Food held at unsafe temperatures. Employees not washing their hands. Dirty countertops. Vermin in the kitchen. An expired restaurant permit.
Restaurant inspectors for San Diego County found these violations during a routine health inspection of a diner in La Mesa in November 2016. Despite the violations, the restaurant was awarded a score of 90 out of 100, the lowest possible score to achieve an ‘A’ grade.
Such grades are a common trend in San Diego, according to an NBC 7 Investigates analysis of a sample of retail food facilities inspections — including restaurants, stores, and bars — dating back to 2014.
The analysis shows more than 99 percent of routine inspections resulted in ‘A’ grades. The data show thousands of retail food facilities maintained ‘A’s despite inspectors finding up to 10 violations, including “major violations” the state says “may pose an imminent health hazard.”
NBC 7 Investigates compared these results to data from five other cities and counties and found the rate of ‘A’s awarded in San Diego was generally far higher than in other jurisdictions. The data also showed a spike in the number of 90 out of 100 scores and a huge dropoff in the number of 89 and lower scores.
“If you’re seeing that and it’s not reflective of the actual conditions, then we’re going in the wrong direction,” said Roy Costa, an international food safety expert who has more than 40 years experience in public health. “If the restaurant operator feels that they’ll always get a good score no matter what, then that takes the motivation out of it. So yeah, that’s troubling.”
Inspectors from the County of San Diego Department of Environmental Health typically perform two unannounced inspections at a restaurant per year. They start with a score of 100 and subtract points if they find violations of the California Retail Food Code. Typically major violations are worth four points but can be worth two or zero depending on severity (San Diego takes corrective action but does not subtract points when it finds an invalid permit or impounds spoiled food). Minor violations are worth two points and violations of good retail practices (a dirty wall or floor) are worth one.
A score between 90 and 100 results in an ‘A’ grade, a score between 80 and 89 earns a ‘B’ grade and one between 70 and 79 earns a ‘C’ grade. A score less than 70, as well as certain major violations, result in the automatic closure of the restaurant. San Diego retail food facilities are required to post the letter grade from their most recent inspection on their storefront and have a copy of their most recent inspection report on hand if a customer asks to see it.
According to NBC 7 Investigates’ analysis, 100 out of nearly 35,000 routine inspections resulted in ‘B’ grades, 11 resulted in ‘C’s and one received a 68. An additional 161 inspections resulted in automatic closure due to certain major violations. A total of 34,648 inspections resulted in ‘A’s.
“It’s a disturbing trend,” Costa said. “What you’re seeing is a multidimensional problem that goes way beyond whether or not a letter grade is an actual reflection of safety in the establishment, all the way to whether or not our public health system is really functioning.”
In an email, the Department of Environmental Health said it doesn’t track grade cards numerically, so it could not confirm or reject NBC 7 Investigates’ findings but said the high number of ‘A’s is “a good thing and to be expected.”
“It means the system is working,” department spokesman Gig Conaughton said. “That restaurants are meeting the ‘A’ card standard of substantially complying with food health and safety regulations; and that we are inspecting to reinforce that standard and making sure the public is informed that food facilities meet that standard.”
Conaughton noted San Diego County inspectors re-inspect any facility that doesn’t achieve an ‘A’ on a routine inspection. If they still don’t comply, they risk an administrative hearing or up to $150 in fines. He said ‘A’ grades are “not analogous to the grades issued in school, which are actual gradations of excellence,” and they “absolutely help the public.”
“The grade cards are a visual sign that show people that restaurants have been inspected, that food facilities know what the food health and safety standards are, that they know they are supposed to meet them to meet that ‘A’ card standard, and finally, that when they are inspected, they met them,” he said. “They also let the public know if and when they don’t meet those standards, by making them show ‘B’ or ‘C’ cards.”
In San Diego and many jurisdictions throughout the country, inspection information is posted online. San Diego County publishes the scores from a restaurant’s past three routine inspections, as well as generic descriptions of the violations inspectors found. Los Angeles County has a similar online database, containing inspection histories from the past two-and-a-half years. Santa Clara County’s database includes both the score and the official inspection report as a .pdf document.
Click here to see the San Diego database.
NBC 7 Investigates wrote computer programs to automatically search and pull data from four retail food facility inspection databases in California and two from out of state. According to the data gathered, each jurisdiction had the following percentage of inspections resulting in a score of 90 or above:
- San Diego County — 99.2%
- Los Angeles County — 96.4%
- Maricopa County, Arizona — 80.6%
- City of Austin, Texas — 66.9%
- City of San Francisco —64.0%
- Santa Clara County — 57.5%
NBC 7 Investigates contacted each of these jurisdictions to verify the findings. Look below for a breakdown of scores from each jurisdiction.
