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Number: 700.04
SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION
REPORT: FOR SURVEY ONLY
Page: 1
Date: 7/9/99
Approved: Director’s signature pending Revised: 3/11/09
I. PURPOSE
To establish procedures for the initiation and completion of the Rabies Control
Investigation Report (Animal Bite/Scratch Report) for a rabies virus survey.
II. POLICY
In the interest of public health and safety, the OC Animal Care Clinic Veterinarian or
Rabies Control Clerk may request testing on a rabies suspect wild animal, despite the fact
that there has been no human or domestic animal exposure for this animal.
If it has been determined that no direct exposure has occurred, the Animal Control
Officer (ACO) will impound the rabies suspect animal and initiate a “Survey Only”
Bite/Scratch Report. Such circumstances requiring a Survey Only Bite/Scratch Report
include, but are not limited to the following:
• Humans and/or domestic animals currently near or having been near the presence
of a bat.
• Bats in indirect contact with humans, i.e. in bedroom overnight, etc.
• Skunks, raccoons and foxes appearing sick or behaving “abnormally” (under
direction of supervision).
• Any animal impounded by direction of the OC Animal Care Clinic Veterinarian
or Rabies Control Clerk.
Once the Survey Only report is completed by the ACO, “exposure” will be determined by
the OC Animal Care Clinic Veterinarian or Rabies Control Office Clerk.
III. SCOPE
Applicable to OC Animal Care personnel required to complete this report for a rabies
virus survey.
IV. FORMS
Rabies Control Investigation Report (Animal Bite/Scratch Report) F272-12.2001.4
Number: 700.04
SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION
REPORT: FOR SURVEY ONLY
Page: 2
Date: 7/9/99
Approved: Director’s signature pending Revised: 3/11/09
Animal Head Information Slip F272-12-2025.
V. REFERENCES
California Code of Regulations, Title 17, 2606.
VI. DEFINITIONS
Not Applicable.
VII. PROCEDURE
A. Distribution of Copies:
1. Refer to P&P 700.02, Completion of Rabies Control Investigation Report
Animal vs. Human and P&P 700.03, Completion of Rabies Control
Investigation Domestic vs. Wild Animal.
B. Completion of Report:
1. It is imperative in Survey Only reports to determine that there was no
exposure to any human or animal. If there was human exposure, complete
the report as in P&P 700.02 for animal vs. human. If there was animal
exposure, complete the report as in P&P 700.03 for domestic vs. wild
animal.
2. Survey Only report (refer to the numbered spaces on the form):
a. Numbered Items:
1. Imp. #: Animal ID generated by Chameleon.
1b. Case #: No change.
2a. Name: Enter “No human/animal exposure”.
2b. Victim (last name): Enter “Survey Only”.
3. Sex: N/A.
4. Age: N/A.
5. Telephone: Home and work numbers of the person for
whom you impounded the animal.
Number: 700.04
SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION
REPORT: FOR SURVEY ONLY
Page: 3
Date: 7/9/99
Approved: Director’s signature pending Revised: 3/11/09
6. Address: Address from where the animal was impounded.
7. Parent/Guardian: Last name first, first name, middle initial
of the person for whom you impounded the animal.
8. Address: Where the person listed in “#7” lives, if different
from #6.
9. Source: Mark the “other” box and list the person and
his/her telephone number. If the source is the person for
whom you impounded the animal, list “#7” and list “same”
for the telephone number.
10. Report Received By: No change.
11. Place of Attack: Although there is no attack, list the place
where the animal was discovered. Be specific.
12a. Attack Date/Time: Line out “attack”. Enter the date and
time the animal was impounded.
12b. Date of Bite: Enter the date of impound.
13. Circumstances: Enter “see attached supplemental” where a
detailed report will be written. “Through material?” will
not apply.
14. Wound Location: N/A.
15. Skin Break: N/A.
16. Wound Treatment: N/A.
17. Treated By: N/A.
18. Anti-Rabies Treatment: N/A.
19-20. Veterinary Review: No change.
21-26. Laboratory Exam: No change.
27. Case Closed: No change.
28. Notification: N/A.
29. QV Date: N/A.
30. QR Date: N/A.
31. Miscellaneous: No change. Generally used to complete
line 13 and line 37.
32a. Owner (Custodian): Of the rabies suspect animal.
