Section 6.05 - Facility Permit D-B1: Facility Requirements for Administration of Moderate Sedation including Nitrous Oxide-oxygen in Conjunction with any Anesthetic or Enteral Sedative Agents Dispensed or Administered in the Dental Facility(1)Application. An applicant shall submit an accurate and complete application on form(s) provided by the Board and accompanied by the permit fee to be determined annually by the Executive Office of Administration and Finance. The application shall, at a minimum, include the following: (a) Applicant name and Massachusetts dental license number;(b) Name(s) of dental establishment(s), owner(s) of said establishment, and address(es) of the site(s) where anesthesia will be administered;(c) Documentation of provision and maintenance of equipment, materials, and drugs required for the administration of moderate, minimal and nitrous oxide-oxygen sedation;(d) A written request for an on-site inspection conducted by the Board; and(e) Other information as may be requested by the Board.(2)Equipment Required for a Facility Permit D-B1. The following equipment shall be required to be provided and maintained on-site: (a) Alternative light source for use during power failure;(b) Automated or manual external defibrillator;(c) Disposable syringes, assorted sizes;(d) Disposable CPR masks (pediatric and adult);(e) Equipment suitable for proper positioning of the patient for administration of cardiopulmonary resuscitation, including a back board;(f) Equipment and maintenance of an intravenous infusion (if IV medications are to be administered by a qualified dentist who is educated and trained commensurate with the ADA Guidelines of Teaching Pain Control Sedation to Dentists and Dental Students 2007;(g) Gas delivery system capable of positive pressure ventilation, which must include: 2. Safety-keyed hose attachments;3. Capability to administer 100% oxygen in all rooms (operatory, recovery, examination, and reception);4. Gas storage in compliance with safety codes;5. Adequate waste gas scavenging system; and6. Nasal hood or cannula.(h) Latex free tourniquet;(i) Means of monitoring vital signs (pediatric and adult);(j) Oxygen (portable Cylinder E tank) pediatric and adult masks capable of giving positive pressure ventilation (including bag-valve-mask system);(k) Pulse oximeter with battery pack;(l) Sphygmomanometer and stethoscope (pediatric and adult);(n) Supervised area for recovery; and(o) Any other equipment as may be required by the Board.(3)Drugs Required for a Facility Permit D-B 1 Permit. The following drugs and/or categories of drugs shall be provided and maintained in accordance with the AHA/ACLS Guidelines ( 234 CMR 6.02) or as determined by the Board for emergency use. All drugs shall be current and not expired. (a) Acetylsalicylic acid (readily absorbable form);(e) Antihypoglycemic agent;(h) Epinephrine preloaded syringes (pediatric and adult); (i) Two epinephrine ampules; (n) Any other drug or category of drugs as may be required by the Board.