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EBAA

EBAA

We restore sight worldwide

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        • About EBAA
        • EBAA is the nationally-recognized accrediting and standards setting body for eye banks.

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        • Since 1961, EBAA member eye banks have provided tissue for more than 2 million sight restoring, life-changing corneal transplants.

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EBAA Accreditation Inspection Application

EBAA Accreditation Inspection Application

Step 1 of 7

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  • Review the Instructions Below

    Complete this application to begin the process for inspection and accreditation by EBAA. See the EBAA’s Accreditation Policies and Procedures, Medical Standards, and Constitution and Bylaws for more information about EBAA inspections and accreditation policies and procedures.

    This application should be completed for any establishment that performs any eye banking function and is seeking EBAA accreditation (e.g. comprehensive and limited function eye banks). To learn more about how the EBAA Accreditation Board defines these eye banking functions, visit Accreditation Governance and Functions.

    All fields are required, unless about satellite or separate entities that are not applicable to the applying eye bank. By clicking the "Save and Continue Later" button at the bottom of the page, you will be able to start the form and finish it later. You will receive an email with instructions on how to go back to the form.

    An application will not be considered complete and inspector(s) will not be assigned until all information is provided to the satisfaction of the EBAA Accreditation Board Chair(s). Additional documentation may be required upon review of your application. If you have questions about this application or the required supporting documentation, please contact Jennifer DeMatteo at 202-775-4999, ext.117 or via email at jennifer@restoresight.org.
  • Person Completing Application

    Enter the information for the person completing this application.
  • Name of Contact
  • Contact Job Title
  • Contact Email Address
  • Eye Bank Applying for Inspection

    Enter the information for the eye bank applying for inspection.
  • Organization Name
  • Organization Address
  • Organization Phone Number
  • Parent Organization

    If applicable, complete the fields below. Otherwise, skip to the Medical Director section.
  • Parent Organization Name
  • Parent Organization Address
  • Medical Director

  • Medical Director Name
  • Is the Medical Director an ophthalmologist?
  • Has the Medical Director completed a corneal fellowship?
  • If yes, list the Fellowship location and year completed.
  • If no, do you have documentation of a consulting relationship with an ophthalmologist who has completed a corneal fellowship?
  • Consulting Ophthalmologist’s Name
  • Consulting Ophthalmologist’s Fellowship Location and Year Completed
  • Does the Medical Director fulfill the role of an EBAA CEBT in a supervisory and training position?
  • If yes, year of initial CEBT Certification
  • Year of last recertification
  • If you have any supplemental documentation or CVs related to your Medical Director, upload them here.
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    • Back-up Medical Director

    • Back-up Medical Director Name
    • Is the Back-up Medical Director an ophthalmologist?
    • Has the Back-up Medical Director completed a corneal fellowship?
    • If yes, list the Fellowship location and year completed.
    • If no, do you have documentation of a consulting relationship with an ophthalmologist who has completed a corneal fellowship?
    • Consulting Ophthalmologist’s Name
    • Consulting Ophthalmologist’s Fellowship Location and Year Completed
    • Certified Eye Bank Technician

    • Does your bank employ at least one EBAA Certified Eye Bank Technician?
    • If yes, list the CEBT Name.
    • Year of initial CEBT Certification
    • Year of last recertification
    • If no, list the consulting CEBT name.
    • Consulting CEBT Organization
    • Is the organization EBAA accredited?
    • Executive Director

    • Executive Director
    • Executive Director Email Address
    • Executive Director Phone Number
    • Is the Executive Director also a CEBT?
    • Year of initial CEBT Certification
    • Year of last recertification
    Save and Continue Later
    • Eye Bank Operations

    • Are cleaning and maintenance records, equipment certifications, and monitoring charts available for review at the main location applying for site inspection?
    • Does your bank have donor records readily available for review including recipient follow-up information and adverse reaction files since your last EBAA inspection?
    • Does the eye bank have sufficient whole eyes / corneoscleral discs to demonstrate practical recovery or processing techniques as outlined in the Accreditation Policy & Procedures?
      *If No, the Applying Eye Bank must make arrangements to acquire adequate tissue for the day of inspection.
    • Does the eye bank have a Policy and Procedures Manual ready for submission and review by the Accreditation Board Inspectors?
    • Have you had a Change in Governance since your last EBAA inspection including a change in the type(s) of eye banking function this bank performs?
    • If yes, please describe.
    • If yes, was the Change in Governance reported to the EBAA Office?
    • Has your facility been inspected by the FDA or Health Canada since your last EBAA inspection?
    • If yes, date of inspection
    • Was a 483 or any other citation issued?
    • If yes, please describe.
    • Did your bank forward all written documentation of observations, findings or results to the EBAA Office?
    • Attach copies of 483s and/or any other observations/documentation that the bank received from the regulatory authority.
      Drop files here or
      Accepted file types: jpg, pdf, png, doc, Max. file size: 50 MB.
      • Has your facility been inspected by any other official agencies since your last EBAA Inspection?
      • If yes, please provide the name(s) of the Agenc(ies) that inspected your facility and the dates of any inspection(s). Provide the scope of the inspection and it’s findings to this application.
      • Did your bank forward all written documentation of observations, findings or results to the EBAA Office and the Chair(s) of the Accreditation Board as required by EBAA?
      • Eye Bank/Entity Proficiency Verification

      • Complete the table below to verify the handling of at least 25 surgical corneas annually for each eye banking function (as defined by EBAA) for which the eye bank/entity is applying for accreditation. Identify at least 25 surgical tissue ID numbers from within the past 12 months, and document every eye banking function that applies to that tissue ID number for which the eye bank/entity is applying for accreditation. To select the appropriate function, place an "X" in the box associated with that function. Multiple functions may be marked for any particular tissue ID. Click the "+" to add additional tissues.

        Please note, for each function, at least 25 tissues must be marked to be considered for Accreditation for that specific function.


        Tissue ID#RecoveryProcessingTissue StorageTissue EvaluationDonor Eligibility DeterminationFinal Distribution 
      • Enter the total number of tissues listed above that were handled for each function.
        RecoveryProcessingTissue StorageTissue EvaluationDonor Eligibility DeterminationFinal Distribution
      Save and Continue Later
      • Eye Bank Function or Task Identification

        For each eye bank function / task listed below, identify every entity / location that performs the task for the organization applying for this site inspection.
      • 1. Perform body examination or physical assessment
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 2. Perform a pen light examination
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 3. Perform ocular recoveries (ie. Enucleation/in-situ)
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 4. Perform laboratory corneoscleral disc excisions
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 5. Preserve sclera
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 6. Perform microkeratome processing (e.g. DSAEK processing)
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 7. Perform manual dissection processing (e.g. DMEK processing)
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 8. Perform laser (e.g. femtosecond) assisted processing
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 9. Perform tissue transfers, scleral trims or blood rinsing
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 10. Perform processing other than those listed above in #4-9 (see MS Glossary for definition of Processing)
      • Describe the other processing function.
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 11. Perform plasma dilution calculations
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 12. Obtain answers to the donor risk assessment interview (DRAI)
      • If you have a physically separate satellite or contracted establishment (includes OPO or tissue bank) that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 13. Perform slit lamp examination
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 14. Evaluate tissue using a specular microscope
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 15. Determine donor eligibility
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      Save and Continue Later
      • 16. Evaluate infectious disease testing results
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 17. Store storage solution(s)
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 18. Store ocular tissue
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 19. Maintain refrigerator records
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 20. Maintain cleaning and environmental monitoring records
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 21. Maintain tissue evaluation records
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 22. Store instruments
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 23. Maintain donor files
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 24. Perform instrument sterilization in-house
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 25. Label tissue for distribution
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 26. Provide a unique ISBT 128 Tissue Identifier for each tissue
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 27. Track tissue
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 28. Ship tissue released for transplant to surgeons or surgical facilities
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 29. Maintain complete donor or recipient case records
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      • 30. Seek required follow-up information 3-6 months post-op
      • If you have a physically separate satellite or contracted establishment that performs the above task, enter their information below. Click the "+" to add additional satellites or contracted establishments.
        Name, City and State of Separate SatelliteName of Contracted Establishment 
      Save and Continue Later
      • Satellite Locations/Contracted Establishments - Skip and Proceed to Next Page if Not Applicable

        If a Satellite (or Other) Location or a Contracted Establishment was listed as performing a task outlined in the previous section, complete the chart below for each establishment, marking “yes” or “no” as appropriate. (The eye bank applying should not be included as it is addressed elsewhere in this application.)
      • Enter yes or no in each column. Click the "+" symbol to add a new row for each Satellite (or other) location.
        Organization NameDoes the entity have a Medical Director?CEBT on Staff?EBAA Accredited?FDA Registered?CLIA Certified?Joint Commission Accredited?State Inspected? 
      • Please include any comments regarding the satellite locations listed above.
      • Is the applying eye bank/entity (the facility applying for site inspection), a subsidiary or part of another organization? For example, if this bank is a satellite, “yes” should be checked.
      • If yes, name of parent organization?
      • Executive Director Name of Parent Organization
      • Medical Director Name of Parent Organization
      • Does the applying eye bank/entity (the facility applying for site inspection), own, operate or use any physically separate location(s) for the performance of any eye bank tasks or functions (not including contracted establishments)?
      • List all physically separate locations. Click the "+" button to add rows for additional locations.
        Location: Name, City, and StateIs this location separately registered with FDA? (Yes or No)Has this location already been included for inspection during a different EBAA Accreditation Cycle? (Yes or No) 
      Save and Continue Later
      • Separate Location Information - Skip and Proceed to Next Page if Not Applicable

        For each physically separate location, complete the following information. If you do NOT have separate locations, you can skip this page by clicking "Next" at the bottom of the page.
      • Separate Location #1

      • Name of Location
      • Organization Address
      • Location Phone Number
      • Name of Lead Staff at This Location
      • Lead Staff Job Title
      • Lead Staff Email Address
      • Does the location have its own Policy and Procedures Manual?
      • If No, what Policy and Procedures Manual does the facility use (Name of Organization)?
      • Does the location have a CEBT on staff?
      • If yes, provide CEBT Name
      • Year of initial certification
      • Year of last recertification
      • If no, provide consulting CEBT Name
      • Organization Name
      • Is the organization EBAA Accredited?
      • Does the location have, or have access to, a qualified Medical Director or his/her designee?
      • Is the Medical Director an Ophthalmologist?
      • Medical Director Name
      • Medical Director Address
      • Medical Director Email Address
      • How many surgical corneas did this location handle over the past year (January 1 to December 31)? This includes any of the following: recovered, processed, stored, evaluated, determined donor eligibility, or distributed the ocular tissue.
      • Do you have an additional location to submit information about?
      • Separate Location #2

      • Name of Location
      • Organization Address
      • Location Phone Number
      • Name of Lead Staff at This Location
      • Lead Staff Job Title
      • Lead Staff Email Address
      • Does the location have its own Policy and Procedures Manual?
      • If No, what Policy and Procedures Manual does the facility use (Name of Organization)?
      • Does the location have a CEBT on staff?
      • If yes, provide CEBT Name
      • Year of initial certification
      • Year of last recertification
      • If no, provide consulting CEBT Name
      • Organization Name
      • Is the organization EBAA Accredited?
      • Does the location have, or have access to, a qualified Medical Director or his/her designee?
      • Is the Medical Director an Ophthalmologist?
      • Medical Director Name
      • Medical Director Address
      • Medical Director Email Address
      • How many surgical corneas did this location handle over the past year (January 1 to December 31)? This includes any of the following: recovered, processed, stored, evaluated, determined donor eligibility, or distributed the ocular tissue.
      • Do you have an additional location to submit information about?
      • Separate Location #3

      • Name of Location
      • Organization Address
      • Location Phone Number
      • Name of Lead Staff at This Location
      • Lead Staff Job Title
      • Lead Staff Email Address
      • Does the location have its own Policy and Procedures Manual?
      • If No, what Policy and Procedures Manual does the facility use (Name of Organization)?
      • Does the location have a CEBT on staff?
      • If yes, provide CEBT Name
      • Year of initial certification
      • Year of last recertification
      • If no, provide consulting CEBT Name
      • Organization Name
      • Is the organization EBAA Accredited?
      • Does the location have, or have access to, a qualified Medical Director or his/her designee?
      • Is the Medical Director an Ophthalmologist?
      • Medical Director Name
      • Medical Director Address
      • Medical Director Email Address
      • How many surgical corneas did this location handle over the past year (January 1 to December 31)? This includes any of the following: recovered, processed, stored, evaluated, determined donor eligibility, or distributed the ocular tissue.
      • Do you have an additional location to submit information about?
      • Separate Location #4

      • Name of Location
      • Organization Address
      • Location Phone Number
      • Name of Lead Staff at This Location
      • Lead Staff Job Title
      • Lead Staff Email Address
      • Does the location have its own Policy and Procedures Manual?
      • If No, what Policy and Procedures Manual does the facility use (Name of Organization)?
      • Does the location have a CEBT on staff?
      • If yes, provide CEBT Name
      • Year of initial certification
      • Year of last recertification
      • If no, provide consulting CEBT Name
      • Organization Name
      • Is the organization EBAA Accredited?
      • Does the location have, or have access to, a qualified Medical Director or his/her designee?
      • Is the Medical Director an Ophthalmologist?
      • Medical Director Name
      • Medical Director Address
      • Medical Director Email Address
      • How many surgical corneas did this location handle over the past year (January 1 to December 31)? This includes any of the following: recovered, processed, stored, evaluated, determined donor eligibility, or distributed the ocular tissue.
      • Do you have an additional location to submit information about?
      • Separate Location #5

      • Name of Location
      • Organization Address
      • Location Phone Number
      • Name of Lead Staff at This Location
      • Lead Staff Job Title
      • Lead Staff Email Address
      • Does the location have its own Policy and Procedures Manual?
      • If No, what Policy and Procedures Manual does the facility use (Name of Organization)?
      • Does the location have a CEBT on staff?
      • If yes, provide CEBT Name
      • Year of initial certification
      • Year of last recertification
      • If no, provide consulting CEBT Name
      • Organization Name
      • Is the organization EBAA Accredited?
      • Does the location have, or have access to, a qualified Medical Director or his/her designee?
      • Is the Medical Director an Ophthalmologist?
      • Medical Director Name
      • Medical Director Address
      • Medical Director Email Address
      • How many surgical corneas did this location handle over the past year (January 1 to December 31)? This includes any of the following: recovered, processed, stored, evaluated, determined donor eligibility, or distributed the ocular tissue.
      • Do you have an additional location to submit information about?
      • Separate Location #6

      • Name of Location
      • Organization Address
      • Location Phone Number
      • Name of Lead Staff at This Location
      • Lead Staff Job Title
      • Lead Staff Email Address
      • Does the location have its own Policy and Procedures Manual?
      • If No, what Policy and Procedures Manual does the facility use (Name of Organization)?
      • Does the location have a CEBT on staff?
      • If yes, provide CEBT Name
      • Year of initial certification
      • Year of last recertification
      • If no, provide consulting CEBT Name
      • Organization Name
      • Is the organization EBAA Accredited?
      • Does the location have, or have access to, a qualified Medical Director or his/her designee?
      • Is the Medical Director an Ophthalmologist?
      • Medical Director Name
      • Medical Director Address
      • Medical Director Email Address
      • How many surgical corneas did this location handle over the past year (January 1 to December 31)? This includes any of the following: recovered, processed, stored, evaluated, determined donor eligibility, or distributed the ocular tissue.
      • Do you have an additional location to submit information about?
      Save and Continue Later
      • Please use this section to provide any additional information you deem important for the Accreditation Board co-chairs to have regarding your inspection.
      • Please upload any additional files or supplemental materials.
        Drop files here or
        Accepted file types: jpg, pdf, png, doc, Max. file size: 50 MB.
        Save and Continue Later

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        phone 202.775.4999
        fax 202.429.6036

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