (a) Past performance on an inspection which uncovered adverse public health conditions and nonconformance with critical control points as specified in the regulations in this subchapter; (b) The number of people who may be affected should an imminent health hazard occur, and whether the population served is a highly susceptible population to the potential hazard; and (c) Complaints received by the Secretary concerning the establishment s operation or sanitary condition that may present an unacceptable health risk. Modified, 1 CMC 3806(d), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Access to Premises and Due Notice

64 After the BEH Health Inspector presents official credentials and provides notice of intent to inspect the establishment or premises during the hours of operation or other reasonable time, the person in charge shall permit the BEH Health Inspector access, either in the company of an employee or otherwise, to all persons employed by, and to all parts of the establishment or premises, and shall permit examination and copying of any and all records, to insure compliance with the rules and regulations in this subchapter. If the person in charge denies access to the BEH Health Inspector, the BEH Health Inspector shall inform the person in charge that: (a) The holder of a sanitary permit is required to allow access to BEH Health Inspectors as specified under 2128 of the Commonwealth Environmental Health and Sanitation Act of 2000 [3 CMC 2128]; and (b) Access to the establishment or premises is a condition of maintaining a sanitary permit to operate an establishment specified in 2122 of the Commonwealth Environmental Health and Sanitation Act of 2000 [3 CMC 2122]. If, after the BEH Health Inspector presents this information, the person in charge is still unwilling to grant access to the establishment or premises, the BEH Health Inspector shall schedule a hearing within ten working days to suspend the sanitary permit on the basis of being unable to conduct an inspection. The BEH Health Inspector shall note in the inspection report the details surrounding the person in charge s refusal to grant access to the establishment or premises. Modified, 1 CMC 3806(d), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Inspection Reports; Demerit Values; Demerit Scores (a) Whenever the BEH Health Inspector makes an inspection and discovers that any provision of the rules or regulations in this subchapter has been violated, he shall record his findings on an inspection report form, which shall be provided to the permit holder or person in charge. Each violation has been assigned a demerit score (see appendix H). (b) Upon completion of an inspection, the BEH Health Inspector shall total the demerit point values for all requirements in violation, such total becoming the grade for the establishment. Grades shall be based on the following demerit scores: (1) Grade A - An establishment having a score of not more than ten demerits; (2) Grade B - An establishment having a score of more than ten, but not more than twenty; (3) Grade C - An establishment having a score of more than twenty, but not more than thirty. (c) An establishment with a score of more than thirty demerits shall be considered an imminent health hazard and shall not be granted a sanitary permit, or in the case of a renewal, shall be subject to immediate suspension and closure as specified in 2135(a) of the Commonwealth Environmental Health and Sanitation Act of 2000 [3 CMC 2135(a)]. Immediately following such a grading during an inspection, the BEH Health Inspector shall post a closure notice placard in an obvious location at the front door of the establishment to alert the public. Anyone other than the Secretary or a BEH Health Inspector is prohibited from removing this placard.

65 Modified, 1 CMC 3806(d), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Content of Inspection Reports Whenever a BEH Health Inspector makes an inspection, he shall notify the permit holder or person in charge of such violations by means of an inspection report. In such notification, the BEH Health Inspector shall: (a) Set forth the specific violations found, together with the demerit score of the establishment; (b) Establish a specific and reasonable period of time for correction of the violations found as specified in of this subchapter; (c) State that failure to correct any deficiencies in accordance with the provisions of any applicable laws, rules or regulations may result in suspension of the permit; (d) State that an opportunity for appeal from any inspection findings shall be provided if a written request for a hearing is filed with the Secretary within the period of time established for notice of corrections; and (e) Request that the person in charge sign an acknowledgment of receipt of the inspection report. However, failure or refusal to sign receipt of the inspection report shall not relieve the permit holder or person in charge from the obligation to correct the violations noted in the inspection report within the specified time frame. Modified, 1 CMC 3806(c), (d), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: In subsection (e), the Commission corrected the spelling of acknowledgment Service of Inspection Reports Inspection reports shall be deemed to have been properly served when a copy of the inspection report form or other notice has been delivered personally to the permit holder or person in charge, or such inspection report has been sent by registered or certified mail, return receipt requested, to the last known address of the permit holder. The permit holder or person in charge shall be required to maintain copies of the inspection report forms at the establishment for a period of seven years. The Secretary shall also maintain files of the inspection report and proofs of service. Modified, 1 CMC 3806(e). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

66 Timely Correction of Violations of Critical Control Points (a) A permit holder who has received a demerit score of more than ten points shall correct a violation of a critical control point and implement corrective actions within a reasonable time period as specified in the inspection report, or as provided in subsections (b) and (c) below. (b) Considering the nature of the potential health risk involved and the complexity of the corrective action needed, the permit holder may avoid suspension of the sanitary permit under 2135(b) of the Commonwealth Environmental Health and Sanitation Act of 2000 [3 CMC 2135(b)], if the permit holder can make corrections or repairs within the following time frames: (1) Five working days for deficiencies that involve general cleaning and easily resolvable critical control point violations; (2) Fifteen working days for deficiencies or violations that require more man hours due to the scope of work, including but not limited to minor building repairs and the purchase of necessary equipment; (3) Thirty working days for deficiencies requiring the purchase of equipment or materials necessary for remodeling that may not be found on island, but must be requested from an offisland supplier or contractor. (c) The Secretary may agree to an extension of the compliance period if: (1) The permit holder provides in writing sufficient evidence that the specified time frame with which to comply is not feasible due to insurmountable circumstances and agrees to an alternative date; (2) No imminent health hazard would result from the delay; and (3) The reasons are deemed justified by the Secretary. However, a second request for an extension shall be cause for suspension of the sanitary permit. Modified, 1 CMC 3806(c), (e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Re-grading After Corrective Action The applicant or person in charge of any establishment or premises that received a low grade may at any time make a written request for an inspection for the purpose of re-grading the establishment after corrective action has been completed. Upon receipt of a written request, which includes a signed statement from the person in charge that the initial inspection report s corrective actions have been carried out, a BEH Health Inspector shall schedule an inspection, for a fee, within ten working days of receipt at the BEH office. Modified, 1 CMC 3806(e). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Verification and Documentation of Correction

