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HOME VISIT CHECKLIST

Dear Volunteer,

The GCCR arranges a home visit with each potential adopting family ("adopters") as soon as possible after receipt of the adoption application, for the following purposes:

1) to verify what the adopters have told us;

2) to identify homes where Cavaliers might be promptly placed after foster home assessment of each dog's needs;

3) to determine the appropriateness of placing a Cavalier in the home, including considerations of willingness and ability to deal with the health, behavior, age, etc. ofa rescued Cavalier;

4) if this is an appropriate home for a Cavalier, to inform the adopters of other opportunities to find a Cavalier, such as through other rescue organizations and local breeders;

5) if there is another Cavalier in the home, to offer the GCCR as a network for information and assistance in caring for a Cavalier, especially if and when the Cavalier becomes ill; and,

6) if appropriate, to encourage the adopters to foster a rescued Cavalier.

When visiting the home, consider whether you would feel comfortable leaving your dog with this family. The questions are not "Pass/Fail" - they are intended to prompt your own good judgment and thoughts about an appropriate placement in this home. This checklist is a private communication between you and the GCCR rescue coordinator and Board; what you write will not be shared with the adopters or any third party.

Thank you!

Patti Insalaco

1. Date of Visit *

2. Applicant's First Name *

It is important to enter the same FIRST name as entered on the foster/adopter application. The first name, last name and email address allow the system to match this home visit report with the person that submitted the adoption application

3. Applicant's Last Name *

It is important to enter the same LAST name as entered on the foster/adopter application.

4. Email (Primary) *

This is the email address of the applicant. It can be found on the foster/adopter's application form. It is important to enter to match the Home Visit Report to the applicant in the system.

5. Length of Visit

Enter the number of minutes spent visiting the applicant and their family.

Home Visited by: *

THIS FIELD IS REQUIRED. Please fill in the name of the volunteer that made the home visit.

7. Applying to:

Adopt Foster

8. Neigborhood *

Give a brief description of the applicant's neighborhood. Rural? Suburban? Urban?

9. Applicant and Family *

Are all members of the household present for you to meet? List those present and specify who they are. Does everyone appear to be informed about Cavaliers and in favor of the adoption? Do any family members seem overly concerned? Describe behavior of any children in relation to adults, other children and to any pets. If you brought your dog, do they take direction from their parents in how to appropriately interact with your dog?

10. Tell us about other dogs in the home:

Ask to meet any dogs the applicant already owns. Do they appear healthy and well cared for? (Note grooming, weight, if nails are trimmed, etc.) Do the dogs seem well-socialized? Responsive to commands? How do the dogs interact with each other and with family members? If you've brought your own dog(s) along for the visit, how do the resident dogs react/interact with your dog? === Do the applicant's cats appear to be dog-savvy? Does the family have a plan to make a "safe"zone for their cat(s) and to keep the Cavalier away from the cat food and litter box? Are any other "critters" (birds, hamsters, reptiles, etc.)? List the other critters owned by the family and describe where they are kept.

11. Dog Compatible Lifestyle

The purpose of this question is to be insightful and not judgemental. GCCR visits a range of adoptive/foster families. Their spoken demostration of willingness to adapt to a new Cavalier family member and having time time to include a new Cavalier in their life is the essense of this question. Just tell us your impressions.

12. Family Dog History

The intent of this question is to discover past successes and failures as a dog owner. Did the family abandon/release a dog in the past? Have they had other rescues that have since past away? What did they learn from their experiences as dog owners?

13. Children Evaluation

14. Emergency Care Plan

15. Hours to be alone / day?

16. Interior of Home *

Do furnishings in the home appear reasonably dog-proof? Does the family seem comfortable with having Cavaliers on carpeted floors, on furniture, beds? Where will the Cavalier stay when the family is away during the day? Does the area appear warm, clean, and free of dangerous objects? Is there a crate?

18. Yard and Fence

If there is a fenced yard, is it large enough to provide adequate exercise space for the dog? Does the yard appear reasonably clean and well-kept? If there is no fenced yard, or the yard is too small, how does the applicant plan to exercise his or her Cavalier? How will this plan work during the different seasons of the year?Is there a swimming pool? If yes, does it have a cover? Is it enclosed with a fence? Is there an outdoor kennel of any kind, or chains or cable runs? What are the plans for their use?

19. Travel Care Plans

20. Is the applicant willing to do house training? *

Yes No

As a GCCR volunteer, you will need to discuss house training. You can point out that the foster family has been working on this training and others. However, you must also tell the applicant that house training often backslides when an Cavalier is moved and the new owner will need to reinforce good house training rules. Is the applicant willing to take on this aspect of adoption?

21. Longest time alone?

22. Cavalier's nighttime location?

23. Rescue Readiness Rating *

24. Rescue Discussion

Describe the convesation about rescue that you initiated with the applicant along with their concerns/questions.

25. Special Circumstances

26. Special Need Cavaliers

Yes No

Record any conversation around adoption of Cavaliers with special needs. Indicate if the applicant was willing to take on this type of responsibility.

27. Special Needs Note *

FOR CAVALIERS WITH SPECIAL NEEDS: Should this family be considered for placement of a Cavalier with special needs? For each item below, state yes or no, and explain: A. diagnosed illness requiring regular veterinary care, such as mitral valve disease,syringomyelia, joint or eye problems? B. lack of socialization, fear of humans, aggressiveness to humans, other dogs or animals? C. puppies or adult dogs requiring house training? D. Are there any special needs, unusual circumstances or concerns that we should consider when placing a Cavalier in this home? Anything else you want to tell us?

28. Cavalier with diagnosed illness

Yes No

30. Conclusions *

Review the information on the application about what kind of Cavalier the adopters would accept. Does it appear the family has realistic expectations about accepting a rescued Cavalier? Why or why not? Would you recommend placement of a Cavalier in this home?

Thank you for volunteering and giving time to visit our adoption & foster applicants.

Sincerely,

Greater Chicago Cavalier Rescue

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