Form U51 - Child Care Food Program Personnel Activity Report
ADVERTISEMENT
1Child Care Food Program
PERSONNEL ACTIVITY REPORT U51
Center____________________________ Employee Name: ____________________________ Month/Year _______
INSTRUCTIONS: This form is required for all private sector employees who work on the Child Care Food Program (CCFP). Each month, indicate the
number of hours per day spent on administrative and operational activities related to the CCFP (to nearest quarter hour). Examples of CCFP
administrative activities include, but are not limited to: monitoring, record keeping, compiling data, completing the claim for reimbursement, and attending
training related CCFP. Examples of CCFP operational activities include, but are not limited to: menu planning, grocery shopping, cooking and serving
meals and clean up after meals.
Total
Total
Hours Worked
Hours Worked
Hours Worked
Date
Hours Worked
on CCFP
on CCFP
Date
(CCFP & Non-CCFP)
(CCFP & Non-CCFP)
Admin.
Oper.
Regular
Paid Leave
Admin.
Oper.
Regular
Paid Leave
1
17
2
18
3
19
4
20
5
21
6
22
7
23
8
24
9
25
10
26
11
27
12
28
13
29
14
30
15
31
16
TOTAL
I certify that this is an accurate record of the number of hours worked on the Child Care Food Program.
____________________________________
______________________________________
_____________________
Employee's Signature
Title
Date
TO BE COMPLETED BY SPONSOR / CENTER DIRECTOR / AUTHORIZED REPRESENTATIVE
A.
(HOURLY PAID STAFF)
Total administrative hours worked on CCFP _________ x $_________ (hourly wage) = $__________ (Total admin. CCFP salary)
Total operational hours worked on CCFP _________ x $_________ (hourly wage) = $__________ (Total oper. CCFP salary)
B.
(SALARIED STAFF)
Total administrative hours worked on CCFP _________ ÷ Total hours worked __________ = ___________%
Total Salary to be paid this month $___________ x __________% = $___________ (Total admin. CCFP salary)
Total operational hours worked on CCFP _________ ÷ Total hours worked __________ = ___________%
Total Salary to be paid this month $___________ x __________% = $___________ (Total oper. CCFP salary)
I certify that payroll records are on file that verifies the total wages as listed above.
Signature of Sponsor/Center Director/Authorized Representative____________________________________ Date________________
Revised 2/2011
I-026-04
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal