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Item No.:
20
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Site:
Galley-Rita's Cantina
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Violation:
There were four slotted screws on the back of the counter-mounted oven and two slotted screws on the door.
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Recommendation:
Use only low profile, nonslotted, noncorroding, and easy-to-clean fasteners on food-contact surfaces and in splash zones. Prohibit the use of exposed slotted screws, Phillips head screws, or pop rivets in these areas.
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Item No.:
16
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Site:
Galley-Chops Show Galley
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Violation:
The lidded countertop cold well had a time control label, but the label was difficult to see.
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Recommendation:
Relocate the time control label so that it is easy to see.
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Item No.:
21
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Site:
Other-Sorrentos
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Violation:
There was a long, rolled cable laying on the bottom of the technical compartment for the self-service soda dispensing machine. This was corrected.
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Recommendation:
Shorten or secure the cable so it does not lay on the bottom of the technical compartment.
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Item No.:
27
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Site:
Other-Sorrentos
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Violation:
The bottom of the technical compartment for the self-service soda dispensing machines was soiled and wet under the long, rolled cable. This was corrected.
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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.:
08
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Site:
Galley-Sorrentos
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Violation:
The vent on the atmospheric backflow prevention device for the potable water line in the multi-flow cabinet was soiled with a black mold, indicating a leak.
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Recommendation:
Maintain backflow prevention devices in good repair.
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Item No.:
29
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Site:
Bar-Bow and Stern
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Violation:
A glass was in the handwashing sink. This was corrected.
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Recommendation:
Ensure handwashing facilities are used for no other purpose and are accessible at all times.
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Item No.:
19
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Site:
Pantry-Boleros
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Violation:
One of the garbage bins was in direct contact with a box of juice syrup stored on an adjacent deck stand. The garbage bin was immediately moved.
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Recommendation:
Protect food from contamination by storing the food: (1) Covered or otherwise protected; (2) In a clean, dry location; (3) Where it is not exposed to splash, dust, or other contamination; and (4) At least 15 centimeters (6 inches) above the deck.
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Item No.:
16
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Site:
Food Service General-Time Control Plans
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Violation:
The recently revised time control plans stated operation hours, but it was not clear from the plans if the set-up times were included in the operation hours. This included plans in the galleys, buffets, and for the milk in the espresso machines.
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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(s): (1) Includes set-up and discard times for each outlet. (2) List refrigeration and hot holding units (compartments and cabinets) on time control (the physical units must also be labeled as such). (3) Describe or show the flow of potentially hazardous food from when last in temperature control to placement in time control and discard.
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Item No.:
10
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Site:
Recreational Water Facilities-Safety Sign
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Violation:
The FLOWRIDER recreational water facility did not have a sign that specified the minimum required information including: (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; and (3) shower before entering the facility. Safety information only was posted. All of the other safety signs for RWFs had been updated since the previous inspection.
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Recommendation:
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.
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Item No.:
22
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Site:
Housekeeping-Soiled Ice Bucket Tong Handling
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Violation:
Over a dozen soiled ice buckets, ice tongs and trays were placed directly on the deck outside the cabins as they were cleaned. This practice transfers deck soil to the areas where these items will be washed.
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Recommendation:
Review options for transfer and holding of these soiled items.
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Item No.:
29
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Site:
Galley-Deck 4 Galley Port Entrance
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Violation:
The water at the handwash station reached 133 F/56 C during use, and the user could not control the temperature. Staff corrected this during the inspection.
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Recommendation:
Ensure handwashing sinks are equipped to provide water at a temperature of at least 38C (100F) through a mixing valve or combination faucet. For handwash sinks with electronic sensors, and other types of handwash sinks where the user cannot make temperature adjustments, ensure the temperature provided to the user after the mixing valve does not exceed 49C (120F).
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Item No.:
17
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Site:
Preparation Room-
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Violation:
There were two pieces of raw chicken with internal temperatures of 49 F during active thawing in the right side Tina upright reach-in thawing refrigerator. It was unclear why only these pieces were thawing out of temperature, as the other pieces in the same bag were at or below 41 F. The high temperature pieces were immediately removed and discarded.
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Recommendation:
Thaw potentially hazardous food: (1) Under refrigeration that maintains the food temperature at 5C (41F) or less; or (2) Completely submerged under running water at a water temperature of 21C (70F) or below, with sufficient water velocity to agitate and float off loose particles in an overflow, and for a period of time that does not allow thawed portions of ready-to-eat food to rise above 5C (41F), (3) Completely submerged under running water at a water temperature of 21C (70F) or below, with sufficient water velocity to agitate and float off loose particles in an overflow, and for a period of time that does not allow thawed portions of a raw animal food requiring cooking to be above 5C (41F) for more than 4 hours, including
the time the food is exposed to the running water and the time needed for preparation for cooking, OR the time it takes under refrigeration to lower the food temperature to 5C (41F). (4) As part of a cooking process if the food that is frozen is cooked or thawed in a microwave oven.
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Item No.:
16
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Site:
Galley-Hot Galley
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Violation:
A full hotel pan of brown gravy was found inside the combination oven with a food temperature of 95 F. Other pans of potentially hazardous foods inside the same oven were at 135 F. Staff stated the gravy had been reheated and transferred to the oven for holding.
