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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Case Definition
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Violation:
The AGE case definition used by the ship did not consider the number of diarrhea episodes that was above normal to certain individuals. The current definition did not allow individuals with pre-existing medical conditions, such as individuals with irritable bowel syndrome, who reach 3 loose stools to be considered non-reportable cases. This definition was in writing. No cases appeared to be reported incorrectly.
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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 38C [100.4F]).
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The AGE surveillance log could not be put into a spreadsheet with the required information in the exact order as Annex 13.2.2 of the 2011 VSP Operations Manual.
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Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns: (1) Date of the first medical visit or report to staff of illness; (2) time of the first medical visit or report to staff of illness; (3) case identification number; (4) person's name; (5) person's age; (6) person's sex; (7) designation as passenger or crew member; (8) crew member position or job on the vessel, if applicable; (9) cabin number; (10) meal seating information; (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) number of episodes of vomiting in a 24-hour period; (c) bloody stools; (d) recorded temperature; (e) abdominal cramps; (f) headaches; (g) muscle aches; (14) entry (yes/no) for whether this was a reportable case; (15) entry (yes/no) for antidiarrheal medications sold or dispensed by designated medical staff; (16) presence of underlying medical conditions that may affect interpretation of AGE. 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.:
06
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Site:
Potable Water-Bunkering
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|
Violation:
The halogen and pH analyzer was not calibrated at the beginning of bunkering. During the bunkering of potable water, the halogen and pH analyzer readings were used to document the manual tests every half hour. The analyzer measured 3.32 ppm of chlorine while the inspector's test kit measured 2.50 ppm and the crew member's test kit measured 2.68 ppm. This was corrected.
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|
Recommendation:
Calibrate at the beginning of bunkering or production when halogen and pH analyzer-chart recorders are used in lieu of manual tests and logs. Ensure the calibration is recorded on the chart.
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Item No.:
08
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Site:
Potable Water-Bunkering
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Violation:
During the bunkering of potable water, the pH was measured but it was unclear if it was over 7.8. The scale of the manual color comparison kit used to determine the pH value and calibrate the halogen/pH analyzer made difficult to determine the precise value.
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Recommendation:
After the free residual halogen level of at least 2.0 mg/L (ppm) and pH level not exceeding 7.8 have been reached, monitor the free residual halogen and pH at least hourly during the bunkering of potable water. After the free residual halogen level of at least 2.0 mg/L (ppm) and pH level not exceeding 7.8 have been reached, monitor the free residual halogen and pH at least once every 4 hours during the production of potable water.
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Item No.:
08
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Site:
Potable Water-Distillate & Permeate Water Lines
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Violation:
The distillate water lines from the evaporator to the potable water halogenation station and the permeate water lines from the reverse osmosis plant to the potable water halogenation station were not striped or painted in accordance with ISO 14726 standards (blue/gray/blue).
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Recommendation:
Uniquely identify all refrigerant brine lines in all galleys, pantries, and cold rooms to prevent cross-connections.
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Item No.:
08
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Site:
Potable Water-Cross-Connection Control Program
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|
Violation:
The test results for a number of reduced pressure zone assemblies appeared to be incomplete. The instructions for the test kit stated to perform four tests and record those pressure differentials to determine any leaks and the proper functioning of the relief vent. Only the results for the first two tests were documented.
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Recommendation:
Inspect and test backflow prevention devices requiring testing with a test kit after installation and at least annually. Maintain the test results showing the pressure differences on both sides of the valves for each device.
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Item No.:
08
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Site:
Potable Water-Cross-Connection Control Program
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Violation:
The cross-connection control program did not list air gaps. There were air gaps at the fillings of the compensation tanks of the recreational water facilities, at the mineralizer backwash drain, and at the two fillings for technical water tanks.
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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-Tank Maintenance
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Violation:
Potable water tank #1 was serviced on 14 October 2011, tank #2 was service on 7 October 2011, and tank #3 was serviced on 23 September 2011. There were notations that the tanks were super chlorinated, but there was no written documentation of the free halogen residual before the tanks were put back in service.
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Recommendation:
Flush the disinfected parts of the system with potable water or otherwise dechlorinate until the free residual halogen is less than or equal to 5.00 mg/L (ppm). Document the free halogen test result.
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Item No.:
08
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Site:
Food Service General-Brine Line Identification
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|
Violation:
The brine lines for the undercounter and upright refrigeration units were not uniquely identified.
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|
Recommendation:
Uniquely identify all refrigerant brine lines in all galleys, pantries, and cold rooms to prevent cross-connections.
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Item No.:
10
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Site:
Recreational Water Facilities-Water Testing
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|
Violation:
There was no means to test the total halogen and alkalinity for the water in the recreational water facilities.
