Food Employee Exclusion and Reinstatement Decisions
Decide whether a sick food employee is excluded or restricted, work out when they can return, and handle approval, privacy and policy correctly.
Table of contents
Sending someone home for vomiting is the easy case. The hard ones arrive on a busy Friday: a dishwasher's child has hepatitis A, a cook who feels fine has just tested positive for Shigella, or a nursing home cook has a sore throat and a fever. Each of these has a different answer, and getting one wrong can start an outbreak or wrongly keep someone from their pay.
These are the decisions that a person in charge has to make. You already know the basic symptoms and how to send someone home. This takes you into the detail of who is excluded, who is restricted, when each may return, and who must approve it.
Everything here follows the 2026 FDA Food Code, sections 2-201.11 to 2-201.13. It's a model code. Your state or local code may be on an older edition, and your health department can set stricter rules, especially during an outbreak. This is training, not medical or legal advice. For a real case, check your own code and call your regulator.
What You Will Be Able to Do
- Explain the difference between excluding and restricting.
- Tell whether your operation serves a highly susceptible population.
- Pick the right action for a symptom, a diagnosis or an exposure.
- Work out the earliest return date, and whether a regulator must approve it.
- Keep employee health matters private and legally sound.
Three Terms That Drive Every Decision
| Term | What it means |
|---|---|
| Exclude | The person can't work in the food establishment or enter it as an employee |
| Restrict | The person can work, but not with exposed food, clean equipment, utensils, linens, or unwrapped single-service or single-use items |
| Highly susceptible population (HSP) | People more likely to get seriously ill, such as those who are immunocompromised, preschool-age children, and older adults, who get food at a place such as a child or adult day care, hospital, nursing home or senior center |
Restricted doesn't mean sent home. A restricted cook might take out trash, work a register with no exposed food, or do paperwork. If you've got no such work, you may have to send the person home in practice, but the legal status is still restricted.
First, work out whether you serve an HSP. A regular restaurant that a few older people visit doesn't count. A hospital kitchen, a preschool or a senior center does. Your answer changes many of the decisions below.
What Employees Must Report
Under section 2-201.11, the permit holder must require food employees, and conditional employees, to report the following to the person in charge. A conditional employee is someone who's been offered a job, subject to the health questions, and who hasn't started.
| Type | What must be reported |
|---|---|
| Symptoms | Vomiting, diarrhea, jaundice, sore throat with fever, an infected wound or boil that's open or draining and isn't properly covered |
| Diagnosed illness | Norovirus, hepatitis A, Shigella, Shiga toxin-producing E. coli (STEC), typhoid fever, non-typhoidal Salmonella |
| Past illness | Typhoid fever within the past 3 months, without antibiotic therapy |
| Exposure | A link to a confirmed outbreak, or a household member diagnosed with norovirus, Shigella, STEC, typhoid fever or hepatitis A, within set time limits |
Jaundice is a yellowing of the skin or eyes. It can be a sign of hepatitis A.
The exposure time limits are 48 hours for norovirus, 3 days for STEC or Shigella, 14 days for typhoid fever and 30 days for hepatitis A, all counted from the last exposure.
You, as the person in charge, must notify the regulator when a food employee is jaundiced, or is diagnosed with any of the six listed illnesses.
Deciding: Exclude or Restrict
Start with the question: does this person have symptoms, a diagnosis, or an exposure? Then use the table.
| Condition | General public | Serving an HSP |
|---|---|---|
| Vomiting or diarrhea | Exclude | Exclude |
| Jaundice that began within 7 days | Exclude | Exclude |
| Hepatitis A diagnosis, with or without symptoms | Exclude | Exclude |
| Typhoid fever, diagnosed or within past 3 months | Exclude | Exclude |
| Norovirus, Shigella or STEC, no symptoms | Restrict | Exclude |
| Non-typhoidal Salmonella, no symptoms | Restrict | Restrict |
| Sore throat with fever | Restrict | Exclude |
| Uncovered infected wound or boil | Restrict | Restrict |
| Exposure to a listed illness, no symptoms | No action under this rule | Restrict |
Three details make a difference.
Noninfectious causes. The vomiting and diarrhea rule doesn't apply when the symptom comes from a noninfectious condition. Morning sickness in pregnancy or a chronic bowel condition are two examples. A person can be reinstated with written documentation from a health practitioner. Use the same practice for everyone, so that no one is singled out.
Jaundice with a medical note. If a practitioner gives written documentation that the jaundice isn't caused by hepatitis A or another fecal-orally transmitted infection, the exclusion doesn't apply.
Covered wounds. A wound on the hand or wrist counts as covered if it's protected by an impermeable cover, such as a finger cot, and a single-use glove. On the arm, it needs an impermeable cover. Elsewhere, it needs a dry, durable, tight-fitting bandage.
Deciding: When Can They Come Back?
