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Item No.:
*
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Site:
Children Area-Adventure Ocean Child Center
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Violation:
Staff stated that children were taken to the toilet room to wash hands after play activities.
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Recommendation:
Recommend that provisions be made so this can be accomplished at the handwash sink in the play area.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
The electronic medical database did not produce or export the standardized AGE surveillance log in exact order with the version specified and provided in section 13.2 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.:
02
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Site:
Medical-Gastrointestinal (GI) Illness Cases
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Violation:
The electronic database did not evaluate GI illness symptoms according to the new definition of a case provided in the VSP Operations Manual 2011. Additionally, the system determined cases and there was no ability to manually correct errors if the symptoms were due to an underlying medical condition or if fewer than 3 diarrheal episodes were more than what is normal for the individual.
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Recommendation:
Update the electronic system so that it meets the operational definition of a GI illness case and that it is possible for a medical professional onboard to make the correct determination/diagnosis.
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Item No.:
02
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Site:
Medical-Gastrointestinal (GI) Illness Cases
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Violation:
The electronic database for recording gastrointestinal illness data did not include GI illness symptoms on the follow-up screen, so when individuals were reviewed a day after initial symptoms there was no place to enter those symptoms and the non-reportable cases could not be changed to reportable in the database. The data that could be entered under follow-up was limited to vital signs.
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Recommendation:
Ensure that as follow-up interviews are conducted that the GI symptoms may be updated and the case determination can be changed.
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Item No.:
08
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Site:
Galley-Deck 5
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Violation:
Behind the ice machine near the warewash machine, a water line was striped indicating both potable water and chilled water. It was determined the line was chilled water. The blue striping was removed.
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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-Solarium and Forward Pools
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Violation:
The rescue hooks used in both pools were telescoping type hooks.
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Recommendation:
Provide a rescue or shepherd?s hook and an approved flotation device at a prominent location (visible from the full perimeter of the pool) at each RWF that has a depth of 1 meter (3 feet) or greater. Mount these devices in a manner that allows for easy access during an emergency. Ensure the pole of the rescue or shepherd?s hook is long enough to reach the center of the deepest portion of the pool from the side plus 2 feet. Ensure it is a light, strong, nontelescoping material with rounded, nonsharp ends. Ensure the approved flotation device includes an attached rope that is at least 2/3 of the maximum pool width.
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Item No.:
10
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Site:
Recreational Water Facilities-All Recreational Water Facilities (RWF's)
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Violation:
The safety and health signs posted at the pools and whirlpool spas did not include the new wording required in section 6.7.1.1.1. The whirlpoos spa signs did not include the precautionary words required in section 6.7.1.1.3 in the 2011 VSP Operations Manual 2011.
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Recommendation:
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. Provide safety signs for all RWFs, except for baby-only water facilities. 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 #. For children?s RWF signs, include the exact wording ?TAKE CHILDREN ON FREQUENT BATHROOM BREAKS? or ?TAKE CHILDREN ON FREQUENT TOILET BREAKS.?
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Item No.:
10
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Site:
Recreational Water Facilities-Maintenance of RWF's
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Violation:
Staff stated that hair and lint strainers and housings were cleaned and disinfected, but it was unclear to what concentration and time, and there were no logs documenting this work.
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Recommendation:
Clean, rinse, and disinfect the hair and lint strainer and hair and lint strainer housing on all RWFs weekly. Ensure disinfection is accomplished with an appropriate halogen-based disinfectant. At a minimum, use a 50-ppm solution for 1 minute, or equivalent CT value. Maintain records on all inspection and cleaning procedures.
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Item No.:
10
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Site:
Recreational Water Facilities-Maintenance of RWF's
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Violation:
Flow meters were not installed in any of the RWF's, so flow was not monitored and turnover rates and bather load were not calculated.
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Recommendation:
Monitor and adjust the RWF?s flow rates, free and combined halogen levels, pH, total alkalinity, and clarity as recommended by the manufacturer and to maintain optimum public health protection and water chemistry.
Maintain documentation on the maximum bather load for each RWF. Ensure the maximum bather load is based on the following factor: one person per five gallons (19 liters) per minute of recirculation flow. 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-Automated Monitoring
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Violation:
There were no analyzers and recorders or data loggers installed on either the return lines or directly from each RWF to automatically monitor the halogen and pH levels.
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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.:
10
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Site:
Recreational Water Facilities-Antientrapment Drains
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Violation:
The single gravity drains in the whirlpool spas were not fitted with compliant covers. New covers were onboard and they do meet the standards in the VSP Operations Manual 2011. The pool gravity multiple drains were covered by a grate, but there was no testing for hair entanglement for these and no alarms installed at the pools or the engine control room.
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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 unblockable drain (per ASME A112.19.8), 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.
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Item No.:
21
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Site:
Galley-Deck 4 Coffee Station
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Violation:
The potable water delivery line and electrical cord from the coffee machine were draped across the counter top, making cleaning difficult. This was corrected.
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Recommendation:
Remove the water lines and cords from the counter tops.
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Item No.:
21
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Site:
Galley-Deck 4 Hot Line
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Violation:
There was a gap around the stainless steel hot plate.
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Recommendation:
Profile the gap at the hot plate.
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Item No.:
21
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Site:
Galley-Windjammer
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Violation:
The door hinge for the left door of undercounter refrigerator #016 was loose, allowing warm air to enter the unit.
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Recommendation:
Repair or replace the door hinge on the undercounter refrigerator.
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Item No.:
26
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Site:
Buffet-Windjammer Forward Port Beverage Station
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Violation:
The four juice dispensing nozzles were soiled. The area was not open at the time of the inspection and had not been in use since breakfast.
