|
|
|
Item No.:
02
|
|
Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
|
|
Violation:
The AGE surveillance log could not be exported from the electronic database to the format in the 2011 VSP Operations Manual Annex 13.0 and did not include all of the information required. This was noted on the previous inspection. Documentation from the corporate officed indicated this will be corrected by April 30, 2013.
|
|
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.
|
|
|
Item No.:
02
|
|
Site:
Medical-AGE Contacts
|
|
Violation:
There were nine crew cases during the last five cruises but there was no documentation indicating the close contacts of the crew had been interviewed. Staff stated these crew had close contacts.
|
|
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.
|
|
|
Item No.:
06
|
|
Site:
Potable Water-Monthly Potable Water Samples
|
|
Violation:
The monthly potable water sample taken from the water supply line to the juice machine in the staff mess was positive for total coliform and E.coli on October 30, 2012, but there was no documented follow-up actions or sample results.
|
|
Recommendation:
Collect and analyze a minimum of four potable water samples per month for the presence of E. coli. Collect samples from the forward, aft, upper, and lower decks of the vessel. Change the sample sites each month so that all of the potable water distribution system is effectively monitored. Conduct follow-up sampling for each positive test result.
|
|
|
Item No.:
08
|
|
Site:
Potable Water-Cross-Connection Control List
|
|
Violation:
The list indicating the devices for backflow prevention and air gaps did not specify the types of devices for the evaporators in the engine spaces.
|
|
Recommendation:
Ensure the cross-connection control program includes at a minimum: a complete listing of cross-connections and the backflow prevention method or device for each, so there is a match to the plumbing system component and location. Include air gaps on the listing. Ensure a schedule for inspection frequency is set. Maintain a log documenting the inspection and maintenance in written or electronic form, and ensure it is available for review during inspections.
|
|
|
Item No.:
11
|
|
Site:
Medical-Crew Reporting
|
|
Violation:
One nonfood worker had an onset of AGE symptoms on February 16, 2013 at 9:30 p.m., but did not report to the medical facility until February 17, 2013 at 8:49 a.m. A food worker had an onset of AGE symptoms on February 13, 2013 at 11:00 p.m. but did not report to medical until February 14, 2013 at 11:35 a.m. The documentation indicating these individuals did not work and isolated themselves in their cabins.
|
|
Recommendation:
Ensure crew members report to medical immediately after their first AGE symptom.
|
|
|
Item No.:
13
|
|
Site:
Galley-Starboard Dishwash
|
|
Violation:
When examining the final spray pattern of the flight-type dishwasher, a crew member removed the final sanitizing curtain and placed it on the adjacent soiled scrapping table. After examining the final spray pattern, the crew member installed the same curtain without properly sanitizing. The inspector had to tell the crew member to stop active use of the machine until the curtain was properly cleaned.
|
|
Recommendation:
Ensure the supervisor or person in charge of food operations on the vessel monitors that: (3) Employees and other persons such as delivery and maintenance persons and pesticide applicators entering the food preparation, food storage, or warewashing areas comply with the guidelines in this manual; (12) Employees are properly trained in food safety, including food allergy awareness, as it relates to their assigned duties.
|
|
|
Item No.:
14
|
|
Site:
Pantry-Pool Bar Pantry
|
|
Violation:
A crew member wearing a large metal watch was observed slicing fruit garnishes. The watch was loosely fitting and was contacting the cutting board where the fruit was being cut.
|
|
Recommendation:
Ensure food employees, including bartenders, do not wear jewelry on their arms or hands while preparing food.
|
|
|
Item No.:
18
|
|
Site:
Galley-Tuscan Grill
|
|
Violation:
Packaged raw octopus and raw beef products were stored in direct contact with each other in the undercounter freezer. The food products had been removed from their original containers and re-packaged on-board. The octopus was served raw.
|
|
Recommendation:
Protect food from cross-contamination or other sources of contamination by the following methods: (1) Physically separating raw animal foods during storage, preparation, holding, and display from raw ready-to-eat food so that products do not physically touch and so that one product does not drip into another. (2) Separating types of raw animal foods from each other such as beef, fish, lamb, pork, and poultry?except when combined as ingredients?during storage, preparation, holding, and display by using separate equipment for each type, or by arranging each type of food in equipment so that cross-contamination of one type with another is prevented, or by preparing each type of food at different times or in separate areas. (3) Cleaning and sanitizing equipment and utensils. (4) Storing the food in packages, covered containers, or wrappings. (5) Cleaning visible soil on hermetically sealed containers of food before opening. (6) Protecting food containers that are received packaged together in a case or overwrap from cuts when the case or overwrap is opened. (7) Separating damaged, spoiled, or recalled food being held on the vessel. (8) Separating unwashed fruits and vegetables from ready-to-eat food.
|
|
|
Item No.:
19
|
|
Site:
Buffet-Gelato Bar
|
|
Violation:
There was no sneeze guard or other means of protection for the gelato dipper well located on the service counter where passengers can place their order. The ship was using a portable ice cream cone stand to block the dipper well, but this was not offering complete protection.
|
|
Recommendation:
Ensure the dipper well is completely protected.
|
|
|
Item No.:
20
|
|
Site:
Preparation Room-
|
|
Violation:
The grey plastic lid to the potato tumbler was cracked and chipped in several areas making cleaning difficult. The lid was replaced.
|
|
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.
