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Ohio Department of Job and Family Services

LIABILITY INSURANCE STATEMENT FOR FAMILY CHILD CARE PROVIDERS

Name of Family Child Care Provider (please print)

According to Ohio law, family child care providers must either maintain liability insurance in the specified amount or obtain a statement from the parents of children in care that verifies the parent's understanding that the home does not carry liability insurance.

By signing this form I have been made aware that this family child care provider does not carry liability insurance which meets the following requirements:

Is provided by an insurer authorized to do business in Ohio under Chapter 3905. of the Revised Code.
Insures the family child care provider against liability arising out of, or in connection with, the operation of the home.
The insurance shall provide coverage in the amount of at least one hundred thousand dollars per occurrence and three hundred thousand dollars in the aggregate.

I am aware that if the licensee of the family child care home is not the owner of the real property where the family child care home is located, the liability insurance, if any, of the owner of the real property may not provide for coverage of any liability arising out of, or in connection with, the operation of the home.