And we'd subtitle the report "Or How 311 Doesn't Quite Work So Well." If you're looking for a page-turning read, look no further than the Department of Health's report - complete with next steps- on the rats at KFC/Taco Bell incident. Yesterday, Health Commissioner Thomas Frieden said, "Our restaurant program performs well overall, but in this instance there were failings of personnel, policy and practice."

Well, that's an understatement. The DOH detailed the rat incident: After four separate calls to 311 between December 11, 2006 and February 11 of this year PLUS a complaint from City Council Maria del Carmen Arroyo on February 7, 2007 (apparently an "administrative error" prevented any action from being taken before February 22), there was this 311 call (warning, it's really gross):

February 12, 2007. A caller to 311 complained of rats. The transcription of the call notes states, “He works at the Taco Bells and he has seen rats and rodent droppings in the oil where the food is fried, in the corn and nachos, and on soda machines. In addition, caller [says] the owner and the managers are not doing anything to fix the problem at all, and if a customer [says] they have seen rodents they are given their food for free. Caller also [says] workers are told not to eat the food. Caller [says] there are 2 restaurants in one and they both have the problem the restaurants are Taco Bell/KFC. Caller [says] the basement is the worst place of all. An employee was bit by a rat in the basement and did nothing about it.” A warning letter was sent.

The next day, at 1:18AM to 4:32AM, calls to 311 started to come in about seeing 50 rats. Then, WNBC 4 and other camera crews to the scene. Finally, the Department of Health closed down the restaurant and suspended the inspector. Oh, wait, and then lots of other restaurants were closed or cited in later, stricter restaurant inspections. Plus, Inside Edition devoted episodes to finding rats at NYC restaurants. Actually, the story's not over - it's the one that keeps giving (those rats multiply quickly!).

The Department of Health says it will now, amongst other things, monitor 311 calls better, revise the inspection system when it comes to rats, and looking at initiatives to combat rats the the neighborhood level. Yes, the DOH is also in charge of getting rid of rats. The official next steps after the jump, along with the DOH's findings.

Major Findings of the Department's Review

* The Health Department currently lacks an adequate mechanism to recognize and respond to multiple complaints involving a single food-service establishment. Multiple complaints about this establishment, including an alleged rat bite, were not responded to appropriately.

* The agency's current protocols do not address repeated complaints about the same establishment if they occur within a three-week period. This rule is designed to prevent redundant letters to restaurant operators, but it can delay responses to severe infestations or other problems.

* Supervisors in the agency's food safety program have had the discretion to order either a complete inspection or a partial one when responding to complaints about a restaurant. Partial inspections can miss significant violations, allowing unsanitary restaurants to remain open despite unsanitary conditions. The supervisor who assigned the February 22nd inspection should have ordered a full inspection.

* The sanitarian who inspected the KFC/Taco Bell on February 22nd observed more signs of rodent activity than she reported to her superiors. Had she cited these violations accurately, they would have justified a failing score and possibly a closure of the restaurant.

* When informed of the sanitarian's initial findings, the food safety program's Director of Customer Service should have ordered a full inspection of the restaurant. She also should have reviewed the decision with a more senior manager but did not.

* Under the current system for citing violations, restaurants are penalized more heavily for direct signs of rodent activity than for conditions that foster infestations.

* Rodent infestations are a community-wide problem. They are not confined to individual buildings or food service establishments.

* Restaurants are a common source of rodent infestation in New York City. Properties within 50 feet of a restaurant are 35% more likely to have signs of rodents than are properties farther from restaurants. If a restaurant has been cited for rodents or poor garbage handling, nearby properties are 50% more likely to be infested.

* The Health Department's restaurant inspection program and its pest control program both deal with rodents, but they operate separately and their efforts are could be better coordinated.

In response to its review, the Health Department will:

* Develop a system to actively monitor 311 records for repeated complaints about particular restaurants, and establish a threshold for inspection based on the nature, frequency and timing of complaints.

* Amend agency policy to ensure that sanitarians always conduct complete inspections when inspecting in response to complaints about restaurants. This change has already taken effect.

* Reassign the current Director of Customer Service and pursue relieving her of supervisory responsibilities. The sanitarian who conducted the February 22nd inspection has resigned from the agency.

* Revise the inspection system to place greater emphasis on conditions that attract and sustain pests.

* Expand and institutionalize the agency's new rodent-control academy for restaurant inspection staff. In March 2007, 145 environmental health technicians, public health sanitarians and managers from the food safety program were trained to better identify rodent-related conditions.

* Adapt the curriculum of the rodent-control academy to include a course for food service operators. The course will be mandatory for food service operators whose establishments have multiple rodent violations.

* Improve coordination between the agency's food-safety and pest-control programs, and require building owners to repair buildings that house rodent-infested restaurants.

* Pursue an initiative to monitor and combat rodent infestations at the neighborhood level.

Restaurant Inspections in the Aftermath of the KFC/Taco Bell Incident

Every week, the Health Department inspects approximately 700 restaurants and closes an average of 20 to 30 for health code violations. Restaurants are generally closed either for immediate health hazards (e.g., improper hand-washing facilities or inadequate refrigeration) or for persistent unsanitary conditions (e.g., failing scores on three consecutive inspections). There was a rise in restaurant closures during the weeks of intense media scrutiny that followed the KFC/Taco Bell incident, but the number has since returned to baseline.

Despite the failures exposed by the KFC/Taco Bell incident, the Health Department's Bureau of Food Safety and Community Sanitation has excelled by most measures during the past five years. New York City was the first jurisdiction in the country to conduct all inspections on hand-held computers, and the Health Department has revised its restaurant scoring systems to better protect against illness. Among other accomplishments, the food safety program has:
* Increased the proportion of restaurants receiving an annual inspection from 88% in fiscal-year 2002 to 99.9% in fiscal-year 2006.

* Increased the number of routine restaurant inspections from 19,207 in fiscal-year 2002 to 30,015 in fiscal-year 2006.

* Reduced the median time between a failed initial inspection and the first attempted re-inspection from 36 days in January 2005 to 14 days in December 2006.