When you serve your family food prepared in your kitchen, you know it’s as clean as you can possibly make it.

But when you go out to eat, how do you know if the food has been prepared with the same diligence, in a spic-and-span atmosphere?

You don’t. You must rely on health inspectors to make sure restaurant operators correct defects – whether they be as serious as raw sewage oozing out into a food preparation area, or as minor as an employee drinking a glass of soda pop in the kitchen without having a cover and straw on the cup.

Most violations found during inspections are relatively minor and are corrected immediately, or within a short time, said Larry Bergner, public health specialist supervisor for the northeast region of Oklahoma.

But the recent E. coli outbreak, traced to the Country Cottage restaurant in Locust Grove, has increased public concern about how well people are protected when dining out. Many Cherokee County residents have dined regularly at the popular Locust Grove buffet, where the parking lot is normally crowded with cars at mealtime and customers often have to wait for a table.

Since Bergner is based in Mayes County, he is all too familiar with that situation. He said the State Department of Health is still investigating the outbreak, which has resulted in 206 cases of illness and one death to date.

Cherokee County had been without a full-time public health specialist (who performs the restaurant inspections) for more than a year until this May, when John Caldwell joined the Cherokee County Health Department staff. Inspectors from other counties had filled in to check local restaurants and perform other duties, such as swimming pool inspections.

According to the state health department Web site, 234 Cherokee County food-related establishments require some sort of inspection. These range from crowded popular restaurants to fast-food joints, convenience stores, traveling concessions trailers, even the ice vending facility next to the E-Z Mart on South Muskogee Avenue. Inspectors visit school cafeterias and other such public health sites, and even places like the Dollar General stores.

“We are on a priority system. It depends on what they serve, and how much,” Bergner said. “If an establishment handles a lot of raw product, raw meat, cooking and reheating, we inspect them four times a year, once a quarter. Our medium priority is the heat-and-serve.”

Many fast-food restaurants fit into the medium category. Lower on the list are the convenience stores and other businesses that don’t serve much food.

“Hospitals are high priority because they serve to sick people,” Bergner said.

While Tahlequah City Hospital is on the list, W.W. Hastings Indian Medical Center is not. And readers who peruse the Web site will note that sites operated by Cherokee Nation and the United Keetoowah Band of Cherokee Indians – including casinos – are not included. As sovereign tribes, they are not subject to state regulation.

The ideal is for a public health specialist to make between 500 and 650 inspections per year, and the number required in Cherokee County is about 550, Bergner said. “If we have critical violations, we will do a follow-up inspection, so some will get more inspections,” he said.

The inspector’s check list has 13 critical items. On the Web site, critical violations at each restaurant are highlighted in orange. The most common are cross-contamination of cooked and raw foods (allowing transmission of bacteria); food stored at improper warm or cold temperatures; violations of hand-washing and handling of prepared food; and food not stored in its original container identifying its source or in a sound container. Some of these items are indisputable — the inspector’s thermometer registers whether a food item is too hot or cold. In those cases, the food is thrown out if it cannot be restored to proper storage quickly, and if it has not been at the improper temperature too long.

Bergner admits it’s harder to gauge some factors, such as whether employees have washed their hands properly after using the restroom.