Restaurant Rating System

We have all seen those white, rectangular signs posted in our favorite restaurants and fast food stops displaying a “Sanitation Grade” for that particular location. While most of us rarely see a rating below an “A” there is a lot of information involved in that score, and there are definitely differences between scores of 100 points and scores in the low 90s that we should all understand. While it may seem like a simple process, there is a lot that goes into it, and the people who inspect these locations have much more training and expertise than you might expect.

“The mission of the Forsyth County Department of Public Health is to prevent disease and promote a healthy community through regulation, education and partnerships,” said Sheryl Emory, Program Supervisor for the Food, Lodging and Institution section of Environmental Health for the Forsyth County Department of Public Health. “The restaurant rating system is not a county system but rather a state system. The inspections are conducted by environmental health specialists that are employed by the county with delegated authority from the state. North Carolina General Statutes Chapter 130A Public Health contains the laws that set forth the requirements for a sanitation program for food and lodging establishments, as well as for local confinement facilities, school buildings, institutions, hotels, bed & breakfast homes and inns, child care centers, tattoo artists and others. Local counties can adopt rules through the local board of health only for areas that are not addressed in the general statutes. The Food, Lodging and Institution section is comprised of one program supervisor, two field supervisors, one plan review specialist and 14 environmental health specialists. The environmental health specialist (EHS) is assigned a list of facilities and is responsible for conducting unannounced routine inspections, verifications of corrections to critical items documented on previous inspections, responding to complaints related to sanitation in establishments, or reports of illness. On any given day an EHS may inspect a school cafeteria, a childcare center and a gas station that serves hot dogs – or any combination of other establishments. The EHS can also spend his or her day tracking down illegal food operators that operate as caterers from their homes or other locations. The EHS agents are also involved in foodborne illness outbreak investigations or other communicable disease investigations associated with regulated establishments, such as shigellosis in a day care or Legionnaires in a nursing home.”

106-ThinkstockPhotos-78493852-SFWThe responsibility of these inspections is not taken lightly, and those behind these ratings have the training necessary to keep us all safe when dining out. “Requirements to be an Environmental Health Specialist include: must have a four-year degree with a minimum of 30 hours of pure science; must be registered with the NC Board of Environmental Health Specialist Examiners within three years of employment; must pass a national registration exam that includes all areas of environmental health such as sewage disposal, water quality, air quality, pesticides and hazardous materials, government and administrative law and structure, food safety, and communicable and vector-borne diseases; and must maintain a minimum of 15 hours of continuing education each year,” said Emory.

The establishments that are required to be inspected include restaurants, food stands (take out places that don’t provide seating such as delis in grocery stores, gas stations that sell hot dogs), school cafeterias, meat markets, educational foodservice (college dining service), institutional foodservice (nursing/rest homes) mobile food units (aka food trucks) and pushcarts. If the owner of a particular establishment disagrees with an inspection score, he or she can fix any deficiencies and request a re-inspection within 15 days of the initial inspection. In the event that the owner disagrees and does not feel any deficiencies need to be addressed, there is a process for an informal review and appeal. “Most issues are able to be resolved through discussions with the owner, the EHS that makes the decision and the supervisor,” said Emory. “Occasionally, the regional EHS, environmental health director or health director is included in the discussions.”

Exemptions from inspections do exist for establishments such as private clubs; however, these places must follow other guidelines to operate legally. All inspections conducted are a matter of public record and are available online at Information about the inspection process and the inspection frequency is also available on the public health website.


How Citizens Can Help

  1. Report concerns related to food safety or sanitation to the FLI section.
  2. Report suspected cases of food borne illness to the FLI section.
  3. Understand that the sanitation rating is determined by evaluating what goes on behind the scenes with employee practices, food storage and preparation, and general construction and sanitation of the food service areas.       The public areas seen by the customers may have very little bearing on the final sanitation rating.       Also the EHS agents do not taste or sample foods during the inspection process and can not accept free food as a customer of the establishment.
  4. Citizens should verify that any caterer or foodservice provider they consider doing business with has the appropriate permit or license from either the local health department or NC Department of Agriculture.