I have the premiere episode of Food Network’s newest reality show, Health Inspectors, on my DVR saved for a particularly nerdy day. To promote the series Food Network pushed out a blog post about what star host, restaurant consultant Ben Vaughn looks for at a restaurant to figure out whether the restaurant is unsanitary.  Vaughn lists the following:

– Restrooms: Check out the restrooms first. Are they clean? Check the floors. Are paper towels readily available and is the soap dispenser full?

– Menus: Many restaurants use clear covers on their dining menus because they’re easy to clean, but are they actually cleaning them? Check for fingerprints — and note whether the menu feels sticky.

– Floors: Does it look like the staff mops regularly and with a clean solution? Some restaurants just sweep and sometimes I find that debris has been pushed into the corner.

– Staff uniforms: Has the staff taken the time to clean themselves and wear pressed shirts and clean aprons? Take a special look at their shoes. Are they clean? Debris always falls on the ground in a restaurant; I would frequently wash my shoes.

– Use your senses: Smell and look around. Uninviting smells like old grease or mildew are bad signs. Customers should be able to visually see everything unless they’re at a romantic restaurant that has dim lighting. If the restaurant is poorly lit otherwise, chances are management is covering something up they don’t want you to see.

I prefer to think of things in terms of whether the restaurant is more likely to cause an outbreak – and what common factors have led to illnesses in the past. Back in 1988 Frank Bryan defined defined illness risk factors as:

– Food from Unsafe Sources;
– Inadequate Cooking;
– Improper Holding Temperatures;
– Contaminated Equipment (and cross-contamination);
– Poor Personal Hygiene.

Bean and Griffin from U.S. Center for Disease Control and Prevention (CDC) in 1990 also looked to these factors in surveillance reporting.

Not included in the evidence-based, peer-vetted list are Vaughn’s sticky menus, clean floors and the smell test. While they might be gross, they are more yuck factor than risk factor. After reviews of inspection results compared to outbreaks (1,2), dirty vs. clean bathrooms also doesn’t seem to matter much. What does matter, which Vaughn gets right, is the availability of handwashing tools like soap and paper towels.

Observation is part of my tactic in selecting a restaurant, but I can but I can’t often assess real risk factors very well by just looking around so I ask a lot of questions (especially if the cooks use thermometers to test cooking temperatures) and review past inspection reports (in jurisdictions where I can get them) for risk factor infractions. If a place demonstrates historic problems with stuff like holding food at the right temperature or improper handwashing procedures, I avoid them.