ࡱ> ! >bjbjSS ;116Rppppp8t0zZ  "...   YYYYYYY$$\^rZp     Zpp..Z$# # # p.p.Y# Y# # 2SW.`rT.Y>Z<zZTH_H_\WH_pW  #     ZZX   zZ    H_          6: PROGRAM DOCUMENT AUDIT Site Visit Questionnaire for Review of Program Records Date of Document Audit Site Visit: Audit Location: Room: Bldg.: Program: Accreditation Status: Self-Study Date: Date of most recent RRC Site Visit: Full/Focused? Date of most recent Annual Program Evaluation(APE)/Review: Date of next APE: Date of most recent Milestones Reporting: Date of next Milestones Reporting: Date of most recent Annual Report to GMEC: Residency Program Director:____________________ Residency Coordinator:_______________________ GME OFFICE Auditor(s): Required DocumentationAdequate? (Yes/No) (Date) Comments and Recommendations *Grade: U/ M/ S/ EAcademic RecordsResident Files In Secure Area Locked File Signed and dated Entry Log Reviewer Log date/signature Pages numbered and dated  Documentation of formal semi-annual face-to face evaluation (with feedback) meetings by Program Director (or designee) overall performance strengths and weaknesses plan for improvement signed by resident (( sample form attached, ( sample form on file)Record of programs annual assessment of each residents suitability for promotion minutes and/or evaluation form Use of specialty specific Milestones to ensure resident capability to practice with reduced supervision (( sample form attached, ( sample form on file)Final Summative Evaluation of Program Graduates document residents performance during the final period of education verify that resident has demonstrated sufficient competence to enter practice without direct supervision based on assessmsent of specialty-specific Milestones regarding core professional activities. (( sample form attached, ( sample form on file)Final Summative Evaluation for Residents Transferred to/from other programs documentation of prior GME experience competency based assessment EvaluationsEvaluations of Resident Rotation Performance For each rotation dated and legibly signed timely completion? (within 2 weeks) competency-based questions? objective assessments in all competencies by specialty Milestones? document progressive resident performance improvement appropriate to educational level? accessible for review by resident? (documented)? multiple settings? multiple evaluators? 360 degree evaluators? (( sample form attached, ( sample form on file)  Program Clinical Competency Committee (CCC) documentation of Milestones assessment submission to ACGME (as applicable) membership (at least 3 program physician faculty) written description of responsibilities semiannual meeting dates advisory report to PD regarding resident progressProgram Evaluation of Faculty Performance (at least annual) review facultys teaching abilities commitment to the educational program clinical knowledge and skill professionalism scholarly activities participation in faculty development considers annual (at least) written confidential evaluation by residents (( sample form attached, ( sample form on file)  Confidential Written Evaluations of Faculty by Resident (( sample form attached, ( sample form on file)Confidential Written Evaluations of Program by Resident ( if using tool other than GME NI survey: ( sample form attached, ( sample form on file)  Confidential Written Evaluations of Program by