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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.

 

  • CACFP At a Glance Calendar
  • Claims Processing Calendar
  • Renewal Preparation Checklist

Administrative 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)
  • 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
  • Media Release for Non-Pricing Programs
  • Free and Reduced-Price Policy Statement for Non-Pricing Programs
  • Organization's Certificate of Incorporation
  • Civil Rights Pre-Award Compliance
  • Procurement Standards and Code of Conduct
  • Food Service Contract Document, if applicable – contact [email protected]
  • Template Forms:
    • Recordkeeping Policy Template
    • Sample Outside Employment Policy
    • Sample Job Descriptions

 

Adding a Site:

  • Add/Change/Delete Form
    • HelpDesk Add/Change/Delete
      • Log into ADEConnect
      • Click 'Help'
      • Click 'HelpDesk'
      • Click 'New Request'
      • Locate Health and Nutrition Services templates
      • Select 'HNS Add/Change/Delete form'
      • Complete all required fields and applicable optional fields within HelpDesk's Add/Change/Delete form
      • *Use/Requestor submitting Add/Change/Delete form must be submitted by an Authorized Signer listed on the Food Permanent Service Agreement
    • Manual (print, sign, scan, and email to the specialist)
  • Child Care Standards for Unlicensed Facilities

 

Household Contact Procedure:

  • Household Contact Procedures
  • Household Contacts Parent Survey (Phone)

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

  • 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

  • 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 (English) (Spanish)
    • Letter to Household (English) (Spanish)
  • Income Eligibility Guidelines (Effective July 1, 2025 - June 30, 2026)
  • Income Eligibility Guidelines (Effective July 1, 2026 - June 30, 2027)
  • Claiming Rosters (PDF) (Excel)

 

Adult Care Center Enrollment:

  • Meal Benefit Income Eligibility Form
  • Required Resources to Provide Families: (Instructions) (FAQ)
  • Income Eligibility Guidelines (Effective July 1, 2025 - June 30, 2026)
  • Income Eligibility Guidelines (Effective July 1, 2026 - June 30, 2027)
  • 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
  • Menu Self-Assessment

 

Identifying and Preparing Nutritious and Creditable Foods:

  • Creditable Foods Guide
  • Team Nutrition Training Worksheets
  • Grains Ounce Equivalents
    • Exhibit A
    • Using Ounce Equivalents for Grains in the CACFP
  • Meal Quality Guidance Tool
  • Food Buying Guide for Child Nutrition Programs Interactive Web-Based Tool
  • Production Worksheet Template
  • Milk Purchasing Calculator 
  • Temperature Log

 

Preparing for the Meal Service:

  • Family Style Meal Service in Arizona (Arizona Early Childhood Education Association)
  • 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)

 

Tracking Program Expenses:

  • Forms:
    • Food Service Cost Report (PDF) (Excel)
    • Time Distribution Report Form
    • Monthly Expense Worksheet (PDF) (Excel)
    • Equipment Pre-Approval Request Form
  • Resources:
    • Allowable Expenses in the CACFP

 

Submitting a Claim:

  • Claims Processing Calendar
  • Monthly Claims Preparation Worksheet (Sponsor Claim) (Site Claim)
  • Request for One-Time Exception Form

 

Program Calculators:

  • Projected Reimbursement Calculator
  • Reasonable Budget Range Calculator

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

Forms:

  • At-Risk Point of Service Meal Counts
  • At-Risk 5-Day Reconciliation Form
  • At-Risk Monitoring Form

 

Resources:

  • Operating At-Risk in a Childcare Center
  • Child Care Standards for Unlicensed Facilities

  • Monitoring Visit Form
  • Sample Unannounced Review Policy
  • Template Monitoring Visit Schedule
  • Administrators and School Leaders
    • Free and Reduced Data and use with other programs
    • SUN Bucks
    • Prospective Waiver Requests
  • Parents and Families
    • Find a Participating Summer Food Service Site
    • Paying for Meals
    • SUN Bucks
    • Menu Requirements
    • Additional Benefits for Children and Families
  • Child Nutrition Program Operators
    • 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
    • USDA Foods in Schools Program
  • Peer to Peer Support for Child Nutrition Professionals
  • Free and Reduced-Price Percentage Report
  • HNS/USDA Memos
  • Civil Rights
  • Submit Data Request
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