67 (a) At the next inspection after a BEH Health Inspector advised an establishment or person to make a correction of a violation of a critical control point or deviation, the BEH Health Inspector shall enter the specifics about the previous violation and information about the corrective action on the inspection report. (b) After receiving notification that the permit holder has corrected a violation of a critical control point, or at the end of the specified period of time for correction, the BEH Health Inspector shall verify correction of the violation through inspection, document the information on an inspection report, and enter the report in BEH records. History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Part Suspension, Revocation of Sanitary Permit Suspension and Revocation of Permit (a) The Secretary may suspend a sanitary permit without prior hearing thereby immediately closing the establishment if a violation is of a nature so as to constitute an imminent health hazard. Suspension without prior hearing may be imposed for such time until the violation is corrected, or may be imposed pending a hearing. Notice of suspension and closure shall be provided to the permit holder or person in charge prior to the suspension and closure taking effect. Hearings requested following the suspension of a permit without prior hearing shall be scheduled as soon as possible, but not later than five business days from the date of closure. Hearings shall be conducted in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.]. (b) A sanitary permit may be suspended by the Secretary pursuant to this section upon a finding that the permit holder or a person in his employ or under his supervision or control has continuously violated the requirements of the Commonwealth Environmental Health and Sanitation Act of 2000 [3 CMC ] or the rules and regulations in this subchapter, although such violations do not constitute an imminent health hazard; or if the establishment has failed to pay fees assessed against it for violations of the Act and the regulations promulgated thereunder; or if the establishment has in any way continuously disregarded the Secretary s efforts to satisfy the requirements of the Act or these regulations. The Secretary shall provide notice of intent to suspend a sanitary permit by giving written notice thereof to the holder, in which case, the permit holder shall have ten calendar days within which to request a hearing. Suspension may be imposed for such time until the violation is corrected or may be imposed as a penalty for repeated violations, in which case, it shall not exceed six months. Hearings shall be conducted in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.]. (c) Revocation of a permit may occur after a permit holder has had his permit suspended on two separate occasions, but continues to violate the requirements of the Commonwealth Environmental Health and Sanitation Act of 2000 [3 CMC ] or the rules and regulations in this subchapter, or if the establishment has resumed operations after being closed by the Secretary as provided for in the Act. The Secretary shall provide notice of intent to revoke

68 a sanitary permit by giving written notice thereof to the permit holder, in which case the permit holder shall have ten calendar days within which to request a hearing. A hearing for revocation of the sanitary permit shall be conducted in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.]. (d) Following an administrative hearing, the permit holder may seek judicial review of the Secretary s decision in accordance with the provisions of the Administrative Procedure Act [1 CMC 9101, et seq.]. Pending a final determination it shall be discretionary with the court to stay the enforcement of the order of suspension or revocation upon the furnishing of adequate bond. Modified, 1 CMC 3806(d), (e), (f), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission changed Administrative Procedures Act to Administrative Procedure Act to correct manifest errors Reinstatement of Permit When the holder of a permit believes he has corrected a condition upon his premises or some other violation for which his permit has been suspended, he may write a letter to BEH for reinstatement of the permit. BEH, upon receipt of such letter, shall schedule an inspection of the premises within five working days. If the findings of this inspection show that the violation has been corrected, the Secretary shall reinstate the permit where suspension was imposed until such time that the violations were corrected. If suspension of the permit was imposed for reasons other than the need to take corrective action, the suspension shall remain in effect through the period specified for suspension. Modified, 1 CMC 3806(e). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Revoked Permit May Not Be Reinstated A permit is no longer valid and may not be reinstated when it has been revoked, except upon order of the court. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) No New Permit No person whose permit has been revoked shall be eligible to obtain a new permit for a period of one year. Modified, 1 CMC 3806(e).

69 History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Closing The Secretary shall effect the closing of any establishment or activity whose permit has been suspended or revoked. Upon the request of the Secretary, the Commissioner of the Department of Public Safety shall provide police personnel to enforce such closing. History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Notification of Commissioner of Public Safety BEH shall notify the Commissioner of the Department of Public Safety of any suspension or revocation of a permit and the Commissioner of Public Safety shall assure that the suspended or revoked permit holder shall not resume operation until reinstated by the Secretary. History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Notice Posted of Closure Whenever any establishment requiring a permit is closed, a BEH Health Inspector shall post a notice, easily visible to the public, stating that said establishment is closed by order of the Secretary for violations of the Commonwealth Environmental Health and Sanitation Act of 2000 [3 CMC ] and the rules and regulations in this subchapter. No person other than the Secretary or the BEH Health Inspector shall remove, deface, destroy, or conceal such notice. Modified, 1 CMC 3806(d). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission inserted a comma after the word destroy pursuant to 1 CMC 3806(g) Inspection Report Public Information The inspection report shall be considered a public document and BEH shall make it available for inspection and copying as provided by law. History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Penalties and Fines for Violations of the Act Those permit holders found violating the requirements or the rules and regulations in this subchapter or the Commonwealth Environmental Health and Sanitation Act of 2000 [3 CMC ] shall, upon issuance of notice to the permit holder or person in charge by BEH, be fined and penalized in the following manner:

70 (a) First Offense: The permit holder shall receive a warning letter. (b) Second Offense: The permit holder shall be fined of up to $ (c) Subsequent Offenses: The permit holder shall be subject to a fine of up to $1, for each subsequent offense. A permit holder who has received notice of imposition of a fine shall have ten calendar days from the date of service of the notice to request a hearing. Hearings shall be conducted in accordance with the provisions of the Administrative Procedures Act [1 CMC 9101, et seq.]. Modified, 1 CMC 3806(d), (e). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Ceasing Operations and Reporting (a) A permit holder shall immediately discontinue operations and notify a BEH Health Inspector if an imminent health hazard arises because of an emergency such as a fire, flood, extended interruption of electrical or water service, sewage backup, misuse of poisonous or toxic materials, the onset of an apparent food borne, waterborne, or vector borne illness or outbreak, gross unsanitary occurrence or condition, or other circumstance that may endanger public health. (b) A permit holder need not discontinue operations in an area of an establishment that is unaffected by the imminent health hazard. History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) Resumption of Operations If operations are discontinued as specified under above or otherwise according to law, the permit holder shall obtain approval from a BEH Health Inspector before resuming operations. Modified, 1 CMC 3806(c). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Part Miscellaneous Provisions Severability If any provision of the rules or regulations in this subchapter or the application of any such provision to any person or circumstance should be held invalid by a court of competent jurisdiction, the remainder of the these rules and regulations or the application of its provisions to persons or circumstances other than those to which is held invalid shall not be affected thereby. Modified, 1 CMC 3806(d), (g).

