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How Do Health Inspections Work?


Summary: Health inspections are mandated for all food service establishments.  In this article, we provide a brief introduction to food service health inspections, what inspectors check for,  how scoring works, and more. 


Keeping food safe from farm to fork requires a tremendous amount of effort and coordination from multiple stakeholders. One way food safety practices are monitored, measured, and improved is through health inspections.

Whether you work in the food industry or not, here is a no-nonsense introduction to how the health inspection process works and how they help keep our food safe.

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What is a health inspection?

Health inspections are regularly conducted visits (typically unannounced) to any establishment licensed to sell, store, prepare and serve food (e.g. restaurants, grocery stores, schools, hospitals, etc.)

Inspections are conducted by health inspectors from local health departments trained to check for potential food safety risks (e.g., storing food at unsafe temperatures.)

What happens if unsafe practices are found during an inspection?

If an inspector notices something out of compliance with a risk item (i.e., a food safety risk), it will be cited as a “violation.”

Aside from the inspector educating and requiring that employees correct the cited issues, here are some other actions that can occur if violations are cited.

  • Negatively impacted health inspection score
    Each violation will typically negatively impact a restaurant's score for that inspection, with some violations that pose a higher risk of foodborne illness, “critical violations,” potentially carrying a higher penalty. Health inspection scores are often required to be displayed publicly in-store or online (via local health department websites, Yelp Health Scores, etc.)

  • Reinspection
    If certain high-risk violations are cited, the establishment may be reinspected within a few days or weeks to ensure that the cited issues have been resolved. These records are typically also made available online.
  • Temporary Closure (shutdown)
    Particularly severe violations may even lead to the establishment being temporarily closed (shut down) until the issues are resolved. This process can often take multiple days, depending on the issues cited.

What do health inspectors check for?

There are typically around 50 risk items assessed during a routine inspection.

Currently, there is no nationally mandated inspection format, so not all health department forms are exactly the same. However, most health departments check for a similar set of violations that are generally based on the guidelines within the FDA Food Code.

Below is a summary of the most common risk items (potential ”violations”) evaluated during an inspection, grouped together by general risk category.

(To see detailed information on your local practices, check out your local health department’s website or check out the latest version of the FDA Food Code. To dive deeper into violation types and severities, check out this video.)

Common Health Inspection Violations by Category (6)

Note: The list above covers the most common violations from each risk category but may not include all violations that your local health department checks for.

Are there different types of health inspections?

Yes. ‘Routine’ inspections are the most common and are what you typically think of when you think of a health inspection. But there are also a few other inspection types. Check them out below:

Inspection Type When and how often?

Routine Inspection
(standard, most common)

These are standard, regularly conducted inspections that all food service establishments receive approximately once a year (can vary by health department) and are typically unannounced (i.e., by surprise). Routine inspections are ‘full-scope,’ meaning they typically cover all areas of potential food safety risks to regularly monitor for proper food safety and hygiene practices.
Reinspection / Follow-up Inspection If higher-risk violations are found during a routine inspection, a reinspection may be required within a few days or weeks to ensure the cited issues have been corrected. (Depending on the health department, reinspections may also cover risk areas beyond just the issues cited during the routine inspection.)
Pre-Opening Inspection Before a new restaurant opens for business for the first time or after a restaurant undergoes a major remodeling. (The items checked during pre-opening inspections can be slightly different than those in a routine inspection.)
Complaint Inspection If a local health department receives a consumer-reported complaint about a restaurant, typically, a complaint inspection will take place to investigate the mentioned issue and/or other risk items.


How do health inspection scores work?

Once the inspection is complete, most health departments assign a score or result to indicate how the establishment performed on the inspection.

The resulting score is often required to be publicly posted in-store and inspection results/details can be found online (via local health department sites, Yelp Health Scores, etc.) for consumers to see and use when making purchasing decisions.



However, there is no nationally mandated standardized scoring system, so scores may look different across the country. To find more information on how health scores work for your local restaurants, check out your local health department’s website. To learn more about the different types of scoring systems that exist, check out this video Health Inspection Explained - Part 3.



Want to learn more?

Check out Health Inspections Explained, our four-part educational video series, to dive deeper into topics like violation types, inspection scoring, and the US health department landscape.

Whether you're a food industry professional or just a curious consumer, there is a lot to learn about inspection data and the food safety trends and insights that can be drawn from it.

To learn more about related research and food service industry applications of health inspection data, check out the Hazel Analytics homepage.