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HomeMy WebLinkAbout1994-085E:\WPD0CS\0RD\SUMMRR.SER 11 ORDINANCE NO. ! -b 9fD AN ORDINANCE OF THE CITY OF DENTON, TEXAS, AUTHORIZING THE CITY MANAGER TO EXECUTE ALL DOCUMENTS AND AGREEMENTS, AS REQUIRED, TO OBTAIN FUNDING FOR THE SUMMER FOOD SERVICE PROGRAM; AUTHORIZING THE EXPENDITURE OF FUNDS TO ADMINISTER THE PROGRAM; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, the City of Denton, Texas will submit an application for funding under the National School Lunch Act, to the Texas De- partment of Human Services for the purpose of making meals avail- able to eligible children at the City's Summer Action Site pro- grams; and WHEREAS, pursuant to the grant, if received, the City will con- tract with the Denton Independent School District to provide the meals at the various sites; NOW, THEREFORE, THE COUNCIL OF THE CITY OF DENTON HEREBY RESOLVES: SECTION I. That the City Manager is hereby authorized to execute, on behalf of the City, an application for funding under the National School Lunch Act, and if funded, the Summer Food Ser- vice Program Agreement with the Texas Department of Human Services, a copy of which is attached hereto and incorporated by reference herein. SECTION II. That the City Manager is hereby authorized to execute a contract with the Denton Independent School District to provide meals for eligible individuals at the various sites, and such certifications as are necessary to carry out the Food Service Program, and to handle all fiscal and administrative matters relating to the application and the program. SECTION III. That the expenditure of funds necessary to administer the Summer Food Service Program is hereby authorized. SECTION IV. That this ordinance shall become effective immed- iately upon its passage and approval. PASSED AND APPROVED this the 3_'0 day of , 1994. ATTEST: JENNIFER WALTERS, CITY SECRETARY BY: APPROVED AS TO LEGAL FORM: DEBRA A. DRAYOVITCH, CITY ATTORNEY BY: A01 Page 2 AGREEMENT TO FURNISH FOOD SERVICE CITY OF DENTON and DENTON INDEPENDENT SCHOOL DISTRICT FOOD SERVICES THIS AGREEMENT is made and entered into by and between the Denton Independent School District and the City of Denton. Denton Tndependent school nistrini-- .-y� inclusive of milk and juice to the Qity of Denton Parks and Recreation Department, at the MLK Recreation Center, Phoenix Park, Denia Park, Civic Center Park, Owsley Neighborhood, TWU Playhouse Program, Village East Apartments, Ginnings Elementary Summer School, and Borman Elementary Summer School, with and for the rates herein listed: Breakfasts ...... $ 0.00 each Lunches ........ $ 1.50 each Snacks...... ..$ 0.00 each Supper ......... $ 0.00 each It, is further agreed that the Denton Independent School District, pursuant to the provisions of the Summer Food Service Program Regulations, a copy of which is attached as Exhibit "A" and is part of this agreement, will assure that said meals meet the minimum requirements as to nutritive value and content as outlined in the U.S.D.A.'s Sponsor Meal Preparation Handbook, and will maintain full and accurate recordings of such, including the following: 1. Menu Records, including amount of food prepared. 2. Meals, including daily number of meals delivered by type. These records must be reported to the institution promptly at the end of each month. Denton Independent School District agrees also to retain records required under the preceding clause for a period of three years and 90 days after the end of the fiscal year to which they pertain (or longer, if an audit or litigation is in progress); and upon request, to make all accounts and records pertaining to the program available to representatives of the U.S. Department of Agriculture and the General Accounting Office for audit or administrative review at a reasonable time and place. The Denton Independent School District agrees to comply with the requirements of the Immigration Reform Control Act of 1986 regarding employment verification and retention of verification forms for any individuals hired after November 6, 1986 who will perform labor -or services under this contract. The agreement shall be effective as of June 1, 1994. It may be terminated by notice in writing given by any party hereto to the other parties at least 30 days prior to the date of termination. IN WITNESS WHEREOF, the parties hereto have executed this agreement as of the dates indicated below: Agreed to this Sponsor Officia School Official Title Location of food preparation center(s) Exhibit A 41001 u c CONTENTS Page INTRODUCTION .. PROGRAM BASICS ...............................1 ADMINISTRATION OF THE SFSP...................... i ............ A SETTING FOR 1 NUTRITION EDUCATION _.,. �.- PP.EPAROTiOA' tL-"7I? �Sr^.ic'JfN�r SI3"tS _... __� -SEI.EOT' THE MEAT 2 _ _- _ -_ --- ---- FOOD SERVICE EQUIPMENT NEEDS ........ . SELECT YOUR PERSONNEL 4 TRAIN YOUR PERSONNEL ......... .......... " 'S ... . SFSP MEAL PATTERN REQLIIREMENT'S . . . . . 7 7 . . . DESCRIPTION OF FOOD COMPONENTS SUMMARY OF MEAL PATTERN POINTS TO REMEMBER 10 STET 'NVOLVED IN MENU PLANNING 1 4 ........ .... SAM. MENUS 1 ......... ................17 MEN1 -/ALUATION .............20 FOOD PURCHASING .............................. HOW TO USE THE FOOD BUYING GUIDE 20 FOOD STORAGE 22 .. ...... FOOD PREPARATION 23 ......... ... USING RECIPES 24 ... 25 MEAL CCLEAANUP...E.................................2 FOOD SANITATION AND SAFETY ............•. 28 ....77 ................29 REFERENCES: Foods Containing Vitamin A ......................... 31 Foods Containing Vitamin C ......................... 31 taining Ir Foods Con ...:.: ":.', ::..... 32 Full -Strength Fruit and Vegetable Juioes ............. . 33 Bread and Bread Alternates ......................... 3 Onsite Food Inventory Record ... ........ 3 3 Serving Size ; 'ieid for Vegetables/Fruits . Food Produc_ . .ec:ord ....... ........ • . 42 38 The Summer Food Service Program for Children is available to all children without regard to race, color, national origin, sex, age, or handicap. Any person who believes he or she has been t• aced unfairly in receiving food services because of discrimination should write immediately to the Secretary of Agriculture, Washington, DC 2M50. Revised February 1992 direct operational -control over all food service sites; and (3) private nonprofit organizations that meet specific criteria, as defined in SFSP regulations. Sponsors can operate the program at one or more food service sites that serve geographical areasin which at least SO percent of the local children are eligible for free or reduced - price school meals, based on school records or census tract data; at sites where meals are served to homeless children; or at "enrolled" sites where at least 50 percent of the enrolled children are individually determined to be eligible for such meals. Enrolled site sponsors must obtain family size and income data, or food stamp or AJ1C case numbers from all en—Iled children and determine that at least half of them are eligible for free or reduced p: . school meals, in order to determine their sites' eligibility. Sponsors of "area eligible" or "open" sites and "homeless feeding" sites are reimbursed for meals served to all attending children; and sponsors of "enrolled" sites are reimbursed for meals served to all of their enrolled attendees. Sponsors of residential summer camps and nonresidential day camps must obtain household size and income data, or food stamp or AFDC case numbers from all of their enrolled children, and can claim for reimbursement only the meals served to those individually determined eligible for free and reduced -price school meals. Nonresidential day camps must offer a continuous schedule of organized cultural or recreational programs for enrolled children between meal services. Administrative and financial responsibility cannot be delegated below the sponsor level, and meal service quality and site personnel conduct reflect directly upon the sponsor's performance. Sponsors that wish to remain. eligible for SFSP must be primarily concerned with the quality and quantity of selected sites, the conduct of sponsor and site per?onnel, the quality of the meals, and the accuracy of records and claims. Food service mac meat companies that have contracted or intend to contras with a sponsor to prepare r serve a -sLs for the summer program must provide meals according to their agreement w1::: the s or and the meal pattern requirements Program to will help ensure that the pr, gram functions properly at each site; and all participating sponsors are subject to audit by USDA's Office of the Inspector General (OIG) and by the General Accounting Office (GAO). A SE777NG FOR NV73t 7ON EDUCATION Nutrition education is an important part of serving meals to children participating in the SFSP. Encourage your staff to provide a variety of activities to help children: ■ develop positive attitudes toward nutritious meals ■ learn to accept a wide variety of foods ■ establish good food habits early in life ■ share and socialize in group eating situations. The teaching of nutrition print plea is most effective when you integrate concepts with other learning experiences. Learning is reinforced when children have an opportunity to practice what you teach theta. IMODUC77ON - This handbook describes the food service responsibilities of a Summer Food Service Program (SFSP) sponsor and provides information regarding meal requirements, recordkeeping requirements, and guidance about food buying and storage. It is intended for use by those sponsors who choose to prepare the meals served to their participating children; and sponsors who choose to operate a vended SFSP will also find much of the information applicable to their operations. PROGRAM BASICS The SFSP provides nutritional help to children 18 years of age or younger, and people over 18 are also eligible if (1) the State educational agency or a local educational agency in the State determines that they are mentally or physically handicapped, and (2) they participate in a public or nonprofit private school program established for the mentally or physically handicapped. Although the SFSP primarily operates during the summer months —May through August —when most schools are closed, it also provides meal service for vacationing children in needy areas where schools are operated on a continuous school calendar, and for enrollees in the National Youth Sports Program (NYSP) when it is operated during the academic year by colleges and universities. Cash reimbursement and, in some cases, donated commodities are available to eligible sponsors to ensure the continued availability during vacation periods of meals that are similar to the high -quality ones provided under the National School Lunch and School Breakfast Programs during the school year. Commodities are foods that the U.S. Department of Agriculture (USDA) acquires through surplus removal and price support programs or purchases in large quantities and then donates to organizations participating in food assistance programs. SFSP sponsors preparing their own meals at the site or at a central kitchen, those that purchase meals from a school food authority, and those that are school food authorities and competitively procure SFSP meals from the same food service management company that competitively provided their most recent National School Iunch Program meals are eligible to receive donated commodities. The administering agency can provide further information on the receipt and use of commodities. ADMINIS77ZA77ON OF THE SFSP The SFSP is administered through an agency of the State government or by a regional office of the Food and Nutrition Service (FNS) that deals directly with the sponsors operating within its geographic domain. Prospective sponsors must demonstrate adequate administrative and financial responsibility to manage an effective food service; must have not previously been seriously deficient in operating under the program; and must conduct a regularly scheduled food service for children from areas in which poor economic conditions exist, for homeless children, or at a summer camp. Service institutions eligible to sponsor the program are (1) public or private nonprofit school food authorities, summer camps, and colleges and universities that participate in the NYSP; (2) units of local, county, municipal, State, or Federal government that have FOOD SERVICE EQUIPMENT.,ZEDS EQUIPMENT NUMBER 07 CHII.iDREN L-i4 5t.100 101-200 201-300 R'ANGL 1 range with 1 range with 1 range with 2 ranges with oven 30 in ­ es oven 30-36 inches oven 30-36 inches oven 30-36 inches domeauc commercial commercial commercial or (2 if over 150) or 30-36 inches I range with oven commercial 60 inches or larger commercial REFRIG- single double double triple section ERATOR section section section commercial reach -in domestic commercial commercial 60.75 cu. ft. 18 cu. ft. reach -in reach -in or 64 sTft. commercial 40-50 cu. ft. 50-60 cu. ft. (8 ft x 8 ft) reach -in or 64 aq. ft. walk-in 20-25 cu. ft. (8 ft x 8 ft) walk-in FREEZER same as above same as above same as above same as above MIXER w/ 10 qt 10 qt 20 qt 20 qt attachments (Veg.siicer -shredder meat & food chopper) WORK TABLES 1 table I table I I table 2 tables (allow 4 linear ft./ worker) Use countertops as tables SINK 1 sink - 3 1 sink - 3 1 sink - 3 1 sink - 3 compartments compartments compartments compartments DISHWASHER I surge tank 1 single -tank or 1 single -tank door -type door -type If the site will serve over 100 children, the following equipment is recommended to supplement the minimum items listed above: Steam Equipment (kettle, steamer) Hot food holding cabinet Convection oven Electric food slicer (manually operated) Young children enjoy sensory experiences. Foods, like a golden orange, a rosy apple, or a bright green pepper, can be an introduction to new .colors, different shapes, textures, and aromas. A child may reject a food simply because it is unfamiliar. Seeing, touching, tasting new foods, and preparing familiar foods in a different way, can lead to better acceptance. Organize tasting parties to offer children a taste -test of a variety of food items. Young children often like being involved in preparing meals and snacks. Have children measure ingredients with real kitchen measuring cups and spoons. Teach children the origin of foods and the sequence of events that lead up to serving a meal. Children can learn many things from field trips that help them discover how food is produced, marketed, and sold. If possible, plan excursions to a farm, market, grocery store, dairy, or bakery. After the trip, have children role-play to recall what they learned. Promote other recreational activities such as food drawings, stories, puppet plays with food characters, songs, and games to help children develop wholesome attitudes toward nutritious foods. Older children are more interested in how food affects their bodies, especially their appearance, physical fitness, and health. Select nutrition education activities that involve group discussions on a variety of subjects. If appropriate, provide videos, poster displays, and guest speakers on such topics as sports nutrition, food shopping tips, and how to read food labels. Audiovisual aids and nutrition education resources are available through your State agency's Nutrition Education and Training Program (NETP) Coordinator. The NET? Coordinator can help you implement your program and identify nutrition education materials and other resources available in your area SELECT THE MEAL PREPARA770MAND SERVING STIES Sponsors are responsible for choosing the most appropriate facilities available for food service. If sponsors prefer on -site meal preparation, sponsors should visit all sites: o to certify that sites are properly equipped with the appropriate facilities and equipment for meal preparation and service for