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Item No.:
02
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Site:
Medical-Reportable Acute Gastroenteritis (AGE) Case Definition and AGE Log
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Violation:
On March 31, a passenger reported to the medical center having experienced two watery stool episodes within less than 24 hours and having no underlying illness. However, the medical staff determined that these symptoms did not meet the definition of an AGE reportable case. As a result, the passenger was not isolated and the AGE log and AGE routine reports to VSP missed one reportable case.
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Recommendation:
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 38°C [100.4°F]). List in the AGE surveillance log (1) the name of the vessel, cruise dates, and cruise number; (2) all reportable cases of AGE; and (3) all passengers and crew members who are dispensed antidiarrheal medication from the master of the vessel, medical staff, or other designated staff.
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Item No.:
08
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Site:
Pantry-Deck 6 - Starbucks
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Violation:
The ice machine's chilled water line label was faded and difficult to read.
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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.
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Item No.:
08
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Site:
Potable Water-Cross-connection Control Log
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Violation:
There was no record documenting visual checks at least annually for hundreds of nontestable backflow prevention devices in the food areas.
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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.:
08
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Site:
Potable Water-Disinfection and Backflow Prevetion Records
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Violation:
Records indicated that a backflow prevention device on Deck 8 FZ1 was installed and disinfected on February 28 but tested on February 19. Staff stated that logging different dates was a clerical error.
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Recommendation:
Ensure that records are accurate.
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Item No.:
08
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Site:
Potable Water-Deck 4 - Starboard Bunker Station
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Violation:
One of the potable water hose connections had a broken cap keeper chain. This was corrected.
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Recommendation:
Ensure the potable water filling line has a screw cap fastened by a noncorroding cable or chain to an adjacent bulkhead or surface in such a manner that the cap cannot touch the deck when hanging free. Ensure the hose connections are unique and fit only the potable water hoses.
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Item No.:
08
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Site:
Preparation Room-Deck 3
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Violation:
The backflow prevention device on the utility sink sprayer next to the far-right potato peeler had its atmospheric vents blocked with white debris.
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Recommendation:
Maintain backflow prevention devices in good repair.
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Item No.:
11
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Site:
Medical-Symptomatic and Meeting the Case Definition for Acute Gastroenteritis (AGE)
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Violation:
A nonfood worker had an onset of AGE symptoms on April 1 at 1130 and reported to the medical center at 1739 the same day. The crew member partially worked his shift and had lunch at the crew mess at 1300 while symptomatic. A disciplinary action was on file.
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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. Maintain records for 1 year and make them available for review during inspections.
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Item No.:
11
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Site:
Medical-Symptomatic and Meeting the Case Definition for Acute Gastroenteritis (AGE)
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Violation:
On March 31, a passenger reported to the medical center having experienced two watery stool episodes within less than 24 hours and having no underlying illness. However, the medical staff determined that these symptoms did not meet the definition of an AGE reportable case. As a result, the passenger was not isolated and the AGE log and AGE routine reports to VSP missed one reportable case.
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Recommendation:
When symptomatic, ill passengers meet the case definition for AGE, ensure the following actions are taken: (1) advise them to remain isolated in their cabins until well for a minimum of 24 hours after symptom resolution, and (2) a follow-up by infirmary personnel is advised.
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Item No.:
18
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Site:
Galley-Deck 7 - Local Walk-in Refrigerator
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Violation:
Raw bacon was stored over ready-to-eat deli meats. This was corrected by placing the raw bacon below the deli meats.
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Recommendation:
Protect food from cross-contamination or other sources of contamination by the following methods: (1) Physically separating raw animal foods during storage, preparation, holding, and display from raw ready-to-eat food so that products do not physically touch and so that one product does not drip into another. (2) Separating types of raw animal foods from each other such as beef, fish, lamb, pork, and poultry?except when combined as ingredients?during storage, preparation, holding, and display by using separate equipment for each type, or by arranging each type of food in equipment so that cross-contamination of one type with another is prevented, or by preparing each type of food at different times or in separate areas. (3) Cleaning and sanitizing equipment and utensils. (4) Storing the food in packages, covered containers, or wrappings. (5) Cleaning visible soil on hermetically sealed containers of food before opening. (6) Protecting food containers that are received packaged together in a case or overwrap from cuts when the case or overwrap is opened. (7) Separating damaged, spoiled, or recalled food being held on the vessel. (8) Separating unwashed fruits and vegetables from ready-to-eat food.
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Item No.:
19
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Site:
Galley-Deck 6 - Pastry
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Violation:
An ice cream scoop was stored in the dipper well without running water. The water temperature was below 135°F.
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Recommendation:
During pauses in food preparation or dispensing, ensure food preparation and dispensing utensils are stored: (1) In the food with their handles above the top of the food and the container; (2) In food that is not potentially hazardous with their handles above the top of the food within containers or equipment that can be closed, such as bins of sugar, flour, or cinnamon; (3) On a clean portion of the food preparation table or cooking equipment only if the in-use utensil and the food-contact surface of the food preparation table or cooking equipment are cleaned and sanitized at least every 4 hours; (4) In running water of sufficient velocity to flush particulates to the drain (if used with moist food such as ice cream or mashed potatoes); (5) In a clean, protected location (if the utensils, such as ice scoops, are used only with a food that is not potentially hazardous); or (6)In a container of water (if the water is maintained at a temperature of at least 57°C [135°F] and the container is frequently cleaned and sanitized).
