Administration and Forms for CACFP

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Programs > Child and Adult Care Food Program > Administration/Forms

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	Program Name
Valid At-Risk Unaffiliated Site Questionnaire/Attestation		CACFP - At-Risk Afterschool
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement		CACFP - Adult Day Care
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement		CACFP - At-Risk Afterschool
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement		CACFP - Child Care Center
Texas Department of Agriculture Food and Nutrition Division Permanent Agreement		CACFP - Day Care Home
Start Up or Expansion Payments Application		CACFP - Day Care Home
Start Up or Expansion Payments Agreement		CACFP - Day Care Home
Sponsoring Organization Disbursement Record	H4503	CACFP - Adult Day Care
Sponsoring Organization Disbursement Record	H4503	CACFP - At-Risk Afterschool
Sponsoring Organization Disbursement Record	H4503	CACFP - Child Care Center
Small Purchase Log		CACFP - Adult Day Care
Small Purchase Log		CACFP - At-Risk Afterschool
Small Purchase Log		CACFP - Child Care Center
Small Purchase Log		CACFP - Day Care Home
Shared Eligibility Form		CACFP - Child Care Center
Shared Eligibility Form		CACFP - Day Care Home
SFSP and At-Risk Invitation for Bid (IFB) and Contract for Purchased Meals	IFB - SFSP AND AT-RISK	CACFP - At-Risk Afterschool
Review	H1602	CACFP - Adult Day Care
Review	H1606-AT	CACFP - At-Risk Afterschool
Review	H1606	CACFP - Child Care Center
Review	H1607	CACFP - Day Care Home
Record of Leftover/Recycled Food	H1568	CACFP - Adult Day Care
Record of Leftover/Recycled Food	H1568	CACFP - At-Risk Afterschool
Record of Leftover/Recycled Food	H1568	CACFP - Child Care Center
Record of Leftover/Recycled Food	H1568	CACFP - Day Care Home
Racial/Ethnic Participant Data Collection Prototype		CACFP - Adult Day Care
Racial/Ethnic Participant Data Collection Prototype		CACFP - At-Risk Afterschool
Racial/Ethnic Participant Data Collection Prototype		CACFP - Child Care Center
Racial/Ethnic Participant Data Collection Prototype		CACFP - Day Care Home
Pre-Award Civil Rights Compliance Review		CACFP - Adult Day Care
Pre-Award Civil Rights Compliance Review		CACFP - At-Risk Afterschool
Pre-Award Civil Rights Compliance Review		CACFP - Child Care Center
Pre-Award Civil Rights Compliance Review		CACFP - Day Care Home
Pre-Approval Visit	H1602-P	CACFP - Adult Day Care
Pre-Approval Visit	H1606-AT-P	CACFP - At-Risk Afterschool
Pre-Approval Visit	H1606-P	CACFP - Child Care Center
Pre-Approval Visit	H1607-P	CACFP - Day Care Home
Permanent Agreement Contracting Entity Specific Amendment - Programs		CACFP - Adult Day Care
Permanent Agreement Contracting Entity Specific Amendment - Programs		CACFP - At-Risk Afterschool
Permanent Agreement Contracting Entity Specific Amendment - Programs		CACFP - Child Care Center
Permanent Agreement Contracting Entity Specific Amendment - Programs		CACFP - Day Care Home
Permanent Agreement Contracting Entity Specific Amendment - Name		CACFP - Adult Day Care
Permanent Agreement Contracting Entity Specific Amendment - Name		CACFP - At-Risk Afterschool
Permanent Agreement Contracting Entity Specific Amendment - Name		CACFP - Child Care Center
Permanent Agreement Contracting Entity Specific Amendment - Name		CACFP - Day Care Home
Permanent Agreement Between Sponsoring Organization and Day Care Home Provider(s)		CACFP - Day Care Home
Permanent Agreement Between Sponsoring Organization and Child Care Site - Sponsoring Organization Provides Meals/Snacks		CACFP - At-Risk Afterschool
Permanent Agreement Between Sponsoring Organization and Child Care Site - Sponsoring Organization Provides Meals/Snacks		CACFP - Child Care Center
Permanent Agreement Between Sponsoring Organization and Child Care Site		CACFP - At-Risk Afterschool
Permanent Agreement Between Sponsoring Organization and Child Care Site		CACFP - Child Care Center

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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