Faculty (if using tool other than GME NI survey: ( sample form attached, ( sample form on file)Programs Evaluation Policy (( sample form attached, ( sample form on file)Program Evaluation Committee (PEC) Committee Membership (minimum 2 faculty, 1 resident, includes faculty from participating affiliated sites) provided with written description of responsibilities documentation of participation in: planning development implementation evaluation educational activities review and make recommendations for revision of curriculum goals /objectives address areas of non-compliance with ACGME standards conducts formal systematic program evaluation resulting in Annual Program Evaluation(APE) including the monitoring and tracking of: Resident Performance Program Quality Faculty Development Graduate Performance Clinical Learning Environment focus areas Generates a Report of the APE written improvement action plan meeting minutes documentation of presentation to and approval by teaching faculty Improvement plan must be specific as outlined in the Policy on Program Evaluation and Annual Program Evaluation Review) (recent report and minutes: ( attached, ( on file)Program StructureWritten overall Program Educational Goals (expressed in 6 ACGME Competencies) attached signature log attesting to receipt by residents and faculty (recent version: ( attached, ( on file)   Written competency-based Goals and Objectives for each rotation at each educational level for each participating site provides name and phone of contact person of responsible supervising faculty documentation (i.e. signatures) attesting to receipt by resident (at least annually) and discussion with faculty (recent version or updates: ( attached, ( on file)   Curriculum for advancing residents knowledge of basic principles of research how conducted how evaluated how explained to patients how applied to patient care.Supervision Written Policy on Supervisory Lines of Responsibility Documentation of appropriate level of supervision in place all residents at every training lvl each rotation using ACGME classification of levels of supervision (including non-hospital sites) identification and contact information for designated supervisor Protocols defining common circumstances requiring faculty involvement (attach) (recent version or updates: ( attached, ( on file)Policies for awarding progressive responsibility and increasing autonomy Delineation of resident responsibilities for patient-care, progressive responsibility for patient management, conditional independence, supervision of residents over continuum of training Documentation that it is assigned by Program Director and faculty based on specific criteria and observed performance (recent version or updates: ( attached, ( on file) Policy on escalation and when resident/fellow must contact supervising/responsible attending faculty (recent version or updates: ( attached, ( on file) Program specific Due Process Policies consistent with GMEC policies (recent version or updates: ( attached, ( on file)  Schedules Rotations Rotation block schedules up-to-date for all residents in New Innovations? Rotation definitions up-to-date for all rotations in New Innovations? External rotators included? On-Call schedules Identifies resident and faculty responsible for each patients care Provides required and necessary contact