Date of visit *
Name of dog applied for *
Adopting or Fostering? * Select Adopting Fostering
Name of applicant *
Address *
Home Phone number
Cell number
Email
Describe neighbourhood (residential, rural urban): *
Describe street - traffic levels, sidewalks, busy intersection, quiet, highway, etc.: *
Type of residence - Bungalow, 2-storey, townhouse, condo, rental apt, multi-family, other: *
Are there off-leash parks nearby? (either fenced or unfenced) * Select Yes No
Notable concerns or observations:
Describe the home's interior - clean, tidy, safe, cluttered, etc.? Note any potential problems (e.g. loose wires, uneven/loose floor surfaces, steep unprotected drops, toxic plants, accessible garbage, small choke-able toys lying around): *
Comment on any areas requiring improvement:
Please describe staircases (steep, dark, narrow, carpeted, hardwood, uneven, etc.) *
Will the dog have access to the basement? If so, please view and describe it (clean, tidy, debris on floor, hazardous substances out of reach of dog) *
Are there screen doors in addition to front or side door(s)? *
Where is the garbage located and is it accessible to the dog? *
Are any areas of the house off limits to the dog? How will they keep the dog out of these areas? *
Make note of any of these outdoor items seen: Dog Door, Outdoor pen/dog run, Tie-outs/chains, Barbed wire, Excess poop lying around, Outdoor dog house, Circular/patterned wear on the grass:
Is there direct access from the house to the yard: * Select Yes No
If there is a pool, is there a fence around the pool itself? If not, how will they ensure the dog doesn’t accidentally fall into the pool?
Is the yard fully and securely fenced? (please describe the type, height and condition of the fence): *
Describe the yard (size, well maintained, free of debris and feces,etc.)
Any gaps or places dog could escape? If they’ve applied for a small dog, check for gaps between the bottom of the fence and the ground. *
Gate that latches? Is the gate(s) normally locked? *
Describe any balconies/decks the dog will have access to (height, gaps between the floor and the bottom of the balcony/deck, side gaps).
Who was present for the home visit? *
Are there any special needs individuals in the home? Explain:
Did you get the impression that everyone in the family supports the adoption? * Select Yes No
Describe the behaviour of the adults among themselves and to children and pets (respectful, commanding, patient, disrespectful, etc.):
Comment on behaviour of the children and their interactions with other pets. What is their expected role in pet care? Do the parents seem to expect the children to be “responsible” for the care of the pets? Do the parents always supervise young children with pets? Note any means of discipline used.
Describe the pets in the home: (dog, cat or other; look for things like: skin/flea issues, length of nails, over/underweight)?
Do dogs wear collars or harnesses? Yes/No What type (choke, flat, prong)? Do they wear them indoors? Do they have ID tags?
Do the pets have access to water? Select Yes No
If there are dog beds, dog crates, dog toys/supplies, where are they located?
If you took a dog on the visit, describe the interaction of the applicant, the family and existing pets to your dog.
What behaviour did you observe from existing pets? (i.e. were they friendly, fearful, interactive, avoidant, other? Please explain)
Cat food and litter can be dangerous for dogs. If there are cats in the house, how will the dog be prevented from gaining access to cat food and litter?
Have the applicant describe “a day in the life” of their household (normal routine, amount of time at home, exercise routines). Comment on any concerns.
If the owner talks about training methods to you, what kind of methods do they use/want to use? (e.g. using treats, using a clicker, Cesar Millan, alpha rolling, dominance, shock collar)”
Describe the accommodations the home has for the adopted dog. Where will the dog be kept when the owners are not at home—e.g. crate, gated off room, outdoor run, free in the house?
Where will the dog be sleeping? *
Will the dog be allowed on the furniture? * Select Yes No
Is there anything that would cause you to feel uncomfortable about placing a dog here? * Select Yes No
Provide any other comments you think would be helpful:
Evaluator Name: *
Phone
Email *
I recommend this home and family for a Speaking of Dogs Rescue dog: * Select Yes No
I would approve this home and family for a Speaking of Dogs rescue dog with the following recommended modifications:
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