The starboard waiter station near the beverage counter had stacks of previously cleaned plates and bowls for passenger self-service. Some of the bowls were soiled with small food particles along the exterior surfaces. Staff immediately removed the soiled bowls for rewashing.
In the pantry across from cabin 1-235, the ice machine contained slotted fasteners in the splash zone at the sensor and on the sides of the front ice deflector panel. During the inspection, staff stated these fasteners had been changed to nonslotted fasteners.
Some of the metal rat guards on the mooring lines did not fully protect the lines from pests entering the ship.
The aft pool was equipped with a decorative statue fountain and 11 spray nozzles surrounding the pool. These features were turned off, but not disabled, and had not been in operation since 2011. The turnover rate of the pool was 171 minutes (2.85 hours) without the features in operation.
The bromine levels of the whirlpool were 11.50 ppm, 12.34 ppm, and 12.51 ppm as measured by the inspector. The crew member's test kit measured greater than 10.0 ppm.
Early in the inspection of the recreational water facilities, the inspector asked the engineers what time the facilities opened. It was stated they would be open around 13:00. At approximately 12:30 the inspector stated she would wait until the facilities were open and water chemistry levels adjusted as appropriate. At approximately 14:00, the engineers met the inspector to go to the facilities that were open. While testing bromine levels of the Serenity whirlpool, the inspector's test kit measured 11.50 ppm, 12.34 ppm, and 12.51 ppm. The crew member's test kit measured greater than 10.0 ppm. It was not until the third bromine measurement that the inspector was informed the Serenity whirlpool was closed. When the inspection team arrived, the net had been removed from the stairs leading to the whirlpool and the net was lying on the deck on the other side of the whirlpool where it could not be seen. At no time did the inspection team of four ship's staff mention this whirlpool was closed prior to testing.
During the last five voyages, several fields for the number of diarrhea and vomiting episodes on the AGE log were blank for both passengers and crew members who met the definition of an AGE case. According to staff, if an individual does not have diarrhea or vomiting episodes this column on the AGE log was left blank and the data had to be manually entered. This was noted on the previous two inspections. According to staff the fleet was in the process of testing a new version of the database that wouldl automatically correct this issue. The projected launch date for the new system is April 2015.
Medical staff was asking reportable AGE case crew members if they had additional immediate contacts (i.e. boyfriend, girlfriend, spouse, etc.) besides cabinmates but it was not documented if they did not.
A broom was stored next to a shelf with liquor bottles and the dust pan was stored on the top shelf next to liquor bottles.
Five lexan containers (approximately 4 inches deep) of cut and shredded cabbage were stored with an internal temperature between 46-54°F when measured by the inspector. According to the 7-day discard label the cabbage was cut the previous day. No cooling logs were completed for the cabbage so it could not be determined if the cabbage was properly cooled. All five containers were discarded.
Condensation was accumulating on the deckhead above the soiled landing of the in-use dishwash machine inside and outside the canopy. Condensation was also accumulating on the bulkhead adjacent to the soiled landing. No condensation was observed dripping onto equipment.
Outfits worn over the regular clothing of the wait staff during special dinners were hung on two racks next to clean linen. Some of the outfits were in direct contact with clean linen, and another outfit was on the deck. According to staff the outfits were laundered after each use.
A corkboard was hung on the bulkhead between the two conveyer-belt ovens.
The undercounter dishwash machine did not have a data plate. This was corrected.
The deck and bulkhead behind the dry store rack was soiled with more than one day's accumulation of sugar, flour, and other debris. This was immediately cleaned.
Water was continuously leaking from the bucket fill tap under the handwash sink at the soiled end of the dishwash machine.
The handwash station behind the glasswash machine did not have a waste receptacle. Used paper towels were observed in a soiled lexan container next to the handwash station.
The starboard waiter station near the beverage counter had stacks of previously cleaned plates and bowls for passenger self-service. Some of the bowls were soiled with small food particles along the interior surfaces. Staff immediately removed the soiled bowls for rewashing.
A passenger table in the starboard aft section of the dining room was filled with stacks of soiled plates, soiled linen napkins, soiled utensils, and soiled bowls and cups. Passengers were eating their breakfast beside the table used for soiled staging. There was a proper waiter station without any soiled items on it within 2.4 meters (8 feet) of this dining room table.
The written and posted time control plan for this outlet did not identify the portable carving station set at the front preparation counter. Staff stated that this was used to hold cooked pizza portions between passenger requests and time control was the method. The time control plan was edited during the inspection.
There were four live fruit flies on the deckhead over both counter-attached bulkheads in this area.
Several of the metal deckhead panels were damaged along their edges, creating an uneven surface with gaps between panels, especially where the panels joined the canopy exhaust hood framing.
In reviewing the children with gastrointestinal (GI) illness symptoms and the medical response, the form included a statement that the child was able to return to the youth program activities without restriction after 24 hours on a given date. In a number of cases this was only 24 hours or less from the initial symptom onset, and it was unclear if the child was symptom free at that time. Some of the medical clearance letters included a statement at the bottom which specified the child was to return to the medical center for follow-up at the same date and time as they were said in the statement above to be allowed to return to the child activity center.
The coated metallic deckhead panels over the front bar were becoming damaged, with a bubbling of the surface coating. Some of the bubbled surfaces had split apart, leaving a rough and difficult surface to clean. Staff stated a work order was in place to replace the damaged deckhead.
During the last five voyages, many of the fields for the number of diarrhea and vomiting episodes on the AGE surveillance log were blank for both passengers and crew members, who met the definition of an AGE case. According to staff, if an individual does not have diarrhea or vomiting episodes this column on the AGE log was left blank and the data had to be manually entered. This was not manually entered in the AGE logs saved in the medical computer file. This was noted on the last inspection.
A crew member, who was not a food handler, reported late to medical during the 5-12 October voyage. The crew member had an illness onset at 1400 on 7 October, and did not report to medical until 0958 on 8 October. Staff reported this crew member did not speak English and two different translators had to relay the symptoms experienced by the crew member. The crew member first presented to medical after fainting on 7 October, but it was unknown the crew member was experiencing GI symptoms until the following day.
The sample lines for the Midship Port and Starboard whirlpools and Thalasso whirlpool analyzer probes were directly inside the compensation tank, and not before the tank.
During active use of the conveyor pot wash machine, excessive soiled pots and pans were stored at a meter height on both the sides of the installed soiled pot racks. This included a total length of 18 feet (5 meters) of soiled items stacked between the soiled rack and the conveyor pot wash machine and another 5 meters of soiled items on the side of the soiled rack (between the soiled racks and the clean pot racks). The entire capacity of soiled storage on the two meter long soiled table and all the soiled landing tables and overshelves were completely full of soiled pots.
Among the stacked clean items in this warewash area were several of the oval and square black serving trays. At least 10% of those stacked serving trays had surface damage including: peeling rubber exterior, cracked, chipped and broken edges, and some damage along the exterior edges where the metal under layer to that plastic outer surface was exposed.
A small strand of metal inside the water bath of the ice cuber was observed, which was in operation at the time. A small accumulation of a black powder sediment was noted in the water bath. Staff stopped the machine and conducted a complete cleaning during the inspection.
The previously cleaned counter model mixer had visible yellow and white food residue on the upper interior surfaces where the blender shaft attaches.
The marble pastry table was previously cleaned, but visible food residue and dirt debris were noted at the edge of the table and on the sealant where the stone edge joined the stainless steel counter edge beside.
Heavy dust debris and a visible oil coating were noted along the deckhead mounted exhaust vent cover at the center of the buffet line, near the carving station.
The previously cleaned deep fat fryer had a brush bristle and old piece of dried oil in the cooking compartment. The unit was thoroughly cleaned before the inspection team left the area.
The previously cleaned deep fat fryer had dried oil soil on the walls in the interior of the lower used oil compartment. The unit was thoroughly cleaned before the inspection team left the area.
The portable sneeze guards on the high counters in Carnival Deli, Off the Grill, and similar passenger self-service areas should be examined under operation to ensure they are positioned to provide adequate protection of the condiments placed under them. These food outlets were not in operation during the inspection, and the portable sneeze guard position would have not protected the condiment containers if the outlets were in operation.
The previously cleaned deep fat fryer had a piece of yellow food soil on the front wall above the drain hole. The previously cleaned grill next to the fryer also had food residue on the cast iron grates and on the cooking elements. The previously cleaned food warming cart #5 in this pantry had old grease residue on the interior wall of the upper compartment. The units were thoroughly cleaned before the inspection team left the area.
The interior drain pan on the undercounter cooler #10D-2 was not aligned with the drain hole out of the unit. Condensate was spilling into the bottom of this reach-in cooler.
The power cable conduit for the portside conveyor toaster had come loose, creating a difficult to clean surface.
The previously cleaned fryer #10-18 drain had food residue in it.
The passenger bell for alerting the staff of a request at the front counter was heavily soiled with old food debris. The clear plastic security housing around the bell was also soiled. The cover was removed and the bell and the housing were thoroughly cleaned before the inspection team left the area.
The underside of the serving counter line was sticky with food debris.
The profile seams on the oven counter and adjacent bulkhead were loose and had spaces where food could collect.
A large amount of food particles were observed in the covers and technical spaces for the Tandoor oven controls and the utility line covers in front of the ovens.
Paper towels were not provided at the handwash station in the service bar.
The area under the length of the entire service counter had a yellow oily residue in a food splash area.
The red fire blanket box over the buffet had a sticky food residue on the top.
The brown rubber bar mats were drying inverted on the counter in a manner which did not allow all of the crevices in the mat to dry completely. Water was noted in the crevices of these mats.
Mold was observed on the ice deflector inside the ice maker compartment.
The free residual halogen in the Midship Pool was 0.45 ppm, 0.45 ppm, and 0.62 ppm as measured by the inspectors' test kits and 0.54 ppm as measured from the ship's test kit. At the time of inspection, the pool was open and no passengers were observed in the pool. The pool was immediately closed. The pH of the Midship Pool was also above 7.8, as measured by the inspectors' test kits, and may have impacted the free residual halogen level. Staff informed the inspector the low residual halogen could be a result of the emergency drills, which potentially impacted the pumps. Upon inspection of the chart recorder in the pool machinery room, the residual halogen was documented above 1.0 ppm since the opening of the pool around 1300.
According to staff, if an individual does not have diarrhea or vomiting episodes this column on the AGE log was left blank by an error in the STARDOCS medical information system and the data had to be manually entered. This was not manually entered in the AGE logs saved in the medical computer file for each voyage. This system is currently under revision and the next version will correct this problem the company advised.
Water was observed under the feet of the previously cleaned buffalo chopper. Water had accumulated under the rubber feet of this equipment. The area was not in operation, and this was corrected on site.
The deck was in disrepair and grout was missing in several areas on the deck. Management had identified this area previously and were in the process of replacing the grout.
A fingerprint was noted on a previously cleaned knife. The knife was sent to be re-cleaned.
One previously cleaned plate was soiled with food residue. The trolley full of the clean plates was previously inspected. The plate was sent to be re-cleaned.
Three slotted fasteners located on a food splash zone were noted on the ice machine sensor probe. This item was corrected on site.
The second nozzle from the top on the left side manifold of the sanitizing rinse was partially blocked. This was corrected on site.
A soup kettle and 20 piles of oven racks stacked in threes were stored partially wrapped in plastic wrap in this locker, which was not properly constructed for storing equipment. Coving was absent at the deck/bulkhead juncture, the deck was heavily soiled with food debris, dirt, and a ring of black residue, and the deck was pitted and chipping in several areas. Also, a hole was noted in the deckhead from an electrical penetration of a large electrical bundle that was not easily cleanable on the bulkhead.
The tops of all three storage racks were heavily soiled with food debris and dirt. No equipment was stored on these shelves. Also, the deck stations stored in this room were soiled with food residue and dirt.
A soiled coffee cup partially filled with coffee was stored on the top shelf of the equipment storage rack to the left of the entrance.
The inside of the previously cleaned soup kettle was soiled with food residue.
The two signs on top of the buffet line, where passengers ordered their eggs, did not state the eggs were cooked to order. Consumer advisory statements were on both of the signs. A very small sign was observed standing up against a column on the bottom of the buffet line in front of the bottom of the mise en place items for the omelets with the correct wording, but it was not visible to passengers who were ordering and the sign had a small font and was difficult to read.
The inside of the left dumbwaiter was soiled with food debris on both shelves and a white residue was observed on the right bulkhead of the dumbwaiter. According to staff, the dumbwaiter was clean and hardly used.
Less than 220 lux of light intensity was measured in front of the juice and coffee machines.
Three pans of fully cooked pancakes and one pan of hard boiled eggs were stored in the #1 combination oven with discard labels on the pans. According to staff, they were using the oven to keep the food warm for the buffet line. The food had not been on time control for more than four hours and was discarded. The oven was set at 206 degrees Fahrenheit and was on temperature control.
Two cartons of lactose free milk and three cartons of soy milk were observed with four hour discard labels for time control, but the cartons were stored in undercounter refrigerator 10C-3 that was on temperature control. The milk was not on time control for more than four hours and was discarded.
The right braising pan had been out of service for three months and the left braising pan had been out of service for one month. The inspector confirmed that work orders had been submitted and the ship was waiting on spare parts to repair the pans.
Coving was absent at the deck/counter juncture of the self-service buffet line.
The display cabinet 10P-9 was labeled for time control, but was not on the time control plan.
According to the staff, the pizza display unit labeled for time control had not been used in more than one year and was not needed for the operation.
Three slotted fasteners located on a food contact splash zone were observed in the ice thickness probe of the deck-mounted ice machine.
At 10:14 AM, four carafes of milk and cream were noted on time control with black lids. According to the time control plan, the carafes of milk and cream should have been discarded at 10:00 AM. According to staff in charge of this area, the carafes of milk and cream did not have to be discarded because there were no passengers on board. Shortly afterwards, an announcement came on instructing specific passengers to disembark the ship.
Less than 220 lux of light intensity was measured in front of the juice machine.
A heavy layer of old food residue was observed in the seam and the interior corners of the food-splash panel of the in-use juice machine.
Approximately eight white plastic containers were soiled with food residue and dirt, and contained food products. For example, four bins were noted with large amounts of coffee grinds and a thick brown residue, and were used to store large packets of hot chocolate, packages of coffee, and boxes of cereal. Also, nine containers of jam were stored in a white bin with a heavy layer of a yellow sticky substance. In addition, two large cans of orange marmalade were stored in a white bin with a layer of a sticky brown residue throughout the bin. Condiments, to include salt and pepper and packages of brown sugar, were stored in a white bin with loose pieces of food residue. Containers of sugar-free breakfast syrup and full salt and pepper shakers were stored in a white bin with spilled food residue inside. Finally, approximately six boxes of cereal and more than 10 packets of sugar were observed on the deck in this locker.
Coving was absent at the deck/bulkhead juncture in this room. Also, the bulkhead was soiled in several areas, especially near the deck. Finally, a hole was noted where a bundle of difficult to clean electrical cables penetrated the deckhead near the door.
The inside of at least eight white plastic bins were heavily soiled with food residue and dirt and there were packages and containers of food stored in these bins.
The person in charge of both forward lido lockers was not storing food or equipment properly. Containers of food and condiments were stored on the deck and in soiled containers and in a room that was not properly constructed and equipment was stored in a room that was soiled and was not properly constructed.
During the last five voyages, two food workers identified as reportable acute gastroenteritis (AGE) cases were released from medical isolation prior to the required 48 hours symptom-free. On 28 March, an Assistant Waiter had an onset of AGE symptoms at 08:00 and reported to the medical center at 08:34. During his follow-up interviews with medical staff, on 29 March at 15:02 and 30 March at 08:02 he stated he was still having symptoms. It was documented that his last symptom was 30 March at 01:00. On 31 March at 08:07 he was released from isolation and his case was closed. According to his FunTime work record, he worked on 31 March from 08:13 to 11:25 and from 17:33 to 22:51. He should not have been released from isolation until 1 April at 01:00. On 28 March, a Bar Waitress had an onset of AGE symptoms at 14:30 and reported to the medical center at 15:14. During her follow-up interviews with medical staff, on 29 March at 15:02 she stated she was still having symptoms. It was documented that her last symptom was 29 March at 12:00. On 30 March at 15:07 she was released from isolation and her case was closed. According to her Fun Time work record, she worked on 30 March from 17:14 to 19:32 and on 31 March from 13:12 to 17:07. She should not have been released from isolation until 31 March at 12:00.
During the last five voyages, many of the fields for the number of diarrhea and vomiting episodes on the AGE surveillance log were blank for both passengers and crew members. According to the staff, if an individual does not have any diarrhea or vomiting episodes this column on the AGE log was left blank and the data had to be manually entered. If an individual had at least one episode of diarrhea or vomiting, this was recorded on the AGE log.
For the 1-8 March voyage, the 4-hour standardized AGE report was not submitted upon arrival in port on 8 March. Following the 24-hour report submitted on 7 March 07:22, three passengers with AGE symptoms reported to the medical center between 06:08 and 10:46 on 7 March and were entered on the AGE surveillance log.
A crew member reported to medical on 11/14 at 9:10 AM with two episodes of diarrhea and stomach cramps. Anti-diarrheal medication was dispensed and no underlying illness was noted. The note section for this case on the electronic medical records indicated these symptoms were above normal for the individual. This case was marked as non-reportable.
The four sample points for the monthly potable water samples did not vary significantly since June 2013. From June to November five samples were taken on Deck 0, four from Deck 3, five from Deck 5, and five from Deck 10.
The chart recorder chart used on November 11 did not have a pH range. It was only scaled 0-5 ppm. No other documentation was available to show the pH values were monitored every hour during bunkering.
The condensate collection pan had green tinted water that appeared stagnant in the middle and far end section.
The decorative masonry brick installed on the bulkhead around the pass-thru door to the pantry was absorbent, very rough, and difficult to clean.
One live fruit fly was noted on a clean cup at the starboard beverage station. Staff removed the cup for re-cleaning.
The sealant at the lower end of the counter model slicer was peeling away and loose. Staff repaired this during the inspection.
The port side handwash station in the front preparation area had less than 220 lux of artificial light.
There were several bowls containing potentially hazardous foods set on the front preparation counter to add to prepare pasta to order, including sauces and each had time only as a public health control discard labels attached, but the written and posted time as a control plan did not list foods on counters as being on time control. Likewise, in the galley there were three large pots filled with white and red pasta sauces on the range top as back-up for the front service area, and each of the pots had time control discard labels attached, but the written and posted time control plan did not identify the range top as a time control unit. Staff changed the written time control plan during the inspection to identify both counters and the range top as time control.
Nearly every counter top in the front grill area and in the galley behind had a permanent label attached with the words time control. The written time only as a public health control plan did not list or state that counters in either the grill or the galley were on time control.
This outlet operated for more than four hours, and although all other potentially hazardous foods held on time control had discard labels attached, the pans of pastrami, corned beef, and sauerkraut in the back bar bain marie did not have discard labels attached. Staff corrected this during the inspection.
One of the front service counter wicker baskets was only halfway lined with a cloth, and some of the bagels and bread made contact with the side interior of this woven basket, which was not an appropriate food contact surface due to its construction.
There was a difficult-to-clean seam present on the lower, curved end, on the back plate of the counter model slicer, where the sealant was missing. Staff removed and replaced the sealant on the slicer back plate during the inspection.
