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Item No.:
*
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Site:
Galley-Soiled Drop-Off Area
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Violation:
A crew member was observed either drinking or washing his face with water from the handwash station.
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Recommendation:
Do not use a handwash station for any other purpose.
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Item No.:
01
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Site:
Medical-Report Submission
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Violation:
On a few occasions, the 4-hour report was submitted although there were no changes from the 24-hour report. Also, on a few occasions, the 24-hour and the 4-hour report were submitted, even though the ship was sailing between U.S. ports and the number of acute gastroenteritis (AGE) reportable cases was less than 2% among passengers or crew members.
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Recommendation:
If the number of cases changes after submission of the initial report, submit an updated report no less than 4 hours before the vessel's arrival at the U.S. port. Ensure that the 4-hour update report contains a cumulative total count of the reported crew and passengers during the entire cruise, including the additional cases. Only submit AGE reports when sailing to a U.S. port from a foreign port.
When in a foreign port and within 15 days of arriving at a U.S. port, if the number of AGE reportable cases is greater than or equal to 2% among passengers or crew members, submit an AGE report. Continue to submit daily updated reports as the number of reportable cases changes.
When in a U.S. port, if the number of AGE reportable cases is greater than or equal to 2% among passengers or crew members, submit an AGE report.
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Item No.:
01
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Site:
Medical-Report Submission
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Violation:
No AGE report was submitted prior to arriving in San Juan, Puerto Rico when the ship sailed from Grand Turk. The ship departed Grand Turk on 24 June and arrived San Juan on 25 June.
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Recommendation:
Ensure the master, medical staff, or other designated staff of a vessel destined for a U.S. port from a foreign port submits at least one standardized AGE report based on the number of reportable cases in the AGE log to VSP no less than 24 hours-but not more than 36 hours-before the vessel's expected arrival at the U.S. port.
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Item No.:
01
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Site:
Medical-Report Submission
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Violation:
On 29 May at 06:16, the 24-hour report was submitted, but the wrong arrival port was included. The ship arrived 30 May in Saint Thomas, U.S. Virgin Islands, but the report indicated San Juan, Puerto Rico. The ship departed Saint Maarten on 29 May and arrived Saint Thomas on 30 May.
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Recommendation:
Ensure medical reports submitted contain accurate information.
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Item No.:
02
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Site:
Medical-Reporting
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Violation:
On a few occasions, the patient was listed as nonreportable, but the medical paperwork did not contain any notations related to any underlying conditions. For example, on 21 June, an Assistant Waiter experienced 2 episodes of diarrhea, stomach cramps, and headache, and was listed as nonreportable. When the inspector asked the medical staff if 2 episodes of diarrhea was normal for this individual, her response was that she didn't know and didn't ask the crew member. On 17 June, a Stateroom Steward experienced 2 episodes of diarrhea and stomach cramps, and was listed as nonreportable. The medical paperwork did not contain any notations related to any underlying conditions.
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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-Reporting
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Violation:
On a few occasions, a patient reported to the medical center with AGE symptoms that were consistent with the nonreportable definition. However, as the patient was followed up by the medical staff, the patient reported additional symptoms, but these were not added to the AGE surveillance log. This possibly resulted in under-reporting of AGE cases. For example, on 18 June a Hotel Steward experienced initial AGE symptoms of 2 episodes of diarrhea and was listed as nonreportable. When the medical staff contacted this patient on 19 June at 09:13, the patient stated he had an additional episode of diarrhea last night. On 20 June at 08:19, the patient was symptom-free and was returned to work. On 20 June at 13:52, StarDocs stated this patient's symptoms started again in the morning hours. The patient experienced another episode of diarrhea. This additional symptom was not included in the AGE surveillance log. The medical staff concluded this patient was falsifying his symptoms. Throughout the follow-up, this patient became a reportable AGE case. A similar situation was written on the previous inspection.
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Recommendation:
Ensure the AGE log contains accurate information, including the total number of symptoms experienced by a patient.
