How to Improve Your Health Inspection Scores & Have a Cleaner Restaurant

Few things strike fear in the heart of a restaurateur more than the sudden, unexpected appearance of a health inspector. Rather than fear a health inspection, however, operators should view the inspectors’ inevitable visits as a tool to keep their restaurants clean at all times.

Unsanitary conditions result in unsanitary food, which can threaten the very existence of a restaurant. One infection, outbreak, cockroach on the potato skin, and you could be finished.

This article will provide a general overview of the inspection mechanism, what you can do to improve your establishment’s health inspection score and other tips for running a clean operation.

Regulations and Inspections

In the United States, all commercial foodservice establishments are subject to local, state and federal food codes that have been instituted to protect the general public from the dangers of foodborne illness.

The U.S. Food and Drug Administration (FDA) is the lead agency governing oversight of America’s food-handling processes. The FDA publishes “Food Code,” a model that helps food protection agencies at all levels of government regulate the retail and foodservice segments of the industry. The 2009 Food Code is the latest full edition, and represents best practices regarding safe food storage, handling and preparation.

Virtually every state has adopted a form of the FDA’s Food Code dating back to the 1993 version. State food and safety rules trickle down to the county and city level where these local health authorities take the lead on the front lines, preventing foodborne illness outbreaks through regular inspections of businesses serving food. (On a federal level, inspections are geared toward large-scale food manufacturing centers.)

Local laws regulate how frequently these inspections take place, but, in general, routine inspections occur twice a year and are typically unannounced.

There are three standard types of inspection:

Routine inspection

A routine inspection, sometimes called the “initial inspection,” is typically unannounced and involves a thorough examination of the establishment to ensure compliance with local, state and federal health code regulations. These inspections typically occur once every six months.

Compliant inspection

The complaint inspection, as the name suggests, usually occurs when a restaurant patron has filed a complaint with the local health department about possible unsafe practices. This typically occurs when someone falls ill soon after eating at a restaurant. During a complaint-triggered inspection, an inspector will likely conduct a detailed sweep of the facility, and in some cases take samples of questionable material for further testing, with the goal of tracing a possible source for food poisoning.

Follow-up inspection

The follow-up inspection occurs in cases in which an establishment receives a low score or has been given a warning to resolve a critical violation within a specified period. These should be taken very seriously, for if the establishment fails a follow-up inspection it can be closed, fined or both.

How Restaurants are Scored

While local health departments across the country share common underlying goals with their health inspections, scoring systems and the methods by which they display inspection results to the dining public can vary.

Inspectors record observations as they tour a facility and check for possible violations listed on their inspection forms. Violations generally fall into two categories: critical violations and noncritical violations.

Critical violations, if left uncorrected, are more likely than other violations to directly contribute to food contamination or illness.

Examples of critical violations include:

  • Failure to maintain proper food temperatures during preparation, storage or service.
  • Infected employees not restricted from handling food.
  • Poor hygienic practices, including washing hands when required.
  • Bare hand touching of ready-to-eat foods.
  • Toxic items improperly stored, labeled or used.
  • Presence of pests in the establishment.

Noncritical violations are those that do not directly relate to the cause of foodborne illness, but if uncorrected, could lead to critical violations.

Examples of noncritical violations include:

  • Improper storage of food-dispensing utensils.
  • Employees failing to wear hair restraints.
  • Failure to keep floors and walls of establishment clean.
  • Equipment in disrepair.

Each possible violation is assigned points depending on both the type and extent of the violation and the risk it poses to the public. At the end of the inspection, the points are tallied together for an inspection score. Depending on the scoring system, a higher inspection score could indicate a better compliance with the health code, with points being earned for proper compliance, or it could mean poor compliance with demerit points being issued for observed violations.

The City of Dallas, for example, has a scoring system that begins with a perfect score of 100. Violations result in deductions from the maximum score. Scores ranging from 80 to 100 are considered good to very good, and do not require a follow-up inspection. Scores ranging from 70 to 79 are considered passing, but require a re-inspection within 30 days. Any score below 70 is considered failing and requires a passing follow-up inspection within 10 days or the establishment will face closure. Anything below 60 results in immediate closure and requires inspection before reopening.

Displaying Inspection Results

Once results of an inspection report have been obtained, communicating them to the public can be accomplished in a variety of ways.

The New York City Health Department takes numerical inspection results from their adopted scoring system and converts them into a letter grade. New York restaurants are required to conspicuously display the letter grade. A score between 0 and 13 points earns an A, 14 to 27 points receives a B, and 28 or more points receive a C. Los Angeles has a similar letter grading system.

