Child And Adult Care Food Program - Arizona Department Of Education printable pdf download

Child And Adult Care Food Program - Arizona Department Of Education

Child and Adult Care Food Program

-G

OMPUTER

ENERATED

EAL

OUNT

GREEMENT

Sponsor:

CTD#

This Agreement is being made between

and the Arizona

(Sponsor)

Department of Education. By completing this Agreement and submitting it to the Department, the

Sponsor is requesting permission to use

to track the

(Name of Computer Software Program)

attendance of its participants and create meal counts to be claimed for reimbursement under the Child

and Adult Care Food Program.

Sponsor will not use computer-generated meal counts until this

Agreement is signed by a representative of the Department and returned to the Sponsor. Copy must be

maintained in permanent records. Furthermore, this Agreement does not replace other meal count

recordkeeping requirements. The Sponsor must continue to complete the Point of Service Meal Count

Sheet and the Meal Count Summary.

1. Describe the procedures in place that ensure that participants are checked “in” and “out” at the

actual times of arrival and departure.

2. Describe the procedures used to determine who is present but does not eat.

3. Describe the procedures for ensuring that no CACFP reimbursement is claimed for participants

who refuse the meal or consume food not provided by the Sponsor.

Sponsors must attach sample copies of the reports to be used to determine the number of meals claimed

for reimbursement.

By completing this agreement, the Sponsor hereby provides assurance that in using a computer- generated

meal count system: meal counts submitted for reimbursement will accurately reflect the number of

creditable meals served; meals claimed for reimbursement will be served within the allowable timelines as

determined by the Department; meals claimed for reimbursement will meet the meal pattern requirements

as mandated by the USDA; Sponsor will notify the Department prior to any change in software system or

meal count procedure.

Printed Name of Authorized Signer

Authorized Signature

Date

------------------------------------------- FOR ARIZONA DEPARTMENT OF EDUCATION OFFICE USE ONLY --------------------------------------------

Approval Date: ____________________ Specialist:

Comments:

Child And Adult Care Food Program - Arizona Department Of Education