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Cannabis Dispensary Inspection Form

This inspection checklist is intended to assist the medical cannabidiol dispensary in becoming operational. . It also contains information that the Office of Medical Cannabidiol will monitor for regulatory compliance as the dispensary continues operations.
MaintainX
07/19/2022

Cannabis Dispensary Inspection Form

This inspection checklist is intended to assist the medical cannabidiol dispensary in becoming operational. . It also contains information that the Office of Medical Cannabidiol will monitor for regulatory compliance as the dispensary continues operations.

    Registration Certificate No.:

    Dispensary Name:

    Inspection Date:

    Facility Location (Address):

    Statute or Rule:

    Administration

    Ensure that the dispensary is operating and available to dispense medical marijuana to qualifying patients and designated caregivers at least 30 hours weekly between the hours of 7:00 a.m. and 10:00 p.m.

    • Pass
    • Flag
    • Fail

    Develop, document, and implement policies and procedures:

    Maintain copies of the policies and procedures at the dispensary and provide copies to the Department for review upon request;

    • Pass
    • Flag
    • Fail

    Review dispensary policies and procedures at least once every 12 months from the issue date of the dispensary registration certificate and update as needed;

    • Pass
    • Flag
    • Fail

    Employ or contract with a medical director;

    • Pass
    • Flag
    • Fail

    Ensure that each dispensary agent has the dispensary agent’s registry identification card in the dispensary agent’s immediate possession when the dispensary agent is:

    Working or providing volunteer services at the dispensary or the dispensary’s cultivation site, or

    • Pass
    • Flag
    • Fail

    Transporting marijuana for the dispensary;

    • Pass
    • Flag
    • Fail

    Ensure that a dispensary agent accompanies any individual other than another dispensary agent associated with the dispensary when the individual is present in the enclosed, locked facility where marijuana is cultivated by the dispensary;

    • Pass
    • Flag
    • Fail

    Provide written notice to the Department, including the date of the event, within 10 working days after the date, when a dispensary agent no longer:

    Serves as a principal officer or board member for the dispensary

    • Pass
    • Flag
    • Fail

    Serves as the medical director for the dispensary,

    • Pass
    • Flag
    • Fail

    Is employed by the dispensary, or

    • Pass
    • Flag
    • Fail

    Provides volunteer services at or on behalf of the dispensary;

    • Pass
    • Flag
    • Fail

    Post the following information in a place that can be viewed by individuals entering the dispensary:

    If applicable, the dispensary’s approval to operate;

    • Pass
    • Flag
    • Fail

    The dispensary’s registration certificate;

    • Pass
    • Flag
    • Fail

    The name of the dispensary’s medical director and the medical director’s license number on a sign at least 20 centimeters by 30 centimeters; and

    • Pass
    • Flag
    • Fail

    The hours of operation during which the dispensary will dispense medical marijuana to a qualifying patient or a designated caregiver;

    • Pass
    • Flag
    • Fail

    If a dispensary cultivates marijuana, the dispensary shall cultivate the marijuana in an enclosed, locked facility.

    • Pass
    • Flag
    • Fail

    Medical Director

    During a dispensary’s hours of operation, a medical director or an individual who is a physician and is designated by the medical director to serve as medical director in the medical director’s absence is onsite or able to be contacted by any means possible, such as by telephone or pager

    • Pass
    • Flag
    • Fail

    A medical director shall:

    Develop and provide training to the dispensary’s dispensary agents at least once every 12 months from the initial date of the dispensary’s registration certificate on the following subjects:

    Guidelines for providing information to qualifying patients related to risks, benefits, and side effects associated with medical marijuana; b. Guidelines for providing support to qualifying patients related to the qualifying patient’s self-assessment of the qualifying patient’s symptoms, including a rating scale for pain, cachexia or wasting syndrome, nausea, seizures, muscle spasms, and agitation;

    • Pass
    • Flag
    • Fail

    Recognizing signs and symptoms of substance abuse; and

    • Pass
    • Flag
    • Fail

    . Guidelines for refusing to provide medical marijuana to an individual who appears to be impaired or abusing medical marijuana;

    • Pass
    • Flag
    • Fail

    A medical director shall provide oversight for the development and dissemination of:

