No member of the two focus groups was able to identify the correct regulations governing FHEs.
One coordinator reported hosting an annual seminar for persons-in-charge of FHEs that enhanced compliance levels, while all interviewees reported that the issuing of closure notices especially at the initial stages increased application rates.
About one-third of noncompliant FHEs tended to be newer, with the majority located in urban areas.
NERHA could target managers and supervisors in FHEs for a comprehensive trainer-of-trainers food safety program.
Smaller FHEs may lack the financial and technical resources to understand the requirements (Grabosky & Braithwaite, 1986; Hutter & Jones, 2006) and therefore can experience difficulties in complying (Hutter & Amodu, 2008).
The majority of respondents from noncompliant FHEs accused PHIs of not following up on noncompliance issues and this could have led them to conclude that the health departments were not serious about compliance.
Owners/operators of FHEs should be encouraged to assume greater responsibility for the certification of their establishments and NERHA should hold PHIs more accountable for the certification of FHEs.