Not Checked:
    Therapeutic Mounted Services
    Therapeutic Driving Services
    Therapeutic Vaulting Services
    Therapeutic Unmounted Services
    Equine-Assisted Occupational Therapy/Physical Therapy/Speech-Language Pathology
    Equine-Assisted Learning involving Academic Learning
    Equine-Assisted Learning involving Personal and/or Professional Development

11: Total number of Equine Assisted Service Providers at PBJ Dressage
10: Total number of Equine Assisted Service Providers at Taco Bella Farm
9: Total number of Equine Assisted Service Providers at PBJ- OSU

---

     1. Anissa Kasarjian, MSW, LISW

         FACILITY PARTICIPATION:

         PBJ- OSU

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Anissa has worked as a Social Worker for ten years with main areas of concentration on child/adolescent and family therapies.She practices traditional talk therapy using Cognitive Behavior Therapies and Solution-Focused therapies. She has branched out to include Equine Therapies as well as Expressive Art Therapies. Anissa has a background in art and is an artist in the community has done Art in Nature Workshops.

---

     2. Beth Rolland

         FACILITY PARTICIPATION:

         PBJ- OSU

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Beth has spent time in her career in the affordable housing industry, and has a BA in Psychology and an MBA from The Ohio State University. Beth is also the organization's Development Director, has served on the Board for 6 years and owns Taco Bella Farm. She has 40 years experience with horses.

---

     3. Colleen Dempsey, MSW, LISW

         FACILITY PARTICIPATION:

         PBJ- OSU

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Colleen started working with PBJ Connections as an intern when she was completing her Bachelor's in Social Work. At the conclusion of her internship, she was hired as an Equine Specialist and began co-facilitating sessions. Once Colleen received her MSW she also began seeing clients as a Mental Health Professional. Colleen has been around horses for almost 20 years.

---

     4. Erica Lewis

         FACILITY PARTICIPATION:

         PBJ- OSU

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Employee

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Erica is the Assistant Director and started working with PBJ Connections in May 2014 as an equine intern while enrolled in The Ohio State University's animal sciences program. She provided support in sessions while learning about the EAGALA therapy model. When her internship ended, she contracted as an equine specialist to continue working with PBJ Connections. In January 2015, she became the Assistant Director. Erica graduated in 2015 with a BS in Agriculture from Ohio State University.

---

     5. Glenda Childress

         FACILITY PARTICIPATION:

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Glenda has owned and shown horses since her childhood and has 50+ years horse experience. She owns and manages PBJ Dressage in Pataskala, Ohio, is active in the Central Ohio dressage community and an avid horse advocate. She organizes dressage clinics at her farm and volunteers her time with several local organizations. Glenda co-founded PBJ Connections in 2006 and has served the organization in many ways, including being the Executive Director for 5 years and holding several positions on the Board of Directors. Glenda is certified in the EAGALA Model of equine assisted psychotherapy. She works as an Equine Specialist in therapy sessions and as Corporate Leadership Consultant in teambuilding experiences through PBJ@Work. Her dedication has helped countless families receive lifesaving equine assisted interventions.

---

     6. Holly Jedlicka, MSW, LISW-S

         FACILITY PARTICIPATION:

         PBJ- OSU

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Employee

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Holly Jedlicka, MSW, LISW-S specializes in child, adolescent and family therapy as well as working with LGBTQ clients. She also specializes in Trauma-Focused Cognitive Behavioral Therapy. Holly holds a bachelors degree in psychology from Otterbein University and a Masters in Social Work from The Ohio State University. She worked in community behavioral health before focusing her efforts on equine-assisted psychotherapy. She holds an Advanced EAGALA certification and is a PATH International Registered Instructor and Equine Specialist. Holly has worked professionally as a dressage trainer for over 20 years and has had horses her entire life. Holly believes horses are honest and that honesty calls us out on our own issues, if we listen to them. They are just reacting, not attached to the outcome and are experts at staying in the moment.This is part of what makes them powerful in therapy. Holly is co-founder of PBJ Connections and now serves as the Executive Director. Under her leadership, she will ensure that PBJ Connections continues to grow and thrive. She has confidence in the staff at PBJ Connections and knows that we are leaders in Central Ohio in using horses professionally and therapeutically. She plans to continue to lead the way to pave a more secure path for equine-assisted psychotherapy.

---

     7. Jennifer Pietsch

         FACILITY PARTICIPATION:

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Jennifer grew up in southern Maryland showing on the local and quarter horse circuits before moving west to attend college at The Ohio State University. While there, she served as the president of the western equestrian team and was a member of the 2014 national champion and 2016 reserve national champion teams. She was also a member of the horse judging team, being top ten at the Congress in both 2014 and 2015 and top fifteen at the AQHA World Show in 2015. Jennifer received her BS in animal science in 2016 and Masters in social work in 2019, both from OSU. She completed certification with PATH International as a therapeutic riding instructor in 2016 and with Eagala as both an Equine Specialist and Mental Health Professional in 2018.

---

     8. Julie Reiswig

         FACILITY PARTICIPATION:

         PBJ- OSU

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Julie is a long time supporter and volunteer of PBJ Connections. She joined our staff as a contractor in May 2013 and is EAGALA certified. Julie graduated from Oberlin College with a BA in psychology, previously taught Special Education, and is the Business Manager & Co-Owner of Equine Veterinary Dental Services, LLC. Julie has loved horses all her life, and began systematically training in 2002. She was a member of the Central Ohio Mounted Search Unit from 2007 to 2015.

---

     9. Kimberly Cole

         FACILITY PARTICIPATION:

         PBJ- OSU

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Dr. Cole is an Associate Professor at The Ohio State University teaching in the Animal Sciences/Equine Studies area. She is also the Equine Extension Specialist at OSU serving as an informational resource for Ohio horse owners, developing and conducting equine educational programs, and providing leadership to the 4-H Horse Program. She has been working with PBJ Connections as an Equine Specialist since 2017.

---

     10. Michelle Kozel

         FACILITY PARTICIPATION:

         PBJ- OSU

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Michelle is a licensed small animal veterinarian. She owns horses and keeps them at home, and has been around horses most of her life. Michelle received her EAGALA certification in 2018 and has worked with PBJ Connections for 5 years.

---

     11. Stacia Barnes, LPCC

         FACILITY PARTICIPATION:

         PBJ- OSU

         PBJ Dressage

         Taco Bella Farm

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Stacia started working at PBJ Connections as a therapist in June, 2013 and received her EAGALA certification in October, 2013. She has worked in the mental health field since 1991, when she received her Bachelor's degree from Otterbein University. She later received her master's degree from the University of Dayton in 1999, and has experience in treatment foster care and adoptions, community mental health, developmental disabilities, and drug and alcohol treatment.

---

     12. Tim Spradlin

         FACILITY PARTICIPATION:

         PBJ Dressage

         RELATIONSHIP: Independent Contractor

         SERVICES PROVIDED:

         Equine-Assisted Psychotherapy/Counseling (Mental Health)

         Equine-Assisted Learning involving Personal and/or Professional Development

         DEGREES, LICENSES AND/OR CERTIFICATIONS

         Tim Spradlin, 1stSgt (Ret) USAFR, is an EAGALA certified military equine specialist. He has over 20 years’ experience training and riding western trail horses. An Iraq combat veteran, he served 30 total years military active duty and reserve. In his civilian career he retired from over 30 years in fire rescue and law enforcement. In 2017 Tim partnered his Finally Home Farm Military EAP program with PBJ’s “On Mission” program to serve veterans in central Ohio.