the anticipated number of children. o to check that sites meet State and local public health standards and have or can obtain the required health department certification. The sanitarian or health inspector from your local health department can assist you in complying with State and local rules and regulations. Because of the many variables at different sites, the kinds of equipment you will heed will vary based on the number of children being served and the type of menu you wish to have prepared. Use the chart on the following page to determine whether the equipment available is adequate. Determine the condition of the equipment and, if appropriate, delegate responsibility for maintenance and repairs. ►3.4 TRAIN YOUR PERSONNEL Once you have selected your food service employees, plan to train them in SFSP operations. Introduce them to the goals of the summer feeding program, and help them to understand the importance of maintaining proper records and meeting meal pattern requirements. Develop a job description for each type of food service employee at the site. Job descriptions identify duties and responsibilities for each employee. Give each a work sc ;c.:e-le of daily requireA. activities. For example, the food production employeety will have foa: , -eparation duties to accomplish while other personnel will have serving line respo -1,ailities. Employees must be shown bow to fill out the necessar, food production recoras required by the SFSP. All employees should be aware of SFSP meal pattern requirements. SELECT YOUR PERSONNEL Sponsors are responsible for selecting personnel. The number of food service employees you will need will depend on the number and type of meals prepared. The following staffing schedule is provided as a guide for a program serving lunches and snacks: Number of Meals Hours of Labor 6 to 8 Staff Needs 1 full-time employee up to 50 51 to 100 8 to 10 1 full-time employee" 1 part-time employee" 101 to 200 12 to 20 2 full -tune employees' 1 part -tune employee" 201 to 300 20 to 24 3 frill -time employees' 1 part -tune employee" • These full-time employees can be scheduled for only the hours they are needed and may not be required to work an 8-hour day. These part-time employees may be optional or as needed based on menu requirements. The range of hours for labor reflects variations in skills of the food service employees and the extent of the convenience foods used in the menus. If the site serves breakfast, add 1 hour of.labor for each 50 breakfasts prepared; if the site serves supper, add 4 hours of labor for each 50 suppers prepared. Sites may require less time for labor when serving snacks than when serving other types of meals. (See Staffing section in the Sponsor's Handbook for additional information on staffing patterns.) When you have determined the number of staff required to meet the needs of the site, you are then in a position to hire your food service employees. The type of employee and the amount of experience required will vary with the duties each will perform. You may wish to consider someone with a food production background and/or serving line experience. However, all food service employees should meet the health standards set by local and State health authorities. You may also want to consider the use of qualified volunteers to help you operate the program. ►S4 SNACK (Supplemental Food) Serve two food items selected from any two of the following four components: MInimum Amount Milk Fluid milk Meat and Meat Alternates 1 cup �1 /2 1:.nt) Lean meat or poultry or fish or 1 ounce Meat alternates: (edible portion as served) ,cheese or 1 ounce egg or 1 large cooked dry beans or peas or 1/4 cup peanut butter or other nut or seed butters or 2 tablespoons nuts and/or seeds or 1 ounce yogurt (plain, sweetened, or flavored) 4 ounces (Or an equivalent quantity of any combination of meat or meat alternates) Vegetables and Fruits Vegetables and/or fruits or 3/4 cup full-strength vegetable or fruit juice 3/4 cup (Or an equivalent quantity of any combination of vegetables, fruits, and juice) Juices cannot be served with milk. Bread and Bread Alternates Bread (wholegrain or enricW) or 1 slice Bread alternates (whole -grain or enriched): cornbread, biscuits, rolls, muffins, etc. or 1 serving cooked pasta or noodle products r 1/2 cup cooked cet _al grains, such as rice, corn grits, or bulgur or 1/2 cup (whole grain, enriched, or foniffed): cooked cereal or areal grains or 1/2 cup cold dry cereal 3/4 cup or 1 ounce (whichever is less) (Or an equivalent quantity of a combination of bread or bread alternates) �8� SUMMER FOOD SERVICE MEAL. PA77ERN REOLUREMENTS The goal of the summer program is to serve meals that meet program requirements, are appetizing to children, and are consistent with the Dietary Guidelines for Americans. Careful planning is necessary to meet these goals. Meal pattern requirements assure well- balanced, nutritious meals that supply the kinds and amounts of foods that children require to help meet their nutrient and energy needs. The following are the minimum requirements for each meal: Milk Fluid mills Vegetables and Fruits Vegetables and/or fruits or full-strength vegetable or fruit juice, (Or an equivalent quantity of any combination of vegetables, fruits, and juice) Bread and Bread Alternates Bread (whole -grain or enriched) or Bread alternates (whole -grant or atriched): cornbread, biscuits, rolls, muffins, etc. or cooked pasta or noodle products or cooked cereal grains, such as rice, corn grits, or bulgur or (whole -grain, enricheA or fortified): cooked cereal or cereal grains or cold dry cereal (Or an equivalent quantity of a combination of bread or bread alternates) Minimum .Amount 1 cup (1/2 pint) 1/2 cup 1/2 cup 1 slice 1 serving 1/7 cup 1/2 cup 1/2 cup 3/4 cup or 1 ounce (whichever is less) ---------------------------------------------------------- (Optional) Serve as often as possible: Meat or Meat alternates Meat Meat alternate 1 ounce 1/2 amount listed under LUNCH or SUPPER ►74 DESCRIPTTON OF FOOD COMPONENTS Milk Milk provides calcium and riboflavin, some protein, vitamin A, vitamin D, phosphorus, and other nutrients. If you serve lowfat or skim milk, it should be fortified with vitamin A as well as vitamin D, as specified by the Food and Drug Administration. In the SFy" the milk component includes fluid types of pasteurized whole, lowfat, or skim milk that i, . avored or unflavored, or cultured buttermilk. All milk served must meet State and local standards. You may use additional milk (fluid, evaporated, or nonfat dry milk) to prepare soups, casseroles, puddings, bakery items, or other baked products, or dishes. Additional milk in these items helps improve the nutritional quality of any meal, however, they are not approved to meet the fluid milk requirement. At breakfast or for snacks, use milk as a beverage, on cereal, or as a beverage and on cereal. At lunch or supper, milk must be served as a beverage. If your site serves only snacks a meal and two snacks; it is a good idea, but not mandatory, to include milk in at leas ae snack. Meat and Meat Alternates Meat and meat alternates, as a food group, provide protein, iron, B vitamins (thiamin, ribofl, 'n, niacin), and other nutrients. Meat and/or meat alternates must be served at lunch and supper, may be served as part of the snack; and are suggested as additional foods at breakfast as often as possil A serving of cooked lean meat (beef; pork, lamb, veal), poultry, fish, cheese, cooked c or peas, eggs, peanut bL:ter or other nut or seed butters (almond, sesame, sunflc, nuts or seeds, or any combination of these may be used to meet this requirement. Yc,_ ..... serve these foods as the entree (main dish) or as part of the main entree and in one other menu item. Examples: Ground meat (1 ounce) and cheese (1 ounce) combined it a casserole meet the requiretent of amain entree; a peanut butter (2 tablespoons) sandwich and half of a deviled egg . :et the requirement as part of the main entree and in one other menu item. Peanut butter and other nut and seed butters may be used as a meat alternate in the amounts specified in the meal pattern. Nuts and seeds may fulfill: (a) all of the meat/meat alternate requirement. for the snack; but, (t) no more than one-half of the meat/meat alternate to fulfill the requirement fe lunch or s taper. Nuts and seed must be combined with another meat/meat alternate t. fulfill the acquirement. For the purpose of determining combinations, 1 ounce of nuts or seeds is equal to 1 ounce of cooked lean meat, poultry, or fish. The nuts and seeds that may be used as a meat alternate include peanuts, soynuts, tree nuts (almonds, walnuts, and LUNCH OR SUPPER Minimum Amount Milk Fluid milk Meat and Meat Alternates Lean meat or poultry or fish or Meat alternates: cheese or egg or cooked dry beans or peas peanut butter or other nut or seed butters or nuts and/or seeds (Or an equivalent quantity of any combination of meat or meat alternates) 1 cup (1/2 pint) 2 ounces (edible portion as served)- 2 ounces 1 large 1/2 cup 4 tablespoons 1 ounce = 50%* Vegetables and Fruits Vegetables and/or fruits (2 or more selections 3/4 cup for a total of 3/4 cup) or full-strength vegetable or fruit juice 3/4 cup (Or an equivalent quantity of any combination of vegetables, fruits, and juice) Juice may not be counted to meet more than 1/2 of this requirement. Bread and Bread Alternates Bread (whole -grain or enriched) or 1 slice Bread Alternates (whole grain or enriched): cornbread, biscuits, rolls, muffins, eta or 1 serving cooked pasta or noodle products or 1/2 cup cooked cereal grains, such as rice, corn grits, or bulgur 1/2 cup (Or an equivalent quantity of a combination of bread or bread alternates) ' No more than one-half of the requirement shall be met with nuts or seeds. Nuts or seeds shall be combined with another meat/meat alternate to fulfill the requirement. Note: The serving sizes of food specified in the meal patterns are minimum amounts. If the administering agency approves the sponsor to serve smaller portion sizes to children under 6 years, the sponsor must meet the meal patterns =spectfled in the Child and Adult Care Food Program (CACFP) regulations. You can obtain copies of dtese regulations from your State agency. Children over 6 years old may be served larger portions, but not less than the minimum requirements specified in the Summer Food Program regulations. Remember that you do not receive reimbursement for meals that do not meet the minimum program requirements. ►94 When you use canned fruits, select ones that are packed in fruit juice, water, or a light syrup, if possible. If you serve fruit or vegetable juice for the midmorning or midafternoon snack, use full-strength juice. (However, you cannot serve juice if you serve milk as the only other component for the snack.) Juice drinks with at least 50 percent full-strength juicy -ire allowed, but discouraged, because double the volume is needed to meet program requirements. Beverages containing less than 50 percent juice such as fruit punches, ades, or drinks made with fruit -flavored powders and syrups do not meet program requirements. Bread and Bread Alternates Bread and bread alternates include whole -grain or enriched breads and/or fortified cerea' that provide carbohydrates, some of the B vitamins (thiamin, riboflavin, and niacin, minerals (such as iron), some protein, and calories. Whole -grain products supply additional vitamins and minem% as well as dietary fiber and a variety of taste and texture. At breakfast, choose from a serving of. enriched or whole -grain bread; cornbread, biscuits, rolls, or muffins made from enriched or whole -grain meal or flour; enriched, whole -grain, or fortified cereal; cooked whole -grain or enriched cereal grains such as bulgur, corn grits, or rice; enriched or wbole-grain pasta products, such as macaroni; or a combination of bread and bread alternates. For midmorning and midafternoon snacks, choose from a serving of. enriched or whole - grain bread; enriched, whole -grain, or fortified cereal; cooked enriched or whole -grain bread alternates such as rice, bulgur, or macaroni; cornbread, biscuits, rolls, muffins, crackers, or cookies made of enriched or whole -grain meal or flour. Hot breads, such as rolls, biscuits, cornbread, or muffins, or raisin bread add variety and appeal as well as nutrients. At lunch or supper, choose from a serving of: enriched or whole -grain bread, or cooked whole -grain or enriched rice, bulgur, or corn grits; or enriched or whole -grain noodles, macaroni, or other pasta products. An equivalent serving of a bread alternate made from whole -grain or enriched meal or flour may be substituted. ■ Cereal may be served at breakfast or as a midme- ~q or mid -afternoon snack. However, cereal cannot be used as a bread altemL inch or supper. ■ "Fortified grain -fruit products" may be used to meet uie bread and fruit requirement at breakfast or for midmorning or midafternoon snacks. All fortified grain -fruit products must meet FNS alternate food regulations and USDA specifications. These products are intended for use at sites with limited or no kitchen facilities for preparing and serving the regular breakfast or snacks. See Meal Substitutions and Variations. ■ Cookies may be used as a bread alternate in the snack only, if the primary ingredient by weight is whole -grain or enriched flour or meal and the minimum serving size is pecans), and seeds (sunflower, sesame, and pumpkin). For more information, contact your State agency for "Guidance for the Nuts and Seeds" and SFSP Regulation Part 225.16. CAUTION: Children under S are at the highest risk of choking. USDA recommends that nuts and/or seeds be served to them ground or finely chopped in a prepared food Commercially prepared fresh and canned yogurt may be used as a meat/meat alternate in the snack only. You may serve 4 ounces (weight) or 1/2 cup (volume) of plain or sweetened and flavored yogurt to fulfill the equivalent of one (1) ounce of the meat/meat alternate component. For younger children, 2 ounce,: (weight) or 1/4 cup (volume) fulfills the equivalent of 1/2 ounce of the meat/meat alternate requirement. Homemade yogurt and non standardized frozen yogurt or other yogurt flavored products such as yogurt bars, yogurt -covered fruit and/or nuts or similar products may not be credited as a snack component. When purchasing yogurt, read the labels to know what you are buying. Note that some yogurts have a higher sugar content than others. In general, plain yogurt is more economical than sweetened and/or flavored yogurt. Yogurt offers new menu variety when planning snacks Try serving yogurt as a dip with bite -size raw vegetables or yogurt with fresh cut-up fruit. It's important to note that commercial flavorings and sweeteners such as fruit, nuts, granola, etc., do not count towards meeting the requirement of the second food component in the snack. Fruits and Vegetables Vegetables and fruits, as a food group, provide most of the vitamin C and a large share of the vitamin A in meals. At breakfast, a serving of fruit or vegetable, or full-strength fruit or vegetable juice, is required. Breakfast is a good time to serve foods containing vitamin C, such as citrus fruits and juices, like oranges or grapefruit. Other foods containing vitamin C are tomato juice, strawberries, and cantaloupe (when in season).. Consider using dried fruits, such as dried apricots, raisins, and prunes, to provide variety in menus. Look for the chart in the reference section of this handbook that shows more suggested foods containing vitamin A, vitamin C, and iron. For lunch and supper, serve two or more vegetables or fruits at each meal to meet program requirements, No more than one-half of the total requirement may be met with full- strength fruit or vegetable juice. For variety, serve full-strength fruit or vegetable juices, fruits, or vegetables for snacks between meals. A serving of cooked vegetables means a drained vegetable as served. A serving of cooked or canned fruit consists of fruit and juice. A serving of thawed frozen fruit is fruit with the juice that accumulates during thawing. Snack time is a good time to introduce new vegetables and fruits that are easy to prepare and eat. Use fresh fruits and vegetables frequently and offer a variety of each. SUMMARY OF MEAL PATTERN POINTS TO Keep in mind the following points when you plan menus to me.. meal pattern requirements for each of the food groups: Meat and Meat Alternates ■ r menu variety, you may use meat and cheese in combination (1 ounce of meat and 1 ounce of cheese) to fulfill the meat reg*cment. Dried beans or peas may be used to fulfill the meat/meat alternate -component or the vegetable component. However, dried beans or peas may no be used to meet both requirements in the same meal. ■ Peanut or other butters, such as almond, may be used as a meat alternate. ■ Nuts and seeds may fulfill: (a) all of the meat/meat alternate requirement for the snack, but (b) no more than one-half of the meat/meat alternate requirement for lunch or supper. ■ Yogurt may be used a meat/meat alternate in the snack only. You may serve 4 oz (weight) or 1/2 cc- volume) of lain, sweetened, or flavored yogurt to fulfill the equivalent of 1 ounc:. of the meat/meat alternate component. Homemade yogurt as well as frozen yogurt and other yogurt -flavored snack products may not be used to fulfill the requirement. Fruits and Veg - ables ■ Use only full-strength juice to fulfill the fruit/vegetable requirement. Juice drinks with at least 50 percent full-strength juice are allowed but their use is discouraged because children must be served double the volume of these drinks in order to meet program requirements. ■ Fruit -flavored drinks, ades, or punches do not meet any part of the fruit/vegetable requirement since they generally contain less than 50 percent full-strength juice: ■ Juice cannot be served as part of the snack when milk is the only other component. It is poor menu planning to offer such a combination since it provides too much liquid for children. ■ Syrup from canned fruit cannot be served to count as fruit juice. ■ Two forms of the same fruit or vegetable in the same meal cannot be used to meet the fruit/vegetable requirement. An orange and orange juice, or ar apple and applesauce are combinations that may not be used. Serve a variety of vegetables and fruits to ensure a nutritionally well-balanczd meal. 1-1/4 ounces (35 grams). USDA recommends that cookies be served as part of a snack no more than twice a week. ® Some bread items or their accompaniments may contain more sugar, fat, or salt than others. Keep this in mind when considering how often to serve them. Other Foods In addition to the foods specified in the charts under the SUMMER FOOD SERVICE MEAL PATTERN REQUIREMENTS, other foods may be served at -meals to help improve acceptability, to satisfy children's appetites, to provide additional energy, and, if wisely chosen, to increase the nutritional quality of the meals. For example at breakfast, serve moderate amounts of honey, jam, jellies, and syrup to add flavor and variety to pancakes, toast, English muffins, etc. Margarine or butter used as a spread or in food preparation provide not only additional calories from fat, but also improve the flavor and acceptability of many foods. However, all fat -based foods, including mayonnaise and salad dressings, should be used in moderation Remember too that "other foods" are often a source of hidden sugar, fat, and salt. Be aware and limit the frequency and the amounts you serve of foods such as chips, pickles, and pastries in your summer meals. Commercial yogurt may be used as an "other food" at breakfast, lunch, and supper. Plain yogurt maybe used as a topping on potatoes (instead of butter or sour cream) or used with fresh cut-up fruits and fresh vegetables at meals. Plain, flavored, or sweetened yogurt, made with whole or lowfat milk, provides additional sources of calcium. Additional foods served as desserts at lunch and supper help to meet the needs of growing children by supplying extra food energy (calories) and other important nutrients. Baked products made from whole -grain or enriched flour supply additional amounts of iron and some B vitamins. Desserts made with milk, such as puddings, provide calcium along with other nutrients. Meal Substitutions and Variations Sponsors must not allow substitutions to the meal pattern requirements except under certain conditions. Please refer to SFSP Regulations Part 225.16 for more information. ► 13 . STEPS INVOLFED_IN MEND PLANMNG Good menu planning goes beyond listing specific foods to be included daily. Recip. d costs, facilities, and personnel must be carefully considered in the planning process. ...:re are the basic steps involved in menu planning. 1. Select specific recipes for preparing the menu items and determine the servinr size. Estimate the number of meals to prepare and adjust the recipes to proviL.' the number of servings you need. 2. Determine unit or portion costs; calculate the amount of food you will need for the total number of meals you will serve. 3. Estimate the total food cost of each menu item. 4. Calculate how much it costs to serve the foods as a single menu item or in a recipe. Compare the estimated cost of the menu with the food budget. If this cost is too high for the food budget, replace some of the foods in the menu with less expensive ones. 5. Based on the estimated amounts of foods needed to prepare the menus, determine the amount of food you have on hand in your storeroom and refrigerators and then decide which foods you need to purchase. 6. Schedule production time and develop work schedules. Menus should be planned in advance-2 weeks to a month ahead of the time you will actually serve them. Advance planning is important as a basis for food purchasing, cost control, and food preparation s6eduling. Record menus on a worksheet designed for that purpose and suited to is Ividual needs. The quantity production records can be kept on the same worksbeet. (See sample food production and inventory records in the REFERENCES section of this handbook) Cycle Menus A cycle menu can p- ' 9e good management control and savings in time and money.. A cycle of menus is L •s of carefully planned memo that are used and repeated in the same order for a de,U : number of days. The cycle doe wt always have to begin on the first day', of the week and the same memo should not be served on the same day each week. . 16 . ® Small amounts (less than 1/8 cup) of onions, pickles, relish, or other condiments added. for flavor or used as a garnish cannot be credited as meeting fruit/vegetable requirements. n Potato chips, sticks, catsup, jams, and jellies cannot count as vegetables or fruits. Serve them only to add flavor or variety to menus as "other foods." Bread and Bread Alternates n Use only whole -grain or enriched breads and bread alternates, or whole -grain, enriched, or fortified cereals, to meet bread requirements. Read labels on commercial products to guide you. n Use enriched or whole -grain macaroni products, noodles, corn grits, and rice as bread alternates to meet the bread requirement. e Foods such as cake and pie crust, items usually served as desserts, cannot be used as bread alternates. Crust used as part of the main dish (Le., for pizza or quiche) is allowed as a bread alternate. n The bread requirement cannot be met with snack foods such as popcorn, hard pretzels, chips, or other low -moisture extruded or shaped items made from grain. a Cookies cannot be used for the bread requirement at breakfast, lunch, or supper. B Doughnuts cannot be served to meet the bread requirement at lunch or supper. ► 15 4 Menu 4 C Tomato Juice Peanut Butter Bean Taco (1) (1/2 cup) (2 tablespoons) (beans - 1/4 cup, Cornmeal Muffin (1) Milk (1/2 pint) cheese - 1 ounce Milk (1/2 pint) Soda Crackers* 1 taco shell) Shredded Lettuce (1/4 cup) Peach (1 medium - 1/2 cup) Milk (1/2 pint) ;rs❑ set atSpanish Rice O-M y t, Menu S "" ''a' 71/4 cup) ioa Grapefruit Juice Soft Pretzel (1) Sliced Turkey on (1/2 cup) Milk (1/2 pint) Roll Whole -Wheat Toast (turkey - 2 ounces, (1 slice) 1 roll) Milk (1/2 pint) Mexicali Corn Peanut Butter* (1/4 cup) Mixed Fruit Cup (1/2 cup) Y'EEK - Milk (1/2 pint) L. Menu 6 Barbecue Chicken Banana (1 small - Onmge Juice (cooked edible 1/2 cup) (3:. cup) portion - 2 ounces) English Muffin (1) Rye Wafers Baked Beans (1/2 cup) Milk (1/2 pint) (4 whole -grain) 'Seedless Grapes Cheese Slice* (1/4 cup) Biscuit Milk (1/2 pint) Menu 7 Pineapple Juice Blueberry Mt. Pizza (cheese - (1/2 cup) (1) 2 ounces, crust Toast (1 slice) Milk (1/2 pint) 1.1 ounces) Milk (1/2.pint) Carrots and Celery Scrambled Egg* sticks (1/4 cup) Plums - 2 (1/2 cup) Milk (112 pint) * A... Donal food, not required to meet the meal pattern. rn. SAMPLE MENUS The following 11-day menu cycle serves as a sample menu. Note the variety of meals that meet USDA meal pattern requirements. You may change any of the meals in this cycle, rearrange the order, or substitute for other items within a meal, provided that each new menu meets all USDA meal pattern requirements. These menus are suggested for your use, depending on the type of your site. SAMPLE MENU CYCLE FOR ONSTTE PREPARATION (11 DAYS): WEEK l Breakfast Snack Lunch/Supper Menu I Cantaloupe Raisin Bread Hoagie Sandwich (1/4 melon-1/2 cup) (1 slice) (turkey ham - 1 ounce Whole -Wheat Toast Milk (112 pint) cheese - 1 ounce, (1 slice) lettuce & tomatoes - Milk (1/2 pint) 1/4 cup, 1 roll) Hard Cooked Egg* Nectarine 1 (medium- 1/2 cup) Milk (1/2 pint) Menu 2 Pineapple (1/2 cup) Orange Juice Oven -Baked Chicken Roll (1) (1/2 cup) (cooked edible Milk (1/2 pint) Raisins portion - 2 ounces) (1/4 cup) Potato Rounds (1/2 cup) Cheese Toast Green Peas & (1 slice bread) Carrots (1/4 cup) Biscuit (1) Milk (1/2 pint) Menu 3 Peach Halves Yogurt (1/2 cup) Hamburger on Bun (1/2 cup) Bran Muffin (1) (cooked meat - Corn Grits (1/2 cup) 2 ounces, 1 bun) Milk (1/2 pint) Oven Roasted - Cheese Wedge* Potatoes (1/2 cup) Lettuce & Tomatoes (1/4 cup) Milk (112 pint) * Additional food, not required to meet the meal pattern. P. 17 .4 MENU EVALUATION Careful, systematicplanning of the menu —well in advance —is a key to good management. You may find the following checklist helpful for evaluating menus before you prepare them. YM Ns '. Have you included all required cor—nnents of the meal and in the minimum poruon sizes as specified by USDA? — — 2. Have you kept foods high in sugars and other sweeteners to a minimum? W eying — — 3. Have you kept calories from fat to a moderate level? � ano 4. Have you kept foods high in salt to a moderate level? 5. Have you included "other foods' to satisfy the appetites and to help meet the nutritional needs of the children? — — 6. Do meals include a good balance of color, texture, shape, flavor, and temperature? — — 7. Are foods containing vitamin A, vitamin C, and iron offered frequently? — — 8. Have you included different kinds of foods (fresh, frozen, canned, dried)? — — 9. Have you varied foods from day to day and week to week? — — 10. Have you considered the children's cultural and ethnic practices? — — FOOD PURCHASING Getting the most for the food dollar takes careful planning and buying experience. Careful use of food buying power will not only help control your food costs but will also reduce waste and help upgrade the quality of meals. Success in food buying depends on getting good -quality foods in the proper quantities at the best possible prices. The proper quantities of foods to buy depends on the number of children -sting at the site, the menus and recipes you use, the amount and kind of storage space : able, inventory on hand, perishability of the food, and the length of time the order covers. L ition to this handbook you may also wish to consult USDA's Food Buying Guide for L?rild . .1tion Programs (PA-1331), which can be obtained from your administering agency. Tom, Orange Juice Cinnamon Toast Pork Barbecue (1/2 cup) (1 slice) Sandwich Oatmeal Yogurt (1/2 cup) (cooked meat - 2 (1/2 cup) ounces, 1 bun) Milk (1/2 pint) Coleslaw/Carrots (1/4 cup) Watermelon Wedge (1/2 cep) Mille (1/2 cup) Menu 9 Applesauce Grapefruit- Grilled Cheese/Tomato (1/2 cup) Orange Juice Sandwich French Toast (3/4 cup) (cheese - 2 ounces, (1 slice bread) Graham Crackers tomato, 1 slice - Milk (1/2 pint) (3 squares, 1/8 cup, bread - 2-1/2 in) 2 slices) Carrot Sticks (1/8 cep) Apple, small (1/2 cup) Milk (1/2 pint) Memo 10 l Orange (1 medium - Apple Juice Fish sticks 1/2 cup) (3/4 cup) (4 sticks - Bagel (1/2) Peanut Butter 2 ounces Milk (1/2) Cookie (1) cooked fish) Crinkle -Gut Potatoes (1/2 cep) Carrot/Raisin Salad (1/4 cup) Muffin Square (1) Milk (1/2 pint) Pineapple -Orange Raisin Toast Juice (1/2 cup) (1 slice) Cold Cereal Milk (1/2 pint) (3/4 cap) Milk (1/2 pint • Addirional foo4 not reTdred to meet the meal pattern. Meatballs/Spaghetti (cooked meat - 2 ounces, spaghetti - 1/2 cup) Tossed Green Salad (1/4 cup) Nectarine, 1 medium (1/2 cup) Italian Bread' (1 slice) Milk (1/2 pint) 0 19 4 and quantities you will need to buy. Check your inventory to determine what is on hand and subtract that from -the list of foods to purchase. Consider the number of servings per pound or per can each time you purchase in order to get the total quantity needed. You must keep in mind, however, the size of the storage facilities and buy only the quantities of food that you can store properly. Buy only the products you need in the quantities necessary to fulfill your site's requirement. HOW TO USE THE FOOD Bi717NG GUIDE The Food Buying guide for Child Nutrition. Pro -is (PA-1331) has been designed to help determine quantities of food to purchase for utise in preparing meals for children. Use the Food Buying Guide and the following steps to determine how much food to buy: 1. Determine the serving size and the total number of servings needed for each food item as follows: - For meat, poultry, fish or cheese, multiply the number of servings times the serving size (in ounces) to get total ounces needed. - For vegetables and fruits, the Food Buying Guide lists amounts to buy based on 1/4- cup servings. Therefore, to calculate the amount to purchase, convert your serving size to the number of 1/4-cup servings. This is done by dividing the serving size by 1/4 and then multiplying the result by the number of servings to get the total number of 1/4-cup servings needed. 2. Divide the amount needed (total ounces of meat or total number of 1/4-cup servings of the vegetable or fru`ie* the number of servings per purchase unit (from column 3 of the Food Buying Gjdde for the food you want to use). 3. See the following examples: Example A: Frozen Potato Rounds 1. Serving size: 1/2 cup Number of servings: 195 2. Calculate the number of 1/4-cup servings: 1/2 + 1/4 = 2 x 195 = 390 1/4-cup servings 3. Amount needed (number of 1/4-M servings) = M = 30.7 or 31 pounds Servings per purchase unit* 12.7* *Servings per pound - - column 3, pag. 102 of the Food Buying Guide Where To Buy Food Consider where to buy foods: o Find out which food companies (suppliers) in the area offer foods that you will use frequently, offer the services you require (prompt and frequent delivery, credit, discounts), and have quality foods at reasonable prices. a Buy from suppliers who provide the best quality foods at the most reasonable prices. a Follow a stein code of business ethics when you purchase foods• .