|
|
|
Item No.:
02
|
|
Site:
Medical-Immediate Contacts Follow-Up
|
|
Violation:
During the 12-16 January 2023 voyage, the acute gastroenteritis (AGE) follow-up interviews for the cabin mate and immediate contact of a food handler were documented as twice in one day and one time 48 hours later, and not daily. For example, the crew member experienced AGE symptoms on 14 January at 14:15 and reported to the medical center at 14:40. Their cabin mate was interviewed on 14 January at 15:15 and 16:19, and on 16 January at 15:45; one immediate contact was interviewed on 14 January at 15:23 and 17:32, and on 16 January at 16:05.
|
|
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: (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 is contacted by medical or supervisory staff as soon as possible. Document the date and time of verbal interviews.
An immediate contact is someone sharing a cabin either full-time or part-time or sharing a cabin's bathroom facilities. This includes boyfriends, girlfriends, spouses, and significant others. Ensure to document if the symptomatic crew member has or not cabin mate(s) or other immediate contact(s).
|
|
|
Item No.:
02
|
|
Site:
Medical-Acute Gastroenteritis Surveillance Log
|
|
Violation:
In the AGE surveillance log for the 28 December 2022 - 2 January 2023 voyage, the underlying illness column was blank for a reportable AGE crew case. Medical staff showed the inspector they entered 'nil' in the electronic database, but this did not transcribe to the spreadsheet.
|
|
Recommendation:
Ensure information entered into the electronic database gets transcribed to the AGE surveillance log. 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.
|
|
|
Item No.:
03
|
|
Site:
Potable Water-Bunker Records
|
|
Violation:
On 19 December 2022, the bunker chart records indicated free halogen levels fell below 2.0 ppm for many minutes to hours during the day. For example, from 10:00 - 10:35 and from 12:15 - 14:00, There were no notes or manual recordings during these times.
|
|
Recommendation:
Continuously halogenate potable water to at least 2.0 mg/L (ppm) free residual halogen at the time of bunkering or production with an automatic halogenation device that is controlled by a flow meter and adjust the pH so it does not exceed 7.8. Ensure the amount of halogen injected during bunkering or production is controlled by a flow meter or a free halogen analyzer.
|
|
|
Item No.:
03
|
|
Site:
Potable Water-Production Records
|
|
Violation:
On multiple days, the potable water production chart records indicated free halogen levels fell below 2.0 ppm for many minutes to hours during the day. For example, on 26 December from 09:15 - 13:34; on 23 December 2022 from 21:15 - 22:03; on 19 December from 0015 - 01:15; on 18 December from 10:45 - 12:35; on 14 December from 22:00 - midnight; and 13 December from 20:00 - 22:40. Only on 26 December was a note written to indicate 'pump slow response, adjusted manually - multiple operations in the engine room' during the hours or low chlorine levels.
|
|
Recommendation:
Continuously halogenate potable water to at least 2.0 mg/L (ppm) free residual halogen at the time of bunkering or production with an automatic halogenation device that is controlled by a flow meter and adjust the pH so it does not exceed 7.8. Ensure the amount of halogen injected during bunkering or production is controlled by a flow meter or a free halogen analyzer.
|
|
|
Item No.:
08
|
|
Site:
Potable Water-Non-Testable Devices
|
|
Violation:
No results of the annual visual inspection of the non-testable backflow prevention devices and air gaps were recorded on the log. This was written on the last USPH inspection in November 2019.
|
|
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. Retain the visual inspection and/or test results for backflow prevention devices and air gaps for at least 12 months and ensure they are available for review during inspections.
|
|
|
Item No.:
08
|
|
Site:
Potable Water-Production Records
|
|
Violation:
On multiple days, the potable water production chart records indicated free halogen levels fell below 2.0 ppm for many minutes to hours during the day. Only on one of these days was a note written about the halogen pump operating slowly.
|
|
Recommendation:
Maintain accurate records of production and bunkering monitoring aboard for 12 months and ensure these records are available for review during inspections.
|
|
|
Item No.:
08
|
|
Site:
Galley-Deck 3 Appetizer
|
|
Violation:
One of the two brine lines for the ice machine was not labeled. Staff immediately added a label.
|
|
Recommendation:
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.
|
|
|
Item No.:
16
|
|
Site:
Buffet-Deck 9 Lido Restaurant
|
|
Violation:
The consumer advisory for the ham benedict did not state that the eggs can be served raw or undercooked.
|
|
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.
|
|
|
Item No.:
16
|
|
Site:
Dining Room-Deck 0 Dining Room 2
|
|
Violation:
The half-and-half out for use near the coffee pots was not labeled with a 4-hour discard time. Staff immediately placed a purple handle on the container, according to the time control plan.
|
|
Recommendation:
If time only-rather than time in conjunction with temperature-is used as the public health control for a working supply of potentially hazardous food before cooking, or for ready-to-eat potentially hazardous food that is displayed or held for service for immediate consumption, ensure the food (3) Is marked, or otherwise identified, to indicate the time 4 hours past the point in time when the food is removed from temperature control (if the time between service set-up and closing is greater than 4 hours). (4) Is labeled with a 4-hour discard time if containers of potentially hazardous foods on time control are placed on preparation counters, even if the outlet is open less than 4 hours.