information to health care team [GME Office will attach report on current program compliance with reporting]  Documentation (policy and procedures) for effective, structured hand-over processes to fulfill continuity of care and patient safety Assurance & documentation of resident competence in communicating with team members in hand-over processDuty Hours, Fatigue and Fitness for Duty Program specific Policy on Duty Hour Limits Program specific Policy on Moonlighting Program specific Policy on Fatigue Mitigation, Fitness for Duty and Transitioning Care to other providers Policy/process to manage resident unable to perform duties (i.e fatigue) and to ensure continuity of care of patients Program specific Policies on Transitions of Care and Patient Hand-offs Documentation of Work Hour Limits Monitoring demonstrating duty hours compliance & supervision compliance Documentation of violations, how they were addressed & remedied Sample documents for episodes when residents/fellows requested to remain on duty beyond scheduled hours or duty hour limits (attach) Methods for how residents raise concerns re: duty hours free from reprisal Residents and Faculty educated concerning professional responsibility to appear for duty appropriately rested and fit to provide patient care services. Residents and faculty educated in alertness management and fatigue mitigation and recognition of fatigue & sleep deprivation (policies recent version updates: ( attached, ( on file) (documentation recent version or updates: ( attached, ( on file)Didactic Curriculum: Descriptive of regular scheduled didactic sessions method to monitor/track attendance Annual Schedule Charting Time and Date Topic Titles [course, lecture, case conference, journal club, Grand Rounds] Presenter Name, Title, Department/Institution (recent years schedule: ( attached, ( on file)   Written criteria and policies for resident selection, promotion & graduation, transfer, discipline &/or dismissal (recent version or updates: ( attached, ( on file)  Engagement in Clinical Learning EnvironmentDocumentation of residents integration and active participation in patient safety activitiesDocumentation of residents and faculty given data to monitor personal clinical effectiveness and performance improvement based on clinical indicatorsDocumentation of residents integration in interdisciplinary clinical quality improvement programsDocumentation of resident access to systems for reporting errors, adverse events, unsafe conditions, near-misses or inadequate supervision in a protected manner free from reprisal Documentation of resident participation in hospital risk reduction strategies and processes such as root cause analysisProcess to inform patients of the respective roles of residents and attendingsCommittee Membership List of resident institutional and departmental appointments (attach copy) resident name and training level committee title dates of service Is committee participation/attendance documented in available minutes and/or attendance sheets?  