|
|
|
Item No.:
21
|
|
Site:
Dining Room-San Marco Waiter Stations
|
|
Violation:
The waiter station drawers and cabinets had exposed raw wood and scratches, making cleaning difficult.
|
|
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.
|
|
|
Item No.:
21
|
|
Site:
Buffet-Toast Stations
|
|
Violation:
The Corian countertops at both the port and starboard toast stations were badly cracked and chipped in several areas. A vertical profile piece of the port worker side countertop was missing which exposed raw wood. The wood was soiled with food residue.
|
|
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.
|
|
|
Item No.:
21
|
|
Site:
Pantry-Deck 9 Forward Cabin Service
|
|
Violation:
There were corroded fasteners in the panel above the single coffee dispenser of the small coffee machine.
|
|
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.
|
|
|
Item No.:
27
|
|
Site:
Buffet-Port Toast Station
|
|
Violation:
A vertical profile piece of the port worker side countertop was missing exposing raw wood. The wood was soiled with food residue.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
27
|
|
Site:
Buffet-Service Line
|
|
Violation:
The small tube lighting installed above the food service lines were covered with a sticky greasy film. The film was also covered in dust and dried food debris.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
27
|
|
Site:
Buffet-Aqua Spa
|
|
Violation:
The electrical cord for a bulkhead mounted battery charging unit was soiled with a heavy build-up of dust. This was located near the handwash station on the worker side of the buffet.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
27
|
|
Site:
Galley-Bell Box
|
|
Violation:
There was grease residue on the underside of the bottom panel to the grooved grill. This area had been previously cleaned.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
33
|
|
Site:
Galley-
|
|
Violation:
The food transportation corridor conecting the port and starboard sides of the main galley had bulkheads with open seams and gaps from loose and missing profile strips at the bulkhead/deck juncture.
|
|
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. Do not use carpet in these areas.
|
|
|
Item No.:
33
|
|
Site:
Galley-Hot Galley
|
|
Violation:
There was some old food residue and a fork on the deck behind the two deck mounted combination ovens.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
|
|
|
Item No.:
33
|
|
Site:
Food Service General-Decks
|
|
Violation:
There were areas of chipped deck tiles and missing or pitted deck grouting throughout different food service areas. These areas included: the Lido Galley, Main Hot Galley, and the Crew Galley.
|
|
Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
|
|
|
Item No.:
36
|
|
Site:
Food Service General-Lighting
|
|
Violation:
There was less than the required 110 lux of light behind deck and counter mounted equipment throughout the food service areas. The areas and equipment included: passenger buffet miship beverage stations, lido galley ice machines, lido ice cream machines, Tuscan Grill espresso station, Bell Box ice machines, Bistro on 5 coffee and juice stations, pastry ovens, crew galley combination ovens, and the ice machine in the deck 9 forward housekeeping pantry. A comprehensive lighting plan to add lighting to different food service areas was provided and new lighting had already been installed.
|
|
Recommendation:
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.
|
|
|
Item No.:
37
|
|
Site:
Buffet-Dishwash
|
|
Violation:
Heavy condensate was observed along the deckhead at the clean landing side of the in-use flight-type dishwash machine. Condensate was observed dripping onto the adjacent sorting table. Crew members had to periodically wipe the deckhead and exhaust vent to prevent the condensate from dripping onto clean items. No clean items were impacted.
|
|
Recommendation:
Ensure exhaust ventilation hood systems in food preparation and warewashing areas--including components such as hoods, fans, guards, and ducting--are designed to prevent grease or condensation from draining or dripping onto food, equipment, utensils, linens, and single-service and single-use articles.
|
|
|
Item No.:
39
|
|
Site:
Galley-Seaside Pantry
|
|
Violation:
A live fly was flying around in this area. The area was in operation at the time of the inspection.
|
|
Recommendation:
Effectively control the presence of insects, rodents, and other pests to minimize their presence in the food storage, preparation, and service areas and warewashing and utensil storage areas aboard a vessel.
|
|
|
Item No.:
39
|
|
Site:
Provisions-Fruit and Liquior Room Corridor
|
|
Violation:
There were approximately 3 small fruit flies along the bulkhead and deckhead of this area.
|
|
Recommendation:
Effectively control the presence of insects, rodents, and other pests to minimize their presence in the food storage, preparation, and service areas and warewashing and utensil storage areas aboard a vessel.
|
|
|
Item No.:
40
|
|
Site:
Integrated Pest Management-Active Surveillance
|
|
Violation:
There were no documented follow-up inspection results for pests found during active surveillance. For example, house flies were found in the garbage room on January 2, 2013 and cockroaches were found in the garbage room on January 15, 2013, but it was unknown what the follow-up inspection results were after the areas had been treated.
|
|
Recommendation:
When pests are noted during an inspection, ensure the log includes action taken and follow-up inspection results.
|
|
|
Item No.:
41
|
|
Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
|
|
Violation:
The OPRP indicated all of the bar areas were disinfected using Oxivir. Also, staff stated the crew were notified of an outbreak by email, but this was not indicated in the OPRP.
|
|
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. Ensure food areas are only disinfected with 50-200 ppm chlorine and indicated in the OPRP.
|
|
|
Item No.:
41
|
|
Site:
Housekeeping-Bridge Toilet Room
|
|
Violation:
There were no paper towels in the public toilet room.
|
|
Recommendation:
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.
|
|