Making sure it’s safe to eat out in Oakland

By Mark H. Stowers

When the late Oakland County Executive L. Brooks Patterson would eat out at Oakland County restaurants and other food institutions inspected by the Oakland County Health Department, he had no qualms according to former Oakland Health Director Kathy Forzley.

“Brooks told me if the food establishment was open, he figured we were doing our job and the place was safe to eat at,” Forzley recalled.

And when Brooks dined and met restaurant owners who had been inspected, he had his health department staff’s back.

“He told me one time that he went somewhere and the owner, a friend of his, said, ‘You need to see this report one of your sanitarians left me.’ And Brooks told him, ‘No, I think you should read the report, what was written is likely something you should be familiar with.’”

With three degrees from Oakland University – BA in biology, a BS in environmental health and a masters in public administration, Forzley was appointed by Patterson as the director of the Oakland County Department of Health and Human Services in 2017. She provided oversight of the health division, Children’s Village and homeland security divisions, as well as strategic direction and management expertise to these departments, ensuring an outcome-driven approach, increased collaboration, and a dedication to improving health and quality of life for anyone who lives, works and plays in Oakland County. Under her oversight, Forzley created and sustained numerous award-winning community initiatives such as Healthy Pontiac, We Can!, Homeless Healthcare Collaboration, and a county-wide health improvement initiative known as Energizing Connections for Healthier Oakland (ECHO). Forzley also assumed a lead role advocating for health initiatives on a regional and statewide level through participation on the Michigan Public Health Advisory Commission, Michigan Local Public Health Accreditation Commission, Southeastern Michigan Health Association, Michigan Association of Local Public Health, Oakland County Human Trafficking Task Force, and has recently been selected to serve on the Michigan Governor’s Public Health Advisory Council. She oversaw the inspection of Oakland County eating establishments and worked with the department for 28 years serving as Sanitarian, Senior Sanitarian, Supervising Sanitarian, Administrator of Environmental Health, Health Officer and Director of Oakland County Health and Human Services.

Claudia Terrell is the current Chief of Public Health for Oakland County. She has been with the department for the past 12 years in the food program. With nearly 1.3 million residents, Oakland County is home to 4,700 restaurants, food trucks and institutions that serve food. Each one is under the inspection process overseen by the Oakland County Health Department. The health department and the entire state of Michigan are under the 2012 State of Michigan Modified Food Code Guidelines.

With her undergrad degree in microbiology and a master’s in epidemiology both from the University of Michigan, Terrell has 32 employees that license and inspect. Her department has a food program budget for fiscal year 2025 set at $7.353 million. Of that $1.595 million will come from fees and $2.18 will million come from cost sharing from the Michigan Department of Health and Human Services.

“We inspect food service establishments, which includes food items that you’re going to eat right away. Anything that’s retail, like a grocery store, that you would take home and cook it yourself is licensed by the Michigan Department of Agriculture and Rural Development (MDARD),” Terrell said.

For a restaurant to first become a reality in Oakland County, they visit Terrell’s’ office.

“We start with our plan review process,” she said. “They have to submit their plans. It doesn’t have to be an architectural layout. It can be hand-drawn, whatever they have access to. Their layout of how they’re going to build the restaurant, their standard operating procedures, how they plan on cooking and cooling items. They’ll go through that. They’ll also have to get all of their city approvals and we’ll make sure they have that before we sign off on their license.”

The inspection process also begins in her office.

“We’ll do a file review. I’m looking at their past history, seeing if they have a certified manager, what violations they may have trouble with and then we’ll go to the facility. It’s not scheduled. Routine inspections do happen every six months,” she said. “The facility kind of has an idea about the general time that will be out there but they don’t know the exact date and time.”

Each inspection begins with the staff introducing themselves, showing their credentials and finding who’s in charge.

“We’ll usually ask them if there’s been any changes since we were last there at the facility and what’s going on for the day. Then we’ll conduct a walkthrough where we observe the food safety processes that are happening at the facility. We’ll interact with the actual staff on site, ask them questions about food safety. Make sure that they’re knowledgeable. And after we’ve done the walkthrough, we’ll identify any violations or items that need to be corrected and items that can be corrected. At the time, we try to get those corrected on-site before we leave. And then we will type up a report, and we’ll go over that with the person in charge noting violations we observed, how they’re supposed to be corrected, method of correction, how they were corrected, when they need to be corrected, if they haven’t been corrected. And then we will leave a printed copy with the person in charge at the establishment.”

If any violations are found, they fall into the following categories - priority, priority foundation and core. Terrell offered more detail of the violations.

