Name of adoptive/foster “parent”:_________________________________________
Street Address:__________________________________________________________
Address below needs to be the *exact* location where the lamas will be.
Physical Address: _______________________________________________________
City:_________________________________ State: ______ Zip Code:___________
Phone(Home/Work/Cell):___________________________________________________
Email: __________________________________________________________________

  This facility check is being done in preparation for an adoption
  This facility check is being done in preparation for providing a foster home

Please place a 1 for “excellent” a 2 for “acceptable” and a 3 for “improvement needed” next to each item. Items marked ‘ 3’ must be addressed in the problem& planning section.

A. Pasture
____At least 1/2 acre with an additional 1/4 acre per llama
_____Pasture shared with other species has an acceptable amount of space per head to allow clean areas to eat and recreate (i.e. animals have enough space to choose not to stand or lie down in muck and mud).
_____Enclosed with safe fencing in good repair (no loose, rusty wire or loose high tensile, etc.)
_____Free of hazards, i.e. abandoned farm machinery, “dump” areas with rusty metal and glass
_____Free of poisonous plants, i.e mountain laurel

B. Shelter
_____At least 3 sides, facing out of prevailing wind
_____At least 30 square feet per llama
_____Floor can be kept dry in wet, cold weather by bedding with straw, etc..
_____If shelter is not free access, llama(s) are put in if the weather is wet and temperature below 30, or if the temperature is below 0.
_____Adequate shade

C. Catch pen
_____6 feet high
_____Made of sturdy materials
_____Not larger than 1600 square feet (i.e. 40 feet by 40 feet)
_____Not applicable as caretaker demonstrates ability to catch llama easily without a catch pen

D. Truck/Trailer/Van
_____Floor is well maintained such that legs cannot fall through
_____No holes or rusty places that could entrap feet, legs, heads or cause injury
_____Hitch weld is secure, and hitch has pin and safety chains
_____Doors latch securely
_____Enclosed so that llamas cannot jump out
_____Tires have tread, including spare tire
_____Lights, signals and brake lights work
_____Adequate ventilation
_____NA as transport is not provided by this adoptive/foster home

E. Misc Information (Not scored)
Number and type of dogs on the premises:__________________________________________________
Dogs securely separated from livestock/other animals (if non LGD)? [ ] YES [ ] NO
Arrangements:___________________________________________________________
Does this adopter/foster have llamas or alpacas in residence?
If YES, number of llamas:: __ Intact Males __ Geldings __ Females
If YES, number of alpacas:: __ Intact Males __ Geldings __ Females
Add'l info regarding llamas, alpacas or other livestock in residence:
__________________________________________________________________________
___________________________________________________________________________

Facility Problem List and Plan

Please list each item rated a 3 below with specific detail, followed by how it will be addressed and the deadline for completion.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Next review date:_______________________________________
Signature of adoptive/foster “parent”:___________________________ Date:__________
Signature of SELR volunteer mentor/peer:_______________________ Date:____________