Brigett McNamana has a deathly fear of rats. She even gets scared when she sees them in movies, and in real life – don’t even get her started. Now that McNamana has moved to Los Angeles her fear of rats has changed her eating habits. McNamana will not eat at a restaurant that has a B or C rating, no matter how hungry she is or inconvenient it may be. She doesn’t know what the letter grades entail, but her gut instinct warns her to stay away.

"Restaurants with B’s are disgusting," she says. "They probably have rats."

Despite the common misperception that hangs over the heads of restaurants with green B’s or blue C’s, however, those grades were not earned because of vermin or bugs, officials say.

If a restaurant has problems with animals then it is immediately closed down for a minimum of 48 hours to take care of the problem, says Arturo Aguirre, director of environmental health for the Los Angeles County Department of Health Services. This means that even if a store doesn’t have an A rating, customers should feel safe that cockroaches won’t be crawling around the stove and mice won’t scamper down the aisles.

"If a facility is open for business, then it’s safe," he claims.

Furthermore, bugs are not as big of a problem as people might think, he says. Last year, inspectors found that only 0.6 percent of restaurants had problems with mice or vermin and 0.3 percent had problems with cockroaches, which is a relatively small percentage compared to other types of problems that are found, Aguirre assures.

This doesn’t necessarily mean that every single restaurant in Los Angeles County is free of all bugs, of course. The grade reflects the condition at the time of the inspection, so it’s possible that problems, or animals, were in hiding when the inspector came, or have since surfaced. But, as a general rule, it’s safe, insists Aguirre, who says he will eat at restaurants with B’s or C’s.

But perhaps what restaurants more often get less-than-A grades for is even more unnerving for the stomach than bugs or vermin. Storing food at improper temperatures is probably the most common problem that restaurants get knocked down for, Aguirre says, and general cleanliness is next. These two problems are the leading causes of health-related sickness, according to the Center for Disease Control, although it’s also reported that more than one factor usually contributes to illness.

The report noted that 63 percent of illnesses come from inadequate cooling, and 29 percent come from preparing food ahead of planned service, while 27 percent come from inadequate hot holding temperatures. Cleanliness is the next most common cause of illness, with 26 percent of people who get sick from poor personal hygiene or infected persons.

Since the new restaurant inspection system was implemented, however, these kinds of problems have decreased, reports show, because it entices people like McNamana to use caution when choosing a dining locale, motivating restaurant owners to clean up their act, literally.

The restaurant letter grading system was started in 1997 after reporters with KCBS-TV Los Angeles put hidden cameras in thousands of restaurants and found incidents such as employees not washing hands and restaurants not following safe practices. Under pressure from the four-month report named "Behind the Kitchen Door," the Health Department changed its system, forcing storeowners, who before only had to present their health report upon request, to display a letter grade in their store’s window.

Since then, poor health reports have affected businesses negatively, when before they didn’t, according to the economist Ginger Zhe at the University of Maryland and Phillip Leslie at Stanford University. The economists found that health inspections affected business by examining 13,500 restaurants and their revenues in Los Angeles. They found that restaurants posting A’s had revenue increases of 5.7 percent, while those with B’s had increases of 0.7 percent and ones with C’s suffered decreasing revenues of about 1 percent, as was reported in a 2003 Wall Street Journal article.

More restaurants have been scoring higher grades annually, according to the article, with fewer citations for problems such as bathroom cleanliness, ventilation and lighting. As a result, there have been fewer food-related patients at local hospitals. The article reported hospital admissions for food-related illnesses fell 13 percent in Los Angeles County in 1998 while they rose by 3.2 percent elsewhere in California.

"The bottom line: Forcing restaurants to provide better [health] information led both consumers and businesses to change their ways, and public health improved as a result," according to the Journal’s article.

Not everyone, however, approves of the new grading system.

In 2000, Thomas Peacock wrote a book questioning the integrity of health inspectors, called Is It Safe to Eat Out?

"There has been graft corruption, lack of enforcement, bribery and just plain sloth," he writes. "In North Carolina they have had letter grades for over 40 years, and are talking of scrapping the whole idea. It just doesn’t mean anything when over 99 percent of all restaurants get an A."

Peacock also points to the problems related with having one inspector cover the same area for long stints of time, which eliminates the possibility of a second opinion and, as discovered by Channel 2000 in L.A., can lead to inspector corruption in selling A’s. Training food-handlers proper safety measures would be more effective then grading them on what they’re doing, he argues.

The health department already requires such training to a certain degree, Aguirre claims. At least one person at every establishment is required to go to training and then, ideally, would train the rest of the staff or at least insure that correct policies are followed.

As it is right now, 140 inspectors grade the close to 34,000 restaurants, grocery stores and other food establishments in Los Angeles County at least once per year. Larger venues or ones that have large numbers of patrons can be evaluated up to three times per year.

At the beginning of each evaluation, a venue starts off with one hundred points. Then, as the inspector walks around, checks temperatures and analyzes cooking procedures, points are deducted based off standard criteria, which can be viewed online at A restaurant is subject to closure if it scores lower than 70 percent twice in one year.

Customers can now view restaurants’ letter grades online, instead of showing up to a restaurant to be met by a B or C grade, by visiting