Critically acclaimed South City Kitchen scored a 47 in January, but earned a perfect 100 on a re-inspection eight days later. Flip Burger Boutique on Roswell Road, operated by celebrity chef Richard Blais, scored a 70 (Grade C) in April after getting a perfect score of 100 in January. Flip regained its "A" status with a score of 98 on April 12, inspection records show.
Even Piedmont Hospital's cafeteria got dinged. It scored an "unsatisfactory" 68 in April before earning a Grade A about a week later. In the previous five years, the hospital said, it had never scored below a 94.
Fulton Commissioner Robb Pitts has held a series of meetings with Fulton's health department staff and restaurant owners to try to address issues with the new inspections, which he said may be unfair to restaurants whose kitchens are clean.
"When the public hears or sees a bad score, the public believes that this place is rat-infested or there are flies or roaches or something," he said. "They do not know it's something like a dented can out of 100 cans -- one can dented. Or out of 50 light bulbs, one is out. Those are the kinds of things we're trying to work through."
Inspectors work with restaurants to correct violations. Those who don't fix problems can be asked to close while changes are made or eventually forced to shut down in the most extreme cases.
The state of Georgia upgraded its food service code in 2007, based on the federal government's 2005 model food code. The new rules are focused on practices that can prevent foodborne illnesses, according to the state Department of Community Health. The old rules were more general, the state said, and put as much emphasis on good retail practices as food safety.
While the rest of the state converted in 2007, state law allowed Fulton to operate under its own rules because the county had so many restaurants. Fulton decided to adopt the state rules to offer uniformity to restaurants owners with multiple locations across the state.
The new rules deduct more points for critical violations than the old ones did. A food safety violation worth 4 or 5 points in the past will now cost 9 points, said Kevin Jones, Fulton's deputy director of environmental health. If it's a repeat violation, the deduction can be as high as 11 points.
The changes include things as simple as the rules for washing hands. In the past, kitchen workers had to wash their hands after visiting the restroom. Now, rules require that hands be washed once in the bathroom and once in the kitchen. Additionally, protocols must be followed when washing, including that the wash take at least 20 seconds. Jones advises staff to sing two stanzas of "Happy Birthday" to meet the standard.
Rules changed the temperature requirements for holding both hot and cold foods and upped the point deductions for those violations. The rules also added a letter grade to the facility's numerical score.
Jones advised that patrons look at the series of recent scores that are now part of the inspection reports restaurants must post. He said a single low score that is quickly corrected should not prompt serious concerns, especially during the transition.
Fulton is mobilizing after a period of low staffing and turnover among inspectors that meant many restaurants saw an inspector only once a year -- or less. When Piedmont's cafeteria got slammed with a failing score, it had been 18 months since its last inspection.
Fulton is getting back to a full staff as it implements the new rules, Jones said. It has also added an instructor to teach classes about the new standards.
"We're trying to up the ante, not only through inspections but education," Jones said.
The state guidelines call for most restaurants to be inspected twice a year. Metro Atlanta counties vary in how often they conduct routine inspections, according to an analysis of inspection statistics by The Atlanta Journal-Constitution.
Fayette County topped the charts with an average of about three routine inspections a year. Gwinnett County did almost as well and exceeded Fayette in total inspections, which include routine checks, follow-ups and informal inspections. Across metro Atlanta, Fulton, DeKalb, Clayton and Henry counties had the least frequent inspection rates, the AJC analysis found.
Experts said protecting the public from food-related illnesses in an important mission. About one in six Americans gets sick every year from a foodborne disease, according to the Centers for Disease Control and Prevention.
Dr. Robert Geller, medical director of the Georgia Poison Center and a pediatrics professor at Emory University, said that proper preparation of foods can often eliminate pathogens that make their way into the food supply. Restaurant inspections can help make sure that raw food is properly stored, that food is cooked properly and maintained at a temperature that keeps it safe, he said.
Meredith Cook, a 25-year-old pharmacy student, said she's changed her dining habits since getting sick after eating chicken at a Mexican restaurant in December. About six hours after the meal, she became violently ill and ended up going to urgent care. The doctor suspected food poisoning and she was treated for dehydration. Cook said she missed several days of work recovering.
"It took me a long time before I could eat Mexican again -- and that was one of my favorite foods," Cook said. "At a Mexican place I still don't order chicken."
Most counties faced some difficulty when they implemented the new rules.
"It was a hard transition," said Hayla Hall, a spokeswoman for the health district that includes Henry County. But now that Henry's restaurants have been through a series of inspections and training classes under the new rules, Hall said most have adjusted.
"Everybody might not like it, but they understand it," Hall said.
Restaurant operators in Fulton say they want to do everything possible to keep their patrons safe. But they say it's important for the public that the inspection system fairly represent risks.
Karatassos, of the Buckhead Life Restaurant Group, said that if one food container out of 100 is not properly labeled, a restaurant can lose the same amount of points as a restaurant without any of its food properly labeled. The same is true in other categories. If one worker on the staff isn't properly wearing a hat or washes his hands just short of the required time, then the restaurant can fail that entire category.
"I think anybody with common sense can clearly see that if restaurants are being marked off for these gotcha's and one-off mistakes, then it's not fair," Karatassos said. "And it's not fair to the customer because they're not getting a clear picture as to what is happening."