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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 38°C [100.4°F]).
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Item No.:
08
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Site:
Potable Water-Distillate Water Lines - Evaporator C
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Violation:
The distillate water lines from the evaporator C to the potable water halogenation station were not striped or painted in accordance with ISO 14726 standards (blue/gray/blue). (2011 VSP Operations Manual)
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Recommendation:
Stripe or paint permeate lines directed to the potable water system in accordance with ISO 14726 (blue/gray/blue).
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Item No.:
08
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Site:
Potable Water-Cross-Connection Control Program
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Violation:
The cross-connection control program listed the test results with pressure differentials of the annual inspection for the testable backflow prevention devices. The record documented a testing date of June 2011 for all testable devices. The test results for 30 of those testable devices were exactly the same as in June 2010. During the record review the same list with the same test results but with a test completion date of June 2012 was also available. As a result, there was no assurance that these test results reflected actual tests performed.
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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.:
09
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Site:
Recreational Water Facilities-Midship Main Swimming Pool
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Violation:
The pH of the water in the open main swimming pool was 8.3. The staff immediately closed the facility. This violation was also noted in the 24 October, 2011 VSP inspection report.
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Recommendation:
Maintain the pH level in all RWFs between 7.0 and 7.8. Immediately close facilities if these halogen and pH ranges are not maintained.
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Item No.:
10
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Site:
Recreational Water Facilities-Water Testing
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Violation:
There was no means to test the total chlorine and alkalinity for the water in the recreational water facilities. (2011 VSP Operations Manual)
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Recommendation:
Ensure a test kit is available for testing water quality parameters, including free and total halogen levels (chlorine and bromine, where applicable), pH, and total alkalinity. Ensure that test kits are accurate to within 0.2 mg/L (ppm) for halogen and have a testing range of free residual halogen normally maintained in the RWF. Ensure test kits for pH are accurate to within 0.2. Ensure all reagents are not past their expiration dates.
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Item No.:
10
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Site:
Recreational Water Facilities-Depth Markers
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Violation:
The depth markers at the RWFs listed depth only in feet. (2011 VSP Operations Manual)
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Recommendation:
Prominently display the depth of each RWF that is deeper than 1 meter (3 feet) so that it can be seen from the deck and in the pool. Label depth markers in both feet and meters. Additionally, install depth markers for every 1 meter (3 feet) change in depth.
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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 contain all elements of the 2011 VSP Operations Manual sign requirements. (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-Chart Recorders/Data Loggers
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Violation:
There were no chart recorders or electronic data loggers with security features that recorded pH and halogen measurements for each individual recreational water facility. (2011 VSP Operations Manual)
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Recommendation:
Install chart recorders or electronic data loggers with security features that record pH and halogen measurements for each individual RWF. 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. In the event of equipment failure, measure free residual halogen and pH by a manual test kit at the RWF or return line at least hourly for whirlpool spas, spa pools, children?s pools, and wading pools and every 4 hours for all other RWFs. Record manual readings on a chart or log, retain for at least 12 months, and ensure that they are available for review during inspections. Complete repairs on malfunctioning halogen analyzer-chart recorders within 30 days of equipment failure. Provide an audible alarm in a continuously occupied watch station to indicate low and high free halogen and pH readings in each RWF.
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Item No.:
10
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Site:
Recreational Water Facilities-Antientrapment Requirements
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Violation:
The swimming pools did not meet the antientrapment drain requirements per the 2011 VSP Operations Manual. There were no antientrapment drain covers and no alarm. (2011 VSP Operations Manual)
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Recommendation:
For RWFs with gravity drainage and multiple drains (2 or more drains greater than 3 feet apart), provide either a standard design (not compliant with ASME A112.19.8) drain cover and an alarm, or an ASME A112.19.8 compliant antientrapment/antientanglement drain cover. Ensure the alarm is audible and sounds in both a continuously manned space and at the RWF. Ensure this alarm is for all draining: accidental, routine, and emergency.