---

GOVERNANCE, MANAGEMENT & FINANCIAL REPORTING

Staff & Volunteers:
Chief Staff Officer (CSO):  Holly Jedlicka
Employees:   Full-Time:  2  Part-Time:  1  Volunteers:  20
Staff Recruitment, Screening and Training processes:
    Prospective staff must provide in writing if they have ever been convicted of a felony, convicted of a sexual offense, or convicted for animal cruelty or neglect
    Every member of the staff is required to complete a Liability Release/Hold Harmless Agreement
    Every member of the staff is required to provide Emergency Medical Information
    Every member of the staff is required to sign a Photo Release
    Every member of the staff is required to undergo a Background Check
    Every member of the staff provides parent/guardian information if applicable
    Every member of the staff carries current health insurance
    Every member of the staff has a written job description
    Every member of the staff is evaluated on an annual and as needed basis or with any change in their job description
    Every member of the staff is updated on all the organization's policies and procedures on a annual and as needed basis or with any change in policy or procedure
    Every member of the staff receives training that includes safety guidelines, confidentiality, horse handling, horse identification, and emergency procedures; additional training is job specific
    Every member of the staff has a supervisor and is responsible for keeping their supervisor up to date on work related activities
    The organization provides an Employee Handbook to every member of the staff
    The Employee Handbook includes employee-related information, such as hours of work, vacation, sick leave, dress code, cell phone usage, and the protocol for dismissal
    The Employee Handbook is reviewed annually and updated
    One or more staff members are trained in CPR and human first aid
    One or more staff members are trained in equine first aid

Volunteer Recruitment, Screening and Training processes:
    Prospective volunteers complete a written application
    Prospective volunteers must provide in writing if they have ever been convicted of a felony, convicted of a sexual offense, or convicted for animal cruelty or neglect
    Every volunteer is required to complete a Liability Release/Hold Harmless Agreement
    Every volunteer is required to provide Emergency Medical Information
    Every volunteer is required to sign a Photo Release
    Every volunteer is required to undergo a Background Check
    Every volunteer provides parent/guardian information if applicable
    Every volunteer has a written job description
    Every volunteer is evaluated on an annual and as needed basis or with any change in their job description
    Every volunteer is updated on all the organization's policies and procedures on a annual and as needed basis or with any change in policy or procedure
    Every volunteer receives training that includes safety guidelines, confidentiality, horse handling, horse identification, and emergency procedures; additional training is job specific
    Every volunteer is assigned a supervisor (staff member and/or senior volunteer) and is responsible for keeping their supervisor up to date on work related activities
    The supervisor assesses the volunteer's abilities and assigns specific duties to the volunteer based on their skills
    The organization records and maintains written attendance information and hours on every volunteer
    The organization provides a Volunteer Handbook to every volunteer
    The Volunteer Handbook includes volunteer-related information, such as hours of work, dress code, cell phone usage, and the protocol for dismissal
    The Volunteer Handbook is reviewed annually and updated
    The organization holds regular orientation sessions for volunteers and prospective volunteers that includes an overview of the organization, its mission, activities, volunteer responsibilities and expectations, safety guidelines, and a tour of the facility

Governing Body:
Board meetings per year:  6
Number of Board Members:  11  Number of Voting Board Members:  10

Board Compensation:
Is Board Chair compensated?  No  Is Treasurer compensated?  No
Are there any other Voting Board Members that are compensated?  No

Board/Staff Relationships:
Are any members of the Board or Staff related to each other through family or business relationships? No

Board Affiliations:
Are any Board members or Staff associated with and/or compensated by another organization with a relationship or business affiliation to your organization? Yes
If yes, provide the name, title, responsibility and family/business relationship of each Board and/or Staff member, and the name of the related organization.
Instructors own two of the facilities where programs are conducted - PBJ Dressage and Taco Bella. Instructor related to third facility - PBJ-OSU

Conflict of Interest:
Does your organization have a written conflict of interest policy and regularly and consistently monitor and enforce compliance with the policy, including requiring officers, directors or trustees, and key employees to disclose annually interests that could give rise to conflicts?  Yes


Organization documents available on our website:
    Most recent Annual Report
    Volunteer Handbook
    Bylaws

Organization documents available on request:
    Most recent Financials
    Most recent IRS Form 990
    Most recent Annual Report
    Volunteer Handbook
    Employee Handbook
    Bylaws

Additional explanation regarding governance, staffing and volunteer practices or further explanation of the answers above.
Volunteers who don't interact with clients are not required to complete a background check. We do not do any formal drug testing.

Financial Reporting:
Budget:  *Missing
Equine Budget:   *Missing
Month Fiscal Year Ends: *Missing
Type of Financial Reporting (Audit, Review, Compilation): *Missing
Type of IRS Filing (990, 990-EZ, 990-N): *Missing
Does the uploaded Pro Forma 990/990 represent 2020? *Missing
IRS Form 990/Pro Forma 990 has not been uploaded for this facility.

---

EQUINE COSTS

Total Facilities: 3
PBJ- OSU: 2019 - Yes
PBJ Dressage: 2019 - Yes
Taco Bella Farm: 2019 - Yes

Actual Horse Care Costs $38246     Feed (Grain/Hay) $5167     Bedding $13031     Veterinarian $9105     Farrier $6564     Dentist $0     Other Therapies $0     Manure Removal $3300     Medications & Supplements $0     Horse Transportation $7957     Maintenance $2910     Horse/Barn Supplies $3710     Horse Care Staff $11068     Horse Training $10144     Other direct horse-related costs not including overhead or other program costs. $111202     2019 Total Horse Care Costs

Donated Horse Care Costs $0     Feed (Grain/Hay) $0     Bedding $0     Veterinarian $0     Farrier $0     Dentist $0     Other Therapies $0     Manure Removal $0     Medications & Supplements $0     Horse Transportation $0     Maintenance $0     Horse/Barn Supplies $27950     Horse Care Staff $17000     Horse Training $0     Other direct horse-related costs not including overhead or other program costs. $44950     2019 Total Donated Costs

/ PBJ Dressage: The line item "Other" above includes costs PBJ Connections paid in 2019 for the 1 horse we own, Rocky. Rocky has foundered several times through his life, and was donated to us by his owner so he could live out his retirement years helping folks with their mental health. The breakout of these costs is: $540 farrier; $1735 supplements/medication; $89 supplies; $194 vet; $3300 board. We appreciate the Equus Foundation's consideration of a grant to offset some of these costs.

Average direct cost per day per horse: $9
Average total cost per day per horse: $11
Average length of stay for an equine: 353 days (10251/29)

---

POLICIES

Acquisition
Our organization acquires horses/equines from the following source(s):
    Donation  
    Free Lease  
    Purchase/Adoption from Owner  

Our organization does not acquire horses/equines from the following source(s):
    Purchase from auction  
    Purchase kill pen or feedlot  
    Return  
    Surrender  
    Seizure  
    Abandonment  

Our organization will accept the following:
    Geldings
    Mares
    Pregnant Mares
    Foals
    Only Stallions to be castrated

Not Checked:
    Stallions
Intake, Assessment & Training
Prior to a horse being accepted and/or arriving at the facility, the organization requires the following with respect to the health status of the horse:
    A current Coggins
    If health records are not available or are out-of-date, the owner is responsible for having vaccinations administered.
    If health records are not available or are out-of-date, our veterinarian will administer appropriate vaccinations

Prior to a horse being accepted and/or arriving at the facility, the organization has the following policies in place:
    The owner of a potential horse is interviewed over the phone or in person prior to seeing the horse
    The horse is evaluated at its place of residence
    The owner completes an application/contract which constitutes the agreement between the owner and our organization
    Horses are not taken on trial

Upon intake, the organization has the following quarantine policy in place:
    The horse is confined to a designated and separate area for isolation and quarantine at the facility for a prescribed period of time

The typical length of quarantine is:   20 to 30 days

Following arrival of the equine at the facility, the following is performed:
    Physical examination by a veterinarian
    Physical examination by trained barn staff
    A Henneke Body Conditioning Score is assigned
    Physical examination by a farrier
    Physical examination by a dentist
    Fecal test
    Vaccinations
    De-worming

Following arrival at the facility, the horse is assessed for following skills and behaviors:
    Retrieval from a pasture/paddock
    Leading with a halter and lead rope
    Temperament, disposition and attitude, such as rated from very calm to very high spirited
    Loading onto and unloading off a trailer
    Tolerance to unusual objects and loud noises
    Known vices, i.e., cribbing, biting, kicking, weaving, stall walking, etc
    Grooming
    Tolerance to multiple handlers at the same time

Horses provided formal training (groundwork or riding):   2-3 times per week


Breeding
The organization has the following policies related to breeding and stallions:
    The facility or facilities where our organization conducts its programs, including foster facilities, are permitted to house stallions
    Our organization prohibits the breeding of horses/equines when re-homed or this statement is not applicable as all horses/equines remain at our organization for their lifetimes and are not re-homed under any circumstances.

Additional information about our breeding policies and practices:
The Ohio State University breeds horses onsite at their facility, but not in the areas where our program operates.
     
     The other 2 facilities do not breed.

Euthanasia
The organization has the following policies related to euthanasia:
    Our organization will never have a horse euthanized for space
    Our organization will never have a healthy horse euthanized under any circumstances
    Our organization may have a horse euthanized after all reasonable treatment options have been explored
    Euthanasia is done on site when possible to decrease trauma from transport
    Disposal of the carcass is handled within 24 hours

Horses will be euthanized upon the recommendation of:
    Veterinarian

The following are authorized to administer the procedure for your organization in accordance with state laws:
    Veterinarian

The organization utilizes the following methods of euthanasia:
    Intravenous administration of an overdose of barbiturates

Additional information about our euthanasia policies and practices:
Euthanasia decisions are made by the facilities/horse owners, not by PBJ Connections.