    Educational materials for qualifying patients and designated caregivers that include:

    Alternative medical options for the qualifying patient’s debilitating medical condition;

    • Pass
    • Flag
    • Fail

    Information about possible side effects of and contraindications for medical marijuana including possible impairment with use and operation of a motor vehicle or heavy machinery, when caring for children, or of job performance;

    • Pass
    • Flag
    • Fail

    Guidelines for notifying the physician who provided the written certification for medical marijuana if side effects or contraindications occur;

    • Pass
    • Flag
    • Fail

    A description of the potential for differing strengths of medical marijuana strains and products;

    • Pass
    • Flag
    • Fail

    Information about potential drug-to-drug interactions, including interactions with alcohol, prescription drugs, non-prescription drugs, and supplements;

    • Pass
    • Flag
    • Fail

    Techniques for the use of medical marijuana and marijuana paraphernalia;

    • Pass
    • Flag
    • Fail

    Information about different methods, forms, and routes of medical marijuana administration;

    • Pass
    • Flag
    • Fail

    Signs and symptoms of substance abuse, including tolerance, dependency, and withdrawal; and

    • Pass
    • Flag
    • Fail

    A listing of substance abuse programs and referral information;

    • Pass
    • Flag
    • Fail

    A system for a qualifying patient or the qualifying patient’s designated caregiver to document the qualifying patient’s pain, cachexia or wasting syndrome, nausea, seizures, muscle spasms, or agitation that includes:

    A log book, maintained by the qualifying patient and or the qualifying patient’s designated caregiver, in which the qualifying patient or the qualifying patient’s designated caregiver may track the use and effects of specific medical marijuana strains and products;

    • Pass
    • Flag
    • Fail

    A rating scale for pain, cachexia or wasting syndrome, nausea, seizures, muscles spasms, and agitation;

    • Pass
    • Flag
    • Fail

    Guidelines for the qualifying patient’s self-assessment or, if applicable, assessment of the qualifying patient by the qualifying patient’s designated caregiver; and

    • Pass
    • Flag
    • Fail

    Guidelines for reporting usage and symptoms to the physician providing the written certification for medical marijuana and any other treating physicians;

    • Pass
    • Flag
    • Fail

    Policies and procedures for refusing to provide medical marijuana to an individual who appears to be impaired or abusing medical marijuana.

    • Pass
    • Flag
    • Fail

    A medical director for a dispensary shall not provide a written certification for medical marijuana for any qualifying patient.

    • Pass
    • Flag
    • Fail

    Dispensing Medical Marijuana

    Before a dispensary agent dispenses medical marijuana to a qualifying patient or a designated caregiver, the dispensary agent shall:

    1,4,5. Verify the qualifying patient’s or the designated caregiver’s identity, the validity of the registry identification, and the amount of medical marijuana that would not cause the patient to exceed the two and one half ounces limit of medical marijuana during a 14 calendar day period.

    • Pass
    • Flag
    • Fail

    Offer any appropriate patient education or support materials,

    • Pass
    • Flag
    • Fail

    Enter the following information into the medical marijuana electronic verification system for the qualifying patient or designated caregiver:

    The amount of medical marijuana dispensed

    • Pass
    • Flag
    • Fail

    Whether the medical marijuana was dispensed to the qualifying patient or to the qualifying patient’s designated caregiver,

    • Pass
    • Flag
    • Fail

    The date and time the medical marijuana was dispensed,

    • Pass
    • Flag
    • Fail

    The dispensary agent’s registry identification number, and

    • Pass
    • Flag
    • Fail

    The dispensary’s registry identification number.

