|
|
|
Item No.:
02
|
|
Site:
Medical-Acute Gastroenteritis Logs (AGE)
|
|
Violation:
The information in the Underlying Illness column in the AGE log for the past 5 cruises in the patient medical history information did not consistently contain information directly pertinent to an underlying cause of AGE. The underlying illness was identified incorrectly on April 11 hypertension, hyperlipidemia, March 03 T2DM, high cholesterol, and on March 08 high cholesterol, hypertension, March 13 diabetes, COPD. The column did not contain specific information to determine an underlying illness causing AGE.
|
|
Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns: (1) Date of the first medical visit or report to staff of illness; (2) time of the first medical visit or report to staff of illness; (3) case identification number; (4) person's name; (5) person's age; (6) person's sex; (7) designation as passenger or crew member; (8) crew member position or job on the vessel, if applicable; (9) cabin number; (10) meal seating information; (11) date of illness onset; (12) time of illness onset; (13) illness symptoms, including the presence or absence of the following selected signs and symptoms, with a separate column for each of the following: (a) number of episodes of diarrhea in a 24-hour period; (b) number of episodes of vomiting in a 24-hour period; (c) bloody stools; (d) recorded temperature; (e) abdominal cramps; (f) headaches; (g) muscle aches; (14) entry (yes/no) for whether this was a reportable case; (15) entry (yes/no) for antidiarrheal medications sold or dispensed by designated medical staff; (16) presence of underlying medical conditions that may affect interpretation of AGE. Ensure the AGE surveillance log contains the above information in the exact order and is entered in the template in Annex 13.2.2. Ensure that the log data is exported in the exact order as in the example template in Annex 13.2.2 with analyzable formats such as Excel or Access. Ensure that any additional data fields are entered only outside of the form margins when exported to VSP.
|
|
|
Item No.:
02
|
|
Site:
Medical-Acute Gastroenteritis Logs (AGE)
|
|
Violation:
On April 09, April 03, March 29, March 26(2), March 24, March 17, March 14, and March 09 the information in the Underling Illness column was left blank.
|
|
Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns: (1) Date of the first medical visit or report to staff of illness; (2) time of the first medical visit or report to staff of illness; (3) case identification number; (4) person's name; (5) person's age; (6) person's sex; (7) designation as passenger or crew member; (8) crew member position or job on the vessel, if applicable; (9) cabin number; (10) meal seating information; (11) date of illness onset; (12) time of illness onset; (13) illness symptoms, including the presence or absence of the following selected signs and symptoms, with a separate column for each of the following: (a) number of episodes of diarrhea in a 24-hour period; (b) number of episodes of vomiting in a 24-hour period; (c) bloody stools; (d) recorded temperature; (e) abdominal cramps; (f) headaches; (g) muscle aches; (14) entry (yes/no) for whether this was a reportable case; (15) entry (yes/no) for antidiarrheal medications sold or dispensed by designated medical staff; (16) presence of underlying medical conditions that may affect interpretation of AGE. Ensure the AGE surveillance log contains the above information in the exact order and is entered in the template in Annex 13.2.2. Ensure that the log data is exported in the exact order as in the example template in Annex 13.2.2 with analyzable formats such as Excel or Access. Ensure that any additional data fields are entered only outside of the form margins when exported to VSP.
|
|
|
Item No.:
*
|
|
Site:
Medical-Acute Gastroenteritis Logs (AGE)
|
|
Violation:
Medical staff reported a recent transition to a new patient tracking database and problems with Celsius and Fahrenheit conversions along with blanks in the patient temperature column. They raised concern about not being able to correct items as they were entered.
|
|
Recommendation:
|
|
|
Item No.:
02
|
|
Site:
Medical-Specimen Collection
|
|
Violation:
The medical department did not have any specimen collection containers on board. They reported they were on back order.
|
|
Recommendation:
Ensure the medical staff maintains a supply of at least 10 clinical specimen collection containers for both viral and bacterial agents (10 for each), as well as a shipping container that meets the latest shipping requirements of the International Air Transport Association (IATA) and U.S. Department of Transportation for Biological Substances, Category B designated shipments (or higher). Ensure the vessel maintains the appropriate labels and markings required for shipping Biological Substances, Category B shipments. Ensure the vessel maintains appropriate refrigerant materials to keep clinical specimens cool. (see Annex 13.4 of the VSP 2011 Operations Manual.)
|
|
|
Item No.:
19
|
|
Site:
Food Service General-Food Only Elevator
|
|
Violation:
While in a transportation area a crew member was observed transporting a plastic grey container with approximately 20 pieces of dirty dishware and glasses off of the food only elevator.
|
|
Recommendation:
During pauses in food preparation or dispensing, ensure food preparation and dispensing utensils are stored: In a clean, protected location
|
|
|
Item No.:
22
|
|
Site:
Bar-Latitude
|
|
Violation:
The under counter glasswasher in this bar was listed as out service for some time.
|
|
Recommendation:
Maintain ware washing equipment in good repair and proper adjustment, including: (1) ware washing 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.