Program Outcomes and MonitoringAnnual Program Report to GMEC Submitted? (most recent report: ( attached, ( on file) Annual documentation of disciplinary or adverse actions taken against residents. (( attached, ( on file)Affiliation Contracts Master Agreement [IR 11.B] Program Level Letters of Agreement (PLA) specifying responsibility for education & evaluation. (core & subspecialty) Names of site-director and faculty Period of assignment Local goals & objectives Policies and procedures governing residents at site Site specific lines of responsibility/supervisionSpecialty Board Certification Results (written and/or oral). Provide program data for first-time takers for past 5 years ACGME Surveys Residents (min.required: 70% response) Most recent results available Action Plans for non-compliant responses Faculty (min. required 60% response) Most recent survey available Action Plans for non-compliant responsesProcedure Logs & Privilege Reports Is program utilizing New Innovations? Are submissions up to date? Policies for awarding privileges to perform procedures without direct supervision. (case/procedure log report available in New Innovations)  Resident Case Logs ABMS and/or ACGME Case/Procedure Log Report Are residents required to log cases or procedures using: ABMS specialty board system? ACGME case logs? (Attach a copy of case/procedure log summary report)Summary of resident involvement/participation in scholarly activities Peer-reviewed publications Chapters/Reviews Presentations at Regional/National meetings GrantsCertifications (indicate those applicable) ACLS BCLS ATLS PALS NALS(NRP) Other (specify:__________________) Provide a database including name of resident, PGY level, date of certification and expiration date (attach copy) Most recent Progress Report to ACGME, if any, requested by your RRC (most recent report: ( attached, ( on file)Most recent Special Review or Internal Review by SUNY Downstate GME Committee with program response to recommendations (most recent report: ( attached, ( on file)ACGME Program Accreditation Data System (webADS on ACGME Website) Annual update completed? Y/N Date of last update Approximate date of next update Scholarly activities for residents & faculty Response to citations entered? Responses to duty hours questions? Responses to other questions? (summary of most recent update: ( attached, ( on file)AMA FREIDA/GME Track Date of last update Approximate date of next updateNational Residency Matching Program (NRMP) (or SFM or other organized match system) Program participates? Y/N All applicants eligibility verified? Y/N NRMP quota up-to-date? Positions unfilled first round Positions filled first round Scramble positions filled Total positions to fill in program Match Violations? Y/N Waivers requested/received? Y/N NRMP Match Outcomes Report (Attach Copies of letters from NRMP and the most recent Match Outcomes Report) Other Documentation Reviewed: Copies of the following most recent items were left with the program for their use: Resident Handbook ___________ GME Program Evaluation Policy and Annual Program Evaluation Template, GME Special Review Policy/Protocol ACGME Program and Institutional Requirements, Adverse action log sheet and adverse action report form and file review log other policies_________________________________________ other documents ______________________________________ This GMEC Document Audit was conducted by ____________________________ Title/Office______________________________ Date____________ [Print] __________________________________ [Signed] *Grade: U = Unsatisfactory M = Marginal S = Satisfactory E = Excellent     SUNY Downstate GME Committee