Home Inspection Report for the Great Pyrenees Rescue of Northern California, Inc.



GPRNC Home Inspection Form

This on-line form is to facilitate reporting the inspection of a prospective adoptive family's home. Please answer the following questions, print it out for your records, and then return the form by clicking on the "submit" button at the end of the form. Thank you for your cooperation

Date:
Name(s):
Address:
City & State:
Phone:
Fax:
e-mail:
Type of Dwelling (Check one) Setting (Check all that apply:)
Single Family Home Rural
Duplex Semi Rural
Townhouse Suburban
Condominium (own) Urban
Trailer Wooded
Apartment (rent) Waterfront
Multi-family home Hiway/Road frontage
Square Footage (home) Property borders park/public field
Condition of House and Yard : (check all that apply)
Home Immaculate Yard formally landscaped
Well-kept Lived-in but clean
Exterior untidy Interior untidy
Exterior unkempt/poorly maintained Interior trashed/dirty
Describe Home Interior including type of furnishings.
Flooring surfaces: important for older or disabled dogs
Describe accomodations home has for dog; where dog will be left when family is not home. For example: in a crate? Where?; baby gates? Where? Pen? Where? Outdoor run - describe type of fencing, flooring and gate for run.
Children: give ages of children and pay special attention to behavior of children, parents' responses & method of discipline, childrens' interaction with pets. Are children supervised with other pets? Do parents expect children to "be responsible for' pets? Do parents show and treat children with respect and vice versa?
Describe breed, age, sex, health of other pets and livestock.
Species Breed Sex Age Health & Condition
Use space below for additional comments about other animals
Are areas dog has access to free of these chemicals? Yes | No
Yard/garden chemicals |
Household/cleaning chemicals |
Paint/solvents |
Automotive/antifreeze |
Toxic/Poisonous plants |
Is Fence Sturdy? Shake to be sure. Yes |No
Is fence recommended six feet high? Yes |No
Free of gaps, holes, loose boards? Yes |No
Gate latches secure against dogs, children? Yes |No
Can gate be locked? Yes |No
Fences/Gates.
Describe fencing and conditions/security of fence and gates/ any "No" answers above
Pool, Hot Tub, Spa None
Securely Fenced?
Sturdy cover will support dog?
Dog cannot slip under pool cover
How will dog be transported Check if yes
Crate or Vari-Kennel
Cross Tied in Truck Bed
Dog Barrier in Wagon/SUV
Comments
Describe your overall feelings about this family; is this a home you would be comfortable leaving your own dog?
Name of Inspector Date:

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