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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

  • Building for the Future Flyer
  • Current WIC Flyer (English) (Spanish) 
  • To order And Justice for All posters email [email protected]

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
  • Condensed 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)
  • Request for One-Time Exception Form
  • 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
    • Additional Benefits for Children and Families
  • 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

Health and Nutrition Services Announces the Availability of the 2023 Summer Food Service Program Wed, Feb 1 2023

The Arizona Department of Education Health and Nutrition Services (HNS) is pleased to announce the availability of the Summer Food Service Program (SFSP) during summer 2023. 

Congratulations to the School Year 2021-2022 BRAVOcado! Excellence Awardees! Tue, Oct 11 2022

The Arizona Department of Education Recognizes Schools for Exemplary Fresh Fruit and Vegetable Programs  

The Arizona Department of Education Health and Nutrition Services is pleased to announce the Program Year 2021-2022 BRAVOcado! awardees for excellent Fresh Fruit and Vegetable Program (FFVP) operations. The BRAVOcado! Excellence Award is given to schools that demonstrate exemplary FFVP service and commitment to promoting fruit and vegetable consumption and healthy lifestyles to their students.

The FFVP BRAVOcado! Excellence Award recognizes schools that go above and beyond to operate a phenomenal FFVP program. To be eligible for the award, sites must meet criteria related to variety of produce items served, frequency of service, frequency of nutrition education, frequency of serving local produce, development of site-level and outside partnerships, and more!

The following three School Food Authorities went above and beyond and received the award this year. Congratulations to all awardees!

  • Concho Elementary School 
  • Concordia Charter School 
  • Southgate Academy, Inc.

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