|
|
|
Item No.:
17
|
|
Site:
Buffet-Deck 9 Omelet Station
|
|
Violation:
The time control plan listed undercounter refrigerators ZB527, ZB528, and ZB529 as time control units. The refrigerators were not labeled with the identification numbers and the time control label was above the technical compartment.
|
|
Recommendation:
Maintain a written time control plan(s) that ensures compliance with these guidelines on the vessel and make it available for review during inspections. Post a time control plan at each outlet where time control is used and ensure time control plan is accessible to all crew working at each outlet where time control is used. Ensure plan(s): (1) Include set-up and discard times for each outlet. Include all services and events where potentially hazardous foods are kept on time control. If used, ensure colored labels correspond to the discard times stated in the plan. (2) List all units (to include preparation counters, cabinets, compartments, and equipment) on time control, but only cabinets and compartments on time control must be physically labeled. and (3) Describe or show the flow of potentially hazardous food from when last in temperature control to placement in time control and discard.
|
|
|
Item No.:
20
|
|
Site:
Galley-Deck 3 Pastry
|
|
Violation:
The countertop mixer had two slotted fasteners in the food splash zone on the mixing head. Staff immediately replaced both slotted fasteners.
|
|
Recommendation:
Ensure multiuse food-contact surfaces 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.
|
|
|
Item No.:
21
|
|
Site:
Galley-Deck 9 Hot Galley
|
|
Violation:
The bottom stacked oven had two of the middle fasteners missing on the front inside bottom edge of the oven. The fasteners were immediately replaced.
|
|
Recommendation:
Design and construct nonfood-contact surfaces of equipment and utensils to be durable and to retain their characteristic qualities under normal use conditions.
|
|
|
Item No.:
27
|
|
Site:
Buffet-Deck 9 Lido Restaurant Aft
|
|
Violation:
A coffee grinder in the coffee bar was soiled with coffee grounds. The area was not in operation and the coffee grinder was previously cleaned and sanitized.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
27
|
|
Site:
Buffet-Deck 9 Lido Restaurant Forward
|
|
Violation:
A stack of 10 previously cleaned and sanitized plates out for passenger use were soiled on the non-food contact surface with syrup.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
27
|
|
Site:
Buffet-Deck 9 Lido
|
|
Violation:
The decorative torches on the buffet line were soiled with more than one day's accumulation of dust.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
35
|
|
Site:
Galley-Deck 9 Extension Galley
|
|
Violation:
The drain under the reach-in refrigerators was clogged and water was pooling on the deck.
|
|
Recommendation:
Ensure black and gray water is discharged to the vessel's wastewater disposal system and does not pool on the deck.
|
|
|
Item No.:
35
|
|
Site:
Galley-Deck 3 Hot Galley
|
|
Violation:
The drain line for washing the ventilation hood was leaking and water was pooling on the deck.
|
|
Recommendation:
Ensure black and gray water is discharged to the vessel's wastewater disposal system and does not pool on the deck.
|
|
|
Item No.:
38
|
|
Site:
Galley-Deck 9 Deli
|
|
Violation:
A scrub mop was stored to the right of the portable hot holding units.
|
|
Recommendation:
Ensure maintenance tools such as mops, brooms, and similar items are stored in a designated locker so they do not contaminate food, food-contact surfaces of utensils, and equipment, linens, and single-service and single-use articles.
|
|
|
Item No.:
38
|
|
Site:
Dining Room-Deck 0 Crew Mess
|
|
Violation:
A damp mop head was stored in an empty yellow mop bucket in the cleaning closet. Staff immediately inverted the mop and hung it to dry.
|
|
Recommendation:
After use, ensure mops are placed in a position that allows them to air-dry without soiling walls, equipment, or supplies.
|
|
|
Item No.:
39
|
|
Site:
Pantry-Deck 5 Alchemy Bar
|
|
Violation:
One fruit fly was inside the entrance to the pantry.
|
|
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.
|
|
|
Item No.:
39
|
|
Site:
Buffet-Deck 9 Lido Restaurant Aft
|
|
Violation:
One fruit fly was near the left coffee grinder at the coffee bar. The area was not in operation.
|
|
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.
|
|
|
Item No.:
39
|
|
Site:
Buffet-Deck 9 Lido Restaurant Forward
|
|
Violation:
One fruit fly and one black crawling insect were in the technical compartment below the starboard beverage center's ice dispenser.
|
|
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.
|
|
|
Item No.:
39
|
|
Site:
Buffet-Deck 9 Lido Restaurant Aft
|
|
Violation:
One fruit fly was near the coffee machine at the portside back beverage station.
|
|
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.
|
|
|
Item No.:
44
|
|
Site:
Potable Water-Production Records
|
|
Violation:
On multiple days, the potable water production chart records indicated free halogen levels fell below 2.0 ppm for many minutes to hours during the day. Only on one of these days was a note written about the halogen pump operating slowly.
|
|
Recommendation:
Ensure the supervisor or person in charge of potable water operations on the vessel demonstrates to VSP-during inspections and on request-knowledge of potable water operations, is able to demonstrate this knowledge by compliance with Section 5 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 5 of the VSP 2018 Operations Manual as it relates to their assigned duties.
|
|
|