Signature of the Head of the Institution Signature of the Inspectors 1 PHARMACY COUNCIL OF INDIA Standard Inspection Format (S.I.F) for institutions conducting B. Pharm for 100 admns. (To be filled and submitted to PCI by an organization seeking approval of the course / continuation of the approval) 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) (SIF-B-1) 2. PART – I A - GENERAL INFORMATION A – I .1 Name of the Institution: Complete Postal address: STD code Telephone K.B.RAVAL COLLEGE OF PHARMACY At-Shertha, Post-Kasturinagar Ta & Distt- Gandhinagar-382423, Gujarat 079 23285315/12 07923285311 [email protected]Year of starting of the course 2006 Status of the course conducting body: Government / University / Autonomous / Aided / Private (Enclose copy of Registration documents of Trust A – I .2 Name, address of the Society/Trust/ Management (attach documentary evidence) STD Code: Telephone No: Fax No: E-mail Web A.K. RAVAL CHARITABLE TRUST, Tarpan, Plot No 808 B/H St. Xaviers High School, Sector-8 Gandhinagar-380008 079 23243087 07923285311 [email protected]www.kbrtec.org 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- Sh. Kedarnath Kantilal Raval Hon. Secretary Tarpan, Plot No 808 B/H St. Xaviers High School, Sector-8 Gandhinagar-380008 079 23243087 07-23285315 07923243087 9376196267 07923285311 [email protected]
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Signature of the Head of the Institution Signature of the Inspectors1
PHARMACY COUNCIL OF INDIAStandard Inspection Format (S.I.F) for institutions conducting B. Pharm for 100 admns.
(To be filled and submitted to PCI by an organization seeking approval of the course / continuation of the approval)
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)
(SIF-B-1)
2.PART – I
A - GENERAL INFORMATIONA – I .1Name of the Institution:
Complete Postal address:
STD codeTelephone No. Fax No.E-mail
K.B.RAVAL COLLEGE OF PHARMACYAt-Shertha, Post-Kasturinagar Ta & Distt- Gandhinagar-382423, Gujarat
Year of starting of the course 2006Status of the course conducting body: Government / University / Autonomous / Aided / Private (Enclose copy of Registration documents ofSociety/Trust)
Trust
A – I .2Name, address of the Society/Trust/ Management (attach documentary evidence)STD Code: Telephone No: Fax No:E-mail Web Site:
A.K. RAVAL CHARITABLE TRUST,Tarpan, Plot No 808 B/H St. Xaviers High School, Sector-8 Gandhinagar-3800080792324308707923285311info@kbrtec.orgwww.kbrtec.org
A – I .3Name, Designation and Address of person to be contacted by phone
STD Code Telephone No Office Residence Mobile No.Fax No E-Mail
Sh. Kedarnath Kantilal RavalHon. SecretaryTarpan, Plot No 808 B/H St. Xaviers High School, Sector-8 Gandhinagar-380008
Signature of the Head of the Institution Signature of the Inspectors3
B - DETAILS OF THE INSTITUTION
B –I .1Name of the Principal
Dr. Ankit A. Ajmera
Qualification/ Experience
Qualification*Teaching Experience
RequiredActual
experienceRemarks of the
InspectorsM. Pharm Yes 15 years, out of which 5 years as
Prof. / HOD 20 years
PhD Yes 10 years, out of which at least 05 years as Asst. Prof
* Documentary evidence should be provided B –I .2For institution seeking continuation of affiliation
Course Date of last Inspection
Remarks of the Previous Inspection Report
Complied/ Not
Complied
Intake reduced/Stopped in the last 03 years*
B. Pharm 10/8/2015 staff deficiency 7 principal relieving letter is missing PF for teaching staff library shared with MCA
complied No
* Enclose Documents
B –I .3Status of Governing Council: TrustDetails of the Governing Body Enclosed Minutes of the last Governing council Meeting Enclosed
B –I .4Pay Scales:Staff Scale of pay PF Gratuity Pension
benefitRemarks of
the Inspectors
Teaching Staff
AICTE /UGC/State Govt. Yes No No No
Non- Teaching Staff
State Government Yes Yes No No
B –I .5
B. Pharm Course: Admission Statement for the Past Three Years
ACADEMIC YEAR Year 2014-15 Year 2015-16 Year 201617
Sanctioned 60 60 60No. of Admissions 18 39 60Unfilled Seats 42 21 0No. of Excess Admissions
0 0 0
Signature of the Head of the Institution Signature of the Inspectors4
B –I .6Academic information: Percentage of UG results for the past three years based on University Calendar
ACADEMIC YEAR Year 2013-14 Year 2014-15- Year 2015-161st year 20 13 412nd year 38 5 123rd year 52 67 34Final year 51 86 100Pass % (Final Year) 51 86 100
B – IICo – Curricular Activities / Sports ActivitiesWhether college has NSS Unit (Yes/No)? If no give reasons
No, Due to Location
NSS Programme Officer’s NameProgramme conducted (mention details)Whether students participating in University level cultural activities / Co- curricular/sports activities
Yes
Physical Instructor Not availableSports Ground Individual
Signature of the Head of the Institution Signature of the Inspectors5
C - FINANCIAL STATUS OF THE INSTITUTION
Audited financial Statement of Institute should be furnished C .1
Resources and funding agencies (give complete list)
C .2 Please provide following InformationReceipts Expenditure Remarks
of the Inspectors
Sl.No.
Particulars Amount Sl.No.
Particulars Amount
1. Grantsa. Governmentb. Others
0CAPITAL EXPENDITURE
2. Tuition Fee 5698350 1. Building 34405883
3. Library Fee 0 2. Equipment 8836389
4. Sports Fee 0 3. Others 0
5. Union Fee 0 REVENUE EXPENDIUTRE
6. Others 0 1 Salary 3045438
2. MAINTENANCE EXPENDITURE
i College 214864
ii Others 1271303. University Fee (If
any)124768
4. Apex Bodies Fee 2000005. Government Fee 06. Deposit held by
the College0
Total7. Others 08. Misc.Expenditure 1013110
Total 4725310
Note: Enclose relevant documents
Signature of the Head of the Institution Signature of the Inspectors6
PART- II PHYSICAL INFRASTRUCTURE1. a. Availability of Land (B. Pharm courses) : Available
a) 2.5 acres District HQ/Corporation/Municipality limitb) 0.5 acre for City / Metros
b. Building : Ownc.Land Details to be in name of Trust and Society
Records to be enclosedSale deed : Enclosed
d. Building†:i) Approved Building plan, to be Enclosed : Enclosed
e. Total Built Area of the college building in Sq.mts : Built up Area 4017
Amenities and Circulation Area 9162. Class rooms:
Total Number of Class rooms provided at the end of 4 Year Course
Class Required Nos
Available Nos
Required Area * for each class room
Available Area in Sq.mts
Remarks of the
InspectorsB. Pharm 06 06 6 of 90 Sq. mts Or
4 of 150 sq.mts. with Public address System.
450
(*To accommodate 100 students).3. Laboratory requirement at the end of 4 Years
*Number of laboratories required for entire course of 4 years.
Sl.No.
Infrastructure for Requirement as per Norms Available No. &
Area in Sq mts
Remarks/ Deficiency
1 Laboratory Area for B.Pharm Course (12 Labs)
90 Sq .mts x n (n=10) - Including Preparation room - Desirable75 Sq. mts - Essential
3 Preparation Room for each lab(One room can be shared by two labs, if it is in between two labs)
10 sq mts (minimum)
1 & 10
4 Area of the Machine Room 80-100 Sq.mts 1 & 1005 Central Instrumentation Room 80 Sq.mts with A/ C 1 & 986 Store Room – I 1 (Area 100 Sq mts) 1 & 1007 Store Room – II
Signature of the Head of the Institution Signature of the Inspectors7
† The Institutions will not be permitted to run the courses in rented building on or after 31.12.20081. All the Laboratories should be well lit & ventilated2. 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 material.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 as per Norms
Multi Media Projector 01 3 0Generator (5KVA) 01 1 0
Signature of the Head of the Institution Signature of the Inspectors9
9. Amenities (Desirable)
Name Requirement as per Norms in
area
Available Not Available
Remarks/ DeficiencyNo. Area in Sq.
mtsPrincipal quarters 80 Sq. mts 0 0Staff quarters 16 x 80 Sq. mts 0 0Canteen 100 Sq. mts 1 500Parking Area for staff and students 2 875Bank Extension Counter 0 0Co operative Stores 0 0Guest House 80 Sq. mts 1 23Transport Facilities for students 2 0Medical Facility (First Aid) 1 10
10. A. Library books and periodicalsThe minimum norms for the initial stock of books, yearly addition of the books and the number of journals to be subscribed are as given below:
Sl.No.
Item Titles (No)
Minimum Volumes (No) Available Remarks of the
InspectorsTitle Numbers
1 Number of books 150 2000 adequate coverage of a large number of standard text
books and titles in all disciplines of pharmacy
1353 4902
2 Annual addition of books 150 to 200 books per year
17 148
3 PeriodicalsHard copies / online
10 National05 International periodicals
10 235
4 CDS Adequate Nos 30 385 Internet Browsing Facility Yes/No (Minimum
Name of the Faculty Subjects taught B. Pharm Total work load
Specific Remarks of the InspectorTh Pr
1 Dr. Ankit A Ajmera Pharmaceutics 2 0 22 Pranit B Patel Pharmacognosy 2 3 53 Dr. Keyur S Patel Pharmaceutics 1 3 44 Jaya M Patel Pharmacognosy 10 6 165 Kinjal B Rathod Pharmaceutics 3 0 36 Sejal R Kharadi Pharmaceutics 6 3 97 Dr. Smita M Talaviya Pharma. Chemistry 3 0 3
8 Sandip N Badeliya Pharma. Chemistry 3 9 129 Vidhi S Dave Pharmachemistry (QA) 0 6 610 Pankti P Dalwadi Pharmacology 8 6 1411 Krunal B Patel Pharmaceutics 5 3 812 Yogeshkumar N Patel Quality Assurance 3 6 913 Hitesh P Patel Pharmaceutics 5 6 1114 Sejal A Madhak Pharmaceutics 3 12 1515 Drashtiben D Mandali Quality Assurance 4 9 1316 Jaiminkumar R Patel QualityAssurance 3 6 09
Signature of the Head of the Institution Signature of the Inspectors15
17 Jaykumar Panchani Pharmaceutics 4 6 1018 Kanal S Joshi Quality Assurance 0 0 019 Rahulgiri Goswami Quality Assurance 5 0 520 Rinku Patel Pharmacognosy 0 0 021 Jaimin B. Patel Pharmaceutics 0 0 022 Darpini S.Patel Pharma. Chemistry 0 0 023 Jainish A. Shah Quality Assurance 0 0 0
13. Percentage of students qualified in GATE in the last Three Years
Details Year 2013-14 Year 2014-15 Year 2015-16No. of Students Appeared 10 4 2No. of Students Qualified 2 2 0Percentage 20 50 0
14. Whether the Institution has an Industry – Institution Interaction cell Yes √ No
If applicable please give the details for the previous Year
Events Details for the Previous YearNo. of Industrial visits 1Industrial Tour 0Industrial Training 0No. of Resource Persons from the Industry for Guest Lectures 6No. of Collaboration projects with Industry 0
Yes No
Signature of the Head of the Institution Signature of the Inspectors16
15. Percentage of students Placed through the College Placement Cell in the Last Three Years
Year Year 2013-14 Year 2014-15 Year 2015-16No. of students appeared for campus interview
2 12 4
% Placed 100 20 25
16. Whether Professional Society Activities are Conducted (Enclose Details) (ISTE, IPA, APTI, ICTA and Related Societies)
√
Signature of the Head of the Institution Signature of the Inspectors17
PART IV - PERSONNEL
TEACHING STAFF:
1. Details of Teaching Faculty for B.Pharm Course to be enclosed in the format mentioned below:
Sl No
Name Designation QualificationDate of Joining
Teaching Experience
State Pharma
cy Council Reg No.
