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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 on the intake questionnaire listed the case definition for AGE as being 3 or more episodes of diarrhea or 1 episode of vomiting plus 1 other symptom and did not consider the number of diarrhea episodes that was above normal to certain individuals. At least 4 individuals were listed as non-reportable cases, but there was no indication on the AGE log or medical notes that the medical staff determined that their symptoms were not above normal for them. If above normal, they should have been determined to be reportable cases. Specifically, (1) on August 6, a crew member reported 2 episodes of diarrhea, no medication was dispensed, and no underlying illness was documented; (2) on August 3, a crew member reported 2 episodes of diarrhea, no medication was dispensed, and no underlying illness was documented; (3) on July 30, a passenger reported 1 episode of diarrhea, no medication was dispensed, and no underlying illness was documented; (4) on July 28, a passenger reported 1 episode of diarrhea, no medication was dispensed, and no underlying illness was documented. In addition, at least two of these non-reportable cases on the AGE log were included as reportable cases on the 24-hour AGE MIDRS reports submitted on August 14 and July 26.
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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]). Ensure that 24-hour reports reflect the information and counts as recorded on the AGE log.
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Item No.:
06
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Site:
Potable Water-Distribution System
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Violation:
The review of the charts from the distant point automated analyzer-chart recorder since the previous inspection revealed that several free residual halogen levels on the charts varied by 0.3 to 1.0 ppm from the results of manual tests. In only some instances, a calibration change was made and indicated on the charts. This practice was repeated frequently through the month of July and August 2013. There were notations in July indicating that there were differences in the manual test results and chart values and that new equipment was ordered. The staff explained that although the chart values were different from the manual test results, the analyzer readings were accurate to their manual tests. The staff added that they understood that there was not a calibration problem but indeed a problem with the automated analyzer-chart recorder.
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Recommendation:
Complete repairs on malfunctioning halogen analyzer-chart recorders within 10 days of equipment failure.
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Item No.:
10
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Site:
Recreational Water Facilities-Maintenance Records
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Violation:
The staff described their activities for cleaning and disinfecting the pool and whirlpool spa filter housing as well as the hair and lint strainer and the housing. The logs for these RWFs documented nearly all of this maintenance, except there was nothing written that the hair and lint strainer housings were cleaned and disinfected.
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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. Ensure to record details of the cleaning and disinfection of hair and lint strainer housings in their maintenance logs.
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Item No.:
10
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Site:
Recreational Water Facilities-Water Tunnel
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Violation:
There was no monitoring automated analyzer-chart recorder installed on the return line of this RWF. A variance request submitted by the cruise line to waive this requirement was not approved. The water cannon features on this wet play area were only chlorinated from the main potable water supply from the ship's distribution system. That lower halogen level would dilute the return line halogen analysis and thereby provide an erroneous reading for the entire RWF. The cruise line RWF designers were advised on this issue and are preparing some solution to both issues. This RWF has not been in operation.
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Recommendation:
Ensure that there is sufficient halogenation applied on the water cannons installed on this RWF so it meets the minimum RWF halogenation requirements prior to release in the wet play area of the system. 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.:
16
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Site:
Room Service-Deck 5 Room Service Pantry
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Violation:
Two large containers of individually wrapped butter had temperatures of 46-54F inside upright refrigerator #2. The staff took them to the blast chiller.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain potentially hazardous foods at 57C (135F) or above, except that roasts may be held at a temperature of 54C (130F); or 5C (41F) or less.
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Item No.:
16
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Site:
Room Service-Deck 5 Room Service Pantry
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Violation:
The temperature of18 containers of 2 liters each of chocolate ice cream liquid mix held on the cold top counter was 56-64F. The staff stated the containers were being thawed for the lunch service and that this was the usual practice. The staff could not state since when the containers were placed out of temperature control. The containers were discarded.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain potentially hazardous foods at 57C (135F) or above, except that roasts may be held at a temperature of 54C (130F); or 5C (41F) or less.
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Item No.:
16
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Site:
Bar-Sir Samuel
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Violation:
Hot trolley #15 was a time control unit and was not listed as such on the time control plan.
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Recommendation:
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.:
17
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Site:
Room Service-Deck 5 Room Service Pantry
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Violation:
The staff was thawing 18 containers of 2 liters each of chocolate ice cream liquid mix on the cold top counter at ambient temperature. These mixes had temperatures of 56-64F. The staff stated that the containers were being thawed for the lunch service and that this was the usual practice. The staff could not state since when the containers were placed out of temperature control. The containers were discarded.
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Recommendation:
Thaw potentially hazardous food: (1) Under refrigeration that maintains the food temperature at 5C (41F) or less; or (2) Completely submerged under running water at a water temperature of 21C (70F) or below, with sufficient water velocity to agitate and float off loose particles in an overflow, and for a period of time that does not allow thawed portions of ready-to-eat food to rise above 5C (41F), (3) Completely submerged under running water at a water temperature of 21C (70F) or below, with sufficient water velocity to agitate and float off loose particles in an overflow, and for a period of time that does not allow thawed portions of a raw animal food requiring cooking to be above 5C (41F) for more than 4 hours, including the time the food is exposed to the running water and the time needed for preparation for cooking, OR the time it takes under refrigeration to lower the food temperature to 5C (41F). (4) As part of a cooking process if the frozen food is cooked or thawed in a microwave oven, (5) Using any procedure if a portion of frozen ready-to-eat food is thawed and prepared for immediate service in response to an individual consumer's order.
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Item No.:
19
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Site:
Galley-Todd English Potwash
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Violation:
An insect light trap was located over a large amount of clean utensils.
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Recommendation:
Do not locate insect control devices, such as insect light traps, over food storage, food preparation areas, food service stations, or clean equipment. Prevent dead insects and insect fragments from falling on exposed food.
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Item No.:
19
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Site:
Other-Crew Shop
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Violation:
Bags of candy were displayed directly on the deck carpet. Boxes of candy were stored directly on the deck under the locker shelves.
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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.
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Item No.:
19
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Site:
Buffet-Kings Court La Piazza
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Violation:
There was no serving utensil for a tray of bacon. This was corrected.
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Recommendation:
Provide food-dispensing utensils for each container displayed at a consumer self-service unit such as a buffet or salad bar.
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Item No.:
19
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Site:
Other-Deck 9 Concierge Lounge
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Violation:
A tray cover was protecting half of a pastry. This was corrected. In addition, the food-contact portion of the serving utensil for the tray of pastries was not covered or located beneath shielding during service.
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Recommendation:
Protect food on display from contamination by the use of packaging; counter, service line, or salad bar food guards; display cases; self-closing hinged lids; or other effective means. Install side protection for sneeze guards if the distance between exposed food and where consumers are expected to stand is less than 1 meter (40 inches). During service, ensure the food contact portion of each self-service food dispensing utensil is covered or located beneath shielding.
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Item No.:
19
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Site:
Provisions-Vegetable and Potato Room
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Violation:
Near the right high fog sprinkler, water dripped on two boxes of potatoes. Staff relocated the boxes so they were not below the dripping water.
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Recommendation:
Protect food from contamination by storing the food: (2) In a clean, dry location; (3) Where it is not exposed to splash, dust, or other contamination.
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Item No.:
19
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Site:
Preparation Room-
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Violation:
Bread products were uncovered and unprotected on the top rack of two trolleys. During the inspection, a crew member covered these bread products with paper.
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Recommendation:
Protect food from contamination by storing the food: (1) Covered or otherwise protected; (3) Where it is not exposed to splash, dust, or other contamination.
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Item No.:
20
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Site:
Pantry-Deck 4 Pantry 2
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Violation:
The magnet to hold the left side white plastic deflector panel on the top compartment of the ice machine was held in place with black electrical tape. The tape was removed immediately.
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Recommendation:
Ensure multiuse food-contact surfaces are: (1) Smooth; (2) Free of breaks, open seams greater than 0.8 mm (1/32 inch), cracks, chips, inclusions, pits, and similar imperfections; (3) Free of sharp internal angles, corners, and crevices; (4) Finished to have smooth welds and joints. 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.
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Item No.:
21
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Site:
Galley-Hot Galley
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Violation:
Plastic rolling containers of sugar and flour had broken lids.
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Recommendation:
Repair or replace the plastic lids of the sugar and flour containers.
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Item No.:
21
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Site:
Room Service-Deck 5 Room Service Pantry
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Violation:
The door gasket of upright refrigerator #2 was loose, making the door not to close properly. This was corrected.
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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.:
21
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Site:
Other-Consumable Locker 6.1.5
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Violation:
Wooden pallets were used in this locker to hold single-service articles. The wood surfaces makes them 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.:
22
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Site:
Galley-Dishwash
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Violation:
A large amount of food debris was in the wash compartment of the in-use dishwash machine.