Alameda County, California, has put in place a unique variation of New York City’s letter grading system. Alameda County’s system uses a simple color code to inform the public in a glance of a particular restaurant’s cleanliness. Green indicates passing, and means that no major violations of food safety were found during the inspection.

How to Improve Your Health Inspection Scores & Have a Cleaner Restaurant

Yellow is a conditional pass, resulting from two or more major food safety violations. A follow-up inspection is scheduled to occur within a week for restaurants earning a yellow card. Red indicates that a facility has been closed due to one or more uncorrected major food safety violations, and will not reopen until all violations have been corrected and the facility has been re-inspected.

In the interest of greater transparency, health departments are working to make health inspection reports from local restaurants available to consumers, with many departments making these reports available online.

While these inspections only represent a snapshot of a food establishment’s health and safety condition, they speak volumes about how consumers perceive a restaurant as they make their dining choices, thus directly contributing to a restaurant’s financial success.

Typically, health departments are county agencies, although large municipalities might have their own. Information on health rating systems is readily available on local government websites. These agencies want this information to be easily accessed. Their goal is public health, not putting you out of business.

Resources to Help Prepare for an Inspection

There are several ways a foodservice establishment can improve its health grade score.

Many local health departments conduct regular live training sessions of which restaurateurs can take advantage to improve their awareness of foodborne illness issues and food safety. Your local restaurant association will have access to many resources, such as the National Restaurant Association’s “ServSafe” program for both managers and food handlers.

There is also a wealth of information regarding food safety that is posted online within each city/county’s health department homepage.

The New York City Health Department has published a handy reference sheet that is applicable to any food establishment with tips on avoiding common sanitary violations and improving the likelihood of a restaurant achieving a good score.

Some of these tips include:

  • Provide food safety training for all employees handling food.
  • Keep food at the proper temperature.
  • Control conditions that promote pests.
  • Protect food from contamination during storage, preparation, transportation and display.
  • Maintain all food surfaces.
  • Maintain all nonfood surfaces.
  • Maintain all plumbing and check it frequently.

The National Restaurant Association (NRA) provides guidance to restaurateurs about both how to prepare for an inspection, and what to do when an inspector visits your establishment.

To prepare, NRA recommends obtaining a copy of your local health inspection grading form so you will be able to review the very items on which an inspector will be grading. Put yourself in the shoes of an inspector and be diligent about working through the process. Upon completion of the exercise, NRA suggests that a briefing with kitchen staff and managers can be helpful to review any problems and carry out corrective action.

How to Improve Your Health Inspection Scores & Have a Cleaner Restaurant

When an inspector arrives at your restaurant, ask first to see his credentials. Many a journalist working on a “Dirty Dining” expos√© has gained easy access to restaurant kitchens by simply announcing to managers on duty that he was there to conduct a health inspection.

If you refuse to be inspected, the inspector will likely return with a warrant and a team of assistants. They will proceed to comb through every dank corner of your restaurant. Instead, accompany the inspector and take notes on the findings. NRA suggests that this might allow you the ability to correct minor infractions on the spot, showing the investigator your willingness to correct problems.

Finally, NRA recommends that at the conclusion of the inspection you ask the inspector to explain any violations that you do not understand and explain his or her findings to your staff and make recommendations on areas that need improvement.

Employee Sick Leave Policies

No article on heath and cleanliness would be complete without addressing employee health. Steve Crosier, director of Food Protection Services at Metro Nashville Public Health Department in Nashville, Tennessee, says that in recent months the Tennessee Department of Health has made a push for restaurants to adopt formal policies deal-ing with sick employees.

“Too many restaurant employees work while being ill, failing to inform their manager or supervisor,” Crosier says. It is important to have policies related to employee illness in place that all employees acknowledge to reduce the risk of transmitting to the general public. “Many employees are part time and don’t have adequate health insurance coverage, so they are more likely to risk coming to work when they shouldn’t,” Crosier says.

A recent study conducted by Duke University Hospital and published in the Journal of Food Protection states that 12 percent of all restaurant workers have come to work twice in the past year while suffering from diarrhea or vomiting. While certain advocacy groups fight for required paid sick leave, many restaurants don’t have it, contributing to the reason employees continue to work while ill. “Investments in such policies may be cost-effective interventions for restaurants, given restaurants’ substantial financial losses associated with foodborne illness outbreaks,” the authors of the Duke study write.

