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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
Staff left a number of the entries for underlying illness blank, rather than indicating none. Additionally, there is a technical problem with the format of the new electronic log in that after the 19th case entry the grid lines are missing, so it was not clear if the data in the columns could be sorted and analyzed correctly. Lastly, there was one respiratory illness case that populated in this lower set of GI illness entries which were outside of the format grid lines of the log.
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Recommendation:
The underlying illness column should be completed with data, so it's clear the question is asked and answered. The electronic database should be reviewed and adjusted so as the cases exceed the grid of 19 there is a new page generated which starts with the 20th case. Some review is also needed to ensure that only gastrointestinal illness cases can populate the AGE log.
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Item No.:
02
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Site:
Medical-Asymptomatic Crew Documentation
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Violation:
Staff identify and document the asymptomatic cabin mates of crew members with gastrointestinal (GI) illness, but there is no mention of any other immediate contact or a statement that there are no other contacts for each ill crew case.
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Recommendation:
Ensure staff identify thru the interview process with the ill crew member any cabin mates and any other immediate contacts so they can follow-up with them. Notation should be made in the record if no other contact is found. When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions: (1) restrict exposure to symptomatic crew member(s); (2) undergo a verbal interview with medical or supervisory staff, who will confirm their condition, provide facts and a written fact sheet about hygiene and handwashing, and instruct them to report immediately to medical if they develop illness symptoms; (3) complete a verbal interview daily with medical or supervisory staff until 48 hours after the ill crew members? symptoms began. If the asymptomatic immediate contact or cabin mate is at work, ensure that he or she must is contacted by medical or supervisory staff as soon as possible. Document the date and time of verbal interviews. Clarifications to the 2011 VSP Operations Manual.
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Item No.:
02
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Site:
Medical-GI Case Reporting
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Violation:
A crew member was listed on the AGE Surveillance Log as a non-reportable GI case, but the initial notes under the triage portion of the electronic database indicated she had headache, abdominal cramps, body aches and vomiting. The public health screen only noted the vomiting symptom and the database declared this a non-reportable case. A later interview by the doctor also noted vomiting and abdominal cramps. It was unclear whether or not this system would allow the return to the public health screen to add the symptoms declared by this crew member which were not selected initially to correctly identify all symptoms and have the option to make her a reportable case. Some review of the electronic database should be made to understand if any person reporting symptoms initially below the threshold of the case definition who experiences additional symptoms could be updated in this database so they can be declared a reportable case.
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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.:
42
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Site:
Children Area-Adventure Ocean
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Violation:
The hot water temperature at the sink in the children's toilet was 126 F.
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Recommendation:
Ensure the maximum water temperature for a handwashing station does not exceed 43C (110F).
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Item No.:
26
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Site:
Galley-Deck 4 - Cold Pantry
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Violation:
Inside the left ice machine, the left side plastic deflector panel had a brown residue in the cut-out for the hinge, green adhesive residue on the inside of the panel, and white adhesive residue on the outside of the panel.
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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.:
21
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Site:
Galley-Deck 4 - Hot Section
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Violation:
A wire whisk with a damaged open-ended handle was in an in-use tilting pan. This open end makes cleaning difficult. The whisk was discarded.
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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.
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Item No.:
26
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Site:
Galley-Deck 4 - Beverage Station
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Violation:
Inside the right juice machine, the inside of the dispensing ports were soiled with juice residue. The machine had been previously cleaned.
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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.:
22
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Site:
Galley-Deck 5 - Dishwash Area
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Violation:
Before inspecting the final rinse spray nozzles, one of the curtains which separates the rinse and final rinse compartments was placed on the soiled end of the glasswash machine. The curtain was washed and sanitized before being placed back into the machine.
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Recommendation:
When removed from a warewash machine, ensure the clean curtains are not placed in the soiled area.
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Item No.:
27
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Site:
Galley-Deck 5 - Beverage Station
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Violation:
The underside of each soda dispensing port was soiled with soda residue. The machine and nozzles had been previously cleaned.
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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.:
27
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Site:
Galley-Deck 5 - Hot Section
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Violation:
Inside the grease drip housing for the flat grill, the soft sealant was soiled with old grease residue.
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Recommendation:
Remove the soft sealant. Replace with sealant that can withstand the heat and repeated washing.
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Item No.:
08
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Site:
Preparation Room-
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Violation:
The backflow prevention device for the bucket fill tap was heavily corroded around the atmospheric vent.
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Recommendation:
Maintain backflow prevention devices in good repair.
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Item No.:
36
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Site:
Galley-Giovanni's / Chops
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Violation:
On the front Chops counter, the light intensity was less than 220 lux at the far right area. On the back counter, the light intensity was less than 220 lux on the preparation counter below the salamander.
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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:
Buffet-Windjammer - Beverage Stations
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Violation:
The light intensity was less than 220 lux in front of the beverage equipment and at the cups storage 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.:
22
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Site:
Galley-Windjammer - Dishwash Area
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Violation:
Large amounts of food were on the prewash strainer basket and food wrappers were on the wash strainer basket. The machine was in use during the inspection.
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Recommendation:
Ensure the wash, rinse, and sanitize solutions are maintained clean.
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Item No.:
22
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Site:
Galley-Windjammer - Potwash Area
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Violation:
Less than one meter separated the soiled tray storage and the clean storage rack. The area was in heavy operation during the inspection.
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Recommendation:
To prevent cross-contamination, provide a separation between clean and soiled operations of at least 2 meters (6 feet).
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Item No.:
19
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Site:
Buffet-Staff Mess
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Violation:
The serving utensil handle was in contact with french fries and pork. These food items were discarded.
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Recommendation:
During pauses in food preparation or dispensing, ensure food preparation and dispensing utensils are stored: (1) In the food with their handles above the top of the food and the container.
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