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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The exportable AGE log did not indicate the number of diarrhea or vomiting episodes for some of the reportable cases and many of the fields were blank. Staff stated the reason why the fields were blank was because there were no episodes of diarrhea or vomiting for those cases but this was not documented anywhere. Also, the crew position field on the AGE log was left blank for all of the crew on the log. Finally, the voyage to and from date on the top of the AGE log was not readable.
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Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns: (1) Date of the first medical visit or report to staff of illness; (2) time of the first medical visit or report to staff of illness; (3) case identification number; (4) person's name; (5) person's age; (6) person's sex; (7) designation as passenger or crew member; (8) crew member position or job on the vessel, if applicable; (9) cabin number; (10) meal seating information; (11) date of illness onset; (12) time of illness onset; (13) illness symptoms, including the presence or absence of the following selected signs and symptoms, with a separate column for each of the following: (a) number of episodes of diarrhea in a 24-hour period; (b) number of episodes of vomiting in a 24-hour period; (c) bloody stools; (d) recorded temperature; (e) abdominal cramps; (f) headaches; (g) muscle aches; (14) entry (yes/no) for whether this was a reportable case; (15) entry (yes/no) for antidiarrheal medications sold or dispensed by designated medical staff; (16) presence of underlying medical conditions that may affect interpretation of AGE. Ensure the AGE surveillance log contains the above information in the exact order and is entered in the template in Annex 13.2.2. Ensure that the log data is exported in the exact order as in the example template in Annex 13.2.2 with analyzable formats such as Excel or Access. Ensure that any additional data fields are entered only outside of the form margins when exported to VSP. Ensure the voyage to and from date on the top of the AGE log is readable.
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Item No.:
11
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
A reportable nonfood member that became ill on February 12, 2013 at 6:00 p.m. but did not report to medical until February 13, 2013 at 8:13 a.m. According to the documentation, this individual worked from 3:00 to 8:00 p.m. on February 12, 2013. Also, there was a food worker with an onset of AGE symptoms on February 21, 2013 at 8:00 a.m. but did not report to medical until February 22, 2013 at 10:12 a.m. According to their work records, this individual worked several hours in the a.m. and p.m. while sick. There was a nonfood worker with an onset of AGE symptoms on February 25, 2013 at 8:00 a.m. but they did not report to medical until February 26, 2013 at 11:44 a.m. According to their work record, this individual worked several hours while sick on February 25, 2013. Also, there was a food worker that had an onset of AGE symptoms on February 28, 2013 at 11:00 a.m. but did not report to medical until February 28, 2013 at 9:50 p.m. According to the documentation, this individual worked from 7:00 to 11:00 p.m. on February 28, 2013. There was a food worker that had an onset of AGE symptoms on March 4, 2013 at 8:00 a.m. but did not report to medical until March 4, 2013 at 5:04 p.m. According to their work record, this individual worked from 12:00 to 3:00 p.m. on March 4, 2013. There was a nonfood worker with an onset of AGE symptoms on January 20, 2013 at 8:00 p.m. but did not report to medical until January 21, 2013 at 8:57 a.m. According to their work record, this individual worked from 5:00 to11:00 p.m. on January 20, 2013. A nonfood worker had an onset of AGE symptoms on January 21, 2013 at noon, but did not report to medical until January 22, 2013 at 8:41 a.m. According to their work record, this individual did not work while sick.
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Recommendation:
When food employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 48 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document date and time of last symptom and clearance to return to work. When nonfood employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 24 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document the date and time of last symptom and clearance to return to work. Exclude food employees suspected of, diagnosed with, or exposed to any communicable disease caused by Salmonella typhi, Shigella spp., E. coli O157:H7, hepatitis A virus, norovirus, or other communicable diseases that can be transmitted by food, from working in any food or food related areas or operations, including working with exposed food, warewashing, equipment, utensils, table linens, single-service articles and single-use articles. Do not allow the excluded individual to return to the above duties until they are symptom free for a minimum of 48 hours.
