Summer food service program for children : monitor's handbook

              . . . C\<3u .
[:\ <"\~:~·. \\(\
Sum.m.er
Food
Service
Program. for
ChUdren
o. positor~
~ IL·(j·L ..
\ IRPf.IO I
AP 1 ' ;
United States
Department of
Agriculture
Food and
Nutrition
Service
FNS-179
SER
CONTENTS
Page
1 INTRODUCTION
1 Organizational Structure
2 Training
2 MONITOR RESPONSIBILITIES
3 Visits and Reviews
3 Review Procedures
6 Monitor Site Review Form
6 Beneficiary Data Form
7 Meal Service Administration
7 Site Activities
7 Daily Record Requirements
8 Daily Record Reviews
8 Accuracy of Records
8 Collection of Site Forms
8 MEAL REQUIREMENTS
12 Monitoring Meals
12 Unitized Meals
12 When to Serve Meals
12 COMMENTS AND SUGGESTIONS
13 MONITOR SITE REVIEW FORM (for Vended Programs)
17 MONITOR SITE REVIEW FORM (for Sponsor Meal Preparation)
20 BENEFICIARY DATA FORM
Revised January 1982
Slightly revised March 1986
The Summer Food Service Program for Children is available
to all children without regard to race, color, national
origin, sex, age, or handicap.
INTRODUCTION
Organizational
Structure
1
This handbook has been prepared to give you, as monitors, a working
knowledge of your duties and responsibilities in the Summer Food
Service Program for Children (SFSP). In addition, you can use the
handbook to help train site workers.
The Summer Food Service Program for Children provides a food service
during school vacation that is similar to the meal service offered
in the schools during the school year. The program serves children
18 years of age or under in areas where poor economic conditions
exist. People over 18 years of age who have been determined by the
State agency to be mentally or physically handicapped are also
eligible to participate in the program. Camps can participate in
the program but must document each child as eligible for free or
reduced-price school meals.
The Summer Food Service Program is administered through an agency of
the State government or by a regional office of the United States
Department of Agriculture's (USDA's) Food and Nutrition Service
(FNS). Summer programs are organized and operated by public or
private nonprofit school food authorities; State, local, municipal,
or county governments (provided that such programs are directly
operated by such governments); and residential public or private
nonprofit summer camps. They are set up to benefit children from
areas in which at least 50 percent of the children are eligible,
under USDA's family size and income standards, for free or reduced­price
school meals. The administering agency deals directly with
the sponsors operating within its domain.
Under the program, sponsors must ensure that children receive
nutritious meals and snacks at food service sites. Your job in the
Summer Food Service Program is of particular importance. As a
monitor, you must make sure that the site operates smoothly in
accordance with program guidelines and requirements. You are the
key link between the sponsor and the sites. This direct link
between the sponsor headquarters and the actual food service is
essential in order for the program to function properly.
As a sponsor representative, you need to develop and maintain a
cooperative relationship with site supervisors and staff. Open
communication between you and site staff depends on everyone knowing
that you will work with the site staff to help correct problems and
provide additional training if necessary. Open communication with
your supervisor is also essential so that the sponsor is aware of
any site problems and what is being done to resolve them. Monitors
should work closely with their supervisors so they may receive
additional guidance when necessary.
The sponsor will be financially responsible for any meals served
incorrectly or served to ineligible people. This could mean a
substantial loss of money to the sponsor if problems at the sites
are not corrected. Your responsibilites as a monitor will differ
depending on whether a food service management company (or vendor)
2
Training
delivers meals to the site or whether the sponsor prepares the
meals. This handbook provides guidance for monitoring programs
where the vendor delivers meals to the sponsors' sites and for
programs where sponsors prepare their own meals.
Your sponsor is required to hold training sessions on program duties
for monitors and other sponsor personnel. At the training session,
monitor duties and responsibilities will be explained to you. You
will receive the monitor review form and any other records you may
need to keep, such as mileage records. During the training you will
be told the general areas where the sites are located for which you
will be responsible.
