Project Summary/Abstract The Lincoln-Lancaster County Health Department (LLCHD) Food Safety Program's primary goal is preventing foodborne illness through a comprehensive program based on the 2013 FDA Food Code and on FDA's Retail Program Standards. LLCHD retail food inspection trend data revealed that violations of key risk factors for foodborne illness had stabilized and a subset of establishments continued to have significantly higher numbers of Critical Item Violations (or Priority and Priority Foundation). While many regulatory programs have worked with retail food industry to implement Active Managerial Controls (AMC), success has been limited. Through previous FDA grants, LLCHD developed and implemented a Food Safety Consultation program and adapted Food Enforcement strategies, developing a hybrid approach of progressive-enforcement-consultation strategy with the goal of achieving high levels of AMC adoption. To build on the increased focus of developing AMCs with facilities, a new Active Managerial Control Inspection approach was created in 2019. Melding both consultation and inspection, the goal was to create a collaborative, educational experience for managers to develop solutions for risk factors identified during visits. The goal of LLCHD's proposal is to reduce foodborne illness originating from retail food establishments and the outcome will be fewer illnesses, hospitalizations and deaths. LLCHD's objective is to strengthen AMCs at the retail level by continuing to develop and expand the Active Managerial Control Inspection Pilot and build upon the Infuse program by creating a method of determining levels of AMC adoptions by facilities. First, components of the AMC inspection will be assessed, policies and procedures will be developed, and the project expanded. Customer Discovery Surveys and subsequent regular and AMC Inspections will be conducted, and data gained will be used to further improve the project. Second, policies for an AMC Inspection process and training program will be created. With the newly developed training program, the AMC Inspection Pilot will incorporate additional LLCHD Food Safety field staff. Second, a system for measuring the level of adoptions of AMCs will be developed to improve communication between the consultant, facilities, and inspectors. Levels of adoption will be defined, with standards for each, along with a visual aid to demonstrate progress through these levels. The aid can serve as a quick, visual tool to express how facilities have progressed or need to improve. This visual aid will serve as a reward system to encourage sustained behavior change. This proposal provides a unique opportunity for the FDA to continue to test an innovative approach to Food Safety Consultation and Active Managerial Control Inspections. If successful, these models can provide new strategies to achieve a higher level of retail food safety across the U.S., reducing foodborne illness.