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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Log
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Violation:
On the November 24- December 4 voyage, the underlying illness box was left blank for four passengers. On the November 13-November 24 voyage, the underlying illness box was left blank for one passenger. On the October 31- November 13 voyage, the underlying illness box was left blank for one passenger. For several passengers, their underlying illness information was recorded in their medical record; however, it was not recorded in the spot that auto populates the AGE log.
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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,? or 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.:
08
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Site:
Potable Water-Aft and Forward Distillate Lines
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Violation:
The distillate lines directed to the potable water tanks leading from the forward and aft evaporators were striped blue/green/blue prior to the injection point. This was corrected.
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Recommendation:
Stripe or paint potable water lines either in accordance with ISO 14726 (blue/green/blue) or blue only. Stripe or paint distillate and permeate lines directed to the potable water system in accordance with ISO 14726 (blue/gray/blue). 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. Identify all refrigerant brine lines and nonpotable chilled water lines in all food areas, such as on ice machines, ice cream machines, etc., with either ISO 14726 (blue/white/blue) or by another uniquely identifiable method to prevent cross-connections.
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Item No.:
08
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Site:
Potable Water-Deck 8 FZ 6 Crew Staircase Behind Bridge
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Violation:
The air gaps below the backflow preventers on the bridge window washing hot and cold lines were insufficient.
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Recommendation:
Ensure air gaps are at least twice the diameter of the delivery fixture opening and a minimum of 25 millimeters (1 inch).
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Item No.:
11
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Site:
Medical-Acute Gastroenteritis (AGE) Log
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Violation:
A food handler had an onset of AGE symptoms on November 4 at 0600. The crew member did not report to medical until 1100. A review of the crew member's time card indicated that the crew member worked from 0730 until 1100. The crew member's food employee risk assessment stated the crew member worked from 0600 to 1100. The crew member received disciplinary action for working while experiencing symptoms. Additionally, the crew member's time card stated they had worked several hours on November 5. Medical staff stated the crew member had been isolated in the medical facility until they were released on November 8 and could not have reported to work. Medical staff stated the time card can auto populate working times if the crew member is unavailable to approve their time card and indicated this is what potentially happened.
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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. 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. Ensure the food employee's supervisor or person in charge conducts an assessment of food prepared or served by the food employee while symptomatic and take appropriate corrective actions. Document corrective actions taken as a result of the assessment. Maintain records for 1 year and make them available for review during inspections. Review [when possible] any AGE cases among passengers or crew reported after the ill food employee?s symptom onset for epidemiologic link/connection. Appropriate corrective actions could include discarding ready-to eat food, thoroughly cooking raw food, and disinfecting the food area and equipment.
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Item No.:
16
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Site:
Galley-Deck 2 Main Galley
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Violation:
A dish of ready-to-eat (RTE) food labelled as jerked seafood with a date marking of Dec 2 to Dec 8 was determined by staff to be mislabeled and should have been ceviche scallops. Staff removed the jerked seafood and date marking stickers. The cooling log presented to the inspector for the ceviche scallops indicated the date marking would have been Nov 25 to Dec 2. Staff immediately discarded the food.
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Recommendation:
Ensure refrigerated, ready-to-eat, potentially hazardous food is discarded if not consumed within 7 calendar days from the date of preparation or opening.
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Item No.:
16
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Site:
Dining Room-Deck 10 NY Deli and Pizza
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Violation:
Some menus that were printed in a different format lacked the consumer advisory for smoked salmon and fried egg items. These were immediately discarded. A nearby permanent mounted menu board appropriately provided the consumer advisory for guests.
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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.:
20
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Site:
Preparation Room-Deck A
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Violation:
One fastener was missing on the interior of the lower bakery oven.
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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; and (2) Cutting or piercing parts of can openers must be kept sharp to minimize the creation of metal fragments that can contaminate food when the container is opened.
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Item No.:
22
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Site:
Galley-Deck 2 Main Galley Warewashing Potwash
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Violation:
The flight type pot wash warewashing equipment was out of service. The work order for the service parts had been created Nov 24. At the time of the inspection, there was no estimated delivery time for the service parts. A three-compartment sink system was being used while the pot wash equipment was out of service.
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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:
Galley-Deck 2 Main Galley Ice Machine B
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Violation:
There was some settled specks of debris in the water tray. Staff immediately began cleaning procedures.
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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.:
33
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Site:
Pantry-Dive-In Deck 9 Pantry
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Violation:
The deck seam adjacent to stainless steel decking was damaged and needed repair to be smooth and easily cleanable.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
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Item No.:
39
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Site:
Buffet-Lido Portside Omelet Station
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Violation:
There was one live housefly in the 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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Item No.:
39
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Site:
Galley-Deck A Crew Galley
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Violation:
There was one live housefly in the 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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