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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
- Procurement and Pricing Programs
- Facts about WIC
At-Risk Afterschool Snack & Supper Program
- Screening for Unlicensed Facilities
- Average Daily Center Attendance Record Instructions
- Average Daily Center Attendance Record
- At Risk Afterschool Daily Meal Count Form
- At-Risk Afterschool Menu Record Instructions
- At-Risk Afterschool Snack/Supper Menu Record
- At-Risk Afterschool Snack/Supper Menu Record Sample
- Meal Attendance Summary Record ARAS Snacks/Suppers
Center Attendance
Claiming
- Visual Snapshot Claim Instructions
- Center Claim for Reimbursement Instructions
- Center Claim Amendment Instructions
- Reimbursement Rates for Centers
- Allowable & Non-Allowable Expense
- Creditable and Non-Creditable Foods Guide
- 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
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 Rev. 10/07
- Weekly Record - Breakfast/Lunch/Snack - Rev. 10/07
- Staff Meal Attendance
- Summary Record Instructions
Menu Information
- Menu Record Instructions
- Menu Record BALP
- Menu Record BALPSE
- Meal Pattern Requirements - Ages 1-12
- Menu Substitution Log Instructions
- Menu Substitution Log
- Fluid Milk Substitution Request Form
- Request for Special Dietary Needs Accommodations Form
- CACFP Special Dietary Accommodations Bundle
- Soy Beverage Chart
- Meal Pattern Checklist
- Vegetarian Diets
- Pre-K Michigan School Meal - FAQs
- Grain-Based Desserts
Parent Forms
- Participant Enrollment Form
- Parent Information Sheet
- Infant Formula/Food Sign-off Statement
- Request for Special Dietary Needs Accommodations Form
- CACFP Special Dietary Accommodations Bundle
Pricing Program
Adult Day Service
- Participant Parent Guardian Letter
- Participant Parent Guardian Letter - Program Pricing
- Household Income Eligibility Statement-Adult Day Services (HIES)
- Instructions for Participants/Guardians-Adult Day Services - Household Income Eligibility Statement
- Instructions for Institutions-Adult Day Services-Household Income Eligibility Statement
- Participant Enrollment Form
- Menu Record Instructions
- Adult Menu Record
- Adult Meal Pattern
- Income Eligibility Guidelines
Sponsor 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 form 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 childcare program and at-risk program at the same facility 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)
- Monitoring Tracking Tool is available upon request. Contact: MDE-CACFP@michigan.gov
Prototype Letters
- Letters are available upon request. Contact: MDE-CACFP@michigan.gov