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Item No.:
02
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Site:
Medical-AGE definition and logs
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Violation:
The AGE definition used by the electronic medical database did not include the number of episodes of diarrhea that is above normal for an individual. Also, the AGE log produced by the database could not be exported into the format required by the 2011 VSP Operations Manual.
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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 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.:
08
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Site:
Galley-Seafood Shack
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Violation:
Water was leaking from the backflow prevention assembly attached to the carbonator.
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Recommendation:
Inspect backflow prevention devices periodically and replace any failed units.
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Item No.:
10
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Site:
Recreational Water Facilities-Whirlpool Safety Signs
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Violation:
The safety signs for all of the whirlpools cautioned against persons with cardiovascular disease, diabetes, and high blood pressure. The signs were missing caution against persons with low blood pressure.
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Recommendation:
Ensure safety signs meet the requirements for Recreational Water Facilities (RWF) as found in the 2011 VSP Operations Manual, and ensure that whirlpools have signs that comply with additional requirements.
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Item No.:
10
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Site:
Recreational Water Facilities-Swimming Pool Antientrapment
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Violation:
The drain covers for the swimming pools were constructed of a standard design and no alarms were installed. Staff stated ASME A112.19.8 compliant drain covers were to be installed on 1 September.
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Recommendation:
For RWFs with gravity drainage and multiple drains (2 or more drains greater than 3 feet apart), provide either a standard design (not compliant with ASME A112.19.8) drain cover and an alarm, or an ASME A112.19.8 compliant antientrapment/ant entanglement drain cover. Ensure the alarm is audible and sounds in both a continuously manned space and at the RWF. Ensure this alarm is for all draining: accidental, routine, and emergency.
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Item No.:
11
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Site:
Medical-Crew Member Reporting
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Violation:
There was an assistant waiter who had their first acute gastroenteritis (AGE) symptom on 7/28 at 1000 and did not report to medical until 7/29 at 1100. A review of the work schedule indicated that the crew member worked from 0536 to 1103 and from 1654 to 2318 on the 28th. A member of the production cast had their first AGE symptom on 7/17 at 1200 and did not report to medical until 7/19 at 0833. This crew member worked from around midnight to 0400 on the 17th and 18th.
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Recommendation:
When food 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 48 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document date and time of last symptom and clearance to return to work. 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.
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Item No.:
16
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Site:
Other-Suite Concierge Lounge & Chef's Table
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Violation:
The time as a public health control plan listed milk compartments of coffee/espresso machines. The milk compartments were not labeled as 'Time-Control.'
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Recommendation:
Maintain a written time control plan(s) that ensures compliance with these guidelines on the vessel and make it available for review during inspections. Post a time control plan at each outlet where time control is used. Ensure 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.:
16
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Site:
Bar-Vitality Spa
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Violation:
The time control plan was inside a binder and not posted.
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Recommendation:
Post time as public health control plans. 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:
Galley-Deck 16 - Warewash
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Violation:
Liquid and food residue from trollies of soiled dishes and utensils fell on to boxes sealed boxes of soda syrup. The boxes were stored inside stainless steel cabinets.
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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 16 - Windjammer Hot
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Violation:
Numerous small nicks and gouges made the top blade of the deck mounted buffalo chopper made cleaning difficult.
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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:
Dining Room-Giovanni's
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Violation:
Numerous food contact surfaces of the large red slicer had slotted fasteners. The clear plastic guide block was cracked where it attached to the slicer and was not easily cleanable. A black-gray metallic residue came off the cast metal guards when gently touched or brushed. In addition, the guards had a rough surface, which was not easily cleanable. The type of metal used in the construction of the cast metal guards was not known.
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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; and (5) Accessible for cleaning and inspection by one of the following methods without being disassembled, by disassembling without the use of tools, or by easy disassembling with the use of handheld tools commonly available to maintenance and cleaning personnel. Use only low profile, non-slotted, non-corroding, and easy-to-clean fasteners on food-contact surfaces and in splash zones. Prohibit the use of exposed slotted screws, Phillips head screws, or pop rivets in these areas. Ensure materials used in the construction of multiuse utensils and food-contact surfaces of equipment do not allow the migration of deleterious substances or impart colors, odors, or tastes to food and are safe under normal use conditions.
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Item No.:
21
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Site:
Galley-Johnny Rockets
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Violation:
Numerous surfaces of a brown plastic food transportation trolley were melted, which made cleaning difficult.
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Recommendation:
Discard the trolley.
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Item No.:
21
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Site:
Room Service-Hot Line
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Violation:
Inside the drip pan housing for the flat grill, the drain pipe was not sealed to the upper surface of the housing.
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Recommendation:
Ensure nonfood-contact surfaces are free of unnecessary ledges, projections, and crevices, and designed and constructed to allow easy cleaning and to facilitate maintenance.
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Item No.:
22
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Site:
Galley-Deck 16 - Warewash
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Violation:
Food residue from trolleys of soiled dishes and utensils soiled previously cleaned utensils stored inside a stainless steel cabinet across from the soiled landing of the warewash.
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Recommendation:
Reevaluate cleaned and soiled storage spaces to prevent/minimize or otherwise eliminate cross-contamination.
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Item No.:
22
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Site:
Food Service General-Ice Machines
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Violation:
Quaternary ammonia test strips were not available to test the concentration of quaternary ammonia used to sanitize the internal food contact surfaces of ice machines.
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Recommendation:
Accurately determine the concentration of the sanitizing solution by using a test kit or other device.
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Item No.:
24
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Site:
Galley-Deck 3 - Dishwash
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Violation:
The final sanitizing rinse temperature of the in-use conveyor warewash machine was measured three times at 155F using the inspector's thermometer and two staff thermometers. The gauge was measuring 187F. Around 15 minutes later the machine was re-inspected and the final rinse temperatures were corrected. The staff explained that the temperatures were adjusted.
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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-Deck 5
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Violation:
The tray under the air relief vent of the backflow prevention device in hood cleaning cabinet 5617.058GWC5 was heavily soiled with white and dark materials that appeared to be mold.
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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-Deck 16 - Windjammer Hot
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Violation:
Old grease soiled the top of the drip pan housing of the deep fat fryer.
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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-Johnny Rockets
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Violation:
A red substance soiled the bottom shelf of the brown trolley.
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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-Doughnut Shop
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Violation:
A sticky substance soiled the bottom of the previously cleaned doughnut display.
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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:
Galley-Deck 16 - Warewash
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Violation:
Food residue, particles and liquid waste from soiled dishes and utensils stored on trolleys soiled boxes of single-service articles inside stainless steel cabinets located across from the soiled landing of the warewash.
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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:
Provisions-Tank Top House Stores
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Violation:
Single serve paper cups, napkins, and other food related items were stored in an unfinished storage room with exposed deckhead, electrical wiring, and condensate water pipes. This was noted in the previous inspection.
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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.:
29
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Site:
Preparation Room-
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Violation:
The handwash station at the entrance of the butcher shop had a water temperature of 135F. The temperature could not be adjusted by the user. This was corrected.
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Recommendation:
Ensure handwashing sinks are equipped to provide water at a temperature of at least 38C (100F) through a mixing valve or combination faucet. For handwash sinks with electronic sensors, and other types of handwash sinks where the user cannot make temperature adjustments, ensure the temperature provided to the user after the mixing valve does not exceed 49C (120F).
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Item No.:
29
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Site:
Room Service-Handwash
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Violation:
At the handwash by the clean dish storage racks, the water temperature was measured at greater than 128F. This was corrected during the inspection.
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Recommendation:
Ensure handwashing sinks are equipped to provide water at a temperature of at least 38C (100F) through a mixing valve or combination faucet. For handwash sinks with electronic sensors, and other types of handwash sinks where the user cannot make temperature adjustments, ensure the temperature provided to the user after the mixing valve does not exceed 49C (120F).
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Item No.:
33
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Site:
Galley-Crew Corridor 42801-42827 Ice Machine
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Violation:
The deck behind the ice machine was soiled with food residue 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:
Provisions-Buffet and Show Store Locker
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Violation:
The storage locker was very crowded with trays and mops stored under the pallets, preventing easy cleaning. The deck was soiled under the pallets with liquid spills and debris.
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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.:
36
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Site:
Galley-Deck 5 - Beverage Station Lighting
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Violation:
The light intensity behind and around many pieces of counter-mounted equipment was less than 110 lux.
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Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment.
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Item No.:
36
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Site:
Galley-Crew Corridor 42801-42827 Ice Machine
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Violation:
The light intensity behind and around the deck-mounted ice machine was less than 110 lux.
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Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment.
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Item No.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
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Violation:
The OPRP did not include the contact time for the disinfectant used onboard or how the crew would be notified of an outbreak. The plan did state that the surfaces should be air dried. The staff stated how the crew would be notified, but it was not described in the written plan.
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Recommendation:
Ensure each vessel has a written OPRP that details standard procedures and policies to specifically address AGE onboard. Include the following in the written OPRP: (1) Duties and responsibilities of each department and their staff for all the passenger and crew public areas; (2) Steps in outbreak management and control and the trigger for required action at each step. Ensure the triggers address a graduated approach to outbreak management in response to increasing case counts; (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); (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; (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.:
42
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Site:
Children Area-Aquanauts
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Violation:
The children's toilets were greater than 11 inches above the deck and there were no step stools for the toilets.
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Recommendation:
If toilet rooms are located in a child-activity center, provide a child-size toilet(s) or child-accessible toilet(s) (child-size seat and step stool) and handwashing facilities. Ensure child-size toilets (to include the toilet seat) have a maximum height of 280 millimeters (11 inches) and a toilet seat opening no greater than 203 millimeters (8 inches). Ensure handwashing sinks have a maximum height of 560 millimeters (22 inches) above the deck or a step stool.
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