Foster Home/animal Shelter Agent - Inspection Report printable pdf download

FOSTER HOME/ANIMAL SHELTER AGENT - INSPECTION REPORT

Georgia Department of Agriculture [Hereinafter “GDA”]

[1] “Pet” is used as defined in the “Rules of “GDA” 40-13-13-.01 Animal Protection”

[2] “Animal Shelter Agent” is used as stated in the “Rules of “GDA” 40-13-13-.02(6) Animal Protection”

“GDA” Licensed Animal Shelter ___________________________________________________ “GDA” License # _________________

Enter the following Foster Home/Animal Shelter Agent information: Name _______________________________________________

Physical address _______________________________________________________________County _________________________

City ________________________________________________________ State ____________________ Zip ____________________

Please check type of inspection and enter the date: Routine Inspection____/ Re-Inspection____/ Inspection date ____________

Please check one or more categories: Indoor Pet Housing____/ Outdoor Pet Housing____/ Pet Transport Vehicle____/

[1] Any category marked fail must be re-inspected; [2] Categories not marked pass or fail require an explanation on the adjacent

line; [3] This report must be on file at the Animal Shelter’s licensed address and a copy at the Foster Home/Animal Shelter Agent’s

address; [4] The following categories are found in the “Rules of “GDA” 40-13-13 Animal Protection”

(1) Adequate food 40-13-13-.01 > Pass____/ Fail____/ ____________________________________________________________

(2) Adequate water 40-13-13-.01 > Pass____/ Fail____/ ___________________________________________________________

(3) Adequate temperature control 40-13-13-.01 > Pass____/ Fail____/ ______________________________________________

(4) Adequate ventilation 40-13-13-.01 > Pass____/ Fail____/ _______________________________________________________

(5) Proper animal health care 40-13-13-.01 > Pass____/ Fail____/ ___________________________________________________

(6) Classification & separation 40-13-13-.04 > Pass____/ Fail____/ __________________________________________________

(7) Housekeeping 40-13-13-.04 > Pass____/ Fail____/ ____________________________________________________________

(8) Pest control 40-13-13-.04 > Pass____/ Fail____/ ______________________________________________________________

(9) Sanitation 40-13-13-.04 > Pass____/ Fail____/ _______________________________________________________________

(10) Shelter 40-13-13-.04 > Pass____/ Fail____/ _________________________________________________________________

(11) Space requirement 40-13-13-.04 > Pass____/ Fail____/ _______________________________________________________

(12) Structural strength 40-13-13-.04 > Pass____/ Fail____/ ________________________________________________________

(13) Waste disposal 40-13-13-.04 > Pass____/ Fail____/ ___________________________________________________________

Inspected by (signature) _________________________________________ (print) _________________________________________

Foster Home/Animal shelter Agent (signature) ______________________________________________________________________

Foster Home/animal Shelter Agent - Inspection Report