|
|
|
Item No.:
33
|
|
Site:
Food Service General-Decks - Provisions / Crew Galley / Windjammer Galley
|
|
Violation:
The decks outside the provisions refrigeration rooms near the door scuppers were in poor repair and difficult to clean. Grout was receding between the deck tiles in the crew galley and the Windjammer galley making them difficult to clean. Complete deck replacement was planned for the galleys and major renovation was planned for the decks in poor repair in the dry dock in a few weeks.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, ware washing, pantries, and storage areas are cleaned as often as necessary. Ensure decks, bulkheads, and deckheads in food preparation, ware washing, pantries, and storage areas are maintained in good repair.
|
|
|
Item No.:
33
|
|
Site:
Preparation Room-Deck 1 - Poultry Thaw Room
|
|
Violation:
The deckhead seam nearest the door in the poultry thaw room (#16-19) had four leaks where water was dripping onto the deck in a walk way. The staining on the stainless steel deckhead showed these leaks to be longstanding. No food was impacted.
|
|
Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, ware washing, pantries, and storage areas are maintained in good repair. Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, ware washing, pantries, and storage areas are cleaned as often as necessary.
|
|
|
Item No.:
19
|
|
Site:
Preparation Room-Deck 1 - Fish Thaw & Prep Room
|
|
Violation:
Thawing plastic bags of haddock were adjacent to the constant deck head hatch drips noted below. Empty plastic trays were placed over the fish as a temporary measure to assure the drips didn't contaminate the outside of these food packages.
|
|
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.
|
|
|
Item No.:
33
|
|
Site:
Preparation Room-Deck 1 - Fish Thaw & Prep Room
|
|
Violation:
Constant water drips were noted from each of the four corners of a large deckhead hatch in the right side of the walk-in cooler used for fish thawing and preparation.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, ware washing, pantries, and storage areas are cleaned as often as necessary.
|
|
|
Item No.:
08
|
|
Site:
Galley-Deck 2 - Hot Galley
|
|
Violation:
The automatic hood wash system water supply line had a leaking reduced pressure backflow preventer.
|
|
Recommendation:
Maintain backflow prevention devices in good repair.
|
|
|
Item No.:
22
|
|
Site:
Buffet-Deck 2 - Serving Line #1
|
|
Violation:
The wiping cloth sanitizing solution was heavily soiled with grease.
|
|
Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
|
|
|
Item No.:
22
|
|
Site:
Galley-Deck 9 - Windjammer Pot Wash
|
|
Violation:
The pot wash machine was out of order awaiting a spare part. Soiled dishware was being stored on the clean landing area between the sanitizing compartment of the three compartment sink and the broken pot wash machine.
|
|
Recommendation:
Ensure drain boards, 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.
|
|
|
Item No.:
22
|
|
Site:
Galley-Deck 9 - Windjammer Pot Wash
|
|
Violation:
A grease film was present on the surface of the sanitizing solution in the three compartment sink.
|
|
Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
|
|
|
Item No.:
22
|
|
Site:
Bar-Deck 9 - Pool Bar
|
|
Violation:
The dishwasher was out of order.
|
|
Recommendation:
Maintain ware washing equipment in good repair and proper adjustment, including: (1) ware washing 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.
|
|
|
Item No.:
22
|
|
Site:
Galley-Deck 9 - Park Cafe
|
|
Violation:
The dishwasher was out of order.
|
|
Recommendation:
Maintain ware washing equipment in good repair and proper adjustment, including: (1) ware washing 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.
|
|
|
Item No.:
16
|
|
Site:
Dining Room-Deck 6 - Chops Steakhouse
|
|
Violation:
The roasted lobster, which the chef described as fully cooked product, was marked with an asterisk indicating that it could be ordered undercooked.
|
|
Recommendation:
Ensure receiving temperatures are as follows: (1) Refrigerated, potentially hazardous food is at a temperature of 5C (41F) or below when received, (2) If a temperature other than 5C (41F) for a potentially hazardous food is specified in law governing its distribution, such as laws governing milk, molluscan shellfish, and shell eggs, the food is received at the specified temperature, (3) potentially hazardous food that is cooked and received hot is at a temperature of 57C (135F) or above, (4) A food that is labeled frozen and shipped frozen by a food-processing plant is received frozen, (5) Upon receipt, potentially hazardous food is free of evidence of previous temperature abuse.
|
|
|
Item No.:
22
|
|
Site:
Galley-Deck 5 - Potwash
|
|
Violation:
Soap suds were found in the sanitizing solution of the three compartment sink.
|
|
Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
|
|
|
Item No.:
22
|
|
Site:
Galley-Deck 4 - Pastry
|
|
Violation:
A large kettle valve had been repaired so it was not possible to take apart for cleaning.
|
|
Recommendation:
Ensure ware washing machines, drain boards, 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 of equipment and utensils and to ensure that the equipment performs its intended function; (3) at least every 24 hours (if used).
|
|
|
Item No.:
26
|
|
Site:
Galley-Deck 4 - Pastry
|
|
Violation:
Heavy food soil and a pungent liquid were found in this kettle valve that had not been taken apart for cleaning.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
|
|
|
Item No.:
28
|
|
Site:
Galley-Deck 9
|
|
Violation:
The pot wash machine was out of order awaiting a spare part. Soiled dishwasher was being stored on the clean landing area between the sanitizing compartment of the three compartment sink and the broken pot wash machine.
|
|
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.
|
|