71 History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: The Commission changed or than those to other than those to correct a manifest error Repeal Clause The Rules and Regulations Governing the Operation, Management and Maintenance of Cemeteries, promulgated by the Department and published in the Commonwealth Register vol. 6 no. 6, June 15, 1984, are hereby repealed in their entirety. Modified, 1 CMC 3806(f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001) References (a) Blood Borne Pathogens, Occupational Safety and Health Administration (OSHA), 29 CFR Part to end, section , pp , July 1, (b) California Business and Professions Code, sections , , (c) Citation, Construction, Maintenance and Use of Mausoleums, article 9, Kansas Dept. of Health and Environment. (d) 6 CMC 3108, article 1. General Offenses, Excavation for or Removal of Human Remains. (e) Funeral Industry Practices, Federal Trade Commission, 16 CFR, chapter 1, part 453. (f) Funeral Directors and Embalmers, 38 Am. Jur. 2nd. (g) Mortuaries, Cemeteries, Embalmers, Undertakers, and Mortuary Authorities, title 11, Administrative Rules, Hawaii Department of Health, chapter 22, Hawaii. (h) PL Excavating, digging, or looking for remains (i) CNMI PL 3-64, law creating the Commonwealth Recorder s Office, 1 CMC (j) CNMI PL , Public Cemetery Act of (k) CNMI PL , Commonwealth Environmental Health and Sanitation Act of (l) Regulations Governing Interments and Dead Bodies, Commonwealth Register vol. 17 no. 1, January 15, (m) Rules and Regulations Governing the Operation, Management and Maintenance of

72 Cemeteries, Commonwealth Register vol. 6 no. 6, June 15, (n) Rules and Regulations Pertaining to Embalmers, Funeral Directors and Funeral Service Establishments (R Emb), Rhode Island Department of Health, September (o) Rules and Regulations for the Orderly Management of the Cemetery, Proposed, San Isidro Church Parish Council, Rota. Modified, 1 CMC 3806(f), (g). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001). Commission Comment: In subsections (a), (c), (d), (f) through (m), and (o), the Commission moved punctuation inside of the closing quotation marks Schedule A (a) Return to Work Dates for Parasitic Infestations (1) Head Lice: Return to work twenty four hours after treatment. (i) Appropriate treatment 1% permethrin. (TMNix, Rid), may be obtained over the counter. Reapplication in seven to ten days may be necessary. (ii) Recommend concurrent disinfection of clothing and bedding by washing in hot water and drying in the hot cycle of a dryer for 20 minutes. (2) Body Lice: Return to work twenty four hours after treatment. (i) Appropriate and effective treatment may require a doctor visit since 5% permethrin is not sold over the counter. (ii) Recommend concurrent disinfection of clothing and bedding by washing in hot water and drying in the hot cycle of a dryer for 20 minutes. (iii) Clothing and bedding need to be dusted with pediculocides such as 1% malathion, 0.5% permethrin powder, or 2% temefos. (3) Scabies: (i) Return to work twenty four hours after treatment started. (ii) Recommend concurrent disinfection of clothing and bedding by washing in hot water and drying in the hot cycle of a dryer for 20 minutes. (b) Return to Work Dates for Viral Illnesses (1) Measles: Excluded from work four days before to four days after the onset of rash. Illness may not be recognized before the onset of rash. (2) Mumps: Exclusion from work nine days after the onset of swelling (parotitis) if susceptible (those not immunized). Susceptible contacts should be immunized. (3) Rubella: Exclusion from work for seven days after onset of rash. Pregnant contacts, especially those in first trimester, should be identified, serologically tested, and advised accordingly. (4) Chickenpox: Exclude from work until all vesicles become dry. (i) Period of transmissibility is one to five days prior to the onset of the rash and continues until all lesions are crusted (usually 5 days). (ii) Susceptible (not previously infected nor immunized) should be considered infectious ten

73 to twenty one days following exposure. (iii) Susceptible contacts should be immunized. Vericella vaccine is effective in preventing illness and or modifying it if used within three days, and possibly up to five days, after exposure. Consider VZIG for those ineligible for the vericella vaccine. (c) Return to Work Dates for Bacterial Infections (1) Vibrio cholera: There is not a direct person to person transmission of cholera. Transmission is by way of a fecal oral route between people. Therefore, if transmission were to occur, potential communicability would be limited to shedding of the bacteria over several days after becoming infected. (2) Tuberculosis: A person with active or suspected TB should be referred to DPH s Center for Tuberculosis and Lung Disease for treatment, as should any individual who has had close contact with another person with active TB. The date that a diagnosed patient may return to work is dependent upon the Center for Tuberculosis and Lung Disease s evaluation. Modified, 1 CMC 3806(e), (f). History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

74 Appendix A Burial Permit History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

75

76 Appendix B On Island Burial Transit Certificate History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

77 Appendix C Off Island Burial Transit Certificate History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

78 Appendix D Authorization to Embalm or Cremate History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

79 Appendix E Cremation Certificate

80 History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

81 Appendix F Exhumation Permit History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

82 Appendix G Funeral Establishment, Crematorium and Cemetery Inspection Report Form

83 History: Adopted 24 Com. Reg (Feb. 28, 2002); Proposed 23 Com. Reg (Sept. 24, 2001).

84 SUBCHAPTER FOOD HANDLERS RULES AND REGULATIONS Part 001 General Provisions [Reserved] Part 100 Food and Drinking Establishments [Reserved] Part 200 Food Retail/Wholesale Establishments [Reserved] Part 300 Screening of Food Handlers Definitions Physical Examination Screening for Communicable Disease Food Handler Education Issuance of Food Handler Certificate Division Record Keeping and Tracking Measures Food Handlers with Positive Test Results Application of These Rules and Regulations to Food Handlers Currently Working in the CNMI Penalties for Violation of These Rules and Regulations Subchapter Authority: 1 CMC 2603 and 2605; 3 CMC Subchapter History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: PL 1-8, tit. 1, ch. 12, codified as amended at 1 CMC , created the Department of Public Health and Environmental Services (DPHES) within the Commonwealth government. See 1 CMC CMC 2603(a) grants the Department the power and duty to maintain and improve health and sanitary conditions in the CNMI. 1 CMC 2605 directs the Department to adopt rules and regulations regarding those matters over which it has jurisdiction. Executive Order 94-3 (effective August 23, 1994) reorganized the Commonwealth government executive branch, changed agency names and official titles, and effected numerous other revisions. According to Executive Order : Section 105. Department of Public Health. The Department of Public Health and Environmental Services is re-designated the Department of Public Health. The full text of Executive Order 94-3 is set forth in the commission comment to 1 CMC PL (effective Apr. 26, 2001), the Commonwealth Environmental Health and Sanitation Act of 2000, codified at 3 CMC , revised the Commonwealth statutes related to environmental health and sanitation. PL repealed former 3 CMC and enacted new sanitation provisions. PL ( 2122), 3 CMC 2122, requires a sanitary permit to operate enumerated establishments, including any establishment or activity involving food or drink service, food retail, wholesale and transportation operations, or food manufacturing, processing, etc. PL ( 2123), 3 CMC 2123, directs the Secretary of Public Health to promulgate rules and regulations required to ensure the sanitary operation of listed establishments. Public Law (effective Jan. 15, 2010), the Commonwealth Healthcare Corporation Act of 2008, codified at 3 CMC 2801 et seq., established the Commonwealth Healthcare Corporation, which assumed the duties of the Department of Public Health as of January 15, 2011.

