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A few months ago, I was completing a routine inspection and was asking the manager on duty basic food safety questions. I came across some raw Turkey burgers above queso in the bottom portion of a prep cooler. I grabbed the manager and asked if she could point out anything wrong. She couldn't. I explained the raw animal products must be below ready-to-eat foods. I then asked her if she knew why. She said because the bottom of the cooler is colder. I said not exactly, try again. She couldn't give an answer. I pointed to the storage sign on their walk-in cooler and explained cooking temperatures and cross contamination, and how we may not be able to cook out the bacteria in the queso if the raw Turkey comes in contact with it. She gave me a confused look. I reiterated that all raw animal products have bacteria and that's why we cook them to a certain temperature. She didn't know raw meat had bacteria. It was a lot of training that day, but I will never forget how crazy her answers were.

I have two actually. Both very early in my career. My first inspection on my own was at a very well known Indian food restaurant. It was always busy and also very dirty. As soon as I walked into the kitchen, I observed the cook carrying a large container of raw chicken. He slipped and dropped the entire container scattering chicken across the black grimy floor. He then picked them up, put them back in the container and took them to the walk-in cooler. Needless to say, that was my first last discard. My second, fairly early in my career. TCEQ and EPA called me to come close a facility. This facility had been known for drugs and homicides. When I arrived on site, I informed them I was fairly green and they said don't worry, we just need you to close this establishment for improper discharge of wastewater. They had bypassed their septic tank and was dumping raw sewage into the Creek behind their facility. [It was] somewhat of a dam that was full to the brim ready to spill over anytime. There was a large storm brewing as well. Had this spilt over it would pour into the lake in the next city. Needless to say, there were pump trucks that were immediately called and lots of heavy fines to this facility.

I was conducting a routing kitchen inspection at an assisted living facility in Aiken, SC. The inspection already was not going well as there was uncovered food in the reach-in coolers, no date marking system in place whatsoever, and a staff member was only "sanitizing" dishes in the three compartment sink with Gain dish detergent. While I was inspecting the food storage, amongst it I had noticed a big bag of dog food in the dry storage room. In one reach-in cooler cans of dog food were also stored in there along with the food for residents living in the facility. I asked the designated person in charge of the kitchen why they were storing dog food inside the kitchen. She explained to me that the kitchen was delegated to feeding the dogs in the facility that were owned by the residents. She picked up a cowbell out of a storage bin and rang it, and all of the sudden four (4) dogs showed up in the kitchen. Needless to say, the inspection did not go well and this facility received a score of 81/B.

I received a complaint that a bar/restaurant that was next to a feed mill (incredible food source) had a rat infestation. I saw evidence of rats entering building from the outside, the kitchen (was very clean) had rat traps set up all over, and yet I felt compelled to go into the dark basement to look further. I crawled down into basement on a ladder type stairway, heard scurrying, and had to take two steps to reach the string to turn on the lights. In those two steps, I felt crunch, crunch under my feet. When the lights went on, the rats were running to hide all around me and the crunch was rat feces under my feet. To this day, I do not know why I felt the need to go into the basement. I knew there were rats when I entered the building and the owners knew they had a problem. That should have been it; close the kitchen. Going into the basement served no purpose but to freak me out...

I was involved in a sting operation with the local police department; Sheriff's office; Alcoholic Beverages & Tobacco; and other law enforcement agencies at a bar in the middle of nowhere that was known to be the headquarters for the KKK. My supervisor and I were asked to enter the establishment first and announce our arrival so that if anyone assaulted us, additional charges could be added to the arrest. (Luckily, everything went smoothly.) Undercover agents were already inside the bar eating and drinking. The first cooler I opened wasn't even plugged in and that's where all the raw hamburger meat was stored for the cheeseburgers that had been served to the undercover agents. The stench of rotting meat was horrible. Next was a cooler full of moldy blocks of cheese; there was a strong suspicion that some dumpster diving may have taken place. My supervisor discreetly told a nearby agent that anyone who had eaten here should probably go purge themselves immediately. Unfortunately (for the law enforcement agencies at least), I didn't discover any large caches of weapons, cash or drugs. However, it was still incredibly exciting and without a doubt my most memorable inspection.