“Priority in the food code are high-level hazards that are associated with foodborne illness. They’re more so quantifiable measures. Where you can take action to eliminate a hazard. And so those are the items that we for sure want to get corrected while we’re there on site,” she said. “And then priority foundation are items that could lead to issues and make a priority violation.”

A priority violation such as not having soap at the hand sink leads to a priority foundation violation because it leads to not handwashing. Other priority violations include not having a metal stem thermometer or not having sanitizer test strips.

Core violations have to do with physical facilities, according to Terrell.

“Your chipped tiles, your cleaning under your equipment, kind of related usually to your general good operating practices,” she said. “The priority and the priority foundation, if they’re not able to correct on-site, we give them 10 days to correct. The food law does have an allowance for if they only have a few minor priority foundations. It doesn’t need to be corrected right away. However, in Oakland County, we do have the resources available to follow up on those, so we will give all of those 10 days and follow up on those. The core items, they get 90 days to correct but we won’t reassess those until their next routine inspection six months later.”

The horror stories of restaurant inspections are few and far between.

“We will close restaurants for what’s known as an imminent health hazard. Something that is likely to cause immediate illness or concern. If there’s a sewer backing up. If the rain is coming down through the ceiling and leaking on foods, if it’s obvious that everyone within the restaurant has vomiting and diarrhea, those are the type of things that we will immediately close the restaurant so that they can correct those.”

The inspections are not posted physically at the restaurant as some other states and municipalities do.

“We don’t do scores in Michigan, so there’s not a pass-fail. They would only essentially fail if they had that imminent health hazard closure where they would be closed,” Terrell said. “Our inspection reports are available on our website through Sword Solutions (swordsolutions.com/inspections). That is our public-facing site where our inspections are located. But otherwise, we just work with the owner to close the facility until they’ve remedied whatever needs to be corrected.”

She further explained, “The Michigan Food Law does not require the scoring or posting of letter grades for restaurant inspections. In addition, a single inspection is just a snapshot in time and may not reflect the overall, on-going conditions in the facility.”

And following the late Oakland County leader’s direction, Terrell has no qualms about eating out across Oakland County.

“I’m really proud of the work that we do. If a restaurant’s open, I know that they’re doing the right things. And I will eat out. Usually for me, it’s more ‘do we have a good relationship with that owner?’”

With restaurants continually opening and closing, Terrell and her staff are constantly updating records and conducting inspections. But the biggest challenge is the “moving restaurants.”

“The biggest thing right now is our food trucks,” she said. “A decade ago, we were at a total of 4,400 licenses across the counting, about 300 of those were vending machined. But in 2017, the state took back vending machines but our numbers now are around 4,700 with about 500 of those being mobile food operations or food trucks or tents that you might see.”

Terrell also delved into the types of licenses for food establishments.

“In Michigan, we have two different license types. Our mobiles are associated with a fixed establishment or a fixed kitchen. They give us what’s known as a route list where they plan on going each day. And we can usually connect with them at their fixed location to see what’s going on at their commissary, we call it. The transitory food units, which are really the restaurants on wheels, they have to give us what’s known as a notice of intent. Anytime they plan on operating within our county, they have to let us know. Those trucks can be licensed from any county within the state and operate throughout the entire state. Just anytime they plan on operating in a certain jurisdiction, they have to give us that notice of intent. And then what they do is they actually get to request their inspection. They do get a pre-scheduled inspection, but they do have to be in operation.”

And festivals and events are licensed and inspected.

“The kind of pop-up events where you might just see a stand at Arts, Beats, and Eats. Those could have temporary licenses. And so those licenses are good for 14 days at one location. The mobile and the TFU are a year-long license and allow them to operate anywhere throughout that year. But the temporary is very specific, 14 days at that one location. We used to do a bunch of those, and those are kind of coming down a bit because we’re getting more of the licensed trucks operating at those special events and festivals. But we still do. We did over 1,100 temporary inspections last year.”

The pandemic was tough for the department and all of those working in health departments across the state. Restaurants were changing service to full carry-out and eventually offering more outdoor seating and spacing out indoor seating. Many restaurants changed hands as well.

“We did have to pause our inspections for about a year because all of our staff were reassigned to help with the COVID testing sites and the COVID immunization sites. But we did do phone calls and then we still followed up on any complaints. We were still out in the community. We had a handful of inspectors who would still follow up on complaints and calling our facilities to make sure they understood the regulations and what was going on. But we did have to pause those for a little bit,” Terrell said.

Covid changed the restaurant landscape physically.