Rehoming
Our organization has the following re-homing (adoption/purchase) policies and procedures in place:
    Our organization does not re-home horses under any circumstances; our organization retains custody of our horses and ensures care of the horses for their lifetimes.

Our organization has the following policies and procedures related to horses that need to be retired, are no longer useful, or are no longer manageable:
    Horses remain at our organization for their lifetimes
    In the case a horse is unsound and/or unhealthy and cannot be treated to relieve suffering, the horse may be euthanized


Additional information about our rehoming policies and practices:
Generally speaking, none of the facilities we work with rehome their horses.
Re-homing Agreement not applicable.

---

EQUINE CARE & SHELTER/FACILITY INFORMATION

Total facilities at which our organization cares for and shelters horses used in our programs: 3

Our organization has the following policies and procedures in place pertaining to foster, overflow and/or satellite facilities: Our organization uses foster, overflow and/or satellite facilities which adhere to all the policies, procedures and practices of our organization

PBJ Dressage:
Taco Bella Farm:
PBJ- OSU:

---

PBJ Dressage

---

PBJ Dressage
9800 Jug St NW Pataskala OH 43062
Contact: Glenda Childress
Contact's Phone: 740-739-1190
Contact's Email: glenda@pbjdressage.com

Does your organization own, lease or use a part of this facility? Lease

Please list all local, state and federal licenses held by the organization, including the expiration dates, or indicate that no licenses are required at the local, state or federal level. Please also list if this facility is accredited and recognized as compliant with the published standards of an accrediting organization, including the name of the organization and the date of the accreditation.
     *Missing

Provide the contact information for the individual or organization responsible for investigating abuse in the county where the facility is located, including mailing address, email address, and phone information.
     Licking County Humane Society, Humane Agent Paula Evans https://www.lchspets.org/humane-agent-program/ Phone: 740-644-2200 825 Thornwood Drive Heath, OH 43056 info@lchspets.org

Does your organization conduct Equine Assisted Services (EAS) at this facility in accordance with the EQUUS Foundation Guidelines on Qualifications of Organizations Conducting Equine Assisted Services (EAS)? Yes

Total number of Equine Assisted Service Providers AT THIS FACILITY, including instructors, specialists, therapists, counselors, coaches and/or facilitators (full-time, part-time, volunteer, independent contractors, and/or providers accompanying clients) that conduct Equine Assisted Services (EAS) in accordance with the EQUUS Foundation Guidelines on Qualifications of Organizations Conducting Equine Assisted Services (EAS) AT THIS FACILITY:  11

Equine Assisted Service Providers Assigned to this Facility: (see Equine Assisted Service Provider Section below for details)

     1. Anissa Kasarjian, MSW, LISW
     2. Beth Rolland
     3. Colleen Dempsey, MSW, LISW
     4. Erica Lewis
     5. Glenda Childress
     6. Holly Jedlicka, MSW, LISW-S
     7. Jennifer Pietsch
     8. Julie Reiswig
     9. Michelle Kozel
     10. Stacia Barnes, LPCC
     11. Tim Spradlin

---

PBJ Dressage:

---

Grounds
Total number of horses involved with your programs at this facility: 12
Of the total number of horses involved with your programs at this facility, the number of horses that are microchipped: 0
Total number of horses at this facility INCLUDING those not involved with your programs: 12
Maximum capacity of horses at this facility: 12
Total acreage dedicated specifically to the horses: 16
Our organization has use of the following at this facility:
Structures/Barns: 1  Run-in sheds: 1
Pastures: 4  Paddocks/Pens: 3
Uncovered Outdoor Rings: 0  Covered Outdoor Rings: 0  Indoor Rings: 1






Regarding structures at this facility where horses are stalled:
Do horses have assigned stalls in the structure(s)?    Yes    
Do all stalls/enclosures allow horses to lie down, stand up and turn around?    Yes    
Is there adequate ceiling & beam height (a minimum of 12 feet above the tip of the horse's ear) when standing in all stalls/enclosures?    Yes    
How often are the stalls/enclosures cleaned? 6-7 Days a Week
Are floors constructed and maintained for both good drainage and traction?    Yes    
Is there a ventilation and circulation system in place to control temperature and prevent buildup of toxic gases?    Yes    
Is wiring inaccessible to horses and maintained for safety?    Yes    
Are fire prevention/protection measures (fire alarms, extinguishers and sprinkler systems) maintained and in good working order?     Yes    
Is there adequate lighting to ensure safety in all areas of facility?     Yes    
Are emergency contacts, including veterinarian contact information, conspicuously posted in easily accessible locations?    Yes    
Are human and equine first aid kits easily accessible?     Yes    

How many hours per day, on average, are horses stalled? 4-8
How many hours per day, on average, are horses turned out:
    Horses are out 16+ hours per day

The following describes the pastures at this facility:
    A dedicated staff person(s) is responsible for pasture management
    All pastures are fenced to prevent escape or injury
    Electric fencing is used; electric wires or tape fence are visibly marked
    Fencing checks, such as broken or missing planks, loose fence posts, exposed or loose nails, detached wires, etc., are done regularly
    Pastures are rotated
    Pastures have natural protection for horses (i.e., trees)
    Pastures have man-made protection for horses (i.e., shelters)

The following describes the turnout areas other than pastures at this facility:
    A dedicated staff person(s) is responsible for the maintenance of turnout areas
    All turnout areas are fenced to prevent escape or injury
    Electric fencing is used; electric wires or tape fence are visibly marked
    Turnout areas have man-made protection for horses (i.e., shelters)
    Fencing checks, such as broken or missing planks, loose fence posts, exposed or loose nails, detached wires, etc., are done regularly

The following policies and procedures are in place at the facility to restrict public access and to keep horses safe:
    The property owner, staff member or caretaker lives on the premises and ensures that public access is restricted and is responsible for the security of the facility and horses
    By Appointment Only signs are posted.
    No Trespassing signs are posted
    Hold Harmless signs are posted
    Visitors are only permitted at specific times
    Visitors are only permitted in specific areas
    The property is fitted with motion lights
    The property is fitted with a security system that is monitored internally by staff (or the property owner)
    The perimeter of the property is fully fenced

---

PBJ Dressage

---

Veterinarian Information
*Vet Assessment Not Current.

Veterinarian: Jeff Reiswig, DVM, DAVDC/Eq, Board Certified
Clinic Name: Equine Veterinary Dental Services
1333 Lundy's Lane
Newark   OH   43055
Phone: 740-587-3116

---

Equine Care
Horse Health Care/Barn Management Records: What system is used to collect and store health/horse care records?
    Notebook or equivalent (technology not utilized)

The following items are consistent with our feed management plan and practices:
    Horses are provided with individualized feeding plans, including supplements, according to age and any health issues
    Feed plans are determined in consultation with a veterinarian
    Supplement plans are determined in consultation with a veterinarian
    Horses are fed in individual stalls
    Staff and volunteers are trained in proper feed measurements and protocols and observed periodically to ensure they are feeding correctly
    The feed chart is centrally located and updated as needed
    The area(s) where hay, feed, grain, and supplements are stored are kept clean, free of debris and chemicals, and protected from weather and other animals in rodent-proof and mold-proof containers and grain bins
    Feed, supplements and hay types are clearly labeled
    Water sources, i.e., buckets, troughs, automatic waterers, etc. are kept clean, free of debris and chemicals, and protected from weather and other animals
    Medications are kept in a locked, climate-controlled area

Our organization has the following policies and procedures in place pertaining to the ongoing assessment of horses in its care:
    Horses are assigned a Henneke Body Condition score upon arrival at the facility
    The Henneke Body Condition score is updated monthly
    The Henneke Body Condition score is updated with each visit by the veterinarian
    Horses at our facility may be treated by an equine chiropractor
    Horses at our facility may be treated by an equine acupuncturist
    Horses at our facility may be treated by an equine massage therapist
    Horses at our facility may be treated by an equine nutritionist

Our organization has the following policies and procedures in place pertaining to the weight-carrying or workload capabilities of horses/equines in our care:
    Our organization evaluates the weight-carrying and workload limitations for each equine at least annually

The following variables are considered in determining the weight-carrying and workload limitations for each equine:
    Equine age, weight, breed, body condition, fitness, balance, health and soundness
    Equine conformation to include the top line, length of back, strength and width of loin, bone density (measured by the circumference of the cannon bone just below the knee)
    Size, shape, condition and angle of the hooves
    Participant weight, height, body proportions, balance, fitness and riding skills as well as behavioral issues and safety concerns
    Weight and proper fit of the saddle and other equipment
    Terrain and footing in the working environment
    Duration and frequency of working sessions, as the frequency with which an equine is subjected to maximum weight carrying and/or workload
    Nature and pace of work, repetitive or varied, radius of turns, degree of incline and regularity of footing when equine is subject to maximum weight-carrying capacity
    Temperature and/or weather conditions
    Seasonal impact on the equines' workload and weight-carrying capabilities and limitations

Do horses have access to clean drinking water at all times?     Yes    

Hoof Care: How often is hoof care provided for each horse? Every 4-8 weeks and when an issue arises

Dental Care: How often is dental care provided for each horse? Annually and when an issue arises

Physical Examinations: How often is each horse given a physical exam by a veterinarian? Annually and when an issue arises

Horse checks: How often are horses visually and physically checked by personnel at the facility? Every day or 6 days a week

Parasite Control: Our organization has the following worming protocols in place: (Check all that apply
    The protocol for each horse is determined in consultation with a veterinarian
    Fecal testing is performed prior to the use of a de-wormer.

Fly/Insect Control: What remedies are used to control flies and insects?
    Fly Traps and Tapes
    Premise Sprays/Insecticides
    Fly Spray Repellent
    Fly Masks
    Fly Sheets
    Fans

The following represent the biosecurity practices in place at facility:
    All staff are trained in best practices related to biosecurity
    All volunteers are trained in best practices related to biosecurity
    A specific individual is assigned to care for sick, affected and/or quarantined horses
    Sick, affected and/or quarantined horses are cared for last if the caretaker must also care for healthy horses
    Sick, affected and/or quarantined horses do not have contact with other horses or other animals
    Hand sanitizers and footbaths are available at all primary points of access to sick, affected and/or quarantined horses
    Horse trailers/vans used by sick, affected and/or quarantined horses are cleaned and disinfected after each use and cleaning takes place away from where horses are sheltered
    Horse-specific equipment used by sick, affected and/or quarantined horses is not shared and is clearly labeled
    Shared equipment used by sick, affected and/or quarantined horses is cleaned of organic debris and disinfected after each use
    Latex gloves are worn when working with sick, affected and/or quarantined horses
    Personnel are required to leave the facility (or shower and change clothing) after working with quarantined horses

The following represent the manure removal practices in place at facility:
    Manure piles are composted or spread on pastures

The following steps are taken to help staff and volunteers readily identify each horse on the property::
    Name plates are located on the stall
    Staff and volunteers are provided with an information packet with horse profiles, including photos and detailed descriptions
    Staff/volunteers are provided training on confirmation, markings, colors, and breeds
    Team leaders work with new staff/volunteers until they are able to identify the horses

Our organization has the following policies and procedures in place pertaining to tack, apparel and equipment:
     All horses have specifically assigned tack, apparel and equipment that is not shared
    Blankets, sheets and turn out apparel are fitted and utilized for each horse appropriate to the horse's needs and the weather conditions
    Blankets, sheets and turn out apparel are cleaned regularly as needed
    Tack is cleaned after each use
    Tack is inspected for overall working condition before each use by trained personnel
    Tack is assessed for fit before each use by trained personnel
    Tack is assessed for fit by trained personnel when a horse's body condition changes
    Tack is assessed for fit by trained personnel when a horse's disposition changes
    This facility enlists the services of a professional saddle fitter at least once a year
    Assigned tack is clearly labeled
    Tack is stored in a climate-controlled location
    Helmets are replaced after a fall
    Helmets are replaced at least every five years.

---

Emergency Preparedness
The following plans, policies, and procedures are in place at the facility to handle emergencies and address weather related issues, fire safety procedures, and/or any additional hazardous scenarios the facility could potentially experience:
    Emergency procedures are posted prominently
    Emergency phone numbers are posted prominently
    The facility owns or has access to a generator
    The facility maintains at least two weeks of hay, feed, shavings and medications
    The facility maintains appropriate liability and/or workers' compensation insurance
    All staff/volunteers are briefed regularly on emergency preparedness/safety procedures
    The organization has a written emergency preparedness/safety plan (EPP)

The written EPP addresses the following areas:
    Local fire department and/or the state's emergency planning department procedures
    Medical emergencies for clients, staff, and volunteers
    Medical emergencies for horses
    Evacuation plans
    Natural Disasters - thunderstorm, hurricanes, earthquakes, tornados, etc
    Protocols to notify emergency personnel

The facility follows the specific procedures to help PREVENT emergency situations:
    Smoking is strictly prohibited
    NO SMOKING signs are posted prominently
    Permanent or temporary structures where horses are stalled are kept free of dust, cobwebs, trash, cleaning rags, and other flammable items
    Aisles and doorways are kept clear
    Heaters with automatic shutoff settings are used

How often are the following checked or performed?
Fire Extinguishers are checked: Daily
Smoke detectors are checked: Not at all/NA
Electrical Systems are checked: Daily
Fence lines are checked: Daily
Turnout Areas are checked: Daily
Sprinkler systems are checked: Not at all/NA
Fire drills are conducted: Not at all/NA
Review of safety protocols with staff are conducted: Daily
Review of safety protocols with volunteers are conducted: Daily
The Emergency Preparedness Plan is reviewed and updated: Annually

Equine Transportation
2-horse trailer with truck or van:
    0 Owned onsite  1 Access onsite but not owned  0 Access offsite;
3-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
4-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
6-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
8-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
10-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;

---

Equine Assisted Services (EAS)

2020 EAS Operations	Mounted Only	Unmounted Only	Both Mounted & Unmounted	Total
Horses/Equines participating in EAS programs at this facility
Number of horses/equines aged 3-8	0	0	0	0
Number of horses/equines aged 9-14	0	0	0	0
Number of horses/equines aged 15-20	0	0	0	0
Number of horses/equines Over 20	0	0	0	0
Total number of horses/equines participating in EAS programs at this facility	0	0	0	0
	Mounted	Unmounted
Number of hours per day each horse works	0	0
Number of days per week each horse works	0	0
Clients participating in EAS programs at this facility	Mounted Only	Unmounted Only	Both Mounted & Unmounted	Total
Total number of individual clients (not lessons) served annually
Average number of clients (not lessons) participating in activities per week
	Mounted	Unmounted
Number of days per week programs are conducted at this facility	0	0
Number of weeks per year programs are conducted at this facility	0	0
	Mounted	Unmounted
Average wait list time for a client		0

Taco Bella Farm

---

Taco Bella Farm
3231 Burnside Rd Johnstown OH 43031
Contact: Beth Rolland
Contact's Phone: 614-989-8417
Contact's Email: beth@pbjconnections.org

Does your organization own, lease or use a part of this facility? Lease

Please list all local, state and federal licenses held by the organization, including the expiration dates, or indicate that no licenses are required at the local, state or federal level. Please also list if this facility is accredited and recognized as compliant with the published standards of an accrediting organization, including the name of the organization and the date of the accreditation.
     *Missing

Provide the contact information for the individual or organization responsible for investigating abuse in the county where the facility is located, including mailing address, email address, and phone information.
     Licking County Humane Society, Humane Agent Paula Evans https://www.lchspets.org/humane-agent-program/ Phone: 740-644-2200 825 Thornwood Drive Heath, OH 43056 info@lchspets.org

Does your organization conduct Equine Assisted Services (EAS) at this facility in accordance with the EQUUS Foundation Guidelines on Qualifications of Organizations Conducting Equine Assisted Services (EAS)? Yes

Total number of Equine Assisted Service Providers AT THIS FACILITY, including instructors, specialists, therapists, counselors, coaches and/or facilitators (full-time, part-time, volunteer, independent contractors, and/or providers accompanying clients) that conduct Equine Assisted Services (EAS) in accordance with the EQUUS Foundation Guidelines on Qualifications of Organizations Conducting Equine Assisted Services (EAS) AT THIS FACILITY:  10

Equine Assisted Service Providers Assigned to this Facility: (see Equine Assisted Service Provider Section below for details)

     1. Anissa Kasarjian, MSW, LISW
     2. Beth Rolland
     3. Colleen Dempsey, MSW, LISW
     4. Erica Lewis
     5. Glenda Childress
     6. Holly Jedlicka, MSW, LISW-S
     7. Jennifer Pietsch
     8. Julie Reiswig
     9. Michelle Kozel
     10. Stacia Barnes, LPCC

