MVISD-ADMINISTRATIVE REVIEW-EXTENDED

• Conducted on

  Date

• Prepared by

• Location
  Address

MEAL COUNTING AND CLAIMING - NSLP - DAY OF REVIEW

• BASED ON THE MEAL OBSERVATION, DOES THE MEAL COUNTING SYSTEM AS IMPLEMENTED PREVENT OVER IDENTIFICATION OF STUDENTS RECEIVING FREE AND REDUCED PRICE BENEFITS? IF NO, EXPLAIN.

  Yes

  No

  N/A

• DOES THE SCHOOL LIMIT CHOICE OF REIMBURSABLE MEALS BASED ON STUDENT'S ELIGIBILITY STATUS? IF YES, EXPLAIN.

  Yes

  No

  N/A

• DOES THE SCHOOL USE DIFFERENT MEDIUMS OF EXCHANGE BASED ON ELIGIBILITY STATUS? IF YES, EXPLAIN.

  Yes

  No

  N/A

• AT THE SELECTED SCHOOL, DOES EACH TYPE OF MEAL SERVICE LINE AS OBSERVED ON THE DAY OF REVIEW PROVIDE AN ACCURATE COUNTY BY ELIGIBILITY CATEGORY AT THE POINT OF SERVICE ( OR APPROVED ALTERNATE)? IF NO, DESCRIBE THE PROBLEM AND INDICATE WHETHER THE PROBLEM WAS NON-SYSTEMIC OR SYSTEMIC. IF SECOND MEALS OR MEALS SERVED TO INELIGIBLES WERE OBSERVED, LIST THE TOTAL IN THE COMMENTS SECTION.

  Yes

  No

  N/A

• ON THE DAY OF THE REVIEW, ARE EXCESSIVE OVERRIDES USED AT THE POS? IF YES, FOR WHAT PURPOSE?

  Yes

  No

  N/A

• IS THE USE/PURPOSE OF THE OVERRIDES REASONABLE? IF NO, DESCRIBE THE PROBLEM AND INDICATE WHETHER THE PROBLEM WAS SYSTEMIC OR NON-SYSTEMIC.

  Yes

  No

  N/A

• ARE THE MEAL COUNTS BY CATEGORY AND RECORDED CORRECTLY? IF NO, DESCRIBE THE PROBLEM AND INDICATE WHETHER THE PROBLEM IS SYSTEMIC OR NON-SYSTEMIC.

  Yes

  No

  N/A

• SCHOOL COUNT-FREE:

• AUDIT COUNT-FREE:

• DIFFERENCE-FREE:

• SCHOOL COUNT-REDUCED:

• AUDIT COUNT-REDUCED:

• DIFFERENCE-REDUCED:

• SCHOOL COUNT-PAID:

• AUDIT COUNT-PAID:

• DIFFERENCE-PAID:

• ARE TOTAL MEAL COUNTS BY CATEGORY FOR THE REVIEW PERIOD REASONABLE COMPARED TO MEAL COUNTS FOR THE DAY OF REVIEW? IF NO, OBTAIN THE SCHOOL'S EXPLANATION AND RECORD EXPLANATION.

  Yes

  No

  N/A

• DOES THE EXPLANATION DESCRIBE AN ACCEPTABLE SYSTEM? IF NO, EXPLAIN AND LIST TOTAL NUMBER OF SECOND MEALS AND MEALS SERVED TO INELIGIBLES IN THE FOLLOWING SECTIONS.

  Yes

  No

  N/A

• DAY OF REVIEW MEAL COUNTS-FREE

• DAY OF REVIEW MEAL COUNTS-REDUCED

• DAY OF REVIEW MEAL COUNTS-PAID

MEAL COUNTING AND CLAIMING - NSLP - REVIEW PERIOD

• WERE THERE ANY DAYS WHEN THE FREE, REDUCED PRICE, OR PAID MEAL COUNTS EXCEEDED THE NUMBER OF FREE, REDUCED PRICE, OR PAID ELIGIBLE STUDENTS? IF YES, INDICATE WHETHER THERE IS AN ACCEPTABLE EXPLANATION AVAILABLE FOR EACH DAY.

