Facility ______________________
Inspector _______________________
Address _____________________ Date __________________________
Phone _______________________ Owner/Manager __________________
Total # Employees ______________
Contact Person ___________________
1.0 Personnel
1.1 List each employee (no names) directly involved in grooming or pet care, their race, age, sex,
amount of time in this occupation, smoker or non-smoker, and education.
1.2 | 1.3 | 1.4 | 1.5 | 1.6 | 1.7 | 1.8 |
ID# | Race | Sex | Age | Time | Smoker/Non | Education |
#1 | ||||||
#2 | ||||||
#3 | ||||||
#4 | ||||||
#5 | ||||||
#6 |
1.9 Number dogs/cats groomed per day (inclusive)______________________
1.10 How Paid? Per dog, per hour or salary? ____________________
1.11 Are employees certified or do they have any formal training to groom pets?
Yes _____ No _______ From Where? _________________________
1.12 Does the owner belong to any groomer’s organization? Yes _____ NO____
Which one? __________________________________
1.13 Do your work activities change day to day or seasonal? Yes ____ NO ____
If yes, explain _________________________________________________
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