Bright From The Start Audit Form - with Procurement

• Site conducted

  Select

• Document No.

• Audit Title

• Site

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Atlanta Public Schools SOS Review Form Child and Adult Care Food Program Review Form ( Center Sponsor Use Only)

• School/Center Name

  Select

• Arrival Time

  Date

• County

  Fulton County

• Licensed Capacity

• Number Enrolled Number of students enrolled in program

• Number Present on Date of Visit Number of students present

• Eligibility Method

  Profit

  Non-Profit

• Visit

  1st Visit

  2nd Visit

  3rd Visit

• Unannounced Visit?

  Yes

  No

  N/A

• Date

  Date

• Non- Profit Food Service Assessment

  Yes

  No

  N/A

• Procurement Assessment

  Yes

  No

  N/A

• SOS Serving Time

  Date

• Departure Time

  Date

• Reviewer

  Monty Waites

  Akilah Issa

• Program Type

  At Risk After School Care

Licensing or Approval Type

• Alternate Licensure

  Select Exempt from Licensure/approval per CACFP regulations ( At- Risk, Outside School Hours and Emergency/Homeless Shelter only) Bright from the Start (DECAL)

  • Exempt from Licensure/approval per CACFP regulations ( At- Risk, Outside School Hours and Emergency/Homeless Shelter only)
  • Bright from the Start (DECAL)

License

• Is the center within Licensed capacity at time of review?

  Non Applicable

• If a Federal/State/Local Authority approved the center, is there verification of the approval on file? <br>(Not applicable to At Risk, Outside School Hours or Emergency Shelters)

  Non Applicable

• If the CACFP Childcare Standards were used to meet the alternate licensure requirements, does the center meet all of the standards?

  Non Applicable

Meal Type

• Supper

Civil Rights

• Is the a "Justice for All" poster on display in a conspicuous area?

  Yes

  No

  N/A

• Are admission placement procedures nondiscriminatory?

  Yes

  No

  N/A

• Is there any separation by race, color, national origin, sex, age, or disability?

  Yes

  No

  N/A

• Is ethnic and racial data collected annually and maintained by the center?

  Yes

  No

  N/A

Participation Information

• Is current WIC information distributed to participant households(child care centers excluding after school programs) per 7 CFR 226.15(n)?

  Yes

  No

  N/A

• Is the Building for the Future Flyer or applicable sponsor notice that contains the required information distributed to participant's households to inform them of the facility's participation in the CACFP per CFR 226.16(b)(5)?

  Yes

  No

  N/A

• Is the site applying the approved free and reduced price policy statement correctly

  Yes

  No

  N/A

Claim For Reimbursement Verification

• Are Meals claimed only for enrolled participants?

  Yes

  No

  N/A

• Is the number of participants in care according to enrollment and attendance records for the five-days reviewed comparable to the number of meals claimed?<br>Use the Meal Count Reconciliation Page to Document

  Yes

  No

  N/A

• Are meals claimed only for participants who are within regulatory age limits?

  Yes

  No

  N/A

At Risk School Care Snack Centers

• Are enrichment or educational activities being offered during the At Risk Program?

  Yes

  No

  N/A

• Document the activities being conducted during the visit?

Recordkeeping

• Are annually updated enrollment forms on file for participants per 7 CFR 226.15(e)(2)?

  Yes

  No

  N/A

• Is the "Weekly Menu & Food Service Record" form used and up-to-date for all meals for the current month?

  Yes

  No

  N/A

• Are records given to the sponsoring organization on a regular basis as provided for in the agreement between the sponsoring organization and the center?

  Yes

  No

  N/A

• Does the center maintain all program records for three years after the date of submission of the final claim for reimbursement for the fiscal year to which they pertain, or if an audit is outstanding, until the audit is closed? Records are maintained for three (3) years plus the current year.

  Yes

  No

  N/A

• Are receipts and supporting documentation available to support both operating and administrative costs charged to the CACFP?

  Yes

  No

  N/A

• Do the administrative costs claimed by the facility and the administrative fee charged by the sponsor equal no more than 15% of the center's monthly reimbursement?

  Yes

  No

  N/A

• Are all costs charged to the CACFP allowable?

  Yes

  No

  N/A

• Are shared costs prorated appropriately so that CACFP is charged only for the portion used?

  Yes

  No

  N/A

• Are the following documents available to support labor cost charged to the CACFP?

  Yes

  No

  N/A

• a) Time and attendance reports for all labor costs charged to the CACFP or combination of forms based on Bright from the Start Labor Costs Policy Memo dated 5/23/05?

  Yes

  No

  N/A

• b) Time distribution reports for all labor costs charged or combination of forms based on Bright from the Start Labor Costs Policy Memo dated 5/23/05?

  Yes

  No

  N/A

Fiscal Record Keeping

• Does the center utilize a financial management system or a comprehensive record that captures all financial activities for the food service program? The center must utilize one (1) of the three (3) methods below:

  Select Yes

  • Yes

• a) Manual tracking, this system must identify the source and application of funds,

  N/A

• b) Separate CACFP bank account,

  N/A

• c) A comingled account with a chart of accounts and general ledger (accounting code/program identifier)

  Yes

• Indicate which financial management system the center uses

  Lawson

• Does the center track program funds that adequately and clearly identify the receipt and distribution of program funds?

  Yes

• Is financial documentation available to support both operating and administrative costs charged to the CACFP (invoices, receipts, contracts, etc.)?

  Yes

• Did the center provide a complete and accurate Monthly Record of Costs Form?

  Yes

• Are all costs charged to the CACFP allowable costs?

  Yes

• Are shared costs prorated appropriately so that CACFP is charged only for the portion used?

  Yes

• Are the following documents available, accurate and complete to support labor costs charged to CACFP in accordance with DECAL's policy 39- Financial Recordkeeping in the CACFP and SFSP and memo. Labor Cost Documentation, dated 5.23.05?

  Yes

• a) Time and attendance reports for all labor costs charged to the CACFP (always required)?

  Yes

• b) Time distribution reports for all labor costs charged to the CACFP (if applicable)?

  Yes

Non-Profit Food Service

• Is the center operating a non-profit food service per DECAL memo? 1.)Refer to the instructions to calculate an acceptable non-profit food service balance; 2.) Complete the table below to calculate the CACFP fund balance compared to the average three (3) months threshold that should not be exceeded; 3.) Attach copies of the applicable financial documents reviewed to the monitoring review form (i.e., Monthly Record of Cost, invoices and receipts , bank statements and /general ledger).

  Yes

Procurement Procedures

• Does the center have written procurement procedures?

  Yes

  No

  N/A

• Is the center using DECAL's Procurement and Purchasing Policy Template or does the center have its own written procedures that include procurement policy language noted in the policy memo, Monitoring Requirements- Monitoring Sponsored Centers Non-profit Food Service and Procurement procedures and do the procedures meet federal and state requirements?

  Yes

  No

  N/A

• Does the center's written procedures include the following requirements?

  Yes

  No

  N/A

• a) Written standard of conduct covering conflicts of interest and governing the actions of its employees engaged in the selection, award and administration of contracts?

  Yes

  No

  N/A

• b) Indicate no employee , officer or agent of affiliated or unaffiliated sites, participates in the selection, award or administration of a contract or purchasing agreement supported by a Federal award if he or she has a real or apparent conflict of interest?

  Yes

  No

  N/A

• c) Indicate that officers, employees and agents of sponsored centers may neither solicit nor accept gratuities, favors or anything of monetary value from contractors or parties to subcontracts?

  Yes

  No

  N/A

• d) Provide for disciplinary actions to be applied for violations of such standards by officers, employees or agents of the non-Federal entity?

  Yes

  No

  N/A

Procurement Assessment

• Did the center complete the Suspension and Debarment Certification using one (1) of the three (3) USDA recommended methods below?

  Yes

  No

  N/A

• a) Checking the System for Award Management (SAM) or the Excluded Parties List System (EPLS), or

  Yes

  No

  N/A

• b) Collecting a certification from that person (DECAL has a published template, Suspension and Debarment Certification Form)

  Yes

  No

  N/A

• c) Adding a clause or condition to the covered transaction with that person.

  Yes

  No

  N/A

• Did the center conduct and follow procurement procedures for all purchases? (If no procurement was conducted, refer to the review instructions and access based on micro purchase).

  Yes

  No

  N/A

• Is the center implementing required procurement procedures for micro purchases?

  Yes

  No

  N/A

• a) Were transactions $10,000 or less?

  Yes

  No

  N/A

• b) Were purchase prices reasonable?

  Yes

  No

  N/A

• c) Did the institution use multiple vendors and were the costs equally distributed?

  Yes

  No

  N/A

• Is the center implementing required procurement procedures for small purchases?

  Yes

  No

  N/A

• a) Was the aggregate cost associated with this procurement under the small purchase threshold?

  Yes

  No

  N/A

• b) Did the center document quotes received on the DECAL Small Purchase Procurement Form?

  Yes

  No

  N/A

• c) Were price or rate quotations obtained from an adequate number (2 or more) of qualified sources?

  Yes

  No

  N/A

• d) Did the center restrict competition by placing unreasonable requirements on firms to qualify for business?

  Yes

  No

  N/A

• e ) Did the center restrict competition by requiring unnecessary experience or excessive bonding?

  Yes

  No

  N/A

• f) Did the center restrict competition by specifying a :brand name" product or not allowing "an equal " product to be offered?

  Yes

  No

  N/A

• g) Were clear and accurate descriptions of the technical requirements provided for the product or service being procured?

  Yes

  No

  N/A

• h) Did the center evaluate and award the bid/offers accurately?

  Yes

  No

  N/A

• Is the center implementing required procurement procedures for formal purchases?

  Yes

  No

  N/A

• a) Did the center notify the sponsoring organization and DECAL before posting the competitive procurement?

  Yes

  No

  N/A

• b) Did the center notify the sponsoring organization and DECAL before awarding the contract?

  Yes

  No

  N/A

TRAINING

• Has key center staff attended the sponsoring organization's CACFP training within the last 12 months?

  Yes

  No

  N/A

• Has the center implemented ideas/information provided during training?

  Yes

  No

  N/A

Other Requirements

• Does the center have program guidance materials issued by the sponsor available for reference?

  Yes

  No

  N/A

• Has effective action been achieved for all problem(s) noted during the last review?

  Yes

  No

  N/A

Food Handling/Sanitation and Food Storage

• Are disposable items discarded after each use?

  Yes

  No

  N/A

• Is the food service equipment free of dirt, dust, food, grease deposits and odor?

  Yes

  No

  N/A

• Is there evidence of good personal hygiene practices?

  Yes

  No

  N/A

• Is the food safely transferred from the kitchen/cafeteria to the classroom?

  Yes

  No

  N/A

• Observations:

• Is a thermometer in use in refrigerator and freezer?

  Yes

  No

  N/A

• Is the refrigerator kept at 40 degrees or below and the freezer temperatures at zero degrees or below?

  Yes

  No

  N/A

• Is potentially hazardous food properly thawed?

  Yes

  No

  N/A

• Method Used:

• Does food appear to be in sound condition with no evidence of spoilage?

  Yes

  No

  N/A

• Is all food stored at least 6 inches above the floor?

  Yes

  No

  N/A

• Are storage areas and containers adequate to maintain food in sound condition?

  Yes

  No

  N/A

• Is food stored separately from cleaning items and other toxic material?

  Yes

  No

  N/A

• Are uncooked items, which are removed from original labeled package, which are in refrigerator/freezer covered/sealed, labeled and dated?

  Yes

  No

  N/A

• Are leftovers properly labeled?

  Yes

  No

  N/A

• Are trash containers covered?

  Yes

  No

  N/A

• Is the kitchen free of obvious fire, health and and/or safety hazards?

  Yes

  No

  N/A

• Is food service conducted in compliance with generally accepted health and sanitation practices<br>(staff refrains from use of tobacco products and use hair restraints?

  Yes

  No

  N/A

• Are dishes sanitized correctly?

  Yes

  No

  N/A

• Method Used:

• Is the center free of rodent or insect infestation?

  Yes

  No

  N/A

Observation of Meal Service Record the meal type observed, the total number of participants and food items served and the serving sizes for all meals including infant meals, if applicable.

• Indicate Meal Type Observed

  At Risk Supper

  Non Applicable

• Total Number of Participants Served on Date of Review At Risk Meals

• Meal Components (please check meal components present)

  Select Milk Meat/Meat Alternative Fruit/Vegetable Fruit/Vegetable Bread/Bread Alternative

  • Milk
  • Meat/Meat Alternative
  • Fruit/Vegetable
  • Fruit/Vegetable
  • Bread/Bread Alternative

• Food Items Served and Serving Size

Meal Service for Date of Review

• Does the posted menu correspond to the meal observed?

  Yes

  No

  N/A

• Are all components of the meal served on this date creditable?

  Yes

  No

  N/A

• Is skim or 1% milk being served to persons 2 years of age or older are required?

  Yes

  No

  N/A

• Was today's meal served in appropriate quantities?

  Yes

  No

  N/A

• Was an accurate meal count taken at the point of service on the date of visit?

  Yes

  No

  N/A

• Was an accurate, daily meal count taken for program and non-program adults?

  Yes

  No

  N/A

• Does the observed meal provide a variety of colors, temperatures, textures, shapes, sizes and flavors?

  Yes

  No

  N/A

• Does the meal service occur in a positive/pleasant environment?

  Yes

  No

  N/A

• Does the center offer infant formula to applicable program participants?

  Yes

  No

  N/A

• Are only infant meals claimed that meet the USDA requirements?

  Yes

  No

  N/A

• Are medical statements on file for all substitutions related to medical, special dietary, or religious needs?

  Yes

  No

  N/A

• Is potable drinking water being made available to children?

  Yes

  No

  N/A

• Is the number of participants in care at the time of the meal service consistent with the number of participants being claimed for the previous five operating days?

  Yes

  No

  N/A

• a) If the answer to the previous question is no, can the Center Contact provide a valid and reasonable explanation for the discrepancy? (Household Contacts may be required.)

  Yes

  No

  N/A

• b) If the answer to the previous question is yes, please list the explanation.

• Meal Count Reconciliation
  For the current or prior claiming period, for five consecutive days, determine the number of participants in care according to attendance and enrollment records. For At-Risk, Outside School Hours and Emergency shelters which are not required to maintain enrollment records, conduct reconciliation using attendance only. Record these numbers according to these records. Record the facility meal counts documented on the Weekly Menu and Food Service Record. Attach the Weekly Menu and Food Service Records and the attendance records for the five days reviewed on this form.

Supper Meal Service

• Date

  Date

• Number According to Attendance Enrollment-At Risk

• Meal Counts Documented by Facility-At Risk

• Date

  Date

• Number According to Attendance Enrollment-At Risk

• Meal Counts Documented by Facility-At Risk

• Date

  Date

• Number According to Attendance Enrollment-At Risk

• Meal Counts Documented by Facility-At Risk

• Date

  Date

• Number According to Attendance Enrollment

• Meal Counts Documented by Facility

• Date

  Date

• Number According to Attendance Enrollment

• Meal Counts Documented by Facility

Summary of Findings Child and Adult Care Food Program Center Review Form

• Review Item #

  Yes

  No

  N/A

• Brief Description of Finding

• Corrective Action (C. A.) Needed

  Yes

  No

  N/A

• Corrective Action (C.A.) Needed

• Corrective Action Due Date

  Date

• How will findings be corrected and corrections maintained?

• Follow-Up Visit Date

  Date

• Date corrected

  Yes

  No

  N/A

• Date Corrected

  Date

• Afterschool Coordinator Signature

  Sign

• Audit Monitor Signature

  Sign