I started a routine inspection of a well known sub [sandwich] chain and only one (disgruntled) employee was working ready-to-go with bare hand contact with bread and building toppings. When I asked him to wash his hands and get new gloves on as a customer began their order, he told me he couldn't get his hand wet due to this sore, lifting up his hand to show me. That customer and a few more were turned away while this employee called in additional healthy staff to replace him.

I received a call around 11:30 pm (on my way home from inspections at the local minor league baseball stadium) from the local police department regarding screams coming from a grocery store meat market. The Captain informed me once his officers were on scene that had found two goats tied up in the back loading dock area of the store. He asked, "Does that meet health code?" Well, we do not regulate live animals on the loading dock. I turned my vehicle around, met him at the store. Yep, two goats tied up on the loading dock. We went into the store and found a very foul stench in the back area of the stock room. During my routine inspections, there was always the smell of something rotting around the car wash area, but I could never figure out what it was. I think by now, if you are reading this far you have figured out - the market guys were slaughtering the goats in the back, bleeding and gutting them in the car wash, then cutting the meat and putting it out for sale the next day. All of the product that night in the cooler as well as product in the display case was discarded and denatured.

1. On Halloween, I entered an Asian style restaurant who had a very regional-based menu from China. They were serving a new dish with pig brains - I thought it was a Halloween prank - it was not.
2. A similar Asian style facility was cooking and drying meats on a stick in the garbage area. This was noted by the operator as a personal and traditional food for a holiday.
3. A facility with a DIY roof had a "gutter" installed in the dinning room where rain water seeping through the roof would run into a bucket to be dumped every so often, it was raining so hard one day that customers were going around with soda pitchers to help catch dripping water - to help the staff so they could still get their food while waiting. Lost a lot of hope for the public and my job that day.

1. Baby having diaper changed on the cutting board during prep.
2. Cockroach diving off of the hood onto the forehead of the new staff I was training.
3. 24" of sewage in the basement of an operating restaurant.
4. "Pappy" the mouse who was chilling out in a styrofoam cup of paprika with just his head and front paws sticking out.
5. Operator wetting his finger, sticking his finger into an unlabeled cup of white food before tasting it and telling me it was salt.
6. Bloody meringue on a pie that was stored under raw ground beef.
Just a few. So many bad memories.

Inspected food carts exclusively for almost 8 years and what I saw in those years is enough to keep me from ever eating from one. Our county had several food cart pods in the downtown area that had limited electricity, no running water, and no grey water disposal on-site. Operators had dilapidated old food carts that never moved and they needed to have fresh water either brought to them daily or they conveyed it themselves and a licensed grey water hauler was needed to collect the grey water. Water conservation was standard procedure in these mobile unit pods to the detriment of their patrons. I observed a lack of handwashing, improper warewashing, soiled food-contact surfaces, heavily soiled interiors of refrigeration units, and shocking prevalence of rat and cockroach activity inside and outside of these food carts. I had to close so many food carts daily for not having any fresh water and grey water discharges/releases occurred nightly to save money and created an unsanitary, putrid-smelling environment at the pods. Fresh water tanks often looked like grey water tanks inside they were so filthy and had never been cleaned (until I cited them for it and they had to correct it). On hot days, refrigeration couldn't keep up inside the little hot boxes (food carts) and with the limited electricity, operators were often forced to choose which pieces of equipment were used and often chose to unplug refrigeration units to use a rice cooker, etc. I could go on and on, but the worst was observing the rat and cockroach activity inside of the food carts and operators who never noticed until I was there to inspect and pointed out droppings, live pests, or obvious signs of activity.