`ix the program. Know what the food suppliers expect, and let them know what you expect of them. What To Buy How to use. the food determines both the form and quality that you should buy. Consider the product's style, size, count, container, and packing medium. The label describes the product. Inspect the product before you purchase it and when it is delivered. Whenever possible, purchase foods that are federally graded. Here are some additional tips to help you decide what to buy: n Buy government -inspected meats and poultry. n Purchase only pasteurized Grade A milk and milk products. e Purchase government -approved seafood whenever possible. ® Purchase bread and bread products that are properly wrapped or kept in paper -lined containers with covers to keep them fresh and wholesome. Check dates on packages of bread and bread products to be sure that they are fresh. e Purchase frozen foods that have been kept frozen solid. Do not accept delivery of frozen foods that are, or have been, thawed or partially thawed. n Purchase perishable foods that have been kept under refrigeration. Specifications You should provide the supplier with clear specifications for each food item ordered. Once the supplier delivers the order, check to see that the food meets the specifications and is in good condition. How Much To Buy The first step iu purchasing is to plan the menus. Secondly, determine the recipes you will use. After you decide which recipes to use, calculate the quantities of food you need to serve the children who eat at the site. The menus and recipes must be checked to determine that the meal patterns have been met. Then, compile the "grocery list" of foods 21 -4 requiring restitu-, •1 for foo-'- that are lost or spoiled. Use preventive measures to control food losses throt - deteric on and infestation by insects and rodents. Guidelines for } .er Stop. ■ Examine all food upon delivery to be sure it is not spoiled, dirty, or info° ' with insects. Do not accept or use bulged or unlabeled cans. Do not accept frc foods that have started to thaw. Send these items back. ■ Store all food o,+F the floor on clean racks, dollies, or other clean surfaces. Pallets and dollies should be at least 6 inches off the floor- to permit cleaning under them. ■ Keep storage rooms clean, sanitary, and free from rodent infestations. Clean on a rotatin schedule. :c, as , I ; - or mf.,. ■ Protecr'%ods such as flour, cereals, cornmiOaJugar, dry beans, and dry peas from rodents and insects by storing them in tightly t&ered containers. ■ Use food on a "first in, first out" basis. Arrange foods so older supplies will be used first. FOOD PREPARATION Inventory Record A sample inventory form is provided in the reference section of this handbook. Use this form as a guide for determini� value of foods used durigca reporting period. This may be obtained by taking a p count of foods c hand (closing inventory), obtaining the value of these foods from invoices, and calculating the total value of food on hand. Quantity on hand x Unit cost = Total value of food on hand. You should inventory and list any stock you have on hand at the beginning of program operations as "beginning inventory.' Beginning inventory of a given period is the same as the ending inventory of the preceding period. 'Cost of food used" is, in its simplest form, beginning inventory plus food received, less ending inventory. The dollar value of food received is obtained from the receipts or invoices for the reporting period You must report the cost of the food you used, not the cost of all the food you purchased. Unused Food Food purchased but not used for the program cannot be claimed for reimbursement. Careful planning and ordering, especially toward the close of program operations, are ease- 11. Contacahe agency distributing the commodities to properly dispose of _fused comr ities when the program closes. Example B: Carrot Sticks 1. Serving size: 1/4 cup Number of servings: 195 2. No conversion is needed because the serving size is 1/4 cup. 3. Amount needed (number of 1/4-cup servings) _ JM = 18.9 or 19 pounds Servings per purchase unit' 10.6' 'Servings per pound - - column 3, page 75 of the Food Buying Guide Example C: Ground Beef, market style 1. Serving size: 2 ounces Number of servings: 195 2. Number of servings x serving size = total ounces needed 195 servings x 2 ounces = 390 ounces 3. Amount needed (total ounces) _ IM = 34.8 or 35 pounds Servings per purchase unit' 112' ' 1-ounce servings per pound - - column 3, page 26 of the Food Buying Guide FOOD STORAGE When To Buy Food The following guidelines can help you decide when to buy each type of food. Buy bread, milk, and produce every day or every 2 days if storage equipment is sufficient. Buy perishable foods, such as meat, fish, poultry, and frozen food, in quantities that can be accommodated by refrigerated and freezer storage. If dry storage is available, you may buy canned foods and staples monthly or twice a month. Keep Records Current Keep accurate and up-to-date records: Record the date you order the food, the name of the supplier, the date you receive the food, its condition on arrival, the price paid, and when and how much you used. These records can be helpful in planning future purchases and menus. Records on the cost of the food you used will be very important in filing your claim for reimbursement. Storage Facilities Good storage facilities —both dry and refrigerated —help keep food safe, fresh, and appetizing. Food products must be in excellent condition when they arrive at the receiving area. They must be kept that way as you store, prepare, and serve them. Sponsors that accept USDA -donated foods also accept the responsibility to handle and correctly store them. Failure to do so may result in USDA either withholding further donations or ► 23 Sources for Recipes Quantity recipes may be available from State agencies, industry, ar. reliable cookbooks. How to Use Quantity Recipes To properly use quantity recipes, follow these step! 1. Read the entire rec;vie carefully before beginning preparation and follow directions exactl,.. 2. Adjust the food quantities in the recipe to provide the number of servings yuu require. 3. Determi'-:r the amot- , of food :ou need for prepa:ig the recipe. (Refer to page 22, How to Use the Food buying Guide.) 4. Assemble the necessary utensils and ingredients. S. Weigh and measure ingredients accurately. Weigb ingredients whenever possible since weighing is more accurate. If you must measure ingredients, use standar� measuring equipment. 6. Follow directions ca. .dUy for combining ingredients and cooking the product. Abbreviations Used in Recipes AP ---as purchased EP--••-^dible portion Cyl -- ylinder pkg---package tsp---teaspoon Tbsp»tablespoon lb —pound pt--pint Equivalent Measures 1 tablespoon = 3 teaspoons 1/8 cup = 2 tablespoons or 1 fluid ounce 1/4 cup = 4 tablespoons 1/3 cup = 5-1/3 tablespoons 3/8 cup, = 6 tablespoons 1/2 cup, 2/3 cup = 8 tablespoons = 10-2/3 tablespoons 3/4 cup = 12 tablespoons qt---quart gal --gallon oz--ounce fl oz—fluid ounce No —number wt—weight incl—including excl—excluding 1 cup = 16 tablespoons 1/2 pint = 1 cup or 8 fluid ounces 1 pint = 2 cups 1 quart = 2 pine 1 gallon = 4 quarts 1 peck = 8 quarts (dry) 1 bushel = 4 pecks 1 pound = 16 ounces Amounts To Prepare Serving acceptable and nutritious foods depends not only on good planning, selection, and storage, but also on preparation. First determine how much food to prepare by examming the menu (which shows the kinds of foods to prepare and the serving size of each), determining the total number of children you will serve, using standardized recipes whenever possible, and becoming familiar with food yields (the number of servings you can obtain from a purchase unit). Charts in the back of this section provide information on serving size, yield of servings, and yield of selected foods. If you prepare food at the site, maintain daily food production records to document the types and quantities of food prepared to meet USDA requirements for the number of meals claimed for reimbursement. This handbook includes a sample worksheet for this purpose and instructions for its use. Tips for Food Preparation ■ Wash fresh fruits and vegetables with water (no soap) and use brush if necessary to remove soil. Trim carefully to conserve nutritive value. Remove damaged leaves, bruised spots, peels, and inedible parts. Use a sharp blade when trimming, cutting, or shredding to avoid further bruising and loss of nutrients. n Steam or cook vegetables in small batches for best quality. Avoid over -cooking, using as little water as possible to help retain vitamins and minerals. a Add only a small amount of salt, if any, to water or to foods when cooking. n Cook root and tuber vegetables in their skins to help retain their nutritive value. e Trim visible fat from meats and meat products. ■ Cook cereals and cereal grains according to cooking directions using the right amount of water. Then there is no need to rinse or drain the cereals or cereal grains after cooking. ■ Use seasonings sparingly. Ti ink of children's tastes and preferences. e Follow standardized recipes exactly. Measure and weigh ingredients precisely and follow procedures carefully. This includes using equipment, time, and temperature for cooking as specified in the recipe. USING RECIPES In these days of rising costs, it is important that sponsors stay within their budgets. Quantity recipes are a management tool that will help you control food and labor costs and provide a quality product. ► 25 • Serving Spoons You may use a se q spoon (solid or perforated) instead of a scoop. Since these spoons are not identifier number, you must measure or weigh the quantity of food from the various sizes of s ins you use in order to obtain the approximate serving size you need. You may want to keep a list of the amount of food each size spoon holds as an aid for the staff serving the food. Family -Style Service Family -style service presents unique2roblems that require sQe«al training for site personnel. Sitea- vonsorpersonnel ,cr- "illy monitor family -style service toer -!•re that the meals se Meet program rm*vj ., ind that fobd service employees re le the necessary tra;.nngltnis especia%uinir .....nt in family -style service to prr le aapppprropII ate serving tools that allow for t�proper portioning of food while minimizing i ad 8: Serving Guidelines Even when food is ready to serve, food service employees must continue their efforts to maintain food quality and avoid food contamination. Train employees to: ■ Maintain foods at correct mperatures before and during service. Hot foods must be hot and cold foods must cold until they are served. ■ Use suitable utensils to reauce food handling. Plastic gloves must be use when you serve food by hand ` ■ Serve meals as a unit with only o%meal served per child ■ Keep an accurate count of the number of children and adults you serve. Give careful attention to cleanup procedures following food preparation and service. If you use disposable ware (dishes, trays, utensils. ,. iasses, etc.) promptly and carefully remove the disposables from the site. If you use perma ,...t ware, you must make sure to sanitize them. Dishwashing Procedures Whether washing dishes by hand or by machine, the procedures are the same. They include, as a minimum, the following: ■ Scape and pre -rinse befo.. washing. ■ Wash with detergent solution in hot water (100 °F to 120 °F if washing by hand: 140 °F if washing by machine). ► 28 . MEAL SERVICE Portion Control To be reimbursed under the program you must serve each meal as a unit, whether food is served cafeteria or family style. This means that each meal must contain all of the required food items in the proper amounts. Serving utensils that measure foods while they are being served are useful in meeting these requirements (for instance, a #16 scoop makes a 1/4- cup serving). Food service employees should be trained to recognize proper portion sizes. As a guide in portioning servings, you can use a sample plate containing the proper amounts of food in an appealing arrangement. You =n use the sample meal not only as a training tool but also as a visual reminder to the staff on the serving line. Measures for Portion Control Scoops, ladles, and serving spoons of standard sizes provide dependable measures and help serve food quickly. These are approximate measures. Scoops - The number of the scoop indicates the number of scoopfuls required to make 1 quart. The following table shows the level measure of each scoop in cups or tablespoons: Scoop No. revel Measure 6 2/3 cup 8 1/2 cup 10 3/8 cup 12 1/3 cup 16 1/4 cup 20 3-1/3 tablespoons 24 2.2/3 tablespoons 30 2 tablespoons 40 1-2/3 tablespoons You may use scoops for portioning such foods as drop cookies, muffins, meat patties, and some vegetables and salads. Ladles You may use ladles to serve soups, stews, sauces, and other similar products. The following sizes of ladles are most frequently used for serving meals: Number on Ladle Approximate Measure 1 fluid ounce................................1/8 cup 2 ounces........................................1/4 cup 4 ounces........................................1/2 cup 6 ounces.......................................3/4 cup 8 ounces........................................1 cop 12 ounces.......................................1-1/2 cups ► 27 4 ■ Wipe up spilled food immediately; properly sanitize all food preparation and service areas. - Food Safety Food workers can help prevent food contamination and can keep harmful bacteria out of food by following these rules: ■ Keep hot food hot at a holding temperature of 140 °F or above. Serve within 2 hours. ■ Keep cold foods refrigerated or chilled foods at 40 OF or lower unt;. served ■ Keep frozen foods4ma freezer registc , 0 °F or low e- • Cook meats such as beef, pork, poultry, and fish to proper internal temperatures. Use a meat thermometer when roasting meats. Juices should run clear and meat should not be pink. ■ Do not partially cook food one day and complete cooking the nex, day. Maintain a constant tempi ure; never set the oven lower than 325 *F. ■ Prepare sandwiches and salads with a minimum amount of handling. Use plastic gloves. ■ Promptly refrigerate or freeze leftovers. Divide large quantities into smaller containers or use shallow pans, for quick cooling. Reheat leftovers to at least 165°F. ■ When transporting perishable foods, maintain proper holding temperatures. Keep hot foods hot and cold foods cold ■ Thaw poultry and meat in a refrigerator. Use thawed roasts, steaks, and chops within 3 to 5 days. Use T wed ground beef and poultyy within 1 to 2 days. Use frankfurters, ham slices, and IL .eon meats within 3 to 5 days. Refreeze only if ice crystals are still present. ■ Remember USDA's 2-Hour Rule: NEVER LEAVE FOOD OUT AT ROOM TEMPERATURE FOR MORE THAN 2 HOURS. There is no need to bring foods to room temperature before cooking or rebigemdng. ■ Marinate food in the refrigerator, NOT at room temperature. ■ Remember that you cannot always determine food spoilage by sight, taste, odor, or smell. If there is any doubt, throw the food away. Safety of Equipment Tra:a food service employees on the safe use of all types of equipment. ■ Follow instructions exactly on how to use and clean kitchen equipment. ■ Keep a fire extinguisher and first -aid kit handy and instruct all personnel in their use. ,rk . n Rinse with clear, hot water. e Sanitize with a- final rinse of at least 180 °F or a final rinse containing a chemical sanitizing agent. ■ Air dry on a clean dish table. e Store in a clean area, protected from contamination. Cleaning Schedule In addition to the cleanup of disposable or permanent ware, you must properly clean and sanitize food service facilities (equipment, floors, etc.). A cleaning schedule should be part of the overall work schedule to assure that the site is cleaned regularly. FOOD SANITATION AND SAMY Sanitation Sanitation is one of the most important aspects of good food service. Follow these rules: e Meet health standards set by State and local health authorities. n Wash hands thoroughly with soap and hot water before bandling food or utensils. Repeat after each visit to the restroom. o Use disposable plastic gloves, as required by local health codes. Use gloves for only one task and throw away. n Keep hands off face and hair. ■ Wear clean uniforms and hair restraints. ■ Food service workers with open cuts, sores, colds, or other communicable diseases should not prepare or serve food ® Wash hands and sanitize utensils, cutting boards, and work surfaces thoroughly after contact with raw eggs, fish, meats, and poultry. Sanitize between use for raw and cooked, if separate equipment is not available. e Properly clean and sanitize serving and cooking utensils, and equipment,. n Handle serving utensils and plates without touching the eating surface. n Thoroughly rinse all fresh fruits and vegetables before cooking or serving. e Empty garbage cans daily. They should be kept tightly covered and thoroughly cleaned. Use plastic or paper liners. ►294 Foods Containing Iron: Meat and Meat Alte"wes Meats: Beef Liver Liverwurst Turkey dark meat Fish: Shellfish Trout Dry beans and peas: Black-eyed peas (cowpeas) Chickpeas (garbanzo beans) Kidney beans, red or white Lentils Soybeans Nuts and seeds: Pine netts Pumpkin seeds Squash seeds Whole -grain, enriched, or fortified bread or bread alternates, such as: Bagel, plain, pumpernickel, or whole-wheat Farina - Muffin, bran Noodles Oatmeal Pita Bread, plain or whole, a ..at Pretzel, soft Ready -to -eat cereals, fortified Rice, white Beans, lima Spinach Fruits Apricots, dried Prunes' Prune juice REFERENCES Foods Containing Vitamin A: Fruits Vegetables Apricots Broccoli Cantaloupe Carrots Mandarin Orange Sections Chard Mango Collards Melon balls (cantaloupe Endive and honeydew) Escarole Nectarines Kale Plums Mustard greens Watermelon Peas and Carrots Peppers, sweet, red Plantain ' Pumpkin Romaine Spinach Squash, winter Sweet potatoes Foods Containing Vitamin C: Fruits Vegetables Apples Apple juice* Bananas Blackberries Blueberries Cantaloupe Grapefruit Grapefruit juice Grapefruit -orange juice Grapefruit and orange sections Grape Juice* Honeydew melon Kiwifruit Mandarin orange sections Mangoes Nectarines * Contains added Vitamin C Oranges Orange juice Papaya Peaches Pears Pineapple Pineapple juice Pineapple - grapefruit juice Pineapple - orange juice Plums Pomegranates Raspberries Strawberries Tangelos Tangerines Watermelon is. ...