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Item No.:
02
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Site:
Medical-Immediate Contacts of Symptomatic Crew
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Violation:
The review of the acute gastroenteritis (AGE) logs found that there was no documentation if the symptomatic crew members had immediate contacts or significant others, other than cabin mates.
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Recommendation:
When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions: (1) restrict exposure to symptomatic crew member(s); (2) undergo a verbal interview with medical or supervisory staff, who will confirm their condition, provide facts and a written fact sheet about hygiene and handwashing, and instruct them to report immediately to medical if they develop illness symptoms; (3) complete a verbal interview daily with medical or supervisory staff until 48 hours after the ill crew members' symptoms began. Ensure that the first verbal interview is conducted within 8 hours from the time the ill crew member initially reported to the medical staff. If the asymptomatic immediate contact or cabin mate is at work, ensure that he or she must is contacted by medical or supervisory staff as soon as possible. Document the date and time of verbal interviews. An immediate contact means sharing a cabin either full or part time or sharing its bathroom facilities. This includes boyfriends, girlfriends, spouses, or other significant others. If the symptomatic crew member has no cabin mate or other immediate contact, this must be documented.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Case Definition
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Violation:
The AGE case definition used by the medical staff did not consider the number of diarrhea episodes that was above normal to individuals.
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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-Acute Gastroenteritis (AGE) Medication
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Violation:
The review of the acute gastroenteritis (AGE) logs found that a waiter and assistant waiter on 8 February and 29 January, respectively, presented to the medical center with AGE symptoms, were given medication to treat diarrhea, and were not included on the AGE logs.
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Recommendation:
List in the AGE surveillance log (1) the name of the vessel, cruise dates, and cruise number; (2) all reportable cases of AGE; and (3) all passengers and crew members who are dispensed antidiarrheal medication from the master of the vessel, medical staff, or other designated staff. 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.:
06
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Site:
Potable Water-Distant Point
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Violation:
There was no chart for 1 February 2017.
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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.
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Item No.:
08
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Site:
Potable Water-Tank Maintenance Records
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Violation:
Tank maintenance records dating back to September 2016, documented 10 inspections to potable water tanks following SMS Chapter 7. The information did not include if the tanks were only cleaned or if they were spot painted. Also, records indicated that in July and August 2016, tanks 5103 and 5213 were spot painted but there was no documentation about paint drying and curing times. Staff stated that the cruise line forms don't provide space for entering this information.
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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-Disinfection Records
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Violation:
Records dating back to September 2016 documented 12 jobs where pipes were disinfected with a chlorine solution of 50 ppm for 4 hours and flushed until less than 5 ppm was in the flushing water. However, these actual chlorine values after flushing were not documented.
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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.:
08
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Site:
Galley-Lido Hot Galley
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Violation:
The relief vent on the backflow prevention device on both water supply lines to the combination ovens were heavily soiled.
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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-Fecal Accident Plan
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Violation:
The fecal accident plan named 'Human Spillage Event Response' had a required pH rage of 7.2-7.5 during a response in sea-to-sea mode, but there was no pH requirement during a response in recirculation mode. In addition, the recirculation mode procedure also instructed to increase the chlorine concentration to 100 ppm for 2 hours for diarrhea incidents. It also instructed to use a table with chlorine concentrations and contact times that instructed 100 ppm for 3 hours.
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Recommendation:
Ensure a fecal and vomit accident response procedure that meets or exceeds the procedure provided in Annex 13.8 is available for review during inspections.
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Item No.:
10
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Site:
Recreational Water Facilities-Safety Signs
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Violation:
The spa safety signs did not cautioned individuals with diabetes against the use of the facilities. In addition, there was no safety sign for the children's 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." In addition to the safety sign requirements in section 6.7.1.1.1, install a sign at each whirlpool spa and spa pool entrance listing precautions and risks associated with the use of these facilities. Include, at a minimum, cautions against use by the following: (1) individuals who are immunocompromised; (2) individuals on medication or who have underlying medical conditions such as cardiovascular disease, diabetes, or high or low blood pressure; and (3) pregnant women, elderly persons, and children. Additionally, caution against exceeding 15 minutes of exposure.
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Item No.:
19
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Site:
Galley-Deck 5 Hot Line
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Violation:
Excessive steam was escaping from all of the in-use bains marie on time control and it was accumulating on the underside of the overshelf and back bulkhead above the two port bains marie. The condensation was above exposed food but no water drips were observed.
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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; and (4) At least 15 centimeters (6 inches) above the deck.
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Item No.:
19
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Site:
Buffet-One Pool
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Violation:
Bread was out for passenger self-service on the end of the buffet line was not protected by a sneeze shield or other effective means. This included the tong used for the bread.
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Recommendation:
Protect food on display from contamination by the use of packaging; counter, service line, or salad bar food guards; display cases; self-closing hinged lids; or other effective means. Install side protection for sneeze guards if the distance between exposed food and where consumers are expected to stand is less than 1 meter (40 inches). During service, ensure the food contact portion of each self-service food dispensing utensil is covered or located beneath shielding.
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Item No.:
19
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Site:
Buffet-Crew Mess
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Violation:
One of the bread baskets out for self-service on the portable table at the beginning of the service line was not fully protected under the portable sneeze shield. This included the tong used with the bread basket. Also, the portable sneeze shields did not have any protection from the side where the consumer could stand less than 1 meter from the exposed bread.
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Recommendation:
Protect food on display from contamination by the use of packaging; counter, service line, or salad bar food guards; display cases; self-closing hinged lids; or other effective means. Install side protection for sneeze guards if the distance between exposed food and where consumers are expected to stand is less than 1 meter (40 inches). During service, ensure the food contact portion of each self-service food dispensing utensil is covered or located beneath shielding.
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Item No.:
20
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Site:
Buffet-Crew Mess
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Violation:
Four woven wicker baskets used for bread service on the buffet line were not properly lined with linen during operation. Bread in each of these four baskets was in contact with the woven wicker surface.
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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.
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Item No.:
20
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Site:
Buffet-Lido Pizzeria
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Violation:
The oven stones in the top two compartments on the deck oven were severely chipped, cracked, and pitted in several locations.
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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.:
21
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Site:
Bar-Midship Buffet Bar
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Violation:
The water supply line for the espresso machine was draped on the counter making cleaning difficult.
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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-Petty Officer Mess Beverage Station
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Violation:
The electrical cord for the juice machine was draped on the counter which created a difficult to clean surface.
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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-Officer Mess Beverage Station
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Violation:
The counter mounted espresso machine was installed with less than a 100 mm (4 inch) clearance with the countertop.
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Recommendation:
Ensure table-mounted equipment that is not easily movable is elevated on legs that provide at least a 100 mm (4-inch) clearance between the table and the equipment.
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Item No.:
21
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Site:
Room Service-Deck 10
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Violation:
The water line for the espresso machine was draped on the counter, making cleaning difficult.
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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.:
22
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Site:
Galley-Starboard Warewash
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Violation:
The far right spray nozzle on the upper final rinse manifold in the rack-type glasswash machine was partially blocked creating an ineffective spray pattern.
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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-Deck 5 Potwash
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Violation:
The mechanical pot wash machine was not working as of the morning of the inspection.
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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-Deck 5 Warewash
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Violation:
The far right spray nozzle on the upper final rinse manifold in the rack-type glasswash machine was partially blocked creating an ineffective spray pattern.
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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-Crew Mess Warewash
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Violation:
When the inspector opened the hood-type glasswash machine six plastic cups on the rack were turned upright and filled with water. Staff stated that a larger, deeper rack was normally used to wash the plastic cups to prevent this from happening.
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Recommendation:
Ensure soiled items to be cleaned in a warewashing machine are loaded into racks, trays, or baskets or onto conveyors in a position that (1) exposes the items to the unobstructed spray from all cycles; (2) allows the items to drain.
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Item No.:
26
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Site:
Galley-Midship Buffet Bar
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Violation:
The top of the white water dispensing tube inside the ice machine was soiled with a black residue. Also, the interior surface of the white deflector panel had black soil residue in two areas.
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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 5 Ice Machines
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Violation:
The inside of the ice scoop for the ice crusher was soiled with a black debris.
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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
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Site:
Buffet-Crew Mess Beverage Station
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Violation:
The openings around the ice chute on both counter mounted ice/water dispensers were soiled with a black and sticky debris.
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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
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Site:
Galley-Deck 6 Hot Galley
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Violation:
The inside of the left deep fryer on the starboard side of the galley was soiled with grease residue at the bottom. Staff stated these deep fat fryers were in-use for breakfast the morning of the inspection and had been cleaned after the service period.
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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.:
27
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Site:
Galley-Lido Hot Galley
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Violation:
The water supply lines to both combination ovens were heavily soiled with grease residue.
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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.:
33
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Site:
Buffet-Lido Burger Buffet
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Violation:
The deckhead vent above the burger buffet was heavily soiled with dust.
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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:
Galley-Deck 5 Hot Line
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Violation:
Water was dripping from a deckhead seam to the deck on the starboard side of the hot galley by the salamander. No food was impacted.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair. Ensure water does not drip from the deckhead to the deck.
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Item No.:
37
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Site:
Galley-Deck 5 Hot Line
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Violation:
Excessive steam was escaping from all of the in-use bains marie on time control and it was accumulating on the underside of the overshelf and back bulkhead above the two port bains marie. The condensation was above exposed food but no water drips were observed.
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Recommendation:
Ensure all food preparation, warewashing, and toilet rooms have sufficient ventilation to keep them free of excessive heat, steam, condensation, vapors, obnoxious odors, smoke, and fumes.
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Item No.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
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Violation:
The OPRP instructed to use HB Quat for responses to all fecal incidents. Staff stated that they would use the same procedure for a food area since there was no other procedure in place. In addition, staff did not have test strips to test concentration of this disinfectant. It was discussed that accelerated hydrogen peroxide compounds are not to be used in food areas.
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Recommendation:
Specify that this procedure is not to be used in food areas and provide an alternative procedure for responses in food areas. This can be accomplished using 1000 ppm of chlorine solution with a contact time of 5 minutes, rinsing, and then applying a solution of 50-200 ppm chlorine. Test strips for disinfectant also ensure that the minimum concentration is achieved.
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