In Allegheny County, restaurants are supposed to get an annual checkup by local health inspectors probing for dangerous food handling practices that could make people sick.

Doing inspections once a year is not a particularly lofty goal. In North Carolina, for example, the mandate is to inspect most restaurants a minimum of three times a year. Full-service restaurants are scheduled to get a look every three months.

In Allegheny County, longtime health department director Bruce Dixon has repeatedly said that the county is meeting its goal of annual inspections. After a spot-check of 100 restaurants by the Pittsburgh Post-Gazette in the fall of 2008 found roughly one in three inspections were late, he disputed the implications, contending that countywide "90 percent" of inspections were conducted on time that year. And he vowed that "100 percent" of food facilities would be inspected on time in 2009.

But a comprehensive review of health department inspection data by the newspaper last month found the department is far from meeting that mark.

An examination of the most recent inspection dates for each of the approximately 6,900 restaurants and other food establishments inspected by the health department's food safety division found 1,605 inspections, or roughly one in four, had not been performed on time.

Sarah Klein, staff attorney with the food safety division at the Center for Science in the Public Interest, called annual inspections the "bare minimum" for trying to defend the public's health, noting that most health departments set a higher standard.

The Post-Gazette tried to be conservative in its on-time analysis. Inspections were only considered late if they were at least a full month overdue. In addition, inspections for roughly 300 facilities appeared to be so late that it was assumed to be a clerical error and the newspaper instead counted them as being on time. Another roughly 700 facilities had missing data or not enough historical information to determine whether the inspections were on time. Nevertheless, those also were counted as being on time.

When the Post-Gazette began its review of the restaurant data, obtained through a right-to-know request, the health department initially said the term "annual" did not mean an inspection should be done every 12 months. Because the department worked on a "calendar year" basis, "theoretically [a restaurant] could go as long as 23 months between inspections and still meet the requirement," spokesman Guillermo Cole said. For example, if a restaurant were inspected in January 2009 and not again until December 2010, the department still would be in compliance even though inspectors had not visited the facility for 23 months.

Ms. Klein called that explanation "absolutely bizarre."

"The common sense meaning of annual is once in a 12-month period," she said. "The health department should not be creative with the length of time between inspections."

When pressed, the health department later changed its view.

"Dr. Dixon doesn't agree with the calendar year [approach]," Mr. Cole said.

County Executive Dan Onorato, who at a February 2007 news conference pledged that county restaurant inspections would be performed on time, understands the "traditional definition" of annual, spokesman Kevin Evanto said. "Annual means once every 12 months. Give or take a day or a week or two, but yes, it means every 12 months."

Dr. Dixon did not respond to an e-mail or several telephone calls seeking comment for this story. Through his spokesman, he did not comment directly on the newspaper's latest findings but said that when he made the pledge of 100 percent compliance for 2009 he was using the looser definition of annual inspections.

He said the health department's database of restaurant inspections provided to the newspaper was a "work in progress" and may not accurately reflect the food division's on-time performance.

When asked how the department knows whether inspections are being conducted on time, Dr. Dixon did not provide an answer, Mr. Cole said.

County officials twice denied the newspaper's request to review its database of restaurant inspection reports made under the Pennsylvania Right-To-Know Law. After the newspaper initiated an appeal for the second time, the department provided a list of the food facilities, plus the dates of the last three inspections. Full inspection reports were not provided, so the newspaper's appeal is pending with the state Office of Open Records.

The department has not made it easier on restaurant patrons who wish to review inspection reports.

Unlike many jurisdictions across the country, Allegheny County does not post inspections online, despite repeated promises over the years to do so. The only way to look at the reports is to comb through individual paper files at the food safety division in Lawrenceville or make a written request for copies through the mail at 50 cents per page.

It's an outdated and cumbersome process that Ms. Klein has called "useless," requiring diners to act days, weeks, even months in advance.

The Pennsylvania Department of Agriculture, which inspects restaurants in counties and municipalities that do not have their own inspection programs, has made those reports available on the Web for the past three years. Since then, Allegheny County has repeatedly missed its targets for going online.

In May, Dr. Dixon set a new target of mid-October, but two weeks ago told the newspaper there probably would be another delay.

Several days after the Post-Gazette contacted the county executive's office to discuss the delay, Mr. Onorato's office said an agreement had been reached to post the most recent inspection report for all food facilities on the health department's website by July 9.

"Going forward, all future reports will be posted as they are conducted," Mr. Evanto said.

If the county follows through, the reports will give local residents a glimpse of what goes on in the kitchens and pantries of their favorite restaurants.

