Cacfp Site Review (Page 3 of 4) in pdf

Exhibit 23.29

5-Day Meal Count Reconciliation

Record in the chart below the date, the meal counts for each meal type claimed and the total number of children in attendance during

the five preceding serving days. Also, record the meal count for the meal observed on the day of the review.

Date

Breakfast

A.M.

Lunch

P.M.

At-Risk

Supper

Evening

Total Daily

Snack

Attendance

Yes

The number of meals served during the meal observation was reflective of the meal counts for the same meal type

for the five preceding serving days. If no, document the reason: ________________________________________

___________________________________________________________________________________________

The meal counts for one or more meal type(s) claimed exceeded the number of children/eligible adults (in adult

care centers) in attendance during one or more of the five preceding serving days. If yes, document the reason

and the correction made to ensure the number of meals claimed does not exceed the number of children in

attendance.

___________________________________________________________________________________________

___________________________________________________________________________________________.

Enrollment Form Verification

List in the chart below ten percent of the names of the children in attendance during the five preceding serving days (list no less than

five children), and indicate if the child has an E/IEA (Enrollment Income-Eligibility Application) or EF (Enrollment Form) on file.

E/IEA or EF on file

Name of child in attendance

Yes

N/A

Enrollment forms (not more than a year old) were on file for ten percent of the children listed on the attendance

form(s) for the five preceding serving days. If no, obtain the missing enrollment forms. (This does not apply to

adult care centers, at-risk, homeless, or outside-school-hours centers).

FORM SPI CACFP 1207 (Rev. 7/08)

Page 3

Cacfp Site Review Page 3