Results of inspection
 33. (1) After an inspection of a premises, the College shall determine, in accordance with the accepted standards of practice, whether the premises passes, passes with conditions, or fails the inspection. O. Reg. 415/16, s. 1. (2) In determining whether a premises passes, passes with conditions or fails an inspection, the College may consider, (a) the inspection results provided to the College by the inspector; (b) information provided by one or more members who perform or may perform a procedure in the premises respecting the inspection, including the answers given by them in response to inquiries or questions asked by the inspector; (c) the information contained in a notice given by a member under subsection 31 (1) or (3); (d) any submissions made by a member or members practising in the premises that are relevant to the inspection; and (e) any other information that is directly relevant to the inspection of the premises conducted under this Part. O. Reg. 415/16, s. 1. (3) The College shall deliver a report, in writing and in accordance with section 39 of the Regulated Health Professions Act, 1991, to the designated member for the premises, within a reasonable time after the inspection is completed. O. Reg. 415/16, s. 1. (4) Any report made by the College respecting an inspection of a premises where a procedure is or may be performed shall make a finding that the premises passed, passed with conditions, or failed the inspection and shall provide reasons where the premises passed with conditions or failed the inspection. O. Reg. 415/16, s. 1. (5) Any report made by the College that makes a finding that the premises failed an inspection or passed with conditions is effective on the day when the report is received in accordance with section 39 of the Regulated Health Professions Act, 1991, by the designated member for the premises. O. Reg. 415/16, s. 1. (6) The designated member who receives a report made by the College that finds that a premises failed an inspection or passed with conditions shall promptly provide copies of the report to all members who perform or may perform a procedure in the premises. O. Reg. 415/16, s. 1. (7) A member shall not perform a procedure in a premises that fails an inspection until, (a) the College delivers a report, in accordance with section 39 of the Regulated Health Professions Act, 1991, indicating that the premises passed a subsequent inspection, or passed with conditions; or (b) the College substitutes a finding that the premises passed or passed with conditions, after considering the written submissions, if any, under subsection (9). O. Reg. 415/16, s. 1. (8) A member shall not perform a procedure in a premises that passed an inspection with conditions except in accordance with the conditions set out in the report until, (a) the College delivers a report, in accordance with section 39 of the Regulated Health Professions Act, 1991, indicating that the premises passed a subsequent inspection; or (b) the College substitutes a finding that the premises passed the inspection, after considering the written submissions, if any, under subsection (9). O. Reg. 415/16, s. 1. (9) A member may make submissions in writing to the College within 14 days from the day the designated member receives the report under subsection (5). O. Reg. 415/16, s. 1. (10) The College may or may not elect to re-inspect the premises after receiving a member’s written submissions, but no more than 60 days after a member provides his or her written submissions, the College shall do one or more of the following: 1. Confirm its finding that the premises failed the inspection or passed with conditions. 2. Make a report and find that the premises passed with conditions. 3. Make a report and find that the premises passed the inspection. O. Reg. 415/16, s. 1. (11) Premises that fail an inspection or pass with conditions may be subject to one or more further inspections within a reasonable time after the College delivers its report, at the request of a member or any other person to whom the College gave the report, or at any time at the discretion of the College. O. Reg. 415/16, s. 1. (12) Where, as a result of an inspection carried out under this Part, a report made by the College finds that a member’s knowledge, skill or judgment is unsatisfactory, the College may direct the Registrar to refer the report to the Quality Assurance Committee. O. Reg. 415/16, s. 1. (13) Where, as a result of an inspection carried out under this Part, a report made by the College finds that a member may have committed an act of professional misconduct or may be incompetent or incapacitated, the College may direct the Registrar to refer the report to the Inquiries, Complaints and Reports Committee. O. Reg. 415/16, s. 1. Table 1   prescribed Substances that may be Administered by Inhalation Substance   Limitations 

  Acetylcysteine   No limitation specified. 

  Glutathione   No limitation specified. 

  Ipratropium Bromide   Administered to a patient by the member in his or her office only in emergency circumstances. In an emergency, administer a maximum daily dose of 0.5 mg but only after the member has administered Salbutamol to the patient. 

  Salbutamol   Administered to a patient by the member in his or her office only in emergency circumstances. In an emergency, administer a maximum of two doses, each dose 2.5 mg.   

  Saline   No limitation specified. 

  Therapeutic Oxygen   No limitation specified. Table 2    prescribed Substances that may be Administered by Injection Substance   Route of Administration    Limitation 

  Acetylcysteine   Intravenous   Must be in combination with other amino acids. 

  Adenosine triphosphate   Intravenous   No limitation specified. 

