- The Fresno Bee
Monday, Mar. 26, 2012 | 07:57 AM
Walk into any Los Angeles restaurant and you're likely to see a card in the window with a letter grade for its most recent health inspection.
In Sacramento, you can find a green, yellow or red sign with the same kind of information.
In Fresno County, you'll see nothing of the sort.
To find out how a restaurant in this county did on its most recent inspection, you have to screw up your courage and ask its staff for a copy. Or you can go to a little-publicized county website several weeks later and look it up.
It's easier elsewhere.
Los Angeles County began issuing letter grades and requiring restaurants to post them in 1998.
Over the next three years, hospitalizations for food-borne illnesses declined 20%, a subsequent academic study reported. Restaurants got higher average inspection scores after their grades were posted. Restaurants with the highest scores got more business on average.
Sacramento's program began five years ago and boasts of similar success, as well as support from local restaurateurs.
Despite those possible benefits, Fresno County health officials continue to resist the idea of posting inspection results on-site. Local restaurant owners are hesitant as well, an industry spokeswoman says.
"It's something that our members have not been in favor of," said Amalia Chamorro, director of local government affairs in Fresno for the California Restaurant Association.
More than 15,000 food facility inspections were conducted last year by Fresno County's division of environmental health.
Its 22 inspectors try to inspect restaurants four times per year (Sacramento and Los Angeles counties do three inspections per year) and bars twice per year. They check a long list of things that, if done wrong, can lead to food poisoning.
Do employees have a place to wash their hands, with hot water, soap and towels? Is cold food stored at 41 degrees or below and hot food at 135 degrees or higher?
Are the dishes and counters clean and chemically sanitized? Is the sewage system working right? Is the place free from vermin such as rats and cockroaches?
Each inspection results in a rating: either "in compliance," "minor violations," "significant violations, reinspection required," or "imminent public health hazard."
Last year, roughly one in four unannounced routine inspections resulted in an "in compliance" rating. Slightly more than half were "minor violations." One in five found "significant violations" warranting reinspection.
Of almost 12,000 routine inspections in 2011, only 12 found an "imminent public health hazard" -- a rating that generally results in closure. Most were due to water outages or sewer backups.
Other major violations only rarely result in a closure order.
The San Joaquin Country Club went three weeks with a heavy cockroach infestation early last year but never got an "imminent public health hazard" rating and was closed only once, overnight.
One time, an inspector's supervisor allowed the kitchen to remain open and finish serving a large group despite "live cockroaches in all different stages of life cycle." (Club manager Mike Carroll, hired in mid-November, said he has addressed the kitchen's roach problems as well as violations for too-warm refrigerators.)
What rating a restaurant receives depends partly on the inspector's judgment and partly on whether certain high-risk violations were found, which can be a judgment call as well, said Michael Robinson, a supervisor in the environmental health division.
All of the inspection reports are posted on a county website. But the county could be doing a lot more to publicize the results, said Doug Powell, a Kansas State University food safety professor who consults on the design of restaurant inspection systems.
"Online is a start, but lots of people don't have access at the time they make a dining decision -- when they walk in the door. That's why on-site disclosure is important to paying consumers," Powell wrote in an email.
Other central San Joaquin Valley counties vary in their practices.
None has a placard system like Sacramento or Los Angeles, although Madera County is considering one. Kings County issues silver stars, but only to restaurants that perform well on inspections and pass other food safety tests. Tulare County issues gold seals on similar criteria.
Kings County has posted inspection reports on its website since 2008. Tulare County sends weekly summaries to the Visalia Times-Delta newspaper, which posts them on its site. Madera does not post reports but hopes to start by the end of 2012, county Environmental Health Director Jill Yaeger said.
Fresno County's environmental health director, David Pomaville, joined the department only in December and said so far he hasn't seen a need to post inspection results at restaurants.
"I haven't drawn the conclusion that that is a tack that we would benefit from," Pomaville said. Instead, Pomaville says he is focusing his inspectors' attention on high-risk issues such as temperature control and sanitation.
In the past, Robinson said, the department's criticism of posting results on-site has centered on the fact that the inspection reflects a restaurant's condition at a single point in time. That, he said, might give diners "a false sense of security" when they go to the same restaurant on another day.
"At that moment they got an 'A' letter grade, and the next day they had sewage backing up, and it didn't change the letter grade," Robinson said.
Those kinds of concerns haven't slowed the momentum elsewhere toward posting inspection results on-site.
New York City began posting letter grades in 2010. One year later, a survey said 70% of the city's adults had noticed the signs, and of those 88% considered them when deciding where to eat.
Sacramento County last month marked its fifth year with a system of green, yellow and red signs and said major health risks found by inspectors had dropped 26% since the county began issuing the placards and requiring restaurants to post them.
Daniel Conway, legislative and public affairs director for the California Restaurant Association, said the Sacramento system has been well-received by restaurant owners, in part because inspectors are quick to do follow-ups when initial inspections result in something less than a green placard.
"It really comes down to the system and the ability of a restaurant to comply with it, as well as the message to the consumer," Conway said.