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Item No.:
10
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Site:
Potable Water-Sand Filter Backwash
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Violation:
The sand filter backwash was performed as often as required according to the records kept by the staff. However, these were automatic backwashing systems and an individual most of the times was not present in the filter room to ensure that backwashing was repeated as necessary until the water run clear. (2011 VSP Operations Manual)
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Recommendation:
Monitor filter pressure differentials. Backwash granular filter media until the water viewed through a sight glass runs clear and at the following frequencies: (1) whirlpool spa and spa pool: every 72 hours, or sooner if the whirlpool spa is drained; (2) baby-only water facility: daily; and (3) all other RWFs: at a frequency recommended by the manufacturer. For automatic backwashing systems, ensure an individual is present in the filter room to ensure that backwashing is repeated as necessary until the water runs clear. Clean cartridge filters according to the manufacturer?s recommendations. Maintain a written or electronic record documenting filter backwashing and cleaning.
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Item No.:
11
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Site:
Medical-Crew Acute Gastroenteritis (AGE) Reporting
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Violation:
The review of the AGE logs for the last 5 cruises revealed that there was a hotel stewardess (food worker) reported having an onset of AGE symptoms on 20 February 2012 at 1730 but reported to the medical center at on 21 February 2012 at 1107. She did not work in between. She was counseled of the importance of reporting to the medical center as soon as having her first AGE symptom.
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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:
Buffet-Officer and Petty Officer Mess
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Violation:
The WMF espresso/cappuccino machines in both messes had milk refrigerators on the side of the machines that were managed and labeled under a time only control system. The milk transfer tube from the refrigerator to the coffee machines were cleaned and sanitized only at night, according to staff. The milk container inside is removed and a clean one used to refill on the 4 hour discard.
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Recommendation:
Ensure that the time control plans for milk refrigerators to coffee machines in these locations and throughout the ship include a procedure for removal of the tubes at the 4 hour interval when the milk and milk containers are removed. Ensure there are spare tubes which are maintained in a clean condition so the change does not require a specific cleaning step for the original tube.
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Item No.:
16
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Site:
Dining Room-Menu's
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Violation:
There was no consumer advisory on the main dining room breakfast menu to caution about the risks associated with food items such as eggs benedict, eggs cooked to order and the cold-smoked salmon served in ready-to-eat form.
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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 raw shell egg preparations are not used in uncooked products as described in section 7.3.3.2.3. 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-Lido Center Galley and Forward Grill
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Violation:
In the hot galley center there was a time control sticker attached to the in-use soup kettle during luch service. Staff stated that after cooking the back-up soup in this kettle was on time only as a public health control, but there was no mention in the time control plan that this unit was one of the holding units for time control. In the forward grill there were two hotel pans of cooked hamburger patties and reheated hot dogs on the grooved griddle. These were labeled as time control and staff stated that that is how they were managed, but the griddle was not listed among the hot units under time control 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.:
19
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Site:
Preparation Room-Fish Preparation
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Violation:
There were 5 deckhead light fixture covers which contained a large amount of standing water inside the fish walk-in freezer. In one case the water was not frozen, but in all others it was hard frozen inside the light cover and there was evidence of some water dripping out in two cases to boxes of food stored on the top shelf below the lights.
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Recommendation:
Protect food from contamination by storing the food: (1) Covered or otherwise protected; (2) In a clean, dry location; (3) Where it is not exposed to splash, dust, or other contamination; and (4) At least 15 centimeters (6 inches) above the deck.
The cause of the water leaking into these light fixtures should be investigated thoroughly and the condition corrected. In the interim period, the light covers should be removed and drained, then inspected daily for leaks. Food pallets should not be stored under any lights with this leaking condition until the condition is fully corrected.
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Item No.:
19
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Site:
Preparation Room-Meat Preparation
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Violation:
There were 4 deckhead light fixture covers which contained a large amount of standing water inside meat walk-in freezer #22. In one case a box below the light had a small amount of ice on top which clearly leaked from the light cover above it.
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Recommendation:
Protect food from contamination by storing the food: (1) Covered or otherwise protected; (2) In a clean, dry location; (3) Where it is not exposed to splash, dust, or other contamination; and (4) At least 15 centimeters (6 inches) above the deck.
The cause of the water leaking into these light fixtures should be investigated thoroughly and the condition corrected. In the interim period, the light covers should be removed and drained, then inspected daily for leaks. Food pallets should not be stored under any lights with this leaking condition until the condition is fully corrected.
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Item No.:
20
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Site:
Other-Main and Crew Galleys
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Violation:
The blast chill refrigerators in both the main and crew galleys (2 of 4 total on the ship) were in disrepair, and have been in this condition awaiting parts since 2 February. The part order submission was reviewed during the inspection.
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Recommendation:
Food contact equipment must be maintained in good repair and proper adjustment: (1) Equipment must be maintained in a state of repair and condition that meets the materials, design, construction, and operating specifications of these guidelines; and (2) Cutting or piercing parts of can openers must be kept sharp to minimize the creation of metal fragments that can contaminate food when the container is opened.
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Item No.:
20
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Site:
Food Service General-All Food Areas - Thermometers
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Violation:
Staff working with thin foods were not equipped with or using sensitive-tip probe thermometers as required in the 2011 VSP Operations Manual. Staff stated these have been ordered.
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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.:
21
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Site:
Food Service General-All Food Areas
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Violation:
There were several undercounter reach-in refrigerator doors which were not sealing tightly to the door frame when shut, leaving a gap in the lower half which allowed warm air to enter inside. The refrigerators and locations are as follows: main galley center - R3-33 (left of 2 doors) and R3-34 (left of 3 doors), main galley garde' manger - R3-12 (left and middle of 3 doors) and R3-06 (center of 3 doors), crew galley - 7-106 (left and middle of 3 doors), and lido buffet pantry - R9-20 (center of 3 doors) and R9-19 (center and right of 3 doors).
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Recommendation:
Ensure nonfood contact equipment is maintained in good repair and proper adjustment including: (1) Equipment maintained in a state of repair and condition that meets the materials, design, construction, and operation specifications of these guidelines; (2) Equipment components such as doors, seals, hinges, fasteners, and kick plates are kept intact, tight, and adjusted in accordance with manufacturer's specifications.
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Item No.:
22
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Site:
Galley-Pacific Dishwash
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Violation:
During active use of the flight-type conveyor dishwash machine the water spray from the upper and lower final sanitizing rinse nozzles was continually changing from full spray to no spray and back again. Staff repaired the machine during 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-Pot Wash
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Violation:
During operation of the 3-compartment sink the hot water sanitizing sink gauge registered a water temperature of 190 °F, while the manual measure of the water temperature using the inspector's thermometer registered only 182 °F.
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Recommendation:
Ensure water temperature-measuring devices are scaled: (1) in Celsius or dually scaled in Celsius and Fahrenheit are designed to be accurate to within 1.5°C (within 3°F) in the intended range of use; (2) only in Fahrenheit are designed to be accurate to within 3°F in the intended range of use.
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Item No.:
26
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Site:
Galley-Garde' Manger
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Violation:
Some of the previously cleaned plate covers stacked on the overshelves for this preparation area were visibly soiled with food debris and stored as clean.
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Recommendation:
Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized. Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
26
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Site:
Galley-Bakery/Pastry
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Violation:
Seven previously clean plate covers in the stacks of those stored as clean in the overshelf were visibly soiled with food debris.
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Recommendation:
Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized. Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
26
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Site:
Buffet-Officers Mess
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Violation:
The area was previously cleaned and the panini grill was soiled with loose burned food debris on the lower food surface.