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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.:
26
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Site:
Galley-Deck 5 Hot Galley
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Violation:
The flat grill was soiled at the edge seams.
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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:
Galley-Deck 5 Hot Galley
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Violation:
The upper left corner of the grease pan housing of grooved grill #006 was soiled with grease residue. The upper left seam and upper back seam of the grease pan of groove grill #007 were soiled with grease residue.
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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.:
30
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Site:
Galley-Deck 4 Pastry
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Violation:
The soap dispenser at the handwash station near the elevator was broken.
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Recommendation:
Repair or replace the soap dispenser.
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Item No.:
33
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Site:
Galley-Deck 4 Hot Line
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Violation:
Below flat grill #012 and the adjacent groove grill, soft sealant was used for coving at the equipment/deck juncture. In some areas this sealant was missing or peeling.
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Recommendation:
Replace soft sealant with hard or semi-hard sealant and ensure it is throughout the length of the equipment foundation and deck length.
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Item No.:
33
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Site:
Galley-Windjammer
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Violation:
Inside the technical compartment below the hot galley bain marie, there was a hole where the pipe penetrated the back bulkhead. It appeared the stainless steel profile plate was loose.
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Recommendation:
Repair or replace the profile plate at the bulkhead pipe penetration.
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Item No.:
33
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Site:
Galley-Deck 5
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Violation:
Behind the ice machine near the warewash machine, there was a gap where a drain line penetrated the deckhead.
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Recommendation:
Profile the gap at the drain line or install a grommet to close tight.
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Item No.:
33
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Site:
Galley-Deck 5 Room Service
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Violation:
There was a gap on the bulkhead profile strip behind combitherm oven #18 to the right of the water line.
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Recommendation:
Repair or replace the profile.
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Item No.:
36
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Site:
Dining Room-Deck 4 Gatsby
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Violation:
Not all of the lights above the waiter stations were shielded, coated, or shatter-resistant.
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Recommendation:
Ensure light bulbs are shielded, coated, or otherwise shatter-resistant in areas where there is exposed food, clean equipment, utensils, and linens, or unwrapped single-service and single-use articles.
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Item No.:
36
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Site:
Food Service General-Lighting
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Violation:
The light intensity was below 110 lux behind and around many pieces of deck- and counter-mounted equipment. This was observed behind the ice machines, behind the deck 4 pastry oven, and behind and beside equipment at the Windjammer beverage stations.
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Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) at a distance of 75 centimeters (30 inches) above the deck when in use, in walk-in refrigerator units and dry storage areas, and in other areas and rooms during periods of cleaning. 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.:
37
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Site:
Galley-Hot Galley
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Violation:
There was excess condensation on the deckhead and the exhaust hood overhang above the left tilting kettle. The crew member working in the area kept opening and closing the kettle lid while preparing pasta. The crew member closed the lid and one drop of condensation dripped from the deckhead onto the outside of the kettle lid. Another crew member wiped off the condensation from the deckhead and the front exhaust hood overhang. After a period of time, no condensation began to form on the deckhead and exhaust hood overhang.
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Recommendation:
Ensure exhaust ventilation hood systems in food preparation and warewashing areas--including components such as hoods, fans, guards, and ducting--are designed to prevent grease or condensation from draining or dripping onto food, equipment, utensils, linens, and single-service and single-use articles.
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Item No.:
39
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Site:
Buffet-Starboard Mediterranean Market
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Violation:
Two live flies were observed in an open container with food. The container was removed to the galley for the food to be discarded. The area was not open at the time of the inspection.
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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:
Preparation Room-
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Violation:
Two live flies were observed in this area. The area was not open at the time of the inspection. A door leading to the corridor was open, and active loading was taking place in the corridor.
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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-Windjammer
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Violation:
Two live flies were observed near the HACCP/Time Control Plans. The area was open at the time of the inspection.
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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:
Buffet-Windjammer Forward Port Beverage Station
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Violation:
One live fly was observed on an empty tray. The tray was removed to be cleaned and sanitized. Two live flies were observed near the juice machine. The area was not open at the time of the inspection.
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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.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
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Violation:
The electronic OPRP housekeeping section 2.17 specified that the Oxivir Five 16 disinfectant was to be used in electronic sprayers only, due to the scientific evidence of efficacy against norovirus. In sections 4.110 and 4.111 of the same document the instructions specified use of either Oxivir Five 16 or Vital Oxide in the electrostatic sprayers. The various sections which followed gave the option to use Oxivir Five 16 whenever Vital Oxide was not available for the electrostatic sprayer disinfection.
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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.:
41
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Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
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Violation:
There were some confusion notification letters for passengers regarding the OPP level 2 gastrointestinal illness elevations onboard. The two letters for placement on pillows in the staterooms both at the implementation of this level 2 procedure and on turnaround days following a cruise of level 2 elevation both began with statements about cold and flu, but neither letter actually mentioned a GI illness elevation. The guest boarding letter advised about the GI illness elevation, but this was only in the event that the boarding was delayed. It was unclear if any of these were meant to advise of an actual GI illness outbreak or not.
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Recommendation:
Ensure the notification letters are not confusing because they describe illnesses other than gastrointestinal. Ensure that those letters presented to passengers following an outbreak are consistent, so it's clear if an outbreak took place on the previous voyage or voyage segment.
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Item No.:
42
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Site:
Children Area-Adventure Ocean Child Center
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Violation:
The handwash sink in the child toilet room had a hot water temperature of 136 F. Additionally, the sink was over 22 inches in height and there was no step stool specifically for it.
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Recommendation:
Ensure the maximum water temperature for a handwashing station does not exceed 43C (110F).
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