Your sponsor will train you on procedures for adjusting meal
deliveries, reporting complaints to the vendor, and collecting site
records. You will also be asked to attend the training session
required for monitors and site supervisors. This meeting will
introduce you to the site supervisors with whom you will be working
directly. It will also familiarize you with the specific duties of
site supervisors.
MONITOR As a monitor, you are responsible for providing technical assistance
RESPONSIBILITIES and training, and ensuring that sponsors' sites meet program
regulations. Effective monitoring is necessary for many reasons.
Monitoring ensures that sites operate according to program
guideHnes and that accurate site records are available to justify
payment to the sponsor. But most importantly, monitoring ensures
that children in the community are getting nutritious meals. To be
an effective monitor, you will be required to spend enough time at
each site to check all pertinent operations. Therefore, you must
know the program requirements so you can spot problems at the sites
quickly and recommend solutions.
As an official representative of the sponsor, you will be
responsible for:
*Checking site operations to make sure that the sites maintain
adequate records and that the program is operating in
accordance with the requirements;
*Conducting site training as necessary, including training on
the nondiscrimination policy;
*Visiting all assigned sites within the first week of operation
to ensure that the food service is operating smoothly and that
any needed adjustments are made or problems resolved;
*Reviewing food service operations of all assigned sites within
the first 4 weeks of operation to thoroughly examine the meal
service from start to finish, correcting problems and providing
addi tiona! training where necessary·;
Visits and
Reviews
Review
Procedures
*Revisiting sites as necessary to collect records or deliver
forms;
3
*Preparing reports of your site visits and reviews and ensuring
that the reports are included in an official file for each
site;
*Suggesting corrective action to the site supervisor for
problems encountered;
*Informing sponsor officials about problems found at a site and
ensuring that corrective action is completed.
Site visits and reviews are vital functions of a sponsor's
administration of the program. A site visit requires the monitor to
make sure that the food service operates smoothly and that problems
are immediately resolved. In some instances, monitors will be asked
to visit food service sites before the program starts. When
applying for this program, a sponsor must certify that it visited
all sites planning to conduct a food service. These visits must be
made before the program begins at those sites, and monitors may be
asked to conduct these visits. Each site must have the appropriate
facilities for serving the anticipated number of children and must
have the capability to conduct the proposed meal service. In making
these visits, you will be asked to verify information listed on the
site sheets, such as address; storage, holding and preparation
facilities; and serving capacity. You will also want to record the
date of each visit and the names of people you spoke with during
these visits.
When conducting a site review, you should observe all of the meal
service to determine if the site meets program requirements. During
each review or visit, you should discuss any concerns or problems
with the site supervisor or other site staff. You should also
instruct the site supervisor to call the sponsor's office
immediately when help is needed.
Before reviewing the sites, you should be familiar with the site
information sheets which include the meal delivery schedules (time
of delivery, type of meal, and number of meals), and with cycle
menus for each site. The site information sheets describe the
staffing pattern, method of meal preparation, meal services and
times, and if applicable, the approved level of meal service at the
sites. Your sponsor should explain which meal type(s) will be
served at each site you will be reviewing. Sponsors of regular
sites may be approved to serve up to two meals daily. (This does
not apply either to sites where meals are served primarily to
migrant children or to camps.) The two meals may include either
lunch and a snack or lunch and breakfast. Camps and sponsors
serving meals primarily to migrant children may be approved to serve
up to four meals daily--breakfast, snack, lunch, and supper.
4
As the summer progresses, you should be familiar with the records
submitted by the site and with corrective action taken on any prior
reviews or visits.
When conducting a review:
*Plan to arrive at the site before food is delivered or meals
are prepared.
*Check to make sure that each site has at least one supervisory
person who has been trained in program requirements. This
person should be present during the meal service.
*Observe food delivery or meal preparation. Are meals handled
according to local health codes? (For example, does the
refrigerated truck operate at the correct temperature? Are
meals delivered on time? If the sponsor prepares the meals, is
the f~cility adequate for meal preparation?)
*For vended sites (sites that do not prepare their own meals,
but have them delivered), count the number of meals delivered.
Does the number delivered equal the number ordered? Does the
delivery receipt show the correct number delivered? Are all
meals complete? Are any items spoiled?