+ Beans, yellow Beans, Lima Bean Sprouts Broccoli Cabbage Cauliflower Chickory Collards Endive Escarole Kale Kohlrabi Mustard greens Okra Onions Parsnips Tomatoes Tomato juice Tomato -Vegetable juice Turnip greens Peas Peppers Plantain Potatoes Pumpkin Radishes Snowpeas Spinach Squash Romaine Rutabagas Tomatoes Tomato juice Turnip greens Turnips Watercress ►31. Group B Crackers and Low Moisture Breads. A serving must weigh at least 20 grams (0.7 ounce). Batter and/or Breading Bread Sticks (dry) Chow Mein Noodles Graham Crackers Melba Toast Rye Wafer Rice Cakes, puffed Saltine Crackers Soda Crackers Taco/Tostada (whole and pieces) Toaster Pastry Crust (breakfast and snack only) Zwieback Note: You may serve cookies, granola bars, etc. a bread alternate in the snack if the primary in"edient is whole -grain enriched flour , :,real and minimum weight of a serving is 1-1/4 ounces (35 grams). USDA recommends Ulast cookies as a bread be served as part of a snack no more than twice a week. You cannot serve cookies as a bread alternate at breakfast, lunch, or supper. - Note: To determine a serving of batter/breadinr.. (minimum 20 grams or 0.7 ounce) 1.. Rely on Child Nutrition (CN) labels; or 2. Fi^-1 the percentage of batter/breading per serving from the processor. Multiply by -eight of serving (multiply ounces by 2835 to convert to grams, if desired);or 3. Remove the cooked b; *ter/breadiar from a serving v ,d weigh. (Multiply ounces by 2835 to convert v, mmts, u aesired.) Group C Miscellaneous items. A serving must weigh at least 30 grams (1.1 ounces). Pancakes i ushpPuppies Sopapillas Meat/Meat Alternate Spoonbread Pie Crust Tamales Meat/Meat Alternate Tortillas Turnover Crust Woes Note: Cookies, Granola BAM etc. (Snack only)-1 serving = 35 grams. Full -Strength Fruit and Vegetable Juices: The following is a list of full-strength fruit and vegetable juices that may be served in the Summer Food Service Program. Apple Pineapple Grape Prune Grapefruit Tangerine Grapefruit -Orange Tomato Orange Vegetable Any blend or combination of the above full-strength juices is acceptable. Bread And Bread Alternates: The following listing of bread and bread alternates is divided into four groups. All the items in the four groups have approximately the same nutrient content. All breads and bread alternates must be whole -grain or enriched. Items within each group have approximately the same total solid content and grain content. The minimum weights given for each group are based on the grain content of the product only (exclusive of fillings, toppings, etc.). Children younger than 6 years should receive one-half of the serving sizes listed below. Group A Breads, Rolls, and Quick breads. A serving of an item in group A must weigh at least 25 grams (0.9 ounce). Bagels French, Vienna, or Biscuits Italian Bread Boston Brown Bread Muffins Breads, sliced, all Pizza C rust types (white, rye, Pretzels (soft) whole wheat, raisin, Roils and Buns quick breads, etc.) Stuffing, Bread Coffee Cake (breakfast (weights apply and snack only) to the bread Cornbread in the stuffing) Corn Dog Batter and Breading Sweet Roils and Croissants Sweet Buns Doughnuts (breakfast (breakfast and and snack only) snack only) Egg Roll/Won Ton Wrappers Pita Bread English Muffins (' ••• • A VA�:-•�• to Food Item On Site Food Inventory Record Name of Site Inventory PeFl Beginning I=mntory. Purchase Unit (i.e., Ibs,. cans, cases, etc.) Unit* Cost (X) Quatity ud— (a) Value of food on hand To obtain Food Oust for Mmith Total Value of Beginning Lwm*ory S Food on Hand $ Food Pease + (Closing Inventory *-) Closing Inventory Cost of Food Used a *Use invoice to determine the unit cost per item and total food P=Chases for the reporting period. **Ihe closing inventory for one month becomes the Beginning Irrventcry for the next month. .z4. Group D Pasta, rice and other cereal grains. A serving of an item in group D is 1/2 cup of the cooked product, except for ready -to -eat cereal (breakfast or snack only). The serving size for ready -to -eat cereal is 3/4 cup or 1 ounce, whichever is less. Barley Breakfast Cereals, cold dry or cooked (breakfast and snack only) Bulgur Corn Grits Millet Lasagne Noodles Macaroni, Spaghetti and assorted pasta shapes Noodles (egg) Ravioli Pasta Rice Note: When any cereal grain is used as an ingredient in a bread or bread alternate, use the serving size given for the appropriate bread group. For example, a serving of oatmeal bread should weigh 25 grams (Group A). Some of the above foods, or their accompaniments, may contain more sugar, salt, or fat than others. Keep this in mind when considering how often to serve them. D. 35 4 D l �f ♦ ' /I / i / size and Courit Servim Size* and Yield Mmify U.S. 01 carrots with I stick is 4 inches 1-118 inch nMUy{ a =i -+ 1cnq x 1/2 inch wide six per .• Specify f Y- 7 •qnabout pamds. or .1 5-5 .0 q .. - •' v i! _ .f.fir :,{1 stick is 3 inches . u crate, Crates.,• 1cnq and 3/4 inch Wide • • pmuds net. 4 sticks � r q� • u - �7�r � !t! f Slices Sticks lettuce, (Iceberg) IettL=e f isaf SSi9tlfiiiS6Yi uis �G1L�7�YOy�.L•il/�wiiU be stamped of the basket. Oxmznbws will vary trod 2 to 2-1/2 inches in diameter and are about 7-1/2 inches long. 1/8-inch thick slices 4 slices - 1/4 czr, Cut in thirds C=,.<: m and then each third iVzz friths lengthwise foe: sticks .;H= weight 18 Pounds Olives, Rips large Pickles, Dill $mci,=y larva size 4 to 4-3/4 inches long, 22 to 39 count per goon Sweet ,amifv small size. 2-3/4 to 3-1/2 iinrihes lcng, 52 to 99 count per gallca 1 cuannber - 12 sticks 2 sticks - 1/4 cup 1 pike - 1/4 cup 1 laws leaf - 1/4 cup 8 olives - 1/4 cup 1/2 pickle - 1/4 cup I pickle - 1/4 cup Radishes Specify O.S. *1. 1/2 inch 7 radishes - 1/4 cup diameter minimm, without taps, small size, 45 radishes per pearl. .. - =11-0 Fbod Item On Site Food inventory Naar d Name of site �G%ram s LiDcrfy CsM�++w•�y G�-{ir inventory Period Tw l Begjl=dng D;;; ory"rex?. ad te unitCoat (i.e., Iha, cans, cases, etc.) ( Quatity on heel ( ! on hand EPNy --0- /a Ch"4) AO/ (o -CAW yy _. A 91 q. To Obtain Food Coat for Month Total. Vale. of 0 Food on Hmnd Food Purchase +fie (Closing Ire / *) �• Cloain3 Inventory - iajA. Coat of Food Used = a2L. 4T *Use invoices to determine the unit Coat per item and total load purchmea for the reporting period. **The closing imw tosy for one month beoomm the Buji ming inventory for the next month. ►37• Medium size fruit (size 70 and 1 nectarine - about 1/2 cup 72). Approximately 3 per pound. Oranges Specify size 138 or 113 (Calif. or Ariz) or size 125 (Fla. or 1 orange - about 3/4 cup Peaches Sbeci y size 84 (2-1/8 inches peach - about 1/2 cup diamet.,=-bmc my state 2 to 2-1/4 ind:es diauee r). Approx. 3-1/2 to 4 peaches s pound. Medium size fruit (size 60 to 64) 1 peach - about 3/4 pup 2-1/2 inches diameter or larger. App=. 3 per pound. Pears Specify size 150 (2-1/4 to 2-3/8 1 pear w about 1/2 cup Medium size_ fruit (Size 120) 1 pear m about 3/4 sip Approximately 3 per pound. Plums Specify size 4 x 5. About 8-' 2 plume - about 1/2 cup plums per pound. Medium size fruit (Size 4 x ' 2 places w.aboht 3/4 cup 6-7 plums per pound. Raisins Specify hulk purchase or individual. Yield of Bulk: cqy 1-1/2 ounces each 2-2/3 ounces - about 1/2 CUP Yield of Individual package: 1 paccage (1-1/2 ounces) - about 1/4 sup of fruit. Tangerine Specify size 176. Fruit will. 1 tangerine = about 1/2 sup average 2-3/8 incises in diameter. Pour tangerines per pound. watermelm ,Specify averwe size. Mehra Yield of melon: will average about 27 pounds. 1/ 64 wedcra - about 1/2 pup Specify y.4rt cup CM*Ainer. X 3 inches in diameter, per pound. • • • Specifysize 185-195 .1 lareper. apple cup ApprMdMtely diameter. apples tional pack, 150 per case. 7hreft to four bananas I Specify U.S. 01. Sold in pints. =r 1/2 cup measure U.S. 01., Kininn 1/2 cup measure diameterSpecify quarts and pints. Specify p 5-1/2 inches diameter, pp 1-2/3 pounds per malon. grapes +. cup Seedless grapes cup Smcify size 96, (2 to 2-1/8 1 nectarine about 1/2 diameter) Appreodmately 14 rJ ►39. , Food Production Record Directions: Food service personnel must complete the Food Production RecordJAChAgy and sponsors must maintain this record in their files for a minimum of 3 years. This provides an auditable record that verifies that the meals and snacks served meet the meal or snack requirements and, therefore, qualify for reimbursement. Item No. INST11UMON 1. 'Name of the site. 2. Write the calendar date this menu is served, showing month, day, and year. 3. Record all menu items you serve on this date in the appropriate section. 4. Enter the name of each food used to meet meal or snack requirements. For example, with a menu item like beef pot pie, the foods that meet the meal requirements at lunch or supper are as follows: stew beef fulfills the meat/meat alternate requirement; potatoes and carrots in the pie meet part of the fruit/vegetable requirement; and the pie crust meets part or all of the bread/bread alternate requirement. Additional food items used in the meals may also be listed. 5. Enter quantity of each ingredient or food used in each meal to meet the meal requirements. Use weights, measures, or number. For example, list stew beef, 10 Ibs, potatoes, 3 lbs; etc. 6. Enter the portion or serving size of each menu item you serve (5-ounce serving of pie, 1/2 cup juice, etc.). Sett^—!z sizes can be shown in measures (such as cup measures, scoop size, ladle sus :,, weight, or number (such as number of apples). 7. Enter the number of children served at each meal or snack. 8. Enter the number of program adults served at each meal or snack. 9. Enter the total number of persons served at each meal and/or snack. While SFSP sponsors are reimbursed only for meals served to participating children, at sponsor discretion adults working in the food service operation (program adults) may be allowed to eat meals. If these adults are served meals, production records must reflect the amount of food used to prepare meals for children and program adults. *Any serving size may be planned. For simplicity, this table of serving sizes and yields for vegetables and fruits Provides 1/4 cup servings of vegetables and 1/2 cup and/or 3/4'cup servings of fruits. Note: Riere sizes are specified for fruits, they indicate numbers of fruit in box. The lard the Mbar, the smaller the fruit. Any fruit that is larger than that specified may be used. ►414 Food Production Record wgs I.J. Ita Corwwuni!� Cenks Name of Site ) Date 1 ! 1(2) ONSITE FOOD PRODUCTION RECORD Menu, Foods Used Quantity Site Number Served Used Serving Children Program Total Adults (3) (6) (7) (a) (9) 'PcotAes 4 /0 ew 'h emp !!D s 19S ?84,A Curt Con+.4rclS So Re¢"w �/: wp Ault Iss-A p" t voyt 001/ srrvto N Ya�•bu►c��r iist� Pat * sl 47 is oa aur. so � 3 Fr&WA *44 Fyn f A cup Z41 '�, L50 de#vda Ord GEWC& r46 t�7 3 ZSO -lowwaacs '%w+�t�4 i (y emp L47 3 Z50 It.yc. 2so- A perh Yt pa+ Z*7 7nfa P,w sappb- JA 82 OL e �. r 0 9 s JN1LAr jue" OL its w au��e k��M COIlL11eM'11� qs I 8s � •'35 AZV& ar&Lb Food Production Record .a3• Form 160611•92 "exas DeW rnent .f Human Services SUMMER FOOD SERVICE PROGRAM APPLICATION FOR PARTICIPATION tional sheets If needed; NOTE: Give ie se Identify each attachment with the acme of the tach lcontracting organization. SECTION I —SPONSOR INFORMATION City of Denton Mailing Address (Street or PIO. 321 E. McKinne Street Address Of different) Name of Administrator Brenda Burton A. Contractor Classification: City. State, ztrt Denton, Texas ❑ National Youth Sports Program ❑School Food Authority 76201 OHS STAFF ❑ Breakfast ❑ A.M. Supp. []Lunch P.M. ID No. Telepnom No. (include r1_Inn? I (8171_566—E Children's Pro ❑ Residential/Nonresidential Summer Camp ❑ Private Non-profit 0 Unit of Government —Contractor certifies that all food service sites are operated directly by the contractor. No B. Is your program a year-round program? ............................... Yes ❑ C. Type of Contractor: 0 I E tit lain)• 14..., ..F T)_nh r Pub, c n y (exp Is your agency considered to be state owned/operated? ...................................... © N/A No ❑ Yes Yes © No Do you deposit your program reimbursement directly into the State Treasury?,,,,,,,,,,,,,,,, ❑ ❑ Do you deposit your program reimbursement directly into a local bank? .......................... ©N/A Yes ❑ No ❑ Private Nonprofit Organization —Tax-exempt status established. Attach letter of determinatlon (IRS 501.30) of tax-exempt status from IRS D. Does the organization provide an ongoing year-round service to the community that is to be X❑ Yes ❑ No served by the Summer Food Service Program (SFSP)? ............................ If no, which of the following circumstances applies? ❑ Residential camp ❑Serves migrant children ❑ Failure to operate would deny program to a poor area ❑ Failure to operate would deny a significant number of children access to program E.,,. Does the organization receive $100,000 or more in federal funds yearly? .................................. ❑ Yes ❑ No 2. Does the organization receive more than $25,000 but less than 5100,000 in federal funds yearly? ..:.......... . ❑ Yes © No 3. Attach a copy of the audit covering last year's program operation or documentation that an audit conforming with SFSP policy will be conducted, including the date it will be conducted. SECTION II —Budget A. Estimate all SFSP costs which will be claimed for reimbursement for the month with the most operating days: 1. ESTIMATED OPERATIONAL COSTS MONTHLY COSTS Program Labor I $ 2,690.38 Fringe Benefit Food 19,050 Non-fOOd SJ [las 1 nnD Utilities Rent Equipment Use Fee Rental of Equipment Rate per mite Transportation 29C 174 Omer (spedly): Omer (specify): Omer (specify): TOTAL I: 23,184.38 Form 15 1 Page Y• ESTIMATED'ADMINISTRATIVE COSTS MONTHLY I COSTS Administrative labor (management, monitor, clerical) $1, 207. 47 Fringe Benefits Rental of Office Space Office Supplies 150 Office Building Maintenance Equipment Use Fee Audit fees Legal Fees Rate per mile Transportation 29p 116 Other (specify): Telephone 100 Omer (specify): TOTAL2: 1,573.47 B. Indicate projected income to the food service from all sources other than SFSP reimbursement. Identify exactly the costs this incom will cover: - Source of Income None I $mount Will De used for. Source of Income I Amount I Will be used for. SECTION III —MANAGEMENT PLAN A. List administrative level personnel who will be responsible for management and monitoring of the SFSP. (Do not include site sups visors, cooks, janitors or other personnel involved in on -site food sarvica.) TITLE OF POSITION I NUMBER IN POSITIONSPECIFIC FOOD SERVICE PROGRAM DUTIES Director 1 Conducts training session, monitor sites, prepare reports, coordinates food services Coordinator I 1 Assists Director,with duties Form 150 Page 3. If the contracting organization is sponsoring a camp or other enrollment program that charges separately for meals, the contractinc organization has read Attachment B to this application, "Additional Assurances For Camps And Other Enrollment Programs That Charcc Separately For Meals", and -assures the DHS that all requirements have been or will be met. S. Public Release (SFSP Handbook, Chapter 11, page 22) 1. The contracting organization will make efforts to ensure that the local news media will make a public announcement of the prograr, and will supply them with a news release: If the contracting organization is sponsoring a camp or other enrollment program, this release must contain, at a minimum, a list o all approved sites, a list of the current standards for determining free and reduced price eligibility, and the following statement: "The (Name of the contracting organization) announces the sponsorship of the Summer Food Service Program. Income eligibility will be based on family size and Income using the Standards for Determining Free and Reduced -Price Eligibili• ty, provided by the United States Department of Agriculture. Meals will be provided at the site(s) listed. People who are eligible to participate In the program must not be dler_.rtminated against because of race, -co!or, n3t!onal origin, Sex, agc, dwablll:r, relig!en. or political belief. Anyone who believes that they have been discriminated against should write Immediately to: Director, Clvi Rights Division, MC E-609, Texas Department of Human Services, P.O. Box 149030, Austin, Texas 78714-9030 or the Secretary of Agriculture, Washington, D.C. 20250. NOTE: Discrimination complaints based on religion or political beliefs must be referred only to the Director, Civil Rights Division, Texas Department of Human Services." For all other programs the announcement must contain, at a minimum, a list of all approved sites and the following statement "The (Name of the contracting ow,,,;ralion) announces the sponsorship of the Summer Food Service Program. Meals will be provided at the site(s) listed. People who are eligible to participate in the program must not be discriminated against because of race, color, national origin, sex, age, disability, religion, or political belief. Anyone who believes that they have been discriminated against should write Immediately to: Director, Civil Rights Division, MC E-609, Texas Department of Human Serv. Ices, P.O. Box 149030, Austin, Texas 78714.9030 or the Secretary of Agriculture, Washington, D.C. 20250. NOTE: Discrimina- tion complaints based on religion or political beliefs must be referred only to the Director, Civil Rights Division, Texas Depart• ment of HumanServices." 2. This public release was or will be published in the following news media outlet(s): NAME OF MEDIA OUTLET DATE OF RELEASE Denton Record Chronicle 5/2/94 Dallas Morning News 5/2/94 UNT Daily 5/2/94 NAME OF MEDIA OUTLET DATE OF RELEASE TWU Student Paper 5/2/94 KENT Radio 5/2/94 KNTU Radio 5/2/94 3. Attach a copy of the contracting organization's public release statement as submitted to the news media and any other materials used to publicize the program's availability and nondiscrimination requirements. SECTION VI —CERTIFICATION (see Form 1506, Attachment C) ! certify that the Information on this application Is true and correct to the best of my knowledge. I certify that reimbursement will ra° clpic,eel only for approved meals served to eligible e)hildren during the hours they are in attendance at approved sites. I know misregy!!sentation or y✓l;Xholding ofjn atlon.may result In prosecution under applicable state and federal statutes. la zantracr iation Date Name (pease type or print) Title Llovd Harrell I Citv Manaeer FOR DHS USE ONLY ❑APPROVED ❑DENIED If denied, reason: Approved for Food Distribution .+L Date ❑ Yes ❑ No 7 It yes, give date Forth 1608 sent to FOD: rue Date Form 1606 Page 3 B. Are children charged separately for meals? ...................... ....... ...:.................. .......... ❑ Yes %❑ No If yes, see Form 1508, Attachment-B. C. Do you want to receive advance payments?.....................................•....................... ❑ Yes %❑ No If yes, 1.For Operational Costs?..................................................................... ❑ Yes ❑ No 2. For Administrative Costs? ..................................................... . ............. ❑ es o Y ❑N D. If meals service is self -preparation, do you want to receive commodities? .................................... ❑R Yes ❑ No If yes, Form 1608, Application and Agreement for Commodities must be completed. SECTION IV —PROGRAM OPERATION A.I. Beginning and Ending Dates of Meat Service: From, June 6, 1994 through August 12, 1994 2.Number of sites: ............................................................................. B. List dates and topics of SFSP training: DATES TOPICS 6/1/94 Site supervisor and monitor training on S.F.S.P. guidelines C. Is the organization planning to contract with a food service management company for the preparation of unitized meals? ..................................... : ............................... ❑ Yes KI No If yes, and the contract will exceed $10,000, attach a copy of the invitation to bid. Also give: Date of Bid Publication Place of Publication Date of Sid Opening rime of Bid Opening Is bid exoecled to be $100,1100 or morel �11 yes, give piece of bid opening: - ❑ Yes ❑ No Also, attach a copy of an 11-day-cycle menu including all specific menus to be used. D. Is organization contracting with a year-round food service management company? ............................. []Yes © No If yes, submit a copy of your procurement procedures, bid, contract, and all amendments. E. Attach a copy of the letter which has been (or will be) sent by the organization to the Health Department notifying them of intent to operate a Food Service Program at the she(s) indicated on the attached She information sheet (Form 1507). SECTION V—ASSURANCES A. Free Meal Policy Statement 1. The contracting organization assures the Texas Department of Human Services (OHS) that all Children at the sites described on the Site(s) Information Sheets for the Summer Food Service Program, will be offered the same meals with no physical segregation of, or other discrimination against, any child because of race, color, disability, age, sex, national origin, religion, or political beliefs. No separate charge will be made for any meal except in accordance with attachment B of this application. 2. The contracting organization assures DHS that, if it is sponsoring camps or other enrollment programs,: • The contracting organization has or will obtain family size and income data about all children whose meals will be reported as free or reduced -price; and • The children claimed as tree or reduced -price meet the current family size and income standards set by the United States Deparmer.: of Agriculture, OHS Forth 4504, Standards for determining Free and Reduced -price Eligibility. yr CITY of DENTON, TEXAS MUNICIPAL BUILDING / 215 E. McKINNEY / DENTON, TEXAS 76201 Name Of Person Name Of Site Visited Date Of Visit Who Visited Site Civic Center Park March 29, 1994 Brenda Burton Phoenix Park March 29, 1994 Brenda Burton Owsley Neighborhood March 29, 1994 Brenda Burton Denis, Park March 29, 1994 Brenda Burton MLK Recreation Center March 29, 1994 Brenda Burton TWU Clubhouse March 29, 1994 Brenda Burton Village East Apts March 29, 1994 Brenda Burton Ginnings Elementary March 29, 1994 Brenda Burton School Borman Elementary March 29, 1994 Brenda Burton School Signature of Authorized Representative 19q Date 8171566-8200 O/FW METRO 434.2529 summer Food service Program Sack LunchggMenus El ! Day Cycle Monday - June 6 Peanut Butter/Jelly Sandwich Carrot Sticks Banana Lowfat Milk Tuesday - June 7 Bologna/Cheese Sandwich Carrot Coins Mixed Fruit Potato Chips Lowfat Milk Wednesday - June 8 Tuna Salad Sandwich Pickle Spears Orange Juice Lowfat Milk Thursday - June 9 Ham/Cheese Sandwich Whole Pickle Fruit Cup Cookie Lowfat Milk Friday - June 10 Deli Sandwich Pickle/Carrot Apple Lowfat Milk 2 oz Peanut Butter, 1 T. Jelly, 2 slices Bread 1/4 cup 1/2 cup 1/2 pint 1 1/2 oz Bologna, 1/2 oz Cheese 2 slices Bread 1/4 cup 1/2 cup 1/2 pint 2 oz Tuna 2 slices Bread 1/4 cup 6 oz 1/2 pint 1 1/2 oz Ham, 1/2 oz Cheese 2 slices Bread 1/4 cup 1/2 cup 1/2 pint 2 oz Meat 2 slices Bread 1/4 cup 1/2 cup 1/2 pint Mondav - June 13 Peanut Butter/Jelly Sandwich Carrot Sticks Banana Lowfat Milk Tuesdav - June 14 Deli Sandwich Pickle/Carrot Apple Lowfat Milk Wednesday - June 15 Tuna Salad Sandwich Pickle Spears Orange Juice Lowfat Milk Thursday - June 16 Ham/Cheese Sandwich Whole Pickle Fruit Cup Cookie Lowfat Milk Friday - June 17 Bologna/Cheese Sandwich Carrot Coins Mixed Fruit Potato Chips Lowfat Milk Monday - June 20 Deli Sandwich Pickle/Carrot Apple Lowfat Milk 2 oz Peanut Butter, 1 T. Jelly 2 slices Bread 1/4 cup 1/2 cup 1/2 pint 2 oz Meat 2 slices Bread 1/4 cup 1/2 cup 1/2 pint 2,oz Tuna 2 slices Bread 1/4 cup 6 oz 1/2 pint 1 1/2 oz Ham, 1/2 oz cheese 2 slices Bread 1/4 cup 1/2 cup 1/2 pint 1 1/2 oz Bologna, 1/2 oz Cheese 2 slices Bread 1/4 cup 1/2 cup 1/2 pint 2 oz Meat 2 slices Bread 1/4 cup 1/2 cup 1/2 pint CITY of DENTON, TEXAS MUNICIPAL BUILDING / 215 E. McKINNEY / DENTON, TEXAS 76201 May 1, 1994 Ms. Laurie Callahan, Registered Sanitarian Environmental Health Department 300 Woodrow Denton, Texas 76205 Dear Ms. Callahan, The Denton Parks and Recreation Department is applying to the Texas Department of Human Services for a grant to provide the Summer Food Service Program to the children of Denton. This program will provide lunch for children ages 1 - 18 years of age. The food preparation will be contracted with the Denton Independent School District. We request that your department inspect the facility locations of food service. Time of Site/Address Dates Lunch Service Civic Center Park 6/6/94- 8/12/94 12:00 p.m.- 1:00 p.m. 321 E. McKinney Phoenix Park 6/6/94- 8/12/94 12:00 p.m.- 1:00 p.m. Wood Street Owsley Neighborhood 6/6/94- 8/12/94 12:00 p.m.- 1:00 p.m. Stella Street Denia Park 6/6/94- 8/12/94 12:00 p.m.- 1:00 p.m. 1001 Parvin MLK Recreation Center 6/6/94-8/12/94 12:00 P.M. - 1:00 P.M. Bradshaw at E. Prairie TWU Clubhouse 6/6/94- 8/12/94 12:00 p.m.- 1:00 p.m. Mary Hufford Court Village East Apts. 6/6/94- 8/12/94 12:00 p.m.- 1:00 p.m. 1700 Village East 8171566-8200 D/FW METRO 434-2529 Borman Elem School 6/6/94 - 7/1/94 11:45 a.m.- 12:45 p.m. 1201 Parvin Ginnings Elem School 6/6/94 - 7/1/94 11:45 a.m.- 12:45 p.m. 820 Sun valley If you, have any questions I may be reached at 566-8125. i Brenda Burton Children's Programs Supervisor CITY o/ DENTON, TEXAS MUNICIPAL BUILDING / 215 E. McKINNEY / DENTON, TEXAS 76201 The Denton Parks and Recreation Department announces the sponsorship of the Summer Food Service Program. Children one year through eighteen years of age may participate. Income eligibility will be based on family size and income using the Standards for Determining Free and Reduced -Price Eligibility, provided by the United States Department of Agriculture. Meals will be provided at the sites listed. People who are eligible, to participate in the program must not be discriminated against because of race, color, national origin, sex, age, disability, religion, or political belief. Anyone who believes that they have been discriminated against should write immediately to: Director, Civil Rights Division, MC E-609, Texas Department of Human Services, P.O. Box 149030, Austin, Texas 78714-9030 or the Secretary of Agriculture, Washington, D.C. 20250. Note: Discrimination complaints based on religion or political beliefs must be referred only to the Director, Civil Rights Division; Texas Department of Human Services. Date Site June 6-July 1 Borman Elementary June 6-July 1 Ginnings Elementary June 6-Aug10 Village East Apts. 1201 Parvin 820 Sun Valley 1700 Village East Time 11:45 am-12:45 pm 11:45 am-12:45 pm 12:00 pm-1:00 pm %Y I` 8171566-8200 D/FW METRO 434-2529 CITY of OENTON, TEXAS MUNICIPAL BUILDING / 215 E. McKINNEY / DENTON, TEXAS 76201 The Denton Parks and Recreation Department announces the sponsorship of the Summer Food Service Program. Children one year through eighteen years of age may participate. Income eligibility will be based on family size and income using the Standards for Determining Free and Reduced -Price Eligibility, provided by the United States Department of Agriculture. Meals will be provided at the sites listed. People who are eligible to participate in the program must not be discriminated against because of race, color, national origin, sex, age, disability, religion, or political belief. Anyone who believes that they have been discriminated against should write immediately to: Director, Civil Rights Division, MC E-609, Texas Department of Human Services, P.O. Box 149030, Austin, Texas 78714-9030 or the Secretary of Agriculture, Washington, D.C. 20250. Note: Discrimination complaints based on religion or political beliefs must be referred only to the Director, Civil Rights Division, Texas Department of Human Services. Data Sitr, Address June 6-Aug 10 Civic Center Park 321 E. McKinney June 6-Aug 10 Denia Park 1001 Parvin June 6-Aug 10Owsley Neighborhood Stella St. June 6-Aug 10 Phoenix Apartments 308 Ruddell June 6-Aug 10TWU Clubhouse Mary Hufford Ct. June 6-Aug 10MLK Recreation Ctr. 1300 Wilson Time a2:00 pm-1:00 pm 12:00 pm-1:00 pm 12:00 pm-1:00 pm 12:00 pm-1:00 pm 12:00 pm-1:00 pm 12:00 pm-1:00 pm 8171566.8200 D/FW METRO 434-2529 Form 1506I Attachment A Page 2 B. Are there any policies or practices that result in unequal treatment in the delivery of benefits or services to participants, applicants, or employees according to disability? ................................. ❑ Yes %❑ No If Yes, explain: C. Does the contracting organization employ 15 or more people? ......................................... X❑ Yes ❑ No If Yes: 1. Enter the name and title of the coordinator who will work with DHS to ensure that Section 504 requirements are met. Name Tiae Brenda Burton Children's Programs Supervisor 2. Has the organization established grievance procedures that incorporate appropriate due process standards?..................................................................... 