A Short History of Toronto People have lived in the Toronto region on the north shore of Lake Ontario for almost 11,000 years since the first indigenous people moved here from the south after the ice age. Additionally, it was geographically well positioned to serve the commercial needs of a newly-settling hinterland at a time of expanding trade and improving transportation. Industrialization, beginning modestly in the mid-19th century, expanded greatly after Confederation, and contributed significantly to shaping the city's environment and prosperity. By 1901, the industrial, commercial, financial, and institutional centre had a population of 208,000, which rose to 667,500 by 1941. A great shift in the spirit of the community began with the numerous waves of immigrants after 1945. By 2001, Toronto had become one of the most multicultural cities on the planet, where 152 languages and dialects were spoken in an atmosphere of comparative harmony. According to that year's census, more than half of Toronto's 2.5 million residents were born outside Canada, and a million people belonged to visible minorities. Today's Toronto is a large and complex urban centre. Like any similarly large city it faces important challenges and competing opinions on how to face them. At the same time, Toronto continues to flourish as a tremendously exciting city, embracing a strong and prospering economy, rich cultural underpinnings, and retaining its long heritage as a comparatively safe, orderly, and inclusive community, where working and living conditions are among the very best to be had on the planet. Canada’s Health Care System Canada has a predominantly publicly financed, privately delivered health care system that is best described as a network of ten provincial and two territorial health insurance plans. The system, commonly known as Medicare, provides access to universal and comprehensive coverage for necessary hospital, inpatient and out-patient physician services. The system can be referred to as a "national" health insurance system in that the individual provincial/territorial hospital and medical insurance plans are linked through adherence to national principles set at the federal level. These principles are laid out in the Canada Health Act, which includes the national standards for health care. The federal government also manages the financial aspect of health care (which consists primarily of fiscal transfers to the provinces) and direct functions such as health care delivery to groups such as veterans, the military, and native Canadians living on reserves. In addition, programs such as disease prevention and health promotion are also managed at the federal level. However, the specific management and delivery of health services is the responsibility of each individual province or territory. Provinces and territories plan and evaluate the provision of hospital care, physician health care services, some aspects of prescription care, and public health. How the System Works Canada's health care system relies extensively on primary care physicians (family physicians and general practitioners), who make up about 60 percent of all active physicians in Canada. However, the majority of health care professionals in Canada are not employed by the government. Most doctors are private practitioners who work in independent or group practices and enjoy a high degree of autonomy. Some doctors work in community health centers, hospital-based group practices, or in affiliation with hospital out-patient departments. When Canadians need medical care, in most instances, they go to the physician or clinic of their choice and present the health insurance card issued to all eligible residents of a province. They do not pay directly for insured hospital and physicians' services, nor are they required to fill out forms for insured services. In addition to insured hospital and physician services, provinces and territories also provide public coverage for other health services that remain outside the national heal the insurance framework for certain groups of the population (e.g., elderly, children and welfare recipients). These supplementary health benefits often include prescription drugs, dental care, vision care, assistive equipment and appliances (prostheses, wheelchairs, etc.) to independent living and services of allied health professionals such as podiatrists and chiropractors. Canadians must pay privately for these non- According to the most recent Statistics Canada data, 21 percent of Canadians encounter difficulties when they need to see a specialist; 13 percent, in receiving non-emergency services; and 16 percent, in having diagnostic tests done – a total of 1.1 million Canadians. Long waiting times and the rationing of access to health services are symptoms of a costly health care system in need of a cure. As we head to the polls, Canadians and political leaders continue to debate the question of changes to Canada’s universal public health care system and the proposed privatization of some specialized services. In 2004, the federal government agreed to transfer $41 billion to the provinces for health care spending over the next ten years. A top priority at that time was more family doctors. Are you getting the medical care you need? In our May Reader’s Digest we highlight findings that many Canadian patients are not getting the proactive tests and treatments that will keep them healthy and out of hospital. The result is too many unnecessary heart attacks and strokes, uncontrolled diabetes