---

Taco Bella Farm:

---

Grounds
Total number of horses involved with your programs at this facility: 7
Of the total number of horses involved with your programs at this facility, the number of horses that are microchipped: 0
Total number of horses at this facility INCLUDING those not involved with your programs: 7
Maximum capacity of horses at this facility: 7
Total acreage dedicated specifically to the horses: 14
Our organization has use of the following at this facility:
Structures/Barns: 2  Run-in sheds: 1
Pastures: 6  Paddocks/Pens: 7
Uncovered Outdoor Rings: 1  Covered Outdoor Rings: 0  Indoor Rings: 1





Regarding structures at this facility where horses are stalled:
Do horses have assigned stalls in the structure(s)?    Yes    
Do all stalls/enclosures allow horses to lie down, stand up and turn around?    Yes    
Is there adequate ceiling & beam height (a minimum of 12 feet above the tip of the horse's ear) when standing in all stalls/enclosures?    Yes    
How often are the stalls/enclosures cleaned? 6-7 Days a Week
Are floors constructed and maintained for both good drainage and traction?    Yes    
Is there a ventilation and circulation system in place to control temperature and prevent buildup of toxic gases?    Yes    
Is wiring inaccessible to horses and maintained for safety?    Yes    
Are fire prevention/protection measures (fire alarms, extinguishers and sprinkler systems) maintained and in good working order?     Yes    
Is there adequate lighting to ensure safety in all areas of facility?     Yes    
Are emergency contacts, including veterinarian contact information, conspicuously posted in easily accessible locations?    Yes    
Are human and equine first aid kits easily accessible?     Yes    

How many hours per day, on average, are horses stalled? 0-3;
How many hours per day, on average, are horses turned out:
    Horses are out 24/7 except they are brought in if there is inclement weather
    Horses are out 24/7 except when they are being trained
    Horses are out 24/7 except when they are used for the conduct of the organization's programs

The following describes the pastures at this facility:
    A dedicated staff person(s) is responsible for pasture management
    All pastures are fenced to prevent escape or injury
    Electric fencing is used; electric wires or tape fence are visibly marked
    Fencing checks, such as broken or missing planks, loose fence posts, exposed or loose nails, detached wires, etc., are done regularly
    Pastures are rotated
    Pastures have natural protection for horses (i.e., trees)
    Pastures have man-made protection for horses (i.e., shelters)

The following describes the turnout areas other than pastures at this facility:
    A dedicated staff person(s) is responsible for the maintenance of turnout areas
    All turnout areas are fenced to prevent escape or injury
    Electric fencing is used; electric wires or tape fence are visibly marked
    Turnout areas have man-made protection for horses (i.e., shelters)
    Fencing checks, such as broken or missing planks, loose fence posts, exposed or loose nails, detached wires, etc., are done regularly

The following policies and procedures are in place at the facility to restrict public access and to keep horses safe:
    The property owner, staff member or caretaker lives on the premises and ensures that public access is restricted and is responsible for the security of the facility and horses
    By Appointment Only signs are posted.
    No Trespassing signs are posted
    Hold Harmless signs are posted
    Visitors are only permitted at specific times
    Visitors are only permitted in specific areas
    The property is fitted with motion lights
    The property is fitted with a security system that is monitored internally by staff (or the property owner)

---

Taco Bella Farm

---

Veterinarian Information
*Vet Assessment Not Current.

Veterinarian: Chrissie Schneider DVM
Clinic Name: Bella Vista Equine Veterinary Services
6320 Darling Rd.
Blacklick   OH   43004
Phone: 614-540-0040

---

Equine Care
Horse Health Care/Barn Management Records: What system is used to collect and store health/horse care records?
    Notebook or equivalent (technology not utilized)

The following items are consistent with our feed management plan and practices:
    Horses are provided with individualized feeding plans, including supplements, according to age and any health issues
    Feed plans are determined in consultation with a veterinarian
    Supplement plans are determined in consultation with a veterinarian
    Horses are fed in individual stalls
    Horses are fed in groups
    Staff and volunteers are trained in proper feed measurements and protocols and observed periodically to ensure they are feeding correctly
    The feed chart is centrally located and updated as needed
    The area(s) where hay, feed, grain, and supplements are stored are kept clean, free of debris and chemicals, and protected from weather and other animals in rodent-proof and mold-proof containers and grain bins
    Feed, supplements and hay types are clearly labeled
    Water sources, i.e., buckets, troughs, automatic waterers, etc. are kept clean, free of debris and chemicals, and protected from weather and other animals
    Medications are kept in a locked, climate-controlled area

Our organization has the following policies and procedures in place pertaining to the ongoing assessment of horses in its care:
    Horses are assigned a Henneke Body Condition score upon arrival at the facility
    The Henneke Body Condition score is updated monthly
    The Henneke Body Condition score is updated with each visit by the veterinarian
    Horses at our facility may be treated by an equine chiropractor
    Horses at our facility may be treated by an equine acupuncturist
    Horses at our facility may be treated by an equine massage therapist
    Horses at our facility may be treated by an equine nutritionist

Our organization has the following policies and procedures in place pertaining to the weight-carrying or workload capabilities of horses/equines in our care:
    Our organization evaluates the weight-carrying and workload limitations for each equine at least annually

The following variables are considered in determining the weight-carrying and workload limitations for each equine:
    Equine age, weight, breed, body condition, fitness, balance, health and soundness
    Equine conformation to include the top line, length of back, strength and width of loin, bone density (measured by the circumference of the cannon bone just below the knee)
    Size, shape, condition and angle of the hooves
    Participant weight, height, body proportions, balance, fitness and riding skills as well as behavioral issues and safety concerns
    Weight and proper fit of the saddle and other equipment
    Terrain and footing in the working environment
    Duration and frequency of working sessions, as the frequency with which an equine is subjected to maximum weight carrying and/or workload
    Nature and pace of work, repetitive or varied, radius of turns, degree of incline and regularity of footing when equine is subject to maximum weight-carrying capacity
    Temperature and/or weather conditions
    Seasonal impact on the equines' workload and weight-carrying capabilities and limitations

Do horses have access to clean drinking water at all times?     Yes    

Hoof Care: How often is hoof care provided for each horse? Every 4-8 weeks and when an issue arises

Dental Care: How often is dental care provided for each horse? Annually and when an issue arises

Physical Examinations: How often is each horse given a physical exam by a veterinarian? Annually and when an issue arises

Horse checks: How often are horses visually and physically checked by personnel at the facility? Every day or 6 days a week

Parasite Control: Our organization has the following worming protocols in place: (Check all that apply
    The protocol for each horse is determined in consultation with a veterinarian
    Fecal testing is performed prior to the use of a de-wormer.

Fly/Insect Control: What remedies are used to control flies and insects?
    Fly parasites
    Fly Traps and Tapes
    Premise Sprays/Insecticides
    Fly Spray Repellent
    Fly Masks
    Fans

The following represent the biosecurity practices in place at facility:
    All staff are trained in best practices related to biosecurity
    All volunteers are trained in best practices related to biosecurity
    A specific individual is assigned to care for sick, affected and/or quarantined horses
    Sick, affected and/or quarantined horses are cared for last if the caretaker must also care for healthy horses
    Sick, affected and/or quarantined horses do not have contact with other horses or other animals
    Horse trailers/vans used by sick, affected and/or quarantined horses are cleaned and disinfected after each use and cleaning takes place away from where horses are sheltered
    Horse-specific equipment used by sick, affected and/or quarantined horses is not shared and is clearly labeled
    Shared equipment used by sick, affected and/or quarantined horses is cleaned of organic debris and disinfected after each use
    Latex gloves are worn when working with sick, affected and/or quarantined horses

The following represent the manure removal practices in place at facility:
    Manure is piled in an area where horses are not located
    Manure is hauled, sold or given away
    Manure piles are composted or spread on pastures
    Our organization adheres to the manure management guidelines set by state and/or local authorities

The following steps are taken to help staff and volunteers readily identify each horse on the property::
    Name plates are located on the stall
    A notebook or binder with photos and information on each horse is easily accessible
    Staff/volunteers are provided training on confirmation, markings, colors, and breeds
    Team leaders work with new staff/volunteers until they are able to identify the horses

Our organization has the following policies and procedures in place pertaining to tack, apparel and equipment:
     All horses have specifically assigned tack, apparel and equipment that is not shared
    Saddles are shared
    Blankets, sheets and turn out apparel are fitted and utilized for each horse appropriate to the horse's needs and the weather conditions
    Blankets, sheets and turn out apparel are cleaned regularly as needed
     Halters are shared
    Tack is cleaned only when needed
    Tack is inspected for overall working condition before each use by trained personnel
    Tack is assessed for fit before each use by trained personnel
    Tack is assessed for fit by trained personnel when a horse's body condition changes
    Tack is assessed for fit by trained personnel when a horse's disposition changes
    Assigned tack is clearly labeled
    Tack is stored in a climate-controlled location
    Helmets are replaced after a fall
    Helmets are replaced at least every five years.

---

Emergency Preparedness
The following plans, policies, and procedures are in place at the facility to handle emergencies and address weather related issues, fire safety procedures, and/or any additional hazardous scenarios the facility could potentially experience:
    Emergency procedures are posted prominently
    Emergency phone numbers are posted prominently
    The facility owns or has access to a generator
    The facility maintains at least two weeks of hay, feed, shavings and medications
    The facility maintains appropriate liability and/or workers' compensation insurance
    All staff/volunteers are briefed regularly on emergency preparedness/safety procedures
    The organization has a written emergency preparedness/safety plan (EPP)

The written EPP addresses the following areas:
    Local fire department and/or the state's emergency planning department procedures
    Medical emergencies for clients, staff, and volunteers
    Medical emergencies for horses
    Evacuation plans
    Fire
    Natural Disasters - thunderstorm, hurricanes, earthquakes, tornados, etc
    Terrorist attacks
    Protocols to notify emergency personnel

The facility follows the specific procedures to help PREVENT emergency situations:
    Smoking is strictly prohibited
    NO SMOKING signs are posted prominently
    Hay is stored away from permanent or temporary structures where horses are stalled
    Permanent or temporary structures where horses are stalled are kept free of dust, cobwebs, trash, cleaning rags, and other flammable items
    Aisles and doorways are kept clear
    Heaters with automatic shutoff settings are used

How often are the following checked or performed?
Fire Extinguishers are checked: Daily
Smoke detectors are checked: Not at all/NA
Electrical Systems are checked: Daily
Fence lines are checked: Daily
Turnout Areas are checked: Daily
Sprinkler systems are checked: Not at all/NA
Fire drills are conducted: Not at all/NA
Review of safety protocols with staff are conducted: Daily
Review of safety protocols with volunteers are conducted: Daily
The Emergency Preparedness Plan is reviewed and updated: Annually

Equine Transportation
2-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  1 Access offsite;
3-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
4-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
6-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  1 Access offsite;
8-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
10-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;

---

Equine Assisted Services (EAS)

2020 EAS Operations	Mounted Only	Unmounted Only	Both Mounted & Unmounted	Total
Horses/Equines participating in EAS programs at this facility
Number of horses/equines aged 3-8	0	0	0	0
Number of horses/equines aged 9-14	0	0	0	0
Number of horses/equines aged 15-20	0	0	0	0
Number of horses/equines Over 20	0	0	0	0
Total number of horses/equines participating in EAS programs at this facility	0	0	0	0
	Mounted	Unmounted
Number of hours per day each horse works	0	0
Number of days per week each horse works	0	0
Clients participating in EAS programs at this facility	Mounted Only	Unmounted Only	Both Mounted & Unmounted	Total
Total number of individual clients (not lessons) served annually
Average number of clients (not lessons) participating in activities per week
	Mounted	Unmounted
Number of days per week programs are conducted at this facility	0	0
Number of weeks per year programs are conducted at this facility	0	0
	Mounted	Unmounted
Average wait list time for a client		0

PBJ- OSU

---

PBJ- OSU
3658 Kays Ave Dublin OH 43017
Contact: Dan Rhodeback
Contact's Phone: 614-459-4208
Contact's Email: rhodeback.1@osu.edu

Does your organization own, lease or use a part of this facility? Use

Please list all local, state and federal licenses held by the organization, including the expiration dates, or indicate that no licenses are required at the local, state or federal level. Please also list if this facility is accredited and recognized as compliant with the published standards of an accrediting organization, including the name of the organization and the date of the accreditation.
     The University is in the process of obtaining AALAC accreditation. https://www.aaalac.org/accreditation/ The University has also established the IACUC (Institutional Animal Care and Use Committee) to oversee responsible animal use, review protocols, and the animal care and use program, and monitor animal care facilities to ensure compliance with standards and regulatory requirements. https://orrp.osu.edu/iacuc/

Provide the contact information for the individual or organization responsible for investigating abuse in the county where the facility is located, including mailing address, email address, and phone information.
     Columbus Humane 3015 Scioto Darby Executive Ct Hilliard, OH 43026 614-777-7387 questions@columbushumane.org

Does your organization conduct Equine Assisted Services (EAS) at this facility in accordance with the EQUUS Foundation Guidelines on Qualifications of Organizations Conducting Equine Assisted Services (EAS)? Yes

Total number of Equine Assisted Service Providers AT THIS FACILITY, including instructors, specialists, therapists, counselors, coaches and/or facilitators (full-time, part-time, volunteer, independent contractors, and/or providers accompanying clients) that conduct Equine Assisted Services (EAS) in accordance with the EQUUS Foundation Guidelines on Qualifications of Organizations Conducting Equine Assisted Services (EAS) AT THIS FACILITY:  9

Equine Assisted Service Providers Assigned to this Facility: (see Equine Assisted Service Provider Section below for details)

     1. Anissa Kasarjian, MSW, LISW
     2. Beth Rolland
     3. Colleen Dempsey, MSW, LISW
     4. Erica Lewis
     5. Holly Jedlicka, MSW, LISW-S
     6. Julie Reiswig
     7. Kimberly Cole
     8. Michelle Kozel
     9. Stacia Barnes, LPCC

---

PBJ- OSU:

---

Grounds
Total number of horses involved with your programs at this facility: 10
Of the total number of horses involved with your programs at this facility, the number of horses that are microchipped: 0
Total number of horses at this facility INCLUDING those not involved with your programs: 39
Maximum capacity of horses at this facility: 39
Total acreage dedicated specifically to the horses: 40
Our organization has use of the following at this facility:
Structures/Barns: 2  Run-in sheds: 10
Pastures: 10  Paddocks/Pens: 19
Uncovered Outdoor Rings: 1  Covered Outdoor Rings: 0  Indoor Rings: 0





Regarding structures at this facility where horses are stalled:
Do horses have assigned stalls in the structure(s)?    No    
Do all stalls/enclosures allow horses to lie down, stand up and turn around?    Yes    
Is there adequate ceiling & beam height (a minimum of 12 feet above the tip of the horse's ear) when standing in all stalls/enclosures?    Yes    
How often are the stalls/enclosures cleaned? 6-7 Days a Week
Are floors constructed and maintained for both good drainage and traction?    Yes    
Is there a ventilation and circulation system in place to control temperature and prevent buildup of toxic gases?    Yes    
Is wiring inaccessible to horses and maintained for safety?    Yes    
Are fire prevention/protection measures (fire alarms, extinguishers and sprinkler systems) maintained and in good working order?     Yes    
Is there adequate lighting to ensure safety in all areas of facility?     Yes    
Are emergency contacts, including veterinarian contact information, conspicuously posted in easily accessible locations?    Yes    
Are human and equine first aid kits easily accessible?     Yes    

How many hours per day, on average, are horses stalled? 0-3;
How many hours per day, on average, are horses turned out:
    Horses are out 24/7 except they are brought in if there is inclement weather
    Horses are out 24/7 except when they are being trained
    Horses are out 24/7 except when they are used for the conduct of the organization's programs

The following describes the pastures at this facility:
    A dedicated staff person(s) is responsible for pasture management
    All pastures are fenced to prevent escape or injury
    Electric fencing is used; electric wires or tape fence are visibly marked
    Fencing checks, such as broken or missing planks, loose fence posts, exposed or loose nails, detached wires, etc., are done regularly
    Pastures are rotated
    Pastures have man-made protection for horses (i.e., shelters)

The following describes the turnout areas other than pastures at this facility:
    A dedicated staff person(s) is responsible for the maintenance of turnout areas
    All turnout areas are fenced to prevent escape or injury
    Electric fencing is used; electric wires or tape fence are visibly marked
    Turnout areas have man-made protection for horses (i.e., shelters)
    Fencing checks, such as broken or missing planks, loose fence posts, exposed or loose nails, detached wires, etc., are done regularly

The following policies and procedures are in place at the facility to restrict public access and to keep horses safe:
    Entrance gates are locked at night
    Visitors are only permitted at specific times
    Visitors are only permitted in specific areas
    The property is fitted with a security system that is monitored internally by staff (or the property owner)
    The perimeter of the property is fully fenced

---

PBJ- OSU

---

Veterinarian Information
*Vet Assessment Not Current.

