Administration and Forms for CACFP

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FNS Instruction 796-2 and Tip Sheet

FNS Instruction 796-2 Financial Management - Child and Adult Care Food Program (CACFP)
Tip Sheet - Assessing Costs in the Child and Adult Care Food Program (CACFP)

CACFP Forms

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Form Name	Form Number	Form Download	Form Download (Alternative Format)	Instructions Download	Program Name
CACFP Meal Benefit Income Eligibility Form (Child Care)					CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form (Child Care) in Spanish					CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form Letter to Households (Child Care Centers)					CACFP - Child Care Center
CACFP Meal Benefit Income Eligibility Form Letter to Households (Child Care Centers) in Spanish					CACFP - Child Care Center
CACFP Medical Statement Form					CACFP - Child Care Center
Child Nutrition Programs Waiver Request					CACFP - Child Care Center
Contracting Entity Request for Waiver of 15% Limit for Allowable Administrative Costs					CACFP - Child Care Center
F&N Complaint Form - English					CACFP - Child Care Center
F&N Complaint Form - Spanish					CACFP - Child Care Center
Male/Female Separation Exception Request Form					CACFP - Child Care Center
Household Contact					CACFP - Child Care Center
Permanent Agreement Between Sponsoring Organization and Child Care Site					CACFP - Child Care Center
Permanent Agreement Between Sponsoring Organization and Child Care Site - Sponsoring Organization Provides Meals/Snacks					CACFP - Child Care Center
Permanent Agreement Contracting Entity Specific Amendment - Name					CACFP - Child Care Center
Permanent Agreement Contracting Entity Specific Amendment - Programs					CACFP - Child Care Center
Pre-Award Civil Rights Compliance Review					CACFP - Child Care Center
Racial/Ethnic Participant Data Collection Prototype					CACFP - Child Care Center
Shared Eligibility Form					CACFP - Child Care Center
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement					CACFP - Child Care Center
Good Cause Transfer Request Form					CACFP - Child Care Center
Micro-Purchase Log					CACFP - Child Care Center
Small Purchase Log					CACFP - Child Care Center
Excess Net Cash Resources Plan for CACFP/SFSP					CACFP - Child Care Center
CACFP Serious Deficiency Process Notification Template Letters					CACFP - Child Care Center
CACFP Serious Deficiency Process Notification Form					CACFP - Child Care Center
Building for the Future - Black and White					CACFP - Day Care Home
Building for the Future - Color					CACFP - Day Care Home
CACFP - DCH Claim for Reimbursement - Provider Level					CACFP - Day Care Home
CACFP Infant Feeding Preference					CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form (Child Care)					CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form (Child Care) in Spanish					CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form Letter to Households - Tier II Day Care Homes					CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form Letter to Households - Tier II Day Care Homes - in Spanish					CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form Letter to Provider - Tier I or Provider's Own Children					CACFP - Day Care Home
CACFP Meal Benefit Income Eligibility Form Letter to Provider Tier I or Provider's Own Children in Spanish					CACFP - Day Care Home
CACFP Medical Statement Form					CACFP - Day Care Home
Child Nutrition Programs Waiver Request					CACFP - Day Care Home
F&N Complaint Form - English					CACFP - Day Care Home
F&N Complaint Form - Spanish					CACFP - Day Care Home
Male/Female Separation Exception Request Form					CACFP - Day Care Home
Household Contact					CACFP - Day Care Home
Permanent Agreement Between Sponsoring Organization and Day Care Home Provider(s)					CACFP - Day Care Home
Permanent Agreement Contracting Entity Specific Amendment - Name					CACFP - Day Care Home
Permanent Agreement Contracting Entity Specific Amendment - Programs					CACFP - Day Care Home
Pre-Award Civil Rights Compliance Review					CACFP - Day Care Home
Racial/Ethnic Participant Data Collection Prototype					CACFP - Day Care Home
Shared Eligibility Form					CACFP - Day Care Home
Start Up or Expansion Payments Agreement					CACFP - Day Care Home
Start Up or Expansion Payments Application					CACFP - Day Care Home
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement					CACFP - Day Care Home

Assistance available in English and Spanish. Please call 877-TEX-MEAL (877-839-6325) for help. Additional translations services available as well.

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

1. Mail:

U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or

2. Fax: (833) 256-1665 or (202) 690-7442; or

3. Email: program.intake@usda.gov.

This institution is an equal opportunity provider.

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