A salmonella outbreak at an Aurora restaurant killed one and hospitalized three in November.

At least 33 people, including one employee, were infected at La California, a restaurant that has previously failed to meet health department standards.

The outbreak affected people who ate the restaurant’s family combo menu item from Nov. 10-14, according to a report from the Tri-County Health Department. Thirteen of the cases were confirmed while 20 were probable.

An investigation into the restaurant, which sits at Peoria Street north of East Colfax Avenue, revealed four critical violations: cross-contamination, improper or lack of hand washing, hot food not being kept hot enough and cold food not being kept cold enough.

The Tri-County Health Department did frequent inspections following the outbreak and La California continues to improve, Executive Director Dr. John Douglas said.

The restaurant in 2015 failed to meet the health department’s standards. Douglas said inspectors worked with the restaurant for a year and a half until it started to do consistently well on inspections by the end of 2016 and beginning of 2017.

Douglas said the biggest factor in the restaurant’s regress was likely a lack of oversight from a kitchen manager to make sure food prep and the kitchen layout were up to health standards. Often times, a lack of knowledge about good health-safety practices, either from employee turnover or language barriers, can lead to salmonella.

In Colorado, a handful of people die from salmonella a year, Douglas said. Preliminary numbers show that five people died in 2017, three of which were in the Tri-County Health Department’s jurisdiction.

Citing Center for Disease Control numbers, Douglas said about a million people in the U.S. get salmonella from a food-borne source a year. Of those, 20,000 are hospitalized and 300 to 400 die. In 2016, the last year with complete data, there were 136 outbreaks, which is defined by two or more cases.

“It’s not common — thank God,” Douglas said. “It does happen. That’s terrible.”

Think you have salmonella?

If you get sick a couple days after eating at a restaurant, Douglas encourages you to report it. This is especially true if another family member or friend also gets sick. Tri-County Health has an online form to report food poisoning and illnesses.

Additionally, if you’re sick, Douglas recommended a high level of suspicion. If you get sicker, go to a doctor or urgent care.

“The food supply, in general, is quite safe,” he said. “Every once in a while it can not be.”