Drug Control Division Inspection Forms

Welcome to the Department of Consumer Protection, Drug Control Division Inspection Form webpage. This page will be updated with inspection forms used by the Drug Control Division during  inspections inside the State of Connecticut.  We will be updating the forms on this page regularly and all forms are subject to change without being posted on the website.  It is recommended that individuals that intend to utilize these forms obtain a copy from the website each time to ensure that the most current form is utilized.  The official version of the form is the one used by the inspecting agent.  

The Drug Control Division is utilizing all-inclusive mobile inspection forms that encompass multiple inspection types and business models. Inspection sections and/or inspection fields may intentionally remain blank when such sections and/or fields do not apply to the inspection type and/or business model for which the mobile inspection forms are being utilized. Please contact the Drug Control Agent who conducted your inspection if you feel an inspection section and/or inspection field was inadvertently left blank.

 

Pharmacies and Hospital
 

Licensed Pharmacy Inspection -

 

Pharmacy Inspection Form - Compliance
Pharmacy Inspection Form - Nuclear Pharmacy

Pharmacy Inspection Form - Ownership Change

Pharmacy Inspection Form - Closing

Pharmacy Inspection Form - Remodel

Pharmacy Inspection Form - Relocation

Pharmacy Inspection Form - Balance Certification

Pharmacy Inspection Form - Safe Inspection

 

USP 797

 

Certification Submission Form - September 2022

Inspection Form - February 2024

Sterile Compounding Inspection Requirements Please use this document to prepare for your Sterile Compounding inspection.

Designated Pharmacist - means a pharmacist responsible for overseeing the compounding of sterile pharmaceuticals and the application of the USP chapters, as said chapters pertain to sterile compounding.

  • The Designated Pharmacist in a licensed pharmacy or an institutional pharmacy must notify the department  when they commence or cease being the designated pharmacist via email to DCP.PharmacistLicense@ct.gov.  

  • Approved program(s) for Designated Pharmacists must at minimum include a total 30 hours (can be obtained from different programs) of education in the following areas:
    • Fundamentals of sterile compounding
    • Hazardous drug and high risk compounding
    • Sanitation of pharmacy controlled environments
    • Viable facility sampling metrics
    • Personnel sampling metrics
    • Engineering controls for sterile compounding

 

For questions and reporting USP related issues please email DCP.DrugUSPcompounding@ct.gov.

USP 795

 

Inspection Form Version 1  September 2015- Please use this form as a reference for our inspection of your facility.
 
For questions and reporting USP related issues please email DCP.DrugUSPcompounding@ct.gov.
 
For information about USP 795, USP 797, and USP 800 or official copies of the chapters please go to the USP website.

 

Collection Receptacles

 

Pharmacy

General Inspection Form

Closing Inspection Form

 

Law Enforcement

General Inspection Form 

Closing Inspection Form 

 

General Inspection Form (Non FDA facility)

 
 
General Inspection Form (Without Controlled Substances)- May 2021

General Inspection Form (With Controlled Substances) - May 2021