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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The AGE surveillance log could not be put into a spreadsheet with the required information in the exact order as Annex 13.2.2 of the 2011 VSP Operations Manual.
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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.
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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 used by the ship did not consider the number of diarrhea episodes that was above normal to certain individuals. The current definition did not allow individuals with pre-existing medical conditions, such as individuals with irritable bowel syndrome, who reach 3 loose stools to be considered non-reportable cases. This definition was in writing. No cases appeared to be reported incorrectly.
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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:
Potable Water-
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Violation:
The nonpotable chilled water lines connected to the back of the ice machines in food areas throughout the ship were not uniquely identified.
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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 pools and whirlpools did not contain all elements of the 2011 VSP Operations Manual sign requirements. The signs did not include cautions against using the facilities if experiencing fever and bather load information. In addition, the signs for the whirlpools did not include cautions against use by individuals on medication.
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Recommendation:
Ensure the signs include cautions against using the RWF if experiencing fever and bather load information. 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 cautions against use by individuals on medication.
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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 lines for the analyzer chart recorders for all of the recreational water facilities were located after the compensation tanks.
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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.:
16
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Site:
Food Service General-Consumer Advisory
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Violation:
There was no consumer advisory at the buffet lines or 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 that could be ordered by the consumer in an undercooked form. The staff stated that they were awaiting new standardized consumer advisory signage and menu statements.
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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-Deck 14 Horizon Court
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Violation:
Individual containers of yogurt stored in reach-in cooler #2419 had temperatures of 41F to 53F. The yogurt was discarded.
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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:
Other-Time Control Plan - Ice Cream Bar
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Violation:
In areas operating under time control plans that exceeded four hours, such as the ice cream bar, more specificity was needed on procedures and monitoring to assure compliance with the time control plans. The time control plan did not provide detailed instructions on how the operations were actually conducted using alternating soft serve ice cream machines. Each of the two ice cream machines was set-up, operated for four hours, emptied, cleaned and sanitized in four hour blocks of time. The cycle began with refill from the temperature-control back-up supply. Labeling or other specificity on where each of the machines was in its cycle was not included in the time control plan.
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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.
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Item No.:
20
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Site:
Food Service General-Food Thermometers
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Violation:
None of the staff in the cooking areas were equipped with tip-sensitive food thermometers.
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Recommendation:
Ensure food temperature-measuring devices are provided and readily accessible for use in ensuring attainment and maintenance of food temperatures. Use tip-sensitive temperature-measuring devices, such as a thermocouple or thermistor, for measuring thin food products.
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Item No.:
20
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Site:
Galley-Deck 6 Pastry
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Violation:
The large and small ice cream machines had plastic paddles that had rough and cracked surfaces that were difficult to clean.
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Recommendation:
Ensure multiuse food-contact surfaces are smooth and free of breaks, open seams greater than 0.8 mm (1/32 inch), cracks, chips, inclusions, pits, and similar imperfections.
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Item No.:
20
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Site:
Galley-Deck 5 Butcher Shop
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Violation:
The meat saw metal and fiber saw blade guides were severely scored making them difficult to clean. The plastic push stick for the meat grinder also had rough surfaces making it difficult to clean.
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Recommendation:
Ensure multiuse food-contact surfaces are smooth, free of breaks, open seams greater than 0.8 mm (1/32 inch), cracks, chips, inclusions, pits, and similar imperfections.
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Item No.:
22
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Site:
Galley-Deck 6 Pot Wash
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Violation:
The soiled utensil storage area was severely overloaded. Deck stands loaded to a height of more than five feet with soiled pots and pans extended the length of the three compartment sink. This was less than 12 inches from the path by which the cleaned utensils went to the automatic potwashing machine.
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Recommendation:
Ensure drainboards, utensils, racks, or tables large enough to accommodate all soiled and cleaned items that may accumulate during hours of operation are provided for necessary utensil holding before cleaning and after sanitizing.
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Item No.:
26
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Site:
Galley-Deck 14 Horizon Court
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Violation:
A previously cleaned and stored food slicer had a slight build-up of food residue under the slicer's backplate next to the exit path of the food from the slicer blade.
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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:
Bar-Deck 7 Crooner's Bar
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Violation:
The pantry handwash sink was partially blocked by cleaning buckets placed on the deck in front of it. The buckets were immediately removed.
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Recommendation:
Ensure handwashing facilities are used for no other purpose and are accessible at all times.
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Item No.:
33
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Site:
Provisions-Deck 4 Cold Stores
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Violation:
The produce walk-in coolers evaporator fins were heavily soiled with dirt.
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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.:
33
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Site:
Galley-Deck 5 Butcher Shop
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Violation:
Walk-in cooler evaporator fins were heavily soiled with dirt.
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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.:
33
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Site:
Galley-Deck 4 Hot Galley
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Violation:
Walk-in cooler evaporator fins were heavily soiled with dust.
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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:
Bar-Handwash Sink Lighting
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Violation:
The light intensity over the handwash station could not be raised to 110 lux.
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Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) at handwashing stations in bars.
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Item No.:
36
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Site:
Food Service General-Lighting
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Violation:
In the pantries and the galleys, the light intensity behind and around many pieces of counter-mounted and deck-mounted equipment 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.:
37
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Site:
Galley-Deck 4 Officers Mess
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Violation:
Condensate was collecting inside the ventilation hood above the bain marie above the hot serving line. No food appeared to be impacted.
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Recommendation:
Ensure ventilation hood systems and devices operate effectively to prevent condensate from collecting on the bulkheads and deckheads and remove contaminants generated by equipment located under them.
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Item No.:
40
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Site:
Integrated Pest Management-Follow-Up Inspections
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Violation:
The integrated pest management log did not include follow-up inspection results for most of the inspections when pests were found.
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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.:
40
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Site:
Integrated Pest Management-Loading Inspections
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Violation:
There were no records of pest inspections of incoming shipments since July 2011.
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Recommendation:
Routinely inspect incoming shipments of food and all other supplies for evidence of insects, rodents, and other pests. Maintain a record of these inspections onboard the vessel and make the record available for review during inspections.
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Item No.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan
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Violation:
The outbreak prevention and response plan did not include procedures for informing current and embarking passengers and crew members of an outbreak or procedures for returning the vessel to normal operating conditions after an outbreak. In addition, there was no information on the required contact time for chlorine solutions to be used in food areas.
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Recommendation:
Include the following in the written OPRP: disinfectant products or systems used, including the surfaces or items the disinfectants will be applied to, concentrations, and required contact times; procedures for informing passengers and crew members of the outbreak, including procedures for notification of passengers embarking the vessel following an outbreak voyage or segment of a voyage; procedures for returning the vessel to normal operating conditions after an outbreak.
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Item No.:
41
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Site:
Housekeeping-Public Toilets
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Violation:
The public toilet in the bridge did not have a sign advising users to use a hand towel, paper towel, or tissue to open the door upon exiting.
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Recommendation:
Post a sign advising users of toilet facilities to use hand towel, paper towel, or tissue to open the door unless the exit is hands free.
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Item No.:
42
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Site:
Children Area-Toilet Room
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Violation:
The child-size toilets were 12.5 inches above the deck. No step stools were provided.
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Recommendation:
Ensure child-size toilets (to include the toilet seat) have a maximum height of 280 millimeters (11 inches) or a step stool.
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Item No.:
42
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Site:
Children Area-Theater
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Violation:
The seat cushions were soiled under and around them with used napkins, spoons, buttons, and glitter. This area was previously cleaned and not in use at the time of the inspection.
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Recommendation:
Ensure surfaces that children touch with their hands are cleaned and disinfected at least daily with products labeled by the manufacturer for that purpose.
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