Cacfp Monitor Checklist For Day Care Centers
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2CACFP Agreement # ____________ Center #____________
MONITOR CHECKLIST
for Day Care Centers
Monitoring of CACFP operations is required to be documented a minimum of three times per year. Monitoring
reviews cannot be more than six months apart. Two of the three monitoring reviews must be conducted
unannounced (without advance notice) and at least one of these must include the observation of a meal.
Center Name and Address
______________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________
This visit was:
Announced
Unannounced
___________
___________
Meal observed today:
Breakfast
Lunch
Snack
Supper
___________
___________
___________
___________
Number of Participants Served
Age Range
Number of Staff Served
_____________
_________________________
_____________
DID EACH PARTICIPANT RECEIVE
AT LEAST THE REQUIRED
REQUIRED
MENU COMPONENTS
FOOD SERVED
MINIMUM SERVING SIZE?
SERVING SIZE
YES
NO
Milk
Vegetables/Fruits
Vegetable/Fruits
Bread/Bread Alternate
Meat/Meat Alternate
Does the meal contain all of the required components?
Yes
No
___________
___________
If no, what is missing?
_______________________________________________________________________________________________________________________
YES
NO
NUTRITION
Staff sits with participants during meals.
Participants are assisted with dining as necessary.
Participants react positively to the meal served.
Participants are allowed/encouraged to serve themselves.
Adequate time is allowed for the meal.
YES
NO
RECORDKEEPING
The day care license (or other approval to operate) is current. If not, the center has
documentation that it is in the process of renewing the license.
Income eligibility forms, completed by the participant or household within the last year, are
on file for all enrolled participants and have been accurately categorized by staff.
A random sample of day care enrollment (registration) forms on file indicates that there is
one for each child, that they are updated annually and include parent’s signature, child’s
usual days and hours in care and meals usually received.
Attendance records are completed daily.
USDA is an equal opportunity provider and employer.
CACFP-4259 (3/14)
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