Transcription of Inspection Form - OCPInfo.com
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Inspection FormDPP InformationName of DPP OwnerName of DPP (if different from owner's name)DPP Designated MemberDesignated Member EmailDesignated Member Phone numberStreetCityPostal CodePhone NumberFax NumberPharmacy Hours (Weekday)Pharmacy Hours (Weekends and Holidays) Inspection InformationLast Inspection DateCurrent Inspection DateFirst InspectionType of InspectionRe InspectionStaff InformationName of Pharmacy StaffRoleOCP NumberService InformationType of CompoundingOther ServicesNon Sterile PreparationsPre packing/RepackagingHazourdous Sterile PreparationsDirect delivery to patientNon Hazourdous Sterile PreparationsDelivery to other organizationsOCP DPP Assessment CriteriaV2 (updated February 2017 )Page 1 of 31 ExtemporaneousBatch/Bulk (Non prescription)List of organizations that regularly receive products prepared by this DPPA dditional InformationOCP DPP Assessment CriteriaV2 (updated February 2017 )Page 2 of 31A.
A. Systems to Provide Safe Category Meet Partially Meet Do Not Meet N/A Criteria # Criteria Statement Comments References A.3 SECURITY 23 All medication storage areas are secured and protected by locked doors or similar secure barriers within DPP.
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