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Plumas County Grand Jury Report Page 6 meals delivered to the elderly, fruits and vegetables sold on the street, goods sold at our markets, or an occasional trip to a local restaurant, we can always rely on the safety of our food products and handling. We must be assured that retail food han- dlers/vendors and street vendors are properly moni- tored for quality and safety. The process by which Food Safety and related consumer protections are administered in Plumas County is the focus of this Grand Jury investigation. Summary of the Investigation: The Grand Jury addressed the question: What does the County Government do to protect consumers from unsafe food? The Grand Jury found that the Environmental Health Division of the Plumas County Public Health Agency has as one of its nine areas of responsibility Food Safety and Consumer Protection. Three Division Specialists spend a part of their time inspecting every retail food provider (grocery store, minimart, restaurant, food stand and mobile facility) twice a year to ensure they meet the "California Retail Food Code". Inspections are based on a 51 point inspection form, which is completed at the time of the inspection, posted on the Plumas County web site and must be made available to customers by the establishment upon request. As outlined in the County's training manual, the procedure by which inspectors address infractions is highly individual- ized and discretionary, placing a heavy emphasis on maintaining goodwill between the facility owner and the inspector as the best way to ensure that a facility provides clean and safe food to customers. While there is no record of a serious outbreak of food-relat- ed illness in the recent past, the Grand Jury believes that consumer safety can be best served by changes in the Environmental Health policy and procedures to increase the transparency of the results of inspec- tions, and to make the enforcement of corrections of code violations more uniform and rigorous. Findings and Recommendations: The Plumas County Division of Environmental Health is doing a commendable job in addressing the concerns of Food Safety, keeping County residents safe from food related illnesses as might be found in food handling facilities, or illnesses found in food product distribu- tion from outside of County sources. One significant measure of the Division's effectiveness, based on County Health Agency records and other County health facilities records, is that there were no inci- dences of food borne illnesses that could be traced back to food facilities within the County in recent years. The Grand Jury feels that County residents may not realize the many $unctions that the Division performs and the importance of those tasks in providing the high mar- gin of safety to County residents. Even with a smoothly running Division, the Grand Jury feels certain aspects of the Division's process are open to modification. It is easy to stand on the outside looking in and make suggestions, but the Grand Jury believes that if certain procedures were implemented by the Division, the process would be stronger, allow- ing for even more safety for residents and tourists. The Grand Jury's recommendations are as follows: Finding 1: Plumas County ordinances do not require that restaurants and other food facilities visibly dis- play their inspection sheet, so customers don't know the quality and cleanliness of the facility. The Grand Jury believes that more transparency should exist for the inspection results. Recommendation 1: The County's Environmental Health Division should either establish a grading system whereby the quality and cleanliness (safety) of the facility is displayed in the form of letter grade of A, B, or C, or by the colors green, yellow, or red, as determined by the quality of the latest inspection. If a grading system is determined not workable, the Division should require food facilities to display the most recent inspection form, placed near the entrance, visible to patrons. Finding 2: Presently, mobile/temporary food facili- ties don't have to display their permits or inspection compliance sheets. Recommendation 2: If a grading system is not used for all food handling facilities, the Division should require the mobile/temporary businesses to display the operating permit and the results of the most recent inspection, visible to potential customers. Finding 3: The current approach for handling infrac- tions appears to be based more on establishing a pos- itive, collaborative, relationship with own- ers/managers of food handling facilities than with setting strict guidelines and times for correcting the problems. Recommendation 3a: The Division should establish a brief but detailed set of instructions for inspectors to apply uniformly for correction of infractions. Recommendation 3b: The Division should establish a standard pattern of rotation for inspectors in such a manner that the same inspector does not conduct more than one of the two inspections of a facility in the same calendar year. Recommendation 3c: The Division should establish a standard schedule of fines or sanctions for reoccur- ring violations of a consistent nature. Recommendation #3d: The Division should establish a fee for owner/operator requested re-inspections for those owners who want to improve their previous inspection grade. Finding 4: The Division's web site, where food facil- ity inspection results are posted, is a very positive process for creating transparency and awareness for food safety. The Grand Jury commends the effort, but believes that many County residents and tourists are not aware of the site. Recommendation 4: The Grand Jury suggests that the Division increase their effort to publicize the existence and nature of this site, using any and all media approaches to reach as many people as possi- ble. Finding 5: The funding for the department comes from a variety of sources. If any of those funds were reduced, service would suffer if the other sources were not increased. Recommendation 5: That the Board of Supervisors not reduce the County's tax contribution further than it is now nor take any actions that would com- promise the state and other resources that fund the program. Background information: In Plumas County, the Environmental Health Division of the Plumas County Public Health Agency has the responsibility for Food Safety and Consumer Protection as one of its nine functions. The Department inspects every restaurant, grocery, and mobile or temporary food facility in the County twice a year for compliance with the "California Retail Food Code". A procedural manual for guide- lines and training of food facility inspectors--the "Food inspection Data Fields Marking Guideline"-- is used to gain consistency and uniformity in the inspection process. When infractions are found, the Division must assure that the facilities correct them to meet the Code. The Division has three Specialists assigned to Food Safety in specified geographic areas of the County. They each inspect all of the facilities in their given area. Among their other State mandat- ed functions, these three Specialists are responsible for inspecting more than two hundred food facilities twice a year. In addition to the inspections of food handling facil- ities themselves, the Division places on the County web site all food facility inspection sheets for public viewing. Since only about half of the Counties with- in the State do this, the Jury feels the process is a positive asset for our County. To view these inspec- tion sheets go to (www.countyofplumas.com/public health/envhealth). The Division also takes an active role in public edu- cation regarding public and consumer safety issues. A list of the Division's functions and parameters are published in the Annual Report. The Division fur- nishes information on the County web site where much information about the Division, including the Annual Report can be found. The Division also pub- lishes newspaper articles, handouts, and other infor- mation regarding food safety. As a free service to County clients, they also administer the State required Serve Safe Certificate test for food service workers. As indicated in the 2008 Annual Report, the Division's total revenue sources for all programs, including the Food Safety program, are "Fees for Service--34%, State Realignment--32%, State Program Reimbursement Grants--15 % Contracts for Services and other revenue--16%, and County Contribution--3%. The Grand Jury feels that if any of the funding sources mentioned above were reduced, the Division's performance could be nega- tively affected, and the Division's functions are cru- cial to the well being of County residents. Procedures: Information about the Environmental Health Division Food Safety and Consumer Protection pro- gram came from the 2008 General Fund Budget, the Plumas County Public Health Agency Environmental Health Division Annual Report for 2008 and the information about the Division and its programs contained on the County web site. The Division Director provided manuals and procedur- al documents. The Director and other members of the Division's staff involved in food safety were interviewed. To assess the effectiveness of their process, the Grand Jury has reviewed Division pro- cedures and assessed County Health Department records and the records of other health facilities within the County for food borne illnesses that could be traced to local food handling facilities: The Grand Jury wishes to express its thanks and appreciation to the Environmental Health Division and its staff for the cooperation it has shown during this investigation.