In the late 1990s, a television station's hidden-camera investigation showed shocking conditions in Los Angeles restaurants, including roaches, rat droppings, spoiled meat, rotten vegetables, and employees licking their fingers while preparing food. The Board of Supervisors implemented a letter-grade posting system two months later.
A group of researchers has done several studies of the Los Angeles system. In one of their most dramatic findings, the researchers compared reports of food-poisoning hospitalizations before and after the grading system was begun. They found that illnesses declined by 20% over the program's first three years -- but only in areas where grades were posted. Neighboring counties saw no such decline.
The study didn't prove cause-and-effect between letter grades and food poisonings, but one of the researchers, UCLA economist Phillip Leslie, said the decline is unlikely to be a coincidence.
"You really have to twist yourself into knots to believe that," he said.
Restaurant revenues also changed after grade cards were posted, the group found in another study. Restaurants with "A" grades saw an average 5.7% increase in revenues and those with "B" grades gained 0.7%. In restaurants with "C" grades, revenues dropped by an average of 1%.
On the downside, the group also concluded that implementing grade cards made inspectors slightly more lenient and led to grade inflation at the cutoff points between an "A" and a "B," or a "B" and a "C." In other words, inspectors were rounding up grades when it was close.
That doesn't surprise Kansas State's Powell, who helped design a restaurant inspection system for New Zealand and was not associated with the Los Angeles studies.
"Restaurant owners tell us that 'We need an "A" on that door and I will do whatever is necessary to get that "A" '," he said.
Fresno County's Robinson raised the possibility that restaurant owners might also pressure inspectors for a favorable grade -- even offer them bribes -- if the results were posted in their windows. He said that was another reason for the county's past reluctance to post inspection results in restaurants.
"We don't want to put our staff in that situation, where there's any kind of manipulation, or indignation or anything like that to get a particular grade," he said.
Leslie is unconvinced by the suggestion that there might be bribery.
"To my knowledge there's no real evidence of this happening where grade cards have been implemented," he said. "It seems to me that it's a poor reason not to implement grade cards."
Chamorro of the California Restaurant Association said her group's view on posting grades is starting to evolve. Though her members are still happy with Fresno County's current system, she said they are also open to change.
"We don't outright oppose a letter grading system," she said.
Lorraine Salazar, co-owner of the Sal's chain of Mexican restaurants, echoed Robinson's objection that posting grades could give the public a false sense of security. Still, she might support it if the same system was in place everywhere.
"If we're going that route, I'd like to see something happen at the state level," she said. "I'm not opposed to it but certainly it needs to be consistent."
Advocates of posting inspection results in restaurants say the benefits are twofold.
First, it gives information to consumers in a format that is easy to understand and available exactly when they need it -- when they're picking a place to eat.
Second, it helps create what Powell calls a "food safety culture" in which restaurant managers and employees are routinely watching for unsafe conditions nd correcting them, regardless of whether an inspector is present.
"This is just a basic check to hold people responsible," Powell said. "This is just one little tool."
Leslie describes posting restaurant inspection results as an example of using information disclosure as a tool to achieve public policy goals.
It's similar, he says, to publicizing school test scores as a way of improving education, or hospital complication rates as a way to enhance health care quality.
"Putting a letter grade in the window is such an ideal way of doing this," Leslie said. "People know what it means ... and you see it before you go into the restaurant. This is a really compelling, specific example of how notifications should work."
Faulty refrigeration, improperly stored food and poor employee hygiene are among the most frequent offenses found by Fresno County's restaurant inspectors. Here are the top five violators for 2011, ranked by the number of inspections that found "significant violations."
Oaxaca Restaurant, 4773 E. Belmont Ave., Fresno
Significant violations: 9
Refrigerators not cold enough; unlabeled meats and cheeses in display case.
Management comment: Did not respond.
Al Rico Tacos, 3069 W. Ashlan Ave., Fresno
Significant violations: 8
Refrigerators not cold enough; meat stored on floor of cooler.
Management comment: Owner Jose Nino attributed problems to previous owner; significant violations found again this month (March 8, 12 and 19).
El Mexicano, 2833 E. Manning Ave., Fowler
Significant violations: 8
Refrigerators not cold enough.
Management comment: Owner Manuel Camacho said refrigerators have been repaired and now read from 36 to 40 degrees.
IHOP No. 1727, 7119 N. Fresno Street, Fresno
Significant violations: 8
Pooled eggs stored at room temperature; refrigerators not cold enough; cook did not wash hands after cracking eggs; ant infestation.
Management comment: Did not respond.
San Joaquin Country Club, 3484 W. Bluff Ave., Fresno
Significant violations: 8
Cockroach infestation; refrigerators not cold enough; assistant chef did not wash hands after licking fingers.
Management comment: Club manager Mike Carroll said new management was hired late last year and has addressed the problems.
-- Compiled by Russell Clemings and Heather Somerville
Fresno County’s restaurant inspections website
Website of Doug Powell, Kansas State University food safety professor
Sacramento County restaurant inspections: desktop | mobile
Tulare County restaurant inspections
Kings County restaurant inspections
Los Angeles County restaurant inspections
Video: Los Angeles television report on restaurant inspections