*Instruct the site supervisor to sign only for delivered meals
that are complete and wholesome. The site supervisor should
not accept poor or incomplete meals or meals that are wholly or
partially spoiled.
*Compare number of meals delivered with daily attendance/
participation records; observe trends and when appropriate,
advise sponsor and site supervisor to adjust meal order to
prevent excessive leftovers or service of seconds in excess of
two percent of firsts during the claiming period.
*Make sure the site supervisor signs only accurate delivery
receipts, making corrections as necessary on the slip before
signing or refusing to sign if an entire delivery is rejected.
*Compare a meal delivered or prepared with the cycle menu. Was
the scheduled meal delivered or prepared that day?
*Observe the preparation of a meal if meals are not delivered.
Are raw fruits and vegetables thoroughly washed before cooking
and serving? Are hot and cold foods kept at the proper
temperatures?
*Observe whether workers meet the health standards set by State
and local authorities.
*Check receiving reports if meals are prepared by the sponsor.
*Check purchasing invoices if meals are prepared by the
sponsor.
*Observe the meal service. Does meal service occur during the
appropriate hours? Are children given complete meals? Is only
one meal given to each child? Are unauthorized adults served?
Are all meals eaten at the site? Is a site worker counting the
meals as they are being served?
*Check to see if there is a nondiscrimination poster, provided
by the sponsor, displayed in a prominent place.
*Determine if meals are served to all attending children,
regardless of the child's race, color, national origin, sex,
age, or handicap.
*Make sure that all children have equal access to services and
facilities at the site regardless of race, color, national
origin, sex, age, or handicap.
*Observe whether or not informational material in the
appropriate translation is available concerning the
availability and nutritional benefits of the program.
*Count the number of first meals served to children.
*Count the number of second meals served to children (if any).
When second~ are served, check to make sure that they are only
served after all children have received their first meal.
Determine if the number of seconds being served appears
excessive.
*Count the number of ineligible meals served and note the
reason. (Examples: incomplete meals served or meals served to
adults.)
*Some sites you review may have been approved by the admin­istering
agency to serve a maximum level of meals at each
meal service. Chec~ to make sure that these sites do not
claim meals in excess of the maximum number approved for each
meal service.
*Review daily records kept by the site.
*Check plate waste (trash) for acceptability of menu items.
*Stay at the site until the meal service is complete. Are
meals served after the 2-hour time limit for lunch and supper
or 1-hour time limit for breakfast or snack?
*Are there many leftover meals? Are seconds recorded?
Instruct the site supervisor to make adjustments in the meal
order as necessary.
*Complete the monitor's review form. Record your arrival and
departure time. Record all violations and any corrective
action taken.
5
6
Monitor Site
Review
Form
Beneficiary
Data Form
*Make corrections onsite, if possible.
*Report problems to the sponsor.
*Schedule a revisit, if necessary.
Many people working at sites may not be familiar with operating food
service programs or they may not be accustomed to maintaining
records. During many reviews and visits, you will find it necessary
to explain the importance of complying with program rules and show
how operations can be improved. This type of ongoing training of
site personnel is a basic responsibility of each monitor. You may
decide that it is necessary to give new site workers additional
training in program requirements. Again, it is important to
document this training on your report.
You must complete a monitor site review form after each review.
This form includes your arrival and departure time, site super­visor's
signature or the signature of the person you talked to,
certification statement of violations found, corrective action
taken, and time and number of meals served. These forms are
required records for the sponsor.
You must thoroughly explain the specific nature and extent of any
problems and the action to be taken to correct these problems. For
example, you must record "19 meals were served without milk" and
document the action the site supervisor agreed to take to correct
the situation.
The forms included in this handbook are examples of monitor review
forms. However, the administering agency may require that a
different form be used. If the agency requires a different form to
be used, it should provide the form to each sponsor.
You must complete a beneficiary data form to report the racial/
ethnic category of participating children at each site. This
form must be completed at least once during the site's operation.
You should determine a child's racial/ethnic category visually, or,
if necessary, consult a child's parents for identification only
after you have explained to them, and they understand, that this
information is collected strictly for statistical reporting
requirements and has no effect on the determination of their
eligibility to receive benefits under the program.
A child may be included in the group to which he or she appears to
belong, identifies with, or is regarded as a member of by the
community.
A sample beneficiary data form is shown in·the back of this
handbook. However, your sponsor may provide a different form for
your use.
Meal Service
Administration
Site
Activities
Daily
Record
Requirements
7
Experience has shown that monitoring the food service at sites is
necessary to ensure good meal quality. Problems need to be solved
quickly and routinely. As a monitor, you need to remind site
supervisors often of their responsibility to promptly report changes
in site attendance (up or down) to the sponsor. You may also need
to explain to the site supervisor how to report attendance changes.
If the administering agency has established an approved level for
sites, you should emphasize that your sponsor will not receive
reimbursement for the meals that exceed the maximum approved level
for each meal service.
Sometimes attendance drops during the summer at sites and the
sponsor is not notified. When this happens, too many meals are
delivered and both food and money are wasted. The site supervisor
should guard against over-ordering and delivery of excessive meals.
It is a serious violation. If a site is receiving too many meals,
you should emphasize to the site supervisor the need to adjust the
meal order and report that need to your sponsor, since excessive
leftovers and seconds in excess of 2 percent of first meals are
not reimbursed. You must know your sponsor's procedures for
transferring, returning, or stopping the meal servic~. ·Make sure
site personnel know that meals must be delivered within 1 hour of
each meal service, if no refrigeration facilities are available at a
site.
Know the activity schedule of each assigned site. If the site
will not be open on a certain day, the sponsor must be alerted in
advance so the vendor can be notified and meal deliveries can be
canceled. If the site is planning a field trip, the sponsor must
notify the vendor and the administering agency, which must approve
meal delivery to the place .where the children will be that day.
Sometimes sponsors experience problems because sites close earlier
than originally scheduled. You, as the monitor, are responsible
for keeping informed about the plans of each site supervisor.
This way, you can make sure your sponsor is promptly notified if
the site will close earlier than the date indicated on the site
information sheet.
Sponsors will provide the sites with a daily meal record sheet.
These records are very important. Sponsors will not receive money
for the meals served at their sites if the sites do not keep these
records. Site records must be accurate, and staff must complete
them at the end of each meal. Monitors may be required to collect
these records daily or weekly and return them to the sponsor's
office. A frequent, uniform basis of collection is necessary to
minimize the possibility of losing these records, since sponsors
receive reimbursement for the meals they serve based on these daily
records. These records must include:
*The number of meals delivered or prepared, listed by type
(breakfast, snack, lunch, supper). This information must be
supported by a signed delivery receipt in the case of ve nded
~rograms. A designee of the sponsor at the site must verify
the adequacy and number of meals delivered.
8
Daily
Record
Reviews
Accuracy of
Records
Collection of
Site Forms
MEAL
REQUIREMENTS
*The number of children in attendance.
*The number of first meals served to children, listed by type,
based on actual count.
*The number of second meals served to children, if any.
*The number of meals served to adults who work with the program
(program adults) and nonprogram adults, if any.
*The amount of money, if any, received from adults.
*The number of hours that each paid food service employee
worked on the food service, if applicable.
Review the daily records kept by the site. Check to make sure all
forms are completed and signed. The information on the delivery
receipts should match the information on the forms. Site staff
should have a signed delivery receipt available to show the
deliveries for all meals served. If the number of meals delivered
is the same as those served each day, this may mean that no one is
actually counting the number of meals served.
You must remind site supervisors that complete and accurate daily
records at the sit; level are the only way to document program
performance and guarantee reimbursement. The sole basis for
reporting the number of meals served is accurate daily records.
These records account for all categories of meals served and are
signed by the site supervisors.
If your responsibilities include collecting site forms and delivery
receipts, be sure to keep collections on schedule. If records can­not
be obtained from a particular site, this is a serious problem
that your sponsor should know about immediately. Familiarize
yourself with the forms to be used for this purpose. Since you
will be assisting site supervisors in the proper use of these
forms, you must be thoroughly familiar with them.
As a monitor, you will check meals at sites to see that meal
patterns are being met. Meal requirements for this program ensure
well-balanced, nutritious meals that supply the kinds and amounts of
foods children need to help meet their nutrient and energy needs.
