The Health Inspector and Your Operation: How to Make the Grade

You might not think that the average Joe or Jane gives a hoot about your health inspection. As long as the grade on your inspection was better than their grade in high school algebra, they might not even give it a second thought.

But then they read that contaminated green onions are served at a Chi Chi’s restaurant northwest of Pittsburgh, and soon 615 cases of hepatitis, including three deaths, are reported. Now food safety becomes a big deal, not soon erased from the dining public’s conscience. Even with the best precautions, we’re all vulnerable.

The food safety chain includes proper training and education, fastidious organization and care of perishable inventory, and a penchant for the cleanliness of a scrub nurse. At the front of the chain is the health inspector. Preventing the spread of foodborne illness is the job of the local health inspector, also known as food inspectors or environmental health specialists. The titles vary but the task is the same: Protect the public. Some restaurateurs dismiss them as nosy government bureaucrats. Give them a break. Better yet, embrace health inspectors as consultants, and get them involved in your restaurant plans.

The Earlier the Better

The moment you decide to open a restaurant, call the local health department for a rundown of all local, state and other requirements you’ll need to meet. A good portion of your restaurant design and equipment are going to be affected by health code, and you want to sidestep expensive retrofitting and opening delays.

There’s no such thing as a dumb question, with these guys. Cities and counties that inspect restaurants do much more than make sure you operate a safe business. Education is a big part of their job. Many jurisdictions have Web sites packed with information useful to restaurateurs.

A Spin Around the Country

The New York City Department of Health and Mental Hygiene provides suggestions for the planning of a well-designed restaurant. (See sidebar for Web site information.) Keep in mind that the suggestions are not all required. The Food Protection Program of King County and Seattle, Washington, provides on its Web site a mock restaurant health inspection, giving restaurateurs a taste of what to expect. The site includes a list and photo of tools that might be used during an inspection.

Denver, Colorado, has online a “Food Service/Restaurant Permitting Handbook.” Clay County, Missouri, also has a handy Web site and the health center provides new restaurateurs a thick manila folder of information. Inside you’ll find an example of a food inspection report; a list of suppliers for food thermometers, test strips and gloves; 140-page food code; a handbook for food handlers; hand washing fliers for posting in your restaurant; and brochures and schedules for classes required of managers and food handlers. In addition, New York City offers new restaurateurs a self-assessment of needs.

First, restaurateurs should determine the menu they plan to provide customers, and then use this menu to list the steps in the food preparation process for each menu item, which generally include:

  • Defining whether specific food items are potentially hazardous.
  • Determining how food items are received into the facility.
  • Deciding the storage method and length of time food items are to be stored prior to preparation.
  • Reviewing how foods are to be prepared (e.g., cooked to order, as opposed to prepared in advance of order), including an assessment of necessary cooking, cooling, and holding methods.
  • Determining the extent of necessary hand contact by food preparation workers during the preparation and serving stages.
  • Ensuring that all food items are maintained at proper temperatures through- out these processes until service.

Critical vs. Noncritical Violations

Once you’ve opened your doors, it is not the time to become lax. Established restaurants are subject to surprise inspections from health officials. Typically, inspectors look for what are classified as “critical” and “noncritical” violations, based on the Center for Disease Control and Prevention (CDCP) classification. The CDCP defines a critical violation as one that relates directly to factors that lead to foodborne illness. A noncritical violation is one that relates to maintenance and cleanliness of food service operations.

As you might guess, health inspectors are particularly tuned in to critical violations. In King County/Seattle, inspectors pay particular attention to:

  • Foods frequently associated with foodborne illnesses.
  • Foods prepared in large volumes.
  • “Ready to eat” foods that will be served without further cooking or processing. (For example, these foods require that food workers use a barrier between their hands and the food. A “barrier” could be tongs, bakery papers, or gloves.
  • “Complex recipes” that involve multiple ingredients or that are assembled or mixed, like salads and sandwiches. These recipes create the greatest risk of foodborne illness because the food will be handled several times.

Most violations fall into the noncritical category. In a two-day period last November, the Hall County Health Department in Gainesville, Florida, inspected 11 restaurants, and all easily exceeded the “85” score, which is considered passing. The department scores on a 100-percentile scale. Startup restaurateurs, however, are held to a higher standard; a new restaurant must score a 100 before it can open. When a restaurant changes ownership, the establishment must score a 94 or higher to receive a new permit.

Within reason, inspectors are more focused on fixing problems than punishing owners for them. One Gainesville County restaurant that scored a 95 did so even though the following problems were recorded. Food handlers did not all wear proper hair restraint. (A hat or hairnet is required for anyone working with food.) Tea nozzles had buildup of mold inside. (Nozzles need to be taken completely apart [remove rubber nipple inside] for proper cleaning.) Also, a hand sink was not sealed securely to the wall. To prevent water accumulation and food debris, and for safety concerns, the sink had to be recaulked to the wall.