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Item No.:
13
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Site:
Medical-Crew Member Reporting
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Violation:
There was a food worker with an onset of AGE symptoms on February 21, 2013 at 8:00 a.m. but did not report to medical until February 22, 2013 at 10:12 a.m. According to their work records, this individual worked several hours in the a.m. and p.m. on February 21, 2013 while ill. Also, there was a food worker that had an onset of AGE symptoms on February 28, 2013 at 11:00 a.m. but did not report to medical until February 28, 2013 at 9:50 p.m. According to the documentation, this individual worked from 7:00 to11:00 p.m. on February 28, 2013. There was a food worker that had an onset of AGE symptoms on March 4, 2013 at 8:00 a.m. but did not report to medical until March 4, 2013 at 5:04 p.m. According to their work record, this individual worked from 12:00 to 3:00 p.m. on March 4, 2013.
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Recommendation:
Ensure the supervisor or person in charge of food operations on the vessel monitors that: (13) Food employees are informed of their responsibility to report to the supervisor or person in charge information about their health and activities as they relate to diseases that are transmissible through food.
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Item No.:
02
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Site:
Medical-Close Contact Interviews
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Violation:
During voyage #7, it was unknown if there was a contact for a reportable nonfood member that became ill on February 12, 2013. No documentation was available and no interviews were recorded. Also, during voyage #7, a food worker with an onset of AGE symptoms on February 21, 2013 at 8:00 a.m. had a contact and the contact was interviewed within 8 hours of the food worker becoming sick, but the medical staff relied on the contact to report any illness and no other documentation for the 24-hour and 48-hour follow ups was provided. During voyage #5, a nonfood worker that was a reportable case with an onset of AGE on January 12, 2013 at 1:00 a.m. had a cabin mate documented but the contact was not interviewed. During voyage #8, a food worker had an onset of AGE on February 28, 2013 11 a.m. indicated they had a cabin mate on their 72 hour survey, but according to staff they told them they didn't have a roommate and there were no interviews documented. During voyage #8, there was food worker with an onset of AGE symptoms on March 4, 2013 at 8:00 a.m. and it was not known if this individual had a contact because there was no documentation of a cabin mate or of interviews.
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Recommendation:
When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions for asymptomatic cabin mates or immediate contact of symptomatic crew: (1) restrict exposure to symptomatic crew member(s); (2) undergo a verbal interview with medical or supervisory staff, who will confirm their condition, provide facts and a written fact sheet about hygiene and handwashing, and instruct them to report immediately to medical if they develop illness symptoms; (3) complete a verbal interview daily with medical or supervisory staff until 48 hours after the ill crew members' symptoms began. Ensure that the first verbal interview is conducted within 8 hours from the time the ill crew member initially reported to the medical staff. If the asymptomatic immediate contact or cabin mate is at work, ensure that he or she must is contacted by medical or supervisory staff as soon as possible. Document the date and time of verbal interviews. Maintain the following records on board for 12 months and make them available for review by VSP during inspections and outbreak investigations: (1) medical log/record; (2) AGE surveillance log; (3) 2-hour self-administered questionnaires; (4) interviews with cabin mates and immediate contacts of crew members with AGE [initial, 24-, and 48-hour]; (5) documentation of the 3-day assessment of crew members with AGE symptoms before joining the vessel; (6) documentation of the date and time of last symptom and clearance to return to work for food and nonfood employees; and (7) documentation of the date and time of verbal interviews with asymptomatic cabin mates and immediate contacts of symptomatic crew.
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Item No.:
08
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Site:
Potable Water-Potable Hose Locker
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Violation:
The potable water hose lockers were not labeled 'Potable Water Hose and Fitting Storage.'
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Recommendation:
Label potable water hose lockers "POTABLE WATER HOSE AND FITTING STORAGE" in letters at least 13 millimeters (0.5 inch) high.
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Item No.:
08
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Site:
Potable Water-Cross-Connection Control Log
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Violation:
There was no plumbing component listed on the cross-connection control log for the pool room on deck 9. The type of device was listed. Staff could not identify this component when asked.
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Recommendation:
Ensure the cross-connection control program includes at a minimum: a complete listing of cross-connections and the backflow prevention method or device for each, so there is a match to the plumbing system component and location. Include air gaps on the listing. Ensure a schedule for inspection frequency is set. Maintain a log documenting the inspection and maintenance in written or electronic form, and ensure it is available for review during inspections.
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Item No.:
03
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Site:
Potable Water-Bunkering pH
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Violation:
During bunkering, staff measured the pH of the potable water at 9.12. The meter staff used was checked against a buffer reference and was found to be accurate. The bunker records filled out by staff on the same day stated that the pH before the ship started bunkering was 9.1 and the pH during bunkering was 7.8 from 7:40 a.m. until noon. When questioned, staff stated they filled in the required pH of 7.8 because there was no way to adjust the pH.
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Recommendation:
Continuously halogenate potable water to at least 2.0 mg/L (ppm) free residual halogen at the time of bunkering or production with an automatic halogenation device that is controlled by a flow meter and adjust the pH so it does not exceed 7.8. Ensure the amount of halogen injected during bunkering or production is controlled by a flow meter or a free halogen analyzer.
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Item No.:
03
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Site:
Potable Water-Bunkering pH
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Violation:
During bunkering on several occasions, the pH was 8.0 or higher and was even above 9.0 on several days including November 15, 2012; December 8, 11, 17, 22, 25, 29, 31, and 29, 2012; January 26, 28, 19, 22, 12, 14, 5 and 8, 2013; and February 2 and 5, 2013.
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Recommendation:
Continuously halogenate potable water to at least 2.0 mg/L (ppm) free residual halogen at the time of bunkering or production with an automatic halogenation device that is controlled by a flow meter and adjust the pH so it does not exceed 7.8. Ensure the amount of halogen injected during bunkering or production is controlled by a flow meter or a free halogen analyzer.
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Item No.:
40
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Site:
Integrated Pest Management-Active Surveillance Montoring
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Violation:
The active surveillance log did not indicate follow-up inspections or action taken on several days when pests were found. For example, on March 1, 2013, flies were found in the crew mess, and the area was treated, but there was no mention of a follow-up inspection or any further action. On March 17, 2013, flies were found in the Market restaurant fruit station and treated the same day but no follow-up inspection was recorded and no action taken was documented. Also, on March 16, 2013, flies were found in the fruit station of Calypso but there was no action taken or follow-up inspection documented. The follow-up inspection/action taken column were left blank in these instances. This was noted on the previous inspection.
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Recommendation:
When pests are noted during an inspection, ensure the log includes action taken and follow-up inspection results.
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Item No.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
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Violation:
The OPRP indicated a letter would be provided to passengers stating there was an outbreak onboard, but the letter provided to the inspector did not state this information. Also, the OPRP did not indicate when or how the ship moves from green level to yellow level to red level.
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Recommendation:
Ensure each vessel has a written OPRP that details standard procedures and policies to specifically address AGE onboard. Include the following in the written OPRP: (1) Duties and responsibilities of each department and their staff for all the passenger and crew public areas; (2) Steps in outbreak management and control and the trigger for required action at each step. Ensure the triggers address a graduated approach to outbreak management in response to increasing case counts; (3) Disinfectant products or systems used, including the surfaces or items the disinfectants will be applied to, concentrations, and required contact times. Ensure the disinfectant products or systems are effective against human norovirus or an acceptable surrogate (e.g., caliciviruses); (4) Procedures for informing passengers and crew members of the outbreak. Ensure this section also includes procedures for notification of passengers embarking the vessel following an outbreak voyage or segment of a voyage; (5) Procedures for returning the vessel to normal operating conditions after an outbreak; (6) Procedures to protect the passengers and crew from exposure to disinfectants, if not already included in the vessel's safety management system. Ensure this protection includes: (a) Material safety data sheets (MSDSs); (b) Personal protective equipment for crew; (c) Health and safety procedures to minimize respiratory and dermal exposures to both passengers and crew.
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Item No.:
10
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Site:
Recreational Water Facilities-Filter Housing Disinfection
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Violation:
The log was shown to the inspector indicating the filter housings were being cleaned and sanitized before using new media, but there was no documentation of the concentration and contact time used during the disinfection process.
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Recommendation:
Clean, rinse, and disinfect the filter housing before the new filter media is placed in it. Ensure disinfection is accomplished with an appropriate halogen-based disinfectant. At a minimum, use a 50-ppm solution for 1 minute, or equivalent CT value. Maintain records on all inspection and cleaning procedures.