Many years ago, when I was conducting a health inspection at this Chinese Food Buffet restaurant, I saw this employee cutting up fruit at this three compartment sink. After cutting up the fruit, he would repeatedly rinse the fruit off with water before putting it into a serving dish. When I looked closer, it turned out that he was bleeding from a deep cut on his hand and he was washing the blood off of the fruit before putting it into the serving dish. Since they were short staffed and it was during a major lunch rush, he thought there was no time for him to get a band aid.

Early in my career, my environmental health officers were tasked with conducting both the food history interview and on-site food inspection for foodborne illness complaints. As inspectors, we kept missing key aspects of the interview that we were unable to pass on to our Epi partners. About 10 years ago, we transitioned over to having our epis conduct the initial assessment and then grading the assessment as Emergency (2 right now), 24 hours, or 48 hour follow-up. This partnership has allowed us to better assess each foodborne illness case by allowing each section of our agency to focus on their strengths.

There were several "NY style Chinese takeout” restaurants that were habitually out of compliance for holding temperatures on the cookline (e.g., egg rolls, sweet and sour chicken, General Tso chicken, etc.) and there was a language barrier. Our agency was lucky enough to hire an inspector who spoke several dialects of Chinese and he would interpret for us whenever needed. Through these interpreted discussions, it was clear that the owners wanted to find a permanent solution to the problem while still being able to serve their customers efficiently. All but one of the restaurants I was responsible for agreed to use Time as a Public Health Control (TPHC) for the items on the cook line that were always out of compliance. Instead of documenting times for each product, they decided having set discard times for all the foods worked better for them because the 4-hour cycles coincided with opening through lunch, dinner rush, and end-of-dinner rush through closing. I would randomly drop by (usually shortly before or shortly after the established discard times I knew were in their TPHC plans) to ensure they were following the plan as intended. Very few violations occurred for the products over the next two years that I was inspecting that area. One owner in particular was really happy to see me every time I stopped by for a random check or a routine inspection; he usually had questions about how to improve other processes. The simple assistance provided in the implementation of TPHC was the catalyst for a greatly improved rapport and provided a level of understanding and trust that allowed for more open and successful communication.
Replies to this thread:
1. That is a great example of how communicating and implementing tools can help our facilities. I have had many discussions with inspectors where they told me they don't give TPHC option to their "problem" establishments and that is taking a tool and opportunity for their success and misses the evaluation of the "why", where we can help with solutions that will work for THEM. Thank you for sharing.
2. I have used this same method with several of the same type of facilities over my years.

Prior to the update of the Food Code, approximately 5+ years ago, we went to every Food Establishment and conducted an inspection based on the new requirements that were coming, however, we were not going to publish the results. So, as I was explaining the results to the owner/manager he starts waving what had to be a 10-12 inch butcher knife at me while yelling. He was telling me that I was going to make him have to close his business. So, I put down my thermometer, notepad, and pen. I raised my hands and told him that I would give him a 100, and that I did not care enough to bleed for the city. He then looked at the knife, then looked at me, and he put the knife down and continued to complain while shaking his finger at me.
After he calmed down, I was able to explain that we were doing this so that he would not be blindsided by the upcoming changes....he actually apologized after putting the knife down!

I make a huge effort to not take it personally. Identify their feeling and validate that they are angry, or ... I don't have to agree with it, but acknowledge it. My worse case scenario was with an operator that had a big knife in his hand as he waved his arms in anger. I'm guessing most of us have had something similar to that at one time early in our careers.

Similar to the first comment, let them complain/vent but remind them they get a chance to speak first, then you get a chance. As long as they know you will listen they are much more apt to actually hear what you have to say. I find allowing them to know they get input and then offering help beyond the inspection itself can build a relationship that is more then regulation.

The most successful and effective escalation strategy that I've learned is to "let them vent.” Typically, if they just get it out of their system; no matter what it's about...the fired employee, their ex-wife, the business next door, etc., then we can move on and they'll do whatever they need to do. Sometimes, people just need people to talk to.
Replies to this thread:
1. This is my time-tested go-to strategy for inspections, interventions, court citations, etc. No matter the outcome of the situation, people just want to feel that they have been heard.
2. I agree! This is my strategy as well - both in life and at work. People just want to be heard and they need to get it out so they can move on. We have to really worry about those that never get to vent - those are the ticking time-bombs. Eventually, it will come out and you don't want to be there when it does.