The following are minimum requirements for each meal:
BREAKFAST
Optional
Vegetables and Fruits
Vegetables and/or fruits
- or full-strength vegetable or
fruit juice
Or an equivalent quantity of any combination
of vegetable(s), fruit(s), and juice
Bread and Bread Alternates
Bread (whole grain or enriched)
Or Bread Alternates
(whole grain or enriched):
-cornbread, biscuits, rolls, muffins, etc.
-or cooked pasta or noodle products
-or cooked cereal grains such as rice, corn
grits, or bulgur
(whole grain, enriched, or fortified):
-or cooked cereal
-or cold dry cereal
Or an equivalent quantity of a combination
of bread or bread alternate(s)
Milk
Fluid milk
Meat and Meat Alternates
Lean meat or poultry or fish
Or Meat Alternates
-cheese
-or eggs
-or cooked dry beans or peas
-or peanut butter
Or an equivalent quantity of any combination
of meat or meat alternate(s)
1/2 cup
1/2 cup
1 slice
1 serving
1/2 cup
1/2 cup
1/2 cup
3/4 cup or
1 ounce
(whichever
is less)
1 cup
9
(1/2 pint, 8 fl. oz)
1 ounce
(edible portion
as served)
1 ounce
1 large egg
1/2 cup
2 tablespoons
10
SNACK
(supplemental
food)
(Choose two from the following four components):
Meat and Meat Alternates
Lean meat or poultry or fish
Or Meat Alternates
-cheese
-or eggs
-or cooked dry beans or peas
-or peanut butter
Or an equivalent quantity of any combination
of meat or meat alternate(s)
Vegetables and Fruits
Vegetables and/or fruits
-or full-strength vegetable or
fruit juice
Or an equivalent quantity of any combination
of vegetable(s), fruit(s), and juice
(juices cannot be served with milk)
Bread and Bread Alternates
Bread (whole grain or enriched)
Or Bread Alternates
(whole grain or enriched):
-cornbread, biscuits, rolls, muffins, etc.
-or cooked pasta or noodle products
-or cooked cereal grains such as rice, corn
grits, or bulgur
(whole grain, enriched, or fortified):
-or cooked cereal
-or cold dry cereal
Or an equivalent quantity of any combination
of bread or bread alternate(s)
Milk
Fluid milk
1 ounce
(edible portion
as served)
1 ounce
1 large egg
1/2 cup
2 tablespoons
3/4 cup
3/4 cup
1 slice
1 serving
1/2 cup
1/2 cup
1/2 cup
3/4 cup or
1 ounce
(whichever
is less)
1 cup
(1/2 pint, 8 fl. oz)
;
'
'
't
·.,
LUNCH or
SUPPER
eat or Meat Alternates
Lean meat or poultry or fish
Or Meat Alternates
-cheese
-or eggs
-or cooked dry beans or peas
-or peanut butter
Or an equivalent quantity of any combination
of meat or meat alternate(s)
Ve etables and Fruits
(Must include 2 or more selections for a total
of 3/4 cup):
2 ounces
(edible portion
as served)
2 ounces
1 large egg
1/2 cup
4 tablespoons
11
Vegetables and/or fruits 3/4 cup total
-or full-strength vegetable or
fruit juice (may be counted to meet not more
than 1/2 of this requirement)
Bread and Bread Alternates
Bread (whole grain or enriched)
Or Bread Alternates
(whole grain or enriched:)
-cornbread, biscuits, rolls, muffins, etc.
-or cooked pasta or noodle products
-or cooked cereal grains such as rice, corn
grits, or bulgur
Or an equivalent quantity of any combination
of bread or bread alternate(s)
Milk
Fluid milk
1 slice
1 serving
1/2 cup
1/2 cup
1 cup
(1/2 pint, 8 fl. oz)
12
Monitoring
Meals
Unitized
Meals
When to Serve
Meals
COMMENTS AND
SUGGESTIONS
Study the meal pat terns and learn to recognize deficiencies.
Remember that each meal must contain all required components and
that components must meet the minimum portion size. If meals are
incomplete, if quantities are too small, or if the food is spoiled,
children are not getting the nutritious meal for which the sponsor
is paying. It is particularly important that children do not eat
any food that is spoiled. Spoiled food, juice, or milk can make the
children sick. Make sure site personnel do not serve any spoiled
meals to the children. If meals are delivered by a vendor, site
supervisors should be recording any deficiencies on the delivery
receipts and discussing any problems with you. You should
immediately report any problems with deliveries or meals to your
supervisor so that the vendor can be promptly notified.
All meals must be served as units. This means that each component
of the meal must be served at the same time to the child. Sometimes
site workers will split up a meal between several children or serve
an incomplete meal to a child. Whether the meal is prepared by a
sponsor or delivered by a vendor, the complete meal must be served
to each child as a unit. The nutritional value of the meal is
dependent upon serving all the components. Serving them separately
is a serious violation. Your sponsor cannot receive reimbursement
for incomplete meals served to children. The sponsor's reimburse­ment
for meals depends on the recordkeeping system, which maintains
records of complete meals served (as units) to children and adults.
Three hours must pass between the beginning of one meal service
(including snacks) and the beginning of another. If no snack is
served between lunch and supper, supper must be served at least 4
hours after the beginning of the lunch service. In any case, staff
must begin serving supper no later than 7 p.m. and end no later than
8 p.m. None of the above time restrictions apply if the site
participates in the program as a camp.
Breakfast or snack service cannot last more than 1 hour, and lunch
or supper service cannot last more than 2 hours. Meals must be
served only during designated meal service times. These time
restrictions also apply to all sites participating in the program,
including camps.
The sponsor will ask for your comments and suggestions at the end of
the program. As a monitor, you should think about ways the program
can be improved and include these in your recommendations.
13
MONITOR SITE REVIEW FORM (for Vended Programs)
Two copies of this form should be filled out. One should be left
with the site supervisor and one turned in to the sponsor.
Monitor's arrival time ---------------- Departure time -------
Sponsor ____________________ __ Name of site ------------
Date of review- --------------- Address- ----------------
Phone -------------------
Site supervisor ------------------------------------------ Name and title of person
contacted at the site ---------------------------------
Regular site_ _______________ __ Camp site ------------
Approved level(s)
of meal service
B
Attendance on day of visit
Sn(a.m) L Sn(p.m) s
----------------------------
Number eligible for free and reduced-price meals (camp only)
Type(s) of meal service reviewed ---------------------
DAY OF VISIT:
# meals delivered
Times meals delivered
Times meals served
# meals first served
to children
# meals served as
seconds to children
# meals served to
program adults
# meals served to
nonprogram adults
# meals left over
B
TYPE OF MEAL
Sn(a.m) L Sn(p.m.) s
14
MAJOR VIOLATIONS
1. Adult meals included in count .
of meals served to children
2. Offsite consumption (children)
3. More than one meal served at
one time to children
4. Meal pattern not met . (specify)
5. Meals not served as a unit
6. Meal times not met
CHECK AT RIGHT IF FOLLOWING APPLY
ACTUAL COUNT
(Explain any checked items on the next page)
7. No records
8. Incomplete records
9. Poor sanitation
10. Other
YES NO
TYPE OF MEAL
1. --- Does staffing pattern correspond to that listed
on approved site sheet?
2. --- Has site supervisor attended training session?
3. Does site supervisor use site handbook?
4. ---- ---- Does site have sufficient food service
s.
6.
supervision?
Are meals counted before signing delivery
receipt?
Are meal counts taken of meals served?
7. Do meals meet approved menu?
8. Do meals meet meal pattern requirements?
9. Are meals checked for quality?
10. Is there proper sanitation/storage?
11.
12.
13.
14.
Is the ratio of meals served as seconds to
meals first served excessive considering the
2-percent limit on claiming seconds?
Is site supervisor following procedures
established to make meal order adjustments?
Are meals served within approved time frames?
Does site have a place to serve children meals
in case of inclement weather?
15. Is each meal served as a unit?
16.
17.
18.
19.
20.
21.
22.
Is the meal delivery schedule followed?
Are there provisions for storing or returning
excess meals?
____ Is there documentation of children eligible for
free and reduced-price meals, if applicable?
Is there a nondiscrimination poster, provided
by the sponsor, on display in a prominent
place?
Are meals served to all attending children
regardless of the child's race, color, national
origin, sex, age, or handicap?
______ Do all children have equal access to services
and facilities at the site regardless of race,
color, national origin, sex, age, or handicap?
Is informational material concerning the
availability and nutritional benefits of the
program available in appropriate translations?
EXPLAIN ANY "NO" ANSWERS BELOW:
Corrective action discussed with (Name and title):
Corrective action taken:
16
Site supervisor's comments:
Further action needed by (date):
I certify that the above information is correct.
Monitor's signature Site supervisor's signature
Date Date
Sponsor representative's signature Date reviewed by
sponsor representative
17
MONITOR SITE REVIEW FORM (for Sponsor Meal Preparation)
Sponsor- ----------------------------- Site- --------------------------
Site address -----------------------------------------------------------
Date of review- --------------------- Phone- -------------------------
Monitor's arrival time ----------- Departure time ----------------
Site supervisor~~---------------------------------------------------­Name
and title of
person contacted at the site ------------------------------------------
Regular site~---------------------- Camp site ---------------------
Approved average daily participation (ADP) --------------------------- (if applicable)
Attendance on day of visit --------------------------------------------
Type(s) of meal service reviewed
~------------------------------------
Day of visit Breakfast
II meals prepared
Time which meals
were served
# first meals served
to children
II meals served
as seconds
II meals served
to program adults
# meals served to
nonprogram adults
Food
Item
Other foods
Quantity
used in
preparation
Allowable
servings
per unit
Snack Lunch Snack Supper
Number of servings
total total short/over
available needed
18
YES NO
Are meals served as a unit?
Did meal meet menu as planned?
Were all requirements met?
Are all children fed onsite?
Are meals planned and prepared with one meal per
child in mind?
Is the ratio of meals served as seconds to
meals served first excessive?
Are accurate counts taken of meals served?
Are meal production records kept?
Is required health department certification
available for inspection?
Is an inventory record being kept?
Are receiving reports and purchase invoices kept?
Does staffing pattern correspond to that listed
on approved site application sheet?
Has site supervisor attended training session?
Are program aids being used?
Is there proper sanitation and storage?
Are meals served within time frames?
Are records of adult meals kept?
Is there documentation of children eligible for free
and reduced-price meals if applicable?
Is there a nondiscrimination poster, provided by the
sponsor, on display in a prominent place?
Are meals served to all attending children
regardless of the child's race, color, national
origin, sex, age, or handicap?
Do all children have equal access to services and
facilities at the site regardless of race, color,
national origin, sex, age, or handicap?
19
Corrective action discussed with (name and title) ---------------------
Corrective action taken:
Site supervisor's comments:
Further action needed by: -----------------------------------------------
I certify that the above information is correct.
Monitor's signature Site supervisor's signature
Date Date
Sponsor representative's signature Date reviewed by
sponsor representative
20
BENEFICIARY DATA FORM
Sponsor __________________________ _ Site ________________________ _
Site Address. ____________________________________________________ _
Site Supervisor ____________________________________________________ Racial/Ethnic Category
American Indian or Alaskan Native
(A person having origins in any of the
original peoples of North America, and
who maintains cultural identification
through tribal affiliation or community
recognition (includes Aleuts and
Eskimos).)
Asian or Pacific Islander (A person having
origins in any of the original peoples of
the Far East, Southeast Asia, the Indian
subcontinent, or the Pacific Islands. This
area includes, for example, China, Japan,
Korea, the Philippine Islanps, and Samoa.)
Black (not of Hispanic origin) (A person
having origins in the black racial groups
of Africa.)
Hispanic (A person of Mexican, Puerto Rican,
Cuban, Central or South American, or other
Spanish culture or origin, regardless of
race.)
White (not of Hispanic origin) (A person
having origins in any of the original peoples
of Europe, North Africa, or the Middle East.)
Monitor's signature
lit u.s. Government Prf nting Office' 1986-620·322/40635
Number of
Participating Children
Date
..