Another restaurant that scored a 97 was told to clean and sanitize its ice bin baffle daily. Slime mold had been found growing on the leading edge of the ice bin baffle, which could result in biological contamination. Inspectors also told the eatery to routinely empty the ice bin.

Opening Act

As noted, a restaurant about to open for the first time may be subject to many requirements different from those required for a restaurant already in operation, where health inspectors can watch daily operation of food handling. While high scores are required in some jurisdictions, remember that a new restaurant does not provide the inspector an opportunity to critique the operation in the process of preparing food.

Melva Palmer, an environmental health specialist for Clay County, Missouri, said that once all requirements of restaurant construction are met, all a new restaurant must do to open is make sure everything works. “The refrigeration needs to be in place and working, cold and running water working. The ice machine needs to be hooked up. Fountain machines working. Basically the machines need to be in place and operating,” Palmer said. Problems are rare and usually minor, and involve inadequate caulking or sealing, she said.

More and More, Customers See Your Report

At one time, health inspections were part of an arcane world, deep in the underbelly of the restaurant industry. Nobody pushed a copy of the health inspection report in your customers’ faces, other than the required posting of certificates. But remember, a health inspection report is public information, and an increasing number of health departments are posting restaurant inspection reports online, for anyone to see.

This practice changes the effect of what were once mere food service peccadilloes. Now the little sins behind otherwise passing reports are confessed to anyone with Internet access and the interest. “Evidence of roaches or live roaches present in facility,” which is a notation in the report of many New York City restaurants, still equates to “Man, that’s gross!” in the minds of most diners.

What the readers may not know is that the violation is noncritical, could mean that one roach was spotted and removed, and that the rest of the report looked favorably upon the establishment. One recently retired health inspector said he can find at least one violation in any restaurant but in more than 30 years of inspections he never had to shut down a single establishment. Violations are almost always minor, he said, and are easily remedied; however, for better or worse, you need to avoid any black mark on the report — even minor sins.

The Report on Report Cards

Most communities, such as St. Louis County, Missouri and Los Angeles, California, have gone to a letter or number grading system. The grades, at least in the case of Los Angeles, have made a difference, according to one researcher. Phillip Leslie, assistant professor of strategic management at the Stanford Graduate School of Business, saw the 1998 report card law as a chance to study the effects of information on consumers and on market outcome. “We wanted to look at how responsive consumers were to that information and whether that translated to responsiveness by restaurants to improve product quality,” Leslie said.

What he found was overwhelming evidence that not only did consumers change their behavior once the ratings became public by frequenting restaurants with better scores, but restaurants also improved their hygiene levels. And he saw an additional benefit: fewer hospitalizations due to food-related illnesses. “We found that better information causes a change in the behavior of restaurants and consumers, and resulted in an improvement in public health,” Leslie said.


New Food Establishment Hygiene

There is surprising uniformity among health departments around the country, in regard to restaurant permit requirements. Still, each county has jurisdiction over the quality and fitness of eating establishments within it borders, and there are bound to be variations. We reviewed the lists from a number of health departments throughout the United States. This included Aspen, Colorado; Clay County, Missouri; Hunterdon County (New Jersey) Department of Health; King County/Seattle, Washington; and the New York City Department of Health and Mental Hygiene. The following is a rundown of what the health inspectors in these locales require before he or she can label your establishment fit for the public.

  • Check with appropriate local building and zoning department officials.
  • Establish an “information coordinator” who will be responsible for dealing with the various individuals and agencies involved. This may be an architect, contractor or owner.
  • Submit a proposed menu or general description of food items to be served.
  • Submit site building plans. This should include blueprints (drawn floor plans to scale) and equipment specification sheets; plumbing layout including location of sanitary facilities (including under floor lines and direction of flow), locations, food service sink systems, hand washing lavatories, dishwashing machines, floor drains, mop sinks, and hot water tanks; mechanical plans to include exhaust hoods, and restroom ventilation.
  • Submit a complete finish schedule including materials for floors, base, walls, and ceiling in all food service and toilet areas. Samples of fresh material may be required if degree of “cleanability” is questionable.
  • Submit shop drawings of all custom-fabricated equipment and cabinetry. Drawn to scale.
  • Submit location of chemical and personal belongings storage.
  • Submit plans detailing water supply and wastewater system.
  • Submit a site plan showing the location of the business in the building, location of the building on-site, including alleys, streets, and the location of any outside facility (dumpsters, walk-in units, grease interceptors, etc.)
  • Fill out a food establishment plan review application.
  • Apply for and pay for your food service permit.
  • Schedule a preopening inspection with your inspector, preferably at least a few days before the scheduled opening of the restaurant.
  • Keep copies of all of the above for your personal records.
  • Make sure all applications are completed and all required plans submitted. In some jurisdictions you may be charged extra fees for an incomplete proposal.

Again, requirements vary by jurisdiction. Check with your local health department about the specifics of what you need to do.


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