PHARMACY STAFFING PHARMACY STAFF PRESENT AT TIME OF INSPECTION PHARMACISTS LICENSE# CURRENT? EXP. DATE 1 YES NO □ □ 2 YES NO □ □ 3 YES NO □ □ 4 YES NO □ □ 5 YES NO □ □ 6 YES NO □ □ PHARMACY INTERNS LICENSE# CURRENT? EXP. DATE 1 YES NO □ □ 2 YES NO □ □ 3 YES NO □ □ PHARMACY TECHNICIANS CERTIFIED? LICENSE# CURRENT? EXP. DATE 1 YES NO YES NO □ □ □ □ 2 YES NO YES NO □ □ □ □ 3 YES NO YES NO □ □ □ □ 4 YES NO YES NO □ □ □ □ 5 YES NO YES NO □ □ □ □ 6 YES NO YES NO □ □ □ □ 7 YES NO YES NO □ □ □ □ 8 YES NO YES NO □ □ □ □ 9 YES NO YES NO □ □ □ □ 10 YES NO YES NO □ □ □ □ OTHER PHARMACY STAFF including trainees POSITION TRAINEE HOURS 1 2 3
PHARMACY STAFFING PHARMACY STAFF PRESENT AT TIME OF INSPECTION PHARMACISTS LICENSE# CURRENT? EXP. DATE 1 □ YES □ NO 2 □ YES □ NO 3 □ YES □ NO 4 □ YES □ NO 5 □ YES □ NO 6 □ YES □ NO PHARMACY INTERNS LICENSE# CURRENT? EXP. DATE 1 □ YES □ NO 2 □ YES □ NO 3 □ YES □ NO PHARMACY TECHNICIANS CERTIFIED? LICENSE# CURRENT? EXP. DATE 1 □ YES □ NO □ YES □ NO 2 □ YES □ NO □ YES □ NO 3 □ YES □ NO □ YES □ NO 4 □ YES □ NO □ YES □ NO 5 □ YES □ NO □ YES □ NO 6 □ YES □ NO □ YES □ NO 7 □ YES □ NO □ YES □ NO 8 □ YES □ NO □ YES □ NO 9 □ YES □ NO □ YES □ NO 10 □ YES □ NO □ YES □ NO OTHER PHARMACY STAFF including trainees POSITION TRAINEE HOURS 1 2 3
compliance-inspection-tool.docx