  Yes

  No

  N/A

• IF NO ACCEPTABLE EXPLANATION IS AVAILABLE, EXPLAIN AND LIST THE NUMBER OF INELIGIBLE IN THE COMMENT SECTION.

• SCHOOL FREE ELIGIBLE COUNT:

• SCHOOL REDUCED ELIGIBLE COUNT:

• SCHOOL PAID ELIGIBLE COUNT:

• DATES EXCEEDING ELIGIBLES:

• FREE

• REDUCED

• PAID

• COMMENT

• WERE THERE ANY DAYS WHEN THE FREE, REDUCED PRICE, OR PAID LUNCH EXCEEDED THE NUMBER OF OF ATTENDANCE ADJUSTED ELIGIBLE STUDENTS?

  Yes

  No

  N/A

• IF YES, WAS IT 50% OR MORE OF THE SERVING DAYS?

• IF YES, WAS THERE AN ACCEPTABLE EXPLANATION?

• IF NO, EXPLAIN AND LIST THE NUMBER OF INELIGIBLE LUNCHES IN THE COMMENTS.

• DATES EXCEEDING ATTENDANCE ADJUSTED ELIGIBLES:

• FREE:

• REDUCED:

• PAID:

• COMMENTS:

• WERE THERE PATTERNS IN THE FREE, REDUCED, OR PAID MEAL COUNTS WHICH APPEAR QUESTIONABLE?

  Yes

  No

  N/A

• IF YES, OBTAIN THE SCHOOL'S EXPLANATION AND RECORD IN THE COMMENTS SECTION.

• AFTER CONSIDERATION OF THE EXPLANATION, DO THE PATTERNS INDICATE QUESTIONABLE MEAL COUNT PRACTICES? IF YES, EXPLAIN AND LIST THE NUMBER OF INELIGIBLE MEALS BY PROGRAM IN THE COMMENTS.

  Yes

  No

  N/A

• COMMENTS:

• FOR THE REVIEW PERIOD, COMPLETE THE CHART IN THE COMMENTS SECTION.

• COMMENTS:

• WERE THE COUNTS BY CATEGORY CORRECTLY USED IN THE CLAIM FOR REIMBURSEMENT?

  Yes

  No

  N/A

• IF NO, EXPLAIN AND INDICATE WHETHER THE PROBLEM WAS SYSTEMIC OR NON-SYSTEMIC. LIST THE NUMBER OF INELIGIBLE MEALS IN THE COMMENTS.

FREE

• SCHOOL COUNT

• SFA COUNT

• SA COUNT

• DIFFERENCE

REDUCED

• SCHOOL COUNT

• SFA COUNT

• SA COUNT

• DIFFERENCE

PAID

• SCHOOL COUNT

• SFA COUNT

• SA COUNT

• DIFFERENCE

• COMMENTS

• NON-SYSTEMIC

  SYSTEMIC

MEAL COMPONENTS AND QUANTITIES - NSLP - DAY OF REVIEW

• WERE ALL REQUIRED MEAL COMPONENTS AVAILABLE ON EVERY REIMBURSABLE MEAL SERVICE LINE TO ALL PARTICIPATING STUDENTS?

  Yes

  No

  N/A

• PRIOR TO THE BEGINNING OF MEAL SERVICE?

  Yes

  No

  N/A

• DURING THE MEAL SERVICE?

  Yes

  No

  N/A

• IF NO TO EITHER ABOVE QUESTION, EXPLAIN ALL ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED IN THE COMMENTS SECTION. IF THE ERROR WAS NOT CORRECTED PRIOR TO THE BEGINNING OF MEAL SERVICE, OR IF THE MEAL SERVICE DID NOT OFFER ALL REQUIRED MEAL COMPONENTS THROUGHOUT THE MEAL SERVICE, LIST THE NUMBER OF MEALS SERVED FROM THE APPLICABLE MEAL SERVICE LINE MISSING THE REQUIRED MEAL COMPONENTS IN THE COMMENTS SECTION.

