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Item No.:
02
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Site:
Medical-72-Hour Food/Beverage Questionnaire
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Violation:
The 72-hour food/beverage questionnaire did not have a data element to identify whether the reportable case was a passenger or crew member. This is a new requirement for the 2018 VSP Operations Manual.
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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 an area to mark whether a patient was a crew member or passenger.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The acute gastroenteritis (AGE) surveillance log did not contain the information in the exact order identified in Annex 13.2.2 of the 2018 VSP Operations Manual. The ship's log contained a data column for 'Pax Meal Seat' located directly between the data column for 'Cabin No.' and 'Crew Position.' This is a new requirement for the 2018 VSP Operations Manual.
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Recommendation:
Ensure the AGE surveillance log includes a header containing the following information about the voyage: (1) Vessel name; (2) Voyage number; (3) Date from; (4) Date to; (5) Total number of passengers; (6) Reportable total number of passengers ill; (7) Total number of crew; (8) Reportable total number of crew ill. Total number of passengers and total number of crew must be the totals at the beginning of the voyage (i.e., totals on ?date from?). 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. If none, write ?none,? ?not applicable,? ?N/A,? r similar wording. Comments may also be added to the log in this column after the information about underlying illness. 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.:
06
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Site:
Potable Water-Distant Point Analyzer Chart Recorder Records
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Violation:
Numerous instances of gaps on the distant point analyzer chart recorder records were identified during the record review. On 14 May 2019, a gap from 06:30 until 08:00 was identified on the chart recorder record. On 11 May 2019, a gap from 05:45 until 06:45 was identified on the chart recorder record. On 10 May 2019, a gap from 05:55 until 07:00 was identified on the chart recorder record. There were no notations explaining these events.
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Recommendation:
Change, initial, and date halogen analyzer-chart recorder charts daily. Ensure the charts contain notations of any unusual events in the potable water system. If electronic data loggers are used in lieu of chart recorders, record notations of any unusual events in the potable water system log.
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Item No.:
08
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Site:
Potable Water-Cross-Connection Control Program Log
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Violation:
The cross connection control program log identified double check valve backflow prevention devices were installed in D8 FWD and in D8 Pantry; however, there was no identification of the cross-connections these devices protected. Additionally, the log identified these devices were inspected on 11 May 2019. Staff was unable to identify which cross-connections these devices protected.
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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-Production Analyzer Chart Recorder Records
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Violation:
Staff provided two potable water production analyzer chart recorder records for 15 May 2019. One record, labeled 15-5-19, identified potable water production occurred from 20:29 until 00:45; 01:15 until 10:50; and 19:05 until 00:00. Additionally, this record identified the first calibration for the potable production starting at 19:05 occurred at 20:29, nearly an hour and a half after production began. The second record, labeled 5-15-19, identified potable production occurred from 00:30 until 6:50; 12:30 until 15:30; and 16:52 until 19:30. Staff was unable to explain these duplicate records and the overlap existing between these two records.
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Recommendation:
Maintain accurate records of production and bunkering monitoring aboard for 12 months and ensure these records are available for review during inspections.
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Item No.:
08
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Site:
Potable Water-Pipe Disinfection Records
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Violation:
Staff stated they did not maintain records or electronic documentation of disinfection of affected parts of the potable water distribution before being placed in service; before returning to operation after repair/replacement; or after being subjected to any contamination. Staff stated backflow prevention devices, including the deck 6 pantry glasswash machine and the deck 5 pantry glasswash machine were replaced during May 2019. There was no documentation that a free halogen residual of 50 MG/L (ppm) for 4-hours was used to disinfect these newly installed backflow prevention devices. Additionally, there was no documentation that these newly installed backflow prevention devices were flushed with potable water or otherwise dechlorinated until the free residual halogen was less than or equal to 5.00 MG/L (ppm). Staff stated a record existed approximately one year ago; however, these records were discontinued. Staff stated pieces of pipe were not replaced since the previous inspection.
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Recommendation:
Document the free halogen residual level. Flush the disinfected parts of the system with potable water or otherwise dechlorinate until the free residual halogen is less than or equal to 5.00 mg/L (ppm). Document the free halogen test result.
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Item No.:
10
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Site:
Recreational Water Facilities-Deck 5 Forward Whirlpool Spa Hair and Lint Strainer Disinfection
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Violation:
The hair and lint strainer for the deck 5 forward whirlpool spa was disinfected on 18 May 2019, and was not disinfected again until 27 May 2019.
