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

Inspection Type

Routine Inspection

Re-Inspection

Inspection date

*

Please check one or more categories

Foster Category

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

*

(2) Adequate water 40-13-13-.01

*

(3) Adequate temperature control 40-13-13-.01

*

(4) Adequate ventilation 40-13-13-.01

*

(5) Proper animal health care 40-13-13-.01

*

(6) Classification & separation 40-13-13-.04

*

(7) Housekeeping 40-13-13-.04

*

(8) Pest control 40-13-13-.04

*

(9) Sanitation 40-13-13-.04

*

(10) Shelter 40-13-13-.04

*

(11) Space requirement 40-13-13-.04

*

(12) Structural strength 40-13-13-.04

*

(13) Waste disposal 40-13-13-.04

*

Inspected by

Signature

Print Name

Foster Home/Animal shelter Agent