85 Part General Provisions [Reserved.] Part Food and Drinking Establishments [Reserved.] History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Part Food Retail/Wholesale Establishments [Reserved.] History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Part Screening of Food Handlers Definitions As used throughout this part, the following terms shall have the meaning set forth below: (a) Ameba means clinical or laboratory evidence of an infection caused by the known human intestine protozoan pathogen Entomoeba histolytica. (b) Campylobacter means clinical or laboratory evidence of an infection caused by any species of the genus Campylobacter. (c) Food, retail store, and beverage establishment means a bakery, restaurant, cafeteria, lunchroom, luncheonette, lunch counter, ice cream/soda fountain, soft drink dispenser, bar, tavern, nightclub, karaoke club, liquor/water dispenser, food stand, food store, snack mobile, caterer, kitchen, or any other establishment where food and beverages, (canned, perishable, prepackaged - betelnut, leaves, apigigi, etc.) are prepared, packaged, handled, cooked, processed, or served to the public as part of a service of an institution or for sale. (d) Food handler means any person who prepares, packages, handles, cooks, processes, or serves food or beverages, or uses cooking utensils in a food, retail store, and beverage establishment. (e) Food handlers certificate means an authorization issued by the Secretary to a foodhandler certifying that the food-handler has been examined and found to be in good health, and free of specific food-borne diseases as specified in the rules and regulations in this part. (f) Food handlers education means a seminar conducted by Bureau of Environmental

86 Health. This training course will cover sanitation, sanitary food preparation, and the transmission of food-borne diseases. (g) Giardia means clinical or laboratory evidence of an infection caused by the known human pathogen Giardia lamblia. (h) Salmonella means clinical or laboratory evidence of an infection caused by any species of the genus Salmonella, including S. typhi, the cause of typhoid fever. (i) Shigella means clinical or laboratory evidence of an infection caused by any species of the genus Shigella. (j) Tuberculosis means clinical, PPD skin test, laboratory, or radiological evidence of an infection or active disease process caused by Mycobacterium tuberculosis. (k) Yersinia means clinical or laboratory evidence of an infection caused by any species of the genus Yersinia. Modified, 1 CMC 3806(d), (f), (g). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The 2002 amendments readopted and republished part 300 in its entirety. The Commission, therefore, cites the 2002 amendments in the history sections throughout this part. The 2002 amendments amended subsections (c), (d), (e) and (f). The Commission inserted quotation marks around terms defined. In subsection (e), the Commission inserted the final period. The Commission inserted commas after the words store and processed in subsection (c), store in subsection (d), Physical Examination (a) Obtaining a Physical Examination. A physician authorized by the Division will obtain a clinical history and perform a physical examination of all food handlers prior to commencing employment as a food handler in the CNMI and then annually. A record of the physical examination shall be completed by the physician on a physical examination form approved by the Division. Annual physical examination for food handlers shall be performed at least fortyfive days prior to the expiration of the food handlers certificate and/or alien health certificate. (b) Filing of Forms. The physician performing the physical examination shall provide the complete physical examination form to the Division within forty-five days from the date of the food handler s initial physical examination, and forty-five days from the date of each annual physical examination thereafter. Modified, 1 CMC 3806(e), (f). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg.

87 18359 (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The 2002 amendments amended subsection (a) Screening for Communicable Disease All food handlers shall be screened for specified food-borne diseases, which not only jeopardize the health and life of the food handlers, but also threaten their family, the resident CNMI population, and tourists visiting the CNMI. Screening shall be limited to those food-borne diseases which can be easily tested and monitored, including tuberculosis, salmonella, shigella, campylobacter, intestinal parasites, and any other communicable disease specified by the Secretary through health advisories as being a potential risk to the CNMI community. (a) Procedures for Screening. Concurrent with the performance of the physical examination, the food handler shall obtain health screening tests for the food-borne disease specified in the rules and regulations in this part, and any others required by the Secretary through health advisories. All chest radiographs required by these rules and regulations shall be read by a physician, or may be sent to the Center for Tuberculosis and Lung Disease at the Commonwealth Health Center for reading. (b) Filing of Screening Test Results with the Division. The food handler s physician shall provide the Division with a copy of all screening test results required by this section and by the Secretary s health advisories within forty-five days from the date of the food handler s initial physical examination, and forty-five days from the date of each annual physical examination thereafter. (c) Required Screening Test for Food-borne Diseases. At a minimum, all food handlers shall obtain screening test for the following diseases: (1) Tuberculosis Screening. Every food handler shall obtain a single view PA chest radiograph prior to commencing work as a food handler in the CNMI, and then annually thereafter. The yearly chest radiograph shall be performed at least forty-five days prior to renewal of the employment contract, or forty-five days prior to the anniversary of the expiration of the food handler certificate, whichever date is first. (2) Stool Culture. Every food handler shall obtain a stool culture from a CLIA certified laboratory as part of the initial screening, and then annually thereafter. The yearly test shall be performed at least forty-five days prior to the renewal of the employment contract, or forty-five days prior to the anniversary of the expiration of the food handler certificate, whichever date is first. Food handlers who have a positive stool culture for salmonella, shigella, yersinia, campylobacter or any other bacteria considered pathogenic shall be treated and cured by the food handler s physician. Failure to provide documentation of cure shall result in non-issuance of the food handler certificate. (3) Stool for Ova and Parasite (O&P). Every food handler shall obtain a stool ova and parasite screen from a CLIA certified laboratory prior to commencing employment as a food handler as part of the initial screening, and then annually thereafter. The yearly test shall be performed at least forty-five days prior to the anniversary of the expiration of the food handler