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Recommendation:
Clean, rinse, and disinfect the hair and lint strainer and hair and lint strainer housing on all RWFs weekly. Ensure disinfection is accomplished with an appropriate halogen-based disinfectant. At a minimum, use a 50-ppm solution for 1 minute, or equivalent CT value. Maintain records on all inspection and cleaning procedures. Ensure that if there is not a hair and lint strainer but there is a filter before the pump, this filter must be cleaned, rinsed, and disinfected weekly.
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Item No.:
10
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Site:
Recreational Water Facilities-Fecal/Vomit Accident Response Procedure
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Violation:
The fecal/vomit accident response procedure, version-1-2017, did not meet or exceed the procedure provided in Annex 13.9 of the 2018 VSP Operations Manual. The response procedure provided did not identify to maintain a temperature of 77F (25C) or higher during disinfection. This is a new requirement for the 2018 VSP Operations Manual.
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Recommendation:
Ensure a fecal and vomit accident response procedure that meets or exceeds the procedure provided in Annex 13.9 is available for review during inspections.
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Item No.:
16
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Site:
Dining Room-Dinner Menu
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Violation:
Staff stated the hamburger listed on the dinner menu could be served undercooked. However, there was no asterisk for the hamburger linking it to the consumer advisory statement.
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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 or 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.:
19
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Site:
Buffet-Verandah Bread Pudding Station
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Violation:
The sneeze guard at the bread pudding station did not have side protection and guests could line up right next to the side of the station. The bread pudding was covered, but the serving utensils under the sneeze guard were not protected.
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Recommendation:
During service, ensure the food contact portion of each self-service food dispensing utensil is covered or located beneath shielding. Ensure that dishware, glassware, and utensils out for service are inverted or covered.
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Item No.:
19
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Site:
Galley-Dry Store
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Violation:
Dust had accumulated in the deckhead ventilation vent above bag of flour and other dry goods.
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Recommendation:
Protect food from contamination by storing the food: (1) Covered or otherwise protected; (2) In a clean, dry location; (3) Where it is not exposed to splash, dust, or other contamination; (4) At least 150 millimeters (6 inches) above the deck; (5) At least 127 millimeters (5 inches) for food in packages and working containers on pallets, skids, and racks; and (6) At least 150 millimeters (6 inches) above the deck on shelving racks.
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Item No.:
20
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Site:
Galley-Pastry/Bakery
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Violation:
The edge of the dough sheeter was in disrepair. Staff stated a new one had been ordered.
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Recommendation:
Materials used in the construction of multiuse utensils and food contact surfaces of equipment must be: (1) durable, corrosion resistant, and nonabsorbent; (2) sufficient in weight and thickness to withstand repeated warewashing; (3) finished to have a smooth, easily cleanable surface; and (4) resistant to pitting, chipping, crazing, scratching, scoring, distortion and decomposition.
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Item No.:
21
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Site:
Galley-Pantry
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Violation:
A chair was stored in the pantry area. The back of the chair was woven, making it difficult to clean. Staff stated a plastic chair would be put in its place.
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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.:
26
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Site:
Galley-Cold Pantry
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Violation:
Approximately 10 plate covers had scale build up on the inside. They were also not completely air dried before stacking. They were sent to be rewashed.
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Recommendation:
Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized.
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Item No.:
27
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Site:
Other-Deck 2 Engine Control Room (ECR) Coffee Station
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Violation:
The counter, located underneath the coffee machine, was soiled with greater than a day's accumulation of sticky brown residue. This coffee machine rested directly on a black plastic mat. Moisture and residue were present on the counter located underneath this plastic mat. Corrections started immediately.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
27
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Site:
Galley-Cold Pantry
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Violation:
The technical compartment of refrigerator #17 was soiled. This was cleaned immediately.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
27
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Site:
Galley-Clean Bar Storage Near Dishwash
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Violation:
Five bar trays were found stored soiled above clean bar glasses. They were sent for rewashing.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
27
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Site:
Galley-Hot Galley
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Violation:
The pipes under the deck oven were soiled with greater than one day's worth of accumulation.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
28
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Site:
Galley-Clean Bar Storage Near Dishwash
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Violation:
Five bar trays were found stored soiled above clean bar glasses. They were sent for rewashing.
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Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (1) in a clean, dry location; (2) in a location where they are not exposed to splash, dust, or other contamination; (3) at least 150 millimeters (6 inches) above the deck unless in packages on pallets, skids, or racks, which may be 127 millimeters (5 inches).
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Item No.:
28
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Site:
Galley-Cold Pantry
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Violation:
Approximately 10 plate covers had scale build up on the inside. They were also not completely air dried before stacking. They were sent to be rewashed.
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Recommendation:
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
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Site:
Galley-Soiled Drop Off
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Violation:
An insect-control device was mounted on the bulkhead above chemicals used for cleaning.
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Recommendation:
Do not locate insect-control devices over warewashing, utensil storage areas, equipment, utensils, linens, unwrapped single-service, and single-use articles. Prevent dead insects and insect fragments from falling on clean items.
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Item No.:
28
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Site:
Housekeeping-Deck 4 Housekeeping Pantry
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Violation:
In the neutral storage cabinet, approximate 35 reusable glass water bottles were stored upright with water pooled in the bottom. Additionally, the lids of the water bottles were screwed on.
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Recommendation:
Store clean equipment and utensils in a self-draining position that allows air drying, and covered or inverted.
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Item No.:
33
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Site:
Galley-Dry Store
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Violation:
Dust had accumulated in the deckhead ventilation vent above bags of flour and other dry goods.
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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:
Dining Room-Deck 7 Verandah Outdoor
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Violation:
The deckhead above the starboard side waiter station and the portside waiter station was incomplete. Staff stated there had previously been a canvas deckhead above the waiter stations, but it had ripped in bad weather. Staff stated these waiter stations are only used for soiled dishes. The area was not in operation during the inspection.
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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.
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Item No.:
33
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Site:
Other-Deck 2 Engine Control Room (ECR) Coffee Station
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Violation:
The juncture between the deck and the metal cabinet, located in front of the coffee machine, was soiled with greater than a day's accumulation of dust and dark debris. Corrections started immediately.
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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.:
35
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Site:
Galley-Hot Galley
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Violation:
Water from the drain of the deck oven had accumulated on the deck below the oven. This was immediately cleaned.
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Recommendation:
Ensure black and gray water is discharged to the vessel's wastewater disposal system and does not pool on the deck.
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Item No.:
43
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Site:
Ventilation-Deck 2 AC Unit # 2.11
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Violation:
The bottom of the removable droplet elimination panel for AC unit # 2.11 was soiled with pieces of brown debris, dust, and standing water that was unable to drain. Additionally, when staff opened the droplet elimination compartment a live fly was observed flying inside.
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Recommendation:
Keep air handling units clean.
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Item No.:
43
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Site:
Galley-Soiled Drop Off
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Violation:
When staff opened the droplet elimination compartment, three flies were observed flying inside. Staff was unable to provide information how flies entered into this unit. Additionally, approximately six flies were observed flying around the light fixture inside this ventilation room.
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Recommendation:
Keep air handling units clean.
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Item No.:
44
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Site:
Potable Water-Pipe Disinfection Records
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Violation:
Staff stated they did not maintain records or electronic documentation of disinfection of affected parts of the potable water distribution before being placed in service; before returning to operation after repair/replacement; or after being subjected to any contamination. Staff stated backflow prevention devices, including the deck 6 pantry glasswash machine and the deck 5 pantry glasswash machine were replaced during May 2019. There was no documentation that a free halogen residual of 50 MG/L (ppm) for 4-hours was used to disinfect these newly installed backflow prevention devices. Additionally, there was no documentation that these newly installed backflow prevention devices were flushed with potable water or otherwise dechlorinated until the free residual halogen was less than or equal to 5.00 MG/L (ppm). Staff stated a record existed approximately one year ago; however, these records were discontinued. Staff stated pieces of pipe were not replaced since the previous inspection.
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Recommendation:
Ensure the supervisor or person in charge of potable water operations on the vessel demonstrates to VSP?during inspections and on request-knowledge of potable water operations, is able to demonstrate this knowledge by compliance with Section 5 of the VSP 2018 Operations Manual or by responding correctly to the inspector?s questions as they relate to the specific operation, and properly trains employees to comply with Section 5 of the VSP 2018 Operations Manual as it relates to their assigned duties.
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