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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The electronic AGE log was not exact to the VSP log provided in annex 13.2.2 of the VSP 2011 Operations Manual. There were added fields within the form for total population onboard and total reportable cases. There was an additional column added under fever for C, and the report to medical date and time field was changed to medical date.
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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) Surveillance Log
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Violation:
The temperature was not recorded consistently when the fever determination was 'no'. The staff stated that the temperature was always taken and recorded in the medical visit log, which was provided for review.
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Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain a recorded temperature.
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Item No.:
05
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Site:
Potable Water-Far Point Distribution Analyzer
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Violation:
The chlorine analyzer at the far point in the potable water distribution system displayed a free chlorine residual reading of 1.50 ppm and the ship's test kit reading was 2.12 ppm and the inspector's kit registered over 2.20 ppm. A second manual test on the ship's kit registered 2.20 ppm while the analyzer reading was 1.53 ppm and the inspector's kit registered over 2.20 ppm. The far point analyzer was immediately calibrated and later compared again to the ship's test kit, showing an accurate value.
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Recommendation:
Ensure the free residual halogen measured by the halogen analyzer is within 0.2 mg/L (ppm) of the free residual halogen measured by the manual test.
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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.:
09
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Site:
Recreational Water Facilities-Aurea Spa
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Violation:
The three whirlpools spas in the spa were open and the free chlorine residual in the two whirlpool spas operating through the same compensation tank (forward port and aft/starboard) was 1.42 ppm and 1.45 ppm as tested on the ship's manual kit and the inspector's kit. The whirlpool spas were immediately closed for adjustment. The chlorine residual was raised to 8 ppm in both whirlpool spas and they were re-opened.
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Recommendation:
Maintain a free residual halogen in whirlpool spas and spa pools between 3.0 and 10.0 mg/L (ppm) free chlorine or between 4.0 and 10.0 mg/L (ppm) bromine.
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Item No.:
09
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Site:
Recreational Water Facilities-Children's Pool
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Violation:
There was one adult and one child in the children's pool and the free chlorine residual was 0,54 ppm on the first test and 0.27 ppm on the second test from the inspector. The pool was immediately closed and re-opened after the residual was raised to 2 ppm.
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Recommendation:
Maintain a free residual halogen in children's pools between1.0 and 5.0 mg/L (ppm).
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Item No.:
10
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Site:
Recreational Water Facilities-Forward and Aft Pools
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Violation:
The rescue hooks for the pools had telescoping type poles.
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Recommendation:
Ensure the pole of the rescue or shepherd's hook is long enough to reach the center of the deepest portion of the pool from the side plus 2 feet. Ensure it is a light, strong, nontelescoping material with rounded, nonsharp ends.
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Item No.:
10
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Site:
Recreational Water Facilities-Antientrapment Requirements
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Violation:
There was no safety vacuum release system or automatic pump shut-off system for the dual suction drains on each of the whirlpool spas in the pool area and the Aurea Spa. Additionally, the three pools had dual gravity drains with covers custom constructed at the shipyard and there was no alarm at the pools which would sound when the drain was activated (open). There was no letter from a registered design professional to verify issues such as hair and finger entrapment.
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Recommendation:
For RWFs with suction fittings 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 safety vacuum release system or automatic pump shut-off system. 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. Ensure the design of custom/shipyard constructed (field fabricated) drain covers and suction fittings is fully specified by a registered design professional in accordance with ASME A112.19.8-2007. Ensure the specifications fully address cover/grate loadings, durability, hair, finger and limb entrapment issues, cover/grate secondary layer of protection, related sump design, and features specific to the RWF. Provide a letter from the shipyard for each custom/shipyard constructed (field fabricated) drain cover fitting. At a minimum, ensure the letter specifies the shipyard, name of the vessel, specifications and dimensions of the drain cover, as well as the exact location of the RWF for which it was designed. Ensure the name of and contact information for the registered design professional and signature are on the letter.