A real-life case illustrating this very point involved a Norovirus outbreak at the Reno Hilton in 1996. The plaintiffs brought a class-action lawsuit against the Reno Hilton after 1,300 staff and guests became sick with Norovirus. Hotel employees worked while ill, and the outbreak spread over a number of days. The trial court divided the action into two phases. The first phase consisted of a jury trial regarding liability for negligence, malice and fraud, as well as classwide punitive damages. The second phase was to consist of individual hearings to assess compensatory damages for each class member.

After deliberating for less than one hour, the jury assessed $25 million in punitive damages against the hotel after finding that Reno Hilton’s policy of unpaid sick leave was a proximate cause of the outbreak. In other words, the jury found that the cause of the damages to the plaintiffs was the hotel’s failure to maintain a paid sick leave policy. The litigation lasted a decade in various forms.

The option of paid employee leave is one every restaurateur should consider as a way to offset the danger of a foodborne illness outbreak caused by a sick employee.

Stay Ahead of Sanitation

Though official health inspections occur infrequently, the savvy operator will conduct her own health inspections much more frequently. Staying ahead of the enforcement agents is always a good policy, but it is especially critical in maintaining a clean work environment. Remember, you can’t provide a quality experience for your guests if you prepare their food in unsanitary conditions.

A Food Safety Emergency Contingency Plan: Some Points to Consider

A foodborne illness crisis can vary in severity and number of guests affected. In some cases, you learn that an employee has a contagious disease, such as Hepatitis A, and although no diner has reported illness, you are legally and morally obligated to contact the health department, which will assist you in notifying guests who might have been exposed. In other cases, you might be barraged by a number of complaints, alleging that they became ill shortly after eating at your restaurant. Still, in other cases, you might receive a call or complaint from a single guest. Your contingency plan to protect guests and your business will vary depending on the severity and scope of the problem. In any case, following are some of the steps of a sound contingency plan to prepare for such an unfortunate event. As with all legal content in this magazine, this article is for general information only. It is advisable to have an attorney who specializes in hospitality law create your specific plan.

Communicate and discuss the matter to and with all management and staff, and encourage their support and cooperation

Designate key persons, typically the owner, general manager or your attorney, to field customer complaints, respond to media inquiries and work with the health department. Let your staff know that if they are approached by third parties wanting them to explain the incident, they should direct them to the designated contact persons. If feasible, you might want to enlist the help of a public relations firm to assist with media inquiries and press releases.

Contact your local health department

Proactive cooperation with the health department demonstrates genuine concern and diligence, and could provide access to resources to you to identify the source of foodborne illness and lessen your liability. If health department officials contact you first, treat them as a partner. Do not attempt to evade questions or hide facts relevant to food safety issues. Health department officials do not want to shut down your business unnecessarily, but you need to work with them if you hope to maintain their assistance and support.

Create a form on which to document all reported guest ailments

It should capture the name, address and telephone number of the complaining guests, the time and date on which they dined at your restaurant, and the nature of their complaint, including physical ailments. The form should be signed and dated by the person submitting or recording the information, and carefully filed in a confidential and secure place.

When talking to complaining guests, indicate concern for their welfare and assure them that you are investigating/will investigate the matter and provide a follow-up call

You should not admit liability; however, if the health department or you have identified a food safety problem at your restaurant, you should inform the complaining guests to contact their physicians and the local health department for instructions on how and where to receive prophylactic or therapeutic treatment. (In this case, you should have contacted the health department.) How well you treat complaining customers may influence their decision to take legal action. Injured parties, who would otherwise forgive a bad outcome or accept a modest settlement, will seek legal recourse when treated indifferently or poorly by a business.

Contact your restaurant’s attorney and insurance company representative immediately

Your attorney can provide advice and representation initially; however, if the event is covered by your insurance policy, then the insurance company will assign the matter to its attorneys.

Conduct your own investigation, even if the health department is conducting its own, to determine the source of the illness

This includes inspecting the products and procedures, and interviewing all food-handling staff on duty during the day of the alleged outbreak. You should secure all remaining food product that is believed to be contaminated. Do not destroy it but freeze it (if spoilable) or lock it up in case the health department wants to inspect it. Second, take written statements from all individuals involved in the food handling, which they can show later as a good-faith effort to investigate the matter. Plaintiff’s attorneys always claim there was “really” no investigation if there is no record of it.

Contact your supplier if necessary

If the illness might be related to a vendor’s product, you should notify the distributor and/or supplier immediately.

Hire a food safety consultant

If you can do so, hiring a food safety consultant to assist with the investigation can be invaluable, and that person might be able to serve as an expert witness on your restaurant’s behalf, should the matter become litigious.


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