  Alanine   Intravenous   Must be in combination with other amino acids. 

  Alpha Lipoic Acid   Intravenous   Maximum daily dose of 600 mg for racemic form or 300 mg for R form. 

  Arginine   Intravenous   Must be in combination with other amino acids. 

  Aspartic Acid   Intravenous   Must be in combination with other amino acids. 

  Atropine   Intravenous   Administered to a patient by the member in his or her office only in emergency circumstances. In an emergency, administer 0.5-1 mg q3-5 min. Dose must be 0.5 mg or higher but must not exceed 2 mg.   

  Biotin   Intravenous   No limitation specified. 

  Calcium Chloride   Intravenous   No limitation specified. 

  Calcium Gluconate   Intravenous   No limitation specified. 

  Calcium Glycerophosphate   Intravenous   No limitation specified. 

  Carbohydrates in sodium chloride solution   Intravenous   No limitation specified. 

  Chromium   Intravenous   No limitation specified. 

  Copper Sulfate   Intravenous   No limitation specified. 

  Cupric Chloride   Intravenous   No limitation specified. 

  Dextrose Injection   Intravenous   No limitation specified. 

  Diphenhydramine Hydrochloride   Intravenous, Intramuscular   Administered to a patient by the member in his or her office only in emergency circumstances with a maximum dose of 100 mg. 

  Epinephrine Hydrochloride   Intramuscular    Administered to a patient by the member in his or her office only in emergency circumstances with a maximum dose of 1.5 mg. 

  Ferrous Sulphate   Intramuscular   Must be administered by z-track only. 

  Folic Acid   Intravenous, Intramuscular   No limitation specified. 

  Glutamine   Intravenous   Must be in combination with other amino acids. 

  Glutamic Acid   Intravenous   Must be in combination with other amino acids. 

  Glycine   Intravenous   Must be in combination with other amino acids. 

  Glutathione   Intravenous, Intramuscular   No limitation specified. 

  Histidine   Intravenous   Must be in combination with other amino acids. 

  Hydrochloric Acid   Intravenous   In ratio of 1:1000 or 1:500. 

  Isoleucine   Intravenous   Must be in combination with other amino acids. 

  L-Tryptophan   Intravenous   No limitation specified. 

  Lactated Ringer’s Solution   Intravenous   No limitation specified. 

  Leucine   Intravenous   Must be in combination with other amino acids. 

  Levocarnitine and its salts   Intravenous   No limitation specified. 

  Lysine   Intravenous   Must be in combination with other amino acids. 

  Magnesium Sulfate   Intravenous, Intramuscular   Must never be administered by the member for the treatment of eclampsia or pre-eclampsia. 

  Magnesium Chloride   Intravenous, Intramuscular   Must never be administered by the member for the treatment of eclampsia or pre-eclampsia. 

  Manganese   Intravenous   No limitation specified. 

  Methionine   Intravenous   Must be in combination with other amino acids. 

  Molybdenum   Intravenous   No limitation specified. 

  Ornithine   Intravenous   Must be in combination with other amino acids. 

  Phenylalanine   Intravenous   Must be in combination with other amino acids. 

  Potassium Chloride   Intravenous   In dosage form not more than 0.3 mEq/kg/hr.  Must never be administered as a single agent or by intravenous push. 

  Potassium Phosphate   Intravenous   In dosage form not more than 0.3 mEq/kg/hr. Must never be administered as a single agent or by intravenous push. 

  Proline   Intravenous   Must be in combination with other amino acids. 

  Ringer’s Solution (sodium, chloride, potassium and calcium)   Intravenous   No limitation specified. 

  Saline Solution   Intravenous, Intramuscular   No limitation specified. 

  Selenium   Intravenous   No limitation specified. 

  Serine   Intravenous   Must be in combination with other amino acids. 

  Sodium Bicarbonate   Intravenous   No limitation specified. 

  Sodium Iodide   Intravenous   Must be in combination with other minerals. 

  Sterile Water   Intravenous, Intramuscular   Must be in combination with other substances. 

  Strontium and its salts   Intravenous   No limitation specified. 

  Taurine   Intravenous   No limitation specified. 

  Threonine   Intravenous   Must be in combination with other amino acids. 

  Tyrosine (L-tyrosine)   Intravenous   Must be in combination with other amino acids. 

  Vanadium   Intravenous   Must be in combination with other minerals. 

  Viscum Album   Intravenous, Subcutaneous   No limitation specified. 

  Vitamin A   Intravenous   Maximum daily dose of 10,000 International Units. 

  Vitamin B1   Intravenous, Intramuscular   No limitation specified. 