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Recommendation:
Ensure warewashing machines, drainboards, and the compartments of sinks, basins, or other receptacles used for washing and rinsing equipment, utensils, or raw foods, or laundering wiping cloths are cleaned: (2) throughout the day at a frequency necessary to prevent recontamination of equipment and utensils and to ensure that the equipment performs its intended function.
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Item No.:
26
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Site:
Pantry-Chart Room
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Violation:
The tip of the tubing going to the milk container of the previously cleaned espresso machine was soiled with dark residues.
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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.:
26
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Site:
Galley-Queens Grill
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Violation:
A previously cleaned deli slicer had a slight build-up of food residue under the slicer's backplate next to the exit path of the food from the slicer blade.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
26
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Site:
Buffet-Kings Court La Piazza
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Violation:
At least four previously cleaned and out for service plates had their food contact surfaces soiled with food debris. These plates were removed.
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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.:
28
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Site:
Food Service General-Hotel Stores & Lockers
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Violation:
There were exposed air handling ducts, water pipes, and electrical cabling directly over many cases of single-service articles and pieces of new and previously cleaned pieces of food equipment, such as china plates, cups, coffee dispensers, baking trays, lexan boxes, cutlery, sugar bowls, chafing dishes, portable gas stoves, woks, scoops, mixer whisks, ice cream cone dispensers, napkins, cups, champagne flutes, and glassware. The ducts, pipes, and cabling were soiled with dust. The insulation of some chilled water pipes had condensed water drops. Some of the bulkheads had exposed insulation. The areas of concern are: Hotel Store B.5.5, Hotel Store B.5.7, Consumable Locker 6.1.5, Kings Court Locker 6.5.2, Deck 9 Room Service Locker 9.5.1, and Deck 13 Glassware Locker.
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Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (1) in a clean, dry location; (2) in a location where they are not exposed to splash, dust, or other contamination; (3) at least 150 millimeters (6 inches) above the deck.
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Item No.:
28
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Site:
Galley-Todd English Potwash
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Violation:
A large amount of clean utensils were stored on the pulper counter. An insect light trap was located above the clean utensils. The potwash was not in operation.
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Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (1) in a clean, dry location; (2) in a location where they are not exposed to splash, dust, or other contamination; (3) at least 150 millimeters (6 inches) above the deck.
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Item No.:
30
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Site:
Galley-Kings Court Scullery
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Violation:
The handwashing facility located at the entrance of this area had no waste receptacle. This was corrected.
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Recommendation:
Ensure a handwashing facility includes a sink, soap dispenser, single-use towels dispenser, and waste receptacle.
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Item No.:
31
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Site:
Room Service-Deck 5 Room Service Pantry
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Violation:
A large lexan box with 20 units of 1200 mL of hand sanitizer was stored on the clean side of hood-type warewash machine #1. According to the staff, this scullery is never used. There was a chemical locker at footsteps of this scullery.
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Recommendation:
Store the hand sanitizer containers in a chemical locker outside the food area. Ensure only poisonous or toxic materials that are required for the operation and maintenance of a food area of the vessel, such as for the cleaning and sanitizing of equipment and utensils and the control of insects and rodents, are allowed in the food areas of the vessel.
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Item No.:
33
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Site:
Other-Crew Shop
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Violation:
The carpet of the front shop and deck of the back locker where food items were displayed and stored were soiled with dust and other debris.
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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:
Food Service General-Hotel Stores & Lockers
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Violation:
The deckheads were open to air handling ducts, water pipes, and electrical cabling that were soiled with dust. Some deckheads had exposed insulation from water pipes, and some bulkheads were not finished at all, exposing their insulation material, making them difficult to clean. There were many pieces of new, previously cleaned pieces of food equipment, and single-service articles stored in these areas. Some of the decks were soiled, especially under shelves and wooden pallets. The areas of concern are: Hotel Store B.5.5, Hotel Store B.5.7, Consumable Locker 6.1.5, Kings Court Locker 6.5.2, Deck 9 Room Service Locker 9.5.1, and Deck 13 Glassware Locker.
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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:
Preparation Room-
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Violation:
In the technical compartments above the proofing cabinet, there were gaps around the pipes where they penetrated the deckhead.
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Recommendation:
Close the gaps around the deckhead pipe penetrations.
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Item No.:
33
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Site:
Galley-Pastry
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Violation:
Deck tiles were cracked and deck tile grout was damaged at the ice cream machines.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
33
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Site:
Preparation Room-Decanting Area
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Violation:
Soft sealant was used around the coaming at the handwash station drain. The sealant was loose, which allowed water to pool onto the deck.
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Recommendation:
Remove the soft sealant. Replace the coaming/deck juncture with a hard sealant that can withstand repeated washing.
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Item No.:
34
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Site:
Provisions-Vegetable and Potato Room
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Violation:
Near the right high fog sprinkler, water dripped at a few areas along deckhead panel seams.
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Recommendation:
Ensure the plumbing system in a food area is maintained in good repair.
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Item No.:
34
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Site:
Galley-Production Galley
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Violation:
At the sauce station, water continuously dripped onto the deck from the outside of hood overhang 2.1 at both the fire damper knob and along the horizontal panel at the hood/deckhead juncture. The sauce station was in use, but no food was impacted. Later during the inspection it was determined more water dripped from another area of the hood overhang above the combination oven at panel CH903803. This combination oven was not in use during the inspection.
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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:
The light intensity was less than 110 lux behind and around numerous pieces of equipment. This included equipment on beverage stations, combination ovens, and the CTX machine (salamander) in the starboard side of the main galley. This was noted on the last inspection. In addition, the light intensity could not be raised to 220 lux at the waiter stations of the Brittania dining room for cleaning operations. The staff showed to the inspector their light evaluation conducted with corporate officials and a shore side lighting company. Most of the areas of concern were listed. However, this evaluation did not include any areas in the crew, staff, or officer's messes.
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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. In bars and dining room waiter stations, provide 220 lux (20 foot candles) light intensity during cleaning operations. Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment.
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Item No.:
37
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Site:
Galley-Port Dishwash
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Violation:
At the soiled end of the in-use dishwash machine, excess condensation formed on the right side inside the hood overhang. The condensation dripped onto the deck. Excess condensation also formed on the outside of the air conditioning vent at the prewash spray hose.
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Recommendation:
Ensure ventilation hood systems and devices are sufficient in number and capacity to prevent grease or condensation from collecting on bulkheads and deckheads.
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Item No.:
38
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Site:
Galley-Port Hot Galley
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Violation:
According to the staff, the deck-mounted CTX machine (salamander) had been out of order for more than a year. The staff wanted this food equipment to be removed from the galley.
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Recommendation:
Ensure only articles necessary for the food service operation are stored in food preparation, food storage, and warewashing areas.
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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 cleaning procedures for the galley after service during the red outbreak level called for surfaces to be sanitized with a 1000 ppm chlorine solution followed by the standard 3 bucket wash, rinse, and sanitize with 200 ppm chlorine solution.
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Recommendation:
Use only 1000 ppm chlorine solution followed by a system of wash, rinse and sanitize with a 50-200 ppm chlorine solution for cleaning and sanitation of surfaces after a public vomit or diarrhea incident in food areas.
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Item No.:
43
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Site:
Ventilation-AC Unit 4041
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Violation:
The space to the right of the condensate collection pan had standing water and was heavily soiled with dirt residue.
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Recommendation:
Ensure condensation collection pans are self-draining. Keep air handling units clean.
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Item No.:
43
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Site:
Ventilation-AC Fan Room 401
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Violation:
The condensate collection pan for AC Unit 4141 had black residue accumulated on the side closest to the opening.
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Recommendation:
Keep air handling units clean.
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Item No.:
44
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Site:
Medical-Acute Gastroenteritis (AGE) Case Definition
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Violation:
The medical staff was not clear on the applicability of the new AGE case definition. There was no indication on the AGE log or medical notes that the medical staff determined that symptoms were or were not above normal for the individuals reporting to the medical center. Additionally, the electronic spreadsheet used for the AGE log automatically calculated and decided AGE cases based on the old AGE case definition and the staff did not know that they could override the automatic reportable/non-reportable determination on the AGE log.
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Recommendation:
Ensure the supervisor or person in charge of medical operations related to AGE on the vessel demonstrates to VSP-during inspections and on request-knowledge of medical operations related to AGE, is able to demonstrate this knowledge by compliance with Section 4 of the VSP 2011 Operations Manual or by responding correctly to the inspector's questions as they relate to the specific operation, and properly trains employees to comply with Section 4 of the VSP 2011 Operations Manual as it relates to their assigned duties.
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