Coming back depends on what the person had, and whether the regulator has to approve it. Approval means that you, as person in charge, get the regulator's agreement before the person returns.
| Situation | Approval? | One of these must be met |
|---|---|---|
| Vomiting or diarrhea, no diagnosis | No | 24 hours with no symptoms, or a note that it's noninfectious |
| Norovirus | Yes | A note that they're free of infection, or more than 48 hours since symptoms ended |
| Shigella or STEC | Yes | Two negative tests, or more than 7 calendar days since symptoms ended |
| Non-typhoidal Salmonella | Yes | Two negative tests, or more than 30 days since symptoms ended |
| Hepatitis A or jaundice | Yes | Jaundiced more than 7 calendar days, or other symptoms with no jaundice for more than 14 calendar days, or a note that they're free of hepatitis A |
| Typhoid fever | Yes | A note that they're free of typhoid fever (required) |
| Sore throat with fever | No | A note showing more than 24 hours on antibiotics, a negative culture, or that they're free of the infection |
| Infected wound or boil | No | It's properly covered |
If the person never had symptoms, count from the diagnosis date instead: more than 48 hours for norovirus, more than 7 calendar days for Shigella or STEC, and more than 30 days for Salmonella.
The two negative tests must come from a validated test by an accredited or certified lab, using stool specimens taken at least 24 hours apart, and no sooner than 48 hours after stopping antibiotics. The 2026 Food Code changed the wording from "stool cultures" to "laboratory test results," so older codes may read differently.
The Step Down From Excluded to Restricted
For a diagnosed illness with symptoms, the person doesn't always go straight from excluded to back at work.
- In a general public operation, once someone with norovirus, Shigella or STEC has been symptom-free for at least 24 hours, you change the exclusion to a restriction until the conditions above are met.
- In an HSP operation, the exclusion stays in place until those conditions are met.
- For non-typhoidal Salmonella, a person who still has symptoms stays excluded. Once symptoms end, they're restricted until the conditions are met, in either type of operation.
Lifting a Restriction for Exposure
In an HSP operation, a restricted worker who's been exposed can be reinstated with no symptoms after these times have passed since their last exposure, or since their household contact became symptom-free:
| Illness | Time that must pass |
|---|---|
| Norovirus | More than 48 hours |
| Shigella or STEC | More than 3 calendar days |
| Typhoid fever | More than 14 calendar days |
| Hepatitis A | More than 30 calendar days, or the person is immune |
For hepatitis A, immunity from past illness, vaccination or IgG treatment also lifts it. There's a further option, which involves additional training and no bare-hand contact with ready-to-eat food.
Worked Decisions
Case 1: No diagnosis. A line cook at a restaurant tells you at 2:00 p.m. on Tuesday that he has diarrhea. You send him home. His last episode is at 6:00 a.m. on Wednesday, and he doesn't see a doctor.
He's excluded, and there's no need to tell the regulator. He may return once he's had no symptoms for at least 24 hours, so 6:00 a.m. on Thursday is the earliest. You record the date and time in your log, and the regulator's approval isn't needed.
Case 2: Norovirus at a restaurant. A server is diagnosed with norovirus on Monday, and her last symptoms ended at 8:00 p.m. that night.
- Monday: She's excluded, and you notify the regulator.
- 8:00 p.m. Tuesday (24 hours symptom-free): She moves to restricted. She can work only with no exposed food or clean items.
- After 8:00 p.m. Wednesday (more than 48 hours): She can return to full duty, once you've got the regulator's approval.
If you can't reach the regulator on Wednesday night, she stays restricted until you do.
Case 3: The same illness in a nursing home. In this case, she stays excluded the whole time, with no restricted step. After 8:00 p.m. on Wednesday, she can return, provided you have the regulator's approval.
Case 4: A household exposure at a preschool. A cook at a preschool tells you that her husband has been diagnosed with Shigella. She feels fine. It's an HSP operation, so she's restricted. She can come back to full duty once more than 3 calendar days have passed since her last exposure, or since her husband's symptoms ended. In a regular restaurant, this rule wouldn't apply to her, though she should watch for symptoms and report them.
Case 5: Yellow eyes. A prep cook has a yellow tint to his eyes. You exclude him and notify the regulator, as you would for any jaundice. If a doctor diagnoses hepatitis A, the health department takes over. They might review who was exposed, and they might give orders about food and staff. Any ready-to-eat food that he could have contaminated must be discarded under section 3-701.11.
Warning: Hepatitis A is a serious case, and speed matters. Call your regulator as soon as you learn of jaundice or a diagnosis, and don't wait for the end of the shift. Public health staff may need to act quickly to protect coworkers and guests.
After a Sick Worker Has Left
Your job doesn't stop at the door.
- Discard ready-to-eat food that may have been contaminated by the employee.
- Clean and sanitize what they touched. If there was vomiting or diarrhea, use your written clean-up procedure, and a disinfectant that's right for it.
- Check if anyone else is sick. More than one case may mean an outbreak.
- Record the date, what was reported, what you decided, and the planned return date.
Written Policy and Proof of Training
The Food Code expects your system to be in writing. You need a written employee illness policy, available on request, and a written procedure for cleaning up vomit and diarrhea. Under section 2-103.11, you must also tell food and conditional employees of their reporting duty in a verifiable manner, meaning that you can prove it.
The Food Code's Annex 7 has model forms that are useful here:
| Form | Use |
|---|---|
| Form 1-A | Interview for a conditional or food employee |
| Form 1-B | Reporting agreement for the employee to sign |
| Form 1-C | Medical referral for a health practitioner |
Ask these health questions only after you've made a job offer, as the Food Code's definition of conditional employee is tied to the Americans with Disabilities Act (ADA). Talk to your HR adviser or lawyer before you use these forms. Then train staff, sign the forms, and keep them.
Privacy and Fair Treatment
Health information is private, and employment law applies to how you handle it.
- Ask about symptoms, diagnoses and exposures that the code requires. Don't ask about other health matters.
- Talk in private. Don't discuss a worker's illness in front of the team.
- Keep health records in a separate, confidential file, not in the regular personnel file.
- Tell staff only what they need to do their jobs: "Marcus is off until Thursday."
- Apply your policy the same way to everyone, from the dishwasher to the chef.
- Take advice on the ADA, family and medical leave, paid sick leave and workers' compensation. These all vary by situation and state.
If an employee's illness was reported to the regulator, the regulator may share what's needed for public health, but you shouldn't.
Making It Safe to Tell the Truth
None of these rules work if workers hide their symptoms. In many kitchens, people come in sick because they fear losing pay, losing shifts or letting the team down. As a manager, you have some control over that.
- Thank people when they report. Never punish it.
- Don't call people in when they're sick, and don't make them find their own cover.
- Have a plan for being short-staffed, such as cutting a menu item, so that sending someone home isn't a disaster.
- Know whether your state or city requires paid sick leave, and what your employer offers.
- Be a model. If you come in sick, your team will too.
Ask staff at the start of a shift whether they've got any reportable symptoms. Many operations build this into the pre-shift routine, and it works well if staff trust that nothing bad will happen when they say yes.
Common Mistakes
| Mistake | What it costs |
|---|---|
| Letting a symptomatic worker stay "in the back" | Exclusion means out of the building, and illness can still spread |
| Using restaurant rules in a nursing home or preschool | People who are most at risk are exposed |
| Bringing someone back without regulator approval when it's required | A violation, and possible spread |
| Failing to tell the regulator about jaundice or a diagnosis | Delays public health action |
| Accepting a doctor's note for the wrong condition | The person returns while still a risk |
| Telling coworkers what someone has | Legal risk, and staff stop reporting |
| Punishing sick calls | Workers hide symptoms |
Check Your Understanding
1. A cook at a burger restaurant has a sore throat and a fever. What's the right action, and how does he get back to normal duty?
Restrict him, because this isn't an HSP operation. He can't work with exposed food or clean items. He returns with a note from a health practitioner showing more than 24 hours on antibiotics, a negative culture, or that he's free of the infection. No regulator approval is required.
2. A dishwasher at a hospital is diagnosed with STEC but has no symptoms. What do you do, and what's the earliest she can return without lab tests?
Exclude her, since a hospital serves an HSP, and notify the regulator. Without two negative tests, she can return once more than 7 calendar days have passed since her diagnosis, with the regulator's approval.
3. A restaurant server had vomiting that ended at 9:00 p.m. on Friday. She has no diagnosis. She wants to work the Saturday dinner shift at 5:00 p.m. Can she?
No. That's only 20 hours. She needs at least 24 hours with no symptoms, so the earliest is 9:00 p.m. on Saturday, unless a practitioner documents a noninfectious cause.
4. A cook at a preschool says that his roommate has norovirus. He feels fine. What do you do?
Restrict him, since a preschool serves an HSP and he has an exposure. It lifts once more than 48 hours have passed since his last exposure or since his roommate's symptoms ended. Watch for any symptoms.
5. A new hire tells you, before her first shift, that she was diagnosed with Salmonella last week and feels fine now. What does this mean for her start date?
She can't become a food employee until she meets the reinstatement criteria. That means your regulator's approval and either two negative tests or more than 30 days since her symptoms ended. Contact your regulator, since approval is needed, and talk to HR about how to handle her start date.
Key Takeaways
- Excluded means out of the building. Restricted means no work with exposed food or clean items.
- Check whether you serve an HSP before you decide anything.
- Report jaundice and the six listed diagnoses to your regulator.
- Most diagnosed illnesses need the regulator's approval before the person returns.
- Vomiting or diarrhea with no diagnosis needs 24 hours symptom-free, or proof that it's noninfectious.
- Keep health records private, and make it safe to report.
- Always check your own code, because it may differ from the 2026 Food Code.