Nutrition/Food Service Forms
Food Service Requests
This form is to be used when requesting food for family meetings, socials, special events, and meetings. This form is to be completed and e-mailed to both the Health & Nutrition Services Specialist and the Food Service Coordinator 7-10 days prior to your event. Before submitting your event food service request, please consult the posted center kitchen calendars on the Nutrition Lessons page to try and decrease overlap and multiple events on the same day/week for your kitchen.
Child and Adult Care Food Program (CACFP) Forms
CACFP Enrollment Form
This form is completed for ALL Head Start and Early Head Start center based children upon enrollment. It must be renewed annually. It is filed in the child's individual file and copies are sent to central office. ALL sections of this form must be complete, there cannot be any blank areas. See below instructions for completing this form.
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CACFP Parent/Guardian Application
This form is completed ONLY on child care children. This determines if we are reimbursed at the free, reduced, or paid rate for their meal (all Head Start/Early Head Start children are automatically reimbursed at the free rate). The directions on how to complete the application are below. It is filed in the child's individual file and copies are sent to central office.
Point of Service Meal Tallies
Point of Service meal tallies MUST BE COMPLETED WITHIN 15 MINUTES OF SERVING THE FOOD. The meal tally records which children were present for the meal. As long as the child was in attendance for the meal and we offered them a complete meal then they are present. It does NOT mean that the child chose to eat the food, it just means that we offered the food and gave them the opportunity to eat. Below is a completed example of a Point of Service Meal Tally. The Meal Tally form and the Absentee Reasons Code Sheet can be found on the Center Director Resource sub-tab under the Central Office tab.
Menu Feedback Form
The purpose of this form is to provide useful feedback on the menu, recipes, & food service. This form can be completed as often as needed by staff (daily, weekly, monthly, annually, etc). It is to be sent to the Food Service Coordinator when complete.
Classroom Refrigerator Temperature Log
If your classroom has a refrigerator then please post this log on the refrigerator and check temperatures daily.
Infant feeding guidelines
This menu is for all infants (12 mos and under). This is to be posted in each classroom that has infants. (updated 10/1/2017)
Infant Production Records
These are completed on all infants (under 12 mos) who are following the infant menu instead of the regular center menu. These are submitted to the Food Service Coordinator when complete. In order to get reimbursed by the Child and Adult Care Food Program these must be completed fully on each infant at each meal. (updated 10/1/2017)
Infant Formula Selection Form
This form must be completed for all infants at enrollment (under age 12 mos) prior to their first meal. Parents/Guardians may select to accept the house formula or they may enter an alternate required formula for their child. They may also indicate that they plan to provide breast milk. If a parent/guardian identifies an alternate formula to the house formula it must be an eligible formula by meeting the criteria below or they will require a Special Meals Prescription Form from a Health Care Provider stating the the formula is necessary if it is not considered eligible.