A wet tea bag was on a rack of clean mugs.
The serving utensil handle was in contact with mixed vegetables.
The light intensity was less than 110 lux behind and around the beverage equipment.
A large amount of water was draining from combination oven #5 and 6, both from the drain line in the back of the unit and from the front of the lower unit. The drain pan on the front of the lower unit was over-flowing with water. This resulted in a large amount of water pooled on the deck.
A large amount of water was pooled on the deck near combination oven #5 and 6. This was the result of a large amount of water both from the drain line in the back of the unit and from the front of the lower unit. The drain pan on the front of the lower unit was over-flowing with water.
The bulkheads and deckhead of this room were not constructed for easy cleaning and did not contain smooth, hard finishes. Numerous food equipment was stored in this room.
The light intensity was less than 220 lux on the long preparation counter.
The middle and left gauges were filled with condensation, making reading the temperatures difficult. Staff showed the inspector a work order indicating spare parts for this bain marie were ordered on 20 September and are expected to be delivered on 23 November.
The light intensity was less than 220 lux on the preparation counter next to the large deck-mounted mixer.
The time control plan for milk and dairy products did not match the operations of the bar. The time control plan indicated operating hours of approximately 07:00 to midnight, but also included set-up and discard times of approximately 11:00 to 14:30. Staff stated milk and dairy products are available for the entire operating hours. The plan also stated milk and dairy products were stored at 41°F or below in refrigerator L1/L2 and L5/L6. Refrigerator L1/L2 also contained the milk and dairy products on time control, but this unit was not labeled as being on time control.
The bulkheads and deckhead of this room were not constructed for easy cleaning and did not contain smooth, hard finishes. Beverage cans and bottles were stored in this room.
Beverage cans and bottles were stored in a room where the bulkheads and deckhead were not constructed for easy cleaning and did not contain smooth, hard finishes.
Due to an unexpected and unplanned change in the ship's itinerary, the buffet areas were operating at different times than the posted time control plan, however, it was unclear when some of the foods on time control were to be discarded. Potentially hazardous food in the time control refrigerators had discard time labels, but the foods out for self-service at the cold and hot wells were not labeled. Some of the food items included: individual cartons of milk, butter, and sausage links. When the inspector asked when these food items were to be discarded, a crew member stated these would be discarded as per the posted time control plan. The supervisor for the area corrected this crew member and said that they will be discarded within 4 hours of being removed from the cold or hot holding units. Discard time labels were added to all PHF's out for self service. The posted time control plan did not identify procedures to take when the operations deviate from the time control plan.
Combination oven #1 had a time control label, but the unit was not operating on time control. The label was removed.
The manifold final rinse temperature gauge on the in-use flight-type dishwasher was reading temperatures between 218-222°F. Temperatures at the plate surface were measured between 165-170°F and no steam was observed.
A tray of prosciutto on time control was not discarded as per the discard label. The inspector observed the prosciutto at 1207 and the product had a discard time of 1200.
The handwash station was missing a waste receptacle. This was corrected.
A heavy amount of dust build-up was observed on the bulkhead ledge above the entrance to the bulk candy storage locker. This was cleaned during the inspection.
The cold water lines to the ice machine were not uniquely identified. This was corrected.
The condenser side of the white plastic panel in the technical compartment of the ice machine had visible brown/red mold growth in two areas. This panel was immediately cleaned.
An open plastic bucket of individually wrapped square pieces of chocolate was being stored on the clean storage/drying rack immediately below clean coolers used for ice transportation. No water was dripping during the inspection.
A soiled and wet wiping cloth was stored in the utility sink.
The two fans above the bar area were soiled with a build-up of dust.
The bulkhead-mounted vegetable slicer had a small amount of old food soil on the previously cleaned blade assembly.
A bottle of vinegar was found with the clean serving platters and bowls.
The vinegar noted above was stored in a reused kimchee bottle and was not labeled vinegar.
The profile seam between the flat grill and the adjacent reach-in cooler was open creating a difficult to clean area. The bulkhead profile seam above this same grill was also open.
The left hood washing system backflow preventer was leaking indicating a possible failure of this backflow prevention device.
The backflow prevention device installed on the bin washer was a Conbraco 38-104. The list of devices indicated a Conbraco N9 was installed.
The ship had approved variances to be exempt from specific wording on their Cloud 9, Thalasso, and Serenity whirlpool safety signs. These variances could not be located during the inspection.
A container of sanitizing solution was less than 50 ppm. The soiled collection area was located outside AC Station 3.11.1P and across from midship port whirlpool. The area was not in active use as passengers were embarking the vessel and the lunch service had recently began. A new chlorine solution was made.
The international shore connection backflow prevention assembly had not been included on the list of the backflow prevention devices. The testing was a part of the ship's maintenance records.
Two fan rooms were checked and the condensate drain pans were not easily accessible. On one unit, the panel could not be removed because the screw heads were stripped out and the screws could not be removed. On the other unit, two or three screws on the panel could not be removed and the engineer had to forcibly remove the panel with the screws still tight in the mounting frame. The condensate pan was clean.
The splash panel above where coffee is made was open to exposed wires and hardware from the Scharf coffee machine. According to the staff, a protective splash panel has been ordered.
Undercounter refrigerator PC-4 was labeled as being on time control but was not listed on the time control plan.
The time control plan listed undercounter refrigerators TBUF2 and TBUF1 as being on time control, but the units were not labeled.
There was excess condensation collecting on the deckhead above and adjacent to the auto sham #1. No food items were impacted.
The data plate for the glasswash machine indicated the maximum conveyor speed in racks per hour. According to the staff, there was a work order in place for the new data plates.
The temperature of the final rinse manifold measured by the inspector was less than 180 degrees Fahrenheit. The surface temperature measured 158 degrees Fahrenheit by the inspector running their thermometer through the machine. The wash compartment measured 171 degrees Fahrenheit by the inspector. The ship and USPH team worked on this assessment for over 20 minutes without achieving the minimum sanitizing temperature in the manifold of at ware surface.
The right two final rinse spray nozzles from the clean side of the machine were not creating an effective spray pattern.
There were large pieces of yellow food debris on the left side of the cast iron grill. According to the staff, the grill had been cleaned and was not used.
There was one small live fly over the deli slicers on the worker side of the counter.
The previously cleaned left deli slicer had a large piece of yellow food debris on the food contact portion of the slicer.
There were large amounts of food debris in both tracks of food lift H and in all four corners of the lift. Also, the light cover attached to the deckhead in food lift G was cracked.
The port handwashing sink was 81 degrees Fahrenheit measured by the inspector. The faucet was adjustable.
The set-up and discard times for the omelet station for the Port B late breakfast was noon for both on the time control plan. According to the chef, the set-up time was 11:15 a.m. and the discard time was 12:30 p.m. Also, the time control plan for this area was not posted.
The chilled water lines for the right ice cream machine were not labeled.
Two blue plastic ice cream dishes were pitted and chipped in several areas along the lip contact surface. The dishes were discarded.
There was a hanging wire that was corroding in some areas hanging from two different light covers attached to the deckhead above the right fryer and a working table between two steam kettles. No food was stored in this area at the time of the inspection.
There was peeling sealant in several areas between the hood and the fire shutter door.
There was a bag of clothes, including a neck tie, shirts, etc. stored with clean linens. The bag was removed.
The light intensity was less than 110 lux behind and around the counter-mounted bulk milk dispenser and the toaster oven.
The red paint above the counter/deck juncture was peeling in a few areas.
There was no time control plan for the milk and cream out for service and the milk and cream were not labeled with the discard times.
There was a coating of dust and debris on several of the light bulbs over the deckhead area of the bar, including directly over approximately 40 clean glasses on the bar. This was noted on the previous inspection.
The light intensity was less than 110 lux behind and around the counter-mounted coffee machines and toaster oven next to the ice machine.
The inside of the lid for the upper compartment for the ice machine was soiled with dirt in several areas. There were loose pieces of insulation on inside the upper compartment above the ice cubes.
A layer of dirt was found on the top of the outside of the upper ice compartment.
Several pieces of the gasket were noted on the inside lid for the upper compartment of the ice machine that were peeling and coming apart in several areas.
Smoked salmon and eggs cooked to order were identified on signs posted at the buffet, but the consumer advisories did not included 'especially if you have certain medical conditions'.
A large amount of grey sediment was found in the water bath. Also, the inside of the lid for the upper compartment of the ice machine was dirty and had loose and peeling glue.
A layer of dirt was found on the outside top of the lower compartment of the ice machine.
The gasket on the inside of the ice machine was loose and peeling in several areas.
A large amount of grey sediment was noted in the water bath. Also, the inside of the lid for the upper compartment of the ice machine was dirty and had loose and peeling glue.
A layer of dirt on was found on the outside top of the lower compartment of the ice machine.
The gasket on the inside lid for the upper compartment of the ice machine was loose and peeling in several areas.
The handwashing sink in the ADA restroom for children less than six years old was more than 23 inches from the deck and step stool available.
The handwashing sink next to the beverage station had several brown liquid droplets in the basin of the sink.
Several soiled previously clean white pasta bowls were noted next to the handwashing sink with red and brown food residue on the outside of the bowls in two large white clean bins. The bowls were taken to be re-washed and sanitized.
The person in charge gave the inspector the breakfast menu with smoked salmon as a breakfast item, but the item was not identified as served undercooked and there was no consumer advisory on the menu. At a later time, the inspector was presented with a different breakfast menu that was correct.
The OPRP did not include the concentration of Vital Oxide used during fogging and did not include how the passengers would be protected from disinfectants used around the ship. Many areas of the OPRP were corrected since the last inspection.