    • Pass
    • Flag
    • Fail

    Qualifying Patient Records

    A dispensary shall ensure that:

    A qualifying patient record is established and maintained for each qualifying patient who obtains medical marijuana from the dispensary;

    • Pass
    • Flag
    • Fail

    An entry in a qualifying patient record:

    Is recorded only by a dispensary agent authorized by dispensary policies and procedures to make an entry,

    • Pass
    • Flag
    • Fail

    Is dated and signed by the dispensary agent,

    • Pass
    • Flag
    • Fail

    Includes the dispensary agent’s registry identification number, and

    • Pass
    • Flag
    • Fail

    Is not changed to make the initial entry illegible;

    • Pass
    • Flag
    • Fail

    A dispensary shall ensure that the qualifying patient record for a qualifying patient who requests or whose designated caregiver on behalf of the qualifying patient requests medical marijuana from the dispensary contains:

    Qualifying patient information that includes:

    The qualifying patient’s name;

    • Pass
    • Flag
    • Fail

    The qualifying patient’s date of birth; and

    • Pass
    • Flag
    • Fail

    The name of the qualifying patient’s designated caregiver, if applicable;

    • Pass
    • Flag
    • Fail

    Documentation of any patient education and support materials provided to the qualifying patient or the qualifying patient’s designated caregiver, including a description of the materials and the date the materials were provided;

    • Pass
    • Flag
    • Fail

    For each time the qualifying patient requests and does not obtain medical marijuana or, if applicable, the designated caregiver requests on behalf of the qualifying patient and does not obtain medical marijuana from the dispensary, the following:

    The date,

    • Pass
    • Flag
    • Fail

    The name and registry identification number of the individual who requested the medical marijuana, and

    • Pass
    • Flag
    • Fail

    The dispensary’s reason for refusing to provide the medical marijuana.

    • Pass
    • Flag
    • Fail

    Inventory Control System

    A dispensary shall designate in writing a dispensary agent who has oversight of the dispensary’s medical marijuana inventory control system.

    • Pass
    • Flag
    • Fail

    A dispensary shall only acquire marijuana from:

    The dispensary’s cultivation site

    • Pass
    • Flag
    • Fail

    Another dispensary or another dispensary’s cultivation site,

    • Pass
    • Flag
    • Fail

    A qualifying patient authorized by the Department to cultivate marijuana, or

    • Pass
    • Flag
    • Fail

    A designated caregiver authorized by the Department to cultivate marijuana.

    • Pass
    • Flag
    • Fail

    A dispensary shall establish and implement an inventory control system for the dispensary’s medical marijuana that documents:

    Each day’s beginning inventory, acquisitions, harvests, sales, disbursements, disposal of unusable marijuana, and ending inventory;

    • Pass
    • Flag
    • Fail

    For acquiring medical marijuana from a qualifying patient or designated caregiver:

    A description of the medical marijuana acquired including the amount and strain

    • Pass
    • Flag
    • Fail

    The name and registry identification number of the qualifying patient or designated caregiver who provided the medical marijuana,

    • Pass
    • Flag
    • Fail

    The name and registry identification number of the dispensary agent receiving the medical marijuana on behalf of the dispensary, and

    • Pass
    • Flag
    • Fail

    The date of acquisition;

    • Pass
    • Flag
    • Fail

    For acquiring medical marijuana from another dispensary:

    A description of the medical marijuana acquired including the amount, strain, and batch number;

    • Pass
    • Flag
    • Fail

    The name and registry identification number of the dispensary providing the medical marijuana;

    • Pass
    • Flag
    • Fail

    The name and registry identification number of the dispensary agent providing the medical marijuana;

    • Pass
    • Flag
    • Fail

    The name and registry identification number of the dispensary agent receiving the medical marijuana on behalf of the dispensary; and

    • Pass
    • Flag
    • Fail

    The date of acquisition;

    • Pass
    • Flag
    • Fail

    For each batch of marijuana cultivated:

    The batch number;

    • Pass
    • Flag
    • Fail

    Whether the batch originated from marijuana seeds or marijuana cuttings;

    • Pass
    • Flag
    • Fail

    The origin and strain of the marijuana seeds or marijuana cuttings planted;

    • Pass
    • Flag
    • Fail

    The number of marijuana seeds or marijuana cuttings planted;

    • Pass
    • Flag
    • Fail

    The date the marijuana seeds or cuttings were planted;

    • Pass
    • Flag
    • Fail

    A list of all chemical additives, including nonorganic pesticides, herbicides, and fertilizers used in the cultivation;

    • Pass
    • Flag
    • Fail

    The number of plants grown to maturity;

    • Pass
    • Flag
    • Fail

    Harvest information including:

