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Inspection Detail Report

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Cruise Ship: Aurora Cruise Line: P&O Cruises Inspection Date: 09/18/2023 Inspection Score: 89
This cruise ship inspection report lists the deficiencies found during the inspection. Additional information corresponding to each item number is available in the lastest editions of the CDC VSP Operational Manual.

View/Print Summary Report  |  View/Print Corrective Action Statement
Item No.: 01
Site: Medical-Acute Gastroenteritis (AGE) 24-Hour Report
Violation: The 24-hour AGE report for 18 September 2023 listed the current crew and passenger counts, not the total crew and passengers at the beginning of the voyage.
Recommendation: Ensure the AGE report contains the following: (1) total number of passengers and crew members on the cruise at the beginning of the voyage.
Item No.: 03
Site: Potable Water-Production Records
Violation: On multiple instances in September 2023, halogenation levels during potable water production were noted below the required 2.0 ppm for durations greater than one hour without corrective actions or notations on the records. Specifically, on 17 September from 0800 to 1000 (1.4 ppm); 13 September from 1200 to 1300 (<2.0 ppm); 8 September from 0800 to 1045 (1.5 ppm); and 3 September from 0000 to 0145 (1.4 ppm). These recorded values were noted after the initial 30 minutes of startup where 2.0 ppm had been reached. Staff stated they are working on training staff to ensure corrective action is quickly taken and the logs reflect the action taken.
Recommendation: Continuously halogenate potable water to at least 2.0 mg/L (ppm) free residual halogen at the time of bunkering or production with an automatic halogenation device that is controlled by a flow meter and adjust the pH so it does not exceed 7.8. Ensure the amount of halogen injected during bunkering or production is controlled by a flow meter or a free halogen analyzer.
Item No.: 07
Site: Potable Water-Disinfection Residual
Violation: Records indicated 200 ppm chlorine was used to disinfect the mineralizer on the potable water production system for 2 hours instead of 50 ppm for 4 hours. The record indicated this was a planned process and not an emergency disinfection procedure. Staff was unable to say why they used the 200 ppm and not 50 ppm.
Recommendation: Disinfect after potential contamination by increasing the free residual halogen to at least 50 mg/L (ppm) throughout the affected area and maintain this concentration for 4 hours or by way of another procedure submitted to and accepted by VSP.
Item No.: 08
Site: Potable Water-Cross-Connection Control Log
Violation: The cross-connection control log did not have a complete listing for the ship's Reduced Pressure Zone (RPZ) assemblies. Specifically, there was a list of the RPZs but they did not include the plumbing system component and location. Additionally, air gaps for backwashing the mineralizers and filling the recreational water facility compensation tanks were not listed on the log.
Recommendation: Ensure the cross-connection control program includes at a minimum: a complete listing of cross-connections and the backflow prevention method or device for each, so there is a match to the plumbing system component and location. Include air gaps on the listing. Ensure a schedule for inspection frequency is set. Maintain a log documenting the inspection and maintenance in written or electronic form, and ensure it is available for review during inspections.
Item No.: 08
Site: Potable Water-Mineralizer Striping
Violation: The piping after the mineralizer prior to halogen injection point was striped blue and not blue/gray/blue.
Recommendation: Stripe or paint potable water lines either in accordance with ISO 14726 (blue/green/blue) or blue only. 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.
Item No.: 08
Site: Potable Water-Evaporator RPZs
Violation: Water steadily leaked from the atmospheric vent of the RPZ for evaporator #1 indicating possible malfunction. Additionally, the air gap below the RPZ's atmospheric vent for evaporator #2 was insufficient.
Recommendation: Maintain backflow prevention devices in good repair. Ensure air gaps are at least twice the diameter of the delivery fixture opening and a minimum of 25 millimeters (1 inch).
Item No.: 08
Site: Potable Water-Spa
Violation: Four hair basin spray hoses and two pedicure spray hoses in the Spa did not have individual backflow protection.
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: (1) beauty and barber shop spray-rinse hoses.
Item No.: 08
Site: Bar-Deck 12 Crystal - Soda Machine
Violation: The backflow prevention device for the soda machine was not completely visible for inspection due to installation adjacent to a pipe. The parts of the backflow prevention device that could be visually seen were soiled.
Recommendation: Ensure backflow prevention devices and air gaps are accessible for inspection, testing, service, and maintenance. If access panels are required, ensure panels are large enough for testing, service, and maintenance.
Item No.: 08
Site: Galley-Deck 8 Glass House Warewash
Violation: The backflow prevention device for the pre-rinse sink was in disrepair with water continuously dripping and pooling on the countertop. The area was not in operation.