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Item No.:
08
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Site:
Potable Water-Deck A - Laundry Filling
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Violation:
The air gap for the relief vent of the laundry filling reduced pressure assembly located near cabin A-636 was not at least 25 millimeters (1 inch). A pipe was located under the relief vent to catch draining water and was hard plumbed into piping that went through the deck below.
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Recommendation:
Ensure air gaps are at least twice the diameter of the delivery fixture opening and a minimum of 25 millimeters (1 inch).
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Item No.:
10
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Site:
Recreational Water Facilities-Safety Signs
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Violation:
For the two large slides, there were no safety signs at the entrances where passengers access the slides. Safety signs were located in the water park area near where the slides end.
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Recommendation:
Provide safety signs at the access areas to both large slides.
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Item No.:
11
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Site:
Medical-Reporting
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Violation:
On 22 June, an Assistant Team Waitress had an onset of AGE symptoms at 09:15. According to her medical paperwork, these initial symptoms consisted of 3 episodes of diarrhea and stomach cramps, with the last symptom '10 minutes ago at 09:15.' According to the StarDocs medical surveillance system, her initial symptoms consisted of 4 episodes of diarrhea and stomach cramps and she was prescribed antidiarrheal medication at 09:30. According to StarDocs, she continued to have AGE symptoms on 23 June, was symptom-free on 24 June at 07:59, but experienced her last symptom on 22 June at 17:00. The start time of medical isolation indicated 22 June at 09:29. It appeared this crew member was not restricted from work for at least 48 hours once symptom-free.
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Recommendation:
Exclude food employees suspected of, diagnosed with, or exposed to any communicable disease caused by Salmonella typhi, Shigella spp., E. coli O157:H7, hepatitis A virus, norovirus, or other communicable diseases that can be transmitted by food, from working in any food or food related areas or operations, including working with exposed food, warewashing, equipment, utensils, table linens, single-service articles and single-use articles. Do not allow the excluded individual to return to the above duties until they are symptom free for a minimum of 48 hours. Ensure food employees who have conditions or symptoms of boils, open sores, infected wounds, diarrhea, jaundice, fever, vomiting, sore throat with fever, or discharges from the nose or mouth report these conditions or symptoms to the vessel's medical staff and are restricted from working with exposed food, warewashing, clean equipment, utensils, and linens, and unwrapped single-service and single-use articles.
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Item No.:
13
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Site:
Galley-Variance - Chef's Table
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Violation:
The approved variance stated that all participants were going to be handed a questionnaire of transmissible diseases and that the list of participants were going to be cross-referenced with the AGE log on the day of the event. There was one participant's questionnaire that was dated, but was not signed by the participant, making it impossible to match it to the list of participants. Also, the questionnaires had signatures and cabin numbers, but there were instances where an unreadable signature and a cabin number was not enough to cross-reference to the participant list. The current documentation kept by the ship for the past events made it unclear on how it would verify participants were not on the AGE log.
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Recommendation:
Establish written procedures for cross-referencing participants and the AGE log. If necessary, update the questionnaire to include printed name and signature.
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Item No.:
16
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Site:
Other-Cherry on Top
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|
Violation:
The time control plan stated an initial set-up and discard time for embarkation days to be 11:00 - 15:00, but the staff stated that at that time the venue was not in operation. The venue would open around 16:30.
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Recommendation:
Update the time control plan to reflect accurate set-up and discard times.
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Item No.:
19
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Site:
Provisions-Fruit Room 19
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|
Violation:
An unused metal storage rack was hung on another food storage rack in a manner where the feet were in contact with boxes of food.
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Recommendation:
Protect food from contamination by storing the food: (3) Where it is not exposed to splash, dust, or other contamination.
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Item No.:
19
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Site:
Other-Deck 12 Hot Dog Cart
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|
Violation:
There were no sneeze guards protecting the food preparation counter. Guests stand in front of the cart to order hot dogs.
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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).
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Item No.:
20
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Site:
Galley-Pastry
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Violation:
The mixing head of the portable counter mixer had 2 slotted fasteners.