• COMMENTS:

• DID ALL MEALS OBSERVED FOR THE DAY OF REVIEW COUNTED FOR REIMBURSEMENT CONTAIN ALL THE REQUIRED MEAL COMPONENTS?

  Yes

  No

  N/A

• IF NO, EXPLAIN ANY ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED.

• RECORD THE NUMBER OF MEALS OBSERVED MISSING REQUIRED MEAL COMPONENTS, WHICH INCLUDES THE REQUIREMENT FOR AT LEAST 1/2 CUP OF FRUITS/VEGETABLES UNDER OVS, IN THE COMMENTS SECTION.

• COMMENTS

• DO PORTION SIZES MEET THE MINIMUM AMOUNTS PER MEAL PATTERN REQUIREMENTS AND PLANNED MENU FOR THE DAY OF REVIEW?

  Yes

  No

  N/A

• IF NO, EXPLAIN ANY ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS COUNTED FOR REIMBURSEMENT.

• COMMENTS:

• WAS FLUID MILK AVAILABLE IN AT LEAST THE TWO REQUIRED VARIETIES THROUGHOUT THE SERVING PERIOD ON ALL MEAL SERVICE LINES?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS COUNTED.

• IF MILK SUBSTITUTIONS ARE MADE, ARE THEY ALLOWABLE?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS COUNTED.

• FOR NSLP, ARE THE MINIMUM DAILY REQUIREMENTS OF GRAINS/BREADS, MEAT/MEAT ALTERNATE, MILK, FRUITS, AND VEGETABLES MET FOR THE AGE/GRADE GROUP BEING SERVED?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS COUNTED.

• COMMENTS:

• HAS THE SCHOOL COMPLIED WITH THE PLANNED MENU FOR THE DAY OF THE REVIEW?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS COUNTED.

• IF CHANGES ARE BEING MADE TO THE PLANNED MENU, ARE THE CHANGES ACCEPTABLE SUBSTITUTIONS?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS COUNTED.

• DID ALL THE OBSERVED MEALS DURING THE REVIEW PERIOD (PRODUCTION RECORDS AND OTHER SUPPORTING DOCUMENTATION) INDICATE THAT ALL OF THE REQUIRED MEAL COMPONENTS PER WEEKLY MEAL PATTERN REQUIREMENTS WERE OFFERED AND SERVED TO STUDENTS?

  Yes

  No

  N/A

• IF NO, EXPLAIN ANY ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD THE NUMBER OF MEALS OBSERVED MISSING REQUIRED MEAL COMPONENTS.

• COMMENTS:

• DO PORTION SIZES MEET THE MINIMUM AMOUNTS PER MEAL PATTERN REQUIREMENTS AND PLANNED MENU FOR THE REVIEW PERIOD?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS CLAIMED.

• IF NO, DO PRODUCTION RECORDS AND/OR OTHER SUPPORTING DOCUMENTATION FOR THE REVIEW PERIOD INDICATE THAT THE REQUIRED QUANTITIES OF FOOD WERE AVAILABLE?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS CLAIMED.

• DID THE SCHOOL COMPLY WITH THE PLANNED MENU FOR THE REVIEW PERIOD?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS CLAIMED.

• IF CHANGES ARE BEING MADE TO THE PLANNED MENU, ARE THE CHANGES ACCEPTABLE SUBSTITUTIONS?

  Yes

  No

  N/A

• IF NO, LIST ALL THE ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED. RECORD ONLY THE NUMBER OF INCOMPLETE MEALS CLAIMED.

• DID ANY OF THE FINDINGS NOTED RESULT IN THE TURNING OFF OF THE PERFORMANCE BASED REIMBURSEMENT?

  Yes

  No

  N/A

• COMMENTS:

• IS OFFER VERSUS SERVE BEING IMPLEMENTED PROPERLY BY THE REVIEWED SCHOOL?

