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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Log and 72-Hour Questionnaire
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Violation:
The AGE Log did not comply with the 2018 Operations Manual. Crew stated they had the new 72-Hour Questionnaire, but that they were still using the 2011 version because they still had copies remaining.
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Recommendation:
Distribute questionnaires detailing activities and meal locations for the 72 hours before illness onset to all passengers and crew members who are AGE CASES. Ensure that the self-administered questionnaires contain all of the data elements that appear in the questionnaire found in Annex 13.2.2. Ensure that completed questionnaires are maintained with the AGE surveillance log. Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns: (1) Patient ID; (2) Date of the first medical visit or report to staff of illness; (3) time of the first medical visit or report to staff of illness; (4) person's last name; (5) person's first name; (6) person's age; (7) person's sex; (8) designation as passenger or crew member; (9) cabin number; (10) crew member position or job on the vessel, if applicable; (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) bloody stools (yes/no); (c) number of episodes of vomiting in a 24-hour period; (d) fever (yes/no); (e) abdominal cramps (yes/no); (f) headaches (yes/no); (g) myalgia (yes/no); (14) date of last symptom; (15) time of last symptom; (16) entry (yes/no) for whether a specimen was requested; (17) entry (yes/no) for whether a specimen was received; (18) entry (yes/no) for antidiarrheal medications sold or dispensed by designated medical staff; (19) entry (yes/no) for whether this was a reportable case; (20) 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-Caf Caribe
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Violation:
The bell on the atmospheric vacuum breaker for the final rinse manifold was leaking water while the conveyor dishwash in this area was in use.
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Recommendation:
Maintain backflow prevention devices in good repair.
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Item No.:
10
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Site:
Recreational Water Facilities-Crew Pool
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Violation:
There was no safety sign posted for the crew pool. There was a wooden plaque that resembled the shape of other safety signs on the vessel, but the printed language was missing. The pool was closed and was netted. There was very little water in the pool.
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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.:
10
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Site:
Recreational Water Facilities-Crew Starboard Whirlpool
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Violation:
The antientrapment drain cover was significantly cracked. The facility was closed and was netted. There was no water in the facility. Crew reported they were in the process of replacing all the antientrapment drain covers due to their expiration.
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Recommendation:
Ensure antientrapment drain covers are maintained in proper repair.
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Item No.:
10
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Site:
Recreational Water Facilities-Deck 17 Pool
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Violation:
One of the round antientrapment drain covers was not secured to the pool. Upon inspection of the drain cover, it pivoted so that part of the drain below was exposed. The facility was closed and was netted. There was no water in the facility. Crew reported they were in the process of replacing all the antientrapment drain covers due to their expiration.
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Recommendation:
Ensure antientrapment drain covers are maintained in proper repair.
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Item No.:
11
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Site:
Medical-Late Report
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Violation:
On 13 August, a food handler had acute gastroenteritis (AGE) symptom onset at 0600, but did not report to medical until 0845 on 14 August. The crew member worked while symptomatic and ate in crew mess at least three times. The crew member reportedly contacts food equipment, but did not prepare any food items. The crew member received disciplinary action.
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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.
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Item No.:
11
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Site:
Medical-Late Report
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Violation:
A nonfood handler had acute gastroenteritis (AGE) symptom onset at 0700 on 29 July but did not report to medical until noon. The crew member did not eat in crew mess while symptomatic; however, the crew member worked while symptomatic. The crew member received disciplinary action.
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Recommendation:
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.:
22
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Site:
Galley-Caf Caribe
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Violation:
The flight-type conveyor dishwash was in use when the inspector entered the area. The inspector tested the final rinse manifold at the backflow preventer and confirmed the temperature was over 180F. The final rinse gauge measured 182F. The inspector's thermometer was placed on the near side of the conveyor and a final rinse temperature at the plate surface of 153F was measured. The temperatures were tested again with the thermometers placed on the near side of the dishwash and the thermometers measured 141F by the inspector and also by galley staff. Galley staff ran their thermometer on the far side of the dishwash and measured a temperature of 166F. The inspector ran his thermometer through the machine for a third time on the far side and measured 160F. When the curtains were removed, the inspector could see that many of the final rinse spray nozzles were partially blocked, which prevented an effective fan-like final rinse spray pattern; therefore, the dishes that were placed on the close side of the machine were not sanitized effectively. It was not clear how long the machine had been operated in this condition.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: (1) warewashing equipment is maintained in a state of repair and condition that meets the standards of the materials, design, and construction of these guidelines. Ensure warewashing machines, drainboards, and the compartments of sinks, basins, or other receptacles used for washing and rinsing equipment, utensils, or raw foods, or laundering wiping cloths are cleaned: (1) before use; (2) throughout the day at a frequency necessary to prevent recontamination and accumulation of excessive debris, and to ensure that the equipment performs its intended function; (3) at least every 24 hours (if used). Ensure a warewashing machine and its auxiliary components are operated in accordance with the machine's data plate and other manufacturer's instructions.
