Please complete and submit the Foster Inspection Report online below. FOSTER HOME/ANIMAL SHELTER AGENT - INSPECTION REPORT Georgia Department of Agriculture (Hereinafter "GDA")"Foster Home" & "Animal Shelter Agent" are used as stated in the "Rules of "GDA" 40-13-13-.02(6) Animal Protection""GDA" Licensed Animal Shelter: "GDA" License Number: Inspection Date:(Required) Month Day Year Please Enter Foster Home/Animal Shelter Agent Information Below:Name(Required) First Last Physical Address(Required) Zip(Required) City(Required) County(Required) State(Required) Please select the Type of Inspection:(Required)RoutineRe-InspectionPre-Sign Up InspectionPlease mark one or more Categories:(Required) Indoor Animal Housing Outdoor Animal Housing Animal Transport Vehicle Select All[1] A category marked fail must be re-inspected; [2] This report must be on file at the animal shelter’s licensed address and a copy at the foster home address; [3] The following categories are found in the “Rules of “GDA” 40-13-13 Animal Protection”For All Failed Categories See Below Signatures#1 Adequate Food 40-13-13-.01(Required) Pass Fail #2 Adequate Water 40-13-13-.01(Required) Pass Fail *#3 Adequate Temperature Control 40-13-13-.01(Required) Pass Fail *#4 Adequate Ventilation 40-13-13-.01(Required) Pass Fail #5 Proper Animal Health Care 40-13-13-.01(Required) Pass Fail #6 Classification & Separation 40-13-13-.04(Required) Pass Fail #7 Housekeeping 40-13-13-.04(Required) Pass Fail #8 Pest Control 40-13-13-.04(Required) Pass Fail #9 Sanitation 40-13-13-.04(Required) Pass Fail #10 Shelter 40-13-13-.04(Required) Pass Fail #11 Space Requirement 40-13-13-.04(Required) Pass Fail #12 Structural Strength 40-13-13-.04(Required) Pass Fail #13 Waste Disposal 40-13-13-.04(Required) Pass Fail * N/A for outdoor housingFoster Home/Animal Shelter Agent Signature:(Required)Foster Home/Animal Shelter Agent Print:(Required) License Holder (Signature) Inspected By - Print PLEASE EXPLAIN THE REASON FOR THE FAILUREFoster Home/ Animal Shelter Agent’s Name First Last Inspection Date: Month Day Year #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-.04Revised 6/8/2021CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.