“What we saw was a lot of the facilities changed how they operated. They expanded to have more outdoor seating or they changed their concepts. Sometimes when restaurants do that, they need to go through what’s known as plan review, with the health division so we can make sure that any of the changes are done up to code. And so that was one of the things that was really challenging, was seeing what was different and saying, ‘Oh, you’re supposed to get approval from us to do that.’”

Across the United States, each one has their own model for restaurant inspections. There are federal guidelines.

“It’s actually interesting as the FDA puts out their food code but it’s just model guidance. It’s not required to be adopted by the individual states. It’s encouraged,” Teerrell said. “In Michigan, we have adopted the 2009 Michigan Food Law (that was codified in 2012). But just across the border in Ohio, they have their own food code. They don’t adopt the FDA’s food code. they have their own violation system, their own code numbers, so sometimes it can be difficult to compare a policy or a regulation across the states.”

Even as health departments across the state work to inspect restaurants and other eating establishments through their districts, the city of Detroit – Michigan’s largest with a population of more than 676,000 – has its own health department and started its own inspection program this past summer. With more than 1,900 restaurants, including full-service, fast-food chains, coffee shops, bars and more, this past June the Detroit City Council passed the ‘Dining with Confidence’ Ordinance to increase visibility and transparency regarding food safety inspections. With visible signs – a green “In Compliance” and a red “Enforcement” card displayed in restaurant windows for customers to see, the goal is to incentivize restaurants to achieve a lasting improvement in food safety.

The green “In Compliance” card equals no serious violations (Priority and priority foundation) or that they have been corrected and that the establishment is not in enforcement, does not require a follow-up inspection and has a valid food service license. The card also has a QR code that links to more information about the inspection.

The red card or “Enforcement” card is issued if a restaurant has to be ordered to close due to severe health hazard, due to not having a valid food service license or as a final step in progressive enforcement of violations. It also includes a QR code.

A white placard is a temporary status and means that the business needs corrections, and also provides visitors with details about how to look further into the results of the restaurant’s inspection results.

Denise Fair Razo, the city’s chief public health officer and Detroit City Council Member Scott Benson initiated the process by asking for further transparency in restaurant inspections.

Restaurant inspections are key in keeping the dining public safe and the placards are a step to physically show that to them. In Manhattan, New York, a city of nearly 1.7 million residents, has more than 17,219 eating establishments – nearly 45 percent of the total in New York City. The procedure in Manhattan includes being inspected at least once a year by the health department and inspectors can visit at any time when the restaurant is open to the public and they look for compliance in areas such as food handling, temperature, personal hygiene and pest control. Points are marked for violations and a letter grade is given based on the score. A for 0-13 points, B for 14-27 points and C for 28 points or more and after the grade is given the restaurant must post a placard showing their letter grade in their front window.

In Illinois, restaurants are inspected by local health departments to ensure they comply with food safety regulations and scored on a 100-point scale. The inspector will assign a risk level to the restaurant based on the types of food and how they are prepared and served. The risk level determines how often the restaurant will be inspected. The frequency of inspections is based on the risk level assigned to the establishment. Risk 1 establishments are inspected twice per year, Risk 2 establishments once per year and Risk 3 establishments every other year. Once inspected and scored, the restaurants are given a color-coded placard. A green placard indicates the restaurant is in compliance with Illinois Food Code rules and regulations. A yellow placard means the restaurant is non-compliant and needs to improve its food safety practices. A red placard marks the restaurant as out of compliance and poses an immediate threat to public health. Each placard is posted in a visible location, such as on the outside door or window and be easily readable.

In addition to the placards, Illinois restaurants must also make the most recent inspection report available to customers upon request by providing a hard copy, QR code or web link. They must also post compliance posters, such as the Illinois Consumer Advisory/Allergen Poster, Pregnancy/Alcohol Poster, and Illinois Hand Washing Poster. And make sure that all employees follow Illinois Food Code rules and regulatio

Across Michigan, Terrell from Oakland County is part of the Michigan Association of Local Environmental Health Administrators that meet monthly and talk about issues in environmental health throughout the state.

“We are hoping to get a new food code adopted into the Michigan Food Law here soon that will have some updates and some new regulations,” Terrell said. There was a big push before COVID to get a newer code, and then COVID kind of stopped that. So, we’re working on getting that back into place. It hasn’t been updated since 2012 when we adopted the 2009 version.”

Washtenaw County has more than 1,285 eating establishments for the Washtenaw Health Department to oversee. Kristen Schweighoefer serves as the Washtenaw County Environmental Health Director and has been with the agency for 24 years.

“There’s eight sanitarians that do the day-to-day inspections and then we have two more that are involved in standardized training for those staff, as well as plan review for new or remodeled restaurants,” she said. “We’ve seen a steady increase of restaurants.”