    Date of harvest,

    • Pass
    • Flag
    • Fail

    Final processed usable marijuana yield weight, and

    • Pass
    • Flag
    • Fail

    Name and registry identification number of the dispensary agent responsible for the harvest

    • Pass
    • Flag
    • Fail

    The disposal of medical marijuana that is not usable marijuana including the:

    Description of and reason for the marijuana being disposed of including, if applicable, the number of failed or other unusable plants;

    • Pass
    • Flag
    • Fail

    Date of disposal;

    • Pass
    • Flag
    • Fail

    Method of disposal; and

    • Pass
    • Flag
    • Fail

    Name and registry identification number of the dispensary agent responsible for the disposal;

    • Pass
    • Flag
    • Fail

    For providing medical marijuana to another dispensary:

    The amount, strain, and batch number of medical marijuana provided;

    • Pass
    • Flag
    • Fail

    The name and registry identification number of the other dispensary;

    • Pass
    • Flag
    • Fail

    The name and registry identification number of the dispensary agent who received the medical marijuana on behalf of the other dispensary; and

    • Pass
    • Flag
    • Fail

    The date the medical marijuana was provided;

    • Pass
    • Flag
    • Fail

    For receiving edible food products infused with medical marijuana from another dispensary:

    A description of the edible food products received from the dispensary including total weight of each edible food product and estimated amount and batch number of the medical marijuana infused in each edible food product,

    • Pass
    • Flag
    • Fail

    Total estimated amount and batch number of medical marijuana infused in the edible food products

    • Pass
    • Flag
    • Fail

    The name and registry identification numbers of the Dispensary and the dispensary agent providing, and Dispensary agent receiving the edible food products on behalf of the receiving dispensary

    • Pass
    • Flag
    • Fail

    The date the edible food products were provided to the dispensary.

    • Pass
    • Flag
    • Fail

    Product Labeling

    A dispensary shall ensure that medical marijuana provided by the dispensary to a qualifying patient or a designated caregiver is labeled with:

    The dispensary’s registry identification number;

    • Pass
    • Flag
    • Fail

    The amount, strain, and batch number of medical marijuana;

    • Pass
    • Flag
    • Fail

    The following statement: “ARIZONA DEPARTMENT OF HEALTH SERVICES’ WARNING: Marijuana use can be addictive and can impair an individual’s ability to drive a motor vehicle or operate heavy machinery. Marijuana smoke contains carcinogens and can lead to an increased risk for cancer, tachycardia, hypertension, heart attack, and lung infection. KEEP OUT OF REACH OF CHILDREN”;

    • Pass
    • Flag
    • Fail

    If not cultivated by the dispensary, whether the medical marijuana was obtained from a qualifying patient, a designated caregiver, or another dispensary;

    • Pass
    • Flag
    • Fail

    The date of manufacture, harvest, or sale;

    • Pass
    • Flag
    • Fail

    A list of all chemical additives, including nonorganic pesticides, herbicides, and fertilizers, used in the cultivation and production of the medical marijuana; and

    • Pass
    • Flag
    • Fail

    The registry identification number of the qualifying patient.

    • Pass
    • Flag
    • Fail

    If a dispensary provides medical marijuana cultivated by the dispensary to another dispensary, the dispensary shall ensure that the medical marijuana is labeled with:

    The dispensary’s registry identification number;

    • Pass
    • Flag
    • Fail

    The amount, strain, and batch number of the medical marijuana;

    • Pass
    • Flag
    • Fail

    The date of harvest or sale; and

    • Pass
    • Flag
    • Fail

    A list of all chemical additives, including nonorganic pesticides, herbicides, and fertilizers, used in the cultivation of the medical marijuana.

    • Pass
    • Flag
    • Fail

    If medical marijuana is provided as part of an edible food product, a dispensary shall, in addition to the information in subsection (A), include on the label the total weight of the edible food product.

    • Pass
    • Flag
    • Fail

    Security

    Except as provided in R9-17-310(A)(7), a dispensary shall ensure that access to the enclosed, locked facility where marijuana is cultivated is limited to the dispensary’s principal officers, board members, and authorized dispensary agents.