Ask the employees how they are doing, you would be surprised how many will tell you "Well, I have XXXX but I'm doing my best"!

The FDA Bad Bug Book is super as an informational resource, found here: https://www.fda.gov/food/foodborne-pathogens/bad-bug-book-second-edition. I have copied segments from the "consumer snapshot" portions of the document, and share these during an inspection.

We use form 1-B quite a bit but the entire FDA Employee Health Manual is a good educational tool. Our staff does interact directly with employees and the "reportable symptoms" are asked, not the big 6. Knowing the big 6 is good for knowing reportable illnesses and we ask that the PIC be aware of any diagnosed illness being reported. Most employees need to know what reportable symptoms are and how they need to communicate that to the PIC. Our staff (while onsite) looks for an established policy (e.g. form 1-B), staff are actually educated to it (questions) and watching for signs of illness or staff talking about recent illnesses. Without an established onsite policy, it is hit-and-miss for food service employees to know what and when to report illness.

After introducing myself and informing the person-in-charge of the reason for the inspection, I ask if anyone has called in sick recently. If the answer is yes, I ask questions to determine if the individual is present and working; and whether any restriction or exclusion situation may be relevant. If necessary, the ill employee can immediately be restricted or excluded and the food they may have worked with addressed. During the inspection, I observe employees for uncovered wounds, frequent trips to the bathroom, and other symptoms of foodborne illness. In addition, I listen to conversations occurring around me (e.g., a message being relayed from one person to another about someone calling out sick, anyone talking about not feeling well, employees from other locations covering shifts, etc.). Towards the end of the inspection, I ask the person in charge if the establishment has an employee health policy and, if the policy is written, encourage them to locate the policy to assist with answering some questions about the policy. I then ask if they can tell me (or show me) the names of the "Big 5" or "Big 6" illnesses that can be spread through food and the symptoms of foodborne illness. (If they cannot answer this main question at all, the questioning stops and education is provided to assist with compliance in the future.) Next, I ask them what happens if an employee reports being diagnosed with a foodborne illness and, assuming the answer is restriction or exclusion of the employee, when the employee can resume normal duties and/or return to work. Then the same question(s) are asked if an employee reports or is experiencing symptoms of foodborne illness. (Unless answers are automatically provided addressing the symptoms individually, I will ask about each symptom individually. If the answer is a general statement that a doctor's note is required any time someone calls out sick, I will probe further, particularly for vomiting and diarrhea.) I ask them to tell me (or show me) what is done or how it is handled if an employee has a cut, burn, or wound on their hand or arm. Next, I ask if an employee reports a foodborne illness or symptom of foodborne illness to you, is there anyone else you would report that information to. (If they are aware that some type of reporting is required to the regulatory authority, I will ask which illnesses and/or symptoms they would report.) Lastly, I ask if employees are informed that they must report all of the employee health information that we've been discussing and, if so, how they are informed. If the employees are informed in some form of verifiable manner, I ask to see the information and I ensure it includes all the required components - "Big 6" illness, symptoms, unprotected wounds/legions, and "high risk exposure situations".
Education is provided for any incomplete or incorrect responses. We provide our inspectors with a business card-size "cheat sheet" that lists the main questions to ask to assess employee health.

One way to assess employee health during inspections is using your eyes to observe the employees. What are they doing? How do they appear? You can also see the facility's latest Employee Illness Policy, if you are lucky. Adding to that, the mouth (i.e. conversation). For example, Staff is working short all week, why? Using open-ended questions, one may discover that two cooks were out sick due to Norovirus, and each worked and became ill while at work a few days ago after cleaning up (incorrectly) a vomit accident left by a customer. You can hear the verbal and see the nonverbal responses to those open-ended questions.