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Item No.:
22
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Site:
Galley-Caf Caribe
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Violation:
The area around the dirty-dish drop off was piled up with a significant number of soiled dishes which blocked the walkway. This occurred at the end of breakfast service. The backup was due to a dishwash machine that was out-of-service since the morning of the inspection. Crew stated that dishes were diverted to another area.
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Recommendation:
Ensure drainboards, utensils, racks, or tables large enough to accommodate all soiled and cleaned items that may accumulate during hours of operation are provided for necessary utensil holding before cleaning and after sanitizing.
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Item No.:
22
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Site:
Pantry-Gazebo
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Violation:
A sanitizing bucket containing cloudy, dirty water was in use outside this area.
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Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
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Item No.:
22
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Site:
Galley-International Cafe
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Violation:
The conveyor dishwash in this area was out-of-order since the morning of the inspection for not reaching the correct temperatures.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: (1) warewashing equipment is maintained in a state of repair and condition that meets the standards of the materials, design, and construction of these guidelines; (2) water pressure and water temperature-measuring devices are maintained in good repair and accurate within the intended range of use.
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Item No.:
22
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Site:
Galley-International Cafe
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Violation:
The sanitizing bucket in this area was cloudy and soiled during service.
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Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
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Item No.:
24
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Site:
Galley-Caf Caribe
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Violation:
The flight-type conveyor dishwash was in use when the inspector entered the area. After three measurements, only the far side of the warewash machine was reaching the proper temperature for sanitization at the plate surface. This was due to blocked spray nozzles which caused an ineffective spray pattern. Approximately half of the plates exiting the machine were not properly sanitized. It was unknown how long this had occurred. The inspector was able to measure 180F at the final rinse manifold.
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Recommendation:
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.:
28
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Site:
Galley-Deck 6 Forward Starboard
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Violation:
Condensation collected on a cooling duct at the end of the rack-type dishwash that was not in use in this area. The water dripped onto a staging area for clean dishes but no dishes were impacted.
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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.
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Item No.:
30
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Site:
Galley-Hamburger Bar
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Violation:
The crew toilet in this area was out-of-service. Staff did not provide information regarding how long it was out-of-service. No staff were in this area; however, the food area adjacent was open for service.
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Recommendation:
Keep toilet fixtures clean and in good repair.
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Item No.:
37
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Site:
Provisions-Frozen Meat
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Violation:
A significant amount of frozen condensation was observed on the deckhead in this area. Staff stated this area was due for renovation during the upcoming dry-dock. No food was impacted.
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Recommendation:
Ensure ventilation hood systems and devices are sufficient in number and capacity to prevent grease or condensation from collecting on bulkheads and deckheads.
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Item No.:
37
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Site:
Galley-Deck 6 Forward Starboard
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Violation:
Condensation collected on a cooling duct at the end of the rack-type dishwash that was not in use in this area. The condensation dripped onto a staging area for clean dishes but no dishes were impacted.
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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.
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Item No.:
38
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Site:
Galley-Caf Caribe
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Violation:
A soiled mop was stored wet inside a bucket by the handwash station in this area.
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Recommendation:
Ensure only articles necessary for the food service operation are stored in food preparation, food storage, and warewashing areas. Ensure maintenance tools such as mops, brooms, and similar items are stored in a designated locker so they do not contaminate food, food-contact surfaces of utensils, and equipment, linens, and single-service and single-use articles. After use, ensure mops are placed in a position that allows them to air-dry without soiling walls, equipment, or supplies.
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Item No.:
39
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Site:
Galley-Deck 4 Bakery
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Violation:
One fruit fly was observed on the bulkhead at the entrance to this area.
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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.
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Item No.:
39
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Site:
Galley-Dirty Dish Drop-off
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Violation:
One fruit fly was observed on the deckhead while the area was open for lunch.
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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.
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Item No.:
39
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Site:
Preparation Room-Potato Peeler
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Violation:
Three fruit flies were observed on the deckhead while the area was in operation.
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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.
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