|
|
|
Item No.:
02
|
|
Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
|
|
Violation:
The AGE surveillance log had a passenger that reported on 12 December having 5 vomit episodes and no other symptom or underlying illness. Although the passenger did not meet the reportable case definition, medical staff deemed this passenger as a 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]).
|
|
|
Item No.:
06
|
|
Site:
Potable Water-Microbiologic Monitoring
|
|
Violation:
The vessel had 2 Colitag color comparator bottles that expired in October 2015.
|
|
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.
|
|
|
Item No.:
10
|
|
Site:
Recreational Water Facilities-Granular Filter Inspection Records
|
|
Violation:
All RWFs had granular filters. The records documenting their inspections were inconsistent. Specifically, there were 24 dates since September in which inspections were to be done and partial notes or no notes at all were recorded to document those inspections or inspection results.
|
|
Recommendation:
Examine granular filter media for channels, mounds, or holes. Inspect a core sample of the filter media for excessive organic material accumulation using a recommended sedimentation method. For whirlpool spas and spa pools, ensure inspections and sedimentation tests are done monthly. For all other RWFs, ensure inspections and sedimentation tests are conducted quarterly. Change granular filter media for whirlpool spas and spa pools based on the inspection and sedimentation test results or every 12 months, whichever is more frequent. For all other RWFs, change granular filter media based on the inspection and sedimentation results or per the manufacturer?s recommendations, whichever is more frequent. Record the results of both the filter inspection and sedimentation test.
|
|
|
Item No.:
10
|
|
Site:
Recreational Water Facilities-Cartridge Filter Rinse Records
|
|
Violation:
Daily cartridge filter rinses were documented for all RWFs. However, all RWFs had granular filters and no cartridge filters.
|
|
Recommendation:
Ensure logs and charts contain correct notations outlining actions taken in accordance with the requirements of this manual. Ensure a written or electronic log of RWF filter inspection results, granular filter sedimentation test results, backwashing frequency and length of backwashing, and date and time of water dumping is available for review during inspections.
|
|
|
Item No.:
11
|
|
Site:
Medical-Crew Acute Gastroenteritis (AGE) Reporting
|
|
Violation:
The review of the AGE logs for the last 5 cruises revealed that there was a room service attendant who experienced AGE symptoms and continued to work after those symptoms began. Specifically, she had an onset on 17 November at 16:00 but reported to the medical center on 18 November at 18:57. She worked both days while symptomatic and had dinner in the crew mess on the 17 November. The crew member received a disciplinary action.
|
|
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.
|
|
|
Item No.:
16
|
|
Site:
Buffet-Conceirge Lounge
|
|
Violation:
The hot and cold potentially hazardous food was not labeled as specified in the time control plan.
|
|
Recommendation:
If time only?rather than time in conjunction with temperature?is used as the public health control for a ready-to-eat potentially hazardous food that is displayed for immediate consumption, ensure the food . (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.
|
|
|
Item No.:
16
|
|
Site:
Galley-Promenade Cafe
|
|
Violation:
Pizza service was not covered in the time control plan.
|
|
Recommendation:
If time only?rather than time in conjunction with temperature?is used as the public health control for a 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.
|
|
|
Item No.:
16
|
|
Site:
Galley-Windjammer - Galley
|
|
Violation:
A neutral cart with pizzas in it was not labeled as a 'Time Control' unit.
|
|
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: (2) List refrigeration and hot holding units (compartments and cabinets) on time control (the physical units must also be labeled as such).
|
|
|
Item No.:
19
|
|
Site:
Buffet-Conceirge Lounge
|
|
Violation:
The hot appetizers on the self-service buffet were not under a sneeze guard. The lid covering the appetizers could fully open exposing the food to the passengers.
|
|
Recommendation:
Protect food on display from contamination by the use of packaging; counter, service line, or salad bar food guards; display cases; self-closing hinged lids; or other effective means. Install side protection for sneeze guards if the distance between exposed food and where consumers are expected to stand is less than 1 meter (40 inches).
|
|
|
Item No.:
21
|
|
Site:
Galley-Windjammer - Galley
|
|
Violation:
Two plastic brown two-shelf trolley's had very rough surfaces and were difficult to clean.
|
|
Recommendation:
Ensure nonfood contact equipment is maintained in good repair and proper adjustment including: (1) Equipment maintained in a state of repair and condition that meets the materials, design, construction, and operation specifications of these guidelines.
