Grooming Salon Inspection Form
Please fill out the checklist for each appointment.
Appointment Date
 /
Month
 /
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Pet Type
Please Select
Dog
Cat
Hamster
Parrot
Bunny
Bird
Fish
Duck
Pig
Pet Name
Owner's Name
First Name
Last Name
Services
Bath
Grooming
Teeth-brushing
Nail buffing
Other
Checklist
Please apply all measures before and after each appointment.
Rows
Check
Ensure separation of >6ft between individuals
1
Close or reconfigure worker common spaces and high density areas where workers are likely to congregate
2
Limit the number of groomers working together at the same time, working at every other table, and allow only one worker and one pet at a time in the pet bathing area
3
Improve ventilation for enclosed spaces where possible
4
Supply leashes to guide pets so there is no hand-off of an owner’s leash at time of service
5
Grooming services may be provided only in mobile units, salons, or stores
6
Avoid sharing tools and supplies between workers
7
Customers may enter facility to drop off their pets provided other physical distancing guidelines are met, though curbside drop-off is encouraged
8
Disinfect heavy transit areas and high-touch surface before and after each appointment
9
Disinfect tools between customers (e.g., shampoo bowls, shears, combs, brushes)
10
Veterinarian Name
First Name
Last Name
Signature
Submit
Should be Empty: