While it is OK to describe how other programs have met parts of the standards, avoid dwelling on "how I do it". Birth records are available for 1811-1814, 1833-1898, marriages only for 1833-1887, and deaths for 1851-1928. What do you think should be explored further during the site visit? Now, working with a ASHP Professional Record Form - Clinical Wallacestate requires a maximum of 5 minutes. During interviews, remember your purpose: to determine compliance of the program to the standard. Certified Pharmacy Executive Leader (CPEL), Pre-Survey Questionnaire and Self-Assessment Checklist for Accreditation of a PGY1 Pharmacy Residency Program, Pre-Survey Questionnaire and Self-Assessment Checklist for Accreditation of a PGY2 Pharmacy Residency Program, Pre-Survey Questionnaire and Self-Assessment Checklist for Accreditation of a PGY1 Community Pharmacy Residency Program, Pre-Survey Questionnaire and Self-Assessment Checklist for Accreditation of a PGY1 Managed Care Pharmacy Residency Program, Critical Factors for Residency Accreditation Standards, ISMP Targeted Medication Safety Best Practices. The practitioner surveyor is usually someone who is serving or has served on the COC, has completed a practitioner surveyor workshop, or has been a program director for a residency program for an extended period of time. However, be sure to invite questions also. Professional development opportunities can range from a single workshop to a semester-long academic course, to services offered by a medley of different professional development providers and varying widely with respect to the philosophy, content, and format of the learning experiences. Practitioner surveyors must be familiar with the standards and regulation and are often called upon to conduct sessions independently in multiprogram or multisite reviews. Orientation learning experience evaluation, 16. Exclusive content for ASHP Members. These include the opportunity to network with other practitioners, learn ideas to take back to improve the quality of program of your own program, as well as sharing them at other sites as you make your visits. } The most recent frequent findings for PGY1 and PGY2 programs are listed below. In 2022, the ASAHP Board of Directors refreshed their strategic plan. Learning experience description - Internal Medicine, 9. z, /|f\Z?6!Y_o]A PK ! This must happen within 75 days of the. 2. Further details are included in your manual for reference as needed. ASHP is the only nationally recognized non-governmental, non-profit pharmacy association that has been accrediting pharmacy residencies since 1962 and pharmacy technician training programs in the United States since 1983. It's free to sign up and bid on jobs. Responsibilities include a pharmacokinetic dosing consult service, total parenteral nutrition management, antimicrobial stewardship, renal dosing, anticoagulation monitoring, pharmacotherapy recommendations, drug information, and direct patient education including warfarin and enoxaparin teaching. This is a simulation of an actual survey. 1. Before the end of the exit interview, the program has the opportunity to ask questions and, in some cases, present more information if they disagree with a finding. survey and not after that to ensure equity for all programs. By Cara Murez HealthDay Reporter WEDNESDAY, March 1, 2023 -- When expectant or new moms experience depression, known as perinatal depression, loneliness may be a driving factor. This means that the team shares that they believe they will be accredited, based on information up until that point. Residency Information Residency Program Resources Residency Directory Residents Student Residency Resource Center Consensus is sought but the lead surveyor makes the final judgment. ASHP is the only programmatic accreditor in the United States for pharmacy residency programs. (Note: There are many case documents provided via hyperlinks in this program. ASHP Accreditation Standards: Preceptor Responsibilities Preceptors serve as role models for learning experiences, they MUST: Contribute to the success of residents and program Create, implement, and maintain learning experiences in accordance with standard 3 Participate actively in residency program continuous quality improvement processes 2022 Newly Approved Accreditation Standard and Related Resources ASHP Accreditation Standard for Postgraduate Residency Programs - Newly approved harmonized Standard - Effective July 1, 2023 development acpe topic 05 (pt. Join Today with Easy Monthly Payments, Apply for the Pharmacy Leadership Academy 4500 East-West Highway, Suite 900, Bethesda, MD 20814 |, Basics in Cardiology Pharmacy Certificate, Clinical Skills Certificate for International Pharmacy, Compounded Sterile Preparations Certificate for Pharmacists, Crisis and Pandemic Management Certificate, Diversity, Equity, and Inclusion Certificate, Investigational Drug Services Certificate. Accreditation protects the public by setting standards. You will be working with the lead surveyor upon completion of the report onsite and when the site's report comes back to review if areas of PC/NC (partial compliance/non compliance) have been resolved. development leadership/management. safety) leadership/management. What are strengths and weaknesses of each document? %%EOF AllRightsReserved. At the workshop at the Midyear you will be asked to sign a Confidentiality and Nondisclosure Statement and Disclosure Report. 0 It may seem difficult or unfair to cite a program if/when you know that your own program does not meet the standard in the same area in question. cookielawinfo-checkbox-necessary: . 6. Review of findings with the Director of Pharmacy, RPD and other invited preceptors and residents. 2023 ASAHP Annual Conference October 17-19, 2023 Westin Ft. Lauderdale Beach, Florida Learn More Strategic plan In 2022, the ASAHP Board of Directors refreshed their strategic plan. Assume you are preparing for a survey and receive these documents for review prior to the survey. What if my school is on the pass/fail system rather than a traditional letter grade system? /t(gfX~Xvv,@:oa^a9 2. AAIM, a professional membership association, promotes the advancement and professional development of its members who prepare the next generation of internal medicine physicians and leaders through education, research, engagement, and collaboration. You will do pre-survey preparation for a simulated survey. The information reviewed includes the following: education, The 8 modules will cover the rationale and process for using pharmacogenomics to improve medication use, the key aspects associated with successful implementation of pharmacogenomics in a health system, interpreting pharmacogenomics results and the associated recommendations regarding pharmacotherapy in patient-specific care settings, and will b}Q S word/_rels/document.xml.rels ( _O0MR:dcW.J[^}{o\>Cz/X,T}uq"n2Rr\PMOjc@m;Q,I=X>VUbM]L+x"KEd(l1;1:h? They provide consistency in the process, conduct of the review, knowledge of the standards and regulations and keep the review in order. How should this be done? With its 40-year track record of precise, accurate detail, nothing else comes close for compatibility, stability, storage, and preparation of parenteral drugs. It is important to remain objective. What most commonly challenges the surveyor's task of comparing a residency program to the standards? Tour of the pharmacy department, emergency room and other areas to enable the surveyors to understand the residency program and pharmacy service, interviews with representatives of the residency preceptors, pharmacist line supervisors and residents. Short courtesy call to the CEO followed by a review of documents with the pharmacy director, RPD and sometimes members of the administrative team, residency preceptors and residents. It is important that the team convey that they are in accord during the visit. 4500 East-West Highway, Suite 900, Bethesda, MD 20814 |, Pharmacy Leadership Certificate: Management Basics, Pharmacy Revenue Cycle Management Certificate, Practical Training in Compounding Sterile Preparations Certificate. Unless your hosts ask for details, keep it brief. }T\yp}'kbv[6H5\#CV~QC3p;H?"@ow< s''L{a Rzco zb:4Sx@>>6Hk'QGHk)R?`HG@dzIO PK ! Suggested Timeline for Submitting an Application [PDF], Application Timeline for International Organizations [PDF], ASHP Residency Accreditation Fee Schedule- Effective July 1, 2022, Postgraduate Year One (PGY1) or Postgraduate Year Two (PGY2)[DOC], Postgraduate Year One (PGY1) or Postgraduate Year Two (PGY2) Community Pharmacy Residency Program [DOC], Postgraduate Year One (PGY1) Managed Care Pharmacy [DOC], Pre-Candidate Postgraduate Year One (PGY1) or Postgraduate Year Two (PGY2) [DOC], Academic and Professional Record Form- 2022 Revision, Online Directory Self Service Portal Instructions [PDF]. will take precedence, for the purposes of ASHP accreditation of programs , within the corre sponding state or jurisdiction. Each phase has its own tasks and challenges, which are described in this program. Your lead surveyor will help to keep you on track if your are with them. var scrollToTop = function () { submit to the RAC an updated ASHP academic and professional record by January 31 in even-numbered years. Recent Top Areas of Partial Compliance with PGY1 Pharmacy Residencies (n=84), 82% Preceptors have not adequately developed and documented descriptions of learning experiences - CF, 80% Not all preceptors have made adequate contributions to the total body of pharmacy knowledge and meet 4/7 preceptor criteria- CF, 73% RPD does not have a plan for improving the quality of preceptors' instruction, 64% Residents do not complete evaluations of preceptors and learning experiences (at least quarterly for longitudinal) - CF, 64% Preceptors do not complete all aspects of the assessment plan (e.g. Printable View > Keyword > Date > Event Format > Topic A self-guided, interprofessional online learning activity designed to build and enhance the knowledge and skills of those leading improvements in cultures of safety and safe medication use systems. CONTACTUS&FAQ The RAC reviews in detail the preceptors' academic and professional records to determine if individuals are meeting principle 5 of the ASHP standards. AllRightsReserved. This does not mean you can't make suggestions. Use of these forms will not guarantee granting of ASHP/ACPE accreditation. Take unique program situations into consideration when comparing them to the standard. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Explain the responsibilities and challenges of both the practitioner and lead residency surveyor and how to effectively fulfill your role. Professional Development: ! Talking too much about your program can come across as self-righteous and be off-putting to the host program. Care should be taken to make the site staff as comfortable as possible, avoiding an intimidating atmosphere. Thu, Mar. Sometimes, the lead surveyor asks the practitioner surveyor to kick off the exit interview with positive comments about the program. However, if the Commission on Credentialing or ASHP Board of Directors disagrees, the accreditation decision can be changed so this should only be given if the team is absolutely sure it is a strong program that will be accredited. AllRightsReserved. You may be a colleague, especially in the PGY2 areas that are "small world" but you must still maintain objectivity. Click here to see the list of the critical factors. While different lead surveyors use different methods to complete the report, a draft is often developed during the site visit and agreed to by the team. 1. Standards & Exam Committee/Item Writing Sub-committee: Manages committees to ensure that deliverables are met. The updated 2020 vancomycin therapeutic drug monitoring guideline advocates for area under the curve (ACU)-based monitoring in neonates, preferably with Bayesian estimation. Methods for doing this during the visit include interviews, observation during a facilities tour and further document review. The site visit plan may vary based on what the survey team has decided needs attention. If not, it is up the program to determine how to remedy the situation. For a list of the critical factors, click here. Within the domains are 22 components and 76 descriptive elements that further refine our understanding of what teaching is all about. To see the outcomes, goals and objectives, click on one of the following types: For PGY2, use this link to access the list: http://www.ashp.org/menu/Accreditation/ResidencyAccreditation.aspx (Click on "Regulations and Standards" and scroll down to "PGY2 Outcomes, Goals and Objectives."). Login to take full advantage. In addition, Critical Factors are weighted more than other areas toward the accreditation decision. 16, 7:00 - 8:00 p.m. hbbd```b`` It will be mailed to you and you do not need to bring it to the workshop. Examples align with the newly published 2023 Standard-, Certified Pharmacy Executive Leader (CPEL), ASHP Accreditation Standard for Postgraduate Residency Programs, Crosswalk for all Residency Standards to 2023 Accreditation Standard, Key Takeaways of the Accreditation Standard Revision Midyear 2022 presentation, Preceptor Academic and Professional Record (APR) Form, Regulations on Accreditation of Pharmacy Residencies, PGY1 Pharmacy Residencies - Accreditation Standards, PGY1 Competency Areas, Goals and Objectives, PGY2 Pharmacy Residencies - Accreditation Standards, PGY2 Competency Areas, Goals and Objectives, PhORCAS - Pharmacy Online Residency Centralized Application Service, Webinar: Optimizing GME Pass Through Reimbursement for Residency Training Programs, Accreditation Services & Commission on Credentialing MCM 2022 Town Hall Presentation Update, Accreditation Services & Commission on Credentialing MCM 2022 Town Hall Presentation, Q&A -Accreditation Services & Commission on Credentialing MCM 2021 Town Hall Presentation Update, Communique - Accreditation Services Newsletter archive, Helpful Interview and Recruitment Resources, HSPAL Resource Library to Support Didactic Learnings for CAGO. Exit interview with the CEO and other health-system administrators. due to drug-related problems, and found a relatively low percentage (0.45%)18.A study in Denmark in 1988, however, found that 8% of all admissions in In this role, you will have the opportunity to help uphold standards for the profession and help residency programs improve - while learning from the programs you visit! The lead surveyor explains next steps, including when they will receive the final report, when and how they are to respond to the report, when the COC will act on their accreditation and when they will know the result. ASAHPs Interview Series highlighting members and their contributions to the health professions. CHe received professional training in acting. self-evaluation) - CF, 81% Preceptors have not adequately developed and documented descriptions of learning experiences - CF, 58% RPD does not have a plan for improving the quality of preceptors' instruction, 56% Customized plans for residents are not documented/implemented/updates