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  • Program Forms and Resources CACFP

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
    • Manual Permanent Agreement (print, sign 1 original, mail to ADE for approval)
    • Electronic Permanent Agreement (complete CACFP Initiation Form, agreement is emailed to signers directly by AdobeSign, electronic signature) 
  • Unique Entity Identifier (UEI) lookup or request a UEI by visiting https://sam.gov/content/duns-uei
  • 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

Emergency Operational Costs Reimbursement Program

  • Use of Emergency Operational Costs Reimbursement Program Funds for Renewing Institutions
  • Use of Emergency Operational Costs Reimbursement Program Funds for New Institutions

Required Postings

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

Training Staff

  • Civil Rights Compliance for Child Nutrition Operators (English) (Spanish)
  • 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 Eligibility Guidelines (English) (Spanish)
    • Claiming Rosters (PDF) (Excel)
  • Adult Care Center Enrollment
    • Meal Benefit Income Eligibility Form
    • Required Resources to Provide Families: (Instructions) (FAQ)
    • Income Eligibility Guidelines (English) (Spanish)
    • 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
  • CACFP Snack Ideas
  • CACFP Cold Entrée Ideas
  • 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 Database
  • ADE Shopping Guides (Yogurt) (Cereal)
  • Grains Ounce Equivalents
    • Exhibit A
    • Using Ounce Equivalents for Grains in the CACFP
  • Meal Quality Guidance Tool (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 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)
    • Equpiment Pre-Approval Request Form (PDF)
  • 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
  • Monthly Claims Preparation Worksheet (Sponsor Claim) (Site Claim)
  • Administrators and School Leaders
    • New Legislation
    • Free and Reduced Data and use with other programs
    • Summer P-EBT
  • Parents and Families
    • Paying for Meals Again
    • Summer P-EBT
    • Menu Requirements
  • Child Nutrition Program Operators
    • Child Nutrition Flexibilities
    • National School Lunch Program and School Breakfast Program
    • Child and Adult Care Food Program
    • Afterschool Care Snack Program and At-Risk Afterschool Meals
    • Summer Meal Service
    • Staying on Track Monthly Webinar
  • Peer to Peer Support for Child Nutrition Professionals
  • Free and Reduced-Price Percentage Report
  • HNS/USDA Memos
  • Civil Rights
  • Submit Data Request

Contact

  • Health & Nutrition Services
  • (602) 542-8700
  • [email protected]

From the Health and Nutrition Services Blog

2022 Farm Fresh Challenge Fri, Oct 22 2021

2022 Farm Fresh Challenge

Interested in Creating Your Kitchen? Fri, May 7 2021

The Arizona Department of Education (ADE) is excited to announce a new partnership with the Chef Ann Foundation, Life Time Foundation, and Whole Kids Foundation! These organizations are part of the newly formed ScratchWorks Collective and are dedicated to improving the quality of school meals and love sharing their expertise with school nutrition professionals. These partners look forward to supporting 10 Arizona Local Educational Agencies (LEAs) in a three-phase program to help operators regain their kitchens and menus as they recover from the impacts of the COVID-19 pandemic. The Chef Ann Foundation will kick-off this collaborative work by sending a culinary trained school food operational expert to each of the selected LEAs for a one-day on-site consultation to create a two-year plan with built-in mentoring designed to transform your kitchens, develop your staff, and take control of your finances to support the menu of your dreams. 

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