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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The AGE surveillance log did not include the underlying illness column.
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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-Bacterial Specimen Collection Containers
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Violation:
Medical staff only had four bacterial collection containers that were within their expiration date. All other bacterial collection containers expired in March 2013.
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Recommendation:
Ensure the medical staff maintains a supply of at least 10 clinical specimen collection containers for both viral and bacterial agents (10 for each), as well as a shipping container that meets the latest shipping requirements of the International Air Transport Association (IATA) and U.S. Department of Transportation for Biological Substances, Category B designated shipments (or higher).
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Item No.:
02
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Site:
Medical-Specimen Shipping Containers
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Violation:
The shipping containers did not meet the specific VSP regulations outlined in Annex 13.4 of the 2011 Operational Manual. The containers do not allow for ice packed along with the specimens.
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Recommendation:
Ensure the medical staff maintains a supply of at least 10 clinical specimen collection containers for both viral and bacterial agents (10 for each), as well as a shipping container that meets the latest shipping requirements of the International Air Transport Association (IATA) and U.S. Department of Transportation for Biological Substances, Category B designated shipments (or higher). Ensure the vessel maintains the appropriate labels and markings required for shipping Biological Substances, Category B shipments. Ensure the vessel maintains appropriate refrigerant materials to keep clinical specimens cool. (see Annex 13.4 of the VSP 2011 Operations Manual.) Use containers that are for packing and shipping the specimens for controlled temperature (specimens must be kept at 4C while in the medical center and then shipped overnight with frozen refrigerant packs to keep them cool).
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Item No.:
08
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Site:
Potable Water-Mineralizer
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Violation:
The water lines from the mineralizer to the chlorine injection point were striped blue/green/blue, indicating potable water.
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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:
Potable Water-Port Bunker Station
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Violation:
Only one end of the potable water hose was labeled 'potable water only.'
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Recommendation:
Label potable water hoses with the words "POTABLE WATER ONLY" in letters at least 13 millimeters (0.5 inch) high at each connecting end.
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Item No.:
08
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Site:
Potable Water-Port Hose Storage Locker
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Violation:
The bottom of the locker was soiled with dirt and debris.
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Recommendation:
Construct potable water hose lockers of smooth, nontoxic, corrosion resistant, easily cleanable material and maintain in good repair.
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Item No.:
16
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Site:
Food Service General-Time Control Plans
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Violation:
All of the time control plans for the milk for coffee and espresso machines were generic for potentially hazardous cold foods and were not specific to the food or the ship's operations. For example, in La Licorne, La Boussole, Room Service, Main Lounge, and Observation Lounge, the time control plans included statements such as foods prepared, sliced, chopped in small batches, and foods placed in the blast chiller. Also, the plans did not clearly identify the flow of milk from temperature control to being placed on time control specific for each area's operation. During the inspection, some of these time control plans were being updated.
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Recommendation:
Maintain a written time control plan(s) that ensures compliance with these guidelines on the vessel and make it available for review during inspections. Post a time control plan at each outlet where time control is used. Ensure plan(s): (1) Includes set-up and discard times for each outlet. (2) List refrigeration and hot holding units (compartments and cabinets) on time control (the physical units must also be labeled as such). (3) Describe or show the flow of potentially hazardous food from when last in temperature control to placement in time control and discard.
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Item No.:
19
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Site:
Buffet-Crew Mess
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Violation:
On the service line, a platter of apples had the distributer's label attached to them.
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Recommendation:
Thoroughly rinse raw fruits and vegetables in water to remove soil and other contaminants before being cut, combined with other ingredients, cooked, served, or offered for human consumption in ready-to-eat form.
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Item No.:
21
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Site:
Galley-Hot Galley
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Violation:
At the soup kettle, the water pressure gauge was filled with what appeared to be chipped paint particles.
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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.
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Item No.:
26
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Site:
Galley-Potwash Clean Storage
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Violation:
A previously cleaned green cutting board was soiled with food debris. Also, there were two stainless steel containers of clean utensils. The inside of these containers was soiled with food debris.
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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:
Pantry-La Licorne and La Boussole
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Violation:
In La Licorne, inside the undercounter wine storage cabinet, approximately 10 stainless steel containers were stacked together and stored wet. In La Boussole, inside the clean storage cabinet on the top shelf, two stainless steel containers were stacked together and stored wet. During service, these containers were filled with ice and used to chill wine bottles. All containers were taken to the dishwash area.
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Recommendation:
Store clean equipment and utensils in a self-draining position that allows air drying, and covered or inverted.
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Item No.:
28
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Site:
Galley-Dishwash Clean Storage Cabinet
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Violation:
Some of the white ceramic bowls inside the clean storage cabinet were stacked wet.
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Recommendation:
Store clean equipment and utensils in a self-draining position that allows air drying, and covered or inverted.
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Item No.:
33
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Site:
Other-Crew Scullery
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Violation:
The waste receptacle for the handwash station was stored on the deck.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, bars, and food and equipment storage areas are constructed and maintained for easy cleaning.
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Item No.:
36
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Site:
Pantry-La Licorne
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Violation:
The light intensity was less than 110 lux around and behind the water dispensing machine.
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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.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
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Violation:
The OPRP indicated passengers and crew would be notified daily during an outbreak, but no specific procedures were listed. Also, the OPRP indicated passengers embarking the vessel on the voyage following the outbreak would be notified, but no specific procedures were listed.
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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: (4) Procedures for informing passengers and crew members of the outbreak. Ensure this section also includes procedures for notification of passengers embarking the vessel following an outbreak voyage or segment of a voyage.
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