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1 Cover Page FEDERAL PREMISES DETAILS INVESTIGATION DETAILS Federal Premises ID Herd ID Reviewed By Business Name Reviewed Date Address Entered By Entered Date City/Town SURVEY TYPE New Herd Plan Annual Review New Modules State NY ZIP New Vet Exiting NYSCHAP Removed Date Voluntary Sold NYSCHAP SURVEY CONTACTS NYSCHAP VETERINARIAN Name: Practice: Phone Number: ( ) - Cell Number: ( ) - HERD VETERINARIAN FOR NYSCHAP Name: Practice: License State: NY License Number: Address: City/Town: State: NY Zip: County: Phone: ( ) - Fax: ( ) - Cell: ( ) - DL Account: FEDERAL PREMISES CONTACT PERSON FOR NYSCHAP Name: Address: City/Town: State: NY Zip: County Phone: ( ) - Fax: ( ) - Cell: ( ) - NYSCHAP MODULE PARTICIPATION General Module Participation (check all that apply) b Core BVD Salmonella BLV Mastitis Expansion BQA Hoof Health Cattle Welfare Johne's Module Participation Johne's Participating Johne's Enhanced Johne's Herd Status Page 1 of 13

2 Treatments / Inventory TREATMENT RECORDS Are all Treatment Recorded: Yes No What Treatment Record Systems are currently used? (check all that apply) Notebook Board Computer No Record System Calendar Other HERD HEALTH RECORDS What Herd Health Record Systems are currently used? (check all that apply) DHIA Record System Other Commercial Record System Written Records / Notebook Farm Specific Computer System No Record System Dairy Comp 305 ANIMAL IDENTIFICATION Check all that apply Metal Ear Tag (State) Electronic ID Metal Ear Tag (Non State) Name Plaques Plastic Ear Tags Freeze Branding Brisket Tags Tattoo Neck Chains Registered Leg Bands Other HERD INVENTORY Type of Herd: Majority of Milking Herd Housed In: Commercial Registered Mixed Organic Freestall Tiestall Bedded Pack Other Other: Herd Use (check all that apply): Dairy Beef Veal Custom Heifer Raiser Animal Counts (record count for only those areas where use has been noted): Dairy Counts Beef / Veal Counts Custom Heifer Raiser Counts Milking: Brood Cows: Heifers: Dry: Calves: Bulls: Heifers On Site: Heifers Off Site: Calves On Site: Feeders / Steers: Replacements: Bulls: Calves Off Site: Bulls: Breed: Page 2 of 13

3 Animals INTRODUCED AND RETURNING ANIMALS Have animals been introduced to this federal premises in the past 5 years? Have animals been introduced to this federal premises in the past year? How often have animals been introduced? Yes Yes No No Less Than Monthly Monthly Quarterly Sporadically INTRODUCED CATTLE (check all that apply) SOURCE OF ANIMALS (check all that apply) Code HEALTH REQUIREMENTS FOR REPLACEMENTS/ADDITIONS (check all that apply) Bulls Calves Single Farm SF Vaccination Health Certificate Heifers Cows Multiple Farms MF Deworming Quarantine Dealer DE ID Bulk Tank Culture Sale Barn SB None Other Club Sale Custom Heifer Raiser CL CHR Please indicate the following for Introduced Animals in the past year. (check if tested) Source Code (See Above) Year Number BLV Test BVD Test Mast Culture JD Test Pre Post Pre Post Pre Post Pre Post What percentage of the herd is purchased? What percentage were born here but raised elsewhere? Were they co-mingled with other farms? Do animals leave farm for exhibition? Yes No NA Yes No Page 3 of 13

4 Milk / Vaccination MILKING DATA Milkings Per Day: > 3 Lbs Per Cow Per Day: Voluntary QMPS Participation: Yes No AVG SCC (12 mos): Rolling Herd AVG (12 mos): VACCINATION and PREVENTION STRATEGIES Is there a written vaccination program? Yes No Are ionophores provided to adult cattle on the farm? Yes No Product: Are ionophores provided to youngstock on the farm? Yes No Product: Has vaccination program been reviewed with the herd vet in the past year? Describe vaccination program (Disease, Frequency, Etc ) Yes No Page 4 of 13

