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CACFP Forms
CACFP Forms
CACFP Enrollment Roster Forms:
CACFP Adult Enrollment Roster Single Site
CACFP Adult Enrollment Roster Multi Site
CACFP Child Enrollment Roster Single Site
CACFP Child Enrollment Roster Multi Site
Child Care Enrollment Forms:
English -
PDF
MS-Word
Spanish
Russian
Vietnamese
Chinese
2013/2014 Confidential Income Statements and Instructions:
Family Day Care Homes
Child Care Centers
Adult Care Centers
Daily Meal Count Forms:
Daily Meal Count (Actual Count)
Daily Meal Count (Head Count)
Daily Meal Count (At-Risk After School Count)
Infant Feeding:
Daily Infant Menu Record (0-3 Months)
Daily Infant Menu Record (4-7 Months)
Daily Infant Menu Record (8-11 Months)
Daily Infant Menu Record (Multi Age)
Infant Feeding Benefit Notification and Acknowledgment Form & Translations
Multi Site Forms:
Site Monitoring Report
Special Dietary Needs Forms:
Medical Statement for Food Substitutions (English)
Medical Statement for Food Substitutions (Spanish)
Medical Statement for Food Substitutions (Russian)
Medical Statement for Food Substitutions (Chinese)
Medical Statement for Food Substitutions (Vietnamese)
Misc. Forms:
Afterschool At-Risk Meals and Snack Program - Site Review Document (School District Use Only)
Preliminary Application for Centers
For-Profit Monthly Site Eligibility Calculation
For-Profit Eligibility Certification
Sanitation Inspection Request
For use at facilities exempt from licensing
Facility Food Service Safety Sanitation Evaluation Report
For use at facilities exempt from licensing
Non-Dairy Substitution Form
Staff Training
Contacts
Lynne Reinoso
(503) 947-5892
Child Nutrition Program - Program Mrg, Community Nutrition Programs
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