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Item No.:
10
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Site:
Recreational Water Facilities-Safety Signs
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Violation:
There were portable signs at the RWFs with the information from sections 6.7.1.1.1 and 6.7.1.1.3 of the 2011 VSP Operations Manual. New permanent signs were ordered according to staff.
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Recommendation:
Ensure to post safety signs in permanent locations for all recreational water facilities.
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Item No.:
10
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Site:
Recreational Water Facilities-Monitoring Analyzer/Recorder
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Violation:
There was no chart recorder or electronic data logger to record pH and halogen measurements directly from the whirlpools or pools. Staff stated that this equipment was to be installed in the next drydock.
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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-Monitoring
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Violation:
Staff were not monitoring total alkalinity, total chlorine, or flow rates in any of the pools or whirlpool spas.
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Recommendation:
Monitor and adjust the RWF's flow rates, free and combined halogen levels, pH, total alkalinity, and clarity as recommended by the manufacturer and to maintain optimum public health protection and water chemistry.
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Item No.:
16
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Site:
Food Service General-Time Control Plans
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Violation:
The time control plans in the food areas did not list refrigeration and hot holding units on time control.
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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 plans 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.:
16
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Site:
Buffet-Port Egg Station
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Violation:
The consumer advisory for the egg station where consumers could order eggs in an undercooked form was posted on a nearby bulkhead and not at the station itself. In addition, the posted advisory was printed in a very small font due to it was printed in six different languages, making it difficult to read.
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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 the advisory is posted at the specific station where the food is served raw, undercooked, or cooked to order.
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Item No.:
16
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Site:
Other-Kaito Sushi Bar
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Violation:
There was a consumer advisory at each of the 2 waiter stations but no consumer advisory on the menu. There were animal-derived foods that could be served raw.
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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. 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:
Other-Le Fontane Restaurant
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Violation:
The menus had a consumer advisory, but did not have asterisks identifying those animal-derived products that could be served raw or undercooked.
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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.:
18
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Site:
Provisions-Meat Holding Walk-In Cooler
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Violation:
Two large plastic containers of raw ground meat balls were stored on a rack directly above several covered plastic bins of raw cuts of pork and veal. Staff repositioned the meat ball containers below the other meat cuts.
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Recommendation:
Protect food from cross-contamination or other sources of contamination by the following methods: (1) 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. (2) Separating types of raw animal foods from each other such as beef, fish, lamb, pork, and poultry-except when combined as ingredients-during storage, preparation, holding, and display by using separate equipment for each type, or by arranging each type of food in equipment so that cross-contamination of one type with another is prevented, or by preparing each type of food at different times or in separate areas. (3) Cleaning and sanitizing equipment and utensils. (4) Storing the food in packages, covered containers, or wrappings. (5) Cleaning visible soil on hermetically sealed containers of food before opening. (6) Protecting food containers that are received packaged together in a case or overwrap from cuts when the case or overwrap is opened. (7) Separating damaged, spoiled, or recalled food being held on the vessel. (8) Separating unwashed fruits and vegetables from ready-to-eat food.
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Item No.:
20
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Site:
Galley-Deck 6 - Pastry
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Violation:
There were loose and protruding cloth fibers from the woven dough sheeter belt at the food contact surfaces. All belt sides were very worn and in bad condition.
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Recommendation:
Replace the worn dough sheeter belt.
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Item No.:
21
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Site:
Other-Palladio Restaurant
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Violation:
The portable induction unit had rough surfaces, crevices, and exposed raw wood, making cleaning difficult.
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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. Ensure nonfood-contact surfaces are free of unnecessary ledges, projections, and crevices, and designed and constructed to allow easy cleaning and to facilitate maintenance.
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Item No.:
21
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Site:
Buffet-Pompeiana Bar
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Violation:
The potable water delivery line to the orange juice machine was draped on the counter, making cleaning difficult.
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Recommendation:
Shorten and/or support the water delivery line above the counter to allow for easy cleaning.
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Item No.:
22
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Site:
Galley-Deck 6 - Pastry
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Violation:
During the active use of the flight-type dishwasher, one of the upper final sanitizing rinse spray nozzles was clogged. This was corrected 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.:
27
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Site:
Buffet-Starboard Beverage Station
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Violation:
There was an accumulation of dust on the knob used to open the drain of the ice dispenser. The knob was located to the right of the ice dispensing chute. This area was in active use at the time of the inspection.
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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.:
29
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Site:
Preparation Room-
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Violation:
The access to the handwash station was blocked by two 5-foot stacks of soiled plastic containers. The area was in use at the time of the inspection. This was corrected.
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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.:
30
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Site:
Buffet-Port Service Line
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Violation:
There was no 'wash hands often' sign at the handwash station.
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Recommendation:
Post a sign over handwashing sinks stating "WASH HANDS OFTEN" in a language that the food employees understand.
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Item No.:
34
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Site:
Buffet-Port Egg Station
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Violation:
The faucet of the utility sink was continuously dripping.
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Recommendation:
Ensure the plumbing system in the food area is maintained in good repair.
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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.:
37
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Site:
Buffet-Dishwash
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Violation:
There was excessive condensation on the deckhead of the soiled end of the in-use flight-type dishwash machine. The condensate was heavily dripping onto the soiled landing. The exhaust system was operating, but was not effectively removing the humidity. This was noted during the previous inspection.
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Recommendation:
Ensure exhaust ventilation hood systems in food preparation and warewashing areas--including components such as hoods, fans, guards, and ducting--are designed to prevent grease or condensation from draining or dripping onto food, equipment, utensils, linens, and single-service and single-use articles.
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Item No.:
37
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Site:
Galley-
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Violation:
There was heavy condensation on the deckhead in front of the right in-use combination oven. In addition, excessive steam was drifting from the bottom of the door and the deck was wet from this steam.
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Recommendation:
Ensure exhaust ventilation hood systems in food preparation and warewashing areas--including components such as hoods, fans, guards, and ducting--are designed to prevent grease or condensation from draining or dripping onto food, equipment, utensils, linens, and single-service and single-use articles.
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Item No.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
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Violation:
There were no written procedures in the OPRP addressing notification of passengers of a gastrointestinal outbreak or notification of oncoming passengers that the ship experienced an outbreak on the previous voyage.
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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 procedures for informing passengers and crew members of the outbreak, ensuring to include procedures for notification of passengers embarking the vessel following an outbreak voyage or segment of a voyage.
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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 explain in detail the steps for the sanitizer application during code red situations. There was also more than one sanitizer mentioned for this procedure. The staff explained that the sanitizer was replaced and that this was the reason why more than one sanitizer was mentioned in the plan.
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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 disinfectant products or systems used, including the surfaces or items the disinfectants will be applied to, concentrations, and required contact times.
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Item No.:
41
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Site:
Housekeeping-Public Toilets
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Violation:
There were no signs advising handwashing in any of the decks 5, 6, and 13 disabled toilet stalls in the public toilets. In addition, there were no signs advising the use of hand towels, paper towel, or tissue to open the door when exiting these stalls.
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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. 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-Public Toilets
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Violation:
The pictograph signs advising handwashing in all the public toilets were not at the handwash stations, but were posted on the exit doors of these toilet rooms.
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Recommendation:
Post the signs advising passengers to wash their hands close to the handwash stations.
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Item No.:
42
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Site:
Children Area-Handwash Stations
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Violation:
The hot water in the toilet room handwash station and the stations in the play room area reached a temperature of 125F.
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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-Child Toilet Room
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Violation:
The height of the handwashing sink in the toilet room was more than 22 inches and the height of the child-size toilet was more than 11 inches. No step stools were provided.
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Recommendation:
If toilet rooms are located in a child-activity center, provide a child-size toilet(s) or child-accessible toilet(s) (child-size seat and step stool) and handwashing facilities. Ensure child-size toilets (to include the toilet seat) have a maximum height of 280 millimeters (11 inches) and sinks have a maximum height of 560 millimeters (22 inches) above the deck or a step stool.
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