1. Telepharmacy Preopening Inspection Digital Evidence
Telepharmacy Information
Teleparmacy Operating Name:
Pharmacy Manager:
Contact Information:
Phone:

2. 1a. External View of the pharmacy (Street view including the external signage)

3. 1b. Hours of Operations sign

4. 1c. Professional products area for Schedule 3 drugs

5. 1d. Lock-and-leave barriers (if the premise is open for business while the pharmacy is closed) or N/A

6. 1e. Signage at 25 feet from dispensary or N/A

7. 1f. “Medication Information” Sign or N/A

8. 1g. Separate Injection Room for iOAT or N/A

9. 2a. Dispensary Area

10. 2b. Gate/door at the entrance into the dispensary

11. 2c. Placeholder for College Licence

12. 2d. Professional Service Area for Schedule 2 drugs

13. 2e. Patient Consultation area

14. 2f. Dispensing counter and service counter

15. 2g. Computer terminals for prescription processing

16. 2h. Shelving

17. 3a. Secure storage space

18. 3b. Locked metal safe or Safe declaration

19. 3c. Security camera system AND surveillance signage

20. 3d. Motion sensors

21. 3e. Monitored alarm or N/A

22. 3f. Physical barriers or N/A

23. 3g. Locked area for sharps containers (for iOAT) or N/A

24. 4a. Double stainless steel sink

25. 4b. Equipment

26. 4c. Equipment (Electronic Recordkeeping) or N/A
Device (e.g. Scanner)
Backed Up Records Storage Area

27. 4d. Equipment (Cold Chain)
Thermometer
Temperature Log

28. 4e. Equipment (Methadone) or N/A

29. 4f. Equipment & Supplies (iOAT) or N/A

30. 4g. References (CPBC)
1. BC Pharmacy Practice Manual
2. ReadLinks

31. 4h. References (General)

32. 4i. References (if applicable) or N/A

33. 5a. Prescription hardcopy (i. e
5a. Prescription hardcopy (i.e. the label/paper attached to the original prescription, which contains prescription information generated after transmitting to PharmaNet)

34. 5b. Marked Prescription (Sample)

35. 6a. Shredder OR Contract with a document destruction company

36. 6b. Offsite storage contract or N/A

37. 7a. Drug receiving area

38. 7b. Drugs

39. 7c. Storage area for non-usable and expired drugs

40. 8a. Prescription Product Label 1. Single-entity product. 2
8a. Prescription Product Label 1. Single-entity product Multiple-entity product

41. 8b. Filling supplies (e.g. vials and bottles including caps)

42. 9a. Name Badge

43. 9b. Policy and Procedure manual – all pages (or email PDF separately)

44. 10a. Tool/ technology enabling direct supervision on dispensary activities

45. 10b. Tool/ technology used for transmitting prescription and personal health information between sites

46. 10c. Tool/ technology used for processing prescriptions at the central pharmacy for prescriptions received at the telepharmacy

47. 10d. Tool/ technology enabling direct supervision on product final check

48. 10e. Tool/ technology enabling direct pharmacists/patient consultation