What Health Department Inspectors Check in US Restaurants

How US health inspections work

Unlike countries with a single national inspection system, US restaurant inspections are conducted by local or county health departments following standards based on the FDA Food Code. Each state and sometimes each county has its own scoring system, inspection frequency, and enforcement approach.

Most jurisdictions inspect restaurants 1-3 times per year, with higher-risk establishments inspected more frequently. Inspections are almost always unannounced.

Common scoring systems

• Letter grades (A, B, C) — Used in New York City, Los Angeles County, and others. Grades must be posted publicly.
• Numerical scores (0-100) — Used in many counties. Scores above 90 are generally considered good.
• Pass/Fail — Some jurisdictions use a simple pass/fail with follow-up re-inspection on failure.
• Green/Yellow/Red placard — Used in some Texas and Midwest counties.

Regardless of the system, inspectors evaluate the same core areas based on the FDA Food Code.

What inspectors check

Critical violations (immediate health risk) These are the violations that can trigger immediate closure or mandatory corrective action:

• Improper holding temperatures — Cold food above 41F (5C) or hot food below 135F (57C). This is the single most common critical violation in the US.
• Inadequate cooking temperatures — Poultry must reach 165F, ground beef 155F, whole cuts 145F.
• Cross-contamination — Raw proteins stored above ready-to-eat food, shared cutting boards, or contaminated prep surfaces.
• Employee hygiene — No handwashing observed, bare-hand contact with ready-to-eat food, sick employees working.
• Chemical storage — Chemicals stored near or above food, unlabeled spray bottles, missing Safety Data Sheets.
• Pest evidence — Live insects, rodent droppings, nesting material, or gnaw marks.

Non-critical violations (not an immediate risk, but must be corrected) - Damaged or missing floor tiles - No thermometer in walk-in cooler - Missing employee health policy signage - Incomplete cleaning schedules - Minor maintenance issues

The documents inspectors ask for

During a US health inspection, expect the inspector to review:

• Food safety plan / HACCP plan — Your written procedures for controlling foodborne illness risks.
• Temperature logs — Daily records for refrigerators, freezers, hot-holding equipment, and cooking temperatures.
• Employee health policy — Written policy on when sick employees must be excluded from work.
• Food manager certification — Proof that at least one manager holds a valid ANSI-CFP accredited food protection manager certification (ServSafe, National Registry, etc.).
• Food handler cards — In states that require them (California, Texas, Arizona, Illinois, and others).
• Pest control records — Professional pest control service reports and any in-house monitoring logs.
• Cleaning and sanitizer concentration logs — Proof that sanitizer solutions are mixed to the correct ppm.

How to prepare

1. Keep all documents in one binder or folder near the manager's station — inspectors should not have to wait while you search for paperwork.
2. Complete temperature logs every day — backfilled logs with identical readings are a red flag.
3. Train every employee on handwashing — proper technique, when to wash, and the location of handwashing sinks (not prep sinks).
4. Check thermometer calibration weekly — document it.
5. Conduct monthly self-inspections — use your county's actual inspection form to score yourself.
6. Fix violations immediately — do not wait for the inspector to find something you already know about.

What DocketPack provides

DocketPack generates a complete food safety documentation set aligned with the FDA Food Code, including temperature logs, employee health policies, cleaning schedules, and self-inspection checklists. All documents are customized to your business and formatted for easy use during inspections.