A – I .1 Name of the Institution: Complete Postal address: STD code Telephone No. Fax No. E-mail Pharmacy College, Saifai, U.P. University of Medical Sciences, Saifai, Etawah 05688 276089 05688276509 [email protected]Year of starting of the course 2015 Status of the course conducting body: Government / University / Autonomous / Aided / Private (Enclose copy of Registration docum ents of Society/Trust) Uttar Pradesh University of Medical Sciences, Saifai, Etawah, U.P. Not Applicable A – I .2 Name, address of the Society/Trust/ Management (attach documentary evidence) STD Code: Telephone No: U.P. State Govt University. Not Applicable A – I .3 Name, Designation and Address of person to be contacted by phone STD Code Telephone No Office Residence Mobile No. Fax No E- Mail Prof. (Dr.) Devender Pathak, Principal, Pharmacy College, Saifai, U.P. University of Medical Sciences,Saifai, Etawah 05688 276089 9897661620 05688276509 [email protected]A – I. 4 Name and Address of the Head of the Institution Dr. (Brig.) T. Prabhakar, Director, U.P. University of Medical Sciences, Saifai, Etawah PHARMACY COUNCIL OF INDIA Standard Inspection Format (S.I.F) for institutions for starting of 1st year B. Pharm course as per The Bachelor of Pharmacy(B.Pharm) Course Regulations,2014. (To be filled and submitted to PCI by an organization seeking approval of the course) (SIF-B-2) To be filled up by P.C.I. To be filled up by inspectors Inspection No. : Date of Inspection: FILE No. : NAME OF THE INSPECTORS: 1. (BLOCK LETTERS) 2. PART – I A - GENERAL INFORMATION Signature of the Head of the Institution Signature of the Inspectors 1
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U.P. University of Medical Sciences, Saifai, Etawah
PHARMACY COUNCIL OF INDIA
Standard Inspection Format (S.I.F) for institutions for starting of 1st year B. Pharm
course as per The Bachelor of Pharmacy(B.Pharm) Course Regulations,2014.
(To be filled and submitted to PCI by an organization seeking approval of the course)
(SIF-B-2) To be filled up by P.C.I. To be filled up by inspectors
Inspection No. : Date of Inspection:
FILE No. : NAME OF THE INSPECTORS: 1.
(BLOCK LETTERS) 2.
PART – I
A - GENERAL INFORMATION
Signature of the Head of the Institution Signature of the Inspectors
1
a. Details of Affiliation Fee Paid
Name of the Course Affiliation Fee paid Receipt No Dated Remarks of the up to Inspectors
B. Pharm N.A.
b. APPROVAL STATUS:
Name of Approved In take PCI STATE UNIVERSITY Remarks of the
the up to Approved and GOVERNMENT Inspectors
Course Admitted
B. Pharm New college Approval Letter 1663 71-3-06-S-19/07 UPTU/regoff/2015/1200-4494
No and Date 09/05/07
Approved Intake 60 60 Actually
Admitted 44 44
c. STATUS O F APPLICATION New College
COURSES INSPECTED FOR
Faculty / Extension of Approval Increase in Intake of Seats Remarks Subject Current Intake
B. Phar m Yes No Yes No
Note: Enclose relevant documents
A –I. 6 Whether other Educational Institutions/Courses are also being run by the Trust / Institution in the
same Building / campus? If Yes, Give Details
Yes No
A – I. 6 a
Status of the Pharmacy Course:
Independent Building
Wing of another college
Separate Campus
Multi Institutional Campus
Examining Authority : Dr. APJ Abdul Kalam Technical University,
With complete postal IET Campus, Sitapur Road, Lucknow
Address, Telephone No. 0522-2732193
and STD Code.
Signature of the Head of the Institution Signature of the Inspectors
2
B - DETAILS OF THE INSTITUTION
B – I .1
Name of the Principal Prof. (Dr.) Devender Pathak
Qualification* Teaching Experience Actual Remarks of the
Qualification/
Required experience Inspectors M. Pharm Yes 15 years, out of which 5 years 26 years
as Prof. / HOD Experience
PhD Yes 10 years, out of which at least
05 years as Asst. Prof
* Documentary evidence should be provided Please see Annexure-I
B –I .2
For institution seeking continuation of affiliation
Course Date of last Remarks of the
Previous Inspection
Report
Complied Intake
reduced/Stopped in the
last 03 years* Inspection / Not Complied
B. Pharm
* Enclose Documents B –I .3
Status of Governing Council: Government/Trust/Society/Individual / University
Details of the Governing Body : UPUMS is a new Univ., Governing body is in the process of of Formation, therefore shall be submitted later on.
Minutes of the last Governing council Meeting Enclosed / Not Enclosed B –I .4
Pay Scales:
Staff Scale of pay PF Gratuity Pension Remarks of benefit the
Inspectors
Yes / No Yes / No Yes / No AICTE /UGC/State Govt. Yes / No Teaching
Staff
Non-
Teaching
Staff
State Government Yes / No Yes / No Yes / No Yes / No
B –I .5
B. Pharm Course: Admission Statement for the Past Three Years
ACADEMIC YEAR Year 2015 Year 200- Year 200-
Sanctioned 60 No. of Admissions 44 Unfilled Seats 16
No. of Excess 0 Admissions
Signature of the Head of the Institution Signature of the Inspectors
3
Out of which
15 years as
Professor and
Director
B –I .6
Academic information: Percentage of UG results for the past three years based on University
Calendar New College
ACADEMIC YEAR Year 2015 Year 200- Year 200- 1st year Result Awaited 2nd year 3rd year Final year Pass % (Final Year)
B – II Co – Curricular Activities / Sports Activities
Whether college has NSS Unit (Yes/No)? Yes
If no give reasons
NSS Programme Officer’s Name Capt. Vijay Kumar
Programme conducted (mention details)
Whether students participating in University level cultural
activities/ Co - curricular/sports activities
Yes/No
Physical Instructor Available / Not available
Sports Ground Individual / Shared
Signature of the Head of the Institution Signature of the Inspectors
4
PART- II PHYSICAL INFRASTRUCTURE
1. a. Availability o f Land (B. Pharm courses) : Available / Not Available
a) 2.5 acres District HQ/Corporation/Municipality limit
b) 0.5 acre for City / Metros
b. Building : Own/Rented/Leased
c. Land Details to be in name of Trust and Society
Records to be enclosed
Sale deed : Enclosed/Not available
d. Building†:
i) Approved Building plan, to be Enclosed : Enclosed/Not available
e. Total Built Area of the college building in Sq.mts : Built up Area 10117Sq.mts
Amenities and Circulation Area 7984 Sq.mts
2. Class rooms:
Total Number of Class rooms provided at the end of 4 Year Course
Class Required Available Required Area * Available Area Remarks of
Nos Nos for each class room in Sq.mts the Inspectors
B. Pharm 04 04 90 Sq. mts each ( Desirable) 04 x 80.26=321 75 Sq. mts each (Essential)
(*To accommodate 60 students).
3. Laboratory requirement at the end of 4 Years
Sl. Infrastructure for Requirement as per Norms Available Remarks/ No. No. & Deficiency
Area in Sq mts
1 Laboratory Area for B.Pharm Course 90 Sq .mts x n (n=10) - Including 10 Labs &
Preparation room - Desirable 915.47
75 Sq. mts - Essential
(12 Labs)
2 Pharmaceutics 03 Laboratories
02 Laboratories
Pharmaceutical Chemistry 3x 91.46
Pharmaceutical Analysis 2x 91.46
Pharmacology
Pharmacognosy
Pharmaceutical Biotechnology
1 Laboratory 1x 92.33 2 Laboratories 2x 91.46
01 Laboratories 1x 91.46 01 Laboratory 1x 91.46
(Including Aseptic Room) 10 Laboratories * 10 Labs Total no. Laboratories for B.Pharm course
10 sq mts 10 Sq.mts 3 Preparation Room for each lab (One room can be shared by two labs, if it is
in between two labs)
(minimum) for each lab
4 Area of the Machine Room 80-100 Sq.mts 91.46 5 Central Instrumentation Room 80 Sq.mts with A/ C 92.33 6 Store Room – I 1 (Area 100 Sq mts) 102 7 Store Room - II 1 (Area 20 Sq mts) 25
(For Inflammable chemicals) *Number of laboratories required for entire course of 4 years.
Signature of the Head of the Institution Signature of the Inspectors
6
† The Institutions will not be permitted to run the courses in rented building on or after
31.12.2008 1. All the Laboratories should be well lit & ventilated
2. All Laboratories should be provided with basic amenities and services like exhaust fans and fume
chamber to reduce the pollution wherever necessary.
3. The work benches should be smooth and easily cleanable preferably made of non-absorbent m aterial.
4. The water taps should be non-leaking and directly installed on sinks. Drainage should be efficient.
5. Balance room should be attached to the concerned laboratories.
4. Administration Area:
Sl.No. Name of infrastructure Requirement Requirement Available Remarks/
6 Nesslers Cylinders 40 40 Yes NOTE: Adequate number of glassware commonly used in the laboratory should be provided in each laboratory and department.
DEPARTMENT OF PHARMACEUTICS
Equipment:
Sl. No. Name Minimum Available Working Remarks of
Required Nos. Nos. Yes / No the Inspectors
1 Mechanical stirrers 10 10 Yes
2 Homogenizer 05 05 Yes
3 Digital balance 05 05 Yes
4 Microscopes 05 05 Yes
5 Stage and eye piece micro meters 05 05 Yes
6 Brookfield’s viscometer 01 01 Yes
7 Tray dryer 01 01 Yes
8 Ball mill 01 01 Yes
Signature of the Head of the Institution Signature of the Inspectors 24
Compliance of the last recommendations by Inspectors
Specific observations if not complied
1.
Signature of Inspectors: 2.
Note:
1. The Inspection Team is instructed to physically verify the details and records filled up by the
college in the application form submitted by the college, which is with you now and record the
observations, opinions and recommendations in clear and explicit terms.
2. The team is requested to record their comments only after physical verification of records and details.
Signature of the Head of the Institution Signature of the Inspectors
29
PHARMACY COUNCIL OF INDIA
STAFF DECLARATION FORM
From
Teacher’s Name ………………………………………………………
(as on University Degree certificate)
Recent Passport size photo of the Employee
Signed by Dean/Principal of the College. Photograph
Date of Birth & Age ………………………………………………………
Qualification College & Year Registration No. Name of the State
University with State Pharmacy Council
Pharmacy Council B.Pharm
M.Pharm
(Ph.D.)/others
Copies of Registration Certificate and University degree/PG/Ph.D. be attached.
Present Designation :
Department :
College :
City :
Nature of appointment : Permanent/Temporary/Adhoc/Honorary/Part-time
Whether belongs to : O.G./SC/ST/OBC/Ex-service/Others
Contd. on page 2
::2::
Permanent Residential
Address of employee : _
Copy of Passport/Voter Card/Ration Card/PAN No./Electricity Bill/Driving License Attached as a proof of residence.
STD Code Phone No.
Phone & Fax Number Office : with Code
Residence :
E-mail address :
Date of joining present institution : as
(Designation)
Details of the previous appointments/teaching experience
Position Name of Institution From To Total Experience
in years Lecturer
Reader/
Assistant
Professor
Professor
Principal
1) Before joining present institution I was working at as
and relieved on after resigning/retiring (relieving order is enclosed from the previous institution).
2) I, hereby undertake that I have not given my name as teaching faculty in any other Pharmacy institution for teaching any Pharmacy course and not working in any where
other than this institution Pharmacy College/Medical College/Dental
College/Industr y/Community Pharmacy/Hospital Pharmacy/Govt. Service/any other
service in the State or outside the State in any capacity full-time/part-time other than
the above. Contd. on page 3
::3::
3) I have drawn total emoluments from this college as under :-
Amount Received TDS
April, 2013 May, 2013 June, 2013 July, 2013 August, 2013 September, 2013 October, 2013