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ADHS INSPECTION REPORTING FORM
ADHS INSPECTION REPORTING FORM
Joe Baldwin

ADHS INSPECTION REPORTING FORM

Please take notes during your inspection with ADHS. Following your inspection, use this form to submit a Compliance Inspection Report to the Compliance Department. This will remain confidential with the Compliance Department and Arizona leadership.

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Free ADHS INSPECTION REPORTING FORM Checklist

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ADHS INSPECTION REPORTING FORM

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Dispensary Site

  • Was the dispensary clean and in good repair? <br><br>E.g., no holes in walls, missing ceiling tiles, dirty dishes, litter in and around the dispensary, hot water, paper towels, soap dispensers, operational televisions, computers, and ordering devices, clean floors, etc.

  • Provide explanation and images here:

  • Was the handwashing sink inspected?

  • List any issues with the handwashing sink

  • Were any maintenance logs inspected? <br><br>(If yes, upload a copy of the maintenance log inspected below)

  • Were store licenses inspected? <br><br>Including, but not limited to, business licenses, tax licenses, cannabis licenses, etc.

  • Were there any issues with the licenses, including but not limited to, expired license, inaccurate license, etc. <br><br>(If yes, upload image and description of license below)

  • Was store signage inspected?

  • Any issues with the signage? <br><br>(If yes, upload an image of the signage and provide description of the issue below)

  • Any issues with doors, windows, or locks?

  • Provide explanation and image below:

  • Did ADHS observe a transaction?

  • Were any issues documented with the transaction?

  • Provide explanation here:

  • Was the patient education booklet requested?

  • Were any issues documented with the patient education booklets? <br><br>(If yes, provide explanation and image of the issue below)

  • Were the store's policies and procedures inspected?

  • List any notes, questions, or issues from the policies and procedures inspection

Security

  • Were any cameras inspected?

  • Were there any issues identified with your cameras, including but not limited to, blind spots, cameras offline, cameras failing to record for at least 30 days, no lighting facilitating surveillance, blurry vision, no time or date stamp on camera image, frozen cameras, etc.

  • Provide explanation and images here:

  • Were any alarms tested? <br><br>Including but not limited to, camera surveillance failure audible and visual notification alarm, panic buttons, police pulls, main alarms, etc.

  • List alarms tested:

  • Any documented issues with the alarm(s)?

  • Provide explanation here:

  • Did ADHS check for staff badging?

  • Any documented issues with linking or badging?

  • Provide explanation here:

  • Were key fobs/access control inspected?

  • Provide explanation, including any documented issues, here:

  • Was the store's back-up battery/APS tested?

  • Provide explanation, including any documented issues, here: (E.g., it did not support at least 5 minutes of back up power when tested, didn't know how to test, etc.)

  • Was the store's security floor plan requested?

  • Provide any documented issues with the security floor plan:

  • Were you requested to print an image from a security camera?

  • Any issues printing an image?

Inventory

  • Were any product labels inspected?

  • List the product labels that were inspected, including at least product names and batch numbers.

  • Did inspectors take issue with any product packaging resembling products made for children?

  • List the product packaging your inspector took issue with, including at least product names, batch numbers, and an image of the product(s)

  • Were any QR codes scanned?

  • List the products scanned, including at least product names, batch numbers, and any issues identified while scanning the product QR code.

  • Were trip plans inspected?

  • Provide the date(s) and vendor(s) that were inspected from the trip plans and upload copies of the trip plans inspected:

  • Were any other issues identified as part of the packaging and labeling for any medical or adult use products?

  • Provide explanation and images here:

  • Were any sales/transaction records requested? <br><br>(If yes, please upload a copy of the requested sales records next)

  • Was the quarantine bin inspected?

  • Any issues documented with the quarantine bin items? <br><br>(If yes, provide image and explanation of issue below)

  • Were your destruction records reviewed?

  • Any issues documented with destruction records?

  • Provide explanation here:

  • Were any product CoA's inspected? <br><br>(If yes, upload copies of the CoA's that were inspected below)

  • Were any deficiencies identified with product CoA's?

  • Provide explanation here:

Miscellaneous Reporting

  • Use this space to provide any other information, details, call outs, ADHS requested deliverables, questions, or any other helpful information that will help

ADHS INSPECTION REPORTING FORM
Joe Baldwin

ADHS INSPECTION REPORTING FORM

Please take notes during your inspection with ADHS. Following your inspection, use this form to submit a Compliance Inspection Report to the Compliance Department. This will remain confidential with the Compliance Department and Arizona leadership.

Use this Template
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.

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