Program Forms and Resources CACFP

The following are program forms and resources for operators of the Child and Adult Care Food Program.

Administration Forms

• Permanent Agreement
• Mandatory Reporting of DUNS Number
• Administrative Review Procedures
• Procedures for Complaints of Discrimination
• State of Arizona W-9
• State of Arizona ACH Authorization Form
• ADEConnect Request for Entity Administrator
• Computer Software Agreement

Required Postings

•  And Justice for All Poster (Must be 11x17)
•  Building for the Future Flier
• Current WIC Flier (English) (Spanish)

Training Staff

• Civil Rights Compliance Training
• Annual Staff CACFP Training Presentation Template
• CACFP Trainer’s Tools: Feeding Infants
• Template Training Agenda and Sign-In Sheet

Adding a Site

• Instructions: How to Add a New Site (Center) (At-Risk)
• Add/Change/Delete Form
  • Manual (print, sign, scan, and email to specialist)
  • Electronic (access and complete online)
    • Applicable Program must be selected
    • Must be initiated by an authorized signer
• Child Care Standards for Unlicensed Facilities

Participant Enrollment and Eligibility

• Participant Menu Modification Form
• Child Care Center Enrollment
  • DHS Emergency, Information, and Immunization Record Card (Blue Card)
  • Meal Benefit Income Eligibility Form (English) (Spanish)
  • Required Resources to Provide Families: (Instructions) (Letter)
  • Income Guidelines
  • Claiming Rosters (PDF) (Excel)
• Adult Care Center Enrollment
  • Meal Benefit Income Eligibility Form (English) (Spanish)
  • Required Resources to Provide Families: (Instructions) (FAQ)
  • Income Guidelines
  • Claiming Rosters (PDF) (Excel)

Building a Menu

• Child and Adult Meal Pattern Requirements
• Menu Template
  • 7-Days: All Meals and Snacks
  • 5-Days: All Meals and Snacks
  • 5-Days: Breakfast, Lunch, AM and PM Snack
  • 5-Days: Breakfast, Lunch, Snack
• ADE Sample Menu
• CACFP Menu Self-Assessment
• Recipes
  • Team Nutrition Recipes
  • Recipes for Healthy Kids (6 servings) (25 servings) (50-100 servings)
  • National CACFP Sponsors Association Recipes
  • Child Nutrition Recipe Box
• American Academy of Pediatrics – Choking Prevention

Identifying and Preparing Nutritious and Creditable Foods

• Creditable Foods Guide
• Team Nutrition Training Worksheets
• WIC Foods List
• ADE Shopping Guides (Yogurt) (Cereal)
• Best Practices (ADE) (USDA)
• Food Buying Guide for Child Nutrition Programs Interactive Web-Based Tool
• ADE’s Simplified Food Buying Guide and Production Worksheets
  • Breakfast (Excel)
  • Lunch/Supper (Excel)
  • Snack (Excel)
  • Milk Only (Excel)
• Temperature Log

Preparing for the Meal Service

• Family Style Meal Service in Arizona
• Offer Versus Serve in the CACFP (English) (Spanish) Only Applicable for At-Risk and Adults

Counting and Totaling Meals Served

• Child and Adult Point of Service Meal Count Forms
  • 7-Days: All Meals and Snacks
  • 5-Days: All Meals and Snacks
  • 5-Days: Breakfast, Lunch, AM and PM Snack
  • 5-Days: Breakfast, Lunch, Snack
• Meal Count Summary Sheet (PDF) (Excel)

Feeding Infants

• Forms:
  • Infant Point of Service Meal Count Sheet
  • Infant Feeding Preference Form (English) (Spanish)
  • DHS Solid Food Introduction Form
• Resources:
  • Infant Meal Pattern Chart
  • Feeding Infants in the CACFP Guide
  • Breastfed Babies Welcome Here

Operating At-Risk

• Forms:
  • At-Risk POS Meal Counts
  • At-Risk 5-Day Reconciliation Form
  • At-Risk Monitoring Form
• Resources:
  • Operating At-Risk in a Childcare Center

Monitoring Sites

• Monitoring Form
• Shortened Monitoring Visit Form

Tracking Program Expenses

• Forms:
  • Food Service Cost Report (PDF) (Excel)
  • Time Distribution Report Form
  • Monthly Expense Worksheet (PDF) (Excel)
• Resources:
  • Micro and Small Purchases Tip Sheet
  • Procurement Flowchart
  • Allowable Expenses in the CACFP

Submitting a Claim

• Reimbursement Rates
• Claims Processing Calendar
• CACFP Claim Process FAQ
• How to Submit a Claim Guide: (Sponsor Claim) (Site Claim)
• Monthly Claims Preparation Worksheet (Sponsor Claim) (Site Claim)

Preparing and Completing ADE Reviews

• Review Preparation Form
• Corrective Action Plan