7 Yes ❑ No If yes, do these procedures provide for the prompt and equitable resolution of complaints that allege an action prohibited by Section 504 of the Rehabilitation Act of 1973? ................. ® Yes ❑ No 3. Has the contracting organization informed the public of the right to file a complaint and of the filing procedure?.................................................................. ElYes ❑ No If yes, briefly describe how the public was informed: There are posters and flyers posted through- out the City of Denton which acknowledges the City's compliance with the guidelines set by.the EEOC, ADA, and the Civil Rights Act. These posters give instructions for filing a formal complaint. D. Has the organizaton taken steps to notify employees, participants, and applicants that the organization does not discriminate on the basis of disability? ......................... 6 .............. 6 ............ 0 Yes ❑ No If yes, do the people notified include those with impaired vision or hearing and members of unions or professional organizations holding collective bargaining or professional agreements with the contracting organization? ........... 0 Yes ❑ No If yes, briefly describe how they are notified: The visually or hearing impaired are notified thro radio and television advertisement. Also flyers, announcements, etc. are mailed periodically to groups and organizations througbout the City. E. Do all organization fors, publications, and recruitment materials which inform the public of program benefits and employment opportunities contain the assurance that the organizationdoes not discriminate on the basis of disability?: ❑ Yes ❑ No If no, indicate steps being taken to comply with this requirement: F. Does the organization have a procedure to ensure that the remedial or corrective action has been or will be taken if noncompliance with non discrimination requirements is found by DHS, USDA, or the contracting Yes 0 ❑ organization itself?.............................................................................. No It yes, explain: If not handled within the department in question, the City generally channels all complaints through the Legal Department. Form 150a/Attachment A Texas Deparfinem January 1990 of Human services SUMMER FOOD SERVICE PROGRAM FOR CHILDREN CIVIL RIGHTS QUESTIONNAIRE I. CIVIL RIGHTS ACT OF 1964 A. t. Estimate, by racial/ethnic group, the number of children that will participate in the program at each site. It the program consists _._. _ ...k,, m ..H OH.nn by eifn and date of session: of several camp Sesmuna, apow,r ,� r•-,-_.__ .._...__ _. _ , SITE AMERICAN ALASKAN ABIAN/ PACIFIC BLACK HISPANIC WHITE (name of site, school, Camp, ate.) INDIAN NATIVE ISLANDER Orman Elementary School 25 75 '25 Ginnin s ElementarySchool 1 Owsley Neighborhood 10 10 20 10 TWU Clubhouse Program 10 10 10 Denia Park 10 10 20 Phoenix Park Civic Center Park 10 10 3u MLK Recreation Center 50 15 10 Village East Apartments 50 50 25 2. Describe howthis projection was made (i.e., based on comparative enrollment in sites, observation of students, student surnames, etc. Observation of neighborhoods S. Does the organization have specific membership requirements which result in the denial of Q No program benefits to specific groups?............................................................... Yes If yes, describe those requirements: C. What efforts will be made by the organization to contact minority and grass roots organizations about the opportunity to participate in the program? Posters displayed in neighborhoods, attend community meetings and public service announcements D. What other outreach stops will be taken by the organization to ensure that minorities in the area from which it draws its attendance will have an equal opportunity to participate in the program? S.F.S.P. information will be printed in Spanish E. Has any federal agency notified the organization of non-compliance with the Civil Rights act of 1964? .............. ❑ Yes 7 No If yes, give details including dates, names, and results: II. REHABILITATION ACT OF 1973 (Section 504) A. Does the contracting organization have any policies, practices, or architectural barriers that limit, deny, or % discourage participation in the program or employment by the contracting organization because of disability? ........ Yes No It yes, explain: SUMMER'FOOD SERVICE PROGRAM FOR CHILDREN Form 1506/As1achmaPavege a COLLECTION OF PAYMENT OPTIONS 2 FOR PROGRAMS THAT CHARGE SEPARATELY FOR MEALS (Camps and Other Enrollment Programs Only) COLLECTION PROCEDURE 1) Each day, children can buy tickets in the food service manager's office, but they do not receive the tickets. The food ser• vice manager sends the purchased tickets and tickets for free meal recipients to the site each day. The site supervisor distributes the tickets just before meal time. The tickets are coded for accounting purposes. COLLECTION PROCEDURE 2 Each day, children pay for their meals in an office. A list with the names of all children who paid or are eligible for free meals is prepared and sent to the meal service area. A staff member who knows the children checks the names as children Pass through the line or otherwise receive their meal. After the service of the meal, the list is returned to the office for accounting purposes. This method works only in a small site where the staff member knows all the children. COLLECTION PROCEDURE 3 The site supervisor gives each child an envelope for daily, weekly, session or monthly payments. Children return the envel• opes with the payments enclosed, or empty if eligible for free meals. The envelopes are collected in the office and coded tickets are issued to each child, COLLECTION PROCEDURE 4 Parents pay in advance by the month or session. Each site supervisor receives a list of those children who have paid. The site Supervisor marks the list as paid for children who receive free meals. Only the bookkeeper knows which children receive a free meal. The site supervisor keeps daily records of each child served and sends the records to the office for ac• counting purposes. COLLECTION PROCEDURE 5 Meal payments are collected in the office. Payments can be made by children or parents on a daily, weekly, session or monthly basis. The secretary records payments and knows which children qualify for free meals. At the sites, the secretary distributes identical tickets labeled only with the children's names. Since the parents may make payments, even children who receive free meals may not know whether their meals are free or paid. COLLECTION PROCEDURE 6 Parents are hly or y ting childrentreceive at coded 6cketseach monthfor paid , wehichals Kistpunchedchildren at each meaPare served. se vrice.ts mAt the ail in le d of them nith,athle tpa. c kets are collected and a clerk calculates the amount to be billed. COLLECTION PROCEDURE 7 Other: Explain in detail (attach a sheet if more space is required). The contractor must ensure that this method prevents the overt identification of children receiving free meals. Form 1506/Attachment B SUMMER FOOD SERVICE PROGRAM FOR CHILDREN January 1990 ADDITIONAL ASSURANCES FOR CAMPS AND OTHER ENROLLMENT PROGRAMS THAT CHARGE SEPARATELY FOR MEALS As required in Section V of this application, the contracting organization assures the Texas Department of Human Services that: 1. The method of collecting meal payments will protect the anonymity of children who receive free meals: 2. The organization has or will establish a hearing procedure for families wishing to appeal a denial of an application for free meals, which provides the following: A. That a simple, publicly announced method will be used for a family to make an oral or written request for a hearing; B. That the family will have the opportunity to be assisted or represented by an attorney or other person; C. That the family will have an opportunity to examine the documents and records supporting the decision being appealed both before and during the hearing; D. That the hearing will be reasonably prompt and convenient for the family; E. That adequate notice will be given to the family of the time and place of the hearing; F. That the family will have an opportunity to present oral or documentary evidence and arguments supporting its position. G. That the family will have an opportunity to question or refute any testimony or other evidence and to confront and cross- examine any adverse witnesses; H. That the hearing will be conducted and the decision made by a hearing official who did not participate in the action being appealed; 1. That the decision will be based on the documentary evidence presented at the hearing and made part of,the record; J. That the family and any designated representative will be notified in writing of the decision; k. That a written record will be prepared for each hearing, whieh.includes the action being appealed, any documentary evidence and a summary of oral testimony presented at the hearing, the decision and the reasons for the decision, and a copy of the notice sent to the family; and L That the written record will be maintained for a period of three years and 90 days following the conclusion of the hear- ing, during which it will be available for examination by the family or its representatives, and officials of the Texas De- partment of Human Services (TDHS), the United States Department of Agriculture and other relevant officials as deter- mined by TDHS at any reasonable time and place. 3. If a family requests a hearing, the children) will continue to receive free meals until a decision is rendered. Form 1506, Attachment C Texas Department February 1991 of Human Services SUMMER FOOD SERVICE PROGRAM FOR CHILDREN CRIMINAL PROVISIONS AND PENALTIES 1. Whoever, in, connection with any application, procurement, record keeping entry, claim for reimbursement, or other document or statement made in connection with the program, knowingly and willfully falsifies, conceals or covers up by any trick, scheme, or device a. material fact, or makes any false, fictitious or fraudulent statements or whoever In connection with the program knowingly makes an opportunity for any person to defraud the United States or does or omits to do any act with intent to enable any person to defraud the United States, shall be fined not more than S10,000 or Imprisoned not more than five years. 2. Whoever being a partner, officer, director, or managing agent connected In any capacity with any partner- ship, association, cooperation, business, or organization, either public or private, embezzles, misapplies, steals, or obtains by fraud, false statement or forgery, any benefits provided by the program, or any money, funds, assets, or property derived from benefits provided by this program, shall be fines not more than S10,000 or imprisoned for not more than five years or both. If the benefits, money, funds, assets, or property involved is not over S200, then the penalty shall be a fine of not more than $1,000 or imprisonment for not more than one year, or both. 3. If two or more persons conspire or collude to accomplish any act made unlawful under this subsection, and one or more such person commit any act to effect the object of conspiracy or collusion, each shall be fined not more than S10,000 or imprisoned for not more than five years, or both. TERMINATION PROCEDURES The following list of deficiencies are grounds for termination. Grounds for termination, however, are not limited to this list: 1. Non-compliance with applicable bid procedures and contract requirements of Federal Child Nutrition regulations. 2. The submission of false Information to the Texas Department of Human Services (DHS). 3. Program violations at a significant proportion of the sponsors' sites. Such violations include but are not limited to the following: A. Non-compliance with the meal service time restrictions. B. Failure to maintain accurate records. C. Failures to adjust meal orders to conform to the variations in the number of participating chiidrem. D. The simultaneous service of more than one meal to any child. E. Service of a significant number of meals which do not include required quantities of all meal components. F. The claiming o'f program payments for meals not served to participating children. G. Excessive instances of off -site meal consumption. H. Continued use of food service management companies that are in violation of health codes. SUMMER FOOD SERVICE PROGRAM OFFERED ONLY IN THE SUMMER OF 1994 To Parents and Participants: The Denton Parks and Recreation Department is happy to announce that we will be sponsoring the Summer Food Service Program which is funded by a grant from the U.S. Department of Agriculture. The program will provide free lunch for children 1-18 years of age. Lunches will be distributed Monday -Friday from 12 p.m. -1:00 p.m. All children in attendance will be offered the same free meal with no physical segregation of, or other discrimination against any child because of race, color, handicap, sex, age, or national origin. This program will operate only during the summer of 1994 and will end on August 12, 1994. If you have any questions or concerns please call 566-8125. Thank you for your participation! Denton Parks and Recreation Department Texas Department of Human Services Form 4508 July 1990 CERTIFICATE OF AUTHORITY This,is to certify that Name of Authorized Official (please type or print) Title Brenda Burton I Children's Programs Supervisor Signature —Authorized Official Is designated as the authorized representative of Name of Contracting Organization City of Denton Address (street, City. State, ZIP) 321 E. McKinney Denton, Texas 76201 The representative designated above is authorized on behalf of the contracting organization to make written agree- ments with the Texas Department of Human Services to operate a food progra , to sign documents or reports about the agreemen;FZMV'/Z/519(C?q_ for reimbursement, when appropri to the department. Si nature —Official of Contracting Agency Date Name of Official (please type or print) TI e Lloyd Harrell City Manager FOR DEPARTMENT OF HUMAN SERVICES USE ONLY: cement No. - I Received By I Date TX_ _ _ Texas Department pe,,,, 4. of Human Services July tt CERTIFICATE OF AUTHORITY This is to certify that Name of Authorized Official (please type or print Title Lloyd Harrell I City Manager 43ignature— 11thonzed Official . is designated as the authorized repre ntative of Name of Contracting Organization City of Denton' Address (Street. City, State, ZIP) 321 E. McKinney Denton, Texas 76201 The representative designated above Is authorized on behalf of the contracting organization to make written agree• ments with the Texas Department of Human Services to operate a food program, to sign documents or reports about the agreement, and to present claims for reimbursement, when appropr te, to the department. Signature —Official of Contracting Agen7 Date Name of officialpease type or poop rtle Lloyd Harrell City Manager FOR DEPARTMENT OF HUMAN SERVICES USE ONLY: Agreement No. Received By Date TX- Tests Department Form 4 of Human Services July CERTIFICATE OF AUTHORITY This Is to certify that Name of Autnonzeo Official (please type or print) Title Tim Button S.F.S.P. Coordinator Signs re —Authorized Official, is designated as the authorized representative of Name of Contradmg Organization City of Denton Adoress (Street. City, State, ZIP) 321 E. McKinney Denton, Texas 76201 The representative designated above is authorized on behalf of the cc ments with the Texas Department of Human Services to operate a food the agreement, and to present claims for reimbursement, when Vpl ing organization to make written agree - am, to sign documents or reports about le, to the department. S19(9( Date Name of Official (please type or print) - _ T Is Lloyd Harrell I City Manager FOR DEPARTMENT OF HUMAN SERVICES USE ONLY: Texas Department of Human Services SUMMER FOOD SERVICE PROGRAM APPLICATION AND AGREEMENT FOR RECEIPT OF USDA COMMODITIES Form legs January 1992 Name of Applicant Agency! Telephone No. City of Denton (817) 566-8125 Address (Street, city, State, ZIP) - county 321 E. McKinney Denton Texas 76201 Denton Mailing Address (if different) Contact Person (for commodity infomution) Telephone No. Period of Operation of Food Service (mo.1daylyr.