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Item No.:
*
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|
Site:
Medical-Antidiarrheal Medication Dispensed
|
|
Violation:
For all passenger and crew member acute gastroenteritis (AGE) reportable and non-reportable cases, the print-out from the STARDOCS medical surveillance system indicated the patient was issued antidiarrheal medication, even though medical staff clearly marked 'no' in the appropriate box in the STARDOCS medical surveillance system.
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|
Recommendation:
Update STARDOCS so the print-out accurately documents when a patient was issued antidiarrheal medication.
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|
|
Item No.:
11
|
|
Site:
Medical-Crew Member Isolation
|
|
Violation:
According to the STARDOCS medical surveillance system, a Team Waiter had his last AGE symptoms on 12 August at 23:00. A medical staff wrote his last symptom was on 13 August at midnight. This crew member was isolated 11 August at 17:51 to 15 August at 08:08. This was not a complete 48 hours of medical isolation following his last symptom.
An Assistant Waitress had an onset of AGE symptoms on 12 July at 16:30. When the medical staff conducted their follow-up interview on 14 July at 16:03, this crew member indicated she was still experiencing symptoms. According to the STARDOCS medical surveillance system, her isolation started on 12 July at 16:52 and ended on 15 July at 16:55. The isolation start time was when she reported to the medical center, and not the time when she was symptom-free.
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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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|
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Item No.:
*
|
|
Site:
Medical-STARDOCS Last Symptom Date
|
|
Violation:
On the print-out from the STARDOCS medical surveillance system, the date of a patient's last symptom was often difficult to determine because the last digit was cut off. For example, a crew members last AGE symptoms were on 14 August, but the print-out indicated 1 August,
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|
Recommendation:
Update STARDOCS so the print-out accurately documents the date of a patient's last symptom.
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|
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Item No.:
02
|
|
Site:
Medical-
|
|
Violation:
A Hairdresser had one episode of diarrhea, which she indicated was above normal. Antidiarrheal medication was given to this crew member and she was listed as a non-reportable case. A Team Headwaiter had two episodes of diarrhea and was given antidiarrheal medication. He was listed as a non-reportable case, but there was no notation of an underlying illness or these condition being above normal for him. A Photographer had two episodes of vomiting and headache and was listed as a non-reportable case.
|
|
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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|
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Item No.:
02
|
|
Site:
Medical-
|
|
Violation:
According to the STARDOCS medical surveillance system, a Commis (Assistant Team Waiter) experienced diarrhea, but his medical paperwork indicated he did not.
|
|
Recommendation:
Ensure the information in STARDOCS correctly corresponds to the information in a patient's medical paperwork
|
|
|
Item No.:
02
|
|
Site:
Medical-Close Contacts
|
|
Violation:
When interviewing an AGE patient's close contacts, not all those who shared the cabin toilet room with the symptomatic patient were included.
|
|
Recommendation:
Ensure an AGE patient's close contacts include everyone in their cabin, as well as those who share the toilet room.
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|
|
Item No.:
44
|
|
Site:
Medical-
|
|
Violation:
The medical staff was not paying close attention to updating a patient's medical isolation start time when symptoms persisted. For example, an Assistant Waitress had an onset of AGE symptoms on 12 July at 16:30. During a follow-up interview on 14 July at 16:03, she indicated she was still experiencing symptoms. The STARDOCS medical surveillance system indicated her isolation started on 12 July at 16:52, but this was the time she reported to the medical center, and not the time when she was symptom-free. Also, a patient was often not isolated for the appropriate 24 or 48 hours symptom-free. For example, a Team Waiter had his last AGE symptoms on 13 August at midnight, but his medical isolation ended on 15 August at 08:08. Also, medical staff listed patients as non-reportable cases, even though a patient experienced AGE symptoms that were not normal for him/her or experienced AGE symptoms that met the case definition as a reportable case. For example, a Hairdresser had one episode of diarrhea, which she indicated was above normal. She was listed as a non-reportable case. A Team Headwaiter had two episodes of diarrhea, was listed as a non-reportable case, but there was no notation of an underlying illness or these condition being above normal for him. A Photographer had two episodes of vomiting and headache and was listed as a non-reportable case. Also, medical staff was not conducting interviews with all individuals who shared toilet facilities with the AGE patient.
