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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Log
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Violation:
On 3 December, a nonfood worker had two episodes of diarrhea, abdominal cramps, was given antidiarrheal medication, but was recorded as non-reportable on the AGE log. The underlying illness column for this worker indicated 'none'. The diagnosis in the medical records stated 'diarrhea' and this patient was isolated for 24 hours. Also, during the cruise from 2-7 December, a nonfood worker had one episode of diarrhea, abdominal cramps, was given antidiarrheal medication, but was recorded as non-reportable on the AGE log. The underlying illness column for this worker stated 'none' and this patient was isolated for 24 hours. For both of these crew members, the symptoms were above normal for them.
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Recommendation:
List in the AGE surveillance log (1) the name of the vessel, cruise dates, and cruise number; (2) all reportable cases of AGE; and (3) all passengers and crew members who are dispensed antidiarrheal medication from the master of the vessel, medical staff, or other designated staff.
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Item No.:
02
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Site:
Medical-AGE Log
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Violation:
During the 28 November - 2 December voyage, a nonfood worker had one episode of diarrhea, abdominal cramps, was given antidiarrheal medication, and was recorded as non-reportable on the AGE log. These symptoms were above normal for this crew member. The underlying illness column stated 'none' This person was isolated for 24 hours. During the same voyage, a food worker with these same symptoms was recorded as reportable on the AGE log.
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Recommendation:
List in the AGE surveillance log (1) the name of the vessel, cruise dates, and cruise number; (2) all reportable cases of AGE; and (3) all passengers and crew members who are dispensed antidiarrheal medication from the master of the vessel, medical staff, or other designated staff.
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Item No.:
02
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Site:
Medical-AGE Log
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Violation:
On 26 November, a passenger had an onset of two episodes of diarrhea, abdominal cramps, myalgia, and was given antidiarrheal medication. This passenger was recorded as non-reportable on the AGE log. These symptoms were above normal for this person. The underlying illness column stated 'n/a' and the diagnosis in the medical record stated 'diarrhea'.
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Recommendation:
List in the AGE surveillance log (1) the name of the vessel, cruise dates, and cruise number; (2) all reportable cases of AGE; and (3) all passengers and crew members who are dispensed antidiarrheal medication from the master of the vessel, medical staff, or other designated staff.
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Item No.:
02
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Site:
Medical-AGE Log
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Violation:
On 24 November, a nonfood worker had two episodes of diarrhea, fever, abdominal cramps, and was given antidiarrheal medication. This crew member was indicated as non-reportable on the AGE log, but the underlying illness column stated 'none'. The medical notes indicated the symptoms were due to this person taking a Nytime syrup the night before.
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Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns: (16) presence of underlying medical conditions that may affect interpretation of AGE.
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Item No.:
02
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Site:
Medical-AGE Log
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Violation:
On 15 November, a passenger had four episodes of diarrhea, five vomiting episodes, and abdominal cramps. This passenger was recorded as a reportable case, but the underlying illness column stated 'Crohn's Disease'. This passenger was isolated for 24 hours and the medical notes indicated all of the symptoms were due to Crohn's disease and colitis.
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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-AGE Log
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Violation:
On 12 November, a passenger had five episodes of diarrhea and one episode of vomiting. The passenger was indicated as reportable on the AGE log, but the underlying illness column stated 'lactose intolerance'. The medical notes indicated all of the symptoms were due to lactose intolerance. This passenger was not placed in medical isolation.
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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.:
08
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Site:
Galley-Deck 3 - Potwash Area
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Violation:
Above the trolley wash machine, the testable backflow prevention assembly had a continuous leak from the vent. A work order was placed on 2 December to replace the backflow assembly. During this time the trolley wash machine was out of service until a new backflow assembly could be installed.
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Recommendation:
Maintain backflow prevention devices in good repair.
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Item No.:
08
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Site:
Potable Water-Post-Mineralizer Water Line
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Violation:
The water line from the mineralizer to the chlorine injection point was labeled as potable water (blue/green/blue).
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Recommendation:
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.
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Item No.:
08
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Site:
Potable Water-Cross-Connection Control Program
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Violation:
The log had two backflow prevention entries for the garbage room, but no further information was provided. Upon inspection of the area, the devices were for the bone crusher and the pulper. The log also had an entry for the vegetable preparation room and meat preparation room, but no additional information was provided.
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Recommendation:
Provide a comprehensive cross-connection control program. Protect the following connections to the potable water system against backflow with air gaps or mechanical backflow prevention devices: (8) garbage grinders and food waste systems; (10) food service equipment.
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Item No.:
10
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Site:
Recreational Water Facilities-Flow Rider Turnover Rates
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Violation:
The calculated turnover rate for the Flow Rider was 3.3 hours and was not in compliance with the 1 hour turnover rate as required in the 2011 VSP Operations Manual. This issue was in continuous progress by corporate staff. As of 4 December an update to the variance was submitted to VSP.