Document Audit PAGE  PAGE 9 GNOPs / 1 B V [ e h ƾ~xr~l~x~r_hxehxe5>*\aJ hspaJ h T|aJ hxeaJ haJ h3faJ hi_aJh 5\aJh5\aJh>*\aJh 5>*\aJhi_5\aJhi_CJaJ#hi_B*CJOJQJ^JaJph&h__>*B*CJOJQJ^JaJph&hi_>*B*CJOJQJ^JaJph"OP  B = h i     $If $$Ifa$gdxe $Ifgdxe !dhgd__$da$   ; < = P Q b o u  »xqxqjc_W_q_PHhJ$MhR'\ hJ$MhR'hJ$MhR'5hR' h35\ hN95\ hR'5\hxehR'5>*\hxehR'>* hxehR' hi_aJh hi_>*\aJh 5>*aJ h5aJ hi_5aJ hi_\aJh hi_\aJ h \aJh >*\aJhxe>*\aJh5\aJhi_5\aJhxe5\aJ ; < E P Q b c \SC$h$If^ha$gd $IfgdJ$Mkd$$Ifl\L/Z%++ 0L,4 laytni,$Ifc d e f ^kd$$Ifl\L/Z%++ 0L,4 laytni,$Iff u cN & F$Eƀ!'.IfgdJnN & F$Eƀ!'.IfgdJ$M cN & F$Eƀ!'.IfgdJnN & F$Eƀ!'.IfgdJn cSICC$If h$If^h$h$If^ha$gdN & F$Eƀ!'.IfgdJnN & F$Eƀ!'.IfgdJn c dN & F$Eƀ!'.IfgdJ$MkdV$$Ifl\L/Z%++ 0L,4 laytni, & ? @  2 3 B ./tu<=>?LRVWXlmqĽν㮧Ľν㟶Ľν㟁hzLhR'5\hD0UhR'6\hJ$MhR'6\hzLhR'5 hJnhR'hJ$MhR'5 hR'5\ hR'6\hzLhR'6\ hR'6 jhR'6hzLhR'6hR' hJ$MhR'hJ$MhR'\hJ$MhR'5\2c w cN & F$Eƀ!'.IfgdJ$MN & F$Eƀ!'.IfgdJ$M cZNEE $Ifgdr]s $$Ifa$gdr]s $IfgdJ$MN & F$Eƀ!'.IfgdJ$MN & F$Eƀ!'.IfgdJ$M B bN & F$Eƀ!'.IfgdJ$Mkd$$Ifl\L/Z%++ 0L,4 laytni,B a cZNEE $Ifgdr]s $$Ifa$gdr]s $Ifgd8N & F$Eƀ!'.IfgdJ$MN & F$Eƀ!'.IfgdJ$M /bN & F$Eƀ!'.Ifgd8kd$$Ifl\L/Z%++ 0L,4 laytni,/ucN & F$Eƀ!'.IfgdJ$MN & F$Eƀ!'.IfgdJ$M=mnop $Ifgdr]s $$Ifa$gdr]s $IfgdJ$MN & F$Eƀ!'.IfgdJ$MpqbN & F$Eƀ!'.IfgdckdY$$Ifl\L/Z%++ 0L,4 laytni,7BGT1;?LMN[aefg{|489abcpvþþþþþþ˭þhD0UhR'5hV(hR'5 hR'hRhJnhR'5 hR'6\hzLhR'6\ hR'6 jhR'6hzLhR'6 hR'>* hR'5 hR'5\hchR'5hR' hchR'hzLhR'\8_SEE  !$Ifgdr]s $$Ifa$gdr]sN & F$Eƀ!'.IfgdcR & F$Eƀ!'.If]gdcb\\QQ  !$If$Ifkd$$Ifl\L/Z%++ 0L,4 laytni,CdK & F$Eƀ!'.Ifkd$$Ifl\L/Z%++ 0L,4 laytni,CVocN & F$Eƀ!'.IfgdcN & F$Eƀ!'.IfgdcocN & F$Eƀ!'.IfgdcN & F$Eƀ!'.IfgdcJcN & F$Eƀ!'.IfgdcN & F$Eƀ!'.IfgdcJ{cN & F$Eƀ!'.IfgdcN & F$Eƀ!'.IfgdccZTTII  !$If$If $IfgdRN & F$Eƀ!' .IfgdcN & F$Eƀ!' .Ifgdc dN & F$Eƀ!'.IfgdJnkd\$$Ifl\L/Z%++ 0L,4 laytni, HlcN & F$Eƀ!'.IfgdJnN & F$Eƀ!'.IfgdJnlcN & F$Eƀ!'.IfgdJnN & F$Eƀ!'.IfgdJncYSS$If h$If^hN & F$Eƀ!'.IfgdJnN & F$Eƀ!'.IfgdJnRdN & F$Eƀ!'.IfgdRkd$$Ifl\L/Z%++ 0L,4 laytni,RvcN & F$Eƀ!'.IfgdRN & F$Eƀ!'.IfgdRcN & F$Eƀ!'.IfgdRN & F$Eƀ!'.IfgdRcN & F$Eƀ!'.IfgdRN & F$Eƀ!'.IfgdRL|~$If h$If^h $IfgdRN & F$Eƀ!'.IfgdRdN & F$Eƀ!'.IfgdRkd$$Ifl\L/Z%++ 0L,4 laytni,LkdW$$Ifl\L/Z%++ 0L,4 laytni,$If $$Ifa$ $IfgdR5 $$Ifa$$If $IfgdJnN & F$Eƀ!'.IfgdRvz{| )*.589JKLMZ`defz{  j ఫ૜૎ hr]shR' hKhR'hKhR'5 hBYhR' hR'5h hR'5 h.FhR'hzLhR'6\hzLhR'6hg8hR'5 hR'5\hR'hD0UhR'6 hR'6 jhR'6 hR'6\8dN & F$Eƀ!'.IfgdRkd$$Ifl\L/Z%++ 0L,4 laytni,*+,-.Lkd$$Ifl\L/Z%++ 0L,4 laytni,$If $$Ifa$ $IfgdR.K{|}~ $$Ifa$$IfN & F$Eƀ!'.IfgdR~dN & F$Eƀ!'.IfgdRkdR $$Ifl\L/Z%++ 0L,4 laytni,DcN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.IfgdRDgpcN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.Ifgdr]sp|cN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.Ifgdr]scN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.Ifgdr]s/cN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.Ifgdr]scN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.Ifgdr]scN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.Ifgdr]s *7H67RSTZ^_`hr 0128<=>FHg{|lŦ󞗒ŦhmrhR'5h bhR'5>*\ hR'5 hhR'h bhR'5h bhR'6 hR'5\hzLhR'5hhR'5 hR'6\hzLhR'6\ jhR'6 hR'6hzLhR'6hr]shR'5hR'hKhR'52+JcN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.Ifgdr]sJjzcN & F$Eƀ!'.Ifgdr]sN & F$Eƀ!'.Ifgdr]sz6ijklcZQKK$If $$Ifa$ $Ifgdr]sN & F$Eƀ!'-IfgdKN & F$Eƀ!'.Ifgdr]slmnopqbQH==  !$If $$Ifa$$If^`gdD0Ukd $$IflH&\L/Z%++ 0L,4 laytni,qrdSJ??  !$If $$Ifa$$If^`gdD0Ukd $$Ifl\L/Z%++ 0L,4 laytni,dN & F $Eƀ!'.IfgdkdQ $$Ifl\L/Z%++ 0L,4 laytni,HJLM  !$If $$Ifa$$If^`gdD0UR & F V$Eƀ!'.If`Vgd|w"MN|dN & F $Eƀ!'.Ifgdkd $$Ifl\L/Z%++ 0L,4 laytni,| & F V$Eƀ!'.If`Vgd|w"R & F V$Eƀ!'.If`Vgd|w"[R & F V$Eƀ!'.If`Vgd|w"R & F V$Eƀ!'.If`Vgd|w"$If  !$If h$If^h $IfgdR & F V$Eƀ!'.If`Vgd|w"dN & F $Eƀ!'.Ifgdkd $$Ifl\L/Z%++ 0L,4 laytni,#1[R & F V$Eƀ!'.If`Vgd|w"R & F V$Eƀ!'.If`Vgd|w"1Khijk[UUU$IfR & F V$Eƀ!'.If`Vgd|w"R & F V$Eƀ!'.If`Vgd|w"klRkdL $$Ifl\L/Z%++ 0L,4 lapytni,lxcN & F $Eƀ!'.Ifgdz#N & F $Eƀ!'.Ifgdmrlx  NOo%)*+34N( , !X!Y!t!u!v!|!󱬤󱬤󱬤hey?hR'>* hR'hmr hR'6\hzLhR'6\ jhR'6 hR'6hzLhR'6hz#hR'6 h qhR'h qhR'5 hR'5h!xhR'5 hmrhR' hR'5\h bhR'5hR'hmrhR'54 _R & F V$Eƀ!'.If`Vgd|w"N & F $Eƀ!'.Ifgdmr o[R & F V$Eƀ!'.If`Vgd|w"R & F V$Eƀ!'.If`Vgd|w"4567$If $IfgdmrN & F $Eƀ!'.Ifgdz#78Rkd$$Ifl\L/Z%++ 0L,4 lapytni,8ZC RN & F $Eƀ!'.Ifgdey?h$If^h`gd bN & F $Eƀ!'.IfgdmrC $Ifh$If^h`gd bN & F $Eƀ!'.Ifgd q Rkd$$Ifl;\L/Z%++ 0L,4 lapytni, X!!!!!$If $$Ifa$ $Ifgd qN & F $Eƀ!'.Ifgd q|!!!!!!!!!!!!!!!!"" """ "!"*"9"j"k"t"""""""""""""###j#k######迺ῲᲿhPhR'aJhFhR'6hfrhR'5 hfrhR' h qhR'h qhR'5\h qhR'\ hR'5h qhR'5hD0UhR'6hzLhR'6\hzLhR'6 hR'5\hR' hR'6 jhR'6 hR'6\/!!!d[ $Ifgd qkd$$Ifl\L/Z%++ 0L,4 laytni,!!" " " "$If $$Ifa$h$If^h`gdD0UN & F $Eƀ!'.Ifgd q " ""dN & F $Eƀ!'.Ifgd qkd_$$Ifl\L/Z%++ 0L,4 laytni,"!"k"[R & F V$Eƀ!'.If`Vgd|w"R & F $Eƀ!'.If`gd|w"k"""[R & F V$Eƀ!'.If`Vgd|w"R & F V$Eƀ!'.If`Vgd|w"""##[R & F V$Eƀ!'.If`Vgd|w"R & F $Eƀ!'.If`gd|w"##k######  !$If$If $IfgdFR & F V$Eƀ!'.If`Vgd|w"##F$dN & F $Eƀ!' .IfgdPkd$$Ifl\L/Z%++ 0L,4 laytni,#$c$$$$$%&h&t&x&&&&&&&&'''''o(p((((()))))))&)')ƾ쓉|t|jct|c hR'6\hzLhR'6\ jhR'6 hR'6hzLhR'6h__hR'5aJ hR'aJhPhR'5>*aJ hR'\hfrhR'\ hfrhR' hR'5hFhR'5hFhR'5\ hR'5\h__hR'aJhfrhR'5hR'hPhR'aJhPhR'5aJ&F$$$$$$IfN & F $Eƀ!' .IfgdP$$$dN & F $Eƀ!' .Ifgdfrkd$$Ifl\L/Z%++ 0L,4 laytni,$%0%cN & F $Eƀ!'.IfgdfrN & F $Eƀ!'.Ifgdfr0%%&cN & F $Eƀ!'.Ifgd__N & F $Eƀ!'.Ifgdfr&W&&cN & F $Eƀ!'.IfgdFN & F $Eƀ!'.Ifgdfr&''cN & F $Eƀ!'.IfgdllsN & F $Eƀ!'.Ifgdlls''p(cN & F $Eƀ!' .IfgdPN & F $Eƀ!' .Ifgdllsp((&)Q)))))$If $IfgdtN & F $Eƀ!' .Ifgd__'))))))))))))************ +\+]+^+y+z+{++++++++(,,,^........//̵ӭӦӝh{fhR'6\hPhR'h hPhR'5aJhPhR'aJ hPhR'hz#hR'5 h hR'hFhR'6hzLhR'6 hR'5\hR'hD0UhR'6\ hR'6\hzLhR'6\ jhR'6 hR'62)))dN & F $Eƀ!' .Ifgdz#kdZ$$Ifl\L/Z%++ 0L,4 laytni,)) *cN & F $Eƀ!'.Ifgdz#N & F $Eƀ!'.Ifgdz# *%*3*cN & F $Eƀ!'.Ifgdz#N & F $Eƀ!'.Ifgdz#3*9**cN & F $Eƀ!'.Ifgdz#N & F $Eƀ!'.Ifgdz#******$If $$Ifa$ $IfgdFN & F $Eƀ!'.Ifgdz#**]+bN & F $Eƀ!' .Ifgdz#kd$$IflW\L/Z%++ 0L,4 laytni,]+++++++F@$Ifkd$$Ifl\L/Z%++ 0L,4 laytni, $Ifgdz# $$Ifa$gdz# $Ifgd +++++UkdY$$Ifl\L/Z%++ 0L,4 laytni,$If $$Ifa$+$,%,&,',$If $$Ifa$N & F$Eƀ!'.Ifgdz#',(,,dN & F$Eƀ!'.IfgdPkd$$Ifl\L/Z%++ 0L,4 laytni,,,,,,Ukd$$Ifl\L/Z%++ 0L,4 laytni,$If $$Ifa$,$-%-&-'-$If $$Ifa$N & F$Eƀ!'.Ifgd '-(--dN & F$Eƀ!'.Ifgd kdT$$Ifl\L/Z%++ 0L,4 laytni,-----Ukd$$Ifl\L/Z%++ 0L,4 laytni,$If $$Ifa$-Z.[.\.].$If $$Ifa$N & F$Eƀ!'.Ifgd ].^..dN & F$Eƀ!'.Ifgd kd$$Ifl\L/Z%++ 0L,4 laytni,.....UkdO$$Ifl\L/Z%++ 0L,4 laytni,$If $$Ifa$../cN & F$Eƀ!'.Ifgd N & F$Eƀ!'.Ifgd /3/C/cN & F$Eƀ!'.Ifgd N & F$Eƀ!'.Ifgd /T/U////00#0$0%0+0/0001090I0J0Z0y0000000000002K2222233}33354n4p4t445+5Q5R5ـhD0UhR'6h+ hR'6h=3hR'B*phh hR'6hFhR'5hthR'5 hR'5hzLhR'5 hR'6\hzLhR'6\ jhR'6 hR'6hzLhR'6 hR'5\h8ShR'5 h{fhR'hR'2C/U/////cZTT$If $$Ifa$N & F$Eƀ!'.Ifgd N & F$Eƀ!'