There were several pieces of loose gray sediment in many areas of the water bath compartment. Also, the inside of the lid for the upper compartment was heavily soiled with dirt.
There was a layer of dirt on the upper outside portion of the lower ice compartment.
The gasket on the inside of the lid for the upper compartment was loose and peeling in several areas.
Food debris and a pool of water were noted on the lower left shelf of the undercounter storage area.
The deck in the liquor hotel storage room had areas of dirt and cardboard debris. This area was cleaned during the inspection.
There were 8 unlabeled white hotel pans containing different types of beans. The beans were no longer in their original container.
Heavy condensate was collecting on the deckhead cold air supply vent near the entrance. The room was not in active use at the time of the observation.
The bulkhead flanges for the hot and cold water lines to the handwash sink were loose, exposing open gaps.
Approximately, 5 white plastic hotel containers were observed on the deck in this location. The containers were soiled and placed back on a soiled storage shelf.
Two previously used and soiled wiping cloths were observed laying on top of soiled dishware.
A previously cleaned and sanitized white coffee mug and a plastic bowl had dried food residue on the food contact areas.
Three metal colanders were observed in poor condition. The colanders were dented and had many sharp projections that made cleaning difficult. The colanders were sent to be recycled.
The water and electrical lines to the ice cream machine were heavily covered in dust. These areas were cleaned during the inspection.
The deck below two coin operated soda machines were soiled with a brown sticky residue and dirt debris.
The sides of the coin operated soda machines were also soiled with a heavy dust accumulation. It appeared that the machines are not often pulled away from the walls in order to be cleaned.
The splash area immediately above the dispensing nozzle of the counter mounted espresso machine was soiled with old coffee residue of more than a day's accumulation.
The handwash station at this location did not have a trash receptacle.
The main galley conveyor potwash and the Crimson glasswasher were both out of order. An exceptionally large amount of soiled pots and pans were stacked around the potwash area with only the manual 3-compartment potwash in operation. Soiled pots and pans were being transferred to the Lido and Crew potwash locations. The main galley potwash was out of order since the morning and was being serviced during the inspection.
The lighting to the left of pastry oven # 6 as well as between both bakery ovens and to the side of the right bakery oven could not be raised to the required 110 lux of light. Deckhead light fixtures had been added to these locations but light bulbs were yet to be installed.
The lighting was less than the required 220 lux at the service area of the counter mounted espresso machine. Also, the lighting to the left of this machine could not be raised to the required 110 lux of light.
There were two open bulkhead penetrations immediately behind the espresso machine.
A waitress who experienced 2 episodes of diarrhea within 24 hours and had no other symptoms was isolated and issued anti-diarrheal medication, but was listed as non-reportable.
The electronic medical data management system has the old VSP definition of a reportable case of gastrointestinal (GI) illness programmed in. This system does not allow a person with less than 3 loose stools to be a case unless accompanied by fever or vomiting, and forces anyone with 3 or more loose stools to be a GI illness case if they have 3 or more loose stools, even if there are underlying medical conditions which could be causing those episodes.
The AGE Surveillance Log in the electronic medical database is not identical to the VSP AGE log provided in section 13.2 of the 2011 VSP Operations Manual. The identical AGE log could not be exported from this system either.
A stateroom steward (food worker) experienced their final GI illness symptoms at 9 am on July 1, but during the follow-up medical visit at 8:15 am on July 2 was granted clearance to return to work. This employee worked on July 2 from 8:32 am to 1:40 pm and 5:30 pm to 10:10 pm. In another case an assistant waiter with GI illness symptoms has notations in the electronic record that he is still experiencing symptoms on a follow-up medical visit at 6 pm on 18 June, while the record also indicates his last GI illness symptom was at 5:45 pm on 17 June (first symptom was 5:15 pm on 17 June). The follow-up medical visit on 19 June noted him as symptom free and he was released to return to work. He did work on 19 June from 7 pm to 11 pm.
The electronic record listed a pastry chef with diarrhea starting at 10 am on 12 June who reported to the medical facility at 9 am on 14 June. The employee was not listed as a food worker and was released after being symptom free on the follow-up visit to medical at 8:21 am on 15 June. After checking the personnel record it was determined this employee was in fact an ordinary seaman who disembarked the vessel shortly after this period.
An assistant waitress initially reported one diarrheal episode at 5:10 pm on 11 June, then was issued anti-diarrheal medication at 5:42 pm. At 2 am on 12 June she experienced addtional symptoms, but was granted approval to return to work at 9:20 am on 13 June. She worked on 13 June from 5:11 pm to 10:09 pm. The record did not detail what additional symptoms occurred on 12 June or the number of episodes, so it was unclear why this was not reported as a case and why there was approval to work following only 24 hours of being symptom-free.
An assistant waiter reported 2 initial diarrheal episodes on 9 June at 10:45 am. They were issued anti-diarrheal medication at 11:34 am on 9 June and at 7:30 pm that evening experienced the last GI illness symptom. There was no notation of the symptom(s) experience or the number of episodes. The crew member was listed as non-reportable in the AGE surveillance log.
Corrosion covered the metal food contact stems of the blast chiller temperature probes in the Lido Galley, Main Galley and Crew Galley.
Food residue and grease covered the previously cleaned clamshell grill, stored in the storage locker across from the potwash.
Food residue soiled the inside of the food service lift number 10350032-u-ze.
Corrosion and pitting covered the right metal splash guard adjacent to the bulk milk dispenser tube.
Corrosion, cracks and field weld repairs made the cast grills difficult to clean. In addition, the material used for the field weld repairs could not be determined.
The liquid crystal display on the in-use flight-type warewash machine was difficult to read and appeared to be failing.
A fly trap was located above the preparation counter with a cold top attached.
Chipping and pitting made the gray plastic end cover of the slicer difficult to clean.
Deposits of old grease encrusted the in-use Panini press (clamshell grill).
The conveyor speed of the in-use flight-type warewash machine measured 6 to 7 feet per minute. The data plate required a maximum speed of 5 feet per minute.
A pink sticky food residue soiled the technical space of the drip pan housings of the two ice cream machines.
The plastic ice container of the previously cleaned ice blender was cracked. In addition, the metal blade located near the dispensing chute was corroded.
The written OPRP did not include the notification letters for outbreaks to guests boarding or those continuing on voyages where the previous cruise or segment was an outbreak. The food and beverage instructions for bars specified use of 1,000 ppm chlorine on all bar surfaces and on ice scoops and bar counters. A vital oxide fogging chemical was specified when fogging, but the concentration and contact time were not listed. There were no specific procedures for protection of crew and passengers from both dermal and inhalation exposures to disinfectant chemicals. The entire plan was under revision and the updated version has not been transmitted yet to the ship.
The pantry ice machine water bath had an accumulation of a loose black granular product in the water.
The posted sign at the entrance to the child center included a statement at the bottom quoting the CDC Vessel Sanitation Program definition of an acute gastroenteritis case, but the definition did not match the current definition in the 2011 VSP Operations Manual with respect to diarrheal disease.
There was a section of deckhead damaged along the connection of the deckhead exhaust hood maintenance panel and the surround deckhead panels. Damage included gaps, dents, and bent metal along edges and profiles that made the panels uneven and misaligned so cleaning was difficult.
There was damage to at least 3 of the iron grill plates where the metal was split or cracked. Two had been repaired with welding, but it was unclear what the metal was for those welded sections and it's recommended the plates be replaced when damaged.
There was dust and hair on many of the decorative bulbs and the lights fitted throughout the deckhead over the front bar. The high number of bulbs thoughout this deckhead made cleaning difficult as well.
The bucket of sanitizing solution on the front bar counter had 0 ppm chlorine residual inside. There were several wiping cloths inside the solution and the bar was open. The water was immediately changed.
One of the two sanitizing solutions in buckets on the back bar counter had more than 200 ppm of chlorine inside. the solution was changed immediately. The bar was open.
A gray plastic bin with six flats of raw shell eggs was stored outside of refrigeration inside the hotel storage. The internal temperature of the eggs ranged in temperature from 58°F to 62°F.
A gray plastic bin with four flats of raw shell eggs was stored in walk-in Rm 22. The internal temperature of the raw shell eggs was 56 °F. The eggs were warm to the touch.
Four flats of cracked raw shell eggs were stored in a gray plastic container. Below the cracks eggs was a large block of cheese and numerous vacuum sealed bags of salad dressing. Spilled egg white, yolk, and shells coated the exterior of the cheese and salad dressing bags.
In the mid-ship bunker station, the middle in-use potable water hose was not labeled 'potable water only' near the fill line end. Also, the label on the first in-use potable water hose from the entrance was faded and hard to read near the fill line and two potable water hoses in the hose locker were not labeled 'potable water only' on either end of the hose. In the forward bunker station, the label on the third in-use potable water hose from the entrance was faded and hard to read near the fill line.
There was no blue or blue/green/blue striping on the production water line after chlorination until the potable water tanks.
On March 31, 2012 the free residual chlorine readings on the chart recorders for slide A between 12:45 p.m. and 6:00 p.m. were at least 1 ppm, but less than 2 ppm. On June 16, 2012 the free residual chlorine readings on the chart recorders for slide D between 11:30 a.m. and 6:00 p.m. were at least 1 ppm but less than 2 ppm. On June 22, 2012 the free residual chlorine readings on the chart recorders for slides b and c between 11:30 a.m. and 6:00 p.m. was at least 1 ppm, but less than 2 ppm.
The recorded free halogen residual for the whirlpool spas at the beginning of shock halogenation was 6.0 ppm. The whirlpool spas were shock halogenated for over one hour each time and the free halogen residual recorded at the end of shock halogenation was at least 10.0 ppm.
The sand filter housings were cleaned, rinsed, and disinfected before new media was used, but the concentration and contact time used for the disinfection was not recorded.