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|
Recommendation:
Ensure a test kit is available for testing water quality parameters, including free and total halogen levels (chlorine and bromine, where applicable), pH, and total alkalinity. Ensure that test kits are accurate to within 0.2 mg/L (ppm) for halogen and have a testing range of free residual halogen normally maintained in the RWF. Ensure test kits for pH are accurate to within 0.2. Ensure all reagents are not past their expiration dates.
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Item No.:
10
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Site:
Recreational Water Facilities-Safety Signs
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|
Violation:
The safety signs posted at the recreational water facilities did not contain all elements of the 2011 VSP Operations Manual sign requirements.
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Recommendation:
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 #. In addition to the safety sign requirements in section 6.7.1.1.1, install a sign at each whirlpool spa and spa pool entrance listing precautions and risks associated with the use of these facilities. Include, at a minimum, cautions against use by the following: (1) individuals who are immunocompromised; (2) individuals on medication or who have underlying medical conditions such as cardiovascular disease, diabetes, or high or low blood pressure; and (3) pregnant women, elderly persons, and children. Additionally, caution against exceeding 15 minutes of exposure.
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Item No.:
10
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Site:
Recreational Water Facilities-Turnover Rates
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|
Violation:
Turnover rates for recirculation for the pools and whirlpools were not available.
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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. Design recirculation systems and equipment, including chemical control equipment, UV disinfection systems, filter, and pumps to maintain adequate water chemistry control while operating at the following minimum turnover rates: (1) swimming pool (VSP 2005 Construction Guidelines or earlier): 6 hours; (2) swimming pool (VSP 2011 Construction Guidelines or later): 4 hours; (3) children's pool: 0.5 hours; (4) wading pool: 1 hour; (5) whirlpool spa: 0.5 hours; (6) spa pool: 2 hours; (7) interactive RWF or activity pool less than 610 millimeters (24 inches) deep: 1 hour; (8) interactive RWF or activity pool greater than 610 millimeters (24 inches) deep: 2 hours; and (9) baby-only water facility: 0.5 hours. Ensure an RWF slide that is combined with a pool has a turnover rate that matches the rate for the pool.
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Item No.:
10
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Site:
Recreational Water Facilities-Antientrapment Requirements
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Violation:
The gravity drains for the Lido swimming pool were more than 3 feet apart, had custom fabricated drain covers, and there was no alarm for draining the pool. It was uncertain if the antientrapment drain requirements were met per the 2011 VSP Operations Manual. Also, the gravity single drain for the aft swimming pool had a blockable drain cover, but it was uncertain if it met the antientrapment drain requirements per the 2011 VSP Operations Manual.
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Recommendation:
For RWFs with gravity drainage and multiple drains (2 or more drains greater than 3 feet apart), provide either a standard design (not compliant with ASME A112.19.8) drain cover and an alarm, or an ASME A112.19.8 compliant antientrapment/antientanglement drain cover. Ensure the alarm is audible and sounds in both a continuously manned space and at the RWF. Ensure this alarm is for all draining: accidental, routine, and emergency. For RWFs with gravity drainage and a single blockable drain or multiple drains less than 3 feet apart, provide an ASME A112.19.8 compliant antientrapment/antientanglement drain cover and a gravity drainage system. Ensure the testing of manufactured drain covers is by a nationally or internationally recognized testing laboratory. Ensure the following information is stamped on each manufactured antientrapment drain cover: (1) certification standard and year; (2) type of drain use (single or multiple); (3) maximum flow rate (in gallons or liters per minute); (4) type of fitting (suction outlet); (5) life expectancy of cover; (6) mounting orientation (wall, floor, or both); (7) manufacturer's name or trademark; and (8) model designation. Ensure the design of custom/shipyard constructed (field fabricated) drain covers and suction fittings is fully specified by a registered design professional in accordance with ASME A112.19.8-2007. Ensure the specifications fully address cover/grate loadings, durability, hair, finger and limb entrapment issues, cover/grate secondary layer of protection, related sump design, and features specific to the RWF. Provide a letter from the shipyard for each custom/shipyard constructed (field fabricated) drain cover fitting. At a minimum, ensure the letter specifies the shipyard, name of the vessel, specifications and dimensions of the drain cover, as well as the exact location of the RWF for which it was designed. Ensure the name of and contact information for the registered design professional and signature are on the letter.
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Item No.:
10
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|
Site:
Recreational Water Facilities-Depth Markers
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|
Violation:
Depth markers at recreational water facilities were only measured in feet.
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|
Recommendation:
Prominently display the depth of each RWF that is deeper than 1 meter (3 feet) so that it can be seen from the deck and in the pool. Label depth markers in both feet and meters. Additionally, install depth markers for every 1 meter (3 feet) change in depth.
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Item No.:
10
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|
Site:
Recreational Water Facilities-Chart Recorders
|
|
Violation:
There were chart recorders for pH and halogen measurements for each individual recreational water facility, but they were not operational.
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|
Recommendation:
Install chart recorders or electronic data loggers with security features that record pH and halogen measurements for each individual RWF. Ensure the sample line for the analyzer probe (monitoring) is either directly from the RWF or on the return line from each RWF and before the compensation tank. Install appropriate sample taps for analyzer calibration. In the event of equipment failure, measure free residual halogen and pH by a manual test kit at the RWF or return line at least hourly for whirlpool spas, spa pools, children's pools, and wading pools and every 4 hours for all other RWFs. Record manual readings on a chart or log, retain for at least 12 months, and ensure that they are available for review during inspections. Complete repairs on malfunctioning halogen analyzer-chart recorders within 30 days of equipment failure. Provide an audible alarm in a continuously occupied watch station to indicate low and high free halogen and pH readings in each RWF.
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Item No.:
16
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|
Site:
Bar-Musical Cafe
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|
Violation:
The time control plan did not list the undercounter refrigerator that was labeled as time control.
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|
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. Ensure plan lists refrigeration and hot holding units (compartments and cabinets) on time control (the physical units must also be labeled as such).
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Item No.:
16
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|
Site:
Buffet-Omelet Stations
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|
Violation:
The consumer advisory for the omelet stations, where eggs could be cooked to order, was not specific to eggs.
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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 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 and 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.:
16
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|
Site:
Food Service General-Time Control Plans
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|
Violation:
The time control plan flow charts had a stopwatch icon to indicate the start of 4-hour time control and a thermometer to indicate temperature control. On many of the plans throughout the vessel, there was a stop watch icon between two steps with a thermometer. The time control procedures in the food areas were correct. Staff were updating the plans during the inspection.
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|
Recommendation:
Update the time control plans to match the operations in the food areas.
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Item No.:
16
|
|
Site:
Preparation Room-Walk-In Refrigerator
|
|
Violation:
The temperature of mung bean sprouts was measured between 44F and 49F. The sprouts had been recently provisioned and were taken to a blast chiller.
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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 57C (135F) or above, except that roasts may be held at a temperature of 54C (130F); or 5C (41F) or less.
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Item No.:
18
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|
Site:
Preparation Room-Meat Thaw Room
|
|
Violation:
There were 4 pans of ground beef on a shelf above top round roasts. The ground beef was still packaged and frozen. The pans of ground beef were moved to a separate shelf.
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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.
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Item No.:
19
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|
Site:
Buffet-Crew Mess
|
|
Violation:
On the top shelf of the cold buffet, there were 3 pans of bread with lids. The lids were not self-closing and once removed, the bread was not protected from contamination. The pans were moved to the lower area below the sneeze guard.
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|
Recommendation:
Protect food on display from contamination by the use of packaging; counter, service line, or salad bar food guards; display cases; self-closing hinged lids; or other effective means. Install side protection for sneeze guards if the distance between exposed food and where consumers are expected to stand is less than 1 meter (40 inches).
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Item No.:
19
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|
Site:
Other-Formalities Shop
|
|
Violation:
There was self-service candy in this shop. The lids on the top row of the candy display were not self-closing.
|
|
Recommendation:
Protect food on display from contamination by the use of packaging; counter, service line, or salad bar food guards; display cases; self-closing hinged lids; or other effective means. Install side protection for sneeze guards if the distance between exposed food and where consumers are expected to stand is less than 1 meter (40 inches).
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Item No.:
20
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|
Site:
Food Service General-Tip-sensitive Thermometers
|
|
Violation:
Chefs and cooks who prepared thin foods did not have tip-sensitive thermometers.
|
|
Recommendation:
Use tip-sensitive temperature-measuring devices, such as a thermocouple or thermistor, for measuring thin food products.
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Item No.:
20
|
|
Site:
Bar-Musical Cafe
|
|
Violation:
Both Scharf espresso machines had gaps, seams and exposed pipes in the splash zone above the coffee making and milk steaming areas of the machines.
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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.
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Item No.:
20
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|
Site:
Preparation Room-
|
|
Violation:
There was soft sealant on the food contact surface of the backplate of the slicer. The sealant was removed and it was determined it was not needed.
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|
Recommendation:
Design and construct food contact surfaces of equipment and utensils to be durable and to retain their characteristic qualities under normal use conditions.
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Item No.:
21
|
|
Site:
Galley-Forward Hot Line
|
|
Violation:
In undercounter oven #3, there were two holes in the area below the hinge of the oven door.