|
|
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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|
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Item No.:
10
|
|
Site:
Recreational Water Facilities-Spray Park
|
|
Violation:
Since the previous inspection, all of the monitoring chart records only included free chlorine residual, and not pH.
|
|
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.
|
|
|
Item No.:
10
|
|
Site:
Recreational Water Facilities-Thalosso Therapy Pool
|
|
Violation:
The safety sign was located approximately 2 meters from the entrance to the whirlpool spa, making it difficult to read.
|
|
Recommendation:
Locate the safety sign at the entrance to the Thalosso Pool.
|
|
|
Item No.:
10
|
|
Site:
Housekeeping-Fecal and Vomit Accidents
|
|
Violation:
On 11 November 2012, corporate staff sent out procedures for fecal/vomit accident response. These procedures included (1) wash with HB Quat or a similar product; (2) rinse with fresh water; and (3) sanitize surfaces with 200 ppm chlorine. Since the last inspection, there were 8 accidents, all of which were vomit. The write-ups for each of these included sanitizing surfaces inside the pool, ladder, overflow channel drain, etc. with the 200 ppm chlorine, but there was no contact time for this solution.
|
|
Recommendation:
Ensure a written or electronic record is made of all accidents involving fecal material or vomit. Ensure the record includes the name of the RWF, date and time of the accident, type of accident, response steps taken, and free residual halogen level and contact time reached during disinfection. For a fecal accident, ensure the record also includes whether the fecal material was formed or loose.
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|
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Item No.:
26
|
|
Site:
Pantry-Deck 6 Forward Starboard Pantry
|
|
Violation:
There was an accumulation of black/gray metal dust in the water reservoir of the ice machine.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
|
|
|
Item No.:
29
|
|
Site:
Pantry-Midship Pool Bar - Deck 9
|
|
Violation:
There was ice inside the hand sink.
|
|
Recommendation:
Ensure handwashing facilities are used for no other purpose and are accessible at all times.
|
|
|
Item No.:
26
|
|
Site:
Galley-Food Preparation Area
|
|
Violation:
A previously cleaned food slicer had a build-up of food residue under the slicer's backplate next to the exit path of the food from the slicer blade.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
|
|
|
Item No.:
27
|
|
Site:
Galley-Hallway Counter
|
|
Violation:
A previously cleaned food slicer had a slight build-up of food residue on the slicer's body.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
36
|
|
Site:
Galley-Center Galley
|
|
Violation:
The light intensity was less than 110 lux behind and around the deck oven and behind and around the combination ovens.
|
|
Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment.
|
|
|
Item No.:
36
|
|
Site:
Buffet-Grand Buffet Service Line
|
|
Violation:
The light intensity was less than 110 lux behind and around the port side toaster.
|
|
Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment.
|
|
|
Item No.:
37
|
|
Site:
Other-Grill Walk-In Cooler
|
|
Violation:
Condensation was leaking from the deckhead to the deck. No food appeared to be impacted.
|
|
Recommendation:
Ensure ventilation hood systems and devices are sufficient in number and capacity to prevent grease or condensation from collecting on bulkheads and deckheads.
|
|
|
Item No.:
33
|
|
Site:
Other-Grill Walk-In Cooler
|
|
Violation:
Ice formed on the deck from a continuous water leak from the deckhead. There was also missing deck tile grout by the door.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary. Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
|
|
|
Item No.:
33
|
|
Site:
Other-Pizzeria
|
|
Violation:
The previously cleaned deck under the service line counters was soiled with food remnants and old debris from more than one day's accumulation.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
|
|
|
Item No.:
26
|
|
Site:
Galley-Pinnacle Grill
|
|
Violation:
A previously cleaned food slicer had a build-up of food residue under the slicer's backplate next to the exit path of the food from the slicer blade.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
|
|
|
Item No.:
21
|
|
Site:
Room Service-
|
|
Violation:
There were seams around the data plates of the previously cleaned food slicer. This was corrected.
