Audit on the Effectiveness of the Compliant Inspection Program for Food Establishments by the Department of Health and Mental Hygiene

Audit Report In Brief

This auditdetermined whether the Complaint Inspection Program of the Department of Health and Mental Hygiene (DOHMH) Bureau of Food Safety and Community Sanitation (BFSCS) effectively followed up on complaints against food establishments.

The Office of Customer Service (OCS), within BFSCS, is responsible for the Complaint Inspection Program. That program handles environmental-related complaints, including complaints against food establishments in the city.

During our audit scope period, complainants notified DOHMH about complaints against food establishments by calling the agency’s Complaint Hotline (Call Center) 24 hours a day, seven days a week. The operator of the Call Center then recorded information on each complaint and the priority assigned to the complaint directly in the Call Center computer database.

Complaints were categorized by the Call Center as Priority One, Priority Two, and Priority Three. Priority One complaints included those of sewage and confirmed food poisoning. Priority Two complaints included those of alleged food poisoning, no hot or cold water, and improper handling of food. Priority Three complaints included operating without a permit; unsanitary conditions; the presence of roaches, flies, or rodents; or improper ventilation.

Complaints of alleged and confirmed food-borne illnesses were to be immediately forwarded by the Call Center to the Bureau of Environmental Sciences and Engineering’s Office of Environmental Investigations (OEI) of DOHMH to be recorded in its automated database. OEI has the primary responsibility for the investigation and surveillance of all alleged and confirmed food-borne illness complaints. After OEI conducts its investigation, the food-borne illness complaints are referred to BFSCS for further follow up.

During Fiscal Year 2003, there were approximately 22,000 food establishments in the city. During that period, BFSCS received 4,743 complaints against approximately 3,808 food establishments. OEI received 642 food-borne illness complaints during Fiscal Year 2003.

DOHMH officials informed us that as of April 2004, the Call Center function regarding complaints against food establishments was taken over by the Citizen Service Center, at 311 (the city’s new phone number for government information and services).

The Complaint Inspection Program of BFSCS is ineffective in following up on complaints against food establishments, as follows:

• Of the 186 complaints in our sample during Fiscal Year 2003, 74 (40 percent) were not followed up by inspectors either by telephone calls or physical visits.
• Of the 112 complaints in our sample during Fiscal Year 2003 that were followed up, the time it took inspections to be conducted ranged from the same day to 344 days (almost a year) later.
• Of the 774 food-borne illness complaints recorded during Fiscal Year 2003, 342 (44 percent) were never forwarded to OEI to be investigated. Those complaints were sent directly to BFSCS.

Regarding our assessment of the inspection reports used in response to complaints, BFSCS did ensure that inspection reports were adequately filled out and that inspectors signed off to attest to the completeness of the data. We did not find that a particular inspector continually found complaints to be unfounded. In addition, most of the complaints were correctly prioritized.

To address these issues, we make eight recommendations, the most significant of which are that BFSCS should:

• Establish formal procedures to govern the Complaint Inspection Program.
• Modify its database to better track the status of complaints and inspections in response to complaints.
• Establish the length of time it should take inspectors to follow up on complaints against food establishments, based on priority and risk to public health. The complaints should then be responded to within the predetermined time, and should be monitored.
• Ensure that all confirmed and alleged food-borne illness complaints that are received have first been forwarded to OEI for investigation.

The matters covered in this report were discussed with officials from DOHMH during and at the conclusion of this audit. A preliminary draft report was sent to officials from DOHMH and was discussed at an exit conference held on June 3, 2004. On June 8, 2004, we submitted a draft report to DOHMH officials with a request for comments.We received a written response from DOHMH on June 24, 2004, stating:

“The Department agrees with seven of the eight recommendations for improving our complaint handling procedures.

“The Bureau’s primary responsibility is to assure that all food service establishments (FSEs) are properly permitted and operating safely. The complaint program supplements this extensive effort.”