and other health problems. Health Canada is the Federal department responsible for helping Canadians maintain and improve their health, while respecting individual choices and circumstances. What is Health Canada's Goal? According to our mission and vision, Health Canada's goal is for Canada to be among the countries with the healthiest people in the world. To achieve this goal, Health Canada: Relies on high-quality scientific research as the basis for our work; Conducts ongoing consultations with Canadians to determine how to best meet their long-term health care needs; Communicates information about disease prevention to protect Canadians from avoidable risks; Encourages Canadians to take an active role in their health, such as increasing their level of physical activity and eating well. Family Violence Family Violence is abusive behaviour that can be physical, sexual or psychological. It can also take the form of physical or emotional neglect. Family violence occurs in relationships of kinship, intimacy, dependency or trust. Individuals can be abused regardless of their age, gender, cultural background, education, income or place of residence. The National Clearinghouse on Family Violence (NCFV) is Canada’s national resource centre for information about family violence. The NCFV collects, develops and disseminates resources on prevention, protection and treatment. REGULATED HEALTH PROFESSIONS ACT, 1991 major elements of the RHPA: •entry to practice •client relations •quality assurance •scope of practice •prosessional misconduct •public participation and openness Canadians cherish their health care system. Health care is viewed as a right, and nobody is denied medical or hospital care because they are unable to pay. Both patients and physicians experience substantial freedom of action within the system: patients are free to chose their doctors and to visit more than one doctor for the same complaint. Physicians are free to prescribe treatments and to admit patients to hospitals with little scrutiny. In the public system, queue-jumping is allowed based on medical need, not on the patient's ability to pay. Yet a patient in Ontario, Canada, jumped a six-month queue for a magnetic resonance imaging (MRI) - high technology diagnostic procedure-by using her husband's benefits plan and paying $600. The Ontario Health Insurance Plan (OHIP) prohibits charging for (or selling private insurance to cover) medically necessary services that are covered by OHIP. Nevertheless, the private insurer used by the husband's company arranged for the MRI within a few days at a Toronto hospital where there is normally a six to nine-month wait for non-urgent MRls. Said the patient's doctor, "If she got an MRI because she could pay for it, when it's a service to be covered by OHIP, that's just not right. She needed an MRI, but she didn't need it any more than anyone else I refer." The MRI patient queue-jumped because her husband's employer provided private health insurance and she had $600. Other patients had to wait. Waiting Times The initial appointment to see the specialist was available within three to four weeks. But there were intriguing differences in the waiting times for surgery. For surgeons who operated only in public hospitals, the prospective "patients" were told that they would have to wait from two to eight weeks for cataract surgery; the average was six weeks. In contrast, the waiting times for surgery at private clinics were from one day to four weeks. However, the waiting times were lengthy-up to a year for surgery performed in public hospitals by surgeons who operated in both public and private sector settings. From the Office of the President General Information about McMaster History of McMaster McMaster Fast Facts Take a virtual tour of our beautiful campus Send an Electronic Postcard from McMaster Campus Map How to get to McMaster University The City of Hamilton Relocating to McMaster University & the Hamilton Community McMaster University McMaster is a medium sized, full-service university offering educational programmes through six Faculties. The extensive activity in research, supported by more than $74 million in grants and contracts, means there are first-class libraries and sophisticated facilities. More than 13,000 full-time students attend McMaster University, 1,500 of whom are pursuing advanced degrees offered through the School of Graduate Studies. In Addition, about 4,000 part-time students are registered in the Fall/Winter session, from September to April, and 3,500 in the Spring/Summer session from May to August. The University also provides courses in centres located outside Hamilton, for which full credit is granted. Most of the 1,000 members of the University faculty hold doctoral degrees in their areas of specialization. Faculty members are expected to teach both graduate and undergraduate courses and may be involved in the academic counselling of students. McMaster campus, which is restricted to pedestrian traffic, is adjacent to the Royal Botanical Gardens at the western end of Lake Ontario. On-campus men's, women's and co-educational residences are available for about 2,765 students. The University is minutes from downtown Hamilton, Ontario, and the activities that a major city has to offer. Students can get there by car or by taking one of the buses from the region's public transit system, which make frequent stops on campus. Undergraduate Registration Information Graduate Studies International Students Continuing Education Part-time Degree