  Vitamin B2   Intravenous, Intramuscular   No limitation specified. 

  Vitamin B3   Intravenous, Intramuscular   No limitation specified. 

  Vitamin B5   Intravenous, Intramuscular   No limitation specified. 

  Vitamin B6   Intravenous, Intramuscular, Subcutaneous   No limitation specified. 

  Vitamin B12   Intravenous, Intramuscular   No limitation specified. 

  Vitamin C   Intravenous   Must administer no more than 15 g per day when patient’s G6PD is deficient. 

  Vitamin D   Intravenous, Intramuscular   No limitation specified. 

  Vitamin E   Intravenous   No limitation specified. 

  Vitamin K1   Intramuscular   No limitation specified. 

  Zinc Chloride   Intravenous   No limitation specified. 

  Zinc Sulphate   Intravenous   No limitation specified. O. Reg. 168/15, Table 2; O. Reg. 94/23, s. 1. Table 3   Drugs that may be Prescribed Drug   Limitations, routes of administration, dosages 

  Adenosine triphosphate   Only if prescribed for intravenous injection to be administered by the member in his or her office to the patient. 

  Calcium Chloride   Only if prescribed in injectable form for intravenous injection to be administered by the member to the patient. 

  Calcium Gluconate   Only if prescribed in injectable form for intravenous injection to be administered by the member to the patient. 

  Colchicine   Must not be prescribed unless the drug is botanical colchicine, compounded from the corm of colchicum autumnale. 

  Dextrose Injection   May only be prescribed when in concentrated solutions for intravenous injection to be administered by the member to the patient. 

  Digitalis Purpurea and its glycosides   Only if prescribed in conjunction with monitoring of patient’s serum levels by member. 

  Estrogen (bioidentical)   Only if prescribed in topical or suppository form. 

  Folic Acid   Only if prescribed in oral dosage containing more than 1.0 mg of folic acid per dosage or, where the largest recommended daily dosage would, if consumed by a patient, result in the daily intake by that patient of more than 1.0 mg of folic acid. 

  L-Tryptophan   Only if prescribed for patient’s use in oral dosage form at a concentration of more than 220 mg per dosage unit or per daily dose.  Recommended daily dose must not exceed 12g and must be provided. May be prescribed as a single ingredient intended for intravenous injection. 

  Levocarnitine and its Salts   Only if prescribed for the treatment of primary or secondary levocarnitine deficiency.  

  Nitroglycerin   Administered to a patient by the member in his or her office only in emergency circumstances and only for angina pectoris. Dosage: 1 to 2 metered doses (0.4 or 0.8 mg nitroglycerin)  administered on or under the tongue, without inhaling. The mouth must be closed immediately after each dose (up to 3 doses in total, at least 5 minutes apart). A sublingual tablet may be used (0.3 or 0.6 mg for initial dose). Maximum dose of 1.8 mg. 

  Pancreatin   Only if prescribed in a dosage form that provides more than 20,000 USP units of lipase activity per dosage unit or for the treatment of pancreatic exocrine insufficiency. 

  Pancrelipase   Only if prescribed in a dosage form that provides more than 20,000 USP units of lipase activity per dosage unit or for the treatment of pancreatic exocrine insufficiency. 

  Pilocarpine and its salts   Must not be prescribed unless, 1. the drug is botanical pilocarpus, compounded from the leaves of pilocarpus microphyllus, 2. the member monitors his or her patient’s drug levels during treatment with the drug and, 3. the drug is never prescribed to treat a patient with glaucoma. 

  Podophyllotoxin   Must not be prescribed unless, 1. the drug is botanical podophyllotoxin compounded from podophyllum peltatum and, 2. the drug is never prescribed to treat a patient with rheumatoid arthritis. 

  Progesterone (bioidentical form)   Only if prescribed in a topical or suppository form.  

  Rauwolfia   No limitation, etc., specified. 

  Thyroid   No limitation, etc., specified. 

  Vitamin A    Only if prescribed in oral dosage form containing more than 10,000 International Units of Vitamin A per dosage or, where the largest daily dosage would, if consumed by a patient, result in the daily intake by that patient of more than 10,000 International Units of Vitamin A. 

  Vitamin D   Only if prescribed in oral dosage form containing more than 2,500 International Units of Vitamin D per dosage form or where the largest recommended daily dosage shown on the label would result in the daily intake by that patient of more than 2,500 International Units of Vitamin D. 

  Vitamin K1   Only if prescribed in oral dosage when the maximum daily dose is more than 0.120 mg. 

  Vitamin K2   Only if prescribed in oral dosage when the maximum daily dose is more than 0.120 mg. 