During their visits, inspectors check for food stored at unsafe temperatures and cross-contamination of prepared foods by raw meats. They dip thermometers in trays of spaghetti to make sure they're being held at high enough temperatures to stop germs from growing. They admonish workers for wiping their hands on dish cloths that can harbor dangerous bacteria instead of using disposable paper towels, use test strips to ensure dishwashers are getting hot enough to sterilize, and peer behind shelving to examine hidden baseboards for the telltale oily residue left by rats.

In fall 2008, a Post-Gazette review of hundreds of inspection reports found inspectors typically uncovered multiple serious food safety violations, the types of conditions that pose a "significant public health risk," according to county regulations.

The health department is empowered to issue fines and post yellow "Consumer Alert" decals in restaurant windows for uncorrected critical violations. The newspaper's review found the department almost never took those steps, allowing restaurants to repeatedly break food safety rules.

Among the unappetizing scenes uncovered during that review were a persistent cockroach problem at a Chinese restaurant where an inspector observed a live roach in the cooking area and a chef arranging broccoli on plates using his bare hand -- the same hand he had used seconds earlier to cover a sneeze and wipe his nose. Those violations, and many others, were encountered during 12 visits inspectors made there over three years without the department issuing fines or alerts.

Earlier this year, Dr. Dixon called the reluctance to post alerts "a philosophical thing we are in the process of trying to change."

The Center for Science in the Public Interest for years has pushed for better public disclosure of restaurant inspection reports. The group supports online access as a first step but believes an even better way to inform the public is to display inspection information prominently in restaurant windows.

"We prefer a numerical score or a letter grade in the front window so consumers can make informed decisions at the point of purchase," Ms. Klein said earlier this year. She said posting grades or scores is a powerful incentive for restaurants to follow the rules.

Dr. Dixon has said the health department is in the process of changing its inspection program to start grading restaurants using a numerical score starting at 100 percent and subtracting points for violations. Restaurants could score as high as 110 percent by exceeding standards.

Although Dr. Dixon said in the past that he was undecided on whether to recommend that scores be displayed publicly, he now favors displaying both a percentage score and a letter grade, Mr. Cole said.

The outgoing president of the local chapter of the Pennsylvania Restaurant Association recently said he would not be in favor of posting inspection results, noting that inspections reflect a single point in time.

"You can always find something [wrong] if you are looking for something," said Jeff Cohen, co-owner of the Smallman Street Deli. "The truth is, restaurant owners take this business seriously. These restaurants are very safe to eat in."

Dr. Dixon said the county's new inspection program was being modeled after the North Carolina system, which uses percentage scores and A-B-C letter grades.

Under that system, more points are deducted for the most serious violations and for repeat infractions. Restaurants that score below 70 percent, or a "C" rating, have their permits immediately revoked and are forced to close, said Larry Michael, head of the food protection branch for the North Carolina division of environmental health.

Dr. Dixon had been expected to present a proposal for revamping the county's inspection program to the county board of health in May. In May, he set a target for July. Last month, he said the earliest a proposal would be ready would be in September.

If one is not ready then, board of health member and Allegheny County Manager Jim Flynn will initiate an "action to compel" that a proposal be completed, Mr. Evanto told the Post-Gazette after learning of the latest delay. Restaurant owners and the public would have the opportunity to comment on proposed changes, which would have to be approved by the board and Allegheny County Council.

Although the county's new program is being patterned after North Carolina's, Dr. Dixon has no plans to boost the frequency of local inspections to come closer to the rate in North Carolina because the department doesn't have manpower or funds to hire more inspectors, Mr. Cole said.

The food division employs 17 inspectors to oversee roughly 7,000 food facilities in the county such as restaurants, caterers, hospital cafeterias, day care centers, temporary food stands, and deli and prepared food counters at supermarkets. Some of those facilities are scheduled to be inspected once every two years instead of annually. In the Post-Gazette's review, biannual inspections were counted late only if there were at least a 25-month span between inspections.

A 2008 study by the Center for Science in the Public Interest found that Allegheny County's inspectors had the second-highest caseload among the 20 areas it reviewed: 440 restaurants per inspector compared with 200 to 300 handled by inspectors in the majority of other regions. Last week, the local health department estimated the current caseload at about 420 facilities per inspector.

Although Dr. Dixon said there was no money to beef up the inspection staff, county financial records show that the health department returned $1.5 million from its budget to the county's general fund last year and almost $1 million the year before. That doesn't include the approximately $3 million the department returned from the budget over the past two years for inmate health care.

Through his spokesman, Dr. Dixon did not directly address the budget surplus."We need to look at the overall priorities in the health department when it comes to utilizing our resources," he said.

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