Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

I. Site Monitoring

  • A. Date of last review

  • B. Were any problems noted during most recent prior review? If yes, list problems.

  • C. Have problems been corrected as of today's visit? If no, what follow-up action is needed and by when?

II. Training

  • A. Have staff attended annual CACFP training? When?

  • B. Have new staff attended CACFP training?

  • C. Is all training documented? (Agenda, date, timelines, trainer, attendee signatures)

  • III. Follow-up based on observations

IV. Meal Requirements

  • A. Meal

  • Number of Participants

  • Meal Components

  • Milk, Meat/Meat/Alternate, Fruit/Vegetable, Bread/Grain, Other
  • Milk

  • Food Item/Serving Size/Amount Prepared

  • Meat/Meat Alternate

  • Food Item/Serving Size/Amount Prepared

  • Fruit/Vegetable

  • Food Item/Serving Size/Amount Prepared

  • Fruit/Vegetable

  • Food Item/Serving Size/Amount Prepared

  • Fruit/Vegetable

  • Food Item/Serving Size/Amount Prepared

  • Bread/Grain

  • Food Item/Serving Size/Amount Prepared

  • Other

  • Food Item/Serving Size/Amount Prepared

  • B. Did the teacher role model: Did the teacher serve themselves first and demonstrate the correct serving size for the children?

  • C. Did the meal start on time?

  • D. Did the children serve themselves to the extent possible?

  • E. Was the milk served in the correct amounts for each child and adult participant?

  • F. Was socialization between teacher and children observed: Open ended questions about the meal and the child should be observed during this time?

  • G. Are children sitting properly at the table: chairs pushed into the table and sitting up straight?

  • H. Do the children who have special diets, know and understand their substitutions?

  • 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?

  • J. Is the table set correctly? Including a knife, spoon and fork for breakfast and lunch?

  • K. Did you observe children setting the table? If yes, were they supervised to ensure sanitation guidelines were followed?

  • L. Did you observe hand washing before meal time?

  • M. As children were finishing their meal what did you observe? Were they allowed to leave and transition to another area?

VII. Meal Counts

  • A. Does site have a roster or attendance sign-in sheet?

  • B. Do attendance records support meal counts?

  • C. Are meal counts taken at the point the participant is served a complete meal?

  • D. If staff eat CACFP meals, are the number of of Program Adults recorded on each claim?

  • E. Are snacks or other meals NOT taken home? (Meals may be claimed only when participants are in care).

  • Meal start and end times?

  • G. Do staff follow these meal times? If no, should times be changed?

Summary

  • 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.)

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