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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The required items in the AGE surveillance log were not in the correct order according to the 2011 VSP Operations Manual. Also, the AGE surveillance log only indicated an individual had a fever if their temperature was above 38C but the actual temperatures were not recorded. In addition, the time an individual reported to medical was not included in the AGE surveillance log. Finally, the AGE surveillance log automatically determined whether a case was reportable or not depending on the number of episodes of diarrhea entered into the log by the medical staff.
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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 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).
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Item No.:
08
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Site:
Potable Water-Striping
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Violation:
The distillate lines form the evaporators to the chlorine injection system were not striped 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). Ensure no other lines have the above color designations. Stripe or paint these lines at 5 meters (15 feet) intervals and on each side of partitions, decks, and bulkheads, except where decor would be marred by such markings, including potable water supply lines in technical lockers.
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Item No.:
08
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Site:
Food Service General-Chilled Water Lines
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Violation:
The chilled water lines for the ice machines in the food areas were not uniquely identified.
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Recommendation:
Uniquely identify all refrigerant brine lines in all galleys, pantries, and cold rooms to prevent cross-connections.
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Item No.:
10
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Site:
Recreational Water Facilities-Sample Lines
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Violation:
The sample lines were after the compensation tanks for each of the RWFs.
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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. 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.
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Item No.:
10
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Site:
Recreational Water Facilities-Shepherd's Hooks
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Violation:
The shepherd's hooks at all of the swimming pools were not long enough to reach the center of the deepest portion of the pools from the side plus two feet.
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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-Shock Halogenation
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Violation:
The concentration of free residual halogen was not recorded at the start or at the completion of shock halogenation for the whirlpools.
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Recommendation:
Ensure a written or electronic record of the date and time of water dumping and shock halogenation (concentration in ppm at the start and completion and time) is available for review during inspections.
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Item No.:
11
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Site:
Medical-Crew Reporting
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Violation:
A nonfood worker in the Accommodations department had an illness onset of AGE on April 19, 2012 at 10:00 a.m., but did not report to the medical center until April 20, 2012 at 9:00 a.m. According to their time card, this individual worked several hours before reporting to medical. A nonfood worker in the youth center had an illness onset of AGE on April 2, 2012 at 6:00 p.m., but did not report to the medical center until April 3, 2012 at 6:10 p.m. According to their time card, this individual worked before reporting to medical.
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Recommendation:
When nonfood employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 24 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document the date and time of last symptom and clearance to return to work. Ensure nonfood employees with AGE symptoms report to the medical center immediately.
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Item No.:
16
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Site:
Food Service General-Consumer Advisories
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Violation:
In the lido, there were animal-derived foods served raw or undercooked such as cold smoked salmon and eggs, but these foods were not identified and the signs included the consumer advisories but were not posted at the food outlets where these items were served. Also, the menus for the specialty restaurants, main dining rooms, and room service had animal-derived foods that could be served raw or undercooked but there were no consumer advisories on the menu. In addition, the sign at the Vines sushi counter did not identify the foods served raw but did have a consumer advisory statement.
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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. (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.:
19
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Site:
Other-Hotel Locker 14125
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Violation:
There was one container of coffee condiments and one box of bottled water stored on the deck. There were also several bottles of cleaning chemicals and personal care items stored in this locker.
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Recommendation:
Protect food from contamination by storing the food: (3) Where it is not exposed to splash, dust, or other contamination; and (4) At least 15 centimeters (6 inches) above the deck.
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Item No.:
20
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Site:
Galley-Deck 6
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Violation:
The ice machine chute was corroded.
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Recommendation:
Materials used in the construction of multiuse utensils and food contact surfaces of equipment must be: (1) durable, corrosion resistant, and nonabsorbent.
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Item No.:
21
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Site:
Galley-Trident Grill Walk-in Unit 15320
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Violation:
The wheel casters on the food transportation trolleys were corroded and difficult to clean.
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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:
Galley-
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Violation:
The wheel casters on the food transportation trolleys were corroded and difficult to clean.
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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:
Provisions-Fish Defrosting Walk-in Cooler 4722
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Violation:
There were seven upright food transportation trolleys that were corroded in several areas.
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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:
Preparation Room-
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Violation:
The wheels of the food transportation trolley were broken and difficult to clean.
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Recommendation:
Ensure nonfood contact equipment is maintained in good repair and proper adjustment including: (2) Equipment components are kept intact, tight, and adjusted in accordance with manufacturer's specifications. 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:
Bar-Vines
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Violation:
The power cable to the microwave oven was draped on the counter, making cleaning difficult.
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Recommendation:
Secure or shorten the power cable above the counter to make cleaning easier.
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Item No.:
22
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Site:
Galley-Deck 6 Forward Port Warewashing
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Violation:
The temperature gauge for the final sanitizing rinse of the in-use flight type warewash machine indicated 180F, but the temperatures of the final sanitizing rinse measured by the inspector's thermometer at the plate surface were 148F and 152F. Also, there was an excessive amount of water flowing out of the right upper final sanitizing rinse spray arm.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: (2) water pressure and water temperature-measuring devices are maintained in good repair and accurate within the intended range of use.
Ensure a warewashing machine and its auxiliary components are operated in accordance with the machine?s data plate and other manufacturer?s instructions.
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Item No.:
22
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Site:
Galley-Pizzeria
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Violation:
The undercounter warewash machine was out of order. According to the staff, the machine had been out of order for more than one month and will be repaired when the spare parts arrive.
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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.
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Item No.:
22
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Site:
Galley-Cafe Caribe Warewashing
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Violation:
The temperature gauge for the final sanitizing rinse of the in-use flight type warewash machine indicated 190F, but the temperatures of the final sanitizing rinse measured by the inspector's thermometer at the plate surface were 144F and 156F.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: (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:
Other-Hotel Locker 14125
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Violation:
There were two soiled drinking glasses stored on the deck.