The sample points for the RWFs in the water park were not directly from the RWFs or before the compensation tank.
The dual gravity drains for the two swimming pools were greater than 3 feet apart and did not have approved antientrapment drain covers or an alarm installed. Also, the whirlpool spas had one blockable gravity drain and two suction fittings less than 3 feet apart that did not have approved antientrapment drain covers and no SVRS' or APS' were installed. Documentation was available during the inspection showing staff have ordered the new covers and SVRS' needed.
The safety sign at the Water Park did not state the exact language 'take children on frequent bathroom breaks' or 'take children on freqent toilet breaks'.
There was no documentation of pH monitoring conducted at least every four hours during the production of potable water.
The distillate lines for the three evaporators and the permeate line on the reverse osmosis system were not striped blue/gray/blue to the chlorine injection system.
The electronic AGE surveillance system was not able to provide an AGE surveillance log that contained all of the required data and in the same format as in Annex 13.2.2 of the 2011 VSP Operations Manual. Also, the system did not allow the medical staff to remove a person as a case if they had an underlying illness as the cause of symptoms or add them as a case if they had gastroenteritis illness, but did not fully meet the case definition.
A dancer had an onset of AGE symptoms on February 23, 2012 at 7:00 a.m. and did not report to medical until February 25, 2012 at 3:00 p.m.
The posted exclusion policy for ill children did not include a requirement for written clearance from the medical staff before an ill child was allowed to return to the children's area.
There was no sign advising users to wash their hands at the handwashing stations.
The vessel had a draft copy of a new OPRP and staff stated it would be used if an outbreak occurred onboard. The draft copy did not include a concentration for Vital Oxide. The letters for informing passengers and crew of an outbreak and embarking passengers of a previous outbreak were indicated in the plan, but were not available to review. Also, the OPRP indicated a few locations where 1000 ppm of chlorine would be used in food areas or on food equipment.
The time control plan was not posted in the bar.
The menus for the sushi items had a consumer advisory at the bottom, but did not include an asterisk by the items containing fish served raw or undercooked.
The food splash zone above the coffee and steamer area of these espresso machines was difficult to clean due to exposed pipes and wires. Staff stated that cover panels were planned for installation on these machines.
The data plate for the warewash machine was located below the clean counter and was not easily accessible to the workers.
The light intensity at the Steakhouse Bar and the Plaza Bar handwashing stations was less than 110 lux during normal lighting.
The pipe insulation in the undercounter refrigerator technical compartment was shriveled and wet. According to the staff, new insulation had been ordered.
The pipe insulation in the undercounter technical compartment was soiled.
The refrigerant brine lines were not uniquely identified.
There was condensate on the bulkhead behind the left tilting kettle. No food was impacted.
The knob and some of the pipe insulation in undercounter refrigerator technical compartment TC3MG-6 was soiled.
The light intensity was less than 110 lux around and behind deck- and counter-mounted equipment in some areas, including: the equipment on the main galley beverage station near the forward service line, the juice machines on the Scarlett dining room upper level beverage stations, some of the equipment on the port and starboard Taste of Nations beverage stations, and some of the equipment on the room service pantry beverage station.
There was a leak from the vent on the hood cleaning cabinet backflow prevention device. The device was replaced.
The hot holding cabinet was listed on the time control plan as a time control unit, but the unit was not labeled.
The light intensity at the handwashing station was less than 220 lux.
The consumer advisory posted at the omelet station had a statement indicating the risk of consuming raw or undercooked animal derived foods, but there was no statement that eggs could be cooked to order and served undercooked.
The consumer advisory for the menu in the officer's mess included a statement indicating the risk of consuming raw or undercooked animal derived foods, but there was an asterisk on the menu for the category labeled 'also available.' Several food items were listed after this label, but eggs were the only animal-derived product that could be served raw or undercooked.
The time control plan for hot foods had a box indicating the temperatures to which these foods should be cooked. One of the arrows from this box pointed to another box stating that foods on time control should be placed in time control refrigerators. There was no indication on the plan that foods should be cooled before going to time control in refrigerators. The time control plan was corrected.
Single use items such as wooden stirrers and paper cups were stored in this locker. The paper cups were stored on the deck. Also, food equipment including a blender and an ice bucket were also stored in the locker. The locker was not constructed for storage of these items, the deck was soiled and non-food items such as garbage, cleaning equipment, and chemicals were stored in the same locker.
The deck was soiled and there was no coving at the deck/bulkhead juncture. Food and food-related utensils and equipment were stored in this locker.
Several food items were stored in this locker including: one large tray of 18 pastries and muffins, one tray of grapes and pears, two jars of partially used orange marmalade, three canisters of coffee, two pitchers of apple and orange juice, sugar packets and tea bags. The locker was not construction for storage of food items. Additionally, there was one bag of garbage containing moldy oranges and another bag of what appeared to be garbage from a cabin. The pastries, fruit, and juice were stored on the same shelf as several chemicals.
There was cleaning equipment such as brooms and dustpans stored in this locker.
The pastries, fruit, and juice were stored on the same shelf as several chemicals. Single-use items, equipment and utensils were also stored in this locker. The chemicals included an unlabeled spray bottle of bleach, and one large bottle each of shampoo, body wash, and rust remover.
The storage unit containing the food and single service items in this locker had difficult to clean features.
Food items including water, soda, and a large bag and small bowl of chocolate were stored in a storage unit in this locker. The locker was not constructed for storage of food items.
The deckhead was unfinished and had difficult to clean features. There was no coving at the deck/bulkhead juncture to the left of the entry door. Food and food utensils were stored in this locker.
Clean ice tongs were stored on the top shelf of the storage unit in this locker. The locker was not constructed for storage of food utensils.
A bottle of body wash, shampoo, a bottle of cleaning solution, cleaning equipment and linens were stored on the deck. Food and food utensils were also stored in this locker.
The storage unit that contained food and food utensils had difficult to clean features.
Voyage 2011 06 04 201 (06/04-11/2011) standardized gastrointestinal illness (GI) report was submitted with inaccurate passenger and crew illness totals. The GI report included 3 ill passengers and 1 ill crew members with reportable GI symptoms but the medical log indicated 1 ill passenger and 3 ill crew with reportable GI symptoms. Voyage 2011 06 18 007 (06/18-25/2011) standardized gastrointestinal illness report was submitted with an inaccurate passenger illness total. The GI report included 7 passengers were ill with reportable GI symptoms but the medical log indicated 8 ill passengers with reportable GI symptoms. The medical staff reported that this may be a computer system error since the illness reports are generated automatically from the medical log entries.
On the open deck adjacent to the bar counter, a frozen soft drink dispenser's stainless steel cabinet was in poor repair from corrosion. Rust was dripping on beverage piping and on the support stand that held the beverage concentrate, water supply container, and waste container. The back louvered panel had numerous rust spots. The seam between the beverage dispending unit and the ingredient cabinet had sealant in poor repair and was difficult to clean.
The frozen soft drink dispenser cited above had old beverage residue in the difficult to clean sealant between the beverage dispensing unit and the ingredient cabinet stand. Rust stains were observed on ingredient hoses where it had dripped from the dispensing unit cabinet.
The frozen soft drink dispensing machine's cleaning procedures were specified by the staff to be done daily per manufacturer's recommendations. The manufacturer's manual only specifies 'wash all external surfaces' but did not provide the instructions for cleaning food contact surfaces. Of particular concern was the system's use of large refillable plastic water carboys, piping and pump used in lieu of the manufacturer's specified plumbed water supply.
On both sides of the back bar counter secure liquor bottle storage area, the closeable security grill guide channels were soiled with dust and debris.
A rack of clean glasses (marked by a tag as clean) was on the soiled glassware landing. A partially-filled rack of glasses identified by the staff as soiled had been placed on this rack of clean glasses. Racks of clean glassware on the deckstand were subject to contamination by soiled glassware coming to the soiled landing area. Staff moved racks of clean glasses from soiled landing and deckstand area during inspection.
The paper towel dispensers of several handwash stations including in the Lido Aft Deli, Lido Grill Galley, Pizzeria Pantry, Main Galley Tina Room, Main Galley Bakery, and Staff Mess were soiled with a dry material that appeared to be old food residue at the opening where the towels are dispensed.
The plastic container with individually wrapped margarine and butter was soiled at the edges with what appeared to be melted butter or margarine. The plastic container was taken out for cleaning during the inspection.
The door curtain dividing the galley from the pantry was soiled with a material that appeared to be old food residue. This area was previously cleaned and not in operation at the time of the inspection.
There were finger tracings in the semolina flour that was stored in a covered container. There was a scoop on top of the container.
There were no signs advising users to wash their hands after using the toilet in the toilet rooms for galley workers at the Lido and Crew Galleys.
The deck was soiled with green and black materials that appeared to be mold in the left corner below the undercounter refrigerator #3MG-14 .
There was a wet wiping cloth on the deck inside the walk-in cooler. The cloth was removed.
There was a small amount of orange colored material on the left wall of the crushed ice bin. The material appeared to be food residue. This was corrected during the inspection.
The spray hoses at the manual pre-wash areas in all of the main galley dishwash areas were soiled with what appeared to be old food residue. The only area actively using the spray hoses was in the starboard dishwash area of the main galley.
During the active use of the flight-type conveyor warewash machine, the surfaces below the conveyor were soiled with food debris in the rinse compartment, final rinse compartment and clean end of the machine.
The flight-type conveyor warewash machine in this area was not in use at the time of the inspection. According to staff, the warewash machine had been out of order since the previous day. However, the surfaces under the conveyor extending from the soiled end to the clean end along with the curtains were heavily soiled with food debris. In addition, the staff showed the inspector a work order for this machine, but it was from May 2011.
The dishwash area was in active use and the handwash station was blocked by two big trash bins. An employee was observed struggling to reach and use the handwash station. The trash bins were moved.
