Making the A-list

It was 2 p.m. on a hot summer afternoon, and the buffet trays at China Bowl Express near downtown Los Angeles brimmed with tantalizing dishes. But by 2:30 p.m., all the chicken teriyaki, orange chicken and black-pepper beef, along with nearly two-thirds of the menu, were gone.

The food didn’t disappear in a rush of diners; it was chucked into the garbage by order of Richard Lavin, a county health inspector.

“Their temperatures were way off,” said Lavin, referring to the lukewarm levels at which much of the food was being held. With some cooked dishes as much as 35 degrees below the legal minimum of 140 degrees, the restaurant was providing an ideal breeding ground for bacteria that cause food-borne illness.

Such infractions can literally prevent a restaurant from making the grade, and Lavin was there to tally them up. The 10-year veteran works the front lines protecting the public health, adhering to a grading system that in five years of use has become an effective tool in keeping restaurant owners vigilant and the public informed.

Upon inspection, each of the 24,000 restaurants in the county health department’s jurisdiction gets a letter grade of either A, B or C or, worse, they’re shut down.

“I think a lot of people check and see if there’s an A in the window and if there isn’t, they go somewhere else,” said Lavin, one of more than 120 Los Angeles County health inspectors. “Consumers want that confidence of an A. I do.”

Five years after instituting its grading system, the county has caught the notice of health officials in New York, Texas, Illinois and even Russia, all of which have sought its counsel on how to institute similar programs. Los Angeles isn’t the first place to enact a grading system -- Riverside and San Diego counties, and states such as North Carolina have used similar systems for decades -- but it’s one of the largest metropolitan areas to do so.

A study published in the May issue of the Quarterly Journal of Economics lends support to the sometimes controversial system. It found that food-related illnesses fell by 13% in Los Angeles County in 1998, the first year of the system, while rising 3.2% in other parts of the state. The authors, a pair of economists from Stanford University and the University of Maryland, also found that restaurants with an A reported an average 5.7% increase in 1998, while those with a C said sales declined about 1%.

County health officials point to steadily improving inspection scores and grades as further evidence of the efficacy of their program, instituted after a television news investigation uncovered a series of gross violations at Los Angeles-area restaurants. In 1998, the county gave only 57% of restaurants the coveted blue-colored A grade. Today, the figure stands at about 83%.

Nationwide, about 76 million people are stricken with food-borne illnesses each year, according to the federal Centers for Disease Control and Prevention. Symptoms can include nausea, vomiting and diarrhea; and, in rare cases, death can result. Almost two-thirds of the cases are caused at least in part when cold or cooled foods such as meats, seafood or dairy products are allowed to creep toward room temperature, thus permitting bacteria to flourish. Another major culprit in food-borne illnesses -- estimated to play a role in a third of cases -- is inadequate hot holding temperatures for cooked foods.

“It sounds corny,” said Lavin, shortly after ordering the food disposal at the China Bowl Express. “But that’s why I’m here -- to protect the public health.”

Critics argue that more A’s don’t necessarily translate into safer restaurants. The high score could just as easily mean inspectors are guilty of grade inflation, getting too cozy with owners, or simply avoiding the inevitable bureaucratic headaches that come with giving a low score or even closing a restaurant. (Following about 75,000 inspections last year, 989 restaurants were closed by county health inspectors, most temporarily.)

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Questioning ratings’ value

“Grades can be silly,” said Thomas Peacock, author of “Is It Safe to Eat Out?” (Writers Showcase Press, 2002) and a health inspector for Alameda County. “When you go to the grocery store and buy milk, is there an A, B or C grade? You don’t need grades. If a place is suitable, it stays open. If it’s not, it should be closed.”

Health departments are notoriously understaffed, continued Peacock, and too few inspectors are charged with keeping tabs on too many restaurants. And then there are things even an army of inspectors couldn’t ferret out.

“How do you check whether a restaurant employee has washed their hands after going to the bathroom?” he said.

Los Angeles County acknowledges a temporary shortage of health inspectors, said Terrence Powell, a chief inspector for the County. He’s waiting to fill more than 20 inspector jobs, but a combination of attrition and the county’s budgetary woes has stalled the process.

“We operate close to the margins as it is,” said Powell, whose department hasn’t been up to full strength for almost a year. “If this continues, it’s going to eventually hurt us.”

The California Restaurant Assn., a Sacramento-based trade group representing 20,000 businesses, says health inspectors shouldn’t be wasting their time giving out grades. Most counties in California, even across the nation, make inspections and then write reports, but they just don’t hand out letter grades.

The system is unfair, overly simplistic and can take months to restore a good rating for the restaurant, said association President John Dunlap. Restaurants that make customers sick won’t be in business very long, he added.

“Letter grades are a just a snapshot in time,” said Dunlap. “They only reflect what was going on for a short time three or four months ago. It tells you nothing about what’s going on right now.”

But Powell disagrees.

“If we walk into your restaurant and your utensils aren’t clean, your plates are dirty and your restrooms are filthy, chances are that’s the way they handle their food too,” he said.

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Rhythm of the routine

On a recent morning, Lavin set out to take his own snapshot of a Kentucky Fried Chicken outlet near downtown Los Angeles. He clipped on his fanny pack, which contains a digital thermometer, flashlight and other tools of the trade, and headed inside. The establishment already had an A-rating, and Lavin was about to determine whether it would keep it.

