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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
In the AGE log for the 25 September - 2 October 2022 voyage, the electronic medical records program populated a numeric code instead of the crew position. Staff stated this was a glitch in the program. This was written on the 8 February 2020 USPHS inspection report.
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Recommendation:
Ensure the AGE surveillance log entry for each passenger or crew member contain the following information in separate columns:(10) crew member position or job on the vessel, if applicable;
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Log
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Violation:
On the AGE log for the 25 September - 2 October 2022 voyage, the underlying illness column was blank. Medical staff explained they type 'none,' 'non applicable,' 'N/A,' etc. in the electronic medical records program, but this does not transfer to the AGE log.
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Recommendation:
Ensure the AGE surveillance log includes a header containing the following information about the voyage: (20) presence of underlying medical conditions that may affect interpretation of AGE. If none, write ?none,? ?not applicable,? ?N/A,? or similar wording.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Reporting
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Violation:
The food questionnaire completed by a cook with AGE symptoms was confusing to understand due to wrong times and place of meal consumption. For example, on the day of illness onset to three days before illness onset, each breakfast and lunch had a port location or sea day as the place of meal consumption. Also, on the day of illness onset, symptoms started at 0200 hrs. and the cook reported to medical at 0215 hrs. The questionnaire stated breakfast was 'at sea' at 0728 hrs. and lunch was 'New York' at 12:31 hrs. The day before illness onset, the questionnaire stated breakfast was in 'New York' at 0730 hrs., and lunch was in 'Bar Harbor' at 1344 hrs. The questionnaire was not reviewed for correctness.
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Recommendation:
Distribute questionnaires detailing activities and meal locations for the 72 hours before illness onset to all passengers and crew members who are AGE CASES. Ensure that the self-administered questionnaires contain all of the data elements that appear in the questionnaire found in Annex 13.2.2. Ensure that completed questionnaires are maintained with the AGE surveillance log.
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Item No.:
02
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Reporting
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Violation:
An immediate close-contact crew member of a symptomatic waiter only received follow-up initially and at 24 hours. The waiter?s initial onset of AGE symptoms was on 24 September 2022.
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Recommendation:
When any crew member (food or nonfood employee) meets the case definition for AGE, take the following actions for the asymptomatic cabin mates (3) complete a verbal interview daily with medical or supervisory staff until 48 hours after the ill crew members? symptoms began. Ensure that the first verbal interview is conducted within 8 hours from the time the ill crew member initially reported to the medical staff. of verbal interviews.
An immediate contact is someone sharing a cabin either full-time or part-time or sharing a cabin?s bathroom facilities. This includes boyfriends, girlfriends, spouses, and significant others. Ensure to document if the symptomatic crew member has or not cabin mate(s) or other immediate contact(s).
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Item No.:
08
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Site:
Potable Water-
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Violation:
On March 16, 2021, staff tested a reduced pressure backflow prevention assembly on Deck 7, starboard entrance to the pantry. The backflow testing log showed the differential pressure relief valve recorded as 1.9 psi and passed inspection. Per manufacturer's instructions, the differential pressure should pass when it is 2.0 psi or above.
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Recommendation:
Inspect and test backflow prevention devices requiring testing (e.g., reduced pressure backflow prevention devices and pressure vacuum breakers) with a test kit after installation and at least annually. Maintain test results showing the pressure differences on both sides of the valves. Reference VSP Operations Manual Annex 13.7.5.2.
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Item No.:
08
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Site:
Galley-Deck 14 - Buffet Galley
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Violation:
The backflow prevention device for the top stacked combination oven was dripping continuously form the atmospheric vent. Water was pooling on the deck below.
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Recommendation:
Maintain backflow prevention devices in good repair.
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Item No.:
11
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Reporting
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Violation:
An non-food worker had an onset of AGE symptoms on 14 September at 0500 hrs., but did not report to the medical center until 1700 hrs. She had four episodes of diarrhea at 0500 hrs., 0700 hrs., 1200-1600 hrs., and 1630 hrs. She did not work or move throughout the ship. This worker was disciplined for late reporting.
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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.
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Item No.:
11
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Site:
Medical-Acute Gastroenteritis (AGE) Surveillance Reporting
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Violation:
A cook had an onset of AGE symptoms on 8 September at 1200 hrs., but did not report to the medical center until 9 September at 0900 hrs. He had diarrhea at 1200 hrs., 1600 hrs., and 1800 hrs., on 8 September. He went to the crew mess at 1200 hrs., 1740 hrs., and 1830 hrs., and his timecard indicated he worked on 8 September from 0900 - 1200 hrs., 1400 - 1730 hrs., and 2030 - 0000 hrs. The cook received a written warning for late reporting.
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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. Ensure the food employee's supervisor or person in charge conducts an assessment of food prepared or served by the food employee while symptomatic and take appropriate corrective actions. Document corrective actions taken as a result of the assessment. Maintain records for 1 year and make them available for review during inspections. Review [when possible] any AGE cases among passengers or crew reported after the ill food employee?s symptom onset for epidemiologic link/connection. Appropriate corrective actions could include discarding ready-to eat food, thoroughly cooking raw food, and disinfecting the food area and equipment.
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Item No.:
20
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Site:
Bar-Deck 8 ? La Cucina ? Coffee Station
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Violation:
Two slotted fasteners were installed on the coffee press plate. Old food soil was observed in the recessed slots.
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Recommendation:
Ensure multiuse food-contact surfaces are: (1) Smooth; (2) Free of breaks, open seams greater than 0.8 mm (1/32 inch), cracks, chips, inclusions, pits, and similar imperfections; (3) Free of sharp internal angles, corners, and crevices; (4) Finished to have smooth welds and joints; and (5) Accessible for cleaning and inspection by one of the following methods without being disassembled, by disassembling without the use of tools, or by easy disassembling with the use of handheld tools commonly available to maintenance and cleaning personnel. 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:
Galley-Deck 5 - Soup Kettle Station
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Violation:
There were two tilting wheel handles with recessed seams along the back perimeter surface.
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Recommendation:
Ensure multiuse food-contact surfaces are: (1) Smooth; (2) Free of breaks, open seams greater than 0.8 mm (1/32 inch), cracks, chips, inclusions, pits, and similar imperfections; (3) Free of sharp internal angles, corners, and crevices; (4) Finished to have smooth welds and joints; and (5) Accessible for cleaning and inspection by one of the following methods without being disassembled, by disassembling without the use of tools, or by easy disassembling with the use of handheld tools commonly available to maintenance and cleaning personnel. 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-Deck 6 - Teppanyaki
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Violation:
The #2 cooking station had a seam around the burner to cooktop surface juncture that was sealed with red silicon making it rough and difficult to clean. The area had previously been cleaned and was not in operation.
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Recommendation:
Ensure multiuse food-contact surfaces are: (1) Smooth; (2) Free of breaks, open seams greater than 0.8 mm (1/32 inch), cracks, chips, inclusions, pits, and similar imperfections; (3) Free of sharp internal angles, corners, and crevices; (4) Finished to have smooth welds and joints; and (5) Accessible for cleaning and inspection by one of the following methods without being disassembled, by disassembling without the use of tools, or by easy disassembling with the use of handheld tools commonly available to maintenance and cleaning personnel. 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-Deck 6 - Warewashing
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Violation:
Two previously cleaned and sanitized waiter trays were significantly damaged with cracked edges and the non-slip surface was peeling. These trays were removed from service.
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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. 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.
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Item No.:
21
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Site:
Galley-Galley - Aft
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Violation:
In the undercounter technical compartment beneath the utility sink, there was peeling tape surrounding a pipe in poor condition making it not easily cleanable.
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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.
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Item No.:
21
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Site:
Buffet-Deck 15 - Garden Cafe Counter Tops
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Violation:
Multiple buffet stations had cracks and open seams along the countertop and bulkhead and counter hot/cold well junctures. Silicone had been applied in these areas; however, multiple areas were peeling and in disrepair.
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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.:
21
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Site:
Buffet-Deck 15 - Garden Cafe Self-service Wine Dispenser Stations
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Violation:
The passenger self-service wine dispenser stations were installed with insufficient cleaning distance on both the left and right sides. The dispenser machines were fixed to the counter and were not easily moveable.
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Recommendation:
Ensure equipment that is fixed because it is not easily movable is installed so that it is: (1) Spaced to allow access for cleaning along the sides, behind, under and above the equipment; (2) Spaced from adjoining equipment, bulkhead, and deckhead at a distance of not more than 0.8 millimeter or 1/32 inch; or (3) Sealed to adjoining equipment or bulkhead.
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Item No.:
21
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Site:
Other-Deck 8 Raw Bar
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Violation:
The undercounter refrigerator, farthest from the crew entrance, had a door gasket that was not sealing correctly causing condensate to build up around the door perimeter.
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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.:
21
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Site:
Other-Deck 8 ? Cagney?s Galley
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Violation:
On refrigerator #5, the gasket was not secured to the door and did not create a proper seal.
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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.:
22
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Site:
Galley-Deck 6 - Main Crew Galley Potwash
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Violation:
The upper and lower final rinse spray nozzles for the hood-type potwash machine were clogged with a white debris, making the spray pattern ineffective.
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Recommendation:
Maintain warewashing equipment in good repair and proper adjustment, including: warewashing equipment is maintained in a state of repair and condition that meets the standards of the materials, design, and construction of these guidelines
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Item No.:
22
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Site:
Galley-Deck 15 Garden Cafe - Dishwash
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Violation:
A spray nozzle on the lower left final rinse spray arm was not emitting an effective spray when evaluated. Additionally, a nozzle on the top auxiliary rinse spray arm was also producing an ineffective spray. This machine was in active use.
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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.
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Item No.:
22
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Site:
Galley-Deck 15 Garden Cafe - Glasswash
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Violation:
The flight type glass wash final rinse spray nozzles were not providing an effective spray pattern. Water was draining from the top arm's connection and not providing an effective spray pattern.
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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.
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Item No.:
22
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Site:
Galley-Deck 6 - Warewashing Station
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Violation:
On machine #0660901, the final rinse spray arm was emitting an infective spray pattern on the flight-type warewashing machine while it was in use. A technician determined there was a broken piece on the spray arm, which was replaced.
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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.
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Item No.:
26
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Site:
Dining Room-Deck 6 - Taste
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Violation:
In a cabinet of clean materials, two previously cleaned and sanitized stainless steel coffee pitchers were soiled. These items were removed for cleaning and sanitizing.
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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 16 - American Diner
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Violation:
A non-food grade plastic container was used to store cut celery intended for drink garnishes. The plastic container and celery were discarded.
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Recommendation:
Ensure materials used in the construction of multiuse utensils and food-contact surfaces of equipment do not allow the migration of deleterious substances or impart colors, odors, or tastes to food and are safe under normal use conditions.
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Item No.:
26
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Site:
Galley-Deck 16 - American Diner
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Violation:
A non-food grade plastic container was used to store cut celery intended for drink garnishes. The plastic container and celery were discarded.
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Recommendation:
Ensure materials used in the construction of multiuse utensils and food-contact surfaces of equipment do not allow the migration of deleterious substances or impart colors, odors, or tastes to food and are safe under normal use conditions.
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Item No.:
26
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Site:
Galley-Deck 16 - Haven Galley
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Violation:
Brown grease residue was observed on the back of the previously cleaned and sanitized deli slicer blade.
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Recommendation:
Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized.
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Item No.:
26
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Site:
Galley-Deck 8 ? La Cucina ? Coffee Station
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Violation:
Two slotted fasteners were installed on the coffee press plate. Old food soil was observed in the recessed slots.
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Recommendation:
Ensure food only contacts surfaces of equipment and utensils that are cleaned and sanitized.
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Item No.:
27
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Site:
Galley-Deck 16 - Haven Galley - Deli Slicer
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Violation:
Two slotted fasteners facing the back of the deli slicer blade had food soil in the recessed areas of the fasteners.
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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:
Preparation Room-Deck 3
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Violation:
The backflow prevention device on the vegetable wash tub was visibly soiled with more than a day's accumulation of debris.
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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:
Dining Room-Deck 6 - Teppanyaki
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Violation:
The #2 cooking station had a seam around the non-food contact area of the cooktop surface that was sealed with red silicon making it rough and difficult to clean. The inspector used an alcohol pad to wipe the seam, confirming that it was soiled. The area had previously been cleaned and was not in operation.
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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.:
33
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Site:
Galley-Galley - Aft
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Violation:
A large pool of standing water was on the deck inside the #17 undercounter technical compartment beneath the pasta boiler.
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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.:
33
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Site:
Galley-Deck 14 - Buffet Galley
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Violation:
Water leaking form the backflow prevention device for the stacked combination oven pooled on the deck below.
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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.:
36
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Site:
Other-Deck 8 - Wasabi Sushi Bar
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Violation:
The Light intensity could not be raised to 110 lux at the handwash station during operation nor could it be raised to 220 lux during cleaning operations.
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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:
Bar-Deck 7 - O'Sheehan's Neighborhood Bar & Grill
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Violation:
Light intensity could not be raised to 220 lux of light at the juice and milk service stations.
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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-Deck 6 - Teppanyaki
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Violation:
In the front of the restaurant at the aft side waiter station, the light intensity did not reach 220 lux for cleaning purposes.
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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.
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