.Ifgd //////dSJDD$If $$Ifa$$If^`gdFkd$$Ifl\L/Z%++ 0L,4 laytni,// 0dN & F$Eƀ!'.Ifgd8Skd$$Ifl\L/Z%++ 0L,4 laytni, 0>0?0@0A0B0LkdJ$$Ifl\L/Z%++ 0L,4 laytni,$If $$Ifa$ $Ifgd-6B000000  !$Ifgdz# $$Ifa$gdz# $Ifgd8SN & F$Eƀ!'.Ifgd8S000dN & F$Eƀ!'.Ifgd8Skd$$Ifl\L/Z%++ 0L,4 laytni,00 1cN & F$Eƀ!'.Ifgd8SN & F$Eƀ!'.Ifgd8S 1U1x1cN & F$Eƀ!'.Ifgd8SN & F$Eƀ!'.Ifgd8Sx111cN & F$Eƀ!'.Ifgd8SN & F$Eƀ!'.Ifgd8S11 2 222cZTT$If $$Ifa$N & F$Eƀ!'.Ifgd8SN & F$Eƀ!'.Ifgd8S222dN & F$Eƀ!'.Ifgd8Skd$$Ifl\L/Z%++ 0L,4 laytni,22222UkdE$$Ifl\L/Z%++ 0L,4 laytni,$If $$Ifa$222cN & F$Eƀ!'.Ifgd8SN & F$Eƀ!'.Ifgd8S223cN & F$Eƀ!'.Ifgd N & F$Eƀ!'.Ifgd 333P3cN & F$Eƀ!'.Ifgd N & F$Eƀ!'.IfgdtP3y3z3{3|3$If $$Ifa$N & F$Eƀ!'.Ifgd |3}33dN & F$Eƀ!'.Ifgd kd$$Ifl\L/Z%++ 0L,4 laytni,333cN & F$Eƀ!'.Ifgd N & F$Eƀ!'.Ifgd 354n4p4r4s4 $$Ifa$gdz# $Ifgdz#N & F$Eƀ!'.Ifgd s4t44dN & F$Eƀ!'.Ifgd kd$$Ifl\L/Z%++ 0L,4 laytni,44 5ZN & F$Eƀ!'oIfgd|w"W & F hh$Eƀ!'-If^hgd|w" 55R5S5T5U5 $Ifgd|w" $$Ifa$gd|w" $Ifgd N & F$Eƀ!'oIfgd|w"U5V55dN & F$Eƀ!'.Ifgd kd@$$Ifl\L/Z%++ 0L,4 laytni,R555555(6k666667(7)7=7>7?7E7I7J7K7S7T7d7777777777777&8A8H8I8O8P8Y8]8 979>9@9A9B9H9L9ٺh?!4hR'\ hR'\hFhR'\h hR'6 hR'6\hzLhR'6\ jhR'6 hR'6hzLhR'6hhR'5hi$hR'6\hi$hR'6 hR'5\ h hR' hR'5h hR'5hR'4555cN & F$Eƀ!'.Ifgd N & F$Eƀ!'.Ifgd 555555cWNN $Ifgdz# $$Ifa$gdz#N & F$Eƀ!'.Ifgd N & F$Eƀ!'.Ifgd 55*6bN & F$Eƀ!' .Ifgd|w"kd$$Ifl\L/Z%++ 0L,4 laytni,*6/646cN & F$Eƀ!'Ifgd|w"N & F$Eƀ!'Ifgd|w"4696>6cN & F$Eƀ!'Ifgd|w"N & F$Eƀ!'Ifgd|w">6H6k66666cZNZZ $$Ifa$gd|w" $Ifgd|w"N & F$Eƀ!'Ifgd|w"N & F$Eƀ!'Ifgd|w"66(7dN & F$Eƀ!' .Ifgd kd$$Ifl\L/Z%++ 0L,4 laytni,(7T7U7V7W7X7Mkd? $$Ifl\L/Z%++ 0L,4 laytni, $$Ifa$gdz# $Ifgdz#X777777 $$Ifa$gdz# $Ifgdz#N & F$Eƀ!' .Ifgd 77A8bN & F$Eƀ!' .Ifgd kd $$Ifl\L/Z%++ 0L,4 laytni,A8^8r88iK & F$Eƀ!' .IfK & F$Eƀ!' .IfK & F$Eƀ!' .If888fN & F$Eƀ!' .Ifgdi$K & F$Eƀ!' .If89 9W9X9Y9Z9cZQKK$If $$Ifa$ $Ifgdi$N & F$Eƀ!' .Ifgdi$N & F$Eƀ!' .Ifgdi$L9M9N9U9V9[9o9p999999";E;o;p;q;u;v;w;};;;;;;;;;;;<<<<[<\<o<w<~<<<<<<<<<<<<l=߼߮ hUaJ h__aJ haJ hi_aJ h__5aJ hlls5aJ hllsaJhD0UhR'6hFhR'6 hR'5hFhR'5 hi$hR' hR'5\hR'hi$hR'6 hR'6\ hR'6 jhR'64Z9[9p9dN & F$Eƀ!' .Ifgd|w"kd!$$Ifl\L/Z%++ 0L,4 laytni,p999999cWNN $Ifgd|w" $$Ifa$gd|w"N & F$Eƀ!'.Ifgd|w"N & F$Eƀ!'.Ifgd|w"999dN & F$Eƀ!'.Ifgdi$kdB"$$Ifl\L/Z%++ 0L,4 laytni,9:@:cN & F$Eƀ!'.Ifgdi$N & F$Eƀ!'.Ifgdi$@:W:v:cN & F$Eƀ!'.Ifgdi$N & F$Eƀ!'.Ifgdi$v:::cN & F$Eƀ!'.Ifgdi$N & F$Eƀ!'.Ifgdi$:::cN & F$Eƀ!'.Ifgdi$N & F$Eƀ!'.Ifgdi$:;";q;r;s;t;cZQKK$If $$Ifa$ $IfgdFN & F$Eƀ!' .Ifgdi$N & F$Eƀ!' .Ifgdi$t;u;v;w;;;;dbb;;;&$d%d&d'dNOPQgd__kd"$$Ifl\L/Z%++ 0L,4 laytni,;;;;;;;;;;;;<I & FEƀ!'gd&$d%d&d'dNOPQgd__ <\<<<k!I & FEƀ!'gdI & FEƀ!'gdI & FEƀ!'gd<<<4=k!I & FEƀ!'gdI & FEƀ!'gdI & FEƀ!'gd4=k=l=m==== >>8>N>O>P>X>k>x>>>>>>I & FEƀ!'gdl=m==M>>>>>>>>>>>>>>>>>>>>>>>>>>>h0z0JmHnHu hN90JjhN90JUhN9 hN9CJhBvjhBvUh35\aJhi_5\aJ hi_aJhi_CJaJ>>>>>>>>>>>>>>>>>gdv&`#$9 0&P1h:pJn/ =!"#$%t $$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V lH&0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54apytni,$$If!vh#v#v+#v #v:V l0L,55+5 54apytni,$$If!vh#v#v+#v #v:V l;0L,55+5 54apytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V lW0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,$$If!vh#v#v+#v #v:V l0L,55+5 54aytni,^ 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH :@:  Heading 1$@&5\DA`D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List tot FR2*$xd,1$7$8$H$]x^a$*5CJOJQJ\^J_HaJmH sH tH 4@4 Header  !4 @4 Footer  !.)