—mo./day/yr.) Joyce Robinson #(817),382-2546 From 6/6/94 through 8/19/94 APPOINTMENT OF THE AUTHORIZED REPRESENTATIVE —The off Wall who signs this form must appoint an authorized representa- tive. The official may name himself as the authorized representative, If he chooses to serve in that capacity. The authorized represen- tative is given full responsibility for all matters pertinent to the receipt, handling, storage, protection, accountability, and use of USDA -donated commodities, and the maintenance of all required records and reports pertaining to the commodities. Name of Authorized Representative Job Title Telephone No. Brenda Burton Childrents Programs Supervisor 817 566-8125 Mailing Address Of different from agency address) I certify that i have read the agreement on the back of this form and that my signature below acknowledges this agency's responsibll- Ity to comply with all of the terms and conditions of that agreement. This agreement shall be In effect for no longer than one year. It may be extended at both parties' option for two additional one-year periods. If extended, the applicant must update all pertinent Information and must demonstrate that all donated food received during the prior contract period has been accounted for. The agreement may be terminated for cause by either party upon 30 days written notice. The officlal who signs this Application and Agreement assumes full respo Ility for complla a with the to and conditions list- ed In the agreementrZ , 5 9�gLl aigruture—Agenry Official Date Title I Vendor lD No. Te bhone No. 817 1 566-8125 TO BE COMPLETED BY DHS - MEAL SERVICE INFORMATION i JUNE JULY AUGUST No. Days Mealy WIII Be Served Average Daily Attendance Total Meals To Be Served This Month No. Days Meals will Be Served Average Daily Attendance Total Meals To Be Solved This Month No. Days Meals will Be Served Average - Daily Attendance Total Meals To Be Served This Month Breakfast AM Supplement Lunch PM Supplement Supper Agreement No, Amt. of Entitlement Effective Dates of Agreemant From: To: Checked By: Date Pa AGREEMENT THE APPLICANT FOR USDA -DONATED COMMODITIES AGREES: 1. To abide by the instructions and regulations issued by DHS and USDA for storing, handling, and using commodities. 2. To use commodities only to benefit people served in the applicant's established food services operation. 3. To request and accept commodities only in amounts that will be properly stored and fully utilized. ' 4. To not sell, trade, or dispose of commodities, including commercial processing of commodities into different and products, without DHS' approval. 5. To provide adequate facilities and personnel to handle, store, protect, and use commodities. 6. To allow DHS and USDA to inspect, at any reasonable time, the commodities in storage and the facilities used for han. dling and storing commodities. 7. To pay the assessments levied by DHS to meet the administrative expenses of the program as provided by state law. 8. To accurately maintain all necessary records, including the application and agreement forms; receipts and freight bills; notices of availability, arrival and issuance of donated foods; Forms 506, Inventory control sheets; financial and support. ing documents; statistical records; and any other records pertinent to the services for which a claim was submitted, for 3 years and 90 days after the contract period ended, orfor 3 years after the end of the federal fiscal year in which services were provided if this contract has no specific termination date. If any litigation, claim or audit involving these records be- gins before the 3 year period expires, the contractor must keep the records for not less than 3 years and 90 days and until all litigation, claims or audit findings are resolved. The case is considered resolved when there is a final order issued In litigation, or when DHS and the contractor enter Into a written agreement. The contractor will keep records of non - expandable property acquired under the contract for 3 years after the final disposition of the property. Contract period means the beginning date through the ending date specified in the original agreement/contract; extensions are consi. dered to be separate contract periods. 9. To comply with the requirements of the Immigration Reform and Control Act of 1986 regarding employment verification and retention of verification forts for any individuals hired after November 6, 1986, who will perform any labor or services under this contract. 10. To comply with the instructions and regulations issued by DHS for conducting financial and compliance audits. 11. To reimburse DHS, according to DHS' procedures, for any Improper distribution or use of donated food, or for any loss of, or damage to, donated foods caused by the applicant's fault or negligence. 12. That any misuse of donated foods may cause them to be disqualified from program participation, and that reinstatement is at DHS' option. 13. That any embezzlement, misuse, theft, or obtainment by fraud of donated foods or donated food -related funds, assets, or property, shall cause the applicant to be subject to Federal criminal prosecution. 14. Civil Rights (a) To comply with Title VI of the Civil Rights Act of 1964 (Public Law 88.352), Section 504 of the Rehabilitation Act of 1973 (Public Law 93.112). The Americans with Disabilities Act of 1990 (Public Law 101.336), and all amendments to each, and all requirements imposed -by tharagulatiorts issued-pumuantto.these acts. In addition, the contractor agrees to comply with Title 40, Chapter 73, of the Texas Administrative Code. These provide in part that no persons in the United States shall, on the grounds of race, color, national origin, sex, age, disability, political beliefs or religion be excluded from participation in, or denied, any aid, care, service or other benefits provided by federal and/or state funding, or otherwise be subjected to discrimination. (b) To comply with Texas Revised Civil Statutes Article 4419b-4, Sections 5.03 and 5.04 (relating to workplace and con• fidentiality guidelines regarding AIDS and HIV). (c) To compile date, maintain records, and submit reports as required, to permit effective enforcement of the above Acts and permit authorized DHS personnel during normal working hours to review such records, books and accounts as needed to ascertain compliance with the above Acts. If there are any violations of this assurance, DHS and USDA have the right to seek judicial enforcement of this assurance. This assurance Is binding on the Contractor, its succes- sors, transferees, and assignees as long as it receives assistance; or retains possession of anyassistance from DHS. The person whose signature appears on this contract is authorized to sign this assurance on the behalf of the Contractor. The above assurances are given in consideration of and for the purpose of obtaining any and all federal financial as- sistance, grants and loans of ledpral funds, reimbursable expenditures, grant or donation of federal property, and interest In property, the detail of federal personnel, the sale and lease of, and the permission to use, federal property or Interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration which is reduced for the purposes of assisting the recipient, or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with federal financial assistance extend- ed to the program applicant by DHS. This includes any federal agreement, arrangement, or other contract which has as one of its purposes the provision of cash assistance extended in reliance of the representation and agreements made In this assurance. SUMMER FOOD SERVICE PROGRAM OFFERED ONLY IN THE SUMMER OF 1994 To Parents and Participants: The Denton Parks and Recreation Department is happy to announce that we will be sponsoring the Summer Food Service Program which is funded by a grant from the U.S. Department of Agriculture. The program will provide free lunch for children 1-18 years of age. Lunches will be distributed Monday -Friday from 12 p.m. - 1:00 p.m. All children in attendance will be offered the same free meal with no physical segregation of, or other discrimination against any child because of race, color, handicap, sex, age, or national origin. This program will operate only during the summer of 1994 and will end on August 12, 1994 If you have any questions or concerns please call 566-8125. Thank you for your participation! Denton Parks and Recreation Department Form 1589 - SPECIAL NUTRITION PROGRAMS SINGLE AUDIT IDENTIFICATION DATA Cena.emr Nrn. e.nmr v...en . City of Denton Brenda Burton Adam liopr a i.0. X.a. Cm. ben, and T.LON.n. Ne. 321 E. McKinney 817 566-8125 Denton, Texas 7*6201 061-1002 II Cenv.ot Ne. - - I CenVwrer F.e.l Vor FM Imm/adM'1 _ _ .. __ . II Check the appropriate. space indicating whether contract Is_ For -profit _ Non-profit XGovernmental f%1 .6 a,e hnY snecifvino aroaram tvoe: COMMODITY ASSISTANCE CASH REIMBURSEMENT A National School Lunch AD Adult Day Care B Charitable Institutions BL Breakfast/Lunch C Area Agency on Aging CC CACFP Center G Summer Camps DH . CACFP Day Home X H Summer Food Service SF Summer Food J Jails SM Special Milk K Soup Kitchen TE TEFAP I TEFAP Commodities Indicate the source and amount of federal financial assistance: SOURCE see attached Signafure rof Person ComplZnager Form Lloyd Harrell, City Name, Title (Please print or type) 5 9 Y Date AMOUNT HUB CERTIFICATION APPLICATION NON-PROFIT ORGANIZATIONS A Non -Profit Historically Underutilized Business is a non-profit organization in which at least 51 percent of the governing board are by definition, one or more persons who are socially disadvantaged because of their identification as members of the following groups why have suffered the effects of discriminatory practices or similar insidious circumstances over which they have no control: Black, Hispanic Asian Pacific, American Indian, Woman or Persons with Disabilities. Currently the Texas Departagnt of Human Services is the oni State Agency that recognizes persons with disabilities as a HUB class. Correa completion of this application will place your organization on a HUB vendor listing which is accessed by Texas State Agencie for procurement opportunities. 1. IDENTIFICATION NUMBER ❑ n ❑ ❑ n n ❑ ❑ ❑ AV1m Do --.- : A-1 - « p of ar-ber. PLEASE INDICATE THE TYPE OF NUMBER YOU ARE PROVIDING: ❑ Social Security Number (9 digits) ❑ Federal Employer Identification Number (9 digits) 2. INFORMATION ABOUT THE ORGANIZATION: Name, Address (to which bid requests are to be mailed), telephone and county ORGANIZATION NAME STREET ADDRESS OR P.O. BOX TX CITY AND ZIP ❑❑❑-❑❑❑-❑❑❑❑ T TELEPHONE (Area Code and Number) COUNTY 3. Members of Board: List all members of governing board and provide requested information on each, as appropriate. (Sex; Ethnicity - Anglo (A), Black (B), Hispanic.", Asian Pacific (AP), American Indian (An; Disabled - yes/no). NAME TITLE SEX ETHNICITY DISABLED ❑ M ❑ F ❑ Y ❑ N ❑ M ❑ F ❑ Y ❑ N ❑ M ❑ F ❑ Y ❑ N ❑ M ❑ F ❑ F ❑ N May 19� 4. If bidding all geographic areas check ❑ . If bidding only certain geographic area numbers, circle appropriate number(s). 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 5. Is your organization located in an enterprise zone? (An enterprise zone is an industrial district that receives a tax benefit.) ❑ Yes ❑ No ❑ Unknown 6. ❑ Please send me information on how to get on the General Services Commission central bidders mailing list. An annual fee required for all individuals and organizations listed on the central bidders mailing list. 7. Comments: 8. I, the undersigned certify, under penalty of law, that the above and foregoing information is a full, true and correct statement of tl• facts and that intentional misrepresentation of fact is subject to prosecution. SIGNATURE - AUTHORIZED PERSON DATE PLEASE RECHECK THIS APPLICATION TO ENSURE YOUR RESPONSE OR ENTRY ON EACH ITEM. RETURN COMPLETED FORM TO ADDRESS SHOWN BELOW. FOR STATE AGENCY USE ONLY: Agency Number Agency Representative Commodity Code of Contractor: Class Item No.(s) Description Class Item No.(s) Description Class Item No.(s) Description } Map used to determine area in Question 4 HIGHWAY DISTRICT MAP 4 ICI- JI r r r. r. r l a r w r r �. I� _ _ r r 3 r •- - r 10 .r • r. r� M - 24 •- -• .. .� ,� r 9 r �J 6 7 20r r r _ 15 DISTRICT 22 r IS DELETED-- CLASS 948 21 25 28 32 42 1 F. 52 64 68 72 HEALTH -RELATED SERVICES" (not Human Services - See Class 952) Item Number and Comawdity Consulting Services _ Counseling Management Services Dental Services Dietician Services Health Care Management Services Hosoitalixati©n Services Infant Mortality Reduction Initiative Services Nursing Services Optician and Optometrical Services (not M.D.) Pharmaceutical Services Item Number and Commodity 74 Professional Medical Services (including General Practice and All Specialities) 76 Psychologists and Psychological Services 86 Therapy Services 90 Training (Seminars) Services (fcz Public Health) 92 Training (Seminars) Services (for Social Services) 99 Services Not Otherwise Classified ""See Art. 664-4, V.T.C.S., "Professional Services Procurement Act", and Art. 6252-11C, V.T.C.S., "Use of•Pri.vate Consultants by State Agencies", for special categories of Professional Personnel Services not included in this Class 948. 05 06 10 15 17 18 20 21 25 2S 30 32 36 37 39 42 43 45 47 49 51 CLASS 952 HUMAN SERVICES Item Number and Cc®modity Alcohol and Drug Detoxification Services Alcohol and Drug Prevention Services Barber and Beautician Services Case Management Services Child Abuse Prevention Services Child Care Food Program Services Correctional Services Counseling Services Day Care Services Day Care Training Consortium Delivered Meals Services Domicile Care Services Emergency Food Services Emergency Shelter Services Employment Generating Activities Services Family Planning Services Family and Social Services .Food Stamps and Coupons Services Foster Home Services Halfway Housing Services Head Start Program Services Item Number and Commodity 53 Home Management Services 54 Homemaker Services 60 Job Search Workshop Services 64 Mortuary and Funeral Services 67 Parenting Intervention Services 71 Rape and Sexual Assualt Prevention Services 74 Referral Services 75 Refugee Assistance Services 78~ 'Safe Housing Services 80 Senior Aides Program Services 83 Summer Youth Program Services 84 Supplemental Food Services 85 Support Services 88 Teenage Pregnacy Services 90 Training and Instruction Services (for Clients; not Staff - See Class 924) 91 Transitional Domicile Services 92 Transitional Living Services 93 Try -out Employment Services 95 Youth Care Services 99 Services Not Otherwise Classified 159 SUMMER FOOD SERVICE PROGRAM AGREEMENT STATE OF TEXAS § The the Nat referred OF TRAVIS § Department of Human Services, hereinafter referred to as TDHS, AND CITY OF DENTON referred to as the contractor, do hereby make and enter into this contract, as required by ial School Lunch Act (Section 13) and the Summer Food Service Program, hereafter as the SFSP, Federal Regulations (7 Code of Federal Regulations [CFR), Part 225). I. MUTUAL AGREEMENTS The Parties mutually agree: A. It the contractor fails to provide services in accordance with the provisions of this contract, the Department may, upon written notice of default to the contractor, immediately terminate the whole or any part of this, contract and refuse to pay claims for reimbursement. Such termination and/or refusal to pay claims for reimbursement shall not be exclusive remedy but additionall be in to any other rights and remedies provided by law or under this contract. B. If federal and state laws or other requirements are amended or judicially interpreted so that the continued fulfillment of this contract, on the part of either party, is substantially unreasonable or impossible, or if the parties are unable to agree upon any amendment which I therefore be needed to enable the substantