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Item No.:
02
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Site:
Medical-AGE Surveillance Log
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Violation:
The acute gastroenteritis surveillance log was not exact in the fields and order as the log required in annex 13.2. There was not field for the time of the report to medical, the fields for abdominal cramps, headache, and myalgia were combined. This same finding was made in the previous VSP inspection report.
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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-AGE Surveillance Log
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Violation:
Staff left the patient id field blank for the two crew cases on the current cruise and the underlying illness field was also left blank.
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Recommendation:
Follow the guidance in 13.2 and complete all fields in the AGE log which can be completed. When no underlying medical condition exists, enter none in the undlerlying illness column.
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Item No.:
02
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Site:
Medical-Retention of Records
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Violation:
One of only two crew gastrointestinal illness records from the voyage of 30 August to 11 September was not available on the ship to review. Medical staff stated that this cook signed off (disembarked) and his record was not copied or retained on board.
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Recommendation:
Maintain the following records on board for 12 months and make them available for review by VSP during inspections and outbreak investigations: (1) medical log/record; (2) AGE surveillance log; (3) 2-hour self-administered questionnaires; (4) interviews with cabin mates and immediate contacts of crew members with AGE [initial, 24-, and 48-hour]; (5) documentation of the 3-day assessment of crew members with AGE symptoms before joining the vessel; (6) documentation of the date and time of last symptom and clearance to return to work for food and nonfood employees; and (7) documentation of the date and time of verbal interviews with asymptomatic cabin mates and immediate contacts of symptomatic crew.
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Item No.:
08
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Site:
Potable Water-Potable Water Tank Maintenance
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Violation:
Potable water tank #2222 was cleaned, spot painted, disinfected and placed back in service. The record for the spot painting was incomplete in that the application of the Interline 850 coating was not described and no details of the curing and drying were given. There was no other statement in the log indicating that the tank coating was applied, dried and cured according to the specifications of the manufacturer.
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Recommendation:
Ensure the interior coatings on potable water tanks are approved for potable water contact by a certification organization. Follow all manufacturers? recommendations for application, drying, and curing. For the tank coatings used, maintain the following onboard: (1) written documentation of approval from the certification organization (independent of the coating manufacturer); (2) manufacturers? recommendations for application, drying, and curing; and (3) written documentation that the manufacturers? recommendations have been followed for application, drying, and curing.
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Item No.:
08
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Site:
Potable Water-Inspection
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Violation:
Monthly logs were completed using the entiree listing of non-testable backflow prevention devices, where staff entered information only when a device was repaired or replaced. The other devices were listed but the remark field was left blank, and this made it difficult to verify if the other backflow devices were ever inspected.
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Recommendation:
Ensure there is a notation or remark regarding the results of inspection for all non-testable backflow preventers and air-gaps, even if the remark establishes that the device or method is in good working order.
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Item No.:
08
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Site:
Food Service General-Ice Machines
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|
Violation:
Refrigerant lines to ice machines located throughout the food service areas and deck pantries were not uniquely identified as non-potable.
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Recommendation:
Uniquely identify all refrigerant brine lines in all galleys, pantries, and cold rooms to prevent cross-connections.
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Item No.:
08
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Site:
Galley-Toscana
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|
Violation:
There was no backflow protection on the potable water line to the combination ovens.
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Recommendation:
Install a continuous pressure type backflow preventer on the potable water supply line to the combination oven.
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Item No.:
10
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Site:
Recreational Water Facilities-Flow Meters
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|
Violation:
No flow meters were installed for any of the RWF's, so the turnover rates and bather load calculations for the swimming pool, two whirlpool spas, and the thalassotherapy pool (spa pool) cannot be confirmed. Staff stated that these parts are on order.
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Recommendation:
Maintain documentation on the maximum bather load for each RWF. Ensure the maximum bather load is based on the following factor: one person per five gallons (19 liters) per minute of recirculation flow.
Once flow meters are installed calculate all turnover rates and bather loads for each RWF and adjust maintenance and signage accordingly. Monitor and adjust the RWF?s flow rates, free and combined halogen levels, pH, total alkalinity, and clarity as recommended by the manufacturer and to maintain optimum public health protection and water chemistry.
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Item No.:
10
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Site:
Recreational Water Facilities-Monitoring Analyzers
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Violation:
There was no monitoring analyzer at each of the RWF's and either chart recorders or data loggers installed which was taken directly from the RWF or on the return line from each and before the compensation tank. Staff stated that this is to be installed this year.
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Recommendation:
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.:
10
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Site:
Recreational Water Facilities-Antientrapment Drains
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|
Violation:
The dual gravity drains on the swimming pool were not compliant with the current ASME A112.19.8 standards and each presented both digit and hair entrapment potentials. There were also no alarms installed for this pool in the event of draining. The port whirlpool spa and thalassotherapy pool single gravity drain covers wereas also not ASME A112.19.8 compliant and no alarms were installed. This is a repeat finding from the previous VSP inspection.
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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/antientanglement 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. For RWFs with gravity drainage and a single unblockable drain (per ASME A112.19.8), 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/antientanglement 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.:
10
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Site:
Recreational Water Facilities-Monitoring and Test Kit
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|
Violation:
Staff were not monitoring flow rates, combined chlorine, or total alkalinity for any of the RWF 's. Staff did not have a test kit capable of monitoring the water chemistry values listed above and there were no flow meters installed on any of the RWF's. Staff stated these items were on order.
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Recommendation:
Monitor and adjust the RWF?s flow rates, free and combined halogen levels, pH, total alkalinity, and clarity as recommended by the manufacturer and to maintain optimum public health protection and water chemistry. Ensure a test kit is available for testing water quality parameters, including free and total halogen levels (chlorine and bromine, where applicable), pH, and total alkalinity. Ensure that test kits are accurate to within 0.2 mg/L (ppm) for halogen and have a testing range of free residual halogen normally maintained in the RWF. Ensure test kits for pH are accurate to within 0.2. Ensure all reagents are not past their expiration dates.
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Item No.:
20
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Site:
Galley-Toscana
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|
Violation:
The stainless metal finish on the center and right grooved grill was peeling off. Also, the surface of the far right grill was pitted and chipping in several areas.
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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, nonslotted, noncorroding, 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.
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Item No.:
20
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Site:
Galley-Terrace Cafe
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|
Violation:
A badly scratched and scored cutting board was being used in this area.
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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:
Buffet-Waves Ice Cream - Juice Station
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|
Violation:
A portable milkshake blender with three mixing arms had slotted fasteners on the bottom of the food contact mixer.
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|
Recommendation:
Contact the manufacturer to replace the slot head fasteners with low-profile hex head fasteners.
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Item No.:
20
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|
Site:
Buffet-Waves Ice Cream - Juice Station
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|
Violation:
There was raw exposed wood along the underside of the stainless steel prep table and handwashing station.
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|
Recommendation:
Varnish the raw wood so it is non-absorbent or replace it with a durable and non-absorbent material.
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Item No.:
20
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|
Site:
Preparation Room-Potato Peeler
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|
Violation:
There was a large crack in the grey plastic top of the potato peeler which prevented it from being easily cleaned. Also, there were approximately five slotted fasteners in the potato contact area.
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|
Recommendation:
Repair the damaged top to the potato peeler, and contact the manufacturer to replace the slot-head screws with low-profile hex head fasteners.
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Item No.:
20
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|
Site:
Bar-Horizons Bar
|
|
Violation:
Slotted fasteners were observed on the bottom of the beverage mixing arm of the milkshake mixer and at the underside of the coffee/steamer juncture of the espresso machine.
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|
Recommendation:
Replace the slot-head fasteners with low-profile hex head fasteners.
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Item No.:
21
|
|
Site:
Buffet-Waves Ice Cream
|
|
Violation:
There were four areas of gouges and penetrations on the surface of the stainless steel preparation table next to the ice/water dispensing machine which prevented the counter from being easily cleaned.
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|
Recommendation:
Repair the damage and penetrations in the preparation table so the surface is smooth, durable, and easy to clean.
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Item No.:
21
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|
Site:
Buffet-Waves Grill
|
|
Violation:
There were open gaps and seams inside the drip pan housings of the grooved and flat grill.
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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.:
21
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|
Site:
Buffet-Waves Grill
|
|
Violation:
Inside of the baine marie technical compartment there was a large opening to a void space located on the right side.
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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.:
21
|
|
Site:
Food Service General-Beverage Counters
|
|
Violation:
Electrical cords and drain lines were draped on the counters at several beverage stations throughout the food service area.
|
|
Recommendation:
Elevate the power cables and liquid drain tubes so the counter below equipment can be cleaned easily.
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Item No.:
21
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|
Site:
Buffet-Terrace - STBD Beverage Station
|
|
Violation:
There was an open panel on the underside of the coffee machine immediately above the dispensing nozzle that prevented the area from being properly cleaned.
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|
Recommendation:
Close or repair the open panel on the coffee machine.
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Item No.:
26
|
|
Site:
Buffet-Terrace - STBD Beverage Station
|
|
Violation:
A heavy accumulation of scale and old sticky residue soiled the ice chute and water dispensing nozzle of the combination ice/water machine.
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|
Recommendation:
Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized. Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
26
|
|
Site:
Buffet-Terrace - STBD Beverage Station
|
|
Violation:
The coffee dispensing nozzle was soiled with sticky brown old coffee residue of more than a day's accumulation.
|
|
Recommendation:
Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized. Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
26
|
|
Site:
Buffet-Waves Ice Cream - Juice Station
|
|
Violation:
A portable milkshake blender with three mixing arms had slotted fasteners on the bottom of the food contact mixer. The slotted fastener on the mixing arm furthest to the right was soiled with dried food residue as well as the area behind the mixing arm. The mixer had been previously cleaned and was stored on the counter immediately below the prep table next to the handwash station.
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|
Recommendation:
Ensure food-contact surfaces of cooking equipment and pans are kept free of encrusted grease deposits and other soil accumulations.
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Item No.:
26
|
|
Site:
Galley-Toscana
|
|
Violation:
The grooves on the three grooved grills were soiled with a large buildup of charred food residue.
|
|
Recommendation:
Ensure food-contact surfaces of cooking equipment and pans are kept free of encrusted grease deposits and other soil accumulations. Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
27
|
|
Site:
Galley-Toscana
|
|
Violation:
The undersides of the stacked combination ovens were soiled with dried food residue and dust.
|
|
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
|
|
Site:
Buffet-Waves Grill
|
|
Violation:
A heavy amount of dust and corrosion was located on the bottom of the technical compartment below the cold well nearest the pantry door.
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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
|
|
Site:
Galley-Dishwash
|
|
Violation:
Plates coming out of the flight-type dishwash were observed being dried with a wiping cloth instead of being allowed to air dry.
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|
Recommendation:
After cleaning and sanitizing, ensure equipment and utensils are air dried or adequately drained before contact with food. 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
|
|
Site:
Galley-Sauce Station
|
|
Violation:
Water from crew member handwashing was observed landing on the adjacent preparation table in this area. At the time of observation, no foods were impacted.
|
|
Recommendation:
Shield the side of the handwashing station or the adjacent preparation table so the table is not contaminated during handwashing.
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Item No.:
33
|
|
Site:
Galley-Soup Station
|
|
Violation:
There was a missing flange where the electrical line to the ice machine penetrates the deckhead exposing an open seam.
|
|
Recommendation:
Use a profile or grommet if needed to close the gap at the electrical line penetration of the deckhead.
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Item No.:
33
|
|
Site:
Buffet-Terrace Buffet
|
|
Violation:
Coving was missing at the deck and bulkhead juncture behind the worker side of the port and starboard pastry stations.
|
|
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).
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Item No.:
33
|
|
Site:
Buffet-Waves Ice Cream and Grill
|
|
Violation:
Sailcloth and ropes were used as deckhead materials immediately above the water/ice machine, ice tea dispenser, and passenger self-service cold well.
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|
Recommendation:
Ensure bulkheads and deckheads have smooth, hard finishes and light colored surfaces. Exception: bars may have decorative surfaces provided that they are easily cleanable. Remove sailcloth and ensure the deckhead over the food area is hard and easy to clean material.
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Item No.:
33
|
|
Site:
Galley-Food Service Elevator
|
|
Violation:
The bottom tracks of the food service elevator located on the right side was soiled with dried food residue of more than a day's accumulation.
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|
Recommendation:
Clean the food elevator tracks more frequently to avoid soil accumulations.
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Item No.:
33
|
|
Site:
Food Service General-Technical Compartments
|
|
Violation:
Electrical cables and drain lines were observed laying on the deck inside the technical compartments throughout the food service areas. Many of the electrical cables were excessive in length.
|
|
Recommendation:
Shorten the cables or bundle and hang them well above the splash area of the technical compartment and allow proper cleaning.
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Item No.:
36
|
|
Site:
Food Service General-Lighting
|
|
Violation:
There was less than the required 220 lux of light at the following areas: deep fat fryer at Waves Grill, passenger self-service cold well at Waves Grill, and drying racks at the crew potwash. There was less than the required 110 lux of light behind and around deck and counter mounted equipment at the following locations: beverage counters, pizza ovens, flight-type dishwashing machines, deck mounted pastry ovens, deck mounted ice machines in both galleys and deck pantries, and at the Toscana bar handwash station.
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|
Recommendation:
Ensure the light intensity is at least 220 lux (20 foot candles) on food preparation surfaces, and at a distance of 75 centimeters (30 inches) above the deck in food preparation areas, handwashing facilities, warewashing areas, equipment, and utensil storage, pantries, toilet rooms, and consumer self-service areas. Ensure the light intensity is at least 110 lux (10 foot candles) at a distance of 75 centimeters (30 inches) above the deck when in use, in walk-in refrigerator units and dry storage areas, and in other areas and rooms during periods of cleaning. 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.:
40
|
|
Site:
Integrated Pest Management-Active Monitoring Logs
|
|
Violation:
The log of the active monitoring inspections had a field described as date/time, but it was sized too small and staff only wrote the date of the inspection. On several logs staff wrote a time range for all the inspections conducted on that page. Staff stated that a new form has been received with a dedicated column for time of inspection.
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|
Recommendation:
Ensure the IPM Plan includes provisions for logs for active monitoring of pest sightings in operational areas of the vessel. Ensure the IPM plan includes provisions for training of crew members in charge of log completion. Record the time of the active monitoring inspections in the log.
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Item No.:
40
|
|
Site:
Integrated Pest Management-Provisions Inspection
|
|
Violation:
The logs for inspection of provisions included only food related supplies and never identified other supplies received or inspections of those supplies.
|
|
Recommendation:
Routinely inspect incoming shipments of food and all other supplies for evidence of insects, rodents, and other pests. Maintain a record of these inspections onboard the vessel and make the record available for review during inspections.
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Item No.:
41
|
|
Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
|
|
Violation:
The written OPRP noted application of either 1,000 ppm chlorine blieach on hard surfaces and Mikrobac III cleaner/disinfectant on those surfaces which are damaged by chlorine. There were statements on application of these products that they were to be applied by rags, Staff stated that the chemicals are sprayed from a bottle onto rags. There was no details on protection of passengers for the dermal risk posed by these chemicals or the inhalation risk.
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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.:
41
|
|
Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
|
|
Violation:
There were procedures established for notification of on board passengers in the event of a GI illness outbreak, but there were none specific to the embarking passengers or those joining as part of a segmented voyage. Announcements from the ships Master were listed, but this would not be sufficient notification for someone embarking, as they should be made aware of an outbreak prior to that time.
|
|
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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|
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Item No.:
41
|
|
Site:
Housekeeping-Bridge Crew Public Toilet
|
|
Violation:
There was no handwashing sign in the toilet room on the bridge. Additionally, there was no sign posted in this toilet room advising users to use a tissue to open the door to exit. There was a bath towel installed for hand-drying and no paper towel or box of tissues to use for opening the door upon exit.
|
|
Recommendation:
Equip passenger and crew public toilet facilities so persons exiting the toilet room are not required to touch the door handle with bare hands. Where toilet stalls include handwashing facilities, ensure the bare-hands-free contact begins in the toilet stall. Ensure that toilet facilities with multiple exits, such as spa dressing rooms, have bare-hands-free contact at each exit. Provide the passenger and crew public toilets with a handwashing station that includes: (1) Hot and cold running water; (2) Soap; (3) A method to dry hands; (4) A sign advising users to wash hands. Post a sign advising users of toilet facilities to use hand towel, paper towel, or tissue to open the door unless the exit is hands free.
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|
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Item No.:
43
|
|
Site:
Housekeeping-Showerhead Disinfection
|
|
Violation:
The showerhead cleaning and disinfection log notes that a concentration contact time of 10 ppm chlorine for 60 minutes or an equivalent CT value must be used, but there was no written standard or log entry of what the concentration and contact time was actually used.
|
|
Recommendation:
Either provide in the description at the top of each log what the actual concentration and contact time for chlorine is or enter values in each log entry so it is clear what is being used for showerhead cleaning and disinfection.
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|