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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.:
20
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Site:
Preparation Room-Potato Room
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Violation:
The left potato peeler had 2 slotted fasteners in the food contact area. The right potato peeler had 4 slotted fasteners on the inside food contact surface. The removable plastic liner for the potato peeler also had 1 slotted fastener.
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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.:
20
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Site:
Dining Room-La Cucina Beverage Station
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Violation:
There were 4 slotted fasteners in the food splash zone of the Scharf coffee machine. This was corrected during the inspection.
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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.:
21
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Site:
Galley-Center Galley
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|
Violation:
Excess steam escaped from around the doors of some of the combination ovens. This included the aft line unit and the forward line left unit.
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|
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; (2) Equipment components such as doors, seals, hinges, fasteners, and kick plates are kept intact, tight, and adjusted in accordance with manufacturer's specifications.
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Item No.:
26
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Site:
Galley-Pastry
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|
Violation:
A slotted fastener on the mixing head of the portable counter mixer was soiled with old food residue.
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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-Dishwash Area
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|
Violation:
On the 'To Be Checked' table in the dishwash area, some of the silverware was soiled with food debris. All of the silverware had been cleaned and sanitized. During the inspection, this table was not actively being checked for the cleanliness of plates and utensils.
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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-Ice Machine
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|
Violation:
Inside the upper compartment of the ice machine, the lower portion of the back side of the plastic cuber panel was soiled with a brown material. The machine was cleaned and sanitized on 11 June.
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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:
Dining Room-La Cucina Beverage Station
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|
Violation:
The 4 slotted fasteners in the food splash zone of the previously cleaned Scharf coffee machine were slightly soiled.
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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:
Buffet-Market Place
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|
Violation:
There was a number of utensils including plates, bowls, ramekins, and silverware out for passenger service that were soiled with food residue. There was also a linen wrapped silverware with a long hair touching the cutlery. All of these items were taken to the dishwash to be rewashed.
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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-Fat Jimmy's C-Side BBQ
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|
Violation:
The shelves inside both previously cleaned portable refrigerators were soiled with food residue.
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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:
Room Service-
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Violation:
The previously cleaned food slicer 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.
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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:
Bar-Taste Bar
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|
Violation:
The two previously cleaned and not in use portable food heaters were soiled by the heating elements with food residue.
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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-Garde Manger
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|
Violation:
Both previously cleaned food slicers had a slight build-up of food residue under the backplate next to the exit path of the food from the slicer blade.
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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.:
30
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|
Site:
Other-Deck 12 Hot Dog Cart
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|
Violation:
There was no sign stating 'wash hands often,' 'wash hands frequently,' or similar wording posted over the handwashing sink. Also, there was no supply of soap.
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Recommendation:
Post a sign over handwashing sinks stating "WASH HANDS OFTEN" in a language that the food employees understand. Ensure each handwashing facility has a supply of hand-cleansing soap or detergent and a supply of single-service paper towels available.
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Item No.:
32
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Site:
Galley-Cantina
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Violation:
The large uncovered waste receptacle on the deck next to the food preparation table was soiled inside with a large quantity of food debris. The area was unattended at the time.
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Recommendation:
Cover receptacles and waste-handling containers when not in continuous use and after they are filled.
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Item No.:
32
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Site:
Pantry-Ocean Plaza
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Violation:
A large uncovered waste receptacle at the prewash station was soiled inside with soiled cups and food debris. The area was unattended at the time.
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Recommendation:
Cover receptacles and waste-handling containers when not in continuous use and after they are filled.
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Item No.:
32
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Site:
Bar-Plaza Cafe
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Violation:
A large uncovered waste receptacle on the deck in front of the far left coffee machine was soiled inside and completely filled with a large amount of soiled cups, a milk container, and food debris. The area was active, but no passengers were present at the time.
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Recommendation:
Cover receptacles and waste-handling containers when not in continuous use and after they are filled.
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Item No.:
33
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Site:
Other-Cherry on Top
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|
Violation:
There was no coving on the bulkhead/deck junctures. Also, the coving at the wooden storage shelves/deck juncture was made from a soft material. There was a large amount of candies stored inside this area.
