After School Snack Program Review Form For National School Lunch
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2Alabama Child Nutrition Programs
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After School Snack Program Review Form for
National School Lunch Program
School Reviewed:________________________________________________________
Date Reviewed:__________________________________________________________
Reviewer (s):____________________________________________________________
First Review
Second Review
This review form must be completed twice per school year for each after school program snack site.
First review must be conducted within first 4 weeks of program initiation.
Area Eligible School
Non - Area Eligible School
Based on your observation, is valid
Based on your observation, is valid
documentation maintained for the following
documentation maintained for the following
records?
Yes
No
records?
Yes
No
1. Area eligibility data (based on
1. Free and reduced priced eligibility
most recent October)?
___
___
of children?
___
___
2. Meal counts (total by site)?
___
___
2. Meal counts by category (free,
3. Attendance records?
___
___
reduced, paid)?
___
___
4. Production records?
___
___
3. Attendance records?
___
___
5. Meal pattern compliance?
___
___
4. Production records?
___
___
6. Is reimbursement claimed for only
5. Meal pattern compliance?
___
___
one snack per student per day?
___ ___
6. Is reimbursement claimed for only
7. Does the meal count for the Day of
one snack per student per day?
___
___
Review follow the pattern for the
7. For pricing program only, list the
previous 10 days?
___ ___
established price for paid and reduced
8. Educational and/or enrichment
snacks.***
Paid_____ Reduced____
activities?
___ ___
8. Does the meal count for the Day of
Review follow the pattern for the
previous 10 days?
___
___
9. Educational and/or enrichment
activities?
___ ___
***Description of Collection Procedure: (Accountability and Collection Procedures listed on instruction sheet)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________
August 2003
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