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Item No.:
19
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Site:
Buffet-Calypso Aft
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Violation:
There was no sneeze shield at the fresh fruit preparation counters (aft of two) in both the port and starboard aft buffet lines to prevent passenger contamination of the fruit being cut, knife, or cutting board. All three were left at the counter unprotected for varying time periods.
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Recommendation:
Protect food on display from contamination by the use of packaging; counter, service line, or salad bar food guards; display cases; self-closing hinged lids; or other effective means. Install side protection for sneeze guards if the distance between exposed food and where consumers are expected to stand is less than 1 meter (40 inches).
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Item No.:
19
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Site:
Buffet-Calypso Bread/Roll Stations
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Violation:
The mock wicker type baskets used for the various breads and rolls on passengers self-service buffet had cloth liners which either covered only the interior bottom surface or extended only partly up the side interiors. Many of the bread pieces or rolls were in direct contact with the side interiors of these baskets, which were not easy to clean due to their braided design.
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Recommendation:
Ensure that linen liners for the mock wicker baskets are installed so no part of the wicker basket makes contact with the bread or rolls stored inside.
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Item No.:
27
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Site:
Buffet-Calypso Yogurt Case - Aft Port
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Violation:
The decorative palm tree situated just behind and over the yogurt self-service display case was heavily soiled with a layer of dust debris along the palm leaves.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
16
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Site:
Buffet-Consumer Advisory
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Violation:
The consumer advisory posted at the cold self-service buffet where a bowl of pickled herring was staged only mentioned eggs as a risk.
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Recommendation:
Either provide an advisory card for the herring fish at the location where they are displayed, or move them to the display where other marinated fish are and an advisory card is already posted.
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Item No.:
21
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Site:
Buffet-Calypso Aft Beverage Counter
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Violation:
Power cables to the beverage equipment were coiled on the counter below, making cleaning of the counter difficult.
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Recommendation:
Shorten or otherwise elevate the power cables for the counter-mounted equipment, so the counter below remains easy to clean.
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Item No.:
21
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Site:
Buffet-Calypso Aft Beverage Counter
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Violation:
The bulk milk dispenser at the beverage counter was mounted on legs only 25 mm in height, making the area below difficult to access for cleaning.
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Recommendation:
Ensure table-mounted equipment that is not easily movable is elevated on legs that provide at least a 100 mm (4-inch) clearance between the table and the equipment.
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Item No.:
27
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Site:
Buffet-Calypso Aft Beverage Counter
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Violation:
The counter below the bulk milk dispenser was soiled with dirt debris.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
39
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Site:
Buffet-Calypso Pizza Station
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Violation:
The area was not in use at the time of inspection but one live fruit fly was present.
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Recommendation:
Effectively control the presence of insects, rodents, and other pests to minimize their presence in the food storage, preparation, and service areas and warewashing and utensil storage areas aboard a vessel.
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Item No.:
21
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Site:
Buffet-Calypso Pizza Station
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Violation:
The counter model dough roller was on legs only 25 mm above the counter, making access for cleaning beneath difficult.
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Recommendation:
Ensure table-mounted equipment that is not easily movable is elevated on legs that provide at least a 100 mm (4-inch) clearance between the table and the equipment.
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Item No.:
16
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Site:
Galley-Calypso Galley
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Violation:
There was a large pan containing a mixture of yogurt and chopped fruit inside the Foster rolling reach-in refrigerator with a food temperature of 49-50F. The staff member who prepared it stated the work was completed some three hours prior. Staff immediately blast-chilled the yogurt.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain potentially hazardous foods at 57C (135F) or above, except that roasts may be held at a temperature of 54C (130F); or 5C (41F) or less.
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Item No.:
16
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Site:
Galley-Calypso Galley
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Violation:
Inside two door upright reach-in refrigerator #16 (breakfast and cheese) were two trays of sliced individual cheese and several large blocks of cheese both on shelves and in a large hotel pan. The food temperatures ranged from 45-51 F as confirmed on the inspector's thermometer and the chef's. A ship's log verified correct temperatures at 7:30 am so the cheeses were all removed and blast-chilled immediately.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain potentially hazardous foods at 57C (135F) or above, except that roasts may be held at a temperature of 54C (130F); or 5C (41F) or less.