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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.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
Medical staff stated the electronic medical reporting system did not allow them to make a case reportable unless the case had 3 episodes of diarrhea within 24 hours or 1 episode of vomiting plus 1 other symptom. There was no way to make a case reportable if a patient had less than 3 episodes of diarrhea but this was above normal for the individual.
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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]). Update the electronic medical reporting system to allow reportable cases if the number of episodes of diarrhea is above normal for the individual.
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Item No.:
02
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Site:
Medical-Immediate Contacts for AGE Ill Crew Members
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Violation:
Medical staff was not following up with and documenting significant others (boyfriend/girlfriend) as immediate contacts for sick crew. Only cabin mates were listed close contacts for followed-up. According to the staff, known contacts were not interviewed unless they were cabin mates.
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Recommendation:
Include immediate contacts such as spouses, boyfriends and girlfriends for verbal interviews and follow-up. When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions: (1) restrict exposure to symptomatic crew member(s); (2) undergo a verbal interview with medical or supervisory staff, who will confirm their condition, provide facts and a written fact sheet about hygiene and handwashing, and instruct them to report immediately to medical if they develop illness symptoms; (3) complete a verbal interview daily with medical or supervisory staff until 48 hours after the ill crew members' symptoms began. Ensure that the first verbal interview is conducted within 8 hours from the time the ill crew member initially reported to the medical staff. If the asymptomatic immediate contact or cabin mate is at work, ensure that he or she must is contacted by medical or supervisory staff as soon as possible. Document the date and time of verbal interviews.
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Item No.:
02
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Site:
Medical-AGE Surveillance Log
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Violation:
A passenger reported to medical on 7/15 with two episodes of diarrhea within 24 hours. This passenger was not a reportable case because the passenger was lactose intolerant. However, nothing was noted in the 'underlying illness' column on the AGE log. Another passenger reported on 7/15 with two episodes of diarrhea but stated this was normal for her during her menstrual cycle so she was not listed as a reportable case. Once again, nothing was noted in the 'underlying illness' column on the AGE log.
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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.:
11
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Site:
Medical-AGE Crew Reporting
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Violation:
A crew member on 7/7 experienced AGE symptoms but did not report to medical until over 8 hours from the time of illness onset. The crew member worked while symptomatic. The ship's staff had investigated this incident and disciplinary action was taken and documented. This was a repeat violation from the previous inspection.
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Recommendation:
When food employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 48 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document date and time of last symptom and clearance to return to work. When nonfood employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 24 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document the date and time of last symptom and clearance to return to work.
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Item No.:
02
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Site:
Medical-4-hour Update Report
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Violation:
A 4-hour update report was submitted on 7/7 even though there were no additional AGE cases reported since the 24-hour report was submitted.
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Recommendation:
Do not submit a 4-hour report if there have been no additional cases since submission of the 24-hour report.
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Item No.:
06
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Site:
Potable Water-Medical Microbiolgic WaterTesting Reagent
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Violation:
One box of reagent used for the water sampling tests expired on 7/25/13.
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Recommendation:
If water samples are collected and analyzed by the vessel for the presence of E. coli, analyze the samples using a method accepted in Standard Methods for the Examination of Water and Wastewater. Ensure test kits, incubators, and associated equipment are operated and maintained in accordance with the manufacturers' specifications.
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Item No.:
08
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Site:
Potable Water-Mineralizer Striping
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Violation:
The water pipes from the mineralizer before the chlorine injection point were labeled as potable water and striped blue, indicating potable water.
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Recommendation:
Stripe or paint potable water lines either in accordance with ISO 14726 (blue/green/blue) or blue only. Stripe or paint distillate and permeate lines directed to the potable water system in accordance with ISO 14726 (blue/gray/blue). Ensure no other lines have the above color designations. Stripe or paint these lines at 5 meters (15 feet) intervals and on each side of partitions, decks, and bulkheads, except where decor would be marred by such markings, including potable water supply lines in technical lockers. Do not stripe or paint potable water lines after reduced pressure assemblies as potable water. Uniquely identify all refrigerant brine lines in all galleys, pantries, and cold rooms to prevent cross-connections.
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Item No.:
26
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Site:
Children Area-Nursery
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Violation:
The microwave used by staff was soiled with food debris.
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Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
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Item No.:
02
|
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Site:
Medical-AGE Surveillance Log
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Violation:
A crew member reported to medical on 7/9 with two episodes of diarrhea and was treated as a nonreportable AGE case. The crew member developed more symptoms later that day, which made them a reportable case. This case was not listed on the AGE log. Medical staff stated after the initial entry into the electronic medical reporting system as a nonreportable case they could go back and change it to a reportable case. This was noted in the previous inspection report.
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Recommendation:
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Item No.:
44
|
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Site:
Medical-AGE Definition
|
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Violation:
The medical staff did not know that the definition for reportable cases included 3 episodes of diarhhea or what was above normal for the individual. Since 23 June, seven individuals had reported to the medical center with less than 3 episodes of diarhhea and were issued antidiarhheal medication, but were considered nonreportable cases. The medical staff did not question these individuals if the diarhhea was above normal for them so it was unknown whether any of these seven individuals were actually reportable AGE cases.
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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 2011 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 2011 Operations Manual as it relates to their assigned duties.
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