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Recommendation:
Ensure drainboards, utensils, racks, or tables large enough to accommodate all soiled and cleaned items that may accumulate during hours of operation are provided for necessary utensil holding before cleaning and after sanitizing.
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Item No.:
22
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Site:
Other-Deck 14 Garbage Store 14346
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Violation:
There were several soiled dishes, utensils, and trays stored on the deck throughout this locker. There were so many soiled items on the deck, there was no access to the cleaning locker within this area.
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Recommendation:
Ensure drainboards, utensils, racks, or tables large enough to accommodate all soiled and cleaned items that may accumulate during hours of operation are provided for necessary utensil holding before cleaning and after sanitizing.
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Item No.:
24
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Site:
Galley-Cafe Caribe Warewashing
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Violation:
During the active use of the flight type conveyor warewash machine, the temperatures of the final sanitizing rinse measured by the inspector's thermometer at the plate surface were 144F and 156F.
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Recommendation:
In a mechanical operation, ensure the temperature of the fresh hot water sanitizing rinse as it enters the manifold is not more than 90C (194F) or less than: (1) 74C (165F) for a stationary rack, single-temperature machine; (2) 82C (180F) for all other machines. Ensure the utensil surface temperature is not less than 71C (160F) as measured by an irreversible registering temperature indicator.
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Item No.:
24
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Site:
Galley-Deck 6 Forward Port Warewashing
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Violation:
During the active use of the flight type conveyor warewash machine, the temperatures of the final sanitizing rinse measured by the inspector's thermometer at the plate surface were 148F and 152F.
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Recommendation:
In a mechanical operation, ensure the temperature of the fresh hot water sanitizing rinse as it enters the manifold is not more than 90C (194F) or less than: (1) 74C (165F) for a stationary rack, single-temperature machine; (2) 82C (180F) for all other machines. Ensure the utensil surface temperature is not less than 71C (160F) as measured by an irreversible registering temperature indicator.
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Item No.:
27
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Site:
Galley-
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Violation:
The back of the technical compartment for the ice machine was soiled with a brown material.
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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.:
27
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Site:
Buffet-Horizon Court Starboard Egg Station
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Violation:
The light stand at the carving station was heavily soiled with dust.
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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.:
27
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Site:
Galley-Pizzeria
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Violation:
The technical compartment of undercounter refrigerator 15.48 was heavily soiled with moist dust.
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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.:
27
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Site:
Preparation Room-
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Violation:
The technical compartment of the vegetable washing sink was soiled with a moist debris.
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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.:
27
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Site:
Galley-Trident Grill Pantry
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Violation:
The technical compartment of undercounter refrigerator 15.52 was heavily soiled with moist dust.
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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:
Other-Deck 14 Garbage Store 14346
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Violation:
There were several pieces of ice in the handwashing sink.
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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.:
31
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Site:
Other-Hotel Locker 14125
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Violation:
There were several bottles of cleaning chemicals and personal care items stored on the deck near one container of coffee condiments and one box of bottled water.
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Recommendation:
Store poisonous or toxic materials used in the cleaning and maintenance of food areas in a cleaning materials locker so they cannot contaminate food, equipment, utensils, linens, and single-service and single-use articles.
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Item No.:
33
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Site:
Other-Deck 14 Garbage Store 14346
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Violation:
The deck was soiled with juice. Also, there were so many soiled items on the deck, the deck was not easy to clean.
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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. 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:
Galley-Trident Grill Pantry
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Violation:
The deck under the food and nonfood cabinets was soiled with dust and food debris. This area was previously cleaned and not in operation at the time of the inspection.
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Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
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Item No.:
33
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Site:
Bar-Crown Grill Door 7.6.12
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Violation:
The side of the door frame was heavily soiled with white mold and there was pooled water and black mold within the door threshold.
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Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
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Item No.:
33
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Site:
Provisions-Meat Walk-in Cooler 4716
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Violation:
The seams between the deckhead panels were heavily soiled with a black and pink material that appeared to be mold.
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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:
Food Service General-Lighting
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Violation:
The light intensity was less than 110 lux behind and around many pieces of deck- and counter-mounted equipment in the pantries and galleys.
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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.:
36
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Site:
Other-Deck 14 Garbage Store 14346
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Violation:
The light intensity was less than 220 lux above the handwashing station.
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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.:
40
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Site:
Integrated Pest Management-Active Surveillance Log
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Violation:
The active surveillance log did not include the follow-up inspection results of the observed pests.
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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-Outbreak Prevention and Response Plan (OPRP)
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Violation:
The OPRP did not include: the concentrations of the disinfectants used for green, yellow, or red sanitation levels, the contact time for the disinfectant used during the red sanitation level, procedures for returning the ship back to normal operating conditions after an outbreak, or procedures for protecting passengers from exposure to disinfectants.
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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: (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); (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.:
41
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Site:
Children Area-Diaper Changing Station
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Violation:
There was no sign advising users of the toilet room to exit using paper towels. The exit was not hands free.
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Recommendation:
Post a sign advising users of toilet facilities to use hand towel, paper towel, or tissue to open the door unless the exit is hands free.
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Item No.:
42
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Site:
Children Area-
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Violation:
The written exclusion policy posted at the entrance of the child care center did not include procedures to be followed when a child develops symptoms of an infectious illness while at the child activity center.
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Recommendation:
Ensure the child activity center has a written exclusion policy on procedures to be followed when a child develops symptoms of an infectious illness while at the center. Ensure the exclusion policy includes a requirement for written clearance from the medical staff before a child with symptoms of infectious illness can be allowed in the child activity center. Post the policy at the entrance of the child activity center.
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