And with the University of Michigan in the middle of her health department territory, there is a unique agreement in place.

“We have an agreement with the University of Michigan that’s been in place for probably 40 years or so, most recently updated in 2019. Our agency delegates the authority to their staff to perform inspections. They have an Occupational Safety and Environmental Health Division at U of M that oversees the inspections of things like the dorms or the different food kiosks that the students can access such as the stadium. They know how to navigate those systems better than you and I would because they’re internal to some of those systems. They would do the same sort of unannounced inspection. I think they actually go above and beyond. For things like the stadium, they actually go out and do inspections every week that the stadium is in operation.”

Tom Barnes, Oakland University educated with both a bachelor’s degree in environmental health with a specialization in public health and master of public administration, and REHS (Registered Environmental Health Sanitarian,) is director of Macomb County’s Environmental Health Services and has been on the job since 2015 and director since 2021. His department oversees the 2,600 restaurants and eating establishments. A decade ago, there were 2,400.

“That includes everything with a food license that we would be required to inspect and regulate. It could be a lot of food trucks involved in that, school kitchens, church kitchens, VFW halls,” Barnes said.

Barnes noted that health department inspections for restaurants include, “looking at everything in the facility from the menu, the dining room, asking questions of the staff, of the person in charge. We’re looking at physical facility things, everything from light fixtures down to the cleanness of the floors, but then also obviously we’re looking at how people are preparing and serving food, how their cook line looks. Are they following all the standards there? Are their food temperatures being held at the right temperatures? Are they cooking things to the right temperature? Is their equipment cooling things or holding cold or holding hot? Do they have the right procedures in place? If they have any specialized processes? Are they monitoring time? Are they monitoring temperature? Do they have proper labeling, proper date marking? If we see them doing any type of cooling, are they knowledgeable on proper cooling techniques? In some cases, we can ask them for logs. If they have paperwork to back up their cooling process, do they have temperature logs? Do they get their shellfish from an approved supplier? It’s a very in-depth process, and it can range anywhere. For a simple bar that doesn’t do much of any food prep, it could take maybe an hour, but it could take, if you look at a large banquet hall or a golf club that has multiple kitchens and licenses, that could be an all-day or a multi-day inspection. It’s an in-depth process.”

He also explained the process is more than just inspecting but finding ways to continually work together across the board.

“As much as it is us being in that regulatory position, we are trying to build a relationship with them. We’re educating staff. In the food industry, staff come and go just like anywhere else. So, we’re also providing education. We’re not trying to be too punitive or penalize people. We’re trying to get compliance. Part of that is building good relationships and working with them. It’s definitely a process.”

Part of the process is also making sure he has enough well-trained employees to get the inspections done.

“It’s a process to get more staff. But we actually did get one additional food staff this year which is great. For the food program, I have 21 staff – two managers over the program and then we have 16 staff that do the actual food inspections and then three staff that do plan review for new restaurants or modifications to existing restaurants. But they’re all capable, even the plan review staff, can go out and perform restaurant inspections. Everyone is trained the same.”

With confidence he states, “You can eat anywhere. If you’re open for business in Macomb County, then they’re good to eat at. Are they all perfect? No. There’s always problems. With an extensive food code, there’s always going to be violations.”

A helpful source for the restaurant industry is the Michigan Restaurant and Lodging Association (MRLA) based in Washtenaw County. Their goal as stated on their website includes, leading “the hospitality industry through advocacy, education and innovation. Whether it’s navigating the complex waters of ever-changing regulations, providing cutting-edge training and certification products, or empowering members to help increase their bottom line with practical, relevant business solutions, the MRLA is an indispensable, one-stop resource for the hospitality industry. Our diverse network of membership ranges from industry owners, operators, staff and suppliers, to educators and students. The MRLA provides its members with value, vision and voice through its daily work.”

Amanda Smith serves as the MRLA’s Executive Vice President of Education and explained more of how they serve the restaurant industry.

“I make sure that we have ServSafe training available to all of our members and we manage our grant in partnership with the department of ag,” Smith said. “We have a number of resources through MichiganFoodSafety.com. Resources for industry, regulatory agencies and consumers alike on food safety. We help promote food safety.”

Smith also runs the MRLA foundation where they teach food safety to students who are studying careers in related pathways. MRLA offers in-person food safety training and online.

“We find pass rates are a little bit better when people come in person and have a little bit of live instruction with it,” she said. “We teach classes around the state and have eight locations every month, including Detroit, Grand Rapids, Lansing, and then some regional ones that rotate, Marquette, Traverse City, Flint, Kalamazoo, Holland. We try to do a regional approach as well.”