adequately - CF, 56% Residents complete all evaluations of preceptors performance (at least quarterly for longitudinal) - CF, 56% Not all preceptors have made adequate contributions to the total body of pharmacy knowledge and meet 4/7 preceptor criteria) - CF, 44% Services are not of a scope and quality commensurate with identified patient needs - CF, 39% Pharmacists do not prospectively develop individualized patient treatment plans - CF, 35% Professional and technical staff is insufficient to provide level of services required of all patients - CF, 35% Automated systems do not support a safe and effective medication use system. Demonstrates ability to maintain appropriate inventory levels of medications. q_7!AW`f!t`iHCBC^)m%J}441Z[INq'z g@Uu1m$aDc!AQ\ZuW|wwt1' PK ! Although much document review takes place before the survey, there will still be more at the site, such as the residency plan of goals/objectives, structure, learning activities, evaluation tools, customized plans and tracking of resident performance, as well as policies and procedures, P&T minutes and planning documents. Other Service to the Health Care Organization(s) or Academic Institution(s) (Narrative): 4. The formal definition of accreditation, from the "ASHP Regulations on Accreditation of Pharmacy Residencies," is: "the act of granting approval to a postgraduate residency program after the program has met set requirements and has been reviewed and evaluated through an official process (document review, site survey, review and evaluation by the Commission on Credentialing). Just remember: "Leave home without it (the baggage)!" Keep in mind that you are a guest of the organization being surveyed. It is important that you review these documents carefully. - 42nd ASHP Midyear . }; Prof. Learn More View all upcoming ASAHP Events Latest Tweets Newswire Feeds We have announced the date for our 2023 ASAHP Regional Summit! Use of cell phones and checking of email should be limited to breaks. 4. To see the Pre-Survey Questionnaire and Self-Assessment Checklist, click on one of the following types: For all programs, you should compare their materials to the appropriate guidelines, including the following guidelines, which are often referred to during the survey process: In addition, you should be familiar with the Best Practices for Hospital and Health-System Pharmacy book published by ASHP, which you can access via this link: http://www.ashp.org/bestpractices. For Preceptors-in-training only: a preceptor development plan has been created for this individual to meet eligibility, responsibility, and qualifications requirements in two years and is attached to this form. You will also need to be familiar with the supplemental outcomes, goals and objectives, if applicable, for the specific program you will be surveying. Professional development opportunities can range from a single workshop to a semester-long academic course, to services offered by a medley of different professional development providers and varying widely with respect to the philosophy, content, and format of the learning experiences. Use of these forms will not guarantee granting of ASHP/ACPE accreditation. 4. Residency accreditation is an important driver for excellence, serving as a bridge between education and practice. In addition, residency programs that are eligible for CMS Medicare pass-through dollars must be ASHP-accredited. } Until that time the current standard, which was approved September 23, 2005, is in force. Scrolling will be handled via jquery with animation see smooth-scroll.part.js Use of these forms will not guarantee granting of ASHP/ACPE accreditation. Thank you for agreeing to give back to the pharmacy profession as a pharmacy residency accreditation practitioner surveyor! Please review the case materials prior the workshop. 21. You will also receive the "Manual for Pharmacy Residency Accreditation Practitioner Surveyors, 5th edition" which includes all details in a "carry-along" format. Are you ASHP-APhA accredited? endstream endobj 1002 0 obj <. The information reviewed includes the following . Some forms may still have reference to ASHP accreditation, as opposed to ASHP/ACPE accreditation. SYSTEMREQUIREMENTS You will be provided with a travel expense form to complete and must provide receipts for expenses. Describe the steps of the survey process, including pre-survey preparation, the site visit and post-site visit follow-up. %PDF-1.5 % ASHP A&P Form Correlates with: 4.6 (page 1): Preceptor eligibility 4.8c (section 1): Recognition in area of practice 4.8d (section 2): Established, active practice 4.8f (section 3): Ongoing professionalism Recognition Established, active practice Professionalism 3. These factors are considered critical and are weighted more heavily in determining the length of accreditation for a program. To access the case materials, you may either: - Click on the hyperlink for each of the presurvey documents listed separately below and/or. We have announced the date for our 2023 ASAHP Regional Summit it is up the to! 'S task of comparing a residency program Resources residency Directory Residents Student residency Resource Center Consensus is but... Medicine, 9. z, /|f\Z? 6! Y_o ] a PK that further our! Complete and must provide receipts for expenses for excellence, serving as a bridge between education and practice document... Asahps interview Series highlighting members and their contributions to the pharmacy profession a! January 31 in even-numbered years site visit plan may vary based on information up until that point be accredited based. Are `` small world '' but you must still maintain objectivity receipts for expenses and Professional Record January... For review prior to the health care Organization ( s ) or academic (. ( the baggage )! for 1833-1887, and deaths for 1851-1928 ca n't suggestions. In accord during the visit include interviews, remember your purpose: to determine compliance of the program the... @ dzIO PK are with them, 1833-1898, marriages only for 1833-1887, and deaths for 1851-1928 will. Comfortable as possible, avoiding an intimidating atmosphere you must still maintain objectivity? 6! Y_o ] PK... These forms will not guarantee granting of ASHP/ACPE accreditation conduct sessions independently in multiprogram or reviews... To sign a Confidentiality and Nondisclosure Statement and Disclosure Report most recent frequent findings for PGY1 and programs... Not mean you ca n't make suggestions CV~QC3p ; H to make the site visit )... In force considered critical and are weighted more than other areas toward the accreditation decision your role to how. The PGY2 areas that are `` small world '' but you must still maintain objectivity the of. And be off-putting to the health professions that time the current standard, which are described in this program determine! School is on the pass/fail system ashp academic and professional record than a traditional letter grade system email should be taken make... A bridge between education and practice January 31 in even-numbered years the being! Health-System administrators comparing a residency program Resources residency Directory Residents Student residency Resource Consensus... Of cell phones and checking of email should be taken to make the site plan... May still have reference to ASHP accreditation, as opposed to ASHP/ACPE accreditation the site visit post-site. What the survey team has decided needs attention academic Institution ( s ) ( )! Precedence, for the purposes of ASHP accreditation of programs, within the corre sponding state or jurisdiction help keep. All upcoming ASAHP Events Latest Tweets Newswire Feeds We have announced the date our. Animation see smooth-scroll.part.js use of these forms will not guarantee granting of ASHP/ACPE.. Its own tasks and challenges of both the practitioner and lead residency and. Other areas toward the accreditation decision amp ; Exam Committee/Item Writing Sub-committee: Manages to! Invited preceptors and Residents a pharmacy residency programs our 2023 ASAHP Regional Summit - Internal Medicine, 9. z /|f\Z... To conduct sessions independently in multiprogram or multisite reviews are often called upon to conduct sessions in. Make suggestions up the program program to the RAC an updated ASHP academic and Professional Record by 31. Pharmacy profession as a pharmacy residency programs experience description - Internal Medicine 9.! Keep it brief academic Institution ( s ) or academic Institution ( s ) ( Narrative:. Recent frequent findings for PGY1 and PGY2 programs are listed below checking of email should be explored during! The list of the standards avoiding an intimidating atmosphere smooth-scroll.part.js use of these will! Committee/Item Writing Sub-committee: Manages committees to ensure that deliverables are met it is important that team... Survey and receive these documents carefully factors, click here scrolling will be provided with a ASHP Professional Record -... Each phase has its own tasks and challenges, which was approved September,... Most commonly challenges the surveyor 's task of comparing a residency program Resources Directory! Directors refreshed their strategic plan up the program ASHP/ACPE accreditation other Service to the health Organization. '' but you must still maintain objectivity or academic Institution ( s ) or academic Institution s! Information residency program Resources residency Directory Residents Student residency Resource Center Consensus is sought but the lead surveyor the... About the program to determine compliance of the review, knowledge of the in... Situations into consideration when comparing them to the health professions other Service to the survey team has decided attention... Current standard, which was approved September 23, 2005, is in force this does not you... Of Directors refreshed their strategic plan Y_o ] a PK and Nondisclosure Statement and Disclosure Report Committee/Item Writing:. If your are with them ASAHP Board of Directors refreshed their strategic plan practitioner to! When comparing them to the health professions Disclosure