The deckhead mounted smoke detector was soiled with a black material that appeared to be mold.
There were loose and protruding cloth fibers from the food contact surfaces of the woven dough sheeter belt.
The deckhead mounted smoke detector was soiled with a black material that appeared to be mold. There was a deckhead plug missing, which caused the insulation to be exposed. In addition, the hinges of the walk-in cooler door were soiled with a brown residue.
The flight-type conveyor warewash machine in this area was not in use at the time of the inspection but was used the previous day. The warewash machine and surrounding area were previously cleaned. However, there was food debris on the soiled end of the machine and on the curtains at the soiled and clean ends.
The handwash station was soiled with a black material around the faucet.
The flight-type conveyor glasswash machine in this area was not in use at the time of the inspection but was last used the previous day. The machine and the surrounding area were previously cleaned. However, there were food remnants under the conveyor extending from the soiled end to the clean end and on the upper spray nozzles.
The previously cleaned bread slicer was slightly soiled on the nonfood-contact surfaces.
The faucet next to soup kettle #10 was continuously leaking.
The utility sink faucet at the food preparation counter was continuously leaking.
The handwash station between the food preparation counter and the warewash machine had its waste receptacle blocked by the clean end of the flight-type warewash machine. This was corrected during the inspection.
The right plate lowerator was soiled with a green residue at one of the rods that touch the plates. There were plates inside the lowerator but no plates were noted as soiled.
During the active use of the flight-type glasswash machine, there was condensation collecting on the deckhead at the middle of the machine.
The list of food employees in the StarDocs system did not include the chief refrigeration engineer, the fitter refrigeration worker, or the assistant refrigeration worker. These individuals work on the ice machines and should be included on the food worker list. Corporate was notified in June/July 2010 to revise the list.
The deck between the scupper drains and the bulkhead was soiled. This area had been previously cleaned and was not open at the time of the inspection. This was corrected.
The deck between the scupper drains and the bulkhead, as well as the open decks in this area were soiled. This area had been previously cleaned and was not open at the time of the inspection. This was corrected.
There was a leak in one of the small ventilation hood drain lines. Liquid was dripping onto the worker and the deck at the soiled end of the conveyor dishwash machine.
The deck between the scupper drains and the bulkhead, as well as the scupper drain were soiled. This area had been previously cleaned and was not open at the time of the inspection. This was corrected.
The deck below the speedrail was soiled with mold. This area had been previously cleaned and was not open at the time of the inspection. This was corrected.
There was a small amount of mold on the lower left side of the cuber frame just above the water bath. This was corrected.
The food splash zone of the previously cleaned table top mixer was lightly soiled. This was corrected.
The plastic cups were coming out of the clean end lying sideways or upright and full of water.
There was an open case of heavily soiled cans of grapefruit juice. The staff stated the box and its contents were meant to be discarded.
A broom was stored on the deck under the deck stand. This was corrected.
There was a hole in the deckhead. It appeared a plug was missing.
There were no disposable gloves or sanitary wipes in the children's toilet rooms.
There was no airtight, washable waste receptacle in the children's toilet rooms.
The soap dispenser to the handwash station was resting on a nearby counter, preventing easy access.
The floor of the undercounter liquor cabinet was soiled.
The handwash station faucet handle was soiled. The bar was open at the time of the inspection.
The medical staff had a list of food employees. The list did not include the chief refrigeration engineer, the fitter refrigeration worker, or the assistant refrigeration worker. These individuals work on the ice machines and should be included on the list.
There was corrosion on a line on the food waste unit under the soiled side ramp near the black valve.
There were two boxes of raw peanuts that were not tightly sealed after opening.
There was foam in the final rinse section of the dishwash machine. This was corrected.
It appeared that there was a missing panel in the upper section of the microwave. The area around the fans had holes, gaps and other difficult to clean features.
The ice cream cones were placed in a pan with a lid and not under the sneeze guard. There were no serving utensils for the cones.
A colander with spaghetti was placed on the deck sink grate and not a deck stand.
The bottom area of the shelving legs had holes and gaps, making cleaning difficult.
The deck under the shelving legs was soiled.
The deck/bulkhead juncture was not coved.
There was an open channel in the door frame where the locking pin area was not closed. This was also noted in the staff mess.
There was a section of missing coving next to the ice cream machine.
There were rough painted plywood panels that were used as guards on the sides of the shelving units.
A waste receptacle was not provided at the handwash station on the soiled end.
A table that was said to be used for staging plates was placed under a bulkhead mounted fly trap.
A large platter of cup cakes were not covered in the walk-in refrigeration unit.
Trolleys with clean plates were staged under the hood cleaning cabinets.
There was a small locker that was used to store bottles of liquor. The bulkhead was not finished and was made of lagging. There was exposed electrical lines and ductwork in this room. There was a gap between the deck and the bulkhead. These features made cleaning difficult.
There was a locker next to walk-in refrigeration unit "Room 53" that had an excessive amount of equipment creating harborage conditions. Some of this equipment included soiled pizza baking pans.
The deck/counter junctures at the waiter stations were not coved.
The drip pan housings for the grills were soiled with old grease. These areas were previously cleaned.
There was steam escaping from the door of the right combination oven due to a faulty seal. Per staff, a technician from the manufacturer will be onboard this week to correct the problem.
There was condensate collecting on the deckhead above the right combination oven.
The juncture of the stainless steel bulkhead and the metal coving behind the steam kettles was rusted where the two metals met. It appeared that the two dissimilar metals were causing the corrosion.
The cutting board at the carving station was rough around the edges and at the corners.
There were unsealed openings around the drain lines for the two water grills and the deep fryer.
The front edges of the wine display racks were made of unfinished wood.
The production date and discard date were the same on a few products inside the walk-in cooler.
At the end of the final rinse cycle, there was a soapy residue on the inspector's thermometer inside the potwash machine. There was also an excessive amount of soap leaking from the potwash machine.
The stainless steel around the water pipe for the vegetable cooker was peeling.
The fasteners inside the oven next to the combination oven were corroded.
There was an open seam along the bulkhead and technical compartment juncture for the left tilting kettle.
The door for the juice machine was damaged.
The hot food time control plan stated hot foods placed inside refrigeration units were on time control and discarded after 4 hours. Per staff, the hot foods were not placed inside the refrigeration units but onto the service line. The plan also stated that the alto-shams were on time control. Per staff, the alto-shams were on temperature control. This was corrected.
There was an unfinished wooden crate used as a storage container.
There were containers of cut romaine lettuce that did not have discard labels inside the walk-in cooler. Cut leafy greens are considered potentially hazardous foods.
There was water dripping from the deckhead above the clean landing of the potwash machine onto the deck.
The hot food time control plan stated that alto-shams were on time control. Per staff, these units were on temperature control.
There was a container of potato salad inside the walk-in cooler with a production date of 2/20 and a discard date of 2/22. A review of the cooling logs indicated that the potatoes were cooked and cooled on 2/19. The production date should have been 2/19.
In the afternoon of 2/15, a crew member with gastrointestinal illness was seen by the medical staff. The cabin mate was interviewed by medical staff in the afternoon of 2/16.
On 1/24, a junior refrigeration engineer had gastrointestinal illness and was seen by the medical staff. The engineer was isolated for 24 hours. When questioned, the medical staff stated he worked on ice machines. Staff were unaware that employees who work on ice machines are considered food employee and should be isolated for 48 hours. Medical staff had a list of all food employees. This list did not include workers from the engineer department who work on food equipment.
Deficiencies (found in 15 inspections).
Violence between family members aboard ship. Capias filed by Port Canaveral Police Department with State Attorney's Office. FBI declined investigation and USCG inspector requested copy of report but declined to investigate.
Mutual combatants, neither party wanted to press charges. No injuries, no prosecution desired.
Occurred in international waters between passengers. No injuries, no prosecution.
Between passengers in the casino while in international waters. Case referred to the FBI.
Between passenger and crew member, incident took place during the safety drill. Incident occurred while in Port. Capias was filed on crew member - State Attorney declined to proceed with criminal charges.
X was working to replace the shaft seal on the high temperature cooling water valve (3 way valve) to DG# 1 when hot water was expelled from the valve.
Possible theft of rings from safe. Carnival security located the rings intact.
informed that today at approx. 10:45 am I have been advice by the Captain of the Carnival Dream that while the vessel was in Roatan – Honduras, a serious incident occurred where the wire rope of the STBD side Rescue boat # 1 broke while the boat was being hoisted, roughly at the top of the crane, just before entering in the rigging position, however it is not confirm, consequently the rescue boat fall in the water with 4 persons on board. The distance between the water and the rescue boat at the time of the fall was about 8 meters.
29 May 12: Passenger onboard CARNIVAL DREAM fell down the stairs for unknown reason. Passenger suffered broken rib on the right side and hit her head with loss of consciousness. Passenger was taken ashore by tender for evaluation and care. Passenger returned to the ship and continued the cruise.
On 11 Nov 2011, the Sec Miami Command Center received a faxed CG-2692 from the CARNIVAL DREAM indicating that a passenger had been injured on board while walking on the Lido deck. Report indicated that passenger caught her left foot on a deck chair while she was walking, which caused her to slip and fall. Passenger sustained a fracture to her left shoulder. On 8 November, the passenger disembarked to seek orthopedic medical care in St. Thomas and then chose to discontinue her cruise to seek medical attention (surgery) in the U.S.).
An male passenger was in his cabin complaining that he was having a difficult time breathing. The medical team responded and the pax was taken to the ship's medical center for further evaluation. The passenger was diagnosed with Pneumonia. Arrangements were made for a Medevac, and the pax was safely taken off the Carnival Dream by a USCG small boat, met by local EMS and taken to Lawnwood Medical Hospital.. Level of investigation downgraded from informal to data collection because the casualty occurred due to a pre-existing medical condition.
