Republic of the Philippines

Department of Agriculture
BUREAU OF ANIMAL INDUSTRY
Visayas Avenue, Diliman, Quezon City

VETERINARY CLINICS AND HOSPITALS

Date Inspected: ___________________Time Started: ___________________ Time Ended: __________________

I. GENERAL INFORMATION

A. Name of Animal Facility: ___________________________________________________ TIN ____________________

B. Type of Facility: Surgical Non-surgical Hospital Mobile

C. Business Organization: Single Proprietorship Partnership

Corporation Government
Cooperative Others, pls. specify _____________

D. Address of Facility: ___________________________________________________________________________________

E. GPS Coordinates Longitude____________________ Latitude____________________

F. Status of Facility: Owned Rented/Leased

G. Owner/Authorized Representative: ________________________________________________________________

Contact Information: _______________________

H. DTI/SEC/ CDA Registration No.: _____________________Date of Registration: _______________________

I. Veterinarian/Consultant: _______________________________ PRC License No.: ___________________

Contact Information: _______________________ Validity: ____________________________

II. PATIENTS

SPECIES NUMBER/CAPACITY REMARKS

III. PERSONNEL (Currently employed)

PERSONNEL NUMBER OF PERSON/S REMARKS

RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form

Revision No.: 01
Effectivity Date: May 30, 2022
Page 1 of 9
IV. GENERAL SPECIFICATIONS FOR ANIMAL FACILITY
Welfare Rating Based on RIRR and AC 4 S 2015:
4 – Good; 3 – Fair; 2 – Needs Improvement; 1 – Poor
CLINIC AND HOSPITAL SETTINGS 4 3 2 1 Remarks/Descriptions
• Clinic/hospital location and topography
• Type of environment/isolation from
residential areas
• Accessibility of the clinic/hospital
• Road condition to clinic/hospital
• Clinic/hospital Security (CCTV, etc.)
• Clinic/hospital facilities and cages design
• No. Of cages available
• Suitability of materials used
• Adequacy of space, floor and cage area
• Type of flooring
• Temperature and humidity
• Ventilation
• Lighting
• Noise and vibration
• Drainage system
• Cleaning, sanitation and disinfection
• Pest Control
• Separate rooms for:
o Reception
o Confinement of Non-infectious cases
o Confinement of Infectious cases
o Laboratory
o Surgery
o Vaccination
o Treatment
o Examination and Diagnosis
o Recovery
o Personnel quarters
• Waste disposal
o Solid wastes
o Hazardous/ Sharps wastes
o Liquid waste
o Disposition of dead animal
• Regular monitoring and assessment of
building and structures
• Back-up systems and alarms
• Availability of emergency kit
• Availability of fire fighting equipments
• Availability of first-aid kit for personnel
• Contingency Plan for natural disasters and
emergencies
FEEDING PRACTICES 4 3 2 1 Remarks/Descriptions
• Feeding program for different types of
confined patients

RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form

Revision No.: 01
Effectivity Date: May 30, 2022
Page 2 of 9
 •Provision of food storage and system to
prevent contamination
• Cleaning, sanitation and disinfection of food
dish/containers/drinkers
• Reference for dietary requirements
• Source of water
• Water potability test
MINIMUM REQUIREMENTS FOR REGISTRATION 4 3 2 1 Remarks/Descriptions
• NON-SURGICAL CLINIC
o Personnel
- At least one (1) licensed
veterinarian
- At least one (1) veterinary aide
o Documents, books and other
reading materials
- PRC License of the veterinarian
- PTR of the veterinarian
- Dangerous drugs/S2 license
- Veterinary drug index
- Formularies/compendiums
- Prescription pads bearing the
name and address of the clinic
- Vaccination certificates
- Clinical record forms
- Waiver forms
o Physical Plant Facilities
- The Reception Room
➢ Lighting
➢ Ventilation and air-
conditioning
➢ Ease of cleaning and
disinfection
➢ No. of clients which can
be accommodated
➢ Sufficient no. of chairs
and reception table
➢ Filing cabinets
➢ Computer w/ printer
➢ Calculator
➢ Functional phone
- The Examination Room
➢ Lighting
➢ Ventilation and air-
conditioning
➢ Ease of cleaning and
disinfection
➢ Examination table w/
top made of either
formica, aluminium,
stainless steel or
porcelain

RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form

Revision No.: 01
Effectivity Date: May 30, 2022
Page 3 of 9
 ➢ Functional sink
(porcelain
coated/stainless steel)
with permanent piping
➢ Cabinets/shelves for
medicines, instruments
and other supplies
o Equipments, instruments and
supplies
- Refrigerator
- Weighing scale
- Muzzle and leash (3 pcs each)
- Dextrose stand/hooks for
attachment
- Oxygen cylinder with gauge
control
- Unused disposable syringes
shall be at least 2.5ml (20pcs)
and needles shall be gauge 23
- Stethoscope
- Thermometer (2pcs)
- Opthalmoscope/penlight
- Compound microscope
- Nail clipper
- Catheters/infant feeding tubes
(2 pcs each of #10 and #12)
- Bandages of various sizes
- Glass slides and cover slips (1
box each)
- Test tubes and racks
- Magnifying lens
- Emergency pack
➢ Tranquilizer, 1 vial
➢ Adrenaline, 2 ampules
➢ Atrophine, 2 ampules
➢ Dexamethasone, 1 vial
➢ Oxytocin, 2 ampules
➢ Calcium gluconate 10%,
1 ampule
➢ 5 disposable 2ml syringe
with 23 gauge needle
➢ 5ml disposable syringe
with needles
➢ Vitamin K1, 2 ampules
➢ 1 needle holder
➢ Needle/silk
➢ 1 thumb forcep
➢ 2 mosquito forceps
➢ Scissors
➢ Bandages and tapes
➢ Diazepam, 1 ampule

RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form

Revision No.: 01
Effectivity Date: May 30, 2022
Page 4 of 9
 - Medicines/drugs
➢ 5% Dextrose-6 bottles,
Lactated Ringer’s -6
bottles, D5LRS-6 bottles
➢ Anesthetics
➢ Dewormers
➢ Vaccines for dog and cat
➢ Antibacterials
➢ Disinfectants
- Waste receptacles
o The Cage Room
- Separated from the examination
and surgery room
- Shall accommodate three (3)
different sizes
- Cages must be made of suitable
materials with drainage
- Waterers and feeder shall be
made of durable materials
• SURGICAL CLINIC (same requirements as
Non-surgical with the addition of the
following)
o Surgery room
- Lighting
- Ventilation and Air-conditioning
- Ease of cleaning and disinfection
- Examination table w/ top made
of either formica, aluminium,
stainless steel or porcelain
- 1 metal pail
- Dextrose stand/hooks for
attachment
- Surgical lamp or equivalent
- Cabinets
- Instrument and supplies
➢ Instrument tray and
➢ Surgical pack including:
▪ 3 Mosquito curve
forceps
▪ 3 Mosquito
straight forceps
▪ 3 Kelly curve
forceps
▪ 3 Kelly straight
forceps
▪ 2 Carmalt
forceps staright
▪ 1 pair of
abdominal
retractor

RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form

Revision No.: 01
Effectivity Date: May 30, 2022
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 ▪ 1 pair
Mayo/Metzenba
um scissors
▪ 2 scalpel handle
with
corresponding
blades
▪ 1 thumb forceps
plain
▪ 1 thumb forceps,
rat toothed
▪ 1 pair sharp and
blunt scissors
▪ 1 needle holder
6”
▪ 4 towel clamp
▪ 2 Allis tissue
forceps
▪ 1 spay hook or
equivalent
➢ Surgical needles
▪ 3 pcs traumatic
(cutting, curved)
▪ 3 pcs atraumatic
(non-cutting for
dogs, curved)
➢ Drapes
(reusable/disposable),
8pcs
➢ Gauze pack 4”x4”, 15pcs
➢ Laparotomy sheets, 3
sizes
➢ Cotton jars
➢ Surgical gloves, 5 pairs
(S, M, L)
➢ Mask, 6 pairs
➢ Caps, 6 pairs
➢ Gowns, 2pcs
➢ Surgical threads,
absorbable and non
absorbable (1 dozen
each)
- Disposal of unclaimed dead
patients
• Hospital
o Personnel
- 2 Licensed Veterinarians
- 1
receptionist/secretary/medi
cal technologist
- 2 veterinary aides
o Physical Plant Facility
RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form
Revision No.: 01
Effectivity Date: May 30, 2022
Page 6 of 9
 Similar requirements as
-
Surgical clinic with the
addition of the following:
➢ Reception room can
accommodate at
least five (5)clients
with their animal
➢ Cage room shall have
at least six (6) cages
- Laboratory room shall be
capable of the doing the
following examinations:
➢ Hematology and
Blood chemistry
➢ Urinalysis
➢ Fecalysis
- Instruments and supplies
shall be the same as that for
the surgical clinic but shall
have 2 or more surgical
packs
- Medicines shall have twice
the clinic requirements
- Shall provide personnel to
attend to emergency cases
outside of the regular
hospital hours
• Routine Procedures
o Dew Claw removal
o Tail docking
o Ear cropping
o Spay and neuter
o Caesarean section
o Orthopaedic procedures
VETERINARY CARE 4 3 2 1 Remarks/Descriptions
• Veterinary health programs
o Vaccination
o Internal parasite control programs
o External parasite control programs
• Disease, injury and pain management
o Treatment and medications
- Case development reports
- Reference for biologics used
o Surgery and perioperative care
- Animal restraint
- Anesthesia
- Pre-operative procedures
- Surgical/operating
procedures
- Post-operative care
o Euthanasia

RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form

Revision No.: 01
Effectivity Date: May 30, 2022
Page 7 of 9
 - Method
• Drugs/vaccines storage and control
• Drug and medical supplies inventory
BEHAVIORAL MANAGEMENT 4 3 2 1 Remarks/Descriptions
• Facility and equipment to promote natural
animal behaviour
• Behaviour enrichment program
• Behaviour observation log
• Behaviour development reports
PERSONNEL QUALIFICATIONS AND 4 3 2 1 Remarks/Descriptions
RESPONSIBILITIES
• Veterinarian’s training and seminars
o Animal welfare legislation and
policies
o Conducted personnel training on
animal handling, etc.
• Other personnel’s trainings and seminars
o Animal welfare legislation and
policies
o Assists the veterinarian in giving
treatment/medication
• Record keeping
o Case records
o Treatment consent/waiver
o Drugs and medical supplies
inventory
• Written duties and responsibilities of
personnel
o Ensure physical, health, and
behavioural needs are met in
accordance with good practice and
scientific knowledge
o Ensure facility is appropriate to
nature, behaviour, size and must be
kept in clean and sanitary condition
at all times
o Regular assessment and monitoring
of facilities
o Regular monitoring and
maintenance of machines,
equipments and instruments

RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form

Revision No.: 01
Effectivity Date: May 30, 2022
Page 8 of 9
V. SUMMARY

DEFICIENCY DEFICIENCY AND PLAN FOR CORRECTION RESPONSIBLE CORRECTION DATE

CATEGORY PARTY SCHEDULE/TIME COMPLETED
FRAME

BAI/RAWO: _______________________________________ _________________________________________ _________________________________________

Facility Repesentatives: _____________________________________ __________________________________________ ________________________________________

Regional Animal Welfare Coordinator/

Regulatory Chief (For DA-RFOs): _______________________________

RF AHWD - 64 Veterinary Clinic & Hospital Inspection Form

Revision No.: 01
Effectivity Date: May 30, 2022
Page 9 of 9