88 certificate whichever is first.* Food handlers who have a positive stool O&P for giardia, ameba, or any other intestinal parasite shall be treated and cured by the food handler s physician(s). Failure to provide documentation of cure shall result in non-issuance of the food handler certificate. (4) Other Food-borne Diseases. All food handlers who contract other infectious or foodborne diseases should be seen promptly by a physician. Any physician who diagnoses a food handler as having a communicable disease shall immediately report the food handler to the Division. *So in original. Modified, 1 CMC 3806(d), (e), (f). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The 2002 amendments amended subsections (c)(2) and (c)(3). The Commission inserted a comma after the word population in the initial paragraph pursuant to 1 CMC 3806(g) Food Handler Education (a) Obtaining Food Handler Education. After the food handler s physician has submitted the physical examination and screening test result to the Division, the food handler shall attend a food handler education seminar scheduled by Bureau of Environmental Health. A record of the food handler s attendance at the seminar shall be submitted to the Division. The food handler must attend this seminar annually at least forty-five days prior to expiration of the food handlers certificate and/or alien health screening. (b) Filing of Forms. The food handler shall provide a record of attendance to the Division within forty-five days from the date of the initial food handler education seminar prior to commencing employment as a food handler in the CNMI, and forty-five days from the date of each annual seminar thereafter. Modified, 1 CMC 3806(e), (f). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The 2002 amendments amended subsection (a) Issuance of Food Handler Certificate (a) Food Handler Certificate. Within forty-five working days of receiving the food handler s physical examination form, all necessary documentation of screening test results, and record of attendance of the food handler education seminar, the food handler shall request a food handler certificate from the Division. If the food handler has been found to be physically fit, in good health, and free from communicable diseases covered by the rules and regulations in this part,

89 the Secretary shall issue the food handler certificate. The food handler certificate shall be valid for a period of one year from the date of issue. (b) Duplicate Food Handler Certificate. (1) Food handlers who have been issued a valid food handler certificate, but who work in more than one food, retail store, and beverage establishment owned and operated by the same employer may request a duplicate food handler certificate(s) to be kept in a file and shall be easily accessible for inspector(s). (2) Food handlers who have been issued a valid food handlers certificate, but who work in more than one food and beverage establishment owned and operated by the different employer may request duplicate food handlers certificate(s) and kept* in a file and shall be easily accessible for inspector(s). *So in original. (c) Suspension of Issuance of Food Handler Certificate for Food Handlers Found to Have a Communicable Disease. Food handlers who test positive for a communicable disease covered by the rules and regulations in this part shall not be issued a food handler certificate unless documentation of cure has been submitted to the Division. The food handler shall refrain from preparing, cooking, and serving food or beverage until such time he/she has been cured of communicable disease. (d) Cost of Food Handler Certificates. The cost of a food handler certificate shall be twenty dollars, payable to the CNMI Treasury upon issuance of the food handler certificate. The food handler or the employer of non-resident worker shall be responsible for the cost of the certificate. (e) Cost of Duplicate Food Handler Certificates. The cost of a duplicate food handler certificate shall be ten dollars for each additional food handler certificate, payable to the CNMI Treasury. The food handler or the employer of non-resident worker shall be responsible for the cost of all duplicate certificates. (f) Cost of Replacement Food Handler Certificates. In the event of a lost (non-expired) food handler certificate, the food handler may request a replacement. The cost of a replacement food handler certificate shall be twenty dollars, payable to the CNMI Treasury upon issuance of the food handler certificate. The food handler or the employer of non-resident worker shall be responsible for the cost of the certificate. (g) Employer to Maintain Files. Upon receipt, the food handler shall provide the food handler certificate to his or her employer. The employer shall keep food handler certificates for all food handlers under his/her employment filed in a location that is easily accessible while maintaining confidentiality. The employer shall be prepared to show these food handler certificates to a duly authorized representative upon request during an inspection. Food handler certificates will only be valid at the food, retail store, and beverage establishment at which the food handler is employed. Food handler certificates are not transferable. In the event that a food handler is employed to work at more than one food, retail store, and beverage establishment owned and operated by the same or different employer, then a duplicate food handler certificate

90 shall be kept on file at each separate establishment. Modified, 1 CMC 3806(d), (e), (f), (g). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The 2002 amendments added a new subsection (b)(2) and amended subsections (b)(1), (c), (d), (e), (f), and (g). In subsection (a), the Commission changed from to form to correct a manifest error. The Commission inserted commas after the word store in subsections (b)(1) and (g) pursuant to 1 CMC 3806(g) Division Record Keeping and Tracking Measures (a) Database Records. The Division shall develop a food handler health database. The database shall be used to track all food handlers for compliance with the screening requirements established in the rules and regulations in this part, and assist the environmental health inspectors in the inspections of food establishments. (b) Notice of Noncompliance. If a review of the Division s database indicates that a food handler has not been issued a food handler certificate within twenty days from the previous expiration date, Division staff shall send a written notice to the food handler, with a copy provided to the employer, of noncompliance with the rules and regulations in this part. The food handler shall have twenty days from the date of the notice to come into compliance with the requirements of these rules and regulations. Failure to respond to the Division s notice shall subject the food handler and the employer to penalties as set forth in of this subchapter. This section shall not apply to those food handlers who have not been issued food handler certificates because they are undergoing treatment for a communicable disease ( (b)) and who remain fully compliant with the Division s or their physician s prescribed treatment regimen for the duration of treatment. Food handlers undergoing treatment shall be issued a letter by the Division setting forth the date treatment is anticipated to be complete and when a food handler certificate can be issued. (c) Inspections by Duly Authorized Representatives. From time to time, a duly authorized representative of the Department may inspect an employer s place of employment, as provided in 3 CMC Upon request by the duly authorized representative, the employer or person-incharge shall grant the duly authorized representative access to the food handlers certificates. Any food handler who does not have a valid food handler certificate in his or her employment file shall cease handling, preparing, cooking, or serving food and shall be reported to the Division. Modified, 1 CMC 3806(c), (d), (e), (f), (g). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The Commission changed access to the food handlers certificate to access to the food handlers certificates to correct a manifest error. The 2002 amendments amended subsections (b) and (c).

