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Item No.:
01
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Site:
Medical-Deck 4 Acute Gastroenteritis (AGE) Routine Report
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Violation:
On the 06 May 2023, 24-hour AGE report, the total number of crew reported was 1167. The total number of crew at the beginning of the voyage was 1175. Staff were not aware that the total number of passengers and total number of crew reported on the AGE report should be the total number at the beginning of the voyage.
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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.
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Item No.:
02
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Site:
Medical-Deck 4
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Violation:
The viral agents for clinical specimen collection and analysis expired 30 April 2023. Staff stated they have ordered more and expect them to arrive in two days.
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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 2018 Operations Manual.)
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Item No.:
02
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Site:
Medical-Deck 4
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Violation:
Close contacts of crew members with acute gastroenteritis (AGE) symptoms were not interviewed daily. (1) A crew member had AGE symptom onset on 5 May 2023 at 1200. The close contact was contacted on 5 May at 1351 and had only one additional follow up interview on 6 May at 1955. (2) Aanother crew member had AGE symptom onset on 4 May 2023 at 1920. The close contact was contacted on 4 May at 2013 and had only one additional follow up interview on 06 May at 1221.
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Recommendation:
When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions for the asymptomatic cabin mates or immediate contacts of symptomatic crew: (1) 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 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.:
08
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Site:
Potable Water-Cross-Connection Control Log
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Violation:
The testable, reduced pressure principle backflow prevention assembly (EVAC 4 Flush Line) on deck 1, fire zone 4, in the domestic refrigerator room was listed on the cross-connection control log as last tested on 17 April 2022. Staff showed the inspector maintenance records that the testable device had been removed from the location.
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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-Cross-Connection Control Log
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Violation:
The electronic list of non-testable devices for deck 4 stated they were last inspected on 28 April 2022. Staff found the printed list with comments used by the plumber during the most recent inspection; however, the devices were inspected between 30 April 2023 and 01 May 2023, which was past the annual date.
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Recommendation:
Inspect backflow prevention devices periodically and replace any failed units. Complete a visual check for all non-testable backflow prevention devices and air gaps at least annually.
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Item No.:
10
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Site:
Recreational Water Facilities-Deck 14 Neptune Pool
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Violation:
The water at the beach level did not reach the skim gutter level across the entire pool which created stagnant pockets of water. Approximately 50% of the pool surface water was not skimming.
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Recommendation:
For RWFs with skim gutters, ensure that the fill level of the RWF is to the level of the skim gutters.
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Item No.:
11
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Site:
Medical-Deck 4
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Violation:
The recorded date and time of a food handler's last acute gastroenteritis symptom did not correlate with the recorded symptoms in the medical database. A food handler became symptomatic on 10 April 2023 at 1300. In the medical log there was a follow-up interview on 13 April 2023 at 1147 which stated the crew member had 1 additional vomiting episode and recorded their last symptom as 0100 on 13 April. The next follow-up interview was on 15 April at 1809 which stated the crew member had one additional episode of diarrhea since their last interview, but their last symptom was still recorded as 0100 on 13 April. The last follow-up interview occurred on 15 April at 1813 which stated the crew member had one additional episode of diarrhea and the last symptom was a updated to 0600 on 13 April. There were no notes to describe any documented errors or clarify the discrepancies in recorded data.
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Recommendation:
When food employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 48 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document date and time of last symptom and clearance to return to work.
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Item No.:
15
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Site:
Galley-Deck 16 Sabatini Cold Galley
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Violation:
There were approximately 16 cartons of raspberries that were coated with a white fuzzy substance in the undercounter refrigerator. The raspberries were immediately removed to be discarded.
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Recommendation:
Ensure food is safe and unadulterated.
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Item No.:
16
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Site:
Galley-Deck 14 Garde Manger Undercounter Refrigerator Portside
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Violation:
The temperature of the roast beef in this unit measured 46°F and 47°F with the inspector's and crew member's tip-sensitive thermometers. The roast beef was prepared on 09 May 2023. Crew immediately removed the roast beef from the unit to be discarded.