Signature of the faculty
Remarks of the
InspectorsAfter PG
1 DR. ANKIT A AJMERA
Principal B.Pharm, M.Pharm, Ph.D
20/8/2013 3.0+17.3 G12091
2 Pranit B Patel Associate ProfessorB.Pharm,M.Pharm 6/8/2009 7.0 + 17.7 G89633 Dr. Keyur S Patel Assistant Professor B.Pharm, M.Pharm,
Ph.D27/8/2009 7.0 +2.2 G24633
4 Kinjal Rathod Assistant Professor B.Pharm,M.Pharm 17/8/2009 7.0 +1.0 G26042
5 Rinkuben Patel Assistant Professor B.Pharm,M.Pharm 16/7/2007 9.1 +0.0 G234246 Dr. Smita Talaviya Assistant Professor B.Pharm, M.Pharm,
Ph.D16/8/2010 6.0 +1.9 G30796
7 Dave Vidhi S. Assistant Professor B.Pharm, M.Pharm, 27/1/2015 1.6 +0.0 G450838 Pankti P. Dalwadi Assistant Professor B.Pharm,M.Pharm 06/7/2015 1.2 +0.0 G499479 Kharadi Sejal R. Assistant Professor B.Pharm,M.Pharm 31/5/2016 0.3 +6.0 G2349810 Badeliya
Sandipkumar N.Assistant Professor B.Pharm,M.Pharm 1/3/2016 0.5 +5.9 G29759
11 Jaya M. Patel Assistant Professor B.Pharm,M.Pharm 18/1/2016 0.6 +6.9 G2530012 Patel Yogesh Assistant Professor B.Pharm,M.Pharm 31/5/2016 0.3 +0.0 G2514913 Patel Hitesh Assistant Professor B.Pharm,M.Pharm 31/5/2016 0.3 +0.0 G3290214 Patel Krunal B. Assistant Professor B.Pharm,M.Pharm 31/5/2016 0.3 +0.0 G5585715 Panchani Jay R. Assistant Professor B.Pharm,M.Pharm 1/8/2016 0.1 +0.0 G5764116 Goswami Rahulgiri R Assistant Professor B.Pharm,M.Pharm 31/5/2016 0.3 +0.0 G6067517 Patel Jaiminkumar R. Assistant Professor B.Pharm,M.Pharm 1/8/2016 0.1 +0.0 G3939718 Mandali Drashti D. Assistant Professor B.Pharm,M.Pharm 1/8/2016 0.1 +0.0 G4837119 Madhak Sejalben A. Assistant Professor B.Pharm,M.Pharm 31/5/2016 0.3 +0.0 G3675520 Kanal S Joshi Assistant Professor B.Pharm,M.Pharm 30/8/2016 0.0 + 0.0 G5660821 Jaimin B. Patel Assistant Professor B.Pharm,M.Pharm 01/9/16 0.0 + 0.0 G5923922 Darpini S.Patel Assistant Professor B.Pharm,M.Pharm 06/9/16 0.0 + 0.0 G2913823 Jainish A. Shah Assistant Professor B.Pharm,M.Pharm 01/10/16 0.0 + 0.0 G28164
2. Qualification and number of Staff Members
QualificationM. Pharm PhD Others - Full Time
23 3
Signature of the Head of the Institution Signature of the Inspectors18
3. Teaching Staff required year wise exclusively for B.Pharm for intake of 100 Students.
No. of staff required1. Pharmaceutical Chemistry2. Pharmaceutical Analysis3. Pharmacology4. Pharmacognosy5. Pharmaceutics6. Pharmacy Practice7. Principal
7244611
Total 25
*Part time teaching Staff 3
Remarks of the Inspection Team
*Part time teaching staff for Mathematics, Biology and Computer Science can be appointed.
Signature of the Head of the Institution Signature of the Inspectors19
4. Staff Pattern for B. Pharm courses Department wise / Division wise:Professor: Asst. Professor: Lecturer
Department / Division Name of the post For strength of 100
students
Provided by the
institution
Remarks of inspection team
Department of Pharmaceutics Professor 1 1
Asst. Professor 2 8
Lecturer 3 0
Department of Pharmaceutical Chemistry
Professor 1 0Asst. Professor 3 3Lecturer 3 0
Department of Pharmacology Professor 1 0Asst. Professor 2 1Lecturer 1 0
Department of Pharmacognosy Professor 1 1Asst. Professor 1 2Lecturer 2 0
Department of Pharmacy Practice
Asst. Professor 1 0Lecturer 1 0
Department of Pharmaceutical Analysis
Asst. Professor 1 7Lecturer 1 0
5. Selection criteria and Recruitment Procedure for Faculty:
a. Whether Recruitment Committee has been formed Yes
b. Whether Advertisement for vacancy is notified in the Newspapers Yes
c. Whether Demonstration Lecture has been conducted Yes
d. Whether opinion of Recruitment Committee Recorded Yes
6.Details of Faculty Retention for:
Name of Faculty Member Period
%NA Duration of 15 yrs. and aboveNA Duration of 10 yrs. and above
Rinku Patel, Ankit Ajmera, Patel Keyur S Mr.Pranit B Patel, Rathod Kinjal B, Smita Talvaiya Duration of 5 yrs. and above 26Vidhi Dave, Pankti Dalwadi, sandip Badeliya, jaya patel, Sejal Kharadi, Yogesh patel, Sejal madhak, Rahulgiri Goswami, Panchani jay, Krunal patel, Hitesh patel, Drashti Mandali, Jaimin Patel Kanal Joshi, Jainin Patel, Darpini patel, Jainish Shah
15. Whether Supporting Staff (Technical and Administrative) are encouraged for skill up gradation programs. Yes
Signature of the Head of the Institution Signature of the Inspectors22
PART V - DOCUMENTATIONRecords Maintained: Essential
Sl. No Records Yes No Remarks of the
Inspectors
1 Admissions Registers √2. Individual Service Register √3. Staff Attendance Registers √4. Sessional Marks Register √5. Final Marks Register √6. Student Attendance Registers √7. Minutes of meetings- Teaching Staff √8. Fee paid Registers √9. Acquittance Registers √
√10. Accession Register for books and Journals in Library √11. Log book for chemicals and Equipment costing more than Rupees
one lakh√
12. Job Cards for laboratories √13. Standard Operating Procedures (SOP’s) for Equipment √14. Laboratory Manuals √15. Stock Register for Equipment √16. Animal House Records as per CPCSEA √
Signature of the Head of the Institution Signature of the Inspectors23
Signature of the Head of the Institution Signature of the Inspectors
PART - VI
1. Financial Resource allocation and utilization for the past three years: (Audited Accounts for previous year to be enclosed)
Observation of the Inspectors:Compliance of the last recommendations by Inspectors
Specific observations if not complied
. Signature of Inspectors: 1
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
2
Photograph
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.
Date of Birth & Age ………………………………………………………
Qualification College & University
Year Registration No. with State Pharmacy
Council
Name of the State 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 ResidentialAddress 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/Industry/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 (Please fill the data of last academic session) :-
(Copy of my form 16 (TDS certificate) for the last financial year is attached)
P.A.N. : Circle :
Declaration
1. I have not worked at any other pharmacy college/institution or presented myself at any inspection during my employment in this college.
2. It is declared that each statement and/or contents of this declaration made by the undersigned are absolutely true and correct. In the event of any statement made in this declaration subsequently turning out to be incorrect or false the undersigned has understood and accepted that such misdeclaration in respect to any content of this declaration shall also be treated as a gross misconduct thereby rendering the undersigned liable for necessary disciplinary action (including removal of his name from Register of Registered Pharmacists).
Signature of the Employee:
Date : Place:Endorsement
This endorsement is the certification that the undersigned has satisfied himself/herself about the correctness and veracity of each content of this declaration and endorses the abovementioned declaration as true and correct. In the event of this declaration turning out to be either incorrect or any part of this declaration subsequently turning out to be incorrect or false it is understood and accepted that the undersigned shall also be equally responsible besides the declarant himself/herself for any such misdeclaration or misstatement
Countersigned by the Director/Dean/ Principal in respect of Teaching Staff