5 Calf / Hygiene NEO-NATAL AND CALF MANAGEMENT Is Calving Area used exclusively for calving (no sick/lame cows)? Calving Area (check all that apply): Yes Group Pack No Pasture (Seasonal) Individual Pen Tie Stall Other Description of calving area and management of newborn calves. Comment as appropriate. Please include year of any major changes since last report: Example current vs past management strategy. MATERNITY PEN HYGIENE Calving Area: Is maternity pen free of excessive manure and mud? Yes No Is maternity pen well bedded and dry? Yes No Is calf allowed to nurse dam? Yes No NA What percent nurse? What % of calves are born outside designated calving area? Type of Colostrum (check all that apply): Fresh Other Frozen Synthetic Colostrum Collection and Feeding: Source of Colostrum (check all that apply): Colostrum Test Status (check all that apply): How soon after birth is initial feeding (hours)? Total Quarts of Colostrum fed (1st 24 hours): Pooled Pasteurized Dam Only Other Single Source Johnes Test Neg BLV Test Neg > Not Timed > 5 Do bulls receive Colostrum? Yes No Calf Exposure to adults and their manure: On average, how soon is the calf removed from the cows (hours)? > What milk source is used through weaning (check all that apply)? Waste Milk Whole Milk Milk Replacer Pasteurized Waste Pasteurized Whole Do you dip the navel? Yes No Milk Source: Do you administer oral preventive meds? Yes No Do pre-weaned calves have direct contact with cows or their manure? Yes No Page 5 of 13

6 BioSecurity / Herd Disease POST WEANED AND COW BIOSECURITY Do heifers have direct contact with cows or their manure? Yes No Describe heifer (consider pre-breeding vs breeding heifers) and cow biosecurity: Are waterers and feed bunks easily contaminated with manure? Yes No Do you use the same tools or machinery to handle both feed and manure? Yes No Do heifers eat feed that may be contaminated with adult manure (refusals)? Yes No Is manure spread on fields used in the same season for pasture or hay? Yes No Are heifers pastured (same paddock) with or after dry or lactating cows? Yes No Do any animals drink from manure contaminated surface water sources (ponds, puddles)? Yes No HERD DISEASE CONTROL TEST STRATEGY (NON-JOHNE'S) If testing supports specific disease or issue control efforts on the farm, please indicate issue addressed, test type used, herd employment strategy and pertinent comments. Use for control strategies for diseases other than Johne's disease. Disease Issue TEST Test Type Employment Strategy Description Comments Page 6 of 13

7 Current Health Concerns CURRENT HERD HEALTH STATUS AND CONCERNS Codes for Incidence and Level of Concern Within the Past Year U = Unknown significance or concern 0 = None seen within the last year 1 = OK, low incidence, not a current problem 2 = Moderate incidence, may need attention 3 = Significance incidence, unsatisfactory, needs attention MILK QUALITY / UDDER HEALTH PERIPARTURIENT / METABOLIC DISORDERS FRESH COWS (<60 dim) WITHIN LAST 12 MONTHS SCC Today Bacteria CT / SPC Mastitis Cases / mo (% milk herd) Do you culture? Bulk Tank Ind Cases Fresh Other Cull rate within 1st 60 DIM U U Milk Fever Fatty Liver Retained Placenta Acidosis Ketosis Stillborn / Dystocia Mastitis Metritis Other Main Cultured Pathogens? DAs REPRODUCTIVE PROGRAM CALF HEALTH (PRE-WEANED) Rate U % Rate U % Heat Detection Rate Pre-wean mortality Conception Rate Pre-wean morbidity Pregnancy Rate U U Abortions / Year (% Herd) Calf Growth Scours U Pneumonia Other % Embryonic Loss Rate U / % HEIFER HEALTH (POST-WEANED) % AI U % AI C Heifer Growth % AI H % Natural Service Breeding Program % Natural Service C % Natural Service H Pneumonia Rate U Mths Diarrhea Age at 1st Freshening Rate U # Other Average Calving Interval Herd Average DIM Page 7 of 13

8 Current Health Concerns CULLING (12 MONTHS) PERCEIVED DISEASE SIGNIFICANCE OF THE HERD Cull Rate % U Rank the following reasons for culling top 4 with 1 being the most frequent Mastitis Died Johne's Reproduction Metabolic Dis. Lameness Injury Salmonella Infectious Dis. Udder Neospora Low Production Other Johne's Disease BVD LAMENESS Respiratory U Digital Dermatitis BLV Laminitis Clostridial Abscesses Foot Rot Leptospirosis Hock Abrasion and Injuries Coccidia Other Foot Trimming Other Times / Year: % Cows with obvious lameness: SUMMARIZE YOUR MAIN HEALTH CONCERNS & PRIORITIES Page 8 of 13