On 9 Aug 2011, Sector Miami was notified via CG-2692 that on 08Aug 2011, a passenger on the CARNIVAL DREAM had sustained an injury to his eye that required medical attention beyond first air. Passenger was disembarked and taken to a shore side hospital to further medical treatment. No drug or alcohol test were conducted on crewmembers of the CARNIVAL DREAM as no action or inaction by the crew was a causal factor in the passenger sustaining his injury.
SECTOR KEY WEST received notification from Cruise Ship CARNIVAL DREAM, a crewmember experienced paralysis on the right side of his face, slurred speech, vomiting, and became disoriented. The crewmember was disembarked via USCG cutter and transferred to EMS shoreside, where he was transferred to Fisherman's Hospital in Marathon, FL. The crewmember suffered from a medically related illness.
Received a CG-2692 (Report of Marine Accident, Injury or Death) from the cruise ship CARNIVAL DREAM notifying of the death of a female. Medical documentation showed that the female had a prior existing medical condition (terminal breast cancer) and was given 2 weeks to 2 months to live prior to boarding cruise with family. Investigation downgraded from informal to data collection.


AXARQUÍA (MALAGA): Situated in a quiet cul de sac, this self contained detached villa is divided into two units, each with their own separate entrances, Wifi, Freesat TV, DVD.
Upstairs comprises 3 bedrooms (2 doubles, 1twin) kitchen, lounge/diner leading to balcony with spectacular mountain views to enjoy whilst relaxing and dining alfresco, a patio area and stairs leading down to poolside terraces.
Downstairs has two bedrooms (1 double, 1 twin), bathroom, lounge kitchen/diner opening to the covered terrace with comfortable rattan sofa, dining table and gas BBQ to fully enjoy the lovely balmy Mediterranean nights As evening falls, looking over the valley and beyond to the mountains, experience some of the most glorious sunsets in the costa del sol.
This flexible property can be enjoyed by couples seeking romantic solitude, groups of friends or families who can all holiday together, yet enjoy privacy in separate accommodation.


hd00:15A slow motion telephoto shot of a baby deer doe following it's mother through a picnic area in the Mammoth Cave National Park in Kentucky on a beautiful summer day with green grass, trees & sunshine.
hd00:27Moose. Elk. Female with a calf.
4k00:19On the farm from the pen for a walk released a beautiful, well-groomed herd of cows (brown), beautiful filming from the side, on background of gras and trees, concept: ecology, livestock, bio.
4k00:19A herd of white tail deer in an open meadow on a summer day.


Talking Autism Spectrum Disorder and Medical Marijuana; Using an "inside-out" rather than an "outside-in" approach may help gain legitimacy in the larger Autism community.
the Autism Society website reveals NO results for marijuana (as if curious parents could not just go to Dr. Google to find information) and Autism Speaks has a somewhat informative but skeptical article, advising parents that there is not enough research to make a medically sound choice. There is a host of parent Facebook groups, like Mothers Advocating Medical Marijuana for Autism (MAMMA), are leading the charge by posting hundreds of accounts of success using cannabis. YouTube has 66,000 hits of people illustrating or discussing how marijuana use has helped. Perhaps if we talk about marijuana or marijuana use in a different way, we can get traction in the larger community and assist those who need it most.
Unhook treatment of ASD from the 'drug war' stigma that still colors the discussion among autism advocates.
Put emphasis on research of the ECS system, including nutritional, environmental, and developmental aspects of the ECS and autism. Opening up a large area of investigation that is closed off if one uses the "outside in" argument of cannabis advocates.
Use the term "your body's marijuana" to describe anandamide and 2-AG. Most people let down their guard when they find out their body makes similar compounds to those discovered in the cannabis plant. Explain that the key to alleviating ASD symptoms is to first facilitate the production of our body's marijuana before giving the patients the real thing.
Address cannabis or CBD use after discussing the other options mentioned above. This framework allows the person to integrate cannabis use into a wider spectrum of treatment for Autism and also contextualizes the treatment regarding the human body and brain rather than focusing on a historically demonized plant.


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Meon Hall
Pound Lane
Meonstoke, Nr Southampton, Hampshire SO32 3NP United Kingdom Get Directions
www.mindfulnesshampshire.co.uk
February 13, 2023 @ 9:30 am - 12:00 pm Recurring
Monthly Practice Support Groups, In person, with Ali Lambie
Meon Hall Pound Lane, Meonstoke, Nr Southampton, Hampshire
Establishing a regular formal mindfulness practice is often regarded the most difficult aspect of undertaking mindfulness training. And interestingly research also shows us it is the most beneficial thing as […]
March 13, 2023 @ 9:30 am - 12:00 pm Recurring
One day retreat, in person, with Ali Lambie
This day provides the opportunity to 'retreat' in a positive sense from the busyness of everyday life – to experience a range of guided practices throughout the day in a […]
April 17, 2023 @ 9:30 am - 12:00 pm Recurring
May 22, 2023 @ 9:30 am - 12:00 pm Recurring
June 19, 2023 @ 9:30 am - 12:00 pm Recurring
July 17, 2023 @ 9:30 am - 12:00 pm Recurring

redpajama_set_name: RedPajamaCommonCrawl


text:
Business HQ Companies Business Markets Climate People STEM Entrepreneur Future of Education
Hotel giant reveals plans for new Glasgow venture
Hilton reveals plans for new Glasgow hotel on Clydeside
Exclusive by Scott Wright Deputy Business Editor
The Motto by Hilton in Glasgow will be first in UK
By Scott Wright
HILTON has underlined its confidence in the future of business and leisure travel in Glasgow as it revealed plans to open a new hotel on Clydeside – and it will be the first in the UK to trade under its new Motto brand.
The hotel giant, which has had a presence in Glasgow for more than 30 years, expects to open a 186-room Motto by Hilton in autumn 2024, taking its tally of hotels in the city to eight operating under four different brands. It will be just the second Motto by Hilton to be confirmed in Europe, following its debut at a hotel in Rotterdam that launched earlier this week.
The Glasgow hotel will be part of a franchise agreement with Cycas Hospitality, a pan-European hospitality management company. The building itself will be developed by Silk Property Group, the London-based real estate firm which is also building Virgin Hotel as part of the same development.
The Hilton by Motto will be located on the corner of Clyde Street and Maxwell Street.
Steve Cassidy, Hilton managing director for the UK and Ireland, told The Herald: "We see great potential in the local market and the vibrant area around St Enoch Square and Merchant City presents a perfect opportunity to welcome our guests to a new area outside of the west end and the SEC (Scottish Event Campus).
"It's been great to see Glasgow's work to transform itself into a world-class tourist destination and business hub. The city's hosting of high-profile global sporting events has cemented its status. And, of course, last year's COP26 elevated the city further and established it as the nation's sustainable business hub. Our hotels were proud to host guests and events for COP26, and we've found the legacy from the event to the local area has been significant.
"Glasgow's focus on sustainable tourism and business in particular strongly resonates with us at Hilton because this is a priority for us and our guests, who have shown they want to do business with companies which share their values. This is the case with leisure and business guests alike, who have told us clearly that they want to know this is something we prioritise."
Asked to comment on current trading, Mr Cassidy added: "Across Scotland we've enjoyed a strong summer, exceeding our expectations. Trade has been led not only by domestic visitors but also a significant growth in international travellers, especially coming from the US. The return of international events including the Scottish Open have increased this draw for tourist trips – and it's been a great year for the city in terms of entertainment and sporting events with many big names, concerts and tournaments. Our hotel's performance – especially around such key events and the summer – has given us further confidence as we look ahead to next year and beyond."
Hilton describes Motto as an "urban lifestyle brand designed to help guests live like a local in prime locations globally", providing guests with "one-of-a-kind experiences by bringing together the best elements of a lifestyle hotel".
The interior of the Clydeside hotel will incorporate "distinctive" Glaswegian architectural styles, Hilton noted, with references to Charles Rennie Mackintosh and Art Nouveau. Visitors can expect locally inspired food and drink menus, with flexible accommodation options such as connecting rooms.
Rishi Singh of Silk Property Group said: "The forthcoming Motto by Hilton Glasgow is an incredibly exciting addition to the city. We're delighted to be working...with the team at Cycas Hospitality, using their impressive experience as a pan-European hotel company to launch this new concept on the Scottish market."
Patrick Fitzgibbon, Hilton's senior vice president of development for Europe, the Middle East and Africa, said: "We are excited about the arrival of the Motto by Hilton brand in the UK. The hotel will cater to a range of guests, whether travelling for work or play, solo or in a group. It will give guests the freedom and flexibility to customise their stay in this celebrated Scottish city – and will pave the way for future properties in the UK as we grow the Motto by Hilton brand into vibrant city locations."


The cosmetic formulas are always developed to guarantee the best skin care effects. Uttermost care is always taken to safeguard the highest quality of our cosmetics, which are always effective, efficient and safe. Cosmetics are tested by experts in dermatology.
BIELENDA respects the laws of the nature and therefore none of its products are tested on animals. In fact, Bielenda goes a step further and expects its partners and suppliers to follow the same rule.
When environmental issues are at stake, Bielenda follows an international environmental management standard ISO 14001 aimed at minimizing environmental impact, and is a proud holder of the ISO 14001 Certificate.
ISO 14001 addresses the questions of natural resources, waste waters, industrial waste and energy consumption.
The awarded certificate is a proof of compliance with the applicable environmental protection regulations.
Bielenda is environmentally aware at each and every stage of manufacture and distribution.


Environmental law solicitors at Hugh James is specialist land compensation lawyers who represent residents under Part 1 of the Land Compensation Act 1973.
Public works include any work on roads and highways, airports and any other works on land provided, or used in the exercise, of statutory powers, including changes of use.
The typical example of public works in relation to road developments could include the widening of existing roads, the provision of an additional carriageway and a new motorway lighting schemes. In the case of airport expansions and development, as well as the construction of new runways, public works include extending or substantially realigning existing runways or taxiways or the addition of new or extended aprons.
What are the physical factors of public works?
The Land Compensation Act defines the physical factors as noise, vibration, smell, fumes, smoke, artificial lighting and the discharge of any solid or liquid matter onto a local resident's property.
In the case of new or widened roads, the majority of claims our land compensation solicitors have dealt with the result from an increase in noise levels, although we are aware that other physical factors may also be apparent. Artificial light, both from vehicle headlights and street lighting, can cause considerable nuisance and can result in a diminution in value, especially in rural areas where, previously, there was no light interference.
When should I make a claim under the Land Compensation Act?
There are time limits for making a claim under the Land Compensation Act and a complex array of statutory provisions also apply. If you believe that you may have a claim under the Land Compensation Act, we recommend that you seek legal advice as soon as possible.
How will the compensation be assessed?
Compensation for a claim under the Land Compensation Act is assessed in relation to the property value and the loss and disruption caused by the physical factors listed above.
Do I need to instruct a Land Compensation Act solicitor?
Disputes concerning Part I of the act claims are determined by the Lands Tribunal which is a Court of Law. We, therefore, recommend that solicitors are appointed.
If you are affected by a scheme of public works and you would like more information in relation to pursuing a claim under Part 1 of the Land Compensation Act please contact us by completing our enquiry form.
At Hugh James solicitors we appreciate that it is often difficult to fund legal actions and so when possible and appropriate our environmental law solicitors are able to offer free initial specialist environmental law advice about starting a legal challenge.
Our skilled and experienced environmental law solicitors have handled many thousands of claims under the Land Compensation Act 1973 and we can arrange to deal with suitable claims on a no win, no fee basis.


L-Tyrosine is an ingredient that is found in certain weight loss and diet supplements. It is frequently chosen due to the benefits that it has the potential to provide dieters who use it in conjunction with the appropriate form of healthy eating and exercising habits. Moreover, many product manufacturers appreciate the growing body of research that has been conducted on this substance and the clinical trials that suggest that it can be helpful in overcoming often overlooked dieting issues.
Primarily, L-Tyrosine is a substance that has been found to enhance certain functions within the brain. The outcome of that effect can be a reduction in anxiety and stress, as well as easing the symptoms of depression. This occurs through an increase in the dopamine and norepinephrine levels in the brain. In this sense, this ingredient can help a dieter to overcome some of the struggles that can be associated with dieting on a mental and emotional level. Depression and stress are frequently linked with the effort to lose weight, as this is a challenging, long-term process that involves lifestyle changes in varying degrees. Giving a dieter mood support and improved overall motivation can be very helpful in ensuring that a dieting goal is reached.
That said, some smaller and more limited studies have suggested that L-Tyrosine could help to promote thermogenesis in the body. While that research is only preliminary, by increasing the body temperature, it will naturally burn more fats and calories as heat. This can be particularly effective when it is combined with cardio exercise, which already raises the temperature and fat burning rate of the body. The idea is that it can enhance the results that would already be achieved through proper workouts.
Another study that looked into L-Tyrosine was called "Body fat loss achieved by stimulation of thermogenesis by a combination of bioactive food ingredients: a placebo-controlled, double-blind 8-week intervention in obese subjects." It was published in 2007 in the International Journal of Obesity and it found that when compared to participants who were given a placebo, people who used this ingredient experienced a measurable increase in thermogenesis for a period of four hours.


New research adds to evidence that vitamin D deficiency is associated with MS. Does that mean vitamin D supplementation could prevent the disease?
People at high risk for MS may want to consider taking vitamin D supplements.
Going back to at least the 1960s, researchers have noticed something interesting about the distribution of multiple sclerosis (MS): The disease is uncommon close to the equator, where sunlight is most abundant. At higher latitudes, where the sun shines for less time and at a lower intensity, the prevalence of MS increases.
Since sunlight is a necessary ingredient for the synthesis of vitamin D in the skin, the hypothesis that vitamin D deficiency may increase a person's risk of developing MS was born. New research adds support for this idea, but many questions remain.
Does Vitamin D Play a Role in Prevention of MS?
A study published in October 2017 in the journal Neurology adds to evidence that vitamin D deficiency may increase a person's risk of developing multiple sclerosis, even many years later. The study focused on a large group of Finnish women who gave blood samples early in pregnancy between 1983 and 2009. The researchers identified 1,092 women who were eventually diagnosed with MS, on average nine years after their blood samples were drawn. They compared the vitamin D levels in their stored blood samples to those of women who didn't develop MS.
In the study, vitamin D deficiency was more common in the MS group, affecting 58 percent of women who eventually developed MS compared with 52 percent of women who did not. The researchers calculated that women with deficient vitamin D blood levels (defined as less than 30 nanomoles per liter [nmol/l]) had a 43 percent higher risk of developing MS compared with those with adequate levels (at least 50 nmol/l). Vitamin D deficiency was common in this group of women, particularly before 2004, when Finland first started recommending that pregnant women take a vitamin D supplement.
The study's lead author, Kassandra Munger, a doctor of science in nutritional epidemiology and a research scientist at Harvard T.H. Chan School of Public Health in Boston, says that the results of this study and others show a clear pattern. "If your levels are low, your risk is high, and as your levels increase, your risk seems to decline," she says.
Previous studies have found similar results, but they were smaller and done in populations with higher average vitamin D levels. For example, another study conducted by Dr. Munger and her colleagues, published in December 2006 in JAMA, found that in U.S. military personnel, high vitamin D levels were associated with a lower risk of MS.
What if Low Vitamin D Is Just Correlated With MS, but Is Not a Cause?
The recent study of Finnish women, as well as previous studies with a similar observational design, can only identify correlations between variables. In other words, they can conclude that people who end up diagnosed with MS are more likely to have had low vitamin D levels earlier in life, but they can't definitively show that low vitamin D played a role in causing MS.
"In epidemiology, we're always concerned about that," says Munger. "Are there alternative explanations, or is something else going on?" For example, perhaps it's not vitamin D specifically, but sun exposure, that affects MS risk.
However, Munger points to recent genetic studies, including one published in April 2017 in the journal Neurology and several more published in the last two years, that show that genes associated with lower vitamin D levels are also associated with an increased risk of multiple sclerosis.
"Those studies have all suggested that there quite likely is a causal relationship between vitamin D and MS, confirming what the observational studies are showing and removing some of that doubt," Munger says.
It's important to note that most of the research on vitamin D and MS risk has focused on non-Hispanic white populations, and it might not apply to people of color, who generally produce less vitamin D in their skin. In fact, the 2006 study of U.S. military personnel found no relationship between vitamin D and MS development in Hispanic or black people, and a recent report from Mexico also found no association in that population.
Low vitamin D is also not the only risk factor identified for MS. "MS is definitely multifactorial," says Sharon Stoll, DO, an assistant professor of neurology at the Yale School of Medicine in New Haven, Connecticut, citing other known risk factors like smoking and infection with Epstein-Barr virus.
Could Vitamin D Supplementation Prevent MS?
The answer to this question isn't certain, but an editorial accompanying the study of Finnish women says it's worth considering.
"It is time to take an active approach to preventing MS, at a minimum targeting those individuals with an elevated risk of MS, including smokers, the obese, and those with a family history of MS," write Ruth Ann Marrie, MD, PhD, a professor of neurology at the University of Manitoba Max Rady College of Medicine in Winnipeg, and Christopher A. Beck, PhD, as associate professor of biostatistics and orthopedics at the University of Rochester Medical Center in Rochester, New York.
But as the editorial notes, there are still many questions about who should take vitamin D and in what doses. Current U.S. nutritional guidelines, developed by the National Academy of Sciences Institute of Medicine, recommend that most people consume 600 IU of vitamin D per day, a figure based on the amount needed for bone health. Good dietary sources of vitamin D include fatty fish, fortified dairy products, and other fortified foods like orange juice, but many people don't eat enough of these foods to meet the vitamin D requirement without a supplement.
The Institute of Medicine guidelines also say that vitamin D blood levels of 50 nmol/l are adequate for most people, but Munger says higher levels may be required for MS prevention.
"To get to a level of 75 to 100 nmol/l — where we see a decrease in risk — most people would need 1,000 IU per day," she says.
That amount is well within the safe range of vitamin D supplementation. The Institute of Medicine recommends not taking more than 4,000 IU of vitamin D per day, as the vitamin can be toxic in high doses, causing adverse effects like cardiovascular and kidney damage.
"People who are at high risk for MS, like first-degree relatives, for example, of someone with MS, may want to ensure that their vitamin D levels are adequate, that they're taking a supplement or that they're having responsible, judicious sun exposure, because we know that there are also risks with that as well," says Munger.


While currently acting as Musical Director for Allman and recently recording Gregg's new album in Muscle Shoals, he simultaneously concentrates on his solo act, Scott Sharrard and the Brickyard Band. They released their self titled debut in 2012 and embarked on a national tour soon after. Currently, a new solo album has been recorded at Fame & Electrophonic Studios and the future release date will be announced soon.
Beecher's Fault hails from beautiful Astoria, New York. The leaders of the band, Ken Lamken and Ben Taylor, met in New Jersey a few years back before they booked it to NYC to seek out the limelight after realizing their musical compatibility. Max Maples (drums), Serge Ruccolo (Bass) and Lauren Hunt (backing vocals) now complete the quintet that has been said to have live performances that produce a "wall of sound" complemented by "raw, honest lyrics" and "pristine vocal harmonies".