Generally enter “stray” because there is usually no owner.
If there is an owner, enter last name first, first name, then
middle initial.
32b. Owner: Of the rabies suspect animal. Enter only if there is
a known owner, otherwise Rabies Clerk will complete.
Number: 700.04
SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION
REPORT: FOR SURVEY ONLY
Page: 4
Date: 7/9/99
Approved: Director’s signature pending Revised: 3/11/09
33. Address: Of the rabies suspect animal owner. Leave blank
if there is no owner.
34. Animal: Enter the information applicable to the rabies
suspect animal.
35. Description: No change.
36. License Number: N/A.
37. Behavior: Mark the appropriate box. Make sure the
specifics are described in line 13 or 31.
38. Travels: N/A.
39. Vaccination: N/A.
43. Release: N/A.
44. Cause of Death: Complete whenever the rabies suspect
animal dies or is euthanized. Mark the appropriate box and
enter the date that death occurred.
45. Veterinarian/Symptoms: If a veterinarian observed the
animal before it was impounded, mark the appropriate box.
If not, leave blank.
46. Signature: N/A.
i. Non-Numbered Items:
Map Ref.: N/A.
QT Fee: N/A.
Supplemental: This box is to be marked and a detailed
report must be written on the attached supplemental page.
The report must include but is not limited to the following:
1. For all species:
a. Describe the exact manner in which the
ACO impounded the rabies suspect animal.
Include any safety equipment used during
the impoundment of the animal, i.e. latex
gloves, leather gloves, four (4) foot Ketch-
All, net with four (4) foot pole, coffee can,
etc.
Number: 700.04
SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION
REPORT: FOR SURVEY ONLY
Page: 5
Date: 7/9/99
Approved: Director’s signature pending Revised: 3/11/09
b. Provide the length of time from which the
reporting party first noticed the bat/rabies
suspect animal to when the animal was
impounded.
2. For Bats:
a. The full names, addresses, telephone
numbers and ages of any individuals that
were within fifty (50) feet of the bat. Also
include an approximation of the closest
distance each may have come to the bat.
b. A full description of any domestic mammals
that were within fifty (50) feet of the bat.
Also include an approximation of the closest
distance each may have come to the bat.

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Rabies control investigation survey report

  • 1. Number: 700.04 SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION REPORT: FOR SURVEY ONLY Page: 1 Date: 7/9/99 Approved: Director’s signature pending Revised: 3/11/09 I. PURPOSE To establish procedures for the initiation and completion of the Rabies Control Investigation Report (Animal Bite/Scratch Report) for a rabies virus survey. II. POLICY In the interest of public health and safety, the OC Animal Care Clinic Veterinarian or Rabies Control Clerk may request testing on a rabies suspect wild animal, despite the fact that there has been no human or domestic animal exposure for this animal. If it has been determined that no direct exposure has occurred, the Animal Control Officer (ACO) will impound the rabies suspect animal and initiate a “Survey Only” Bite/Scratch Report. Such circumstances requiring a Survey Only Bite/Scratch Report include, but are not limited to the following: • Humans and/or domestic animals currently near or having been near the presence of a bat. • Bats in indirect contact with humans, i.e. in bedroom overnight, etc. • Skunks, raccoons and foxes appearing sick or behaving “abnormally” (under direction of supervision). • Any animal impounded by direction of the OC Animal Care Clinic Veterinarian or Rabies Control Clerk. Once the Survey Only report is completed by the ACO, “exposure” will be determined by the OC Animal Care Clinic Veterinarian or Rabies Control Office Clerk. III. SCOPE Applicable to OC Animal Care personnel required to complete this report for a rabies virus survey. IV. FORMS Rabies Control Investigation Report (Animal Bite/Scratch Report) F272-12.2001.4
  • 2. Number: 700.04 SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION REPORT: FOR SURVEY ONLY Page: 2 Date: 7/9/99 Approved: Director’s signature pending Revised: 3/11/09 Animal Head Information Slip F272-12-2025. V. REFERENCES California Code of Regulations, Title 17, 2606. VI. DEFINITIONS Not Applicable. VII. PROCEDURE A. Distribution of Copies: 1. Refer to P&P 700.02, Completion of Rabies Control Investigation Report Animal vs. Human and P&P 700.03, Completion of Rabies Control Investigation Domestic vs. Wild Animal. B. Completion of Report: 1. It is imperative in Survey Only reports to determine that there was no exposure to any human or animal. If there was human exposure, complete the report as in P&P 700.02 for animal vs. human. If there was animal exposure, complete the report as in P&P 700.03 for domestic vs. wild animal. 2. Survey Only report (refer to the numbered spaces on the form): a. Numbered Items: 1. Imp. #: Animal ID generated by Chameleon. 1b. Case #: No change. 2a. Name: Enter “No human/animal exposure”. 2b. Victim (last name): Enter “Survey Only”. 3. Sex: N/A. 4. Age: N/A. 5. Telephone: Home and work numbers of the person for whom you impounded the animal.