Recommendation: Maintain backflow prevention devices in good repair.
Item No.: 10
Site: Recreational Water Facilities-Fabricated Drain Covers
Violation: The ship had internal documentation indicating 10 fabricated drain covers were installed throughout the four pools in December 2022; however, no letter or certificate from a certifying organization accompanied each custom/shipyard constructed (field fabricated) drain cover fitting. Staff stated they had discussed this with corporate and are waiting on this documentation.
Recommendation: Ensure the testing of manufactured drain covers is by a nationally or internationally recognized testing laboratory. Ensure the design of custom/shipyard constructed (field fabricated) drain covers and suction fittings is fully specified by a registered design professional in accordance with ASME A112.19.8-2007. Ensure the specifications fully address cover/grate loadings, durability, hair, finger and limb entrapment issues, cover/grate secondary layer of protection, related sump design, and features specific to the RWF. Provide a letter from the shipyard for each custom/shipyard constructed (field fabricated) drain cover fitting. At a minimum, ensure the letter specifies the shipyard, name of the vessel, specifications and dimensions of the drain cover, as well as the exact location of the RWF for which it was designed. Ensure the name of and contact information for the registered design professional and signature are on the letter. Ensure antientrapment protection equipment (covers, suction fittings, safety vacuum release system, etc.) complies with ASME A112.19.8-2007?or any successor standards?whether the equipment is manufactured or field fabricated.
Item No.: 11
Site: Medical-Acute Gastroenteritis (AGE) Surveillance Log
Violation: On voyage R318, a food employee experienced three episodes of diarrhea while working beginning at 1800 but did not report to medical until 2030 later the same day. A food assessment was conducted and appropriate corrective actions were documented.
Recommendation: 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. 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. 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.
Item No.: 16
Site: Buffet-Deck 12 Horizon
Violation: The consumer advisory placards for all self-service items served raw or undercooked, including eggs and smoked salmon, did not include a statement of how they were served.
Recommendation: If an animal food such as beef, eggs, fish, lamb, milk, pork, poultry, or shellfish that is raw, undercooked, or not otherwise processed to eliminate pathogens is offered in a ready-to-eat form or as a raw ingredient in another ready-to-eat food, ensure the consumer is informed by way of disclosure using menu advisories, placards, or other easily visible written means of the significantly increased risk to certain especially vulnerable consumers eating such foods in raw or undercooked form. Ensure that disclosure is made by one of the two following methods: (1) On a sign describing the animal-derived foods (e.g., ?oysters on the half-shell,? ?hamburgers,? ?steaks,? or ?eggs?); AND that they can be cooked to order or may be served raw or undercooked; AND a statement indicating that consuming raw or undercooked meats, seafood, shellfish, eggs, milk, poultry may increase your risk for foodborne illness, especially if you have certain medical conditions. Ensure the advisory is posted at the specific station where the food is served raw, undercooked, or cooked to order.
Item No.: 21
Site: Buffet-Deck 12 Horizon
Violation: The bain marie at the starboard hot food area was not smooth and in disrepair.
Recommendation: Design and construct nonfood-contact surfaces of equipment and utensils to be durable and to retain their characteristic qualities under normal use conditions. 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.: 21
Site: Galley-Deck 8 Glass House
Violation: The brazing pan's technical compartment had a sticker that was peeling which created a difficult to clean surface.
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.: 21
Site: Food Service General-Brazing Pans
Violation: The back of the tilting handles had a large crevice around the circular handle which created a difficult to clean surface. This included the Glass House galley, bell box galley, and main galley.
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.: 21
Site: Bar-Deck 12 Riviera
Violation: The utility sink's handle was corroded and difficult to clean.
Recommendation: Ensure nonfood-contact surfaces of equipment that are exposed to splash, spillage, or other food soiling or that require frequent cleaning are constructed of a corrosion-resistant, nonabsorbent, and smooth material. 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.: 21
Site: Buffet-Deck 12 Horizon Starboard Forward Beverage Station
Violation: The juice machine was missing a fastener above the dispensing nozzles which created a crevice and difficult to clean surface.
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. 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.
Item No.: 21
Site: Buffet-Deck 12 Horizon Portside Forward Beverage Station
Violation: The juice machine was missing a fastener above the dispensing nozzles which created a crevice and difficult to clean surface.
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. 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.
Item No.: 21
Site: Galley-Deck 6 Pastry
Violation: The bottom oven of deck oven #1 had two fasteners missing which created a difficult to clean void space.
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.: 22
Site: Galley-Deck 12 Horizon
Violation: Both warewash machines for the lido deck were not operational. The glasswash machine was leaking and put out of operation the evening of 17 September 2023. The flight-type dishwasher was out of service since the morning of 18 September 2023 because the final sanitizing rinse was higher than 194F.