  Yes

  No

  N/A

• IF NO, LIST ALL ERRORS IDENTIFIED AND THE TECHNICAL ASSISTANCE PROVIDED IN THE COMMENTS. MEALS MISSING A REQUIRED MEAL COMPONENT, WHICH INCLUDES THE REQUIREMENT FOR AT LEAST 1/2 CUP OF FRUITS/VEGETABLES, ARE RECORDED IN AN EARLIER SECTION. RECORD ONLY THE INCOMPLETE MEALS DUE TO INSUFFICIENT QUANTITIES.

• COMMENTS:

• IS THERE SIGNAGE EXPLAINING WHAT CONSTITUTES A REIMBURSABLE MEAL TO STUDENTS?

  Yes

  No

  N/A

• IF NO, EXPLAIN AND LIST THE TECHNICAL ASSISTANCE PROVIDED.

CIVIL RIGHTS

• IS THE USDA "AND JUSTICE FOR ALL" POSTER DISPLAYED IN A PROMINENT LOCATION AND VISIBLE TO RECIPIENTS OF BENEFITS?

  Yes

  No

  N/A

• IF NO, DESCRIBE REASON.

• DO MEAL SERVICE OBSERVATIONS ON THE DAY OF REVIEW INDICATE THAT PROGRAM BENEFITS WERE MADE AVAILABLE TO ALL CHILDREN WITHOUT DISCRIMINATION?

  Yes

  No

  N/A

• IF NO, EXPLAIN.

ON-SITE MONITORING

• WAS THE ON-SITE REVIEW OF THE MEAL COUNTING AND CLAIMING PROCEDURE COMPLETED PRIOR TO FEBRUARY 1?

  Yes

  No

  N/A

• IF NO, WAS AN EXTENSION REQUESTED AND APPROVED BY THE STATE AGENCY?

  Yes

  No

  N/A

• IF NO, EXPLAIN.

• WAS A CORRECTIVE ACTION OF THE MEAL COUNTING AND CLAIMING PROCEDURE REQUIRED?

  Yes

  No

  N/A

• IF YES, WAS CORRECTIVE ACTION SUFFICIENT?

  Yes

  No

  N/A

• WAS A FOLLOW-UP REVIEW CONDUCTED WITHIN 45 DAYS TO ENSURE THAT THE SCHOOL IMPLEMENTED THE CORRECTIVE ACTION?

  Yes

  No

  N/A

• IF NO, EXPLAIN.

• DOES DOCUMENTATION INDICATE THAT CORRECTIVE ACTION WAS SUCCESSFUL?

  Yes

  No

  N/A

• IF NO, EXPLAIN.

COMPETITIVE FOOD SERVICES

• ARE THERE ANY FOODS OF MINIMAL NUTRITIONAL VALUE AVAILABLE IN ANY FOOD SERVICE AREA DURING ANY OF THE MEAL PERIODS?

  Yes

  No

  N/A

• IF YES, EXPLAIN.

SCHOOL MEAL ENVIRONMENT

WATER

• IS FREE POTABLE WATER AVAILABLE TO ALL STUDENTS FOR LUNCH (IN EACH LOCATION WHERE LUNCHES ARE SERVED DURING THE MEAL SERVICE)?

  Yes

  No

  N/A

FOOD SAFETY

• IS A COPY OF THE WRITTEN FOOD SAFETY PLAN AVAILABLE?

  Yes

  No

  N/A

• IN THE COMMENTS SECTION, LIST THE DATES OF THE TWO (2) MOST RECENT FOOD SAFETY INSPECTIONS.

• IF TWO INSPECTIONS WERE NOT RECEIVED IN THE PREVIOUS SCHOOL YEAR, DOES THE SFA HAVE DOCUMENTATION TO INDICATE THAT THE SFA REQUESTED TWO (2) INSPECTIONS IN THE CURRENT SCHOOL YEAR FROM THE APPLICABLE AGENCY?

  Yes

  No

  N/A

• IS THE MOST RECENT FOOD SAFETY INSPECTION REPORT POSTED IN A PUBLICLY VISIBLE LOCATION? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• WERE SELECTED TEMPERATURE LOGS AVAILABLE FOR REVIEW? IF YES, SPECIFY WHICH DATE WAS SELECTED. IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS: DATES OF SELECTED TEMPERATURE LOGS:

• WERE ON-SITE (OR OFF-SITE, IF OBSERVED) STORAGE VIOLATIONS OBSERVED? IF YES, EXPLAIN.

  Yes

  No

  N/A

REPORTING AND RECORDKEEPING

• ARE THE RECORDS RETAINED FOR 3 YEARS AFTER THE FINAL CLAIM FOR REIMBURSEMENT FOR THE FISCAL YEAR OR UNTIL RESOLUTION OF ANY AUDITS? IF NO, DESCRIBE REASON.

  Yes

  No

  N/A

• COMMENTS:

AFTER SCHOOL SNACK PROGRAM

• WERE ANY AREAS IDENTIFIED REQUIRING TECHNICAL OR CORRECTIVE ACTION? IF YES, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

FRESH FRUIT AND VEGETABLE PROGRAM - REVIEW PERIOD

• IS THE SCHOOL ON TRACK TO SPEND NO MORE THAN 10% OF ITS TOTAL GRANT ON ADMINISTRATIVE COSTS? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• DID THE COST DOCUMENTATION PROVIDED SUPPORT THE SCHOOL'S FFVP CLAIM FOR REIMBURSEMENT? IF NO, EXPLAIN. RECORD UNSUPPORTED COSTS.

  Yes

  No

  N/A

• COMMENTS:

• IS THE COST DOCUMENTATION FOR ALLOWABLE FFVP COSTS? IF NO, EXPLAIN. RECORD UNALLOWABLE COSTS.

  Yes

  No

  N/A

• COMMENTS:

FRESH FRUIT AND VEGETABLE PROGRAM - DAY OF REVIEW

• IS THE FFVP AVAILABLE TO ALL ENROLLED CHILDREN AT NO COST? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• IS THE FFVP OFFERED DURING THE SCHOOL DAY, BUT OUTSIDE THE MEAL SERVICE TIMES OF THE NSLP? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• IS THE FFVP WIDELY PUBLICIZED WITHIN THE SCHOOL? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• WERE ANY OF THE FOLLOWING UNALLOWABLE PRODUCTS OFFERED DURING THE FFVP MEAL SERVICE: FROZEN, CANNED, AND OTHER TYPES OF PROCESSED FRUITS/VEGETABLES; FRUIT/VEGETABLE JUICE, NUTS, COTTAGE CHEESE, TRAIL MIX, FRUIT/VEGETABLE PIZZA, SMOOTHIES, FRUIT STRIPS, FRUIT DROPS, FRUIT LEATHER, JELLIED FRUIT, OR CARBONATED FRUIT? IF YES, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• DID THE SCHOOL CHOOSE TO OFFER DIP WITH THE DAY'S OFFERING?

  Yes

  No

  N/A

• IF YES, WAS IT FAT-FREE OR LOW-FAT, NO GREATER THAN 2 TABLESPOONS, AND PROVIDED FOR VEGETABLES ONLY? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• IS A COOKED VEGETABLE OFFERED TODAY? IF YES, ANSWER THE TWO FOLLOWING QUESTIONS.

  Yes

  No

  N/A

• IS IT INCLUDED AS PART OF A NUTRITION EDUCATION LESSON? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• IS THIS THE ONLY OFFERING OF A COOKED VEGETABLE THIS WEEK? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• ARE TEACHERS WHO ARE IN THE CLASSROOM WITH STUDENTS DURING THE FFVP MEAL SERVICE THE ONLY ADULTS PROVIDED WITH FRESH FRUITS AND VEGETABLES? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS:

• DID THE FFVP MEAL SERVICE FOLLOW HACCP PRINCIPLES AND APPLICABLE SANITATION AND HEALTH STANDARDS? IF NO, EXPLAIN.

  Yes

  No

  N/A

• COMMENTS: