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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The ship's electronic database did not produce the standardized AGE surveillance log exactly as described under annex 13.2.2 in the VSP Operations Manual 2011.
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Recommendation:
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.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Case Definition
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Violation:
The AGE case definition in the STARDOCS electronic medical management database did not consider the number of diarrhea episodes that was above normal to certain individuals such as individuals with irritable bowel syndrome (IBS). This definition did not allow individuals with pre-existing medical conditions who reach 3 loose stools to be considered as non-reportable cases.
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Recommendation:
Ensure a reportable case of AGE is a case reported to the master of the vessel, the medical staff, or other designated staff by a passenger or a crew member and meets the case definition based on the following symptoms: (1) Diarrhea (three or more episodes of loose stools in a 24 hour period or what is above normal for the individual. See section 4.1.2.1.3, illness symptoms); or (2) vomiting and one additional symptom including one or more episodes of loose stools in a 24-hour period, or abdominal cramps, or headache, or muscle aches, or fever (temperature of greater than or equal to 38C [100.4F]).
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Item No.:
08
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Site:
Food Service General-Chilled Water Pipes
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Violation:
The nonpotable chilled water pipes connected to the back of the ice machines throughout the ship were not uniquely identified as nonpotable water.
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Recommendation:
Uniquely identify all refrigerant brine lines in all galleys, pantries, and cold rooms to prevent cross-connections.
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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 posted at the recreational water facilities did not include all the information required per the 2011 VSP Operations Manual.
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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.? In addition to the safety sign requirements in section 6.7.1.1.1, install a sign at each whirlpool spa and spa pool entrance listing precautions and risks associated with the use of these facilities. Include, at a minimum, cautions against use by the following: (1) individuals who are immunocompromised; (2) individuals on medication or who have underlying medical conditions such as cardiovascular disease, diabetes, or high or low blood pressure; and (3) pregnant women, elderly persons, and children. Additionally, caution against exceeding 15 minutes of exposure.
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Item No.:
10
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Site:
Recreational Water Facilities-Turnover Rates
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Violation:
Turnover rates were not calculated for each recreational water facility.
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Recommendation:
Design recirculation systems and equipment, including chemical control equipment, UV disinfection systems, filter, and pumps to maintain adequate water chemistry control while operating at the following minimum turnover rates: (1) swimming pool (VSP 2005 Construction Guidelines or earlier): 6 hours; (2) swimming pool (VSP 2011 Construction Guidelines or later): 4 hours; (3) children's pool: 0.5 hours; (4) wading pool: 1 hour; (5) whirlpool spa: 0.5 hours; (6) spa pool: 2 hours; (7) interactive RWF or activity pool less than 610 millimeters (24 inches) deep: 1 hour; (8) interactive RWF or activity pool greater than 610 millimeters (24 inches) deep: 2 hours; and (9) baby-only water facility: 0.5 hours. Ensure an RWF slide that is combined with a pool has a turnover rate that matches the rate for the pool.
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Item No.:
10
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Site:
Recreational Water Facilities-Bather Load
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Violation:
Bather loads were not calculated for the pools, spa pool, and the children's pool.
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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-Analyzer Chart Recorders
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Violation:
The sample points for the analyzer chart recorders for all of the recreational water facilities 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.
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Item No.:
11
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Site:
Medical-Acute Gastroenteritis (AGE) Reporting
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Violation:
A first officer experienced an onset of AGE symptoms on 24 November 2011 at 7:25 am, but reported to the medical facility at 6:39 pm the same day. A review of his work history showed he worked from 8:00 am to 12:00 pm that day.
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Recommendation:
Ensure that employees having AGE symptoms are restricted from work and report to the medical center as soon as having their first AGE symptom.
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Item No.:
16
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Site:
Food Service General-Consumer Advisories
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Violation:
There were no consumer advisories on the menus indicating that consuming raw or undercooked animal-derived foods may increase the risk for foodborne illness, especially to consumers with certain medical conditions. There were animal-derived products in the menus that could be ordered by the consumer in an undercooked form. In addition, buffet outlets where such foods could be cooked to order did not have a posted consumer advisory.
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Recommendation:
If an animal food such as beef, eggs, fish, lamb, milk, pork, poultry, or shellfish that is raw, undercooked, or not otherwise processed to eliminate pathogens is offered in a ready-to-eat form or as a raw ingredient in another ready-to-eat food, ensure the consumer is informed by way of disclosure using menu advisories, placards, or other easily visible written means of the significantly increased risk to certain especially vulnerable consumers eating such foods in raw or undercooked form. Locate the advisory at the outlets where these types of food are served. Ensure that disclosure is made by one of the two following methods: (1) On a sign describing the animal-derived foods (e.g., ?oysters on the half-shell,? ?hamburgers,? ?steaks,? or ?eggs?); AND that they can be cooked to order and may be served raw or undercooked; AND a statement indicating that consuming raw or undercooked meats, seafood, shellfish, eggs, milk, poultry may increase your risk for foodborne illness, especially if you have certain medical conditions. Ensure the advisory is posted at the specific station where the food is served raw, undercooked, or cooked to order OR (2) On a menu using an asterisk at the animal-derived foods requiring disclosure and a footnote with a statement indicating that consuming raw or undercooked meats, seafood, shellfish, eggs, milk, or poultry may increase your risk for foodborne illness, especially if you have certain medical conditions.
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Item No.:
16
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Site:
Galley-Time Control Plans
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Violation:
The port and starboard cold soup wells were on time control according to the staff, but they were not posted as time control units or identified on the time control plans. Staff posted signs at each units and updated the posted time control plans to identify them during the inspection.
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Recommendation:
Ensure plan(s): list refrigeration and hot holding units (compartments and cabinets) on time control (the physical units must also be labeled as such).
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Item No.:
18
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Site:
Preparation Room-Meat Thawing Walk-In Refrigerator
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Violation:
Two large plastic bins of frankfurters were stored on a rack directly below several covered plastic bins of raw cuts of beef. Staff re-positioned the frankfurter containers to the top shelf of another rack.
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Recommendation:
Protect food from cross-contamination or other sources of contamination by the following method: physically separating raw animal foods during storage, preparation, holding, and display from raw ready-to-eat food so that products do not physically touch and so that one product does not drip into another.
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Item No.:
20
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Site:
Buffet-Crew Mess
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Violation:
There was a hole from a missing screw and a corroded slot-head screw fastened to the inside of the water dispensing chute for the Hoshizaki ice/water dispenser at the beverage station near the entrance to the crew mess. Staff repaired this during the inspection.
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Recommendation:
Close the holes. 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.:
21
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Site:
Buffet-Crew Mess
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Violation:
The power cables and the water tubing to the two beverage stations counter equipment were draped on the counter tops, making cleaning difficult.
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Recommendation:
Shorten or elevate the power cables and water tubing to make cleaning beneath the equipment easier.
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Item No.:
21
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Site:
Bar-Cafe al Bacio
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Violation:
A coiled green power cable was on top of the deck sink inside the front bar undercounter technical compartment. The cable was connected to the deck on one end, but not connected to anything on the other end. It was subject to splash and made cleaning inside the compartment difficult.
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Recommendation:
Remove the power cable to make cleaning inside the compartment easier.
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Item No.:
22
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Site:
Galley-Dishwash Starboard
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Violation:
The in-use flight-type conveyor dishwash machine had a rinse tank temperature of 153F, but the manufacturer's data plate specified a minimum rinse temperature of 160F. The auxiliary rinse tank temperature registered 161F on the mounted gauge, but when measured manually the actual water temperature was 171-174F.
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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.
Ensure a warewashing machine and its auxiliary components are operated in accordance with the machine?s data plate and other manufacturer?s instructions.
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Item No.:
26
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Site:
Buffet-Sea Side Buffet
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Violation:
Several of the previously cleaned coffee/tea mugs on the starboard beverage station were soiled with dark particles on the interior cup surfaces. All were removed and rewashed.
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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.:
27
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Site:
Buffet-Sea Side Buffet
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Violation:
Dust was accumulated on top of the juice dispenser and coffee machines at the forward beverage station and on the juice dispenser at the starboard beverage station.
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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.:
28
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Site:
Bar-Cafe al Bacio
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Violation:
The glass on the front bar counter used to store several previously cleaned spoons was soiled.
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Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (1) in a clean, dry location; (2) in a location where they are not exposed to splash, dust, or other contamination; (3) at least 150 millimeters (6 inches) above the deck.
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Item No.:
29
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Site:
Galley-Main Galley - Port Entrance
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Violation:
The right tap at the dual handwash station was not adjustable by the user and reached a water temperature of 125F.
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Recommendation:
For handwash sinks with electronic sensors, and other types of handwash sinks where the user cannot make temperature adjustments, ensure the temperature provided to the user after the mixing valve does not exceed 49C (120F).
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Item No.:
33
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Site:
Galley-Potwash
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Violation:
At the soiled end of the pot wash and over the handwash sink, there was a gap from a loose corner profile strip at the deckhead/bulkhead juncture.
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Recommendation:
Replace the profile strip to close the gap.
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Item No.:
33
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Site:
Galley-Hot Galley
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Violation:
There were damaged deck tiles and recessed grout at the deck sinks in front of the tilting pans.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, bars, and food and equipment storage areas are constructed and maintained for easy cleaning.
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Item No.:
33
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Site:
Buffet-Sea Side Buffet
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Violation:
There was a significant accumulation of dust between the deckhead panels throughout the port beverage station and directly over the beverage counter.
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Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
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Item No.:
36
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Site:
Buffet-Sea Side Buffet
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Violation:
The light intensity behind mounted equipment at the forward beverage station was less than 110 lux.
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Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) at a distance of 75 centimeters (30 inches) above the deck when in use, in walk-in refrigerator units and dry storage areas, and in other areas and rooms during periods of cleaning. Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment.
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Item No.:
38
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Site:
Pantry-Pool Bar
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Violation:
The five-head soda dispenser was posted as not in use and staff stated it will not be used.
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Recommendation:
Remove the five-head soda dispenser.
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Item No.:
39
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Site:
Buffet-Sea Side Buffet
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Violation:
When food was being placed out for service, there was a live fly on the bulkhead directly over the center buffet counter on the starboard buffet line.
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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.:
39
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Site:
Galley-Dishwash Starboard
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Violation:
A live fly was at the clean end of the in-use conveyor dishwash machine.
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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.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
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Violation:
The OPRP did not include procedures for informing current passengers and crew members of an existing outbreak.
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Recommendation:
Include the following in the written OPRP: procedures for informing passengers and crew members of the outbreak.
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Item No.:
42
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Site:
Children Area-
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Violation:
The water temperature at the handwashing sinks inside the children's toilet room and at the play room could be adjusted to greater than 110F.
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Recommendation:
Ensure the maximum water temperature for a handwashing station does not exceed 43C (110F).
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Item No.:
42
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Site:
Children Area-
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Violation:
One of the previously cleaned pillow cases was stained and soiled on the interior surfaces. It was removed for disposal.
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Recommendation:
Launder linens such as blankets, sheets, and pillow cases between each use.
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