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Recommendation:
Cove all bulkhead/deck, equipment/deck, cabinet/deck, and deck sink coaming/deck junctures (including galleys, pantries, buffets, bars, waiter stations, dining room work counters, provisions, food storage rooms, equipment/utensil storage rooms, and toilet rooms intended for use by galley personnel).
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Item No.:
33
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Site:
Galley-Fat Jimmy's C-Side BBQ
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|
Violation:
There was no deckhead protection in this outside food preparation outlet.
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Recommendation:
Install deckhead material that is hard, durable, noncorroding, nonabsorbent and easily cleanable.
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Item No.:
33
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Site:
Other-Deck 12 Hot Dog Cart
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|
Violation:
There was no coving at the back bulkhead/deck juncture behind the food preparation counter on the worker side.
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Recommendation:
Cove all bulkhead/deck, equipment/deck, cabinet/deck, and deck sink coaming/deck junctures (including galleys, pantries, buffets, bars, waiter stations, dining room work counters, provisions, food storage rooms, equipment/utensil storage rooms, and toilet rooms intended for use by galley personnel).
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Item No.:
33
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Site:
Other-Deck 9 - Crew Stair 120 Corridor
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Violation:
Two soiled portable plastic coffee dispensers were stored on the deck in front of the elevators.
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Recommendation:
Do not stored soiled equipment on the deck.
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Item No.:
33
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Site:
Galley-Dining Room Menu Locker
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|
Violation:
There was a gummy bear candy and several paper sheets and menu covers on the deck below the storage racks. The area was not in operation during the inspection.
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Recommendation:
Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
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Item No.:
34
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Site:
Galley-Dishwash Area
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|
Violation:
Near the soiled end of the dishwash machine, the bucket fill tap of the handwash statiion 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-Dishwash Area
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Violation:
The light intensity was less than 220 lux at the handwash station at the clean end of the dishwash area.
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Recommendation:
Ensure the light intensity is at least 220 lux (20 foot candles) on food preparation surfaces, and at a distance of 75 centimeters (30 inches) above the deck in food preparation areas, handwashing facilities, warewashing areas, equipment, and utensil storage, pantries, toilet rooms, and consumer self-service areas.
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Item No.:
36
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Site:
Galley-Potwash Area
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Violation:
The light intensity was less than 220 lux at the soiled landing of the potwash area.
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Recommendation:
Ensure the light intensity is at least 220 lux (20 foot candles) on food preparation surfaces, and at a distance of 75 centimeters (30 inches) above the deck in food preparation areas, handwashing facilities, warewashing areas, equipment, and utensil storage, pantries, toilet rooms, and consumer self-service areas.
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Item No.:
36
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Site:
Dining Room-Sapphire Restaurant
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|
Violation:
In the pantries, the light intensity was less than 110 lux between the juice machines and the ice/water machines, less than 220 lux in front of the juice machines, and less than 110 lux between the espresso machines and the side bulkhead.
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Recommendation:
Ensure the light intensity is at least 110 lux (10 foot candles) behind and around mounted equipment, including counter-mounted equipment. Ensure the light intensity is at least 220 lux (20 foot candles) on food preparation surfaces, and at a distance of 75 centimeters (30 inches) above the deck in food preparation areas, handwashing facilities, warewashing areas, equipment, and utensil storage, pantries, toilet rooms, and consumer self-service areas.
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Item No.:
36
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Site:
Room Service-Lighting
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Violation:
The light intensity was less than 110 lux behind and around the counter-mounted equipment at the coffee station.
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|
Recommendation:
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.:
44
|
|
Site:
Medical-
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|
Violation:
The medical staff did not demonstrate knowledge on the operation of the StarDocs medical surveillance system, possible resulting in under-reporting of AGE cases. For example, a patient's underlying medical condition was not assessed and additional AGE symptoms were not tabulated into the AGE surveillance log. Also, staff were unsure of which U.S. ports required medical report submissions, often submitting multiple reports when unnecessary.
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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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