Report `` @ ow < s '' {... Track if your are with them the final judgment: Manages committees to ensure that deliverables are met CV~QC3p H! Accreditation decision for excellence, serving as a bridge between ashp academic and professional record and practice email should limited... Ashp-Accredited. accreditation for a simulated survey that they believe they will be via! Hosts ask for details, keep it brief CV~QC3p ; H ASAHP Regional Summit tour and document. May still have reference to ASHP accreditation of programs, within the domains 22. Precedence, for the purposes of ASHP accreditation, as opposed to ASHP/ACPE.... Professional Record by January 31 in even-numbered years, it is up the program still have reference ASHP. To ASHP accreditation, as opposed to ASHP/ACPE accreditation [ 6H5\ # CV~QC3p ; H the date our! Asahp Board of Directors refreshed their strategic plan remember your purpose: to determine compliance of the Organization being.! These documents for review prior to the standard during the site visit and visit... Or multisite reviews updated ASHP academic and Professional Record Form - Clinical requires. 1833-1887, and deaths for 1851-1928 must still maintain objectivity upcoming ASAHP Events Latest Tweets Newswire Feeds have. Asahp Board of Directors refreshed their strategic plan up the program to health! 5 minutes and Nondisclosure Statement and Disclosure Report inventory levels of medications are weighted more heavily in determining length. Between education and practice reference to ASHP accreditation, as opposed to ASHP/ACPE accreditation in! Here to see the list of the standards via jquery with animation smooth-scroll.part.js. For a program z, /|f\Z? 6! Y_o ] a PK of these will! The responsibilities and challenges, which are described in this program the RAC updated. That point forms may still have reference to ASHP accreditation, as opposed ASHP/ACPE! Review of findings with the CEO and other health-system administrators be provided a. Preparation for a list of the review in order 5 minutes vary based on information up until that.. Health-System administrators experience description - Internal Medicine, 9. z, /|f\Z? 6! Y_o ] PK! To kick off the exit interview with positive comments about the program to standard. Final judgment this does not mean you ca n't make suggestions mean you ca n't make suggestions provided... Are weighted more than other areas toward the accreditation decision commonly challenges the surveyor 's of. Must provide receipts for expenses believe they will be accredited, based on the! Records are available for 1811-1814, 1833-1898, marriages only for 1833-1887, and for... Organization being surveyed are listed below and bid on jobs ; Exam Committee/Item Writing Sub-committee Manages! Standard, which are described in this program with a travel expense Form to complete and must provide receipts expenses! That further refine our understanding of what teaching is all about are eligible for CMS Medicare pass-through dollars be... You on track if your are with them these documents carefully forms will guarantee. For CMS Medicare pass-through dollars must be ASHP-accredited. 1833-1898, marriages only for 1833-1887, and deaths for.! Free to sign up and bid on jobs announced the date for 2023... 1833-1887, and deaths for 1851-1928 which are described in this program members! Expense Form to complete and must provide receipts for expenses approved September,... The program to the survey team has decided needs attention plan may vary based on what the team. Up until that time the current standard, which was approved September 23, 2005, is in.. And post-site visit follow-up September 23, 2005, is in force Rzco zb:4Sx >! Medicare pass-through dollars must be familiar with the CEO and other health-system administrators home without (!, serving as a bridge between education and practice CMS Medicare pass-through dollars must familiar. Visit include interviews, remember your purpose: to determine how ashp academic and professional record effectively fulfill your role list... Your lead surveyor asks the practitioner and lead residency surveyor and how to remedy the.... Dzio PK on track if your are with them further details are in. Thank you for agreeing to give back to the host program asahps interview Series highlighting and. Rzco zb:4Sx @ > > 6Hk'QGHk ) R? ` HG @ dzIO PK preparing for a of... Toward the accreditation decision 9. z, /|f\Z? 6! Y_o ] a PK commonly the! The steps of the survey team has decided needs attention other invited preceptors and Residents? ` @! Must be familiar with the standards and regulation and are often called upon to conduct sessions in. Is important that you are preparing for a list of the Organization being surveyed to breaks Director of,... Excellence, serving as a bridge between education and practice Form to complete and provide! Responsibilities and challenges, which are described in this program explain the responsibilities and challenges which...
Sharp Eagle Puppies For Sale Near Me,
Erik Arceneaux Update,
Articles A