|
|
|
Item No.:
22
|
|
Site:
Buffet-Windjammer
|
|
Violation:
Two three-bucket system sanitizing rinses were soiled with an oil film on the surface.
|
|
Recommendation:
Ensure the sanitize solutions are maintained clean.
|
|
|
Item No.:
22
|
|
Site:
Galley-Johnny Rocket
|
|
Violation:
Top final rinse manifold was loose at the connection point of the machine creating a weak spray pattern at the nozzles for the dishes passing underneath.
|
|
Recommendation:
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.:
22
|
|
Site:
Galley-Windjammer - Dishwashing
|
|
Violation:
Glasswasher reported on previous inspection as out of order has broken again. Dishwasher replacement is scheduled for January 2016. Temporary repairs on the wash tank are underway.
|
|
Recommendation:
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.:
22
|
|
Site:
Galley-Windjammer - Dishwashing
|
|
Violation:
The final rinse manifold of the dishwasher had a leak around the upper manifold mount. Last four nozzles on this upper manifold did not have a uniform spray pattern to cover the dishes passing underneath it.
|
|
Recommendation:
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.:
22
|
|
Site:
Galley-Windjammer - Galley
|
|
Violation:
The sanitizing rinse in the potwash sink was soiled with an oil film on the surface.
|
|
Recommendation:
Ensure the sanitize solutions are maintained clean.
|
|
|
Item No.:
22
|
|
Site:
Galley-Windjammer - Galley
|
|
Violation:
A three bucket system sanitizing rinse was soiled with an oil film on the surface.
|
|
Recommendation:
Ensure the sanitize solutions are maintained clean.
|
|
|
Item No.:
22
|
|
Site:
Galley-Deck 4 - Warewashing
|
|
Violation:
The glass wash final rinse manifold was missing the mounting gasket creating an inadequate spray pattern to cover the dishes underneath it.
|
|
Recommendation:
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.:
22
|
|
Site:
Pantry-Deck 10
|
|
Violation:
The wash temperature gauge of the undercounter warewasher was measuring 130F while the temperature at the utensil surface was 157F. The machine was evaluated several times with the same results.
|
|
Recommendation:
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; (2) water temperature-measuring devices are maintained in good repair and accurate within the intended range of use.
|
|
|
Item No.:
22
|
|
Site:
Pantry-Deck 6
|
|
Violation:
The undercounter warewasher was leaking continuously water onto the deck from below while in operation. An amount of water was pooled on the deck in front of the clean storage racks and around the ice machine.
|
|
Recommendation:
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.:
35
|
|
Site:
Pantry-Deck 6
|
|
Violation:
The undercounter warewasher was leaking continuously water onto the deck from below while in operation. An amount of water was pooled on the deck in front of the clean storage racks and around the ice machine.
|
|
Recommendation:
Ensure black and gray water is discharged to the vessel's wastewater disposal system and does not pool on the deck.
|
|
|
Item No.:
41
|
|
Site:
Housekeeping-Outbreak Prevention and Response Plan (OPRP)
|
|
Violation:
The OPRP did not specify a measurable procedure when stepping down from outbreak level to normal operating procedures. The plan only stated the ship would step down from Level 3 to Level 2 seventy two (72) hours after the turnaround sanitation barrier and after a team decision between the cruise line's executive committee and medical center in conjunction with shoreside office. The ship would step down from Level 2 to Level 1 forty eight (48) hours after the turnaround sanitation barrier. Staff stated there should be zero cases within these hours. This was noted on the previous inspection report of September 2016. The ship senior management and the USPHS inspectors had a telephone conference call with corporate public health personnel while on the ship and it was determined that the OPRP was being updated at the time and not being issued.
|
|
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: (5) Procedures for returning the vessel to normal operating conditions after an outbreak.
|
|
|
Item No.:
44
|
|
Site:
Recreational Water Facilities-Records
|
|
Violation:
All RWFs had granular filters. The records documenting their inspections were inconsistent. Specifically, there were 24 dates since September in which inspections were to be done and partial notes or no notes at all were recorded to document those inspections or inspection results. Daily cartridge filter rinses were documented for all RWFs. However, all RWFs had granular filters and no cartridge filters. All these records were reviewed and signed by a supervisor.
|
|
Recommendation:
Ensure the supervisor or person in charge of recreational water operations on the vessel demonstrates to VSP?during inspections and on request ? knowledge of recreational water operations, is able to demonstrate this knowledge by compliance with Section 6 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 6 of the VSP 2011 Operations Manual as it relates to their assigned duties.
|
|