|
|
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.
|
|
|
Item No.:
27
|
|
Site:
Room Service-
|
|
Violation:
There was a build-up of an unknown material inside the seams between the data plates and the body of the slicer. This was corrected.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
33
|
|
Site:
Room Service-
|
|
Violation:
There was missing deck tile grout by the door of the walk-in cooler. There was missing and recessed deck tile grout in the food preparation area allowing for water to be pooled between tiles.
|
|
Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
|
|
|
Item No.:
29
|
|
Site:
Other-Formalities
|
|
Violation:
There was no handwashing station available for the food employee refilling the candies. The staff explained that some preliminary work was done and they have an estimated completion date within the next 2 months.
|
|
Recommendation:
Install a handwash station immediately available for the crew members refilling candies.
|
|
|
Item No.:
27
|
|
Site:
Bar-Sushi
|
|
Violation:
There was food residue over the door of undercounter refrigerator #5.870. This refrigerator had been previously cleaned. This was corrected.
|
|
Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
|
|
|
Item No.:
26
|
|
Site:
Galley-Appetizer Pantry
|
|
Violation:
A previously cleaned food slicer had a build-up of food residue under the slicer's backplate next to the exit path of the food from the slicer blade.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
|
|
|
Item No.:
37
|
|
Site:
Galley-Aft Glasswash
|
|
Violation:
There was a significant amount of steam and condensation collecting inside the hood above the glasswash machine.
|
|
Recommendation:
Ensure all food preparation, warewashing, and toilet rooms have sufficient ventilation to keep them free of excessive heat, steam, condensation, vapors, obnoxious odors, smoke, and fumes.
|
|
|
Item No.:
33
|
|
Site:
Galley-Chef's Locker
|
|
Violation:
The deckhead was open to air ducts and electrical cables. The bulkheads had exposed insulation which was not easy to clean. There were wine boxes and new and used galley equipment stored in this locker.
|
|
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. Install exposed utility service lines and pipes, including lines for fire detection and protection systems, so they do not obstruct or prevent cleaning.
|
|
|
Item No.:
19
|
|
Site:
Galley-Chef's Locker
|
|
Violation:
There were wine boxes stored in this locker where the deckhead was open to air ducts and electrical cables and the bulkheads had exposed insulation which was not easy to clean.
|
|
Recommendation:
Protect food from contamination by storing the food: (3) Where it is not exposed to splash, dust, or other contamination.
|
|
|
Item No.:
28
|
|
Site:
Galley-Chef's Locker
|
|
Violation:
There was new and used galley equipment stored in this locker. The deckhead was open to air ducts and electrical cables and the bulkheads had exposed insulation which was not easy to clean.
|
|
Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (2) in a location where they are not exposed to splash, dust, or other contamination.
|
|
|
Item No.:
28
|
|
Site:
Galley-Engine Locker 31-S-1
|
|
Violation:
A food slicer was stored on the deck.
|
|
Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (3) at least 150 millimeters (6 inches) above the deck.
|
|
|
Item No.:
26
|
|
Site:
Galley-Engine Locker 31-S-1
|
|
Violation:
On the deck of this locker, a deli slicer was stored soiled with food remnants where food contacts the body of the slicer.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
|
|
|
Item No.:
33
|
|
Site:
Galley-Pastry
|
|
Violation:
There was missing and recessed deck tile grout in the walk-in cooler.
|
|
Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
|
|
|
Item No.:
29
|
|
Site:
Galley-Pastry
|
|
Violation:
The handwashing station next to the dough sheeter was blocked by the in-use dough sheeter. The dough sheeter, when open, blocked the handwashing station. There was another handwashing station nearby within 8 meters (26 feet).
|
|
Recommendation:
Ensure handwashing facilities are used for no other purpose and are accessible at all times.
|
|
|
Item No.:
22
|
|
Site:
Galley-Potwash
|
|
Violation:
The potwash conveyor machine had a visual alarm that was continuously blinking, but there was no error message. In addition, there was a continuous stream of water coming out of the doors of the wash compartment. As a result, the deck was flooded with water.
|
|
Recommendation:
Repair the potwash machine to determine the reason for the blinking alarm. 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.
|
|
|
Item No.:
33
|
|
Site:
Galley-Bakery
|
|
Violation:
There was missing deck tile grout by the door of the walk-in cooler. As a result, water was pooled between the tiles.
|
|
Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
|
|
|
Item No.:
33
|
|
Site:
Galley-Center Galley
|
|
Violation:
There was missing and recessed deck tile grout in many areas of the center galley.
|
|
Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
|
|
|
Item No.:
26
|
|
Site:
Galley-Center Galley
|
|
Violation:
The previously cleaned food slicers at the forward and aft service lines had a slight build-up of food residue under the slicer's backplate next to the exit path of the food from the slicer blade.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
|
|
|
Item No.:
33
|
|
Site:
Galley-
|
|
Violation:
There was missing and recessed deck tile grout in many areas of this galley.
|
|
Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
|
|
|
Item No.:
26
|
|
Site:
Galley-
|
|
Violation:
Nine previously cleaned hotel pans were stacked together and staged on a counter next to the soup kettles. The pans had water inside and food remnants. The staff sent these pans back to the scullery.
|
|
Recommendation:
Ensure food contact surfaces of equipment and utensils are clean to sight and touch.
|
|
|
Item No.:
33
|
|
Site:
Buffet-
|
|
Violation:
The deck under the soda vending machines was heavily soiled with dust and food residue.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
|
|
|
Item No.:
33
|
|
Site:
Other-Locker FSD 0.059 (next to Officer's Mess)
|
|
Violation:
The deck was soiled with debris. This was corrected.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
|
|
|
Item No.:
28
|
|
Site:
Other-Locker FSD 0.059 (next to Officer's Mess)
|
|
Violation:
Wrapped and unwrapped single-service cups were stored on the deck. This was corrected.
|
|
Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (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.
|
|
|
Item No.:
33
|
|
Site:
Other-Central Locker
|
|
Violation:
The deckhead was open to air ducts and electrical cables that were heavily soiled with dust. The bulkheads had exposed insulation which was difficult to clean. There was galley equipment, such as juice machines, and single-service utensils, such as bar cups, stored in this locker along with multiple nonfood items.
|
|
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. Install exposed utility service lines and pipes, including lines for fire detection and protection systems, so they do not obstruct or prevent cleaning. Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
|
|
|
Item No.:
28
|
|
Site:
Other-Central Locker
|
|
Violation:
There was galley equipment, such as juice machines, and single-service utensils, such as bar cups, stored in this locker along with multiple nonfood items. The deckhead was open to air ducts and electrical cables that were heavily soiled with dust. The bulkheads had exposed insulation which was difficult to clean.
|
|
Recommendation:
Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (2) in a location where they are not exposed to splash, dust, or other contamination.
|
|
|
Item No.:
33
|
|
Site:
Provisions-Liquor Store Room
|
|
Violation:
The right bulkhead and the deck next to the evaporative condenser were soiled with dark liquor residue.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
|
|
|
Item No.:
33
|
|
Site:
Provisions-Gift Shop Locker
|
|
Violation:
There were broken glass bottles, food remnants, spilled liquor, and a variety of debris under the pallets. Also, there was a number of flattened boxes stored directly on the deck.
|
|
Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary. Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, bars, and food and equipment storage areas are constructed and maintained for easy cleaning.
|
|
|
Item No.:
33
|
|
Site:
Preparation Room-Walk-In Cooler #17
|
|
Violation:
There was missing deck tile grout by the door. Water was pooled between tiles.
|
|
Recommendation:
Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
|
|