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Item No.:
16
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Site:
Galley-Calypso Galley
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Violation:
Inside the two door upright reach-in refrigerator #15 were 3 platters of sliced cheeses and 4 deli meat platters. The food temperatures ranged from
45-52 F. All were removed and blast-chilled.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain potentially hazardous foods at 57C (135F) or above, except that roasts may be held at a temperature of 54C (130F); or 5C (41F) or less.
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Item No.:
26
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Site:
Buffet-Marketplace - Deli Counter
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Violation:
The previously cleaned large counter model slicer had a heavy layer of encrusted old food debris wedged in the seam where the stainless steel lower side panel joined the stainless steel surface panel where sliced food dropped to. Staff later stated this slicer was a decorative unit only.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch. Remove this item if it is not necessary or will not be used anymore.
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Item No.:
16
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Site:
Food Service General-Time Control Plans
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Violation:
The posted time control plans in the buffets stated foods out for service were on time control, but did not identify the induction tops or cold basins as being on time control. In the Marketplace carving station an undercounter Alto-Shaam oven was said to be on time control, but it was not listed as such in the time control plan and was not labeled with the words time control. In the Crew Galley the cold basins and bain marie were not listed as time control in the plan. Additionally, staff set potentially hazardous foods on counters and that wasn't listed among time control in the plan and those containers were not labeled with discard times.
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Recommendation:
Maintain a written time control plan(s) that ensures compliance with these guidelines on the vessel and make it available for review during inspections. Post a time control plan at each outlet where time control is used. Ensure plan(s): (1) Includes set-up and discard times for each outlet. (2) List refrigeration and hot holding units (compartments and cabinets) on time control (the physical units must also be labeled as such). (3) Describe or show the flow of potentially hazardous food from when last in temperature control to placement in time control and discard. See also VSP Clarifications to the 2011 Operations Manual on the VSP website.
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Item No.:
16
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Site:
Galley-Main Galley - Hot Galley
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Violation:
There was a 300 mm deep hotel pan filled with a white sauce which had a food temperature of 62 F inside walk-in refrigerator #38. The production label stated that this was prepared 18 March, so the entire pan was discarded. Another very deep hotel pan of cooked mashed potatoes was found inside the same refrigerator with a food temperature of 47 F. The potatoes were prepared on 17 March and they were also discarded immediately.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain potentially hazardous foods at 57C (135F) or above, except that roasts may be held at a temperature of 54C (130F); or 5C (41F) or less.
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Item No.:
39
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Site:
Galley-Main Galley - Hot Galley Center
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Violation:
One live fruit fly was noted flying in this center galley area.
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Recommendation:
Effectively control the presence of insects, rodents, and other pests to minimize their presence in the food storage, preparation, and service areas and warewashing and utensil storage areas aboard a vessel.
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Item No.:
21
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Site:
Galley-Main Galley - Rossini Pantry
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Violation:
The large counter model sorbet machine was on legs only 1/2 inch above the counter. There was a layer of old dirt and dust debris on the counter below this machine.
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Recommendation:
Ensure table-mounted equipment that is not easily movable is elevated on legs that provide at least a 100 mm (4-inch) clearance between the table and the equipment.
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Item No.:
27
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Site:
Galley-Main Galley - Rossini Pantry
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Violation:
The large counter model sorbet machine was on legs only 1/2 inch above the counter. There was a layer of old dirt and dust debris on the counter below this machine.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
20
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Site:
Buffet-Crew Mess Beverage Station
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Violation:
There were several slot-head screws fastened on the panel on the underside of the orange soda dispensing nozzle.
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Recommendation:
Contact the machine manufacturer to repair or replace this panel according to the other 3 dispenser nozzles. Use only low profile, nonslotted, noncorroding, and easy-to-clean fasteners on food-contact surfaces and in splash zones. Prohibit the use of exposed slotted screws, Phillips head screws, or pop rivets in these areas.
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Item No.:
26
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Site:
Pantry-Pool Bar
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Violation:
There were three piles of a grey granular debris found inside the water bath on the upper ice maker interior compartment. The machine was in use at the time of inspection.
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Recommendation:
Ensure materials used in the construction of multiuse utensils and food-contact surfaces of equipment do not allow the migration of deleterious substances or impart colors, odors, or tastes to food and are safe under normal use conditions. Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized.
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