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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Definition
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Violation:
On June 11, 2013, a nonfood worker had one loose stool, abdominal cramps, and was given antidiarrheal medication. The medical staff recorded this person as non-reportable. According to the staff, they were unaware that an individual could meet the AGE case definition if they had less than three loose stools. According to the documentation, this individual was isolated as a precaution for 24 hours. In the medical notes, AGE was recorded as the illness they had.
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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.:
02
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Site:
Medical-Crew Reporting
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Violation:
A new food worker had an illness onset that met the AGE case definition on May 25, 2013 at 0500, but did not report to medical until May 26, 2013 at 0810. According to the staff, this person boarded the ship and went straight to medical and did not have any close contacts, but this was not documented.
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Recommendation:
When new crew members sign-on with AGE symptoms document all information related to the case.
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Item No.:
02
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Site:
Medical-AGE Log
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Violation:
A passenger had one episode of diarrhea on May 29, 2013 at 08:00 and another episode of diarrhea on May 31, 2013 at 11:30. The AGE log did not contain any other information for this individual in terms of a medical evaluation or any other symptoms they may be having except that they were given antidiarrheal medication. The underlying illness column of the AGE log, stated 'Pharmacy Sale/Loperamide'. According to the staff, this person was not fully evaluated or isolated because they did not have at least three loose stools. However, the diarrhea symptoms were above normal for the individual especially after antidiarrheal medication was prescribed. After the inspector discussed this case with the staff, the staff stated they should have been a reportable case.
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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.:
08
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Site:
Potable Water-Cross-Connection Control List
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Violation:
The list of air gaps did not state the actual number of air gaps for the plumbing components and it was unclear how many plumbing components there were that had air gaps. The staff had to verbally verify the number of most air gaps and plumbing components. Also, air gaps were included on the cross-connection list for the drains of all nine potable water tanks, but upon inspection the staff were actually describing the potable water tank sample cocks.
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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.
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Item No.:
08
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Site:
Potable Water-Striping
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Violation:
The distillate line from the mineralizers to the chlorine injection point was striped blue for potable water. Also, the distillate line from evaporator #1 to the potable tank was labeled 'potable' before the chlorine injection point and the distillate line to the distillate tank was striped blue for potable water. Finally, the distillate line from evaporators #2 and #3 to the potable tank before the chlorine injection point was labeled 'potable', the distillate line to the technical tank was labeled with blue and yellow striping, and the distillate line to the distillate tank was striped blue and black.
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Recommendation:
Stripe or paint potable water lines either in accordance with ISO 14726 (blue/green/blue) or blue only. Stripe or paint distillate and permeate lines directed to the potable water system in accordance with ISO 14726 (blue/gray/blue). Ensure no other lines have the above color designations. Stripe or paint these lines at 5 meters (15 feet) intervals and on each side of partitions, decks, and bulkheads, except where decor would be marred by such markings, including potable water supply lines in technical lockers. Do not stripe or paint potable water lines after reduced pressure assemblies as potable water. 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:
Potable Water-Tank Disinfection
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Violation:
All nine potable water tanks were entered in December 2012 and the alternative disinfection method was used on each tank, but only the concentration of greater than 200 PPM was documented. The contact time for each tank was disinfected for was not documented on the forms.
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Recommendation:
Maintain documentation of all inspections, maintenance, cleaning, and disinfection for 12 months and ensure it is available for review during inspections. Ensure records include a method of disinfection, concentration and contact time of the disinfectant, and a halogen value of less than or equal to 5 ppm before the tank is put back into service.
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Item No.:
10
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Site:
Recreational Water Facilities-Hydropool Safety Sign
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Violation:
The safety sign at this facility did not contain all of the information required in the 2011 VSP Operations Manual. According to the staff, this sign had been ordered and should be arriving soon.
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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.:
11
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Site:
Medical-Crew Isolation
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Violation:
On June 1, 2013, a youth center worker had one episode of diarrhea and two episodes of vomiting. Medical staff recorded her as a reportable case, but only isolated her for 24 hours. The inspector later verified the youth staff serve food and should be isolated for at least 48 hours after their last symptom. According to her work record, this person worked between 24 hours and 48 hours since her last symptom.
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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.:
11
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Site:
Medical-Passenger Isolation
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Violation:
A passenger had one episode of diarrhea on May 29, 2013 at 08:00 and another episode of diarrhea on May 31, 2013 at 11:30. The AGE log did not contain any other information for this individual in terms of a medical evaluation or any other symptoms they may have been experiencing except that they were given antidiarrheal medication. The underlying illness column of the AGE log stated 'Pharmacy Sale/Loperamide'. According to the staff, this person was not fully evaluated or isolated because they did not have at least three loose stools. After the inspector explained the AGE case definition, staff stated this individual should have been isolated and included as a case.
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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-Burger Station
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Violation:
The consumer advisory sign for the cheeseburgers was missing a statement that cheeseburgers can be cooked to order and may be served raw or undercooked.
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Recommendation:
If an animal food such as beef, eggs, fish, lamb, milk, pork, poultry, or shellfish that is raw, undercooked, or not otherwise processed to eliminate pathogens is offered in a ready-to-eat form or as a raw ingredient in another ready-to-eat food, ensure the consumer is informed by way of disclosure using menu advisories, placards, or other easily visible written means of the significantly increased risk to certain especially vulnerable consumers eating such foods in raw or undercooked form. Locate the advisory at the outlets where these types of food are served. Ensure that raw shell egg preparations are not used in uncooked products as described in section 7.3.3.2.3. Ensure that disclosure is made by one of the two following methods: (1) On a sign describing the animal-derived foods (e.g., "oysters on the half-shell," "hamburgers," "steaks," or "eggs"); AND that they can be cooked to order and may be served raw or undercooked; AND a statement indicating that consuming raw or undercooked meats, seafood, shellfish, eggs, milk, poultry may increase your risk for foodborne illness, especially if you have certain medical conditions. Ensure the advisory is posted at the specific station where the food is served raw, undercooked, or cooked to order OR (2) On a menu using an asterisk at the animal-derived foods requiring disclosure and a footnote with a statement indicating that consuming raw or undercooked meats, seafood, shellfish, eggs, milk, or poultry may increase your risk for foodborne illness, especially if you have certain medical conditions.
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Item No.:
16
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Site:
Galley-Hot Galley
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Violation:
The posted time control plan did not list the range top as a time control piece of equipment. Staff had a time control sticker on a curry sauce set on that range top for back-up to the hot line.
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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.:
20
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Site:
Buffet-Crew Mess
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Violation:
The area between the ice cube chute and ice chute housing on the ice/water machine was difficult to clean.
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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-Deck 2 Main Galley Beverage Station
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Violation:
Per employee, the milk container and lid were the only items in the two Franke Spectra Coffee machines being cleaned and sanitized at the four hour discard time. Staff were not also cleaning and sanitizing the dispensing tube or the frothing compartment that the milk travels through at the four hour discard.
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Recommendation:
Conduct cleaning of equipment such as ice bins; beverage dispensing nozzles; and enclosed components of equipment such as ice makers, cooking oil storage tanks, and distribution lines, beverage dispensing lines, and syrup dispensing lines or tubes; and coffee bean grinders: (1) at a frequency specified by the manufacturer; or (2) in the absence of manufacturer specifications, at a frequency necessary to preclude accumulation of soil or mold.
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Item No.:
21
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Site:
Galley-Deck 2 Starboard Beverage Station
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Violation:
The insulated wiring in the undercounter technical compartment to the two undercounter juice machines extended down into the deck sink below. Staff repaired this during the inspection.
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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.:
26
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Site:
Buffet-Crew Mess
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Violation:
The lower edge of the ice cube chute housing on the ice/water machine was corroded. The area between the ice cube chute and the ice chute housing was accumulating corrosion and other debris.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
26
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Site:
Galley-Deck 3 Hot Galley
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Violation:
The conveyer belt chain on the pizza conveyer oven was covered with a grease residue. The unit was labeled not in use.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch. 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.:
33
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Site:
Galley-Potwash
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Violation:
The hole in the bulkhead for the water line penetration to the drinking fountain was not sealed.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
33
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Site:
Preparation Room-A Deck Bakery
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Violation:
The deck was damaged at transition points with equipment foundations and gutterways. The surface was sharp and difficult to clean. Staff have identified this as part of a ship wide deck maintenance project, some of which was observed in the deck pantries and sections of the main galley.
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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. Do not use carpet in these areas. Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
33
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Site:
Buffet-Lido Port Main Line
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Violation:
There was a loose deckhead panel over the condiment section counter which exposed a difficult to clean raised edge of an adjoining deckhead panel.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
33
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Site:
Buffet-Lido Port Main Line
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Violation:
The deckhead was heavily soiled with dust debris around the center supply air vent cover in the condiment section.
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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:
Bar-Lido Bar
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Violation:
The deckhead over the center of this bar was a cloth covering which has a design of folds throughout the surface which could trap dirt and debris, rather than a smooth, easy to clean surface.
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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. Do not use carpet in these areas. Ensure bulkheads and deckheads have smooth, hard finishes and light colored surfaces. Exception: bars may have decorative surfaces provided that they are easily cleanable.
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Item No.:
36
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Site:
Pantry-Lido Bar Pantry - Midship
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Violation:
The artificial light level behind the ice machine was below the minimum 110 lux. This was not one of the areas located on the lighting plan.
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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.
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Item No.:
36
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Site:
Provisions-Meat Freezer
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Violation:
The light fixture above the raw beef section was burned out.
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Recommendation:
Replace the light bulbs in light the fixture.
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Item No.:
36
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Site:
Galley-Deck 9 Ice Machine
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Violation:
The light intensity around and behind the ice machine on the starboard side of the lido galley was below 110 lux.
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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.
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Item No.:
36
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Site:
Galley-Deck 3 Hot Galley
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Violation:
The light fixture on the deckhead by the elevator and the electrical locker by the Deck 3 hot galley was burned out.
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Recommendation:
Replace the light bulbs in light the fixture.
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Item No.:
36
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Site:
Galley-Deck 2 Hot Galley
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Violation:
The light intensity around and behind the four combination ovens in the hot galley was below 110 lux. This location was noted on the ship's lighting correction action plan.
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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.
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Item No.:
36
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Site:
Galley-Deck 2 Main Galley Beverage Station
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Violation:
The light intensity around and behind the milk dispenser and coffee machine at the beverage station across from the two ice machines was not 110 lux. This area was not listed on the ship's lighting correction action plan.
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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.
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Item No.:
36
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Site:
Galley-Deck 2 Main Dishwash
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Violation:
The light intensity for the clean rack next to the drinking fountain in the main dishwash was below 220 lux. This area was not listed on the ship's lighting correction action plan.
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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.
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Item No.:
37
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Site:
Galley-Deck 2 Hot Galley
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Violation:
Condensation was accumulating on the deckhead above the far left soup kettle. Water droplets were ready to fall onto the covered soup kettle below. Staff corrected this issue onsite.
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Recommendation:
Ensure ventilation hood systems and devices operate effectively to prevent grease and condensate from collecting on the bulkheads and deckheads and remove contaminants generated by equipment located under them.
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Item No.:
38
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Site:
Galley-Deck 3 Hot Galley
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Violation:
The conveyer belt on the pizza conveyer oven was no longer in use but was still installed and present in the hot galley.
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Recommendation:
Ensure only articles necessary for the food service operation are stored in food preparation, food storage, and warewashing areas.
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