91 Food Handlers with Positive Test Results (a) Handling of Food Handlers with Positive Test Results. If a food handler is found to have a communicable disease covered by the rules and regulations in this part, the Division shall establish a treatment regimen for the food handler to the extent treatment is available within the CNMI. The Division shall prepare a written advisory to the employer instructing that such food handler be immediately prevented from any activity involving the preparation, handling, cooking, or serving of food and beverages until the Division has determined that the food handler has been cured and issued a food handler certificate. If said food handler is terminated from employment, the Division shall bare* no responsibility for the financial costs or liability for the termination. The Division shall handle positive test results as follows: *So in original. (1) Pathogenic Bacteria. Food handlers found to have pathogenic bacteria, including salmonella, shigella, yersinia, campylobacter, and vibrio in the stool shall be required to comply with the Division s recommendation for treating and eradicating such pathogens. The food handler must show proof of eradication of carriage of stool pathogens by means of subsequent stool culture after treatment before the Division issues a food handler certificate. (2) Stool Parasites. Food handlers found to have stool parasites, including ameba, giardia, round worms, tapeworms, or any other intestinal parasite, shall be required to comply with the Division s recommendation for treating and eradicating such parasites. The food handler must show proof of eradication of carriage of parasites by means of subsequent stool culture after treatment before the Division issues a food handler certificate. (3) Tuberculosis. Food handlers found to have active tuberculosis shall be required to comply with the Center for Tuberculosis and Lung Disease protocol for treating active tuberculosis. Food handlers who have an abnormal chest radiograph suspicious of tuberculosis shall be referred to the Center for Tuberculosis and Lung Disease for further evaluation and treatment as needed. The food handler shall be required to cooperate with any tuberculosis therapy prescribed by the Center for Tuberculosis and Lung Disease. The employer of any food handler diagnosed with active tuberculosis shall be notified. (b) Procedure When Infection Is Suspected. When the Secretary has probable cause to suspect disease transmission by a food handler, the Secretary may require a medical history, physical examination, and any necessary screening tests required to determine whether the suspected food handler has a communicable disease. If the food handler is confirmed to have a communicable disease, the Secretary may require any or all of the following measures: (1) Restriction of the food handler s services to an area of the establishment where there would be no danger of him or her transmitting the disease; (2) Physical examinations and health screening tests of other employees working in the same establishment as the food handler; (3) The immediate exclusion of the food handler from employment until such time that the food handler is considered non-communicable; (4) The immediate closing of the place of employment concerned until, in the opinion of the Secretary, no further danger of disease outbreak exists;

92 (5) Confinement of the food handler in the Commonwealth Health Center or the food handler s is considered noncommunicable.* (6) If applicable, referrals of the food handler to the Department of Labor and Immigration for immediate deportation back to his or her country of origin. *So in original; see the commission comment to this section. Modified, 1 CMC 3806(d), (f), (g). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The 2002 amendments amended subsection (b)(5). The change to subsection (b)(5) appears to be an error. Compare 20 Com. Reg. at (Oct. 15, 1998) ( Confinement of the food handler in the Commonwealth Health Center or the food handler s place of residence until such time as the food handler is considered non-communicable; ) and 23 Com. Reg. at (Sept. 24, 2001) ( Confinement of the food handler in the Commonwealth Health Center or the food handler s is considered non-communicable. ) Section 702 of the Consolidated Natural Resources Act of 2008 (Pub. L. No , codified at 48 U.S.C. 1806) removed the CNMI s authority to create and manage its own immigration laws. On March 22, 2010, the Governor signed PL 17-1, removing all references to immigration and deportation functions from the Commonwealth Code. To the extent this section conflicts with Pub. L. No or PL 17-1, it is superseded. In subsection (a), the Commission changed follow to follows to correct a manifest error Application of These Rules and Regulations to Food Handlers Currently Working in the CNMI Upon the effective date of the rules and regulations in this part, all food handlers currently working in the CNMI shall have ninety days to obtain a food handlers certificate in order to be in compliance with the requirements of these rules and regulations. The clinic shall be required to bring the physical examination and/or screening results to the Division. The food handler shall provide documentation of completion of the food handler education seminar to the Division for entry into the database and for issuance of the food handler certificate. Modified, 1 CMC 3806(d), (e), (f), (g). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998) Penalties for Violation of These Rules and Regulations (a) Penalties for Food Handlers. Food handlers who are found to be in violation of the rules and regulations in this part shall be reported to the Division and recommended for restriction from food handling activities and shall be subject to the following penalties. (1) For first time violations, the food handler shall receive a warning letter from the Division setting forth a date of compliance for obtaining a food handlers certificate; (2) For repeated violations, the food handler shall be subject to a fine of up to $500.00, as provided in 3 CMC (b) Penalties for Employers. An employer found to be employing a food handler who has not

93 been issued a food handlers certificate by the Secretary and is not undergoing treatment at the Division or their physician, or an employer otherwise violating the provisions of these rules and regulations shall be subject to the following penalties: (1) For first time violations, the employer shall receive a warning letter from the Division setting a forth a compliance date for obtaining a food handlers certificate for the food handlers who have not obtained physical examination and screening tests; (2) For repeat violations, the employer shall be subject to a fine a fine of up to $ for each food handler who have* a valid food handler certificate and is not undergoing treatment at the Division, as provided in 3 CMC *So in original; see the commission comment to this section. (c) Penalties for Other Violations. Any person found by the Department to have obtained a food handler certificate by fraudulent means; forged or altered information on a physical examination form or screening test; refused or failed to comply with any order issued by the Secretary or duly authorized representative pursuant to the rules and regulations in this part, or violated these rules and regulations in any other manner, shall be liable for a civil penalty of up to $1, for each violation of the rules and regulations in this part. Modified, 1 CMC 3806(d), (f), (g). History: Amdts Adopted 24 Com. Reg (Feb. 28, 2002); Amdts Proposed 23 Com. Reg (Sept. 24, 2001); Adopted 21 Com. Reg (Jan. 18, 1999); Proposed 20 Com. Reg (Oct. 15, 1998). Commission Comment: The 2002 amendments amended the opening paragraph of subsection (b) and subsections (a)(2) and (b)(2). The starred language in subsection (b)(2) probably should read who does not have. Compare 20 Com. Reg. at (Oct. 15, 1998) and 23 Com. Reg. at (Sept. 24, 2001). In subsection (a)(2), the Commission inserted the final period. In the opening paragraph of subsection (b), the Commission changed regulation to regulations and in subsection (b)(2), the Commission changed handlers to handler to correct manifest errors.