Veterinarian: Dr. Justin D. Kieffer, DVM
Clinic Name: The Ohio State University
327 Plumb Hall, 2027 Coffey Rd.
Columbus   OH   43210
Phone: 614-292-4523

---

Equine Care
Horse Health Care/Barn Management Records: What system is used to collect and store health/horse care records?
    Notebook or equivalent (technology not utilized)
    Onsite computer with onsite backup storage system
    The organization utilizes its own system to maintain records

The following items are consistent with our feed management plan and practices:
    Horses are provided with individualized feeding plans, including supplements, according to age and any health issues
    Feed plans are determined in consultation with a veterinarian
    Supplement plans are determined in consultation with a veterinarian
    Horses are fed in individual stalls
    Staff and volunteers are trained in proper feed measurements and protocols and observed periodically to ensure they are feeding correctly
    The feed chart is centrally located and updated as needed
    The area(s) where hay, feed, grain, and supplements are stored are kept clean, free of debris and chemicals, and protected from weather and other animals in rodent-proof and mold-proof containers and grain bins
    Feed, supplements and hay types are clearly labeled
    Water sources, i.e., buckets, troughs, automatic waterers, etc. are kept clean, free of debris and chemicals, and protected from weather and other animals
    Medications are kept in a locked, climate-controlled area

Our organization has the following policies and procedures in place pertaining to the ongoing assessment of horses in its care:
    Horses are assigned a Henneke Body Condition score upon arrival at the facility
    The Henneke Body Condition score is updated monthly
    The Henneke Body Condition score is updated with each visit by the veterinarian
    Horses at our facility may be treated by an equine chiropractor
    Horses at our facility may be treated by an equine acupuncturist
    Horses at our facility may be treated by an equine massage therapist
    Horses at our facility may be treated by an equine nutritionist

Our organization has the following policies and procedures in place pertaining to the weight-carrying or workload capabilities of horses/equines in our care:
    Our organization evaluates the weight-carrying and workload limitations for each equine at least annually

The following variables are considered in determining the weight-carrying and workload limitations for each equine:
    Equine age, weight, breed, body condition, fitness, balance, health and soundness
    Equine conformation to include the top line, length of back, strength and width of loin, bone density (measured by the circumference of the cannon bone just below the knee)
    Size, shape, condition and angle of the hooves
    Participant weight, height, body proportions, balance, fitness and riding skills as well as behavioral issues and safety concerns
    Weight and proper fit of the saddle and other equipment
    Terrain and footing in the working environment
    Duration and frequency of working sessions, as the frequency with which an equine is subjected to maximum weight carrying and/or workload
    Nature and pace of work, repetitive or varied, radius of turns, degree of incline and regularity of footing when equine is subject to maximum weight-carrying capacity
    Temperature and/or weather conditions
    Seasonal impact on the equines' workload and weight-carrying capabilities and limitations

Do horses have access to clean drinking water at all times?     Yes    

Hoof Care: How often is hoof care provided for each horse? Every 4-8 weeks and when an issue arises

Dental Care: How often is dental care provided for each horse? Annually and when an issue arises

Physical Examinations: How often is each horse given a physical exam by a veterinarian? Annually and when an issue arises

Horse checks: How often are horses visually and physically checked by personnel at the facility? Every day or 6 days a week

Parasite Control: Our organization has the following worming protocols in place: (Check all that apply
    Fecal testing is performed prior to the use of a de-wormer.

Fly/Insect Control: What remedies are used to control flies and insects?
    Fly Traps and Tapes
    Premise Sprays/Insecticides
    Fly Spray Repellent

The following represent the biosecurity practices in place at facility:
    The organization has a written biosecurity plan
    A specific individual is assigned to care for sick, affected and/or quarantined horses
    Sick, affected and/or quarantined horses are cared for last if the caretaker must also care for healthy horses
    Sick, affected and/or quarantined horses do not have contact with other horses or other animals
    Hand sanitizers and footbaths are available at all primary points of access to sick, affected and/or quarantined horses
    Manure and bedding from sick, affected and/or quarantined horses is disposed of in specific areas designated for infectious materials - not put in open air piles, and not spread on pastures
    Stalls, aisle ways, and common areas are disinfected after conclusion of the quarantine
    Horse trailers/vans used by sick, affected and/or quarantined horses are cleaned and disinfected after each use and cleaning takes place away from where horses are sheltered
    Horse-specific equipment used by sick, affected and/or quarantined horses is not shared and is clearly labeled
    Shared equipment used by sick, affected and/or quarantined horses is cleaned of organic debris and disinfected after each use
    Latex gloves are worn when working with sick, affected and/or quarantined horses
    Personnel are required to leave the facility (or shower and change clothing) after working with quarantined horses

The following represent the manure removal practices in place at facility:
    Manure is stored in dumpster(s)
    Manure piles are composted or spread on pastures
    Our organization adheres to the manure management guidelines set by state and/or local authorities

The following steps are taken to help staff and volunteers readily identify each horse on the property::
    Horses are assigned the same stall/location each day
    Name plates are located on the stall
    Horses wear halters with nametags
    A notebook or binder with photos and information on each horse is easily accessible
    Staff/volunteers are provided training on confirmation, markings, colors, and breeds
    Team leaders work with new staff/volunteers until they are able to identify the horses

Our organization has the following policies and procedures in place pertaining to tack, apparel and equipment:
     All horses have specifically assigned tack, apparel and equipment that is not shared
    Tack is cleaned only when needed
    Tack is inspected for overall working condition before each use by trained personnel
    Tack is assessed for fit before each use by trained personnel
    Tack is assessed for fit by trained personnel when a horse's body condition changes
    Tack is assessed for fit by trained personnel when a horse's disposition changes
    This facility enlists the services of a professional saddle fitter at least once a year
    Assigned tack is clearly labeled
    Tack is stored in a climate-controlled location
    Helmets are replaced after a fall
    Helmets are replaced at least every five years.

---

Emergency Preparedness
The following plans, policies, and procedures are in place at the facility to handle emergencies and address weather related issues, fire safety procedures, and/or any additional hazardous scenarios the facility could potentially experience:
    Emergency procedures are posted prominently
    Emergency phone numbers are posted prominently
    The facility owns or has access to a generator
    The facility maintains at least two weeks of hay, feed, shavings and medications
    The facility collects and maintains medical information from staff, volunteers, and clients
    The facility maintains appropriate liability and/or workers' compensation insurance
    All staff/volunteers are briefed regularly on emergency preparedness/safety procedures
    The organization has a written emergency preparedness/safety plan (EPP)

The written EPP addresses the following areas:
    Evacuation plans
    Power outages
    Fire
    Natural Disasters - thunderstorm, hurricanes, earthquakes, tornados, etc
    Protocols to notify emergency personnel
    Building/facility exit plans

The facility follows the specific procedures to help PREVENT emergency situations:
    Smoking is strictly prohibited
    NO SMOKING signs are posted prominently
    Hay is stored away from permanent or temporary structures where horses are stalled
    Permanent or temporary structures where horses are stalled are kept free of dust, cobwebs, trash, cleaning rags, and other flammable items
    Aisles and doorways are kept clear
    Heaters with automatic shutoff settings are used

How often are the following checked or performed?
Fire Extinguishers are checked: Semi-annually
Smoke detectors are checked: Semi-annually
Electrical Systems are checked: Semi-annually
Fence lines are checked: Daily
Turnout Areas are checked: Daily
Sprinkler systems are checked: Semi-annually
Fire drills are conducted: Not at all/NA
Review of safety protocols with staff are conducted: Not at all/NA
Review of safety protocols with volunteers are conducted: Not at all/NA
The Emergency Preparedness Plan is reviewed and updated: Not at all/NA

Equine Transportation
2-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
3-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
4-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
6-horse trailer with truck or van:
    1 Owned onsite  3 Access onsite but not owned  0 Access offsite;
8-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;
10-horse trailer with truck or van:
    0 Owned onsite  0 Access onsite but not owned  0 Access offsite;

---

Equine Assisted Services (EAS)

2020 EAS Operations	Mounted Only	Unmounted Only	Both Mounted & Unmounted	Total
Horses/Equines participating in EAS programs at this facility
Number of horses/equines aged 3-8	0	0	0	0
Number of horses/equines aged 9-14	0	0	0	0
Number of horses/equines aged 15-20	0	0	0	0
Number of horses/equines Over 20	0	0	0	0
Total number of horses/equines participating in EAS programs at this facility	0	0	0	0
	Mounted	Unmounted
Number of hours per day each horse works	0	0
Number of days per week each horse works	0	0
Clients participating in EAS programs at this facility	Mounted Only	Unmounted Only	Both Mounted & Unmounted	Total
Total number of individual clients (not lessons) served annually
Average number of clients (not lessons) participating in activities per week
	Mounted	Unmounted
Number of days per week programs are conducted at this facility	0	0
Number of weeks per year programs are conducted at this facility	0	0
	Mounted	Unmounted
Average wait list time for a client		0

---

EQUINE CENSUS SUMMARY

Total Facilities: 3
PBJ- OSU: 2019 - Yes
PBJ Dressage: 2019 - Yes
Taco Bella Farm: 2019 - Yes

28 Total number of horses involved with your programs on January 1, 2019
PLUS: Horse Intake during 2019
0 Donated
0 Free Lease
1 Purchase/Adoption from Owner
0 Purchased from Auction
0 Purchased from Kill Pen/Feedlot
0 Surrendered
0 Seized
0 Abandoned
0 Returned
0 Transfer
0 Born at facility
1 Total intakes
LESS: Horse Departure during 2019
0 Horses adopted/sold:
0 Horses transferred/returned
0 Horses deceased
0 Horses euthanized
0 Total departures
29 Number of horses involved with your programs on December 31, 2019
17 Total number of active horses (not retired) including
horses undergoing rehabilitation and/or retraining.
12 Total number of horses permanently retired.

Summary: 28 on 1/1/2019+ 1 Intakes - 0 Departures = 29 on 12/31/2019

Total days that equines were in the care of PBJ Connections during 2019: 10251

---

PBJ Dressage Prior Year information not updated.

2019 PBJ Dressage Equine Census
12 Total number of horses involved with your programs on January 1, 2019
PLUS: Horse Intake during 2019
0 Donated
0 Free Lease
0 Purchase/Adoption from Owner
0 Purchased from Auction
0 Purchased from Kill Pen/Feedlot
0 Surrendered
0 Seized
0 Abandoned
0 Returned
0 Transfer
0 Born at facility
0 Total intakes
LESS: Horse Departure during 2019
0 Horses adopted/sold:
0 Horses transferred/returned
0 Horses deceased
0 Horses euthanized
0 Total departures
12 Number of horses involved with your programs on December 31, 2019
5 Total number of active horses (not retired) including
horses undergoing rehabilitation and/or retraining.
7 Total number of horses permanently retired.

Summary: 12 on 1/1/2019+ 0 Intakes - 0 Departures = 12 on 12/31/2019

---

Taco Bella Farm Prior Year information not updated.

2019 Taco Bella Farm Equine Census
6 Total number of horses involved with your programs on January 1, 2019
PLUS: Horse Intake during 2019
0 Donated
0 Free Lease
1 Purchase/Adoption from Owner
0 Purchased from Auction
0 Purchased from Kill Pen/Feedlot
0 Surrendered
0 Seized
0 Abandoned
0 Returned
0 Transfer
0 Born at facility
1 Total intakes
LESS: Horse Departure during 2019
0 Horses adopted/sold:
0 Horses transferred/returned
0 Horses deceased
0 Horses euthanized
0 Total departures
7 Number of horses involved with your programs on December 31, 2019
2 Total number of active horses (not retired) including
horses undergoing rehabilitation and/or retraining.
5 Total number of horses permanently retired.

Summary: 6 on 1/1/2019+ 1 Intakes - 0 Departures = 7 on 12/31/2019

---

1 Horse Intake Detail during 2019 0
0 Donated 0
0 Free Leased 0
1 Purchased from Owner 0
1Miniature Horse1 Aged 15-20  1 Geldings
0 Purchased from Auction 0
0 Purchased from Kill Pen/Feedlot 0
0 Surrendered 0
0 Seized 0
0 Abandoned 0
0 Returned 0
0 Transferred 0
0 Born at facility 0

---

PBJ- OSU Prior Year information not updated.

2019 PBJ- OSU Equine Census
10 Total number of horses involved with your programs on January 1, 2019
PLUS: Horse Intake during 2019
0 Donated
0 Free Lease
0 Purchase/Adoption from Owner
0 Purchased from Auction
0 Purchased from Kill Pen/Feedlot
0 Surrendered
0 Seized
0 Abandoned
0 Returned
0 Transfer
0 Born at facility
0 Total intakes
LESS: Horse Departure during 2019
0 Horses adopted/sold:
0 Horses transferred/returned
0 Horses deceased
0 Horses euthanized
0 Total departures
10 Number of horses involved with your programs on December 31, 2019
10 Total number of active horses (not retired) including
horses undergoing rehabilitation and/or retraining.
0 Total number of horses permanently retired.

Summary: 10 on 1/1/2019+ 0 Intakes - 0 Departures = 10 on 12/31/2019

---

---

---

Definitions:
Donated: The ownership and custody of the equine is transferred to the organization by its owner/trainer/responsible agent utilizing a donation document.
Free Lease: The ownership of the equine is maintained by the owner/trainer/responsible agent; the custody and responsibility for the shelter and care of the equine is transferred to the organization utilizing a free lease document.
Purchased from Owner: The ownership and custody of the equine is transferred to the organization by its owner/trainer/responsible agent utilizing a purchase document.
Purchased from Auction: The ownership and custody of the equine is transferred to the organization by purchasing the equine at an auction.
Purchased from Kill Pen: The ownership and custody of the equine is transferred to the organization by purchasing the equine from a kill pen.
Surrendered (Hardship): The ownership and custody of the equine is relinquished to the organization by its owner/trainer/responsible agent with or without the use of an intake document.
Seized: The ownership and custody of the equine is transferred to the organization as a result of the equine being seized by law enforcement or another agency and removed from the owner.
Abandoned: The ownership and custody of the equine is transferred to the organization as a result of the equine being abandoned by the owner or the owner was unable to be located.
Returned: The equine was previously a part of the organization, was adopted, and ownership and custody of the equine has been transferred back to the organization.
Transferred: The custody of the equine is transferred within an organization or from one organization to another non-profit or foster organization to provide retirement, retraining, rehabilitation and/or adoption services with no change in ownership.
Born: The equine was born at the facility.

Foal: An equine up to one year old; a colt is a male foal and a filly is a female foal.
Mare: A female equine.
Stallion: A male equine that has not been castrated.
Gelding: A castrated male equine.

Equine Assisted Services (EAS): Any activity that incorporates equine interactions and/or the equine environment, mounted or unmounted, to include 1) psychotherapy and/or mental health counseling aimed at achieving goals set forth by the licensed mental health professional and the client, 2) occupational therapy, physical therapy, and speech-language pathology treatment strategies utilizing equine movement set forth by the licensed therapist and the client, 3) horsemanship instruction adapted to the ability/disability of those receiving services, for the purpose of contributing positively to their cognitive, physical, emotional and social well-being conducted by a certified professional, and 4) experiential learning approaches that promote the development of life skills to achieve educational, professional and personal goals conducted by a licensed educator, mental health professional or coach. Please refer to our Guidelines for Conducting EAS for additional information.

Special Needs: Any difficulty or difficulties (such as a physical, emotional, behavioral, or cognitive disability or impairment) that require or benefit from instructors, specialists, counselors, trainers and/or facilitators who have certified training for their scope of practice applicable to the people participating in the programs and specific to the program offerings. The difficulty may not be limited to a health issue but may result from the interaction between the individual and the society in which he or she lives arising from an abusive or unhealthy environment or situation and/or a lack of resources, including economic resources, placing them at risk of a future with less than optimal outcomes.

At-Risk: Refers to being at-risk of a future with less than optimal outcomes. Youth are considered at-risk for a number of reasons, such as if they are homeless or transient, involved in drugs or alcohol, abused sexually, physically or emotionally, mentally ill, neglected at home or live in stressful family environments, lacking social or emotional supports, and involved with delinquent peers. At-Risk youth are likely to be involved in a number of risky behaviors, such as running away, skipping school, drinking underage, engaging in sexual behavior, displaying disruptive behavior, bullying/harassment, fighting, and committing acts of vandalism.

Community Outreach: Refers to public education programs aimed at educating the public about the horse-human bond, issues impacting the welfare of horses, and how horses change lives and activities that include, but are not limited to, any activity OTHER THAN Equine Assisted Services (EAS) that require a credentialed service provider, such as off site visits with horses at hospitals, nursing homes, and schools, crisis response, workplace well-being, on site tours, seminars and clinics, camps, community service hours, able-bodied mounted and unmounted lessons, etc.