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Recommendation:
Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized. Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
33
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Site:
Galley-Garde' Manger
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Violation:
The deckhead panel junctures were soiled. The six live fruit flies observed in this area were all found in these seams between the deckhead panels.
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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. The seams at deckhead panel junctures in this area and throughout the food areas should be aggressively brush cleaned to remove all particles stuck in this crevice and routinely inspected for soilage thereafter.
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Item No.:
33
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Site:
Other-Lido Cafe - Coffee Shop
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Violation:
There was dust debris accumulating in the gap between the decorative deckhead panels over the counters and especially so over the espresso/cappuccino machine. The decorative wood beams attached to the deckhead had a heavy layer of dust debris on top. Staff cleaned this immediately.
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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-Petty Officer's Mess
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|
Violation:
The artificial light level on the counter where clean plates and condiments were placed was below the minimum 220 lux (20 foot candles) of artificial light.
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Recommendation:
Ensure the light intensity is at least 220 lux (20 foot candles) on food preparation surfaces, and at a distance of 75 centimeters (30 inches) above the deck in food preparation areas, handwashing facilities, warewashing areas, equipment, and utensil storage, pantries, toilet rooms, and consumer self-service areas.
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Item No.:
36
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Site:
Food Service General-All Food Areas - Lighting
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Violation:
There were several areas where the artificial light level behind and around either counter or deck-mounted equipment was below the minimum 110 lux of artificial light. The areas and equipment are as follows: main galley - center behind the 5 combination ovens and behind the two ice machines beside the chef's office, pacific dining room pantry #1 lower - behind the coffee machine, crew galley - behind the two combination ovens, room service pantry - on the right side of the ice machine, lido beverage station starboard at cafe - behind the juice dispenser, lido forward taste of nation pantry port - around the ice machine, and trident bar pantry - behind the ice machine.
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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.:
39
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Site:
Food Service General-Most Food Areas - Flying Insects
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|
Violation:
In many of the food areas inspected there were live fruit or filth flies observed. The areas and counts found are as follows: main galley; garde' manger forward - 6 fruit flies on the deckhead over the port preparation counter, bakery/pastry - 1 fruit fly on the deckhead over the forward/starboard preparation counter, potwash - 1 fruit fly on the clean pot rack surface below a pan stored there, pacific dining room pantry #4 lower - 7 fruit flies on the bulkhead and deckhead, provisions fish preparation - 1 fruit fly on the door of the walk-in thawing refrigerator, vegetable preparation - 1 fruit fly on the counter model food chopper, lido buffet pantry - 6 fruit flies on the deckhead throughout and 1 filth fly, and sirens bar pantry - 1 fruit fly on the bulkhead.
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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.:
40
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Site:
Integrated Pest Management-Active Monitoring Logs
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|
Violation:
The active monitoring logs recorded instances where pests were seen with a 'Y' in the document but there were no additional information on what kind of pests were found.
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|
Recommendation:
Ensure to log as much information as needed to identify the pests found for efficient pest control procedures.
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Item No.:
41
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|
Site:
Housekeeping-Toilet Room Signs
|
|
Violation:
Passenger and crew toilet rooms did not have signs advising users to wash hands after using the toilet. Staff explained these were to be received soon from the corporate office. (2011 VSP Operations Manual)
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|
Recommendation:
Provide the passenger and crew public toilets with a handwashing station that includes a sign advising users to wash hands.
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Item No.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
|
|
Violation:
The official OPRP did not meet the written OPRP requirements per the 2011 VSP Operations Manual. A non finalized draft OPRP addressed most new requirements. (2011 VSP Operations Manual)
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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.:
42
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Site:
Children Area-
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|
Violation:
Some of the previously cleaned toys, a truck, a pirate ship, and a castle were soiled with dust and lint fibers.
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Recommendation:
Ensure toys used in the child-activity center are maintained in a clean condition.
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