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 pressure and water temperature-measuring devices are maintained in good repair and accurate within the intended range of use.
Item No.: 27
Site: Galley-Deck 8 Glass House
Violation: Water was pooling on the countertop near the warewash sink. The area was not in operation.
Recommendation: Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
Item No.: 27
Site: Galley-Deck 8 Glass House
Violation: The brazing pan's technical compartment was soiled behind a sticker that was peeling. The area was not in operation and had been previously cleaned and sanitized.
Recommendation: Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
Item No.: 27
Site: Bar-Deck 12 Crystal
Violation: Condensate had collected on the outside of freezer #2 and the water was dripping onto the deck. The area was not in operation.
Recommendation: Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
Item No.: 27
Site: Galley-Deck 12 Lido Grill
Violation: The grease chute for the flat top grill was soiled with black residue. The residue was removed with an alcohol wipe. The area was not in operation and had been previously cleaned and sanitized.
Recommendation: Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
Item No.: 27
Site: Bar-Deck 12 Crystal - Soda Machine
Violation: The backflow prevention device for the soda machine in the undercounter technical cabinet was soiled.
Recommendation: Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
Item No.: 27
Site: Bar-Deck 13 Crows Nest
Violation: The outside of the hot water dispenser was soiled with food residue which was removed with an alcohol wipe. The area was not in operation and had been previously cleaned and sanitized.
Recommendation: Ensure nonfood-contact surfaces of equipment are kept free of an accumulation of dust, dirt, food residue, and other debris.
Item No.: 28
Site: Buffet-Deck 12 Horizon
Violation: The food contact end of a knife out for passenger use was not fully wrapped in a disposable napkin and subject to possible contamination.
Recommendation: Store cleaned equipment and utensils, laundered linens, and single-service and single-use articles: (1) in a clean, dry location; (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 unless in packages on pallets, skids, or racks, which may be 127 millimeters (5 inches). Protect eating utensils dispensed at a consumer self-service unit such as a buffet or salad bar from contamination.
Item No.: 30
Site: Galley-Deck 10 Bell Box
Violation: The toilet room did not have a self-closing door. The inside doors were not self-closing and the outside door stopped at the door frame and did not latch closed.
Recommendation: Ensure toilet rooms are completely enclosed and have tight-fitting, self-closing doors which are kept closed except during cleaning or maintenance.
Item No.: 31
Site: Food Service General-Disinfectant
Violation: Electrolyzed water generating units for disinfecting non-food area surfaces were in multiple food areas. These areas included: Deck 8 Ruffles Pantry, Deck 9 Housekeeping Pantry (FD9/II/02), Deck 12 Crystal Bar/Lido Pantry. The units generated 250 ppm chlorine for disinfecting surfaces outside of the food areas.
Recommendation: Ensure only poisonous or toxic materials that are required for the operation and maintenance of a food area of the vessel, such as for the cleaning and sanitizing of equipment and utensils and the control of insects and rodents, are allowed in the food areas of the vessel.
Item No.: 33
Site: Galley-Deck 5
Violation: The bulkhead behind both brazing pans had two missing fasteners each where the equipment housing was attached to the bulkhead.
Recommendation: Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
Item No.: 33
Site: Galley-Deck 10 Bell Box
Violation: Condensate collected above the right combination oven on the deckhead overhang and was dripping 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.
Item No.: 33
Site: Bar-Deck 8 Glass House
Violation: Water was consistently dripping in the technical cabinet beneath the bar entrance's utility sink and was pooling 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.
Item No.: 33
Site: Galley-Deck 12 Horizon
Violation: Walk-in refrigerator #1 was missing a lock plug for the door which created a void space that was difficult to clean.
Recommendation: Ensure surfaces subject to routine splashes, spillage, or other soiling during normal use have easily cleanable features.
Item No.: 33
Site: Galley-Deck 12 Horizon
Violation: The bulkhead across from the handwashing sink had four small punctures about a foot off the deck. Additionally, one large circular puncture was in the bulkhead behind the combination oven. Both areas were near the exit door that leads to the elevators.
Recommendation: Ensure surfaces subject to routine splashes, spillage, or other soiling during normal use have easily cleanable features. Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
Item No.: 33
Site: Bar-Deck 12 Pennant
Violation: The deckhead was in disrepair which created gaps between the deckhead panels exposing the plenum. The area was not in operation.
Recommendation: Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
Item No.: 33
Site: Buffet-Deck 12 Horizon
Violation: The deck tiles by the deep fat fryer were cracked with crevices which were difficult to clean.
Recommendation: Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
Item No.: 33
Site: Bar-Deck 12 Riviera
Violation: The deckhead above the handwashing sink and right corner of the back bar was in disrepair which created large gaps and difficult to clean areas.
Recommendation: Ensure decks, bulkheads, and deckheads in food preparation, warewashing, pantries, and storage areas are maintained in good repair.
Item No.: 33
Site: Bar-Deck 12 Crystal
Violation: Condensate had collected on the outside of freezer #2 and the water was dripping onto the deck. The area was not in operation.
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: Bar-Deck 12 Riviera Undercounter Refrigerators RI 11 and RI 12
Violation: The pipes for the condensing unit in the undercounter technical cabinet had collected excessive condensate which was dripping onto the deck inside the technical cabinet.
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: Galley-Deck 12 Lido Grill
Violation: The top right track of the fire door shutter was soiled with more than one day's accumulation of cooking grease.
Recommendation: Ensure decks, bulkheads, deckheads, and attached equipment in food preparation, warewashing, pantries, and storage areas are cleaned as often as necessary.
Item No.: 34
Site: Bar-Deck 12 Pennant
Violation: Water was consistently dripping from a pipe in the technical cabinet beneath the bar entrance's utility sink and was pooling on the deck.
Recommendation: Ensure a plumbing system in a food area is maintained in good repair.
Item No.: 36
Site: Buffet-Deck 12 Horizon Portside Forward Beverage Station
Violation: The light intensity between the counter-mounted juice machine and adjacent bulkhead measured 25 lux. The light intensity to the left of the juice machine above the juice glasses measured 160 lux.
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. 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-Deck 12 Horizon
Violation: The light intensity in front of the upright refrigerators in the specialty hot counter section measured less than 220 lux.
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.
Item No.: 36
Site: Buffet-Deck 12 Horizon
Violation: The light intensity at the customer self-service station for cold dishes measured between 35 to 55 lux.
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.
Item No.: 36
Site: Bar-Deck 8 Glass House
Violation: The light intensity above the handwashing sink measured 77 lux. The lights were turned up as bright as possible.
Recommendation: Ensure the light intensity is at least 110 lux (10 foot candles) at handwashing stations in bars. In bars and dining room waiter stations, provide 220 lux (20 foot candles) light intensity during cleaning operations.
Item No.: 36
Site: Galley-Deck 6 Warewash
Violation: The light intensity measured between 11 and 67 lux between the flight-type warewash machine and the bulkhead.
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. Ensure the light intensity is at least 110 lux (10 foot candles) at a distance of 75 centimeters (30 inches) above the deck when in use, in walk-in refrigerator units and dry storage areas, and in other areas and rooms during periods of cleaning. 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: Pantry-Deck 5 Crew
Violation: The light intensity to the right of the ice machine measured between 35 and 78 lux.
Recommendation: Ensure the light intensity is at least 110 lux (10 foot candles) at a distance of 75 centimeters (30 inches) above the deck when in use, in walk-in refrigerator units and dry storage areas, and in other areas and rooms during periods of cleaning. 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: Galley-Deck 10 Bell Box
Violation: Condensate collected above the right combination oven on the deckhead overhang and was dripping on the deck.
Recommendation: Ensure ventilation hood systems and devices are sufficient in number and capacity to prevent grease or condensation from collecting on bulkheads and deckheads. 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.: 39
Site: Pantry-12 Lido Grill
Violation: One small fly was near the dirty area of the warewash sink.
Recommendation: Effectively control the presence of insects, rodents, and other pests to minimize their presence in the food storage, preparation, and service areas and warewashing and utensil storage areas aboard a vessel.
Item No.: 44
Site: Potable Water-Production
Violation: On multiple instances in September 2023, halogenation levels during potable water production were noted below the required 2.0 ppm for durations greater than one hour without corrective actions or notations on the records. Specifically, on 17 September from 0800 to 1000 (1.4 ppm); 13 September from 1200 to 1300 (<2.0 ppm); 8 September from 0800 to 1045 (1.5 ppm); and 3 September from 0000 to 0145 (1.4 ppm). These recorded values were noted after the initial 30 minutes of startup where 2.0 ppm had been reached. Staff stated they are working on training staff to ensure corrective action is quickly taken and the logs reflect the action taken.
Recommendation: Ensure the supervisor or person in charge of potable water operations on the vessel demonstrates to VSP?during inspections and on request-knowledge of potable water operations, is able to demonstrate this knowledge by compliance with Section 5 of the VSP 2018 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 5 of the VSP 2018 Operations Manual as it relates to their assigned duties.
*Inspections scores of 85 or lower are NOT satisfactory
Vessel Sanitation Program