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Item No.:
01
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Site:
Medical-24 Hour Report
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Violation:
On 9 August, a crew member was inadvertently added to eSeaCare as a reportable acute gastroenteritis (AGE) case. The nurse inputting the information added the data on a patient in the crew's file by accident. There was documentation on paper and in the eSeaCare system that this patient was not an AGE case; however, the case was automatically added to the AGE log and to the 24 hour report as a reportable case. Crew reported that they have no ability to override the system.
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Recommendation:
Ensure the AGE report contains the following: (1) name of the vessel; (2) port of embarkation; (3) date of embarkation; (4) port of disembarkation; (5) date of disembarkation; (6) total numbers of reportable cases of AGE among passengers, including those who have disembarked because of illness-even if the number is 0 (zero reporting); (7) total numbers of reportable cases of AGE among crew members, including those who have disembarked because of illness-even if the number is 0 (zero reporting); and (8) total number of passengers and crew members on the cruise. Ensure the ill passenger and crew totals on the 24 hour and 4 hour reports are accurate.
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Item No.:
02
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Site:
Medical-Medical Record Review - Close Contact Follow Up
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Violation:
On 11 August, a crew member was ill with acute gastroenteritis (AGE) symptoms. The crew member did not have a cabin mate, but there were no notes specifying she did not have any close contacts. In the medical logs, the patient's name was listed as the close contact.
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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.
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Item No.:
02
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Site:
Medical-Medical Record Review - Close Contact Follow Up
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Violation:
On 25 August, a crew member was ill with acute gastroenteritis (AGE) symptoms. The crew member had one close contact that shared a bathroom. There was a 24 hour follow up noted for the close contact, but there was no 48 hour follow up noted. Crew reported that the eSeaCare system shuts down for a period of approximately 2 hours at the end of a cruise, and at that time, if crew attempt to input information, the system will look like the information was accepted and saved, but this is not necessarily the case. When the information is not saved, crew are unaware because the system appears as if the information was saved. Crew reported the close contact was followed up but the issue of the missing electronic record was due to a system inconsistency.
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Recommendation:
When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions for asymptomatic cabin mates or immediate contacts of symptomatic crew: (3) complete a verbal interview daily with medical or supervisory staff until 48 hours after the ill crew members' symptoms began. 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.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Log
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Violation:
On 9 August, a crew member was inadvertently added to eSeaCare as a reportable acute gastroenteritis (AGE) case. The nurse inputting the information added the data on a patient in the crew's file by accident. There was documentation on paper and in the eSeaCare system that this patient was not an AGE case; however, the case was automatically added to the AGE log and to the 24 hour report as a reportable case. Crew had no ability to override the system.
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Recommendation:
Ensure cases listed as reportable fit the definition of a reportable case as found in the Vessel Sanitation Program (VSP) Operations Manual. 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-Medical Ward Shower
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Violation:
One medical ward shower hose did not have backflow prevention and the shower head of the hose could touch the deck. Crew reported they would install a backflow preventer after disinfection.
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Recommendation:
Provide a comprehensive cross-connection control program. Protect the following connections to the potable water system against backflow with air gaps or mechanical backflow prevention devices: (7) hose-bib connections; Install an atmospheric vacuum breaker at least 150 millimeters (6 inches) above the flood-level rim of the fixtures.
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Item No.:
08
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Site:
Potable Water-Laundry Room
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Violation:
The potable water piping on the transfer line to the laundry water system was not striped blue or blue/green/blue before the reduced pressure backflow assembly.
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Recommendation:
Stripe or paint potable water lines either in accordance with ISO 14726 (blue/green/blue) or blue only. 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.
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Item No.:
08
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Site:
Potable Water-Cross Connection Control Log
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Violation:
The first entry on the testable backflow prevention device list had a description of 'FW Evaporation' with a location of 'Deck 0 #94, S12 Engine Room N2.' Upon inspection of the backflow prevention device at this location, it was determined the line was not connected or associated with an evaporator. The backflow prevention device was on the technical water bunkering line.
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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.
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Item No.:
08
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Site:
Potable Water-Deck 12 Forward Fan Room 2-8
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Violation:
The water line after the reduced pressure backflow assembly on the potable cold water line for bridge window washing was striped blue/green/blue indicating potable water.
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Recommendation:
Do not stripe or paint potable water lines after reduced pressure assemblies as potable water.
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Item No.:
10
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Site:
Recreational Water Facilities-Beach Pool
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Violation:
On 25 July, a vomit accident occurred in the beach pool while it was operating in sea-to-sea mode. The fecal/vomit accident log only stated 'sea-to-sea mode' and did not include a chlorine concentration or contact time that was used to sanitize the pool once it was drained.
