School Breakfast Program On-Site Monitoring Checklist - Arizona Department Of Education Page 4
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4SPECIFY DATE SBP CORRECTIVE ACTION(S) WILL BE IMPLEMENTED: ________________
BY WHOM: ___________________________________________________________________________
SIGNATURE:
_________________________
_________________________
________________
School Representative
Title
Date
_________________________
_________________________
________________
SFA Monitor
Title
Date
SBP FOLLOW-UP VISIT (must be conducted within 45 days if corrective action was required):
Date(s) of Follow-Up: ______________________________________________________________
Observations of corrective action implementation:
SIGNATURE: _________________________
_________________________
________________
School Representative
Title
Date
_________________________
_________________________
________________
SFA Monitor
Title
Date
THIS INSTITUTION IS AN EQUAL OPPORTUNITY PROVIDER
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