  • 3. Number: 700.04 SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION REPORT: FOR SURVEY ONLY Page: 3 Date: 7/9/99 Approved: Director’s signature pending Revised: 3/11/09 6. Address: Address from where the animal was impounded. 7. Parent/Guardian: Last name first, first name, middle initial of the person for whom you impounded the animal. 8. Address: Where the person listed in “#7” lives, if different from #6. 9. Source: Mark the “other” box and list the person and his/her telephone number. If the source is the person for whom you impounded the animal, list “#7” and list “same” for the telephone number. 10. Report Received By: No change. 11. Place of Attack: Although there is no attack, list the place where the animal was discovered. Be specific. 12a. Attack Date/Time: Line out “attack”. Enter the date and time the animal was impounded. 12b. Date of Bite: Enter the date of impound. 13. Circumstances: Enter “see attached supplemental” where a detailed report will be written. “Through material?” will not apply. 14. Wound Location: N/A. 15. Skin Break: N/A. 16. Wound Treatment: N/A. 17. Treated By: N/A. 18. Anti-Rabies Treatment: N/A. 19-20. Veterinary Review: No change. 21-26. Laboratory Exam: No change. 27. Case Closed: No change. 28. Notification: N/A. 29. QV Date: N/A. 30. QR Date: N/A. 31. Miscellaneous: No change. Generally used to complete line 13 and line 37. 32a. Owner (Custodian): Of the rabies suspect animal. Generally enter “stray” because there is usually no owner. If there is an owner, enter last name first, first name, then middle initial. 32b. Owner: Of the rabies suspect animal. Enter only if there is a known owner, otherwise Rabies Clerk will complete.
  • 4. Number: 700.04 SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION REPORT: FOR SURVEY ONLY Page: 4 Date: 7/9/99 Approved: Director’s signature pending Revised: 3/11/09 33. Address: Of the rabies suspect animal owner. Leave blank if there is no owner. 34. Animal: Enter the information applicable to the rabies suspect animal. 35. Description: No change. 36. License Number: N/A. 37. Behavior: Mark the appropriate box. Make sure the specifics are described in line 13 or 31. 38. Travels: N/A. 39. Vaccination: N/A. 43. Release: N/A. 44. Cause of Death: Complete whenever the rabies suspect animal dies or is euthanized. Mark the appropriate box and enter the date that death occurred. 45. Veterinarian/Symptoms: If a veterinarian observed the animal before it was impounded, mark the appropriate box. If not, leave blank. 46. Signature: N/A. i. Non-Numbered Items: Map Ref.: N/A. QT Fee: N/A. Supplemental: This box is to be marked and a detailed report must be written on the attached supplemental page. The report must include but is not limited to the following: 1. For all species: a. Describe the exact manner in which the ACO impounded the rabies suspect animal. Include any safety equipment used during the impoundment of the animal, i.e. latex gloves, leather gloves, four (4) foot Ketch- All, net with four (4) foot pole, coffee can, etc.
  • 5. Number: 700.04 SUBJECT: COMPLETION OF RABIES CONTROL INVESTIGATION REPORT: FOR SURVEY ONLY Page: 5 Date: 7/9/99 Approved: Director’s signature pending Revised: 3/11/09 b. Provide the length of time from which the reporting party first noticed the bat/rabies suspect animal to when the animal was impounded. 2. For Bats: a. The full names, addresses, telephone numbers and ages of any individuals that were within fifty (50) feet of the bat. Also include an approximation of the closest distance each may have come to the bat. b. A full description of any domestic mammals that were within fifty (50) feet of the bat. Also include an approximation of the closest distance each may have come to the bat.