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Recommendation:
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: (7) interactive RWF or activity pool less than 610 millimeters (24 inches) deep: 1 hour.
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Item No.:
10
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Site:
Housekeeping-Whirlpool Disinfection Log
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Violation:
The type of disinfectant used for the suite whirlpools was not recorded on the super chlorination log or in any procedures. According to staff, chlorine bleach was used.
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Recommendation:
Maintain a record outlining the frequency of cleaning and disinfection. Ensure the record includes the type, concentration, and contact time of the disinfectant. Retain records on the vessel for 12 months.
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Item No.:
11
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Site:
Medical-AGE Log
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Violation:
On 26 November, a nonfood worker had an illness onset of diarrhea at 19:00, but did not report to the medical center until 30 November at 02:25. The medical documentation stated this worker had two watery stools everyday between the first onset and the day they reported to the medical center. The underlying illness column for this worker stated 'n/a'. This worker was isolated for 24 hours. According to their work record, this crew member worked all day between 26 and 29 November, as well as on 30 November from midnight to 02:00.
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Recommendation:
When nonfood employees meet the case definition for AGE, ensure the following actions are taken: (1) isolate in cabin or designated restricted area until symptom-free for a minimum of 24 hours; (2) follow-up with and receive approval by designated medical personnel before returning crew to work; (3) document the date and time of last symptom and clearance to return to work. Ensure crew members report to the medical center immediately upon the first signs and symptoms of AGE.
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Item No.:
12
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Site:
Preparation Room-
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Violation:
One of the food workers was observed washing his hands while holding a blue wiping cloth.
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Recommendation:
Ensure food employees clean their hands and exposed portions of their arms immediately before engaging in food preparation including working with exposed food, clean equipment and utensils, and unwrapped single-service and single-use articles and: (4) After handling soiled equipment or utensils; and (8) After engaging in other activities that contaminate the hands.
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Item No.:
16
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Site:
Children Area-Time Control Plan
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Violation:
There was no time control plan in the nursery for the food on time control during evening hours. According to the staff, chicken, pasta, and mashed potatoes were served.
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Recommendation:
If time only-rather than time in conjunction with temperature-is used as the public health control for a working supply of potentially hazardous food before cooking, or for ready-to-eat potentially hazardous food that is displayed or held for service for immediate consumption, ensure the food (1) Has an initial temperature of 5C (41F) or less or 57C (135F) or greater before placement on time control. (2) Is not be placed on temperature control again. (3) Is marked or otherwise identified to indicate the time 4 hours past the point in time when the food is removed from temperature control (if the time between service set-up and closing is greater than 4 hours. and (4) Is discarded within 4 hours of placement on time control. 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.:
19
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Site:
Medical-Ward Room #4
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Violation:
There were two cases of bottled water and one 12-pack of soda on the deck.
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Recommendation:
Protect food from contamination by storing the food: (4) At least 15 centimeters (6 inches) above the deck.
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Item No.:
19
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Site:
Ventilation-Fan Room 5-1
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Violation:
There was an unopened bottle of beer and four opened large bottles of water that had been partially consumed by staff stored on a shelf with heating elements and spare parts for the air handling units in this fan room.
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Recommendation:
Protect food from contamination by storing the food: (2) In a clean, dry location; (3) Where it is not exposed to splash, dust, or other contamination. Do not store foods: (5) In mechanical rooms; (10) In areas not finished in accordance with 7.7.4 and 7.7.5 for food storage areas.
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Item No.:
19
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Site:
Galley-Deck 4 - Bakery
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Violation:
Four trolleys of bread items were removed from the oven at approximately 10:30. The top trays of breads were uncovered at that time. The inspector returned to the area at 11:12. The trays of breads remained in the same location as before and the top trays remained uncovered.
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Recommendation:
Protect food from contamination by storing the food: (1) Covered or otherwise protected.
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Item No.:
26
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Site:
Buffet-Starboard Coffee Station
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Violation:
The ice deflector panel and the recirculating bath of the ice making unit had a black residue on it. A seam near the right end of the water manifold had frayed sealant which was starting to mold in this water splash-zone. The machine was reinspected after it had been cleaned by the staff and found to be completely clean. All other ice machines inspected by the USPHS team aboard today were in excellent condition.
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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.:
26
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Site:
Galley-Deck 4 - Hot Line
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Violation:
Previously cleaned plates inside the trolleys were soiled with food debris. The trolleys and plates were removed to the dishwash area.
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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.:
27
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Site:
Galley-Deck 4 - Hot Line
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Violation:
Trolleys holding previously cleaned plates were soiled with food debris. The trolleys and plates were removed to the dishwash area.
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Recommendation:
Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
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Item No.:
28
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Site:
Preparation Room-
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Violation:
Four clean wet plastic cutting boards were stored vertically stacked on a preparation table without enough space between them to allow the boards to adequately dry. Another rack was provided to ensure the condition was corrected before the team left the area.
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Recommendation:
Store clean equipment and utensils in a self-draining position that allows air drying.
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Item No.:
29
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Site:
Galley-Deck 5 - Next to Cleaning Locker
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Violation:
Next to the cleaning locker, the temperature of the handwash station was 130F. The user could not adjust the temperature. The area was in use 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.:
29
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Site:
Galley-Deck 5 - Outside Dishwash Area
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Violation:
The 4-faucet handwash station had temperatures of 130F. The user could not adjust the temperature at any of the faucets. The dishwash area was in use 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.:
29
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Site:
Galley-Deck 5 - Near Entrance From Dining Room
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Violation:
Next to the water fountain, the temperature of the handwash station was 130F. The user could not adjust the temperature. The area was in use 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.:
29
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Site:
Galley-Deck 5 - Staff/Officer Dishwash Area
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Violation:
The temperature of the handwash station was 131F. The user could not adjust the temperature. The dishwash area was in use 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.:
33
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Site:
Bar-Plaza Bar
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Violation:
There was a gap in the bulkhead to the right and left where the waterfall feature was removed from the back bar behind the coffee grinding area.
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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.
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Item No.:
34
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Site:
Galley-Deck 5 - Outside Dishwash Area
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Violation:
On the 4-faucet handwash station, the far right faucet had a continuous leak.
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Recommendation:
Ensure the plumbing system in a food area is maintained in good repair.
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Item No.:
36
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Site:
Galley-Deck 4 - Pastry
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Violation:
Light covers were missing inside the second and third shelves of the deck oven. The light bulbs were not 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.:
37
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Site:
Galley-Deck 5 - Dishwash Area
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Violation:
At the soiled end of the dishwash machine, excess condensation had built up on the inside of the hood overhang. Condensation continuously dripped from the front corner of the overhang onto the deck. No clean items were impacted.
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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. Ensure ventilation hood systems and devices are sufficient in number and capacity to prevent grease or condensation from collecting on bulkheads and deckheads.
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Item No.:
38
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Site:
Pantry-Casino Bar
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Violation:
An orange extension cord was stored on top of a box of beer bottles. Staff stated the extension cord did not belong in the area and it was immediately removed.
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Recommendation:
Ensure only articles necessary for the food service operation are stored in food preparation, food storage, and warewashing areas.
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Item No.:
40
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Site:
Integrated Pest Management-Rat Guards
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Violation:
There were no rat guards installed on the forward starboard mooring lines.
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Recommendation:
Protect entry points where pests may enter the food areas.
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Item No.:
40
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Site:
Integrated Pest Management-Active Surveillance
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Violation:
On 15 November, according to the staff, a pest was found, but the records did not indicate whether a pest was found or not, nor what type of pest may have been found. The specific area on the record indicated 'bin for empty glass' and the action stated 'sprayed with 565 XLO'. Also, on 6 December, the time and location of the inspection was recorded for Johnny Rocket's and the Staff and Officer Bars, but no inspection results were recorded. Also, on 6 December, there was an inspection recorded in Schooner Bar, but there was no time of the inspection or any results of the inspection recorded.
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Recommendation:
Ensure the IPM Plan includes provisions for logs for active monitoring of pest sightings in operational areas of the vessel. Ensure the IPM plan includes provisions for training of crew members in charge of log completion. Record the time of the active monitoring inspections in the log. When pests are noted during an inspection, ensure the log includes action taken and follow-up inspection results.
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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 OPRP did not state the contact time for the Oxivir Five 16 that was used in several areas during Level 2, including public spaces. According to the staff, the contact time for this disinfectant was 10 minutes.
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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: (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).
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Item No.:
41
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Site:
Medical-Public Toilet Rooms
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Violation:
In the public toilet rooms of the ward rooms, there were no signs advising users to wash their hands.
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Recommendation:
Provide the passenger and crew public toilets with a handwashing station that includes: (4) A sign advising users to wash hands.
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Item No.:
42
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Site:
Children Area-Diaper-Changing Station
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Violation:
There was no airtight waste receptacle for the diapers.
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Recommendation:
Include in each diaper changing station: (3) An airtight, soiled-diaper receptacle.
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Item No.:
44
|
|
Site:
Medical-AGE Log
|
|
Violation:
On 26 November, a nonfood worker had an illness onset of diarrhea at 19:00, but did not report to the medical center until 30 November at 02:25. The medical documentation stated this worker had two watery stools everyday between the first onset and the day they reported to the medical center. The underlying illness column for this worker stated 'n/a'. This worker was isolated for 24 hours. According to their work record, this crew member worked all day between 26 and 29 November, as well as on 30 November from midnight to 02:00.
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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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