Studies/Summer School Degree Courses Undergraduate Registration Information Graduate Studies International Students Advisor Continuing Education Part-time Degree Studies/Summer School Degree Courses Mohawk College is one of the leading colleges in Canada, with a fine tradition of learning and achievement. We stand, with pride, on our reputation for excellence in teaching and you will find each of our staff ready to support your efforts. We offer relevant and dynamic courses to match a broad range of career choices and we do it on a full time, part time or continuing education basis to meet your life style needs. As a member of our Mohawk community, you will be able to engage in student government, clubs, sports and social activities. We value your involvement and ideas in making Mohawk College the best that it can be for you. Friendships you make here will last a lifetime! About Us Within its four outstanding faculties – Applied Arts, Business, Health Sciences and Human Services and Engineering Technology. In Health Sciences, Mohawk has a long-standing Nursing program and was the first Canadian college to offer a three year program in Medical Imaging. In 1998, Mohawk became the first Canadian college to acquire a CT scanner for its Medical Imaging program. • • • • • • • • • • • • Mohawk is Best Known for: Nursing (B.Sc.N. program) Medical Technologies (Medical Radiation Sciences program) Skilled Trade Apprenticeships Manufacturing Technologies (Process Automation) Biotechnology Insurance Business and Office Administration Design (Packaging Design program) Communications Media (Journalism & Communications program) Early Childhood Education Music Applied Degrees Opening Doors For Internationally Educated Nurses If you are a dedicated, skilled nurse registered outside of Canada, Mohawk College is your bridge to Ontario nursing registration. The Bridging for Internationally Educated Nurses (BIEN) program will provide you with the education and experience necessary to register with the College of Nurses of Ontario (CNO). PROGRAM DESCRIPTION Mohawk College acknowledges your skills and education as a nurse. The program is designed to integrate your skills with Ontario standards as required by the College of Nurses of Ontario. This Diploma Program is available on a part-time basis. • • • • • • BENEFITS Receive a recognized Ontario College Certificate Health care specific language courses Best practices as applied to nursing in Ontario Gain experience in a Canadian hospital setting Eligibility for registration with the CNO Employment in Ontario GETTING STARTED Contact the College of Nurses of Ontario (CNO) and request the "Registering as a Nurse in Ontario" document and an application form. Complete and return the application form to the CNO. The CNO will assess your application and send you a Letter of Direction. When you receive the Letter of Direction, Mohawk College will be able to assist you to determine which courses would be required. An English assessment is required prior to entering the BIEN program. WHAT YOU NEED • Letter of Direction from the College of Nurses of Ontario (CNO) AND • Have practiced as a nurse within the last 10 years AND • Language Assessment. All applicants for whom English is a second language must provide proof they meet the program's Fluency Requirements of Canadian Language Benchmark (CLB) of 7. A CLB of 6 in some areas may be acceptable. AND • Computer literacy is required for program success. You must be able to use a computer to produce a basic Word document, use e-mail and the Internet • Proof of Canadian citizenship, permanent residency OR authorized under the Immigration and Refugee Protection Act (Canada). HOW DO I APPLY ? •Forward a cover letter along with: •Letter of Direction from CNO •Resume outlining your nursing practice •Results of language assessment such as TOEFL (written or computer), TWE, CELBAN, MELAB, and IELTS •Citizenship or immigration status HOW TO BECOME A NURSE IN CANADA If you are currently a NURSE in your home country and you are interested in relocating temporarily or permanently to North America, NSC offers the following options: 1. NURSE WORK VISA program - requires completion of a nursing program of minimum 3 years (4 preferred), very good English skills and minimum 5 years postgraduate experience, preferably in ICU, CCU, OR, ER or L&D. NSC will assist you with: - obtaining the temporary licence to practice in Canada - preparing for the Canadian RN Examination - finding employment in Canada and applying for work visas for you and your family Due to the continuously changing healthcare job market in Canada, applicants must be aware that placement is not guaranteed for all applicants. The Canadian healthcare employers usually pick the best international nurses, who are able to prove extensive hospital experience, have excellent work references, are fluent in English and can adapt fairly quickly to the Canadian healthcare setting. The R.N. average salary in Canada is currently CAN$ 50,000-55,000 / year. You can apply for Canadian Permanent Residence for you and your family once you have completed one year of full time employment in Canada. 