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Item No.:
02
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Site:
Medical-Acute Gastroenteritis Log
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Violation:
The acute gastroenteritis (AGE) surveillance log did not indicate the time ill passengers or crew members reported to the medical center.
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Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain the time of the first medical visit or report to staff of illness.
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Item No.:
02
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Site:
Medical-Cabin Mate and Immediate Contact Interview
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Violation:
There was no documentation of the verbal interview with asymptomatic cabin mates and immediate contacts of symptomatic crew members.
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Recommendation:
Maintain the following records on board for 12 months and make them available for review by VSP during inspections and outbreak investigations: 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.:
02
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Site:
Medical-72-Hour Questionnaires
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Violation:
Crew members who were acute gastroenteritis (AGE) reportable cases were not provided the 72-hour questionnaire to indicate activities or meals prior to illness onset.
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Recommendation:
Distribute questionnaires detailing activities and meal locations for the 72 hours before illness onset to all passengers and crew members who are AGE CASES. Ensure that the self-administered questionnaires contain all of the data elements that appear in the questionnaire found in Annex 13.2.2. Ensure that completed questionnaires are maintained with the AGE surveillance log.
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Item No.:
03
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Site:
Potable Water-Bunker Records
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Violation:
According to the records, the free residual halogen during the bunkering of potable water was less than 2.0 ppm on six days since the last inspection. These days included 19 July, 28 July, 9 August, 10 August, 23 August, and 24 August. The ship was out of the United States during these days.
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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.:
08
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Site:
Potable Water-Reduced Pressure Assembly Testing Records
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Violation:
The records for the pressure tests of the reduced pressure assembly backflow prevention devices were not available on the ship. The pressure tests were conducted by a shoreside company who maintained the test results.
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Recommendation:
Inspect and test backflow prevention devices requiring testing with a test kit after installation and at least annually. Maintain the test results showing the pressure differences on both sides of the valves for each device.
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Item No.:
08
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Site:
Potable Water-Bunker Station Filling Lines
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Violation:
The potable water filling lines at both of the bunker stations were labeled with letters approximately 6 millimeters (0.25 inch) high. Also, the plates were positioned well below the point of hose connection.
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Recommendation:
Ensure each bunker station potable water filling line is striped or painted blue or in accordance with the color designation in ISO 14726 (blue/green/blue) and clearly labeled "POTABLE WATER FILLING" in letters at least 13 millimeters (0.5 inch) high, stamped on a noncorrosive label plate or the equivalent, and located at or near the point of the hose connection.
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Item No.:
08
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Site:
Potable Water-Starboard Bunker Station
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Violation:
The chain for the screw cap for one of the potable water filling lines was not fastened to the surface of the filling line.
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Recommendation:
Ensure the potable water filling line has a screw cap fastened by a noncorroding cable or chain to an adjacent bulkhead or surface in such a manner that the cap cannot touch the deck when hanging free. Ensure the hose connections are unique and fit only the potable water hoses.
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Item No.:
08
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Site:
Potable Water-Production Records
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Violation:
The records for the production of potable water did not indicate the pH.
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Recommendation:
After the free residual halogen level of at least 2.0 mg/L (ppm) and pH level not exceeding 7.8 have been reached, monitor the free residual halogen and pH at least once every 4 hours during the production of potable water.
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Item No.:
08
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Site:
Potable Water-Bunkering and Production Records
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Violation:
The records did not indicate that the free halogen residual was at least 2.0 ppm within 30 minutes of the start of bunkering and production of potable water.
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Recommendation:
Adjust the free halogen residual level to at least 2.0 mg/L (ppm) within 30 minutes of the start of the bunkering and production processes.
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Item No.:
10
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Site:
Recreational Water Facilities-Sample Points
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Violation:
The sample points for the electronic data loggers for all of the recreational water facilities onboard were located after the compensation tank.
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Recommendation:
Ensure the sample line for the analyzer probe (monitoring) is either directly from the RWF or on the return line from each RWF and before the compensation tank. Install appropriate sample taps for analyzer calibration.
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Item No.:
10
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Site:
Recreational Water Facilities-Safety Signs
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Violation:
The safety signs for the swimming pools did not inform passengers to not use the facility if they are experiencing diarrhea, vomiting, or fever, and did not include the bather load #. The safety signs at the spas did not inform passengers to not use the facility if they are experiencing diarrhea, vomiting, or fever. The children's pool did not inform passengers about children's frequent bathroom breaks.
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Recommendation:
Provide safety signs for all RWFs, except for baby-only water facilities. Ensure the signs, at a minimum, include the following words: (1) do not use these facilities if you are experiencing diarrhea, vomiting, or fever; (2) no children in diapers or who are not toilet trained; (3) shower before entering the facility; and (4) bather load #. For children's RWF signs, include the exact wording "TAKE CHILDREN ON FREQUENT BATHROOM BREAKS" or "TAKE CHILDREN ON FREQUENT TOILET BREAKS."
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Item No.:
10
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Site:
Recreational Water Facilities-Whirlpool Shock Halogenation
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Violation:
The free residual halogen concentration was not documented at the start and completion of the shock halogenation for the whirlpools.
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Recommendation:
Ensure a written or electronic record of the date and time of water dumping and shock halogenation (concentration in ppm at the start and completion and time) is available for review during inspections.
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Item No.:
10
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Site:
Recreational Water Facilities-Filter Housing Cleaning and Disinfection
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Violation:
The filter housing was cleaned, rinsed, and disinfected with 200 ppm chlorine, but the contact time for this disinfection was not documented,
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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.:
10
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Site:
Recreational Water Facilities-Hair and Lint Strainer
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Violation:
There was no documentation that the hair and lint strainers were cleaned, rinsed, and disinfected.
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Recommendation:
Clean, rinse, and disinfect the hair and lint strainer and hair and lint strainer housing on all RWFs weekly. 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.:
10
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Site:
Recreational Water Facilities-Swimming Pools Bather Load
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Violation:
There was no documentation for the maximum bather loads for the swimming pools.
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Recommendation:
Maintain documentation on the maximum bather load for each RWF. Ensure the maximum bather load is based on the following factor: one person per five gallons (19 liters) per minute of recirculation flow.
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Item No.:
10
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Site:
Recreational Water Facilities-Electronic Data Logger Calibration
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Violation:
The manual comparison test was not conducted to verify the calibration of the electronic data logger for free halogen residual and pH prior to opening the facilities.
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Recommendation:
Maintain and operate the halogen and pH analyzer-chart recorder in accordance with the manufacturer's instructions. Conduct a manual comparison test before opening the RWF to verify calibration for free halogen residual and pH. Ensure the analyzer reading is within 0.2 ppm for free halogen and 0.2 for pH. For RWFs open longer than 24 hours, conduct a manual comparison test every 24 hours.
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Item No.:
10
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Site:
Recreational Water Facilities-Fecal/Vomit Accident Plan
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Violation:
The fecal/vomit accident plan had a contact time of 960 minutes for 10 ppm of chlorine residual for loose stool.
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Recommendation:
Ensure a fecal and vomit accident response procedure that meets or exceeds the procedure provided in Annex 13.8 is available for review during inspections.
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Item No.:
11
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Site:
Medical-Symptomatic Crew Members Clearance
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Violation:
There was no documentation indicating crew members who were acute gastroenteritis (AGE) reportable cases were cleared by the medical staff prior to returning to work.
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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 non-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 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.
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Item No.:
11
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Site:
Medical-Crew Members Reporting
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Violation:
During two recent cruises, two food employees and one nonfood employee had onsets of reportable acute gastroenteritis (AGE) symptoms and worked while symptomatic before reporting to the medical center. During the 3-10 September cruise, a buffet boy had an onset of AGE symptoms on 4 September at 08:00, but did not report to the medical center until 14:20. A musician had an onset of AGE symptoms on 5 September at 14:00, but did not report to the medical center until 6 September at 16:30. During the 20-27 August cruise, an assistant waiter had an onset of AGE symptoms on 25 August at 07:00, but did not report to the medical center until 16:30. The time cards for these crew members were reviewed to verify work history on these dates.
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Recommendation:
Ensure food employees who have conditions or symptoms of boils, open sores, infected wounds, diarrhea, jaundice, fever, vomiting, sore throat with fever, or discharges from the nose or mouth report these conditions or symptoms to the vessel's medical staff and are restricted from working with exposed food, warewashing, clean equipment, utensils, and linens, and unwrapped single-service and single-use articles. When non-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 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. Ensure crew members are instructed to report to the medical center upon the first symptom of AGE.
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Item No.:
17
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Site:
Galley-Sushi Bar
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Violation:
A letter from the supplier specifying the freezing temperatures and times for each of the fish products being served raw was not available on the ship. These certification letters are to be sent to the ship from the corporate office where they are on file.
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Recommendation:
If raw, raw-marinated, partially cooked, or marinated partially cooked fish are served in ready-to-eat form, ensure: (1) The person in charge records the freezing temperature and time to which the fish are subjected and retains the records on the vessel for 90 calendar days beyond the time of service or sale of the fish; or (2) If the fish are frozen by a supplier, a written letter from the supplier which specifies the fish species involved and both the temperature to which the fish was frozen and the total time period at that temperature. If the supplier provides any of the same species to the vessel in a fresh state, ensure there is a designation on the outer packaging for the parasite-free fish.
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Item No.:
19
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Site:
Housekeeping-Deck 10 Cabin Steward Locker
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Violation:
A plastic ice chest contained melting ice. The ice scoop handle was submerged in the water. Two opened plastic bottles of water that belonged to the cabin stewards were floating in the water.
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Recommendation:
During pauses in food preparation or dispensing, ensure food preparation and dispensing utensils are stored: In the food with their handles above the top of the food and the container; In a container of water (if the water is maintained at a temperature of at least 57°C [135°F] and the container is frequently cleaned and sanitized).
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Item No.:
22
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Site:
Galley-Dishwash
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Violation:
One of the upper right final sanitizing rinse spray nozzles of the flight-type dishwash machine was blocked. The machine was in use at the time of the inspection.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: (1) warewashing equipment is maintained in a state of repair and condition that meets the standards of the materials, design, and construction of these guidelines; (2) water pressure and water temperature-measuring devices are maintained in good repair and accurate within the intended range of use.
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Item No.:
22
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Site:
Galley-Speciality Galley - Dishwash
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Violation:
The far right final sanitizing rinse spray nozzle of the flight-type dishwash machine was blocked. The machine was in use at the time of the inspection.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: (1) warewashing equipment is maintained in a state of repair and condition that meets the standards of the materials, design, and construction of these guidelines; (2) water pressure and water temperature-measuring devices are maintained in good repair and accurate within the intended range of use.
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Item No.:
22
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Site:
Galley-Dishwash
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Violation:
Two pallets of large plastic bins with soiled dishes were stored at the clean end of the dishwash machine. These dishes were soaking as part of a pre-soak cleaning process. The bins of dishes were removed during the inspection.
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Recommendation:
Ensure only cleaned and sanitized dishes and equipment are stored at the clean end of the dishwash machine.
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Item No.:
24
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Site:
Galley-Deck 6 Dishwash
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Violation:
The final sanitizing rinse temperature of the in-use glasswash machine measured below 160°F at the plate surface on multiple tests using the inspector's thermocouple and a 150°F-170°F thermolabel placed on a glass. A 180°F thermolabel was placed on the final sanitizing rinse manifold, but the thermolabel did not change color, indicating 180°F was not reached. The booster heater valve was repaired and an acceptable final sanitizing rinse temperature was confirmed.
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Recommendation:
In a mechanical operation, ensure the temperature of the fresh hot water sanitizing rinse as it enters the manifold is not more than 90°C (194°F) or less than: (1) 74°C (165°F) for a stationary rack, single-temperature machine; (2) 82°C (180°F) for all other machines. Ensure the utensil surface temperature is not less than 71°C (160°F) as measured by an irreversible registering temperature indicator.
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Item No.:
26
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Site:
Galley-Speciality Galley - Hot Galley
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Violation:
A white powder was in the food-contact area of the lid of a previously cleaned tilting pan.
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Recommendation:
Ensure food-contact surfaces of cooking equipment and pans are kept free of encrusted grease deposits and other soil accumulations.
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Item No.:
26
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Site:
Galley-Speciality Galley - Potwash
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Violation:
The bottom of the back plate of the previously cleaned food slicer was soiled with food residue.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
29
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Site:
Housekeeping-Deck 12 Ice Pantry
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Violation:
The handwash sink was inoperable. The repair parts for the automatic flow valve have been ordered.
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Recommendation:
Repair the handwash sink.
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Item No.:
30
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Site:
Galley-Potwash
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Violation:
The faucet of the automatic handwash sink had low water pressure, making proper handwashing difficult. Users could not adjust the water pressure.
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Recommendation:
Provide sufficient water pressure for proper handwashing.
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Item No.:
33
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Site:
Galley-Deck 5 Wine Pantry
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Violation:
Four stacks of boxed beverages were stored on dishwash racks directly on the deck. These racks kept the food above the deck, but reduced the effectiveness of cleaning this area.
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Recommendation:
Ensure dishware racks are not stored directly on the deck.
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Item No.:
33
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Site:
Preparation Room-
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Violation:
A corner profile strip to the right of the walk-in cooler door and to the left of the handwash sink was loose. This was corrected.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
37
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Site:
Galley-Dishwash
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Violation:
There was excessive condensation on the deckhead of the soiled end of the dishwash machine. The condensate was heavily dripping onto the soiled landing. The exhaust system was operating, but was not effectively removing the humidity.
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Recommendation:
Ensure exhaust ventilation hood systems in food preparation and warewashing areas--including components such as hoods, fans, guards, and ducting--are designed to prevent grease or condensation from draining or dripping onto food, equipment, utensils, linens, and single-service and single-use articles.
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