94 SUBCHAPTER SCHOOLS AND CHILD CARE FACILITIES REGULATIONS Part 001 General Provisions Reference to General Provisions Part 100 General Sanitary Requirements Introduction Structures and Equipment Sanitary Maintenance and Grounds Keeping Water Supply Hand Washing Facilities Shower and Locker Rooms Toilet Facilities Waste Control Food Protection Part 200 Health Certificates for Employees and Children Health Certificates Appendix A School and Childcare Inspection Report/Warning Subchapter Authority: 1 CMC 2603 and 2605; 3 CMC Subchapter History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Commission Comment: PL 1-8, tit. 1, ch. 12, codified as amended at 1 CMC , created the Department of Public Health and Environmental Services (DPHES) within the Commonwealth government. See 1 CMC CMC 2603(a) grants the Department the power and duty to maintain and improve health and sanitary conditions in the CNMI. 1 CMC 2605 directs the Department to adopt rules and regulations regarding those matters over which it has jurisdiction. Executive Order 94-3 (effective August 23, 1994) reorganized the Commonwealth government executive branch, changed agency names and official titles, and effected numerous other revisions. According to Executive Order : Section 105. Department of Public Health. The Department of Public Health and Environmental Services is re-designated the Department of Public Health. The full text of Executive Order 94-3 is set forth in the commission comment to 1 CMC PL (effective Apr. 26, 2001), the Commonwealth Environmental Health and Sanitation Act of 2000, codified at 3 CMC , revised the Commonwealth statutes related to environmental health and sanitation. PL repealed former 3 CMC and enacted new sanitation provisions. PL ( 2122), 3 CMC 2122, requires a sanitary permit to operate enumerated establishments, including schools and other child care facilities. PL ( 2123), 3 CMC 2123, directs the Secretary of Public Health to promulgate rules and regulations required to ensure the sanitary operation of listed establishments. Public Law (effective Jan. 15, 2010), the Commonwealth Healthcare Corporation Act of 2008, codified at 3 CMC 2801 et seq., established the Commonwealth Healthcare Corporation, which assumed the duties of the Department of Public Health as of January 15, Part General Provisions

95 Reference to General Provisions All provisions in the General Provisions of the Environmental Health and Sanitation Standards [NMIAC, title 140, subchapter 20.1] are incorporated by reference as if set forth here. Modified, 1 CMC 3806(d). History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Part General Sanitary Requirements Introduction All structures, facilities, or school/child care equipment shall be maintained in sanitary conditions so that students do not contract illnesses associated with poor maintenance and practices of school/child care employees and/or operators. History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Commission Comment: This section was originally the introduction to 2, codified in part 100. The Commission created the section title. The Commission inserted a comma after the word facilities pursuant to 1 CMC 3806(g) Structures and Equipment Structures and equipment of all school/child care facilities shall be, at a minimum, maintained in accordance with the following: (a) Rooms shall be kept clean, neat, and orderly with approved waste paper containers provided. (b) The janitorial rooms, and any storage area used to store hazardous materials, shall be locked to prevent student access. (c) The floors of all rooms shall be of such construction as to be easily cleanable, and shall be kept clean and in good repair. (d) (e) Floors without carpeting shall be sealed with a satisfactory floor sealer. Floors in the toilet rooms shall be impervious, easy to clean material. (f) Walls and ceilings surfaces shall be kept clean and in good repair. Walls shall be finished with easily cleanable material. (g) Rolling, sliding, revolving, or double acting doors are prohibited. Entrance doors shall be self-closing and shall open outward.

96 (h) Doors and windows shall be kept clean and in good repair. Windows shall be louvered and screened effectively, unless other means are provided to prevent the entrance of vectors. (i) Ventilation shall be adequate to provide proper circulation of needed air within a room by either windows or mechanical ventilators. (j) All rooms, areas, and equipment, from which chemicals aerosols, obnoxious odors, noxious fumes or vapor may originate shall be effectively vented to the outside air. (k) Windows shall have light shields, shades, or blinds which shall be kept clean and in good condition and so used or adjusted that glare and excessive light intensities are reduced to a minimum. (l) Ducts and fans in connection with mechanical ventilation shall be so arranged and controlled as to eliminate objectionable air currents directly on the students. (m) When mechanical ventilation is provided, it shall be kept clean and maintained in a good state of repair. (n) Classrooms shall be adequately lighted to illuminate and provide a comfortable visual environment. (o) All decorative ornaments, or any obstructing articles preventing better illumination for visual comfort shall be removed. (p) All lighting fixtures and accessories shall be maintained in a sanitary condition and in good repair. All fluorescent lamp protection guards shall not be removed, or whenever a fluorescent bulb is replaced, the protective guards shall be placed back in position. (q) Any fluorescent lamp or bulb not illuminating or providing enough visual comfort shall be replaced. (r) The classroom equipment such as chalkboards, erasers, and furniture shall be kept clean and in good repair. (s) Each student shall have an individual seating unit with writing table attached or adjacent to the seat and so constructed as to provide comfortable seating and convenient writing without undue strain. (t) The desks shall be so arranged that the light is also admitted from the left and rear of right handed students and left handed students shall be located where light is also received from the right side and rear. (u) (v) Desks shall be kept clean and in good repair. Writing tables attached to the desk shall be smooth and light in color to provide limited

97 contrast against a white paper. (w) Contact surfaces (e.g. toys, desks, floor mats, etc.) shall be sanitized weekly. Modified, 1 CMC 3806(g). History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Commission Comment: In the opening paragraph, the Commission changed followings to following to correct a manifest error Sanitary Maintenance and Grounds Keeping The general areas of all schools/child care facilities shall be sanitarily maintained for the health of the students, employees, and the public and to prevent injuries and/or illnesses. (a) There shall be sufficient separate and secure space for the storage of maintenance equipment, ground equipment, and instructional equipment. (b) All areas, facilities, and equipment shall be maintained in a clean, safe, and sanitary condition and kept in good repair. (c) The building and grounds shall be free of insects of public health significance and conditions which attract, provide harborage, and promote breeding of vermin. (d) When sweeping floors, a dust-arresting compound shall be used in classrooms. Sweeping shall only be conducted during class sessions where it is necessary to maintain sanitary conditions. History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission inserted a comma after the word employees pursuant to 1 CMC 3806(g) Water Supply (a) Each school/child care facility shall be provided with an ample supply of water from an approved public water system. Water reservoir shall be adequately provided for backup use and shall be safe and of sanitary quality. Backup water reservoirs shall be sanitized every three months. (b) Drinking water dispensed by means of drinking fountains, cups, and water coolers shall conform to the following. (c) Water dispensers shall be sanitized daily and kept in good repair. (d) The waste opening and pipe shall be provided with a strainer and be of sufficient size to carry off the water.