  Yohimbine and its salts   Must not be prescribed unless  the drug is botanical yohimbine, compounded from the bark of pausinystalia yohimbine. O. Reg. 168/15, Table 3; O. Reg. 94/23, s. 2. Table 4   Drugs That May be Dispensed Drug   Limitations, routes of administration, dosages 

  Colchicine   Must not be dispensed unless the drug is botanical colchicine, compounded from the corm of the colchicum autumanle. 

  Digitalis Purpurea and its glycosides   Only if dispensed in conjunction with monitoring of patient’s serum level by the member. 

  Estrogen (bioidentical)   Only if dispensed in topical or  suppository form. 

  Folic Acid   Only if dispensed in oral dosage containing more than 1.0 mg of folic acid per dosage or, where the largest daily dosage would, if consumed by a patient, result in the daily intake by that patient of more than 1.0 mg of folic acid. 

  L-Tryptophan   Only if dispensed for patient’s use in oral dosage form at a concentration of more than 220 mg per dosage unit or per daily dose.  Recommended daily dose must not exceed 12g and must be provided in 3 to 4 equally divided doses. 

  Levocarnitine and its salts   Only if dispensed for the treatment of primary or secondary levocarnitine deficiency. 

  Pancreatin   Only if dispensed in a dosage form that provides more than 20,000 USP units of lipase activity per dosage unit or for the treatment of pancreatic exocrine insufficiency. 

  Pancrelipase   Only if dispensed in a dosage form that provides more than 20,000 USP units of lipase activity per dosage unit or for the treatment of pancreatic exocrine insufficiency. 

  Pilocarpine and its salts   Must not be dispensed unless, 1. the dispensed drug botanical pilocarpus compounded  from the leaves of pilocarpus microphyllus, 2. the member monitors his or her patient’s drug levels during treatment with the drug and, 3. the drug is never dispensed to treat a patient with glaucoma. 

  Podophyllotoxin   Must not be dispensed unless, 1. the dispensed drug is botanical podophyllotoxin compounded from podophyllum peltatum and, 2. the drug is never dispensed to treat a patient with rheumatoid arthritis. 

  Progesterone (bioidentical form)   Only if dispensed in a topical or suppository form. 

  Rauwolfia   No limitation, etc., specified. 

  Thyroid   No limitation, etc., specified. 

  Vitamin A    Only if dispensed in oral dosage containing more than 10,000 International Units of Vitamin A per dosage or, where the largest daily dosage would, if consumed by a patient, result in the daily intake by that patient of more than 10,000 International Units of Vitamin A. 

  Vitamin D   Only if dispensed in oral dosage form containing more than 2,500 International Units of Vitamin D per dosage form or where the largest recommended daily dosage shown on the label would result in the daily intake by that patient of more than 2,500 International Units of Vitamin D. 

  Vitamin K1   Only if dispensed in oral dosage when the maximum daily dose is more than 0.120 mg. 

  Vitamin K2   Only if dispensed in oral dosage when the maximum daily dose is more than 0.120 mg. 

  Yohimbine and its salts   Must not be dispensed unless the dispensed drug is botanical yohimbine compounded from the bark of pausinystalia yohimbine. O. Reg. 168/15, Table 4; O. Reg. 94/23, s. 3. Table 5   Drugs that may be Compounded Drug   Limitations, routes of administration, dosages. 

  Adenosine triphosphate   Only if compounded for intravenous injection. 

  Colchicine   Must not be compounded unless the drug is botanical colchicine compounded from the corm of colchicum autumnale. 

  Dextrose Injection   Only if compounded when in concentrated solution for intravenous injection. 

  Digitalis Purpurea and its glycosides   Only if compounded in conjunction with monitoring of the patient’s serum levels by the member. 

  Estrogen (bioidentical)   Only if compounded in topical or suppository form. 

  Folic Acid     Only if compounded in oral dosage containing more than 1.0 mg of folic acid per dosage or, where the largest daily dosage would, if consumed by a patient, result in the daily intake by that patient of more than 1.0 mg of folic acid. 

  L-Tryptophan   Only if compounded for patient’s use in oral dosage form at a concentration of more than 220 mg per dosage unit or per daily dose. Recommended daily dose must not exceed 12g and must be provided in 3 to 4 equally divided doses. May also be compounded as a single ingredient intended for intravenous injection. 

  Levocarnitine and its Salts   Only if compounded for the treatment of primary or secondary levocarnitine deficiency. 

  Pancreatin   Only if compounded in a dosage that provides more than 20,000 USP units of lipase activity per dosage unit or for the treatment of pancreatic exocrine insufficiency.  

