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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Case Definition
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Violation:
The written AGE case definition used by the ship did not consider the number of diarrhea episodes that was above normal to certain individuals. This definition did not allow individuals with pre-existing medical conditions, such as irritable bowel syndrome, who reach 3 loose stools to be considered non-reportable cases. 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.:
02
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Site:
Medical-Asymptomatic Cabin Mates of Symptomatic Crew
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Violation:
The date and time of verbal interviews for cabin mates of symptomatic crew members was not always documented accurately. There were instances in the logs that the date and time for the follow up interviews at 0 hours, 24 hours, and 48 hours were the same.
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Recommendation:
When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions: (1) restrict exposure to symptomatic crew member(s); (2) undergo a verbal interview with medical or supervisory staff, who will confirm their condition, provide facts and a written fact sheet about hygiene and handwashing, and instruct them to report immediately to medical if they develop illness symptoms; (3) complete a verbal interview daily with medical or supervisory staff until 48 hours after the ill crew members' symptoms began. Ensure that the first verbal interview is conducted within 8 hours from the time the ill crew member initially reported to the medical staff. If the asymptomatic immediate contact or cabin mate is at work, ensure that he or she must is contacted by medical or supervisory staff as soon as possible. Document the date and time of verbal interviews.
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Item No.:
03
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Site:
Potable Water-Bunkering & Production Records
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Violation:
An instruction on bunkering and production records specified an acceptable range of pH levels between 7 and 8.
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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.:
06
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Site:
Potable Water-Microbiological Monitoring
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Violation:
The ship used Colisure for coliform tests on water samples from bunkering and distribution. The incubator was not operated in accordance with the reagent manufacturer specifications. On the day of the inspection, several samples were incubated at a temperature of 37C when the Colisure manufacturer's specified an incubation temperature of 35 +- 0.5C. An internal document was presented to the inspector where per company's policy, the incubation temperature was allowed to be between 35C and 38C but not less than 34.5C, which was different from the reagent manufacturer's specifications.
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Recommendation:
If water samples are collected and analyzed by the vessel for the presence of E. coli, analyze the samples using a method accepted in Standard Methods for the Examination of Water and Wastewater. Ensure test kits, incubators, and associated equipment are operated and maintained in accordance with the manufacturers' specifications. Analyze samples using a method accepted in Standard Methods for the Examination of Water and Wastewater. Operate and maintain test kits, incubators, and associated equipment in accordance with the manufacturers' specifications.
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Item No.:
08
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Site:
Potable Water-Distillate & Permeate Water Lines
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Violation:
The distillate water lines from the evaporators to the potable water halogenation station and the permeate water lines from the reverse osmosis plant to the potable water halogenation station were not striped or painted in accordance with ISO 14726 standards (blue/gray/blue).
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Recommendation:
Stripe or paint distillate and 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-Tank Maintenance
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Violation:
Tanks #3 port and #3 starboard underwent maintenance on 14 November 2011 and tank #6 center on 2 November 2011. There were notations that the tanks were super chlorinated and then they were put back in service. However, there was no written documentation on the free halogen residual level before the tanks were put back in service. In addition, they were touched-up with an approved coating system but there was no written documentation that the manufacturers' recommendations were followed for application, drying, and curing. Also, there was no written documentation of approval from a certification organization independent of the coating manufacturer.
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Recommendation:
Maintain documentation of all inspections, maintenance, cleaning, and disinfection for 12 months and ensure it is available for review during inspections. Ensure records include a method of disinfection, concentration and contact time of the disinfectant, and a halogen value of less than or equal to 5 ppm before the tank is put back into service. Ensure the interior coatings on potable water tanks are approved for potable water contact by a certification organization. Follow all manufacturers' recommendations for application, drying, and curing. For the tank coatings used, maintain the following onboard: (1) written documentation of approval from the certification organization (independent of the coating manufacturer); (2) manufacturers' recommendations for application, drying, and curing; and (3) written documentation that the manufacturers' recommendations have been followed for application, drying, and curing.
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Item No.:
08
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Site:
Food Service General-Chilled Water Lines
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Violation:
The nonpotable chilled water lines connected to the back of the ice machines and the ice cream 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.:
08
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Site:
Potable Water-Cross-Connection Control Program
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Violation:
A number of continuous pressure backflow prevention devices installed on combination ovens and a pastry mixer were painted over with a grey paint, sealing their intermediate air vents. These painted devices on combination ovens were in the crew galley (2 devices), Aqua Spa galley (1 device), and main hot galley (7 devices). The pastry mixer was in the pastry galley (2 devices).
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Recommendation:
Maintain backflow prevention devices in good repair. Do not paint over the intermediate vents of backflow prevention devices.
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Item No.:
10
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Site:
Recreational Water Facilities-Charts
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Violation:
The pH and halogen analyzer charts had no initials.
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Recommendation:
Initial, date, and change halogen analyzer-chart recorder charts daily. Initial and date strip recorder charts daily and indicate 24-hour increments.
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Item No.:
10
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Site:
Recreational Water Facilities-Turnover Rates
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Violation:
There was no documentation on the turnover rates for each recreational water facility.
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Recommendation:
For RWFs with skim gutters, ensure that the fill level of the RWF is to the level of the skim gutters. 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-Filter Inspection
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Violation:
There was no written documentation of filter inspection results, granular filter sedimentation test results, and length of backwashing.
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Recommendation:
Ensure a written or electronic log of RWF filter inspection results, granular filter sedimentation test results, and length of backwashing is available for review during inspections.
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Item No.:
10
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Site:
Recreational Water Facilities-Filter Backwash & Cleaning
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Violation:
According to the staff, an individual was not always present in the filter room during automatic backwashing of filters to ensure that backwashing was repeated as necessary until the water runs clear.
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Recommendation:
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.
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Item No.:
10
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Site:
Recreational Water Facilities-Filter Housings
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Violation:
According to the staff, filter housings on the RWFs were cleaned and disinfected, but there was no documentation regarding the frequency of cleaning, disinfectant concentration, or contact time.
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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 & Lint Strainers
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Violation:
According to the staff, hair and lint strainers and hair and lint strainer housings on the RWFs were cleaned and disinfected, but there was no documentation regarding the frequency of cleaning, disinfectant concentration, or contact time.
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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-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.
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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-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.:
10
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Site:
Recreational Water Facilities-Safety Signs
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Violation:
The safety signs for the RWFs did not have bather load information.
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Recommendation:
Ensure the signs include bather load numbers.
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Item No.:
10
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Site:
Recreational Water Facilities-Antientrapment/Antientanglement Requirements
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Violation:
The drains for the swimming pools did not meet the antientrapment drain requirements per the 2011 VSP Operations Manual. The forward swimming pool had gravity drains less than 3 feet apart with only one antientrapment drain cover and no alarm or gravity draining system. The aft swimming pool had gravity drains more than 3 feet apart with only one antientrapment drain cover and no alarm for draining.
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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. For RWFs with gravity drainage and a single blockable drain or multiple drains less than 3 feet apart, provide an ASME A112.19.8 compliant antientrapment/antientanglement drain cover and a gravity drainage system.
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Item No.:
10
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Site:
Housekeeping-Private Whirlpool Spas
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Violation:
Private whirlpool spas logs instructed to disinfect with an halogen-based disinfectant at 50 ppm for 10 minutes.
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Recommendation:
Clean and disinfect private whirlpool spas located in individual passenger cabins, including associated recirculation systems, between occupancies or weekly, whichever is more frequent. Ensure disinfection is accomplished with an appropriate halogen-based disinfectant at 10 ppm for 60 minutes, or an equivalent CT value.
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Item No.:
16
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Site:
Buffet-Staff Mess
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Violation:
The time control plan was posted for this outlet, but the refrigeration units on time control were not physically labeled as such.
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Recommendation:
Ensure the plan lists 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.:
16
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Site:
Food Service General-Consumer Advisories
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Violation:
The menus for Qsine, Bistro on 5, Blu, and S.S. United States did not have asterisks 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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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 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.:
20
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Site:
Galley-Pastry
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Violation:
There were protruding cloth fibers from the woven dough sheeter belt at the food contact surface. This was corrected.
