San Mateo County Grand Jury • 2011-2012

Food-Borne Illness: a Moving Target

Published: December 31, 2011 24 pages

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⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.

⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.

Note: Missing finding numbers detected: F15, F16, F17, F18, F19, F20, F21, F22, F23, F24, F25, F26, F27, F28, F29, F30, F31, F32, F33, F34, F35, F36, F37, F38, F39, F40, F41, F42, F43, F44, F45, F46, F47, F48, F49, F50, F51, F52, F53, F54, F55, F56, F57, F58, F59, F60, F61, F62, F63, F64, F65, F66, F67, F68, F69, F70, F71, F72, F73, F74, F75, F76, F77, F78, F79, F80, F81, F82, F83, F84, F85, F86, F87, F88, F89, F90, F91, F92, F93, F94, F95, F96, F97, F98, F99, F100, F101, F102, F103, F104, F105, F106, F107, F108, F109, F110, F111, F112, F113, F114, F115, F116, F117, F118, F119, F120, F121, F122, F123, F124, F125, F126, F127, F128, F129, F130, F131, F132, F133, F134, F135, F136, F137, F138, F139, F140, F141, F142, F143, F144, F145, F146, F147, F148, F149, F150, F151, F152, F153, F154, F155, F156, F157, F158, F159, F160, F161, F162, F163, F164, F165, F166, F167, F168, F169, F170, F171, F172, F173, F174, F175, F176, F177, F178, F179, F180, F181, F182, F183, F184, F185, F186, F187, F188, 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Findings and Recommendations 15 findings

The San Mateo Grand Jury finds that: EHD inspections of fixed location restaurants are unannounced and include observations of food handlers, food storage, food preparation, food serving and cleanup under normal operating conditions.

No recommendations for this finding

The San Mateo Grand Jury finds that: The large majority of EHD inspections of food trucks are by appointment or on a fixed schedule and do not provide for the opportunity to view normal operations. Food is often not even on the vehicle during initial or annual permitting inspections.

Related Recommendations (2)

As soon as possible in FY 2012-2013, move to a system of unannounced inspections of all food trucks under actual operating conditions, equivalent to that of restaurants.

By October 2012, perform a sufficient number of unannounced inspections of food trucks under actual operating conditions to reliably estimate the time and resources needed to fully implement a program of unannounced inspections of all under actual operating conditions.

The San Mateo Grand Jury finds that: It takes approximately 30 minutes of actual inspection time to do a physical inspection of a food truck by the current process.

No recommendations for this finding

The San Mateo Grand Jury finds that: Only approximately 60 percent of the 146 food trucks showed up for their 2012 scheduled inspection appointments.

Related Recommendations (1)

In January 2013, when the annual inspection notifications are mailed, advise food truck operators that they will be assessed additional fees or penalties if they fail to keep their scheduled appointments.

The San Mateo Grand Jury finds that: An unannounced food truck inspection during actual operations would take an average of 45 minutes, 15 minutes longer than the current process, and incur an estimated one-hour of travel time per inspection.

No recommendations for this finding

The San Mateo Grand Jury finds that: All food truck operators are required to contract with and designate on initial and annual permitting applications, a commissary where they will park their vehicles, clean their facility, discharge waste and utilize other provided services. Some food trucks were not using the commissary they identified and did not reliably report changes to EHD consistent with permitting requirements. 10

Related Recommendations (1)

By October 2012, implement a system that reconciles ongoing reports by commissaries of food trucks that terminated their commissary relationship against EHD’s internal database records to verify that all food trucks are using a commissary as required by Cal Code.

The San Mateo Grand Jury finds that: The new permitting forms for 2012 do not require the food truck operators to contact EHD if they change their route schedule.

Related Recommendations (1)

As part of the 2013 annual permitting process, require food truck operators to report changes to their route schedules to EHD within two weeks of the change. 12

The San Mateo Grand Jury finds that: Beginning with the annual renewal process in February 2012, commissaries are now required to report to EHD when food trucks stop using their services. EHD does not currently have a written procedure in place to act on this information to ensure compliance.

Related Recommendations (1)

The San Mateo Grand Jury finds that: EHD does not routinely check for food truck usage of designated commissaries during its commissary inspections.

Related Recommendations (1)

F10

The San Mateo Grand Jury finds that: All food truck operators are required to complete a food safety certification program or show proof that they have enrolled in one. They have up to a 60-day grace period to complete the food safety certification process.

No recommendations for this finding

F11

The San Mateo Grand Jury finds that: Unless the food truck operator provides EHD with the Food Safety Certificate completion information, EHD will not know whether the required Certificate was obtained until the next annual inspection.

Related Recommendations (1)

By October 2012, change its permitting procedures to require food truck operators or the Food Safety Certificate training program administrators to notify EHD when the certificate is issued.

F12

The San Mateo Grand Jury finds that: Prior to July of 2011, EHD posted to its website food trucks or restaurants with major repeat violations, providing interested consumers with useful information that is no longer easily available.

No recommendations for this finding

F13

The San Mateo Grand Jury finds that: Actual reports of food-borne illness appear to be approximately the same for restaurants and food trucks. However, the low reporting of food-borne illness makes it difficult to reliably evaluate comparative risk levels on a quantitative basis.

No recommendations for this finding

F14

The San Mateo Grand Jury finds that: Food-borne illnesses present a complex set of symptoms and can take up to 14 days to diagnose. Therefore the source is difficult to identify. EHD investigations generally consist of standard inspections of suspect facilities to identify any ongoing risks. Conclusions The San Mateo Grand Jury concludes that:

No recommendations for this finding

F2011 Page 1

This compares to approximately 3,745 fixed location restaurants. The number of food trucks has grown 47% over the last two years compared to a 4% decline in restaurants. Food trucks have also gone up-scale, with more cook-to-order and specialty items available. The storage and handling of raw meats is associated with a greater potential for contamination and food-borne illness than with pre-packaged foods. The San Mateo County Environmental Health Department (EHD) is responsible for permitting and inspecting both restaurants and food trucks. EHD routinely inspects restaurants during normal business hours when food storage, preparation, serving and cleaning conditions can be observed. These inspections are unannounced, increasing the opportunity to see possible health code violations or poor practices. In sharp contrast, EHD inspects all food trucks for initial permitting and for annual renewal by appointment or during scheduled appointment drive-up periods. In many cases, food and beverages are not even in the vehicle during these inspections. Many food-borne illness risks go undetected with this system. EHD claims the difficulty of locating food trucks on their routes and resource constraints prevent an inspection program comparable to that for restaurants. Food trucks are required by law to designate and use commissaries for key support services, such as parking, gray water and waste disposal, potable water supply and, in some cases, for limited food storage and preparation. Food trucks do not always use the commissaries they designate and EHD does not routinely check compliance. Finally, food trucks can operate for up to 60 days without an operator who has completed the Food Safety Certification program, a risk that applies to all food facilities under state law.

No recommendations for this finding

Additional Recommendations 1

These recommendations are not explicitly linked to specific findings.

R7

By October 2012, enhance the EHD website to enable a process of searching and displaying a list of restaurants and food trucks with repeat major violations as of their last inspection. Attachment A: California Retail Food Code Official Definitions California Health and Safety Code, Division 104, Part 7, Chapter 2 Definitions (Relevant Extracts) 113789 Food Facility (a) “FOOD FACILITY means an operation that stores, prepares, packages, serves, vends, or otherwise provides FOOD for human consumption at the RETAIL level, including, but not limited to, the following: (1) An operation where FOOD is consumed on or off the PREMISES, regardless of whether there is a charge for the FOOD. (2) Any place used in conjunction with the operations described in this subdivision, including, but not limited to, storage facilities for FOOD-related UTENSILS, EQUIPMENT, and MATERIALS (b) “FOOD FACILITY” includes permanent and nonpermanent FOOD FACILITIES, including, but not limited to, the following: (1) Public and private school cafeterias (2) RESTRICTED FOOD SERVICE FACILITIES (3) Licensed health care facilities (4) Commissaries (5) Mobile food facilities (6) Temporary food facilities (7) Vending machines (8) CERTIFIED FARMERS’MARKETS, for purposes of permitting and enforcement pursuant to Section 114370 (9) FARM STANDS, for purposes of permitting and enforcement pursuant to Section 114375 113831 Mobile Food Facility (a) “Mobile Food Facility” means any vehicle used in conjunction with a COMMISSARY or other PERMANENT FOOD FACILITY upon which FOOD is sold or distributed at RETAIL. “MOBILE FOOD FACILITY” does not include a “TRANSPORTER” used to transport packaged FOOD from a FOOD FACILITY, or other APPROVED SOURCE to the CONSUMER. 113849 Permanent Food Facility “PERMANENT FOOD FACILITY” means a “FOOD FACILITY operating in a permanently constructed structure, including any room, building, place, or portion thereof, maintained, used, or operated for the purpose of storing, preparing, manufacturing, packaging, or otherwise handling FOOD at the RETAIL level 113751 Commissary “COMMISSARY” means a FOOD FACILITY that services MOBILE FOOD FACILITIES, MOBILE SUPPORT UNITS, or VENDING MACHINES where any of the following occur: (a) FOOD, containers, or supplies are stored. 14 (b) (b) FOOD is prepared or prepackaged for sale or service at other locations. (c) UTENSILS are cleaned. (d) Liquid and solid wastes are disposed, or POTABLE WATER is obtained. Attachment B: Algorithm of Events in the Investigation of Potential Outbreaks 16 17 Legend: Flowchart Abbreviations EH – Environmental Health Department (County) CD – Communicable Disease (County) Lab – Laboratory (County) HO – Health Officer (County) Epi – Epidemiology (County) FDA – Food and Drug Administration (Federal) CDC – Centers for Disease Control and Prevention (Federal) CDPH – California Department of Public Health (State) CalREDIE - California Reportable Disease Information Exchange (State) 18

Conclusions 10

CL1 Page 11

Because food borne illnesses are significantly underreported and so difficult to trace to the original source, it is challenging to quantitatively demonstrate what the Grand Jury believes to be an increased risk of food borne illness from food trucks compared to restaurants.
CL2 Page 11

The nature of the food truck operation clearly provides opportunities for contamination and food-borne illness that require attention. Many of these can be detected only during actual operations.
CL3 Page 11

Even if the argument was made from the limited data available that the food truck operation is no riskier than restaurants from a public health standpoint, that position does not support an EHD inspection program for food trucks that is less diligent than that for restaurants, as exists today. At a minimum, it would make the case for equivalent standards. 11
CL4 Page 12

The annual food truck inspection process is an inefficient use of inspector resources when only approximately 60 percent of food trucks show up for their scheduled appointments.
CL5 Page 12

At least some of the additional time it would take to perform unannounced inspections of food trucks in the field during actual operational conditions could be made available by improving the efficiency of the annual inspection process.
CL6 Page 12

Food trucks that are not using commissaries for required services may be compromising health and sanitation practices and potentially increasing the risk of food-borne illnesses
CL7 Page 12

EHD needs more reliable information about where the food trucks are operating in order to inspect under normal operating conditions.
CL8 Page 12

Food truck operators may be operating without a Food Safety Certificate since EHD does not require confirmation of course completion by receipt of a Food Safety Certificate within 60 days.
CL9 Page 12

Changes made to the EHD website for administrative efficiency eliminated inspection information useful to the consumer.
CL10 Page 12

Even though it is difficult to identify the source and course of food-borne illness complaints, EHD responds appropriately in investigating complaints received.

No Responses Found 2

Government entities assigned to respond to this report. No response documents have been linked in our database.

San Mateo County County

San Mateo County Board of Supervisors Elected County Office