In a flash, he presented his identification and was buzzed through the side door to the cooking area. That’s the way he wanted it -- no stalling, no time for anyone to clean up or correct anything. After washing his hands, he took out his thermometer, grabbed a host of chicken breasts, thighs and drumsticks and started testing for temperatures.

“You have to make sure you probe the center of the meat,” said Lavin, who has an almost Joe Friday-like delivery. “These temperatures are good.”

In the walk-in refrigerator, Lavin detected the first problem. A tray of pot pies had only a sheet of wax paper covering them, making them vulnerable to contamination from another food source or an employee. “We just put them in,” said Luh Sutarmi, the store’s manager, referring to the pot pies.

“If the pies were under raw produce, we’d have to dispose of it,” said Lavin, who instructed the manager to put them in a large plastic container with a secure lid.

Lavin is always on the lookout for cross-contamination scenarios. Often he sees raw chicken left out too long and then cut up on a countertop. Then, unless an employee cleans the countertop and cutting knife, those items transfer bacteria to the next food they touch.

Then Lavin tested the cleaning solution used on sanitizing rags -- to make sure it would eliminate cross-contamination -- and the water temperatures in the restrooms to make certain the water was hot enough to effectively clean hands.

Finally, he finished up with an examination of the tile grout for spaces where cockroaches could enter and evaluated the grease accumulation by the trash bin, which could attract mice and rats.

“They check, everything, everywhere,” said Sutarmi, who shadowed Lavin with her arms folded during the inspection.

It took Lavin about 90 minutes to inspect the restaurant and write the report, which owners are required to show customers upon request. The franchise retained its A.

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Sometimes bigger is better

Chain restaurants tend to do better than mom-and-pop stores, said Lavin. Many franchises receive surprise in-house inspections and more formalized training, and the grades often reflect it, he added.

But franchises aren’t perfect either as a review of recent closures reveals. The list includes a McDonald’s in Los Angeles, a Starbucks Coffee in Cerritos, and a Baskin-Robbins in Burbank. (A complete list can be found at the county’s Web site www.lapublichealth.org/eh.)

Later that afternoon, Lavin entered the China Bowl Express. The restaurant, open less than four months, received a green-colored B on its first and only inspection thus far. Lavin and his colleagues are required to conduct at least three surprise inspections at each county restaurant annually.

“They’re scared of me,” Lavin said matter-of-factly as employees rushed into the back. “I get that sometimes.”

The fear was well-founded. After discovering the display dishes’ low temperatures, Lavin ordered their removal and disposal. A couple of groups of customers walked in during the action, took a look and left.

The low temperatures, resulting in food dumping, were the most dramatic infractions, but not the only ones.

Lavin also found dozens of eggs being stored at room temperature, a food container without labels, soiled wiping rags, food debris under kitchen equipment, and dirty floors, sinks and toilets in the restrooms.

“If they had been open longer, or if they were having these kind of troubles after a year,” said Lavin, “we probably would close them.”

But the restaurant’s new status earned it some leniency. After more than an hour-long inspection, Lavin gave the restaurant a score of 82. The establishment retained its B-rating.

Lavin then informed the manager he’d have to attend a special administrative hearing the next morning at a district office. The meetings are meant not only to be educational but to underscore the seriousness of food safety standards.

In his report, Lavin advised that the restaurant’s food handler be re-trained and that all employees review proper food-safety procedures. He also told the manager his restaurant would be placed under closer scrutiny and subject to a stricter inspection schedule.

The manager, Don Pe, seemed a little shellshocked by all the commotion.

“We have good food here,” said Pe, shaking his head. “Good food.”

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(BEGIN TEXT OF INFOBOX)

ABCs of county health inspections

What the letters mean

Blue-colored A: 90 to 100 points. Generally superior in food handling practices and overall food facility maintenance.

Green-colored B: 80 to 89 points. Generally good in food handling practices and overall food facility maintenance.

Red-colored C: 70 to 79 points. Generally acceptable in food handling practices and overall general food facility maintenance.

0 to 69 points: Poor food handling practices and overall general food facility maintenance. (Corrective actions in these cases range from stepped-up inspections to closure.)

Common violations that result in temporary restaurant closures

* Gross contamination of utensils and equipment.

* No public health permit.

* No hot water.

* Presence of cockroaches or rodents.

* Sewage problems.

Cities that have not adopted the Los Angeles County ordinance:

Avalon, Azusa, City of Industry, Hidden Hills, La Habra Heights, Montebello, Redondo Beach, San Marino, Sierra Madre, Signal Hill. They are still given grades and inspected, they just aren’t required to post the results.

For more information:

Consumers can access records online at www.lapublichealthorg/eh. Online records include a restaurant’s grade, score and inspection history. (Long Beach, Pasadena and Vernon inspect their own restaurants and those records are not on the county’s Web site.)

How to report problems:

Consumers who suspect possible health violations can call local agencies.

* In Los Angeles County,

(888) 700-9995.

* In Orange County,

(714) 667-3600.

* In Ventura County,

(805) 654-2813.

* In Riverside County,

(909) 358-5172.

Source: County of Los Angeles Department of Health Services