    • Pass
    • Flag
    • Fail

    A dispensary agent may transport marijuana, marijuana plants, and marijuana paraphernalia between the dispensary and:

    The dispensary’s cultivation site

    • Pass
    • Flag
    • Fail

    A qualifying patient, and

    • Pass
    • Flag
    • Fail

    Another dispensary.

    • Pass
    • Flag
    • Fail

    Before transportation, a dispensary agent shall complete a trip plan that includes:

    The name of the dispensary agent in charge of transporting the marijuana;

    • Pass
    • Flag
    • Fail

    The date and start time of the trip;

    • Pass
    • Flag
    • Fail

    A description of the marijuana, marijuana plants, or marijuana paraphernalia being transported; and

    • Pass
    • Flag
    • Fail

    The anticipated route of transportation;

    • Pass
    • Flag
    • Fail

    During transportation, a dispensary agent shall:

    Carry a copy of the trip plan in subsection (C)(1) with the dispensary agent for the duration of the trip;

    • Pass
    • Flag
    • Fail

    Use a vehicle without any medical marijuana identification;

    • Pass
    • Flag
    • Fail

    Have a means of communication with the dispensary; and

    • Pass
    • Flag
    • Fail

    Ensure that the marijuana, marijuana plants, or marijuana paraphernalia are not visible.

    • Pass
    • Flag
    • Fail

    After transportation, a dispensary agent shall enter the end time of the trip and any changes to the trip plan on the trip plan required in subsection (C)(1).

    • Pass
    • Flag
    • Fail

    To prevent unauthorized access to medical marijuana at the dispensary and, if applicable, the dispensary’s cultivation site, the dispensary shall have the following:

    Security equipment to deter and prevent unauthorized entrance into limited access areas that include:

    • Pass
    • Flag
    • Fail

    Devices or a series of devices to detect unauthorized intrusion, which may include a signal system interconnected with a radio frequency method, such as cellular, private radio signals, or other mechanical or electronic device;

    • Pass
    • Flag
    • Fail

    Exterior lighting to facilitate surveillance;

    • Pass
    • Flag
    • Fail

    Electronic monitoring including:

    At least one 19-inch or greater call-up monitor

    • Pass
    • Flag
    • Fail

    A video printer capable of immediately producing a clear still photo from any video camera image,

    • Pass
    • Flag
    • Fail

    Video cameras:

    Providing coverage of all entrances to and exits from limited access areas and all entrances to and exits from the building, capable of identifying any activity occurring in or adjacent to the building; and

    • Pass
    • Flag
    • Fail

    Having a recording resolution of at least 704 x 480 or the equivalent;

    • Pass
    • Flag
    • Fail

    A video camera at each point of sale location allowing for the identification of any qualifying patient or designated caregiver purchasing medical marijuana,

    • Pass
    • Flag
    • Fail

    A video camera in each grow room capable of identifying any activity occurring within the grow room in low light conditions,

    • Pass
    • Flag
    • Fail

    Storage of video recordings from the video cameras for at least 30 calendar days,

    • Pass
    • Flag
    • Fail

    A failure notification system that provides an audible and visual notification of any failure in the electronic monitoring system, and

    • Pass
    • Flag
    • Fail

    Sufficient battery backup for video cameras and recording equipment to support at least five minutes of recording in the event of a power outage;

    • Pass
    • Flag
    • Fail

    Panic buttons in the interior of each building;

    • Pass
    • Flag
    • Fail

    Policies and procedures:

    That restrict access to the areas of the dispensary that contain marijuana and if applicable, the dispensary’s cultivation site to authorized individuals only;

    • Pass
    • Flag
    • Fail

    That provide for the identification of authorized individuals;

    • Pass
    • Flag
    • Fail

    That prevent loitering;

    • Pass
    • Flag
    • Fail

    For conducting electronic monitoring; and

    • Pass
    • Flag
    • Fail

    For the use of a panic button

    • Pass
    • Flag
    • Fail

    Edible Food Products

    A dispensary that prepares, sells, or dispenses marijuana-infused edible food products shall:

    Before preparing, selling, or dispensing marijuana-infused edible food product obtain written authorization from the Department to prepare, sell, or dispense marijuana-infused edible food products;

    • Pass
    • Flag
    • Fail

    If the dispensary prepares the marijuana-infused edible food products, ensure that the marijuana-infused edible food products are prepared according to the applicable requirements in 9 A.A.C. 8, Article 1;

    • Pass
    • Flag
    • Fail

    If the marijuana-infused edible food products are not prepared at the dispensary, obtain and maintain at the dispensary a copy of the current written authorization to prepare marijuana-infused edible food products from the dispensary that prepares the marijuana-infused edible products;

    • Pass
    • Flag
    • Fail

    Cleaning and Sanitation

    A dispensary shall ensure that any building or equipment used by a dispensary for the cultivation, harvest, preparation, packaging, storage, infusion, or sale of medical marijuana is maintained in a clean and sanitary condition.

    • Pass
    • Flag
    • Fail

    Medical marijuana in the process of production, preparation, manufacture, packing, storage, sale, distribution, or transportation is protected from flies, dust, dirt, and all other contamination.

    • Pass
    • Flag
    • Fail

    Refuse or waste products incident to the manufacture, preparation, packing, selling, distributing, or transportation of medical marijuana are removed from the building used as a dispensary and, if applicable, a building at the dispensary’s cultivation site at least once every 24 hours or more often as necessary to maintain a clean condition.

    • Pass
    • Flag
    • Fail

    All trucks, trays, buckets, other receptacles, platforms, racks, tables, shelves, knives, saws, cleavers, other utensils, or the machinery used in moving, handling, cutting, chopping, mixing, canning, packaging, or other processes are cleaned daily

    • Pass
    • Flag
    • Fail

    All stored edible food products are securely covered.

    • Pass
    • Flag
    • Fail

    A dispensary shall ensure that a dispensary agent at the dispensary or the dispensary’s cultivation site:

    Cleans the dispensary agent’s hands and exposed portions of the dispensary agent’s arms in a hand washing sink:

    Before preparing medical marijuana including working with food, equipment, and utensils;

    • Pass
    • Flag
    • Fail

    During preparation, as often as necessary to remove soil and contamination and to prevent cross-contamination when changing tasks;

    • Pass
    • Flag
    • Fail

    After handling soiled equipment or utensils;

    • Pass
    • Flag
    • Fail

    After touching bare human body parts other than the dispensary agent’s clean hands and exposed portions of arms; and

    • Pass
    • Flag
    • Fail

    After using the toilet room;

    • Pass
    • Flag
    • Fail

    Physical Plant

    A dispensary shall provide onsite parking or parking adjacent to the building used as the dispensary.

    • Pass
    • Flag
    • Fail

    A building used as a dispensary or the location used as a dispensary’s cultivation site shall have:

    At least one toilet room;

    • Pass
    • Flag
    • Fail

    Each toilet room shall contain:

    A flushable toilet;

    • Pass
    • Flag
    • Fail

    Mounted toilet tissue;

    • Pass
    • Flag
    • Fail

    A sink with running water;

    • Pass
    • Flag
    • Fail

    Soap contained in a dispenser; and

    • Pass
    • Flag
    • Fail

    Disposable, single-use paper towels in a mounted dispenser or a mechanical air hand dryer;

    • Pass
    • Flag
    • Fail

    At least one hand washing sink not located in a toilet room;

    • Pass
    • Flag
    • Fail

    Designated storage areas for medical marijuana or materials used in direct contact with medical marijuana separate from storage areas for toxic or flammable materials; and

    • Pass
    • Flag
    • Fail

    If preparation or packaging of medical marijuana is done in the building, a designated area for the preparation or packaging that:

    Includes work space that can be sanitized, and

    • Pass
    • Flag
    • Fail

    Is only used for the preparation or packaging of medical marijuana.

    • Pass
    • Flag
    • Fail

    For each commercial device used at a dispensary or the dispensary’s cultivation site, the dispensary shall:

    Ensure that the commercial device is licensed or certified pursuant to A.R.S. § 41-2091,

    • Pass
    • Flag
    • Fail

    Maintain documentation of the commercial device’s license or certification

    • Pass
    • Flag
    • Fail

    OTHER:

    Other documentation requested:

    COMMENTS:

    Registration Certificate No.:

    Date:

Source: MaintainX (Community Member)

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