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Recommendation:
Except during preparation, cooking, or cooling, or when time is used as the public health control, maintain potentially hazardous foods at 57°C (135°F) or above, except that roasts may be held at a temperature of 54°C (130°F); or 5°C (41°F) or less.
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Item No.:
16
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Site:
Buffet-Deck 15 Horizon Court Portside
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Violation:
There was no consumer advisory displayed for the smoked whitefish. Staff stated they will create a new one to be displayed immediately.
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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 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.
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Item No.:
21
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Site:
Galley-Deck 14 Hot Galley Undercounter Refrigerator
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Violation:
The thermometer in this unit read 44°F. The inspector left a tip-sensitive thermometer in the unit for approximately 10 minutes which measured 37°F. Food items in this unit also measured 37°F.
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Recommendation:
Ensure ambient air temperature measuring devices are maintained in good repair and are accurate within the intended range of use.
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Item No.:
21
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Site:
Room Service-Deck 11 Refrigerators 1, 5, and 6
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Violation:
The door gaskets on these units were in disrepair and prevented the doors from fully sealing when closed.
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Recommendation:
Ensure nonfood contact equipment is maintained in good repair and proper adjustment including: (1) Equipment maintained in a state of repair and condition that meets the materials, design, construction, and operation specifications of these guidelines; (2) Equipment components such as doors, seals, hinges, fasteners, and kick plates are kept intact, tight, and adjusted in accordance with manufacturer's specifications.
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Item No.:
22
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Site:
Galley-Deck 16 Warewash Starboard
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Violation:
The flight-type dishwasher was out of order since February 2023.
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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 16 Warewash Portside
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Violation:
The forward glasswash machine was out of order on the day of 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 16 Dishwash Portside
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Violation:
The flight-type dishwasher's digital display panel was not reading accurate wash tank temperatures. The panel was continuously fluctuating from 92°F to 192°F. The inspector used a thermocouple temperature measuring device with an accuracy of ± 0.2°F which yielded a wash tank temperature of 155°F. A technician was called to fix the display panel.
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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 Dishwashers
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Violation:
The pastry undercounter warewash machine was out of order since May 2023. The bakery undercounter warewash machine was out of order since April 2023. The portside hood-type potwash machine was out of order since May 2023.
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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:
Preparation Room-and Fish
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Violation:
The undercounter warewash machines in these rooms were out of order since May 2023.
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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.:
26
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Site:
Room Service-Deck 11 Ice Machine
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Violation:
The evaporator cover panel for the ice machine had black residue on the food-contact surface. The inspector wiped the surface with an alcohol wipe and residue came off the panel.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch. Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized.
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Item No.:
26
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Site:
Buffet-Deck 15 Horizon Court Starboard Oatmeal Station
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Violation:
A tray of 16 previously cleaned and sanitized coffee cups had food debris on the inside food contact surface. The whole tray was removed to be cleaned and sanitized again.
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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.:
41
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Site:
Housekeeping-Deck 6
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Violation:
The toilet facilities next to Meridian Bay had multiple exits. The exit from the toilet facility hallway was not bare-hands-free contact. The paper towels, trash can, and sign advising users to use a hand towel, paper towel, or tissue to open the door were only at the first exit.
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Recommendation:
Equip passenger and crew public toilet facilities so persons exiting the toilet room are not required to touch the door handle with bare hands. Where toilet stalls include handwashing facilities, ensure the bare-hands-free contact begins in the toilet stall. Ensure that toilet facilities with multiple exits, such as spa dressing rooms, have bare-hands-free contact at each exit. Post a sign advising users of toilet facilities to use hand towel, paper towel, or tissue to open the door unless the exit is hands free.
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Item No.:
44
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Site:
Medical-Deck 4 Acute Gastroenteritis (AGE) Routine Report
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Violation:
Medical staff were not aware that the total number of passengers and total number of crew reported on the AGE routine reports should be the total number at the beginning of the voyage.
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Recommendation:
Ensure the supervisor or person in charge of medical operations related to AGE on the vessel demonstrates to VSP?during inspections and on request?knowledge of medical operations related to AGE, is able to demonstrate this knowledge by compliance with Section 4 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 4 of the VSP 2018 Operations Manual as it relates to their assigned duties.
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