Each of those jurisdictions has a different rubric for grading, so the same inspection might result in an ‘A’ in one jurisdiction but a ‘B’ in another. In Santa Clara County, for example, major violations are worth eight points off a score of 100. In San Diego and Los Angeles counties, major violations are typically worth four. In Maricopa County, restaurants can only achieve an ‘A’ grade if the inspector finds zero violations directly related to foodborne illness and no more than three violations of good sanitation practices.
San Diego County used to count major violations as eight points but later reduced it to four points. San Diego County also does not subtract points when the facility has an expired permit or if an inspector must impound spoiled food, though the county considers both major violations.
Los Angeles County changed its system in January 2017 after it was scrutinized for allowing restaurants to maintain ‘A’s despite having more than one major violation. The change resulted in inspectors subtracting an additional three points if they find two major violations or specific closure violations, such as no running water or a vermin infestation, for a total of 11 points off the score.
Not all jurisdictions use the letter grade system. In Santa Clara County, restaurants earn colored placards in addition to scores — green means an inspector found no more than one major violation, yellow means the inspector found two or more major violations and red means the facility failed the inspection. In San Francisco, restaurants earn grades of “Good” (90 to 100), “Adequate” (86 to 90), “Needs Improvement” (71 to 85) or “Poor” (70 or less), and they must display them clearly in their storefronts. In Austin, restaurants must achieve a score greater than 70 or face compliance actions.
According to Costa, the letter grade system is productive because it incentivizes restaurant operators to try harder to meet standards, but it’s also “flawed” because it’s full of observation bias, reporting bias and human error.
Costa gave the following example to reiterate his point. Chicken cooked at unsafe temperatures, he said, can lead to salmonella, but during a 30- to 60-minute inspection, an inspector may or may not observe chicken being cooked. Alternatively, he said, an inspector might notice a small violation but decide not to take points if it is easily corrected and would knock a score down from an ‘A’ to ‘B’.
“The bottom line is the letter grade is really, I don’t want to say not important, but because it’s so subject to error and bias, it’s not really something we should be focusing on as food safety people that want to see improvement,” Costa said. “We should be focusing on other foodborne illness risk factors and reducing them.”
Robert Romaine, who worked as an inspector in San Diego for 25 years and now runs a private food safety consulting practice, was “not surprised” by NBC 7 Investigates’ findings. He said the breakdown “doesn’t look that different” from when he was the statistician for the department, and the high rate of ‘A’s means the system is working.
“Most of the operators are used to what’s required to keep a good operation, and they’re just good operators,” said Romaine. “Most people will be very concerned if they see something less than an ‘A’ in the window, and I’ve had business operators tell me that when they get a ‘B’ or a ‘C’, the customers don’t come in. So it works very well.”
Romaine said when he was an inspector, he and his colleagues used to joke about awarding “mercy ‘A’s” — when a restaurant should have earned a high ‘B’ grade, but the inspector instead allows it to fix a violation on site and awards it an ‘A’.
“That would be considered a gift in a way because we’re giving them the chance to fix something rather than penalizing them,” Romaine said. “But that’s usually only done for operators that have an occasional problem, not for operators that have repeated issues.”
Linda Copp, a registered dietitian and a part-time professor at San Diego State University’s food science program, said restaurant operators must go above and beyond what the county requires to ensure food safety.
“It’s great that we have a lot of facilities that are meeting the standards that have been established,” Copp said. “On the flipside of that, I think many facilities could use more instruction on a daily or weekly or monthly basis, more follow-up and more instruction on food safety to their employees so that the knowledge is ongoing, and the importance of food safety is first and foremost.”
Copp works directly with restaurants to design hazard analysis and critical control points (HACCP) plans, which outline food safety and sanitation procedures restaurants should follow based on their clients’ needs. According to her, the current inspection system doesn’t necessarily reflect whether a restaurant prioritizes food safety over earnings and efficiency. She said she would like to see every food service facility have a documented plan they revisit and amend, but because it’s voluntary, most restaurants currently do not have one.
“What they have now suffices the standard that they have established, and I think it does give us a good base, but I think there’s so much more education and instruction that needs to take place,” she said. “That’s where I’m passionate about teaching facilities to have these plans and implement them. It’s a living document, and it changes and grows. Then your employees get on board and everyone contributes, and you have a great environment that is not reflected in an ‘A’ grade.”
Costa supports HACCP plans and advocates for a system in which inspectors quiz employees on their knowledge of the food code and of the restaurant’s own policies and procedures for food safety, instead of performing “spot checks.”
The Food and Drug Administration (FDA) and U.S. Department of Agriculture (USDA) require HACCP programs for producers of meat, juice, and seafood, but not for restaurants.
“The restaurant industry, unfortunately, has fought the idea of mandatory written programs, and that is where the problem is,” Costa said. “The inspector has no policy or procedure that they can review when they go in and then check against those policies and procedures during an inspection. What an inspector sees and what they write down is really a function of that person’s training and experience and motivation, and all those factors together just make a mess.”