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Recommendation:
Ensure that fibers are removed to prevent contamination.
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Item No.:
21
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Site:
Galley-Bain Marie
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Violation:
The steam valve inside the technical compartment was badly corroded and had chipping paint.
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Recommendation:
Ensure nonfood-contact surfaces of equipment that are exposed to splash, spillage, or other food soiling or that require frequent cleaning are constructed of a corrosion-resistant, nonabsorbent, and smooth material.
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Item No.:
21
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Site:
Buffet-Aqua Spa Beverage Station
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Violation:
The power cables to the counter-mounted ice, milk, and juice dispensers were draped on the counter, making cleaning difficult.
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Recommendation:
Shorten and/or support the power cables above the counter to allow for easy cleaning.
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Item No.:
22
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Site:
Galley-Dishwash
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Violation:
The final rinse temperature gauge on the in-use flight-type dishwash indicated temperatures of 200-220F. The temperature at the plate surface was 170F. Also, the prewash temperature gauge was reading below 100F and was measured with the inspector's thermometer at 140-150F.
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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.:
26
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Site:
Preparation Room-Deck 1 - Production Galley
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Violation:
A previously cleaned and sanitized tomato slicer had dried tomato residue on the blades. This equipment was immediately sent to be re-cleaned and sanitized.
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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.:
33
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Site:
Buffet-Staff Mess
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Violation:
The tile deck below the counter mounted automatic ice and water dispenser was badly chipped and cracked.
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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-Deck 10 - Lido Ice Cream Station
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Violation:
The chilled water lines for the ice cream machine were laying on the deck immediately below the machine. Water and food debris were under the machine.
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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. 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-Bell Box
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Violation:
The deckhead at the beverage station above the coffee machines was not smooth and easily cleanable.
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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.:
36
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Site:
Buffet-Staff, Officer, and Crew Service Lines
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Violation:
The light intensity at the service lines at each of these locations was 40 to 60 lux when measured with the inspector's light meter.
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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:
Bar-Sunset Bar
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Violation:
The light intensity over the handwash station was less than 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) behind and around mounted equipment, including counter-mounted equipment.
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Item No.:
39
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Site:
Food Service General-Flies
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Violation:
Small black flies were found in multiple food service outlets throughout the ship. One live small black fly was flying above the handwash sink in the production galley; one live small black fly was near the deck underneath the counter mounted water/ice dispensing machine in the staff mess; one small black fly was in the crew dishwash room flying above the drying rack for clean and sanitized utensils; three live small black flies were on the deckhead above the ice cream machine at the Lido ice cream station; three live small black flies were above the starboard side pastry oven in the pastry galley; one live small black fly was above the ice cream machine in the pastry galley; one live small black fly was on the dough press in the main galley bakery; one live small black fly was in the Sunset Bar pantry near the door.
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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-
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Violation:
The integrated pest management log did not include follow-up inspection results for some of the inspections after 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.:
41
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Site:
Housekeeping-Public Toilets
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Violation:
There were no signs posted advising users of toilet facilities to use hand towel, paper towel, or tissue to open the door after using the toilet.
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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.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan
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Violation:
The OPRP did not include procedures to minimize respiratory and dermal exposures to both passengers and crew. During the inspection, a housekeeping staff member was fogging in the vicinity area of the Cafe al Bacio. The bar manager, the bartender, the VSP inspector, and a group of violinists performing at the time were exposed to the fogging, making them cough after breathing the disinfectant mist.
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Recommendation:
Ensure each vessel has a written OPRP that details standard procedures and policies to specifically address AGE onboard. Include in the written OPRP health and safety procedures to minimize respiratory and dermal exposures to both passengers and crew.
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Item No.:
43
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Site:
Housekeeping-Shower Heads
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Violation:
Shower head logs instructed to disinfect with an halogen-based disinfectant at 50 ppm for 10 minutes.
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Recommendation:
Clean and disinfect shower heads every 6 months. Disinfect with an appropriate halogen-based disinfectant at 10 ppm for 60 minutes, or an equivalent CT value.
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