Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
I. Site Monitoring
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A. Date of last review
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B. Were any problems noted during most recent prior review? If yes, list problems.
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C. Have problems been corrected as of today's visit? If no, what follow-up action is needed and by when?
II. Training
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A. Have staff attended annual CACFP training? When?
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B. Have new staff attended CACFP training?
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C. Is all training documented? (Agenda, date, timelines, trainer, attendee signatures)
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III. Follow-up based on observations
IV. Meal Requirements
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A. Meal
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Number of Participants
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Meal Components
Milk, Meat/Meat/Alternate, Fruit/Vegetable, Bread/Grain, Other
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Milk
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Food Item/Serving Size/Amount Prepared
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Meat/Meat Alternate
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Food Item/Serving Size/Amount Prepared
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Fruit/Vegetable
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Food Item/Serving Size/Amount Prepared
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Fruit/Vegetable
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Food Item/Serving Size/Amount Prepared
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Fruit/Vegetable
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Food Item/Serving Size/Amount Prepared
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Bread/Grain
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Food Item/Serving Size/Amount Prepared
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Other
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Food Item/Serving Size/Amount Prepared
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B. Did the teacher role model: Did the teacher serve themselves first and demonstrate the correct serving size for the children?
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C. Did the meal start on time?
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D. Did the children serve themselves to the extent possible?
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E. Was the milk served in the correct amounts for each child and adult participant?
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F. Was socialization between teacher and children observed: Open ended questions about the meal and the child should be observed during this time?
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G. Are children sitting properly at the table: chairs pushed into the table and sitting up straight?
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H. Do the children who have special diets, know and understand their substitutions?
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I. Are the other children aware of the kids with special diets in the classroom? Do they understand why their friends cannot have certain foods and what and why?
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J. Is the table set correctly? Including a knife, spoon and fork for breakfast and lunch?
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K. Did you observe children setting the table? If yes, were they supervised to ensure sanitation guidelines were followed?
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L. Did you observe hand washing before meal time?
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M. As children were finishing their meal what did you observe? Were they allowed to leave and transition to another area?
VII. Meal Counts
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A. Does site have a roster or attendance sign-in sheet?
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B. Do attendance records support meal counts?
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C. Are meal counts taken at the point the participant is served a complete meal?
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D. If staff eat CACFP meals, are the number of of Program Adults recorded on each claim?
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E. Are snacks or other meals NOT taken home? (Meals may be claimed only when participants are in care).
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Meal start and end times?
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G. Do staff follow these meal times? If no, should times be changed?
Summary
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Write a short summary of your visit. Point out program strengths and weaknesses. Give your opinion on how the program could be improved. Recommend changes that you see desirable or required. (Note: Short comments such as "good program" are not sufficient.)