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Independent Centers and Sponsors of Centers
Annual Administrative Forms
- Administrative Cost Waiver
- Annual CACFP Staff Training Checklist
- Annual CACFP Staff Training Sign-In Sheet
- Prototype Organization Chart
- Ethnicity and Racial Beneficiary Form & Instructions
- Statewide Media Release
- Income Eligibility Guidelines - Current & Historical
- Supporting Documents
Center Attendance
Claiming
- Center Claim for Reimbursement Instructions
- Center Claim Submission Instructions
- Center Claim Amendment Instructions
- Reimbursement Rates for Centers
- Allowable & Non-Allowable Expenses
- Food Costs
- Time & Attendance/Time Distribution Instructions
- Time & Attendance/Time Distribution Form
- Sample Time & Attendance/Time Distribution Form
- Summary of Costs
- Record of Milk Purchases
- Food Donation Form
Handbooks
Income Eligibility Information
- Income Eligibility Guidelines
- Household Income Eligibility Statement
- Instructions for Parent/Participants/Guardians
- Instructions for Institutions
- Dear Parent Guardian Letter
- Dear Parent Guardian Letter (pricing)
- Meal Benefit Income Eligibility
Infant Menu Information
- Infant Meal Pattern Requirements
- Infant Menu Record Instructions
- Menu Record 0-5 Months
- Menu Record 6-11 Months with no supper
- Menu Record 6-11 Months with supper
- Non-Creditable Infant Foods
- Infant Formula/Food Sign-off Statement
Meal Attendance
- All Category C & Emergency Shelter Children by Date
- All Category C & Emergency Shelter Children by Name
- Meal Attendance (daily)
- Meal Attendance Summary Record
- All Meals and Snacks
- Weekly Record - Breakfast/Lunch/Snack
- Staff Meal Attendance
- Summary Record Instructions
- Meal Pattern Checklist
Menu Information
Meal Pattern Flexibility Waiver (SY 2021-2022)
CACFP Meal Pattern Flexibility Waiver (SY 2021-2022) - This waiver request form is for Child and Adult Care Food Program for whole grain-rich, ounce equivalents for grains implementation and flavored milk.
- Menu Record Instructions
- Menu Record BALP
- Menu Record BALPSE
- Meal Pattern Requirements - Ages 1-12
- Menu Substitution Log Instructions
- Menu Substitution Log
- Special Diet Form
- Special Diet Accommodations Guide
- Food Allergy Guidelines
- Creditable Non-Dairy Beverage Chart
Sample Menus:
- CACFP 6-Week Sample Menu
- Pre-K Breakfast Menu (Cold)
- Pre-K Breakfast Menu (Hot and Cold)
- Pre-K Lunch (Cold)
- Pre-K Lunch (Hot)
Parent Forms
- Participant Enrollment Form
- Infant Formula/Food Sign-off Statement
- Special Diet Form
- Special Diet Accommodations Guide
- Building the Future with CACFP Flyer
Sponsors of Centers
For questions regarding the following forms, please contact your Program Analyst:
(Use this for the following program or when you have combination programming: Child Care - including GSRP and Head Start, Emergency Shelter, At-Risk Afterschool)
(Use this for the following program or when you have combination programming: Child Care - including GSRP and Head Start, Emergency Shelter, At-Risk Afterschool, Adult Day Services)
(If you have a facility that operates both a child care program and at-risk program at the same facillity then you should NOT use this form)
(Use this form if the site you are reviewing has additional rooms that need to be reviewed as part of your monitoring review)
(Use this form if enrollment is higher than 70 participants)
- Monitoring Tracking Tool is available upon request.
Word versions of forms are available by emailing MDE-CACFP@michigan.gov.