Health department officials aim to prevent the spread of illness through food at restaurants. (Photo: Damian Siwiaszczyk, Flickr)

Movies and television sometimes depict restaurant inspectors as ruthless and ready to shut down an establishment at the drop of a chef's hat, but there's a lot more to it than that. 

In a Monday article, leaders discussed how open data might improve the process of inspecting restaurants, and this piece provides more insight into exactly what happens when a health department official shows up at a restaurant to examine it. 

Six people with the health department are responsible for inspecting everything from pools and schools to restaurants and special events, such as Riverbend.  

Although the number fluctuates as businesses open and close, officials estimated there are about 1,600 restaurants in Hamilton County.

Here are five things to know about the process. 

Before the restaurant opens 
When a restaurant opens or an establishment wants to start serving food, that's generally when owners start working with health department officials, Lowe Wilkins, supervisor of the Chattanooga–Hamilton County Health Department, said. 

From the start, health inspectors work with business owners to make sure they have the appropriate equipment in the appropriate places. They look at the flow of the restaurant and make sure hand washing sinks are in the needed places. 

After a restaurant gets a certificate of occupancy from the fire department, the health department goes out again for a full inspection. Officials make sure all the equipment—from freezers to fryers—works properly. 

They ensure there is hot and cold water, among other details. 

"You don't realize that we are doing months of work before the restaurant opens," Wilkins said. 

The inspection 
Health inspectors have forms with 59 items to inspect. Some are critical and some are noncritical. 

But they don't go into a restaurant and start at No. 1 and work their way through the form, Wilkins said. 

"Our inspection has a lot to do with getting the manager and asking them open-ended questions about what they are doing," he said. 

Inspections can take two hours or more because officials spend time observing everything from cooking to cooling processes. 

A top priority for inspectors is to prevent foodborne illnesses, so they focus a lot on appropriate temperatures and storage. 

For example, if a restaurant is going to hold a product longer than 24 hours, they are required to date mark it. They aren't allowed to keep anything for more than seven days, but Wilkins said most restaurants have a policy not to keep something more than three days. 

Inspectors observe hand washing and other hygienic practices.

And the inspection is often guided by what's happening at the restaurant at the time. 

"We see it all," he said. 'You don't leave anything out and then you put it all together ... You sit back and watch and you talk to them."

Priority risk factors 
Local officials outline their inspections based on what federal and state leaders have identified as priority risk factors. 

The reports are divided into two sections: high priority and low priority. 

Nos. 1–27 on the health inspection report are items that require immediate correction or a follow-up inspection. Those are the items that officials have found are most likely to cause foodborne illnesses. 

Members of the public often wonder why restaurants with low scores aren't immediately shut down, but inspectors can only do that if there is an "imminent health hazard," such as sewage backup. 

Categories 
Restaurants are also divided into categories, depending on the processes that are in place there and on the establishment's history. The categories help dictate how often inspectors check in on a restaurant. 

For example, if a restaurant—such as a coffeehouse—doesn't cook anything and only sells prepackaged food, that would be category No. 1. Those types of establishments require less oversight unless they have a problematic history. This type of place may only get an inspection once a year. 

Category No. 2 includes restaurants that are preparing food, dealing with raw materials and may have special cooking processes in place. These are generally inspected every six months.

Category No. 3 includes establishments that have had a priority item marked two consecutive times. That means inspectors could come by three times a year. 

Category No. 4 is for restaurants that have experienced a foodborne illness. In that case, inspectors come more often, possibly four times a year, Wilkins said. 

Education and prevention 
Inspectors place a high priority on education and prevention, he also said. 

The goal is to protect citizens and the restaurant from foodborne illnesses. 

Officials offer food safety classes the first Tuesday of every month, and they will also go to restaurants to teach classes. 

Officials do a good amount of education about "shedding," which refers to how long a person can shed a virus through bowel movements. A virus could be in fecal matter for 14 days, so if an employee had been sick but feels better, if they go to the bathroom and don't wash their hands—that virus can be spread to the food. 

"We do a lot of education on shedding so people know how important hand washing is," he said. 

The classes help build positive relationships between the restaurants and inspectors, officials said. 

"We are not trying to say, 'We gotcha,'" he said. "We are there to assist them in serving food safely to the public. We want [them] to ask questions, not have fear."