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Item No.:
20
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Site:
Galley-Deck 6 - Q Texas Smokehouse Ice Machine
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Violation:
The ice machine's deflector panel was in disrepair and dislodged which caused excessive amount of ice to accumulate in the ice bin. When the ice bin's door was opened, ice fell onto the deck. Staff immediately removed the excess ice, cleaned the deck, and replaced the deflector panel.
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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:
Galley-Deck 15 - Garden Cafe Hot Galley
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Violation:
The tilting kettle had a large gap between the cylinder arm and the technical compartment. This gap was difficult to clean.
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Recommendation:
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.:
21
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Site:
Other-Deck 4 - Area 34
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Violation:
A trolley identified as belonging to the breakfast garden had two large plastic containers, two corroded trays, and seven warm hotel pans that were stacked wet. This crew area was not a food service area.
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Recommendation:
Ensure nonfood-contact surfaces of equipment that are exposed to splash, spillage, or other food soiling or that require frequent cleaning are constructed of a corrosion-resistant, nonabsorbent, and smooth material.
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Item No.:
21
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Site:
Dining Room-Deck 6 - Teppanyaki Station 7
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Violation:
The countertop was cracked and the sealant was in disrepair which created a crevice and difficult to clean surface.
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Recommendation:
Design and construct nonfood-contact surfaces of equipment and utensils 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.:
22
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Site:
Galley-Deck 5
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Violation:
A soiled wiping cloth was stored in the sanitizing solution bucket near the soup station's handwashing facility.
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Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
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Item No.:
22
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Site:
Other-Deck 4 - Area 34
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Violation:
A trolley identified as belonging to the breakfast garden had two large plastic containers, two corroded trays, and seven warm hotel pans that were stacked wet. This crew area was not a food service area.
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Recommendation:
Ensure drainboards, 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.
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Item No.:
22
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Site:
Galley-Deck 5 - Potwash
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Violation:
The front-loading potwash machine's door was in disrepair and water continuously dripped from the bottom corners of the door into the deck drain.
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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 - Garden Cafe Flight-Type Dishwashing Machine
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Violation:
Four dishes were stacked together in the conveyor of the dishwashing machine, which blocked them from receiving full exposure to the sprays during the washing, rinsing, and sanitizing cycles.
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Recommendation:
Ensure soiled items to be cleaned in a warewashing machine are loaded into racks, trays, or baskets or onto conveyors in a position that (1) exposes the items to the unobstructed spray from all cycles; (2) allows the items to drain.
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Item No.:
22
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Site:
Galley-Deck 16 - Garden Cafe Glasswashing Machine
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Violation:
The left-most nozzle on the final rinse upper spray arm did not have a fan-like spray pattern. The nozzle was cleaned.
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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 - Garden Cafe Glasswashing Machine
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Violation:
The final rinse curtain was heavily soiled with black debris. The curtain was cleaned.
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Recommendation:
Ensure the warewashing machine wash and rinse tanks are equipped with baffles, curtains, or other means to minimize internal cross-contamination of the solutions in wash and rinse tanks. 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 - Garden Cafe 3-Compartment Sink
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Violation:
The temperature gauge of the sanitizing compartment was in disrepair. When manually tested, the sanitizing water was measured at 174°F while the gauge measured 70°F.
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Recommendation:
Ensure water temperature-measuring devices are scaled: (1) in Celsius or dually scaled in Celsius and Fahrenheit are designed to be accurate to within 1.5°C (within 3°F) in the intended range of use; (2) only in Fahrenheit are designed to be accurate to within 3°F in the intended range of use.
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Item No.:
22
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Site:
Galley-Deck 16 - Garden Cafe 3-Compartment Sink
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Violation:
Water leaked continuously from under the wash and rinse compartments onto the deck below.
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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 6 - Potwash
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Violation:
The flight-type potwash machine was out of service due to a heat exchanger bursting approximately an hour prior to the inspector entering the area.
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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.:
24
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Site:
Galley-Deck 16 - Garden Cafe Flight-Type Dishwashing Machine
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Violation:
The final rinse temperature gauge did not consistently measure above 180°F and the final rinse temperature at the utensil surface did not reach the required minimum of 160°F. Specifically, (1) using a stick and thermocouple, the highest temperature recorded near the upper spray arm was 159°F; (2) a 160°F irreversible thermometer sticker placed on a plate showed no color change, confirming the surface did not reach the necessary temperature; and (3) when the inspector and a crew member placed irreversible thermometer stickers (160°F, 170°F, and 180°F) on the upper final rinse spray arm, only the 160°F section changed color.
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Recommendation:
In a mechanical operation, ensure the temperature of the fresh hot water sanitizing rinse as it enters the manifold is not more than 90°C (194°F) or less than: (1) 74°C (165°F) for a stationary rack, single-temperature machine; (2) 82°C (180°F) for all other machines. Ensure the utensil surface temperature is not less than 71°C (160°F) as measured by an irreversible registering temperature indicator.
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Item No.:
24
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Site:
Galley-Deck 6 - Room Service
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Violation:
The chlorine solution measured less than 50 ppm in the sanitizing bucket.
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Recommendation:
Ensure sanitizing solutions are used with the following concentrations: (1) A chlorine solution with a concentration between 50 mg/L (ppm) and 200 mg/L (ppm).
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Item No.:
25
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Site:
Galley-Deck 5
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Violation:
A soiled wiping cloth was stored in the sanitizing solution bucket near the soup station's handwashing facility.
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Recommendation:
Restrict wiping cloths to the following: (1) Cloths used for wiping food spills are used for no other purpose; (2) Cloths used for wiping food spills are dry and used for wiping food spills from tableware and single service articles or wet and cleaned, stored in a chemical sanitizer, and used for wiping spills from food-contact and nonfood-contact surfaces of equipment; (3) Dry or wet cloths used with raw animal foods are kept separate from cloths used for other purposes. Wet cloths used with raw animal foods must be kept in a separate sanitizing solution; (4) Wet wiping cloths used with a freshly made sanitizing solution and dry wiping cloths are free of food debris and visible soil.
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Item No.:
26
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Site:
Pantry-Deck 6 - Teppanyaki Counter-Mounted Hot Water Dispenser
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Violation:
The food splash zone behind the hot water dispensing nozzle was soiled with grease residue and the dispensing nozzle was soiled with white residue.
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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.:
27
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Site:
Provisions-Deck 3 - Electrical Equipment Repair Room
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Violation:
A pizza press stored in the hallway outside of the electrical equipment repair room was soiled with old food debris.
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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:
Dining Room-Deck 6 - Teppanyaki Station 7
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Violation:
The countertop was soiled in the crevice where the sealant was in disrepair.
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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 8 - Cagney's Show Galley
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Violation:
One of the previously cleaned heat lamps was soiled with dried food debris. This was cleaned prior to the end of the inspection.
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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:
Other-Deck 4 - Area 34
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Violation:
A trolley identified as belonging to the breakfast garden had two large plastic containers, two corroded trays, and seven warm hotel pans that were stacked wet. This crew area was not a food service area.
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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 unless in packages on pallets, skids, or racks, which may be 127 millimeters (5 inches). Store clean equipment and utensils in a self-draining position that allows air drying and covered or inverted.
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Item No.:
33
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Site:
Galley-Deck 5 - Bakery
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Violation:
The deck tile grout was in disrepair with recessed and missing sections near the dough sheeter.
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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.:
33
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Site:
Galley-Deck 5
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Violation:
Two coved tiles to the left of the soup station's handwashing sink were soiled in cracked crevices.
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Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair. 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:
Other-Deck 10 - Aft Restaurant Locker
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Violation:
The deck under black pallets in the middle of the locker was soiled with dust and other debris.
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Recommendation:
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:
Galley-Deck 6 - Soup Station
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Violation:
The deck tile grout was recessed throughout the soup station.
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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.:
35
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Site:
Galley-Deck 16 - Garden Cafe 3-Compartment Sink
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Violation:
Water pooled on the deck under the wash and rinse compartments.
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Recommendation:
Ensure black and gray water is discharged to the vessel's wastewater disposal system and does not pool on the deck.
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Item No.:
41
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Site:
Children Area-Deck 5 - Splash Academy
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Violation:
It was unclear if the disinfectant used at the diaper changing station was effective against norovirus as this information was not listed on the label or the outbreak prevention and response plan documentation.
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Recommendation:
Ensure each vessel has a written OPRP that details standard procedures and policies to specifically address AGE onboard. Include the following in the written OPRP: (1) Duties and responsibilities of each department and their staff for all the passenger and crew public areas; (2) Steps in outbreak management and control and the trigger for required action at each step. Ensure the triggers address a graduated approach to outbreak management in response to increasing case counts; (3) Disinfectant products or systems used, including the surfaces or items the disinfectants will be applied to, concentrations, and required contact times. Ensure the disinfectant products or systems are effective against human norovirus or an acceptable surrogate (e.g., caliciviruses); (4) Procedures for informing passengers and crew members of the outbreak. Ensure this section also includes procedures for notification of passengers embarking the vessel following an outbreak voyage or segment of a voyage; (5) Procedures for returning the vessel to normal operating conditions after an outbreak; (6) Procedures to protect the passengers and crew from exposure to disinfectants, if not already included in the vessel?s safety management system. Ensure this protection includes: (a) Material safety data sheets (MSDSs); (b) Personal protective equipment for crew; (c) Health and safety procedures to minimize respiratory and dermal exposures to both passengers and crew.
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Item No.:
44
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Site:
Medical-Reportable Acute Gastroenteritis (AGE) Log
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Violation:
On April 30, the housekeeping team informed the medical team about a known passenger who vomited in the Manhattan restaurant but was not followed up to determine the need for isolation.
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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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