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|
Recommendation:
Close the holes. 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
|
|
Site:
Bar-Tiffany
|
|
Violation:
There was a gap below the edge of the decorative bar counter above the handwashing station. There was also a rough fiber-like material exposed along the edge.
|
|
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
|
|
Site:
Buffet-Flat-top Grills
|
|
Violation:
Inside the drip pan housings, there were large gaps around the drains.
|
|
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.:
26
|
|
Site:
Galley-Aft Beverage Line
|
|
Violation:
The areas where each juice concentrate container connected to dispense juice were soiled inside both juice dispensers.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
27
|
|
Site:
Buffet-Flat-top Grills
|
|
Violation:
Inside the drip pan housings, the areas around the drains were soiled with old grease and black carbonized material.
|
|
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
|
|
Site:
Galley-Dishwash
|
|
Violation:
There was a side table with 5 tall stacks of plates to be inspected following dishwashing. The plates were not covered or inverted.
|
|
Recommendation:
Store clean equipment and utensils in a self-draining position that allows air drying, and covered or inverted.
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Item No.:
30
|
|
Site:
Galley-Crew Toilets
|
|
Violation:
The toilets inside the galley did not have a 'wash hands after using toilet' sign posted by the exit door. The sign was in the toilet room, but not in the correct location.
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|
Recommendation:
Ensure signs are conspicuously posted on the bulkhead adjacent to the door of the toilet, reading "WASH HANDS AFTER USING TOILET " in a language that the food employees understand.
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Item No.:
33
|
|
Site:
Galley-Soup Section
|
|
Violation:
There was recessed grout between deck tiles in this area.
|
|
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.
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Item No.:
33
|
|
Site:
Galley-Aft Hot Line
|
|
Violation:
In the technical compartment for bain marie #4, there was no grout at the deck tile around the deck penetration. This area of the deck was also soiled.
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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.
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Item No.:
34
|
|
Site:
Buffet-Forward Buffet Line
|
|
Violation:
There was a water leak inside the hood cleaning cabinet. A technician arrived to investigate the leak during the inspection.
|
|
Recommendation:
Ensure the plumbing system in the food area is maintained in good repair.
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|
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Item No.:
36
|
|
Site:
Bar-Handwashing Station Light Intensity
|
|
Violation:
The light intensity at the handwashing stations was less than 110 lux during normal operations at the bars inspected. For some bars, it was adequate during the inspection, but these bars had large windows with sunlight during the inspection.
|
|
Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) at handwashing stations in bars.
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|
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Item No.:
36
|
|
Site:
Food Service General-Light Intensity
|
|
Violation:
The light intensity behind and beside several pieces of deck-mounted and counter-mounted equipment was less than 110 lux. This included the main galley forward hot line combination oven, room service coffee machines, aft wine cellar ice machine, aft dining room service bar ice machine, and bar and deck pantry ice machines.
|
|
Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment.
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Item No.:
36
|
|
Site:
Dining Room-Inspiration Dining Room
|
|
Violation:
On the soiled side of the large waiter stations/pantries, the light intensity was less than 220 lux on the counter surface. There was also less than 220 lux on several of the other smaller waiter stations.
|
|
Recommendation:
In bars and dining room waiter stations, provide 220 lux (20 foot candles) light intensity during cleaning operations.
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|
Item No.:
41
|
|
Site:
Housekeeping-Outbreak Prevention and Response Plan
|
|
Violation:
The outbreak prevention and response plan did not include procedures for informing current and embarking passengers and crew members of an outbreak or procedures. The plan was not specific to the surfaces or items where the disinfectants were to be applied. Also, the plan detailed the use of the sanitizer TOR HB which was replaced with HB QUAT. Concentrations and contact times for the current sanitizer are not detailed in the plan.
|
|
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: (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.
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Item No.:
41
|
|
Site:
Housekeeping-Toilet Room Signs
|
|
Violation:
The bridge toilet room did not have a sign advising users to wash hands after using the toilet or signs advising users to use hand towels, paper towel, or tissue to open the door when exiting. This was corrected.
|
|
Recommendation:
Provide the passenger and crew public toilets with a handwashing station that includes a sign advising users to wash hands. 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.:
42
|
|
Site:
Children Area-
|
|
Violation:
The height of the handwashing sink in the toilet room was more than 22 inches and the height of the child-size toilet was more than 11 inches. No step stools were provided.
|
|
Recommendation:
If toilet rooms are located in a child-activity center, provide a child-size toilet(s) or child-accessible toilet(s) (child-size seat and step stool) and handwashing facilities. Ensure child-size toilets (to include the toilet seat) have a maximum height of 280 millimeters (11 inches) and a toilet seat opening no greater than 203 millimeters (8 inches). Ensure handwashing sinks have a maximum height of 560 millimeters (22 inches) above the deck or a step stool.
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Item No.:
43
|
|
Site:
Ventilation-Air Handling Units
|
|
Violation:
The water used for the cleaning of air handling units was technical water.
|
|
Recommendation:
Use only potable water for cleaning HVAC distribution systems.
|
|