@!. Page NumberH@2H Z Balloon TextCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] 6 9DQQQT  v l|!#')/R5L9l=> ")2GSdmv c f c B /pCoJ lR.~DpJzlqM|1kl 78C !! ""k""###F$$$0%&&'p()) *3***]+++',,,'---].../C/// 0B000 1x1122223P3|333s44 5U5555*646>66(7778889999::::;;<<4=>>!#$%&'(*+,-./013456789:;<=>?@ABCDEFHIJKLMNOPQRTUVWXYZ[\]^_`abcefghijklnopqrstuwxyz{|}~9@DKMT!!8@0(  B S  ?  &&**(0.0666666666666666666OZouJ T n x { KN'' ))002$25566666666666333333333333333333;<OQcBaCm H R  ) 5 .KD+Jzr|Klx8 !0!!!!!9"""&&'U'''((((?)U)x))**+P+}++,----k.A001 1[1112W222"334\444m5P6X6666666666666666666666666666666|I:( Qf'=BojxQU!]J>-G5,(҅:ię(:ܼՆ>VԱ#-«>԰ıʎGaܳ5(0<`J oY`h(n #7q`8 ^`hH.8 ^`hH.8 pLp^p`LhH.8 @ @ ^@ `hH.8 ^`hH.8 L^`LhH.8 ^`hH.8 ^`hH.8 PLP^P`LhH.8 vv^v`hH.8 vv^v`5OJPJQJ^Jo(hH.8 FLF^F`LhH.8 ^`hH.8   ^ `hH.8  L ^ `LhH.8 ^`hH.8 VV^V`hH.8 &L&^&`LhH.hhh^h`OJPJQJ^Jo(-h88^8`OJPJQJ^Jo(hH-h ^`OJQJo(h   ^ `OJQJo(h   ^ `OJQJo(oh xx^x`OJQJo(h HH^H`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`hH.h ^`hH.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.8 ^`hH.8 ^`hH.8 pLp^p`LhH.8 @ @ ^@ `hH.8 ^`hH.8 L^`LhH.8 ^`hH.8 ^`hH.8 PLP^P`LhH.h^`OJPJQJ^Jo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hH8 ^`o(hH.8 pp^p`o(hH. @ @ ^@ `OJQJo( ^`OJQJo( ^`OJQJo(o ^`OJQJo( ^`OJQJo( PP^P`OJQJo(o   ^ `OJQJo(8 ^`hH.8 ^`hH.8 pLp^p`LhH.8 @ @ ^@ `hH.8 ^`hH.8 L^`LhH.8 ^`hH.8 ^`hH.8 PLP^P`LhH.8 ^`hH.8 ^`hH.8 pLp^p`LhH.8 @ @ ^@ `hH.8 ^`hH.8 L^`LhH.8 ^`hH.8 ^`hH.8 PLP^P`LhH.h^`OJPJQJ^Jo(-h ^`OJQJo(oh pp^p`OJQJo(h @ @ ^@ `OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h ^`OJQJo(oh PP^P`OJQJo(hh^h`OJPJQJ^Jo(hH^`OJQJ^Jo(hHopp^p`OJQJo(hH@ @ ^@ `OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHh vv^v`hH.h FF^F`hH.h L^`LhH.h   ^ `hH.h   ^ `hH.h L^`LhH.h VV^V`hH.h &&^&`hH.h L^`LhH.^`5OJPJQJ^Jo(-^`OJQJ^Jo(hHopp^p`OJQJo(hH@ @ ^@ `OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH^`5o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.8 ^`hH.8 ^`hH.8 pLp^p`LhH.8 @ @ ^@ `hH.8 ^`hH.8 L^`LhH.8 ^`hH.8 ^`hH.8 PLP^P`LhH.h^`5o(.h^`5o(hH.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.8 ^`hH.8 ^`hH.8 pLp^p`LhH.8 @ @ ^@ `hH.8 ^`hH.8 L^`LhH.8 ^`hH.8 ^`hH.8 PLP^P`LhH.hh^h`o(.88^8`.L^`L.  ^ `.  ^ `.xLx^x`L.HH^H`.^`.L^`L.h vv^v`hH.h FF^F`hH.h L^`LhH.h   ^ `hH.h   ^ `hH.h L^`LhH.h VV^V`hH.h &&^&`hH.h L^`LhH.h^`5o(.h^`5o(hH.h$ $ ^$ `5o(.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH. (G: oY`S-JQU!07qau_JnUJ0<`vRt5|I=(nlT>PQ(: >-QBo          YL       JM4"                          p                          JM         p                 2R        :@                 :@                                   :@ :@       8[( xep A!|w"&#i$a'V(+J+N,ni,?0/Y06@1=3?!4i5i6;8g8N9|9ey?5Adxe3f[hJnOokApspr]slls,pt!xuhyd={ T|[|Q~-6 U{UJKZ#'@<?%VBv{f ?j%ci_ q8Sm$IDhfrz#zL -uF0z|#tR }-mjP b@Fy#S7xq3+ |svmry_ R'__66@6@UnknownDChungG*Ax Times New Roman5Symbol3. *Cx Arial;Wingdings5. .[`)Tahoma?= *Cx Courier NewACambria Math"1h;(;(!'&v. c&v. cq24663QHP ?;82!xx  APPENDIX B Shushawna Tam Pamela Bowman\               Oh+'0X     ,8@HP APPENDIX BShushawna TamNormalPamela Bowman2Microsoft Office Word@@b@L@L &v.՜.+,0 hp  SUNY-Downstatec6  APPENDIX B Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~     Root Entry F0("Data #1Table_WordDocument;SummaryInformation( DocumentSummaryInformation8CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q