An anesthesiologist's assistant practicing at all sites shall practice pursuant to written scope of practice protocols signed by all supervising anesthesiologists and the anesthesiologist's assistant. Copies of the protocols must be on file at all practice sites. The protocols shall include at a minimum the:
(1) name, license number, and practice addresses of the sponsoring anesthesiologist;
(2) name and practice address of the anesthesiologist's assistant;
(3) date the protocol was developed and dates it was reviewed or amended;
(4) situations that require direct evaluation by or immediate referral to the anesthesiologist.