98 (e) Single-service cups shall be used for dispensing drinking water from imported bottled water or water coolers. Single-service cups shall be stored, handled, and dispensed in a sanitary manner. (f) All drinking water provided at schools/child care facilities shall meet the quality standards established by the U.S. Safe Drinking Water Act. (g) The school/child care facility water supply system shall be in a good working order at all times so as to adequately supply water needed for the sanitary operation of the school/child care facility. (h) All water outlets shall be protected from back-flow either by air gap or back-flow prevention devices. There shall be no existing or potential cross-connection or back-siphonage problems anywhere in the school/child care facility or its premises. (i) There shall be no stagnant water that could contribute to mosquito and vector harborage. Modified, 1 CMC 3806(e). History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Commission Comment: The Commission inserted a comma after the word cups in subsection (b) pursuant to 1 CMC 3806(g) Hand Washing Facilities (a) Hand washing facilities shall be adequate in numbers and conveniently located, especially to rooms which require frequent hand washing. (b) Hand washing basins shall be provided inside each toilet facility in a ratio of one per two toilet fixtures. If hot water is also provided at hand washing facilities, it must be combined with the cold water through a mixing faucet. The hot water shall have a maximum temperature of 120 F. (c) Soap and disposable towels shall be provided and made available at all times. Heated air hand-drying devices may be used in place of disposable towels. Common towels are prohibited. Modified, 1 CMC 3806(g). History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Commission Comment: In subsection (b), the Commission changed facilities to facility and in subsection (c), the Commission changed device to devices to correct manifest errors Shower and Locker Rooms (a) Where athletic or gymnastic activities are conducted, sufficient and adequate shower

99 facilities shall be provided if the Secretary or his/her duly authorized representative determines that there is a need for prevention of the spread of disease. (b) Hot and cold running water shall be sufficiently provided at the showers. (c) The floor of the shower facilities, shall be of smooth finished material with non-slip surface, impervious to moisture and sloped to the floor drain. Junctions between walls and floors shall be covered and sealed. Walls shall be water impervious up to shower-head heights. Upper walls and ceilings shall be of smooth, easily washable construction. (d) Shower and locker rooms shall be kept clean and well ventilated and the lockers, showerheads and floors shall be kept in good repair. History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003) Toilet Facilities (a) Toilet facilities shall be adequate in numbers and conveniently located and toilet and urinals fixtures shall be constructed to be of proper height for the pupils. (b) Separate toilet facilities for each sex shall be conveniently located. (c) Toilet doors shall be self-closing and shall be provided with signs designating the sex for which such room is intended. (d) Floors shall be of impervious material and floor drains should be provided. (e) Each toilet facility shall be completely enclosed and shall have a tight-fitting, self-closing door. Toilet partitions shall begin not more than one foot from the floor and extended to a height of not less than five feet. (f) Toilet rooms shall have adequate ventilation and shall be mechanically or naturally vented to the outside. (g) Toilet facilities shall be well-lighted either by natural or artificial means and each toilet facility shall be provided with adequate and proper trash container. (h) (i) All toilet facilities shall be kept in good repair, cleaned daily, and free from foul odor. Toilet paper shall be available and conveniently located adjacent to each flush toilet. Modified, 1 CMC 3806(e), (g). History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Commission Comment: In subsection (g), the Commission inserted the word by and changed facilities to facility to correct manifest errors.

100 Waste Control (a) Every school/child care facility shall provide an adequate number of garbage and trash containers with tight-fitting lids which shall be located at a place suitable for their use. (b) Watertight and non-absorbent containers shall be used for storing garbage. Garbage containers shall be washed and treated with a disinfectant as often as may be necessary to prevent the growth of microorganism or to become an attractant for vectors. The disinfectant used in such containers shall contain at least the equivalent 20% chlorine solution or its equivalent of an acceptable bactericidal. (c) Garbage, trash, and other solid wastes shall be disposed of daily so as not to emit nuisance odor, become an attractant to vectors, or create health hazard. (d) Trash containers shall be placed in a manner where it does not serve as harborage for vermin. Bulk refuse containers shall be located on impervious asphalt or concrete surfaces. (e) Garbage intended for use as animal feed shall be so stored in a manner so as not to be an attractant for vectors. Modified, 1 CMC 3806(g). History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Commission Comment: In subsection (c), the Commission inserted the word an before attractant. The Commission inserted a comma after the word vectors in subsection (c) pursuant to 1 CMC 3806(g) Food Protection All food storage, preparation, and serving facilities shall comply with the provisions of the Environmental Health and Sanitation Standards relating to eating and drinking establishments. Modified, 1 CMC 3806(d). History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003). Part Health Certificates for Employees and Children Health Certificates (a) Any person who desires to work in, or attend, a school/child care facility shall be physically examined by the Department of Public Health or a licensed physician in private practice and shall be issued a health certificate stating that the applicant employee or student is free of pathogens and parasites and other forms of communicable diseases under PL 6-10, article 6, (b) No person shall be allowed to attend to any client of a school/child care facility who has

101 been found to be infected with any form of communicable disease. (c) Every school and child care facility shall obtain and maintain evidence on file for ready inspection that every child has had all vaccinations or immunizations, including but not limited to diphtheria; pertussis, tetanus, polio, measles (rubeola), mumps, and rubella (German measles), hepatitis B, or against other communicable disease as the Secretary shall, by regulation, require. However, if an exemption from vaccination or immunization has been granted under NMIAC (1st published, Commonwealth Register vol. 13, no. 9, page 7858, 7867, 9/15/91), such documentation of the exemption must be readily available for inspection. (d) The health certificate shall be valid for one year, and shall be renewed annually thereafter from date of issuance. The employee/student shall undergo another physical examination before issuance of a new health certificate. (e) All health certificates of the employees working for, or the children attending, a school/child care facility shall be maintained in the facility s file readily accessible for inspectors. Modified, 1 CMC 3806(c), (e), (f). History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003).

102 Appendix A School and Childcare Inspection Report/Warning

103 History: Adopted 25 Com. Reg (Aug. 22, 2003); Proposed 25 Com. Reg (July 15, 2003).