  Pancrelipase   Only if compounded in a dosage that provides more than 20,000 USP units of lipase activity per dosage unit or for the treatment of pancreatic exocrine insufficiency.  

  Pilocarpine and its salts   Must not be compounded unless, 1. the drug is botanical pilocarpine, compounded from the leaves of pilocarpus microphyllus, 2. the member monitors his or her patient’s serum levels during treatment with the drug and, 3. the drug is never compounded to treat a patient with glaucoma. 

  Podophyllotoxin   Must not be compounded unless, 1. the drug is botanical podophyllotoxin, compounded from podophyllum peltatum and, 2. the drug is never compounded to treat a patient with rheumatoid arthritis. 

  Progesterone (bioidentical )   Only if compounded in topical or suppository form. 

  Rauwolfia   No limitation, etc., specified. 

  Thyroid   No limitation, etc., specified. 

  Vitamin A   Only if compounded in oral dosage containing more than 10,000 International Units of Vitamin A per dosage or, where the largest daily dosage would, if consumed by a patient, result in the daily intake by that patient of more than 10,000 International Units of Vitamin A. 

  Vitamin D   Only if compounded in oral dosage form containing more than 2,500 International Units of Vitamin D per dosage form or where the largest recommended daily dosage shown on the label would result in the daily intake by that patient of more than 2,500 International Units of Vitamin D. 

  Vitamin K1   Only if compounded in oral dosage where the maximum daily dose is more than 0.120 mg. 

  Vitamin K2   Only if compounded in oral dosage where the maximum daily dose is more than 0.120 mg. 

  Yohimbine and its salts   Must not be compounded unless the drug is botanical yohimbine, compounded from the bark of pausinystalia yohimbine. O. Reg. 168/15, Table 5; O. Reg. 94/23, s. 4. Table 6   Drugs That May be Sold Drug   Limitations, routes of administration, dosages. 

  Colchicine   Must not be sold unless the drug is botanical colchicine, compounded from the corm of colchicum autumnale. 

  Digitalis Purpurea and its glycosides   Only if sold in conjunction with monitoring of the patient’s serum levels by the member. 

  Estrogen (bioidentical)   Only if sold in topical or suppository form. 

  Folic Acid   Only if sold in oral dosage containing more than 1.0 mg of folic acid per dosage or, where the largest daily dosage would, if consumed by a patient, result in the daily intake by that patient of more than 1.0 mg of folic acid. 

  L-Tryptophan   Only if sold for patient’s use in oral dosage form at a concentration of more than 220 mg per dosage unit or per daily dose.  Recommended daily dose must not exceed 12g and must be provided in three to four equally divided doses. 

  Levocarnitine and its Salts   Only if sold for the treatment of primary or secondary levocarnitine deficiency. 

  Pancreatin   Only if sold in a dosage form that provides more than 20,000 USP units of lipase activity per dosage unit or for the treatment of pancreatic exocrine insufficiency.  

  Pancrelipase   Only if sold in a dosage form that provides more than 20,000 USP units of lipase activity per dosage unit or for the treatment of pancreatic exocrine insufficiency. 

  Pilocarpine and its salts   Must not be sold unless, 1. the drug is botanical pilocarpine, compounded from the leaves of pilocarpus microphyllus, 2. the member monitors his or her patient’s serum levels during treatment with the drug and, 3. the drug is never sold to treat a patient with glaucoma.  

  Podophyllotoxin   Must not be sold unless, 1. the drug is botanical podophyllotoxin, compounded from podophyllum peltatum and, 2. the drug is never sold to treat a patient with rheumatoid arthritis. 

  Progesterone (bioidentical form)   Only if sold in topical or suppository form. 

  Rauwolfia   No limitation, etc., specified. 

  Thyroid   No limitation, etc., specified. 

  Vitamin A   Only if sold in oral dosage containing more than 10,000 International Units of Vitamin A per dosage or, where the largest daily dosage would, if consumed by a patient, result in the daily intake by that patient of more than 10,000 International Units of Vitamin A. 

  Vitamin D   Only if sold in oral dosage form containing more than 2,500 International Units of Vitamin D per dosage form or where the largest recommended daily dosage shown on the label would result in the daily intake by that patient of more than 2,500 International Units of Vitamin D. 

  Vitamin K1   Only if sold in oral dosage where the maximum daily dose is more than 0.120 mg. 

  Vitamin K2   Only if sold in oral dosage where the maximum daily dose is more than 0.120 mg. 

  Yohimbine and its salts   Must not be sold unless the drug is botanical yohimbine compounded from the bark of pausinystalia yohimbine. O. Reg. 168/15, Table 6; O. Reg. 94/23, s. 5.   Français