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Item No.:
01
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Site:
Medical-24 Hour Report
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Violation:
The 24 hour routine AGE report for the voyage that ended on 14 March was submitted electronically to VSP at 12:16pm on 13 March which was less than 24 hours from arrival in PEV. The ship arrived in PEV at 7:00am on 14 March. Also, the total number of reportable cases of AGE among both passengers and crew members did not match actual totals. The 24 hour report listed 24 reportable passenger cases and 1 crew reportable case. During record review, the electronic medical database showed that there were actually 31 reportable passenger cases and 2 crew cases. These additional cases occurred before the 24 hour report was made. According to the medical staff, a software update for the electronic medical system was conducted on 12 to 13 March which prevented the ship from sending an AGE report on time. The medical staff could not account for why the actual reportable case counts were not accurate. Medical staff showed the inspector emails regarding the software update from the ship's corporate office.
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Recommendation:
Ensure the master, medical staff, or other designated staff of a vessel destined for a U.S. port from a foreign port submits at least one standardized AGE report based on the number of reportable cases in the AGE log to VSP no less than 24 hours-but not more than 36 hours-before the vessel's expected arrival at the U.S. port. Ensure the AGE report contains the following: (1) name of the vessel; (2) port of embarkation; (3) date of embarkation; (4) port of disembarkation; (5) date of disembarkation; (6) total numbers of reportable cases of AGE among passengers, including those who have disembarked because of illness-even if the number is 0 (zero reporting); (7) total numbers of reportable cases of AGE among crew members, including those who have disembarked because of illness-even if the number is 0 (zero reporting); and (8) total number of passengers and crew members on the cruise.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Log - Crew Reporting
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Violation:
There was some discrepancy on the AGE log between the actual time a crew member reported illness to the medical center and what the AGE log listed as the time reported. This was observed for several different crew members on the AGE logs over the last 5 voyages. According to staff, the AGE log was automatically populated by the electronic medical database and the time that went into to the 'time report to medical' field was populated with the time the crew member's intake information was entered into the database by medical staff. In some instances, the medical staff could not enter this intake information in a timely manner and the AGE log would show a later time than when the crew member had actually reported. Staff stated that they could not change the time in this field because it was automatically populated. Staff provided intake questionnaires completed by the crew members which included the reporting time.
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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.
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Item No.:
02
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Site:
Medical-Reportable Case Definition
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Violation:
Over the past five voyages there were more than 6 crew members who presented to medical with 1-2 diarrhea episodes, were administered antidiarrheal medication, isolated, and recorded as non-reportable. There was no documentation for any of these cases on whether or not these symptoms were above normal for the individual. According to staff, these crew members were recorded as non-reportable because they had less than 3 loose stools within 24 hours.
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Recommendation:
Ensure a reportable case of AGE is a case reported to the master of the vessel, the medical staff, or other designated staff by a passenger or a crew member and meets the case definition based on the following symptoms: (1) Diarrhea (three or more episodes of loose stools in a 24 hour period or what is above normal for the individual. See section 4.1.2.1.3, illness symptoms); or (2) vomiting and one additional symptom including one or more episodes of loose stools in a 24-hour period, or abdominal cramps, or headache, or muscle aches, or fever (temperature of greater than or equal to 38C [100.4F]).
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Item No.:
10
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Site:
Recreational Water Facilities-Deck 12 Feature Spray Pad
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Violation:
The safety signs for this interactive facility were temporary signs. New signs had been ordered and were expected to arrive soon. On the previous inspection there were no signs located in this area.
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Recommendation:
Provide safety signs for all RWFs, except for baby-only water facilities. Ensure the signs, at a minimum, include the following words: (1) do not use these facilities if you are experiencing diarrhea, vomiting, or fever; (2) no children in diapers or who are not toilet trained; (3) shower before entering the facility; and (4) bather load #. For children's RWF signs, include the exact wording "TAKE CHILDREN ON FREQUENT BATHROOM BREAKS" or "TAKE CHILDREN ON FREQUENT TOILET BREAKS."
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Item No.:
13
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Site:
Bar-Satellite Red Bull Bars
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Violation:
There were multiple violations observed in these satellite bars, including difficult to clean areas, soiled areas, improper storage of utensils and food, improper sink drainage, and improper storage of wiping cloths. In addition, the areas were used for mixing and serving beverages, but there were not handwashing stations in the bars.