With their grant resources, the MRLA works to continually educate. An example would be their food allergen poster that shows the now nine allergens – up from eight – from the federal level.

“That’s something Michigan’s food law hasn’t completely caught up to but something that consumers, especially those that have a soy allergy, are going to want to know. That the person has a sesame allergy, they’re going to want to know that the person serving them can handle their sesame allergy.”

The posters were disseminated at the Michigan Environmental Health Association’s annual conference.

“We also hand them out at the Cisco show and the Gordon show. We try to share information, pretty collaborative in our ability to share information amongst, like having the health departments help us get word out to all of the industry, and vice versa. When there’s something happening in a certain area, we have a great communication mechanism to reach industry quickly through our membership base at the association.”

The MRLA is a 6,000-member trade association for the state of Michigan and survives on membership fees and grants.

“We make sure members have what they need. And foodborne illness outbreaks, whether it’s your establishment or not. Whenever you read about those in the paper, or you’re hearing it on the radio and you’re driving, it leads to people question things. Nobody wants a foodborne illness, especially not one in their establishment.”

The MRLA was active during the pandemic “trying to figure out how to serve people safely, making sure everyone understands the differences between disinfecting and sanitizing. They are not interchangeable. But disinfecting, sanitizing, making sure that we’re killing things. We also wrote the guide to reopening the restaurants, bringing all the different federal regulations together to getting restaurants in Michigan back up and operational.”

Since COVID, the MRLA has added the Hospitality Training Institute of Michigan.

“This is a manager training mechanism to help the new members working in industry come up to speed. We had a lot of people leave industry during COVID. And so now that we’ve started to recover in our employee count, a lot of it’s been training and making sure they have the skills that they need to go forward.”

Norm Hess is the Executive Director of MALPH – the Michigan Association for Local Public Health. A member since 1985, Hess has been executive director the past four years. The association is a non-profit and supported by dues paying members which are the public health departments across Michigan. He explains that inspections have morphed from simple to a more complex method taking in more and more safety factors.

“Restaurant inspections many, many years ago were, ‘do you have the right equipment? Do you have the right building?’ And now it’s moved to a more risk-based approach. ‘Is food being kept at the right temperature to prevent and help break the foodborne illness? Do you have raw chicken drippings falling into clean dishes?’ Those kinds of things,” Hess explained.

The association members are the 44 health departments covering all Michigan counties and the one city health department in Detroit.

“We have 30 health departments that cover a single county. And we have 14 that cover between two and 10 counties. As you might imagine, some of the larger geographic areas are more northern in Michigan and the Upper Peninsula. Most of our health departments report to a county commission in one way or another, either through the administrator or directly to the commission. If there are more than one county, they have commissioners from each of the affected counties that serve on what’s called the board of health which is the actual governing body and then those individuals report back their individual commissions,” Hess said.

MALPH continually works to increase communication between the health departments.

“We elevate issues that are common to all health departments or most, and then we do lobbying advocacy with the state legislature, and we do a lot of training as well. But we are not affiliated in any way with any state agency,” he said.

He noted that as the restaurant inspection process has increased its effectiveness over the years, there are fewer major outbreaks but “I don’t think that people realize that folks still die in this country from foodborne illness. It’s not always just a matter of getting some gastrointestinal symptoms. It is still something that is very important. And I think that because we don’t have, by and large, very many foodborne illness outbreaks, people don’t really think about it. But it’s because health departments are out there inspecting and consulting and educating people who prepare food on how to keep it safe that it’s just one of those sorts of invisible things to people until something happens. But I think the bigger news is that we haven’t had very many because people are on the job and they’re doing their job.”

He also noted that restaurant inspections are to keep the eating public safe, not punish restaurants

“It’s a collaborative type of a thing. Health departments are not here to ruin your business. We’re here to help you in ways you might not have thought about. Maybe you didn’t think about storing this underneath that and that’s a risk. I would say that by and large, it’s pretty collaborative. This is the standard. How in your restaurant does it make sense to meet this standard? You need to put the knife on the left and you need to hang the ladle here it’s really thought through scenarios to see which one makes sense in the space that they have to operate,” Hess said.

If a restaurant is open in Michigan, it’s been inspected with the same process from the UP down to Detroit.

(Contact the Michigan Department of Agriculture and Rural Development (MDARD) for food safety complaints about grocery stores, convenience stores, and other non-restaurant food establishments. You can call MDARD at (800) 292-3939 or email them at MDA-Complaints@michigan.gov.)