9 Employee Management / SOP / Goals EMPLOYEE MANAGEMENT Are there regularly scheduled staff meetings? How frequently are staff meetings held? Is there an employee handbook? Is employee turnover a problem on your farm? Were there written farm goals prior to NYSCHAP? Yes No NA Daily Weekly Bi Weekly Monthly Yes No NA Yes No NA Yes No NA Quarterly Annually Sporadically STANDARD OPERATING PROCEDURES Are there written Standard Operating Procedures? Standard Operating Procedures that exist (check all that apply) Yes No Milking Protocol Maternity Management Newborn Calf Management Calf / Heifer Management Treatment Protocols Drug Usage And Admin Vaccination Group Feeding CAFO AEM Watershed Protection Plan FDA Feed Ban Emergency Management Plan GOALS Do you plan to be Dairy Farming in 5 years? Do you plan to increase your herd size? Do you plan to decrease your herd size? Yes No Undecided Yes No Undecided Yes No Undecided Check all of the following priority areas to be addressed in the short and long term farm strategic plan Goals Relating To Short Term 1 Year Herd Size Animal Health Long Term 3-5 Years Goals Relating To Short Term 1 Year Marketing Animals Expanding Markets Long Term 3-5 Years Goals Relating To Short Term 1 Year Environmental Issues Milk Quality Improvement Long Term 3-5 Years Animal Performance Business Management Beef Quality Improvement Improved Facilities Employee Management Page 9 of 13

10 Goals GOALS Top 3-4 overall concerns Herd Health Improvements you are making or are planning to make Management Issues you are addressing or are planning to address Facilities Issues you are addressing or are planning to address Page 10 of 13

11 Johne's Risk Assessment JOHNE'S RISK ASSESSMENT For the most recent 12 month period, please indicate the number of animals still in the herd within each category Purchased Home Raised Grand Total TOTAL # < 24 MTH 1st LACT 2nd LACT >= 3 LACT TOTAL # < 24 MTH 1st LACT 2nd LACT >= 3 LACT # Animals Clinical Suspects Sub clinical(test Positives) For the most recent 12 month period, please indicate the number of animals that left the herd within each category Clinical Suspects Sub clinicals (Test Positives) Purchased Home Raised Grand Total TOTAL # < 24 MTH 1st LACT 2nd LACT >= 3 LACT TOTAL # < 24 MTH 1st LACT 2nd LACT >= 3 LACT # Animals JOHNE'S RISK ASSESSMENT What year was the first case of Clinical Johne's Disease on the farm? Purchased: Home Raised: Indicate the age of this animal: What was the age of the youngest animal with Clinical Johne's? Purchased: Home Raised: What year was the youngest animal with Clinical Johne's identified? SELECT A NUMBER FROM 1 TO 8 FOR EACH QUESTION BELOW BASED ON THE ASSOCIATED DESCRIPTIONS What do the number, ages, and timeframe of clinical cases suggest about the prevalence of Johne's Infection in the herd? Low Moderate 1-2 No or rare cases, clinical in only purchased animals, <5% prevalence in mostly older cattle, excellent management. 3-4 Occasional clinicals in home raised, recent history of 2-5% clinical per year, 6-19% test prevalence, management allowed for some contact of youngstock with manure or older animals. High 5-6 Very High 7-8 Frequent clinicals in home-reared animals, increasing clinical cases, decreasing age of clinicals, >20% prevalence distributed across age groups, severe management risks for contact of youngstock with manure of older cattle. What is the likely risk of spreading Johne's Disease in the calving area? Low 1-2 Clean, dry, short stay. Moderate 3-4 High 5-6 Very High 7-8 Dirty environment, long stay. What is the likely risk for spreading Johne's after calving? Low 1-2 No contact, no manure ingested, healthy dam colostrum/milk from test negative cows or milk replacer. Moderate 3-4 High 5-6 Very High 7-8 Significant contact, pooled colostrum or milk from unhealthy cows, ingestion of manure What is the likely risk for spreading Johne's to heifers after weaning? Low 1-2 No contact, no manure ingested Moderate 3-4 High 5-6 Very High 7-8 Significant contact, contaminated feed or water What is the likely risk of having Johne's introduced to the herd? Low 1-2 No imports, imports from low-risk herds. Moderate 3-4 High 5-6 Very High 7-8 Many imported animals, unknown herd status or poorly managed herds. Page 11 of 13

12 Testing Strategy Describe the past year's testing strategy; check those that apply and describe Check Test Strategy What groups were tested and when? How were the results used to meet the goals? KELA (with follow up culture) Pooled Fecal Culture Environmental Sampling Clinical Suspects Individual Fecal Culture Other (Describe) If testing is to be done in the coming year, please describe test strategy including age groups and test timing: If test strategy is the same as the previous year described above, indicate by checking this box and proceed to the next section Check Test Strategy What groups were tested and when? How were the results used to meet the goals? KELA (with follow up culture) Pooled Fecal Culture Environmental Sampling Clinical Suspects Individual Fecal Culture Other (Describe) Page 12 of 13

13 Additional Comments ADDITIONAL COMMENTS Page 13 of 13

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