2. LIVE-IN CAREGIVER program - If you do not feel ready for the Nurse Work Visa Program, you might consider the live-in caregiver program as a first step towards your nursing career in Canada. This program requires completion of a nursing program of minimum 2 years; RNs, LPNs and RMs (registered midwives) are eligible to apply. Your profile will be entered in the online database of our affiliated placement company Select Caregivers Canada, for placement with Canadian families interested in hiring a live-in caregiver/ nanny. If selected by a potential employer, NSC will arrange for a phone interview and assist you in obtaining a live-in caregiver work visa under the Live-in Caregiver Program. Once you arrive in Canada and start working as a live-in caregiver, we can assist you with the licensing process and employment search in order to become a Registered Nurse in Canada. Registering as a Nurse in Ontario This document was updated in collaboration with the Access to Professions and Trades Unit, Ministry of Citizenship and Immigration in November 2005. Requirements may have changed by the time you apply. Please contact the College of Nurses of Ontario before you complete your application. Nursing in Ontario The College of Nurses of Ontario (CNO or College) is the regulatory body for nursing in Ontario. It is not an academic institution or school. In Ontario, nurses are self- regulating health professionals. Self-regulation is a privilege granted to professions that have the ability to put the public interest first. Self regulation means that the profession governs itself through the College and individual members. CNO’s role is to protect the public’s right to quality nursing services by providing leadership to the nursing profession. It does this by establishing requirements for becoming a Registered Nurse (RN) or Registered Practical Nurse (RPN), establishing and enforcing the standards of practice, managing quality assurance programs to help nurses maintain competence throughout their careers. Within the nursing profession, only RNs and RPNs are authorised to perform the procedures in the three controlled acts authorised to nursing. Only those with a Certificate of Registration and a current annual payment card from CNO can practise as a nurse in Ontario, or use the titles ”nurse”, “Registered Nurse,” or “Registered Practiced Nurse.” Expectations of Nurses In Ontario, nursing one profession with two categories – (RNs) and (RPNs). RNs and RPNs study from the same body of nursing knowledge. Programs for RN students are longer and more in depth, while RPN students study for a shorter time, resulting in a more focused body of knowledge. This difference in knowledge influences the level of a nurse’s autonomy, which is affected by the complexity of the client’s condition. On January 1, 2005, the basic education requirement for registration as an RN or RPN changed. All new RNs must have a baccalaureate degree or its equivalent and all RPNs must have a diploma from an approved Ontario nursing or practical nursing program or its equivalent. PROFESSIONAL STANDARDS guide the practice and conduct of the nursing profession in Ontario the seven professional standards reflect the thinking, doing and being aspects of nursing I ACCOUNTABILITY - Each nurse is accountable to the public and responsible for ensuring that her/his practice and conduct meets legislative requirements and the standards of the profession. II CONTINUING COMPETENCE - Each nurse maintains and continuously improves her/his competence by participating in the College of Nurses of Ontario's Quality Assurance (QA) Program. III ETHICS - Each nurse understands, upholds and promotes the values and beliefs described in the Ethical Framework. IV KNOWLEDGE - Each nurse possesses, through basic education and continuing learning, knowledge relevant to her/his professional practice. V KNOWLEDGE APPLICATION - Each nurse continually improves the application of professional knowledge. VI LEADERSHIP - Each nurse demonstrates her/his leadership by providing, facilitating and promoting the best possible care/service to the public. VII RELATIONSHIPS Each nurse establishes and maintains respectful, collaborative, therapeutic and professional relationships. CLASSES OF REGISTRATION There are six classes of registration: General, Temporary, Special Assignment, Extended, Retired and Transitional General Class This is the most common class of registration. It is held for a member's lifetime, and an annual fee is required to maintain a current Certificate of Registration. Temporary Class People who have met all of the registration requirements, except passing the Canadian Registered Nurse Examination (CRNE) or the Canadian Practical Nurse Registration Examination (CPNRE), can still practise as a registered member. If you’re eligible to write the exam, or are waiting for the exam results, have evidence of recent practice one year from the date of your application and have a written offer of employment, you may apply for temporary registration. Temporary registration is granted for a six-month period and restricts practice to a specific employment setting. If you fail the exam while holding temporary registration, the Certificate of Registration will be revoked. You are not eligible for temporary registration if you have previously failed the registration examination. Once you pass the exam and have met all other requirements for registration, you are eligible for General Class registration. Special Assignment Class This is a short-term, non-renewable registration for individuals, usually from outside Ontario, who have an appointment or assignment as an RN or RPN with an approved facility, and who do not plan to stay in Ontario for more than one year. People in this class of registration can only practise within the scope of her or his appointment and under defined terms, limits and conditions. Extended Class Extended Class Registration Only RNs who have obtained advanced education and passed the Extended Class (EC) examination can join this class. RN(EC)s have an expanded scope of practice in the areas of assessment, diagnosis, prescription of tests and treatments, and health promotion Transitional Class The Transitional Class will allow members of other Canadian nursing regulatory bodies who have graduated after January 1, 2005, and who do not meet the new education requirements, to register and work in Ontario for a limited time while pursuing further nursing studies to meet the entry-to-practice education requirement. RNs have four years and RPNs have two years to complete the further studies to meet the requirement. The College of Nurses of Ontario The College includes the Registration and Examination Team, The Customer Service Team, and the Registration Committee. The Committee makes decisions about applicants who do not meet all of the registration requirements. The College will do the following: set (through government legislation) the registration requirements provide information about the registration requirements and the assessment process; assess application and determine whether requirements are met; inform applicants of the status of their application; evaluate document, and when necessary, ask the applicant to request additional information from schools, employers, or the regulatory body; administer the national nursing exams; issue Certificates of Registration; and present applications that do not meet all the requirements to the Registration Committee. • • • • • • • • • • • • • Registration Requirements To practise nursing as an RN or RPN, you must hold a current General Certificate of Registration with CNO. To become eligible for General Class Registration, you will need to meet the following seven requirements to obtain a General Certificate. Completion of an acceptable nursing or practical nursing program. Evidence of recent safe nursing practice. Passing the national nursing registration examination. Evidence of fluency in written and spoken English or French. Registration or eligibility for registration in the jurisdiction you completed your nursing program. Proof of Canadian Citizenship, Permanent Residency or authorization under the Immigration and Refugee Protection Act ( Canada) to engage in nursing practice. Good character and suitability to practice, which includes the following: information about whether your nursing licence has ever been denied or encumbered; information about if you’ve been involved in proceedings for professional misconduct, incompetence or incapacity; information about any criminal convictions, including a criminal record synopsis; and information about any physical or mental condition/illness that may affect your ability to practice. • Before you come to Canada • The College of Nurses of Ontario strongly recommends you begin the application process before coming to Canada. You can write, fax, email or telephone our office in Toronto to request an application package. See address at the end of this document. • You can fill out the application form and mail it along with the application fee. The College can assess your application while you are still in your country and send you notification of your equivalency to Ontario programs. Canadian Registered Nurse Examination Fees • The fee for the Canadian Registered Nurse Examination (CRNE) is $406.17. Please complete and return the Examination Application (E-1) Form with the examination fee by the application deadline indicated below. • Fees must be received by the College of Nurses before or on the examination deadline specified, regardless of the postmark. You should allow at least five days for your mailed payment to reach the College. Ontario graduates • For Ontario graduates writing the examination for the first time, please submit $455.70 ($406.17 examination fee, plus $49.53 assessment fee) with your A2/E1 form. Examination Dates • You cannot apply for another examination before receiving your results from a previous examination. Due to time constraints, unsuccessful candidates writing at one session may not be able to rewrite at the next session. • The examinations will be conducted on each of the dates above at the centres indicated by an "X" below. When submitting your application, please provide a first and second choice of writing centres. Applicants will be entered into a writing centre on a first-come, first-served basis. • Nurse Registration Examinations • Successful completion of the examination is one of the requirements for eligibility for registration with the College of Nurses of Ontario. The exam measures the competencies required of nurses beginning to practise. • The Canadian Registered Nurse Examination (CRNE) includes about 300 multiple choice and short answer questions, while the Canadian Practical Nurse Registration Examination (CPNRE) has 260 multiple choice questions. Approximately half the questions are case-based, while the rest are independent. • The exams are administered over the course of a day, and are available in French. Examination centres are located across the province. • To be eligible to write the exam, you must first apply for assessment. To do so, please contact the College. RN examination fees, dates and locations RPN examination fees, dates and locations Identification Cards/Photo Identification • You will receive an identification card, which will admit you to the examination room. If you have not received this card two weeks before the date of the examination you selected, please notify the College of Nurses. • You must bring your identification card and another piece of identification, which includes both your picture and signature, for admission to the examination. • Acceptable forms of identification include: valid passport, driver's license, age of majority card, Canadian citizenship card or student identification card. If you do not have such documents, a recent photograph bearing your notarized signature will be accepted. Results • Examination results will be mailed — 10 to 12 weeks following the RN examination, or four to six weeks following the RPN examination — to the name and permanent address you provided on your examination application form. • Results are not released over the telephone. Do not phone to ask when examination results will be mailed because this delays the processing of the results. Name/Address Change • Remember to notify the College of any change of address as soon as possible to make sure you receive your ID card and examination result. All requests for a change of name must be accompanied by an original legal document (such as a marriage certificate) or a notarized copy. Refunds • A full refund will be issued only when written notice is received eight or more weeks before the examination date. • A 50 percent refund will be issued if written notice is received less than eight weeks to seven days prior to the examination date. • No refund will be issued if notice is received less than seven days prior to the examination date. Special Accommodation • Candidates with disabilities requiring special arrangements should contact the College of Nurses at least 90 days before the examination. • • • • • • • • • Exam questions 1. A family has recently placed a patient on an Alzheimer's unit for long-term care. On the first visit to the patient, a family member asks die nurse why the patient will not talk and wonders if perhaps the patient is upset about being there and should be cared for at home after all. What is the nurse's best response? a. "This is part of the illness. There is nothing you can do." b. "Fm sure the family has made the right decision for all concerned." с "This must be difficult for you both." d. "Are you feeling guilty about bringing a member of your family here?* 2. P. a 40-year-oid mother of two children ages 6 and 9» is admitted for a surgical biopsy of a suspicious lamp in her left breast. When the nurse comes to take P. to surgery, she finds her tearfully finishing a letter to her children. P, says, "I want to leave this for them in case anything goes wrong today." The muse's best response would be: a. "In case anything goes wrong? What are your thoughts right now?" b. "I can understand that you're nervous, but this is really a minor procedure. You'll be back in your room before you know it." c. "Try and take a few deep breaths and relax, I have some medication thai will help." d. "I 'm sure your children know how much you love them. You'll be able to talk to them on the phone in a few hours." • • • • • • • • • • • • • • • 3. The nurse prepares to conduct the patient interview and initial evaluation. How should she begin? a. "Heilo, Т., I'm R.N., a nurse here at the health center. I need к» learn more about you and your reasons for coming in. Then we'll discuss how the health center can help you," b. "Hi, T. My name is R. Why don't we sit and chat for awhile. How can 1 help you?" с "Ms. S. I'm the nurse assigned to interview you. If necessary, the psychiatrist also will evaluate you today. Otherwise, you'll see him another time." d. "Ms. S., I'm Mrs. N.. a nurse. You mentioned that you feel out of it. Can you tell me more about this?" 4. A patient complains he hears voices. How would you respect the client and at the same time maintain your nurse-client relationship and responsibility? a. "I don't hear any voices here." b. "The only voice I hear in this room is yours." с "I don't hear the voices. Tell me more about them." d. '"I can't hear the voices. Only you can hear the voices." 5. Mrs. Chianti is just admitted to the long-term care facil: While the nurse is helping her unpack her belongings, . suddenly burst out to crying. What is the nurse's best response? a. "Please don't cry. Everyone is happy here." b. "I see that you're upset. It must be very hard fof you to 1 here." c. Reassure the client that it is alright to be in the hospital. d. "I know how difficult it is for you to be here in the hasp • • • • • • • • • • • • A patient receives a medication in either the route of om injection. TJie patient's father complains at this time to \ you are administering an injection form of the medicatic into the patient's deltoid muscle. How would you respoi the patient's father? a, "It can be given in both routes." b. "I will report about this to the doctor." с "It seems you are worried about this. Tell me more abot 7. Mr. T, 45 years old, obese, is admitted and you are assit: to assess him. How would you ask him to know if he ts concerned about his weight"? a. "Does your physician know you're overweight?" b. "How do you feel about your weight?" c. "Are you concerned about the risk of being overweight'.' 8. The wife of a 75-year-old client with end-stage Aliriwir.: disease asks the nurse to help the client end tin misers husband. The wile asks !he nurs? io ciw an narcotics to her husband. Euthanasia is с'еипеЛ а? killing" and this is under what? a. criminal code b. code of nursing ethics с human rights code d. against die guidelines of the licensing body 6.