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Recommendation:
Because of the risks for foodborne illness inherent to the food operation, ensure the supervisor or person in charge of food operations on the vessel demonstrates to VSP - during inspections and on request - knowledge of foodborne disease prevention, application of the Hazard Analysis Critical Point principles, and the food-safety guidelines in this manual. Ensure that the person in charge demonstrates this knowledge: (1) By compliance with these guidelines; (2) By being a domestically or foreign certified food protection manager who has shown proficiency of required information through passing a test that is part of an accredited program; or (3) By responding correctly to the inspector's questions as they relate to the specific food operation. Ensure that the areas of knowledge include: (9) Explaining the relation between food safety and providing equipment that is sufficient in number and capacity as well as properly designed, constructed, located, installed, operated, maintained, and cleaned; (10) Explaining correct procedures for cleaning and sanitizing utensils and food-contact surfaces of equipment; (12) Identifying critical-control points in the operation from purchasing through service that when not controlled may contribute to the transmission of foodborne illness and explaining steps taken to ensure the points are controlled in accordance with the guidelines in this manual.
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Item No.:
16
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Site:
Galley-Bistro on Five
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Violation:
The operations as conducted during the day of the inspection were not done in accordance with the time control plan. The plan stated that the initial set-up time would be 0700 but the day of the inspection potentially hazardous foods were set-up at 1030. The staff explained that operational times, including the initial set-up time, were different during embarkation days, such as the day of the inspection. The staff updated the time control plan.
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Recommendation:
Update the time control plan to match the operations.
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Item No.:
19
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Site:
Buffet-Orange Mess
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Violation:
Four containers of apples out for self-service did not have dedicated serving utensils. 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:
Bar-Gelateria
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Violation:
There was no sneeze guard for the dipper well. The dipper well was within 20 inches of the passenger side of the counter. This was corrected.
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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).
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Item No.:
19
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Site:
Bar-Satellite Red Bull Bars
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Violation:
Numerous bottles of liquor, soda, and water were stored on the shelves that were soiled with general debris. This was corrected. The bars were not in operation at the time of the inspection and were covered with tarps.
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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.:
20
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Site:
Galley-Deck 4 Bakery
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Violation:
The two nonslotted fasteners on the underside of the rotating mixing arm were corroded. They were replaced immediately.
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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; (2) sufficient in weight and thickness to withstand repeated warewashing; (3) finished to have a smooth, easily cleanable surface; and (4) resistant to pitting, chipping, crazing, scratching, scoring, distortion and decomposition.
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Item No.:
20
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Site:
Galley-Oceanview Cafe Production Galley - Convotherm A
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Violation:
This combination oven had been out of service since January and staff stated that was necessary for the operation. A repair order was in place.
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Recommendation:
Repair the oven.
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Item No.:
20
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Site:
Bar-Cafe al Bacio
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Violation:
Both espresso machines had four slotted fasteners in the food-splash zones. Also, the upper panels above the hot water spout were heavily corroded. Both issues were corrected.
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Recommendation:
Use only low profile, nonslotted, noncorroding, and easy-to-clean fasteners on food-contact surfaces and in splash zones. Materials used in the construction of multiuse utensils and food contact surfaces of equipment must be: (1) durable, corrosion resistant, and nonabsorbent; (2) sufficient in weight and thickness to withstand repeated warewashing; (3) finished to have a smooth, easily cleanable surface; and (4) resistant to pitting, chipping, crazing, scratching, scoring, distortion and decomposition.
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Item No.:
20
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Site:
Galley-Bistro on Five
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Violation:
At the dishwash area, the three cutting boards in the clean end of the hood-type dishwasher were heavily scratched and scored, making them difficult to clean. They were sent to be discarded.
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Recommendation:
Ensure surfaces such as cutting blocks and boards that are subject to scratching and scoring are resurfaced if they no longer can be effectively cleaned and sanitized, or discarded if they are not capable of being resurfaced.
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Item No.:
20
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Site:
Galley-Deck 3 - Beverage Station
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Violation:
The black plastic covering immediately behind and below the dispensing nozzle to the espresso machine was cracked and open to the machine's technical space. This area had a buildup of what appeared to be a mix of old coffee residue and corrosion.
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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; (2) sufficient in weight and thickness to withstand repeated warewashing; (3) finished to have a smooth, easily cleanable surface; and (4) resistant to pitting, chipping, crazing, scratching, scoring, distortion and decomposition.
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Item No.:
21
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Site:
Buffet-Yellow Mess - Beverage Station
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Violation:
The electrical cord to the counter mounted toaster oven was draped on the counter making cleaning difficult.
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Recommendation:
Ensure the cord does not drape on the counter.
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Item No.:
21
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Site:
Bar-Satellite Red Bull Bars
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Violation:
The four satellite Red Bull bars on deck 12 were slightly to heavily corroded in many areas, making cleaning difficult. The bars were not in operation a the time of the inspection and were covered with a tarp.
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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:
Dining Room-Deck 3 and Deck 4 Main
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Violation:
There was one wine station located at each of the port and starboard entrances on both decks, for a total of four wine stations. During service, opened wine bottles were placed in removable, recessed metal containers on the top of the station. These stations were installed and secured to the deck with only one inch between the bottom of the station and the deck. These stations were installed with less than three inches of space between the bulkhead and the station. The stations were secured to the deck and were not easily movable. In addition, under the countertops, rough, unsealed cut stone in the top of the stations was observed through the holes for the wine bottle holders.
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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 equipment that is fixed because it is not easily movable is installed so that it is: (1) Spaced to allow access for cleaning along the sides, behind, under and above the equipment; (2) Spaced from adjoining equipment, bulkhead, and deckhead at a distance of not more than 0.8 millimeter or 1/32 inch; or (3) Sealed to adjoining equipment or bulkhead. Ensure deck-mounted equipment that is not easily movable is sealed to the deck or elevated on legs that provide at least a 150 mm (6-inch) clearance between the deck and the equipment.
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Item No.:
24
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Site:
Bar-Gelateria
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Violation:
The free chlorine level in the sanitizing solution container was close to 1000 ppm. The staff instructed a crew member to change the water.
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Recommendation:
Ensure sanitizing solutions are used with the following concentrations: (1) A chlorine solution with a concentration between 50 mg/L (ppm) and 200 mg/L (ppm).
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Item No.:
25
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Site:
Bar-Satellite Red Bull Bars
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Violation:
One of the starboard side satellite Red Bull bars had a wet and soiled wiping cloth stored in the utility sink. This was corrected. The bar was not in operation at the time of the inspection and was covered with a tarp.
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Recommendation:
Restrict wiping cloths to the following: (1) Cloths used for wiping food spills are used for no other purpose; (2) Cloths used for wiping food spills are dry and used for wiping food spills from tableware and single service articles or wet and cleaned, stored in a chemical sanitizer, and used for wiping spills from food-contact and nonfood-contact surfaces of equipment; (4) Wet wiping cloths used with a freshly made sanitizing solution and dry wiping cloths are free of food debris and visible soil.
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Item No.:
26
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Site:
Bar-Satellite Red Bull Bars
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Violation:
One of the port side satellite Red Bull bars on deck 12 had approximately 40 previously-cleaned wine and water glasses, and a bar mixer cup with mixing utensils stored visibly soiled. One of the starboard side bars had a heavily soiled glass inside the sink. This was corrected. These bars was not in operation at the time of the inspection and were covered with tarps.
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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-Aft Port Beverage Station
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Violation:
In the upper compartment of the ice machine, the front white plastic cover over the cuber panel was soiled with black spots that appeared to be mold. This was corrected.
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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-Buttlers Pantry
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Violation:
The far left juice port of the previously cleaned juice dispenser was soiled with juice remnants. This was corrected.
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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-Aqua Spa
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Violation:
On the clean racks, three plates were stored as clean but were still soiled with food residues. They were segregated to be re-washed.
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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-Bistro on Five
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Violation:
At the beverage station next to the front galley, the previously cleaned juice dispenser had all the dispensing ports soiled with juice remnants. This was corrected.
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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-Deck 3 - Beverage Station
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Violation:
The area above and behind the dispensing nozzles to the espresso machine were soiled with a buildup of old coffee residue and corrosion.
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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-Deck 3 - Pastry - Hobart Mixer
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Violation:
The underside of the cleaned rotating mixing arm to the deck mounted mixer was soiled with old yellow dried food residue.
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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.:
27
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Site:
Dining Room-Silhouette - Waiter Stations
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Violation:
The front side of cabinet doors at several waiter stations were soiled with dried food splash.
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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-Yellow Mess - Beverage Station
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Violation:
Old food residue and dust was on the counter underneath the electrical cable to the toaster.
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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:
Bar-Satellite Red Bull Bars
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Violation:
The four satellite Red Bull bars on deck 12 were slightly to heavily soiled with general debris in many areas. The bars were not in operation at the time of the inspection and were covered with a tarp. This bars were cleaned.
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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.:
28
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Site:
Bar-Satellite Red Bull Bars
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Violation:
One of the port side satellite Red Bull bars on deck 12 had wine and water glasses and a bar mixer cup with utensils stored on the shelves with signs of corrosion. Beer buckets were stored with stagnant water inside. This was corrected. The bars were not in operation at the time of the inspection and were covered with tarps.
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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. 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:
Preparation Room-
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Violation:
Two of the rough plastic insert linings for the potato peelers were previously cleaned and stacked together while still 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.:
29
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Site:
Bar-Satellite Red Bull Bars
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Violation:
The four satellite Red Bull bars on deck 12 had utility sinks but there were no handwashing stations nearby. Staff confirmed that multiple drinks are prepared at these bars with the liquor, soda, water, and bar mixing utensils found in the satellite bars.
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Recommendation:
Ensure each food preparation area, bar, warewashing area, and garbage-processing area has at least one handwashing facility located in it.
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Item No.:
33
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Site:
Dining Room-Deck 4 Main Waiter Station 60
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Violation:
The coving had missing grout at the right bulkhead/deck juncture. This area was also soiled.
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Recommendation:
Cove all bulkhead/deck, equipment/deck, cabinet/deck, and deck sink coaming/deck junctures (including galleys, pantries, buffets, bars, waiter stations, dining room work counters, provisions, food storage rooms, equipment/utensil storage rooms, and toilet rooms intended for use by galley personnel). 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:
Dining Room-Deck 3 and Deck 4 Main
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Violation:
There was one wine station located at each of the port and starboard entrances on both decks, for a total of four wine stations. During service, opened wine bottles were placed in removable, recessed metal containers on the top of the station. These stations were installed and secured to the deck with only one inch between the bottom of the station and the deck. The decks under all four wine stations were heavily soiled with broken glass, corks, and foils from the wine bottles. Cleaning under the cabinets began immediately.
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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:
Dining Room-Silhouette - Waiter and Service Stations
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Violation:
Deck tile coving at the working sides of many of the waiter and service stations were either missing or in poor repair. This allowed for recessed areas which were soiled with old food residue and general debris such as pieces of glass and dirt. According to crew, these deck tiles were to be replaced in dry dock scheduled for April 2014.
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Recommendation:
Cove all bulkhead/deck, equipment/deck, cabinet/deck, and deck sink coaming/deck junctures (including galleys, pantries, buffets, bars, waiter stations, dining room work counters, provisions, food storage rooms, equipment/utensil storage rooms, and toilet rooms intended for use by galley personnel). 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.:
34
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Site:
Galley-Ocean View Cafe Pantry
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Violation:
The drain pipe of the evaporative condenser in cold room #14 was continuously leaking onto the deck. This was corrected.
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Recommendation:
Ensure a plumbing system in a food area is maintained in good repair.
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Item No.:
35
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Site:
Galley-Ocean View Cafe Pantry
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Violation:
There was standing water under the evaporative condenser in cold room #14. Water was continuously leaking from the evaporative condenser drain pipe. This was corrected.
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Recommendation:
Ensure black and gray water is discharged to the vessel's wastewater disposal system and does not pool on the deck.
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Item No.:
35
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Site:
Bar-Satellite Red Bull Bars
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Violation:
The four satellite Red Bull bars on deck 12 had open drain pipes from the utility sinks. The sink drains were not directed to appropriate waste systems. One of the port bars had a bucket with stagnant water under the sink drain. The water in the bucket appeared to have come from the utility sink which did not discharge to the vessel's wastewater disposal system.
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Recommendation:
Ensure black and gray water is discharged to the vessel's wastewater disposal system and does not pool on the deck.
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Item No.:
36
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Site:
Dining Room-Deck 3 and Deck 4 Main
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Violation:
There was one wine station located at each of the port and starboard entrances on both decks, for a total of four wine stations. During service, opened wine bottles were placed in removable, recessed metal containers on the top of the station. The light level at both deck 4 stations could not be raised to 220 lux for cleaning. The light level at the deck 3 starboard station could not be raised to 220 lux for cleaning.
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Recommendation:
In bars and dining room waiter stations, provide 220 lux (20 foot candles) light intensity during cleaning operations.
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Item No.:
44
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Site:
Medical-Reportable Case Definition
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Violation:
Over the past five voyages there were more than 6 crew members who presented to medical with 1-2 diarrhea episodes, were administered antidiarrheal medication, isolated, and recorded as non-reportable. There was no documentation for any of these cases on whether or not these symptoms were above normal for the individual. According to staff, these crew members were recorded as non-reportable because they had less than 3 loose stools within 24 hours.
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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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