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Recommendation:
Ensure a written or electronic record is made of all accidents involving fecal material or vomit. Ensure the record includes the name of the RWF, date and time of the accident, type of accident, response steps taken, and free residual halogen level and contact time reached during disinfection.
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Item No.:
10
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Site:
Recreational Water Facilities-Baby-Only Water Facility
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Violation:
The approved variance for this facility stated that every 24 hours the play area and attached equipment would be cleaned with an appropriate cleaner, rinsed, and disinfected with chlorine to achieve a minimum CT value of 50 ppm for 1 minute, but the completion of this task was not documented.
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Recommendation:
Prohibit children in diapers or who are not toilet trained from using any RWF that is not specifically designed and approved for use by children in diapers. Document the 24 hour cleaning and disinfection of the play area and attached equipment.
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Item No.:
10
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Site:
Recreational Water Facilities-Children's and Sports Pool
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Violation:
The floatation device provided for both facilities did not have an attached rope that reached at least 2/3 of the maximum width of the pools.
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Recommendation:
Provide a rescue or shepherd's hook and an approved flotation device at a prominent location (visible from the full perimeter of the pool) at each RWF that has a depth of 1 meter (3 feet) or greater. Mount these devices in a manner that allows for easy access during an emergency. Ensure the approved flotation device includes an attached rope that is at least 2/3 of the maximum pool width.
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Item No.:
10
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Site:
Recreational Water Facilities-Aqua Theatre
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Violation:
This facility, which was only used by crew members, did not have a safety sign posted.
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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-Medical Record Review - Late Report
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Violation:
On 28 August, a guest entertainment crew member became symptomatic with acute gastroenteritis (AGE) symptoms at 2125, clocked into work at 2144, and reported to medical at 2357. Disciplinary action was documented.
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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.:
15
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Site:
Provisions-Deck 2 - Fruit Box
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Violation:
Three containers of blueberries contained small growths of a white fuzzy debris, which appeared to be mold. These blueberries were provisioned during a previous voyage. Staff discarded these right away.
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Recommendation:
Ensure food is safe and unadulterated.
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Item No.:
19
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Site:
Bar-Globe and Atlas Pub
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Violation:
The back bar undercounter refrigerator 4411.054 had an excessive accumulation of water on the bottom shelf behind the far right refrigerator door. Wine was stored on the shelf. The refrigerator was taken out of service for repair. Crew noted that a drip tray had not been installed properly and was fixed immediately.
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Recommendation:
Protect food from contamination by storing the food: (2) In a clean, dry location; and (3) Where it is not exposed to splash, dust, or other contamination. Protect food from contamination that may result from a physical, chemical, biological origin.
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Item No.:
20
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Site:
Pantry-Ice and Detergent Station 9846
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Violation:
The plastic cuber adjustor in the ice machine had a long crack. The area was maintained clean. The machine was taken out of service.
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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. Design and construct food contact surfaces of equipment and utensils to be durable and to retain their characteristic qualities under normal use conditions. Ensure multiuse food-contact surfaces are: (1) Smooth; and (2) Free of breaks, open seams greater than 0.8 mm (1/32 inch), cracks, chips, inclusions, pits, and similar imperfections.
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Item No.:
20
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Site:
Galley-Deck 5 - Midship
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Violation:
The counter-mounted ice machine at the beverage station in this location was out of order. Signage on the machine indicated that a part was ordered and staff stated that the part was scheduled to arrive the day of inspection.
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Recommendation:
Food contact equipment must be maintained in good repair and proper adjustment: (1) Equipment must be maintained in a state of repair and condition that meets the materials, design, construction, and operating specifications of these guidelines.
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Item No.:
21
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Site:
Buffet-Deck 1 - Crew/Officer/Staff Mess
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Violation:
The electrical cord for the counter-mounted toaster located at the beverage station was resting on the counter. Staff corrected this immediately.
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Recommendation:
Elevate the cords above the counter.
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Item No.:
21
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Site:
Bar-Globe and Atlas Pub
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Violation:
A crack in the outer skin of the back bar undercounter refrigerator 4411.054 between the middle and right doors was leaking water which dripped and pooled on the deck. The refrigerator was taken out of service for repair.
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Recommendation:
Design and construct nonfood-contact surfaces of equipment to be durable and to retain their characteristic qualities under normal use conditions. 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:
Pantry-Ice and Detergent Station 9846
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Violation:
There was an accumulation of brown debris on the top metal panel of the ice machine located above the ice bin and cuber that could be wiped away with an alcohol wipe. The machine was taken out of service.
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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:
Children Area-Area For 3-5 Year Olds
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Violation:
The rubber water shield of the water fountain was soiled with black and purple residue that could be wiped with an alcohol pad. The water fountain was taken out of service for cleaning and crew reported the water shield would be replaced.
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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-Windjammer Port Side Coffee Station
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Violation:
The previously cleaned juice dispenser closest to the coffee machine had an excessive accumulation of sticky juice residue along the splash plate immediately behind the pouring spouts. The machine was not in use.
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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:
Preparation Room-Deck 2 - Commissary
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Violation:
The potato peeler on the left side of the sink had a detached gasket. The surface behind the gasket was heavily soiled with more than a days' worth of debris. The machine was previously used and was sitting soiled since use that morning; however, it was clear to the inspector that the debris had accumulated over time and was not from only the morning's use. Due to the improper placement of the gasket, the normally nonfood-contact area was exposed; therefor, the soiled area came in contact with food and was a food contact surface. Crew immediately fixed the issue.
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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:
Buffet-Windjammer Port Side Coffee Station
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Violation:
The metal surface above the filter baskets of two previously cleaned coffee machines were heavily soiled with excessive coffee debris. The inspector wiped the area with an alcohol pad and the entire pad turned black, while there was still a significant amount of debris on the machine. The coffee station area was not in service.
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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:
Buffet-Windjammer Port Side Coffee Station
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Violation:
The previously cleaned juice disperser closest to the coffee machines had juice residue along the gasket inside the door and along the upper edge of the container housing.
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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-Deck 5 - Cold Pantry
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Violation:
Greater than a day's accumulation of dried food debris was found on the upper hinge/fitting behind the face place of the previously cleaned meat slicer.
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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:
Buffet-Windjammer Port Side Coffee Station
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Violation:
The outer housing of the previously cleaned coffee machine had several areas that were soiled with coffee 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.:
27
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Site:
Buffet-Solarium Bistro Starboard Side Beverage Station
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Violation:
On the counter under the ice disperser, a hole had been filled with silicone; however, condensation from the catch tray leaked onto the silicone where it accumulated. Excessive black debris accumulated on the silicone.
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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:
Bar-Solarium
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Violation:
Approximately 30 glasses were resting on the counter inverted and ready for use. Six of the glasses were wet inside and out. Staff were preparing to open the bar.
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Recommendation:
After cleaning and sanitizing, ensure equipment and utensils are air dried or adequately drained before contact with food.
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Item No.:
28
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Site:
Buffet-Windjammer Coffee Station B
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Violation:
Two trays of cups were out for service on the counter of the open coffee station. Water pooled in the indented areas on the bottom exterior of the cups. Staff stated that the cups were warm and had recently been washed.
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Recommendation:
After cleaning and sanitizing, ensure equipment and utensils are air dried or adequately drained before contact with food.
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Item No.:
33
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Site:
Galley-Windjammer Hot Galley
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Violation:
Two hi fog sprinkler faucets mounted on the deckhead above the food preparation counter and the grill were heavily soiled with grease and food debris.
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Recommendation:
Install exposed utility service lines and pipes, including lines for fire detection and protection systems, so they do not obstruct or prevent cleaning. 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-Globe and Atlas Pub
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Violation:
A crack in the outer skin of the back bar undercounter refrigerator 4411.054 between the middle and right doors was leaking water which dripped onto the deck. Water accumulated on the deck in areas of recessed grouting.
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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. Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary. 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-Windjammer Coffee Station A Forward/Starboard
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Violation:
The electrical conduit entering the deckhead behind ice machine # 4411.166P.740 had a flange that did not fit snug into the deckhead which created a gap and a difficult to clean area.
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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. Ensure light fixtures, vent covers, and similar equipment attached to the bulkheads or deckheads are easily cleanable. Install exposed utility service lines and pipes, including lines for fire detection and protection systems, so they do not obstruct or prevent cleaning. Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
36
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Site:
Buffet-Windjammer Starboard Buffet Island
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Violation:
The right heat lamp bulb was chipped and peeling. The bulb was replaced during the inspection. No food was located under the bulb.
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Recommendation:
Ensure light bulbs are shielded, coated, or otherwise shatter-resistant in areas where there is exposed food, clean equipment, utensils, and linens, or unwrapped single-service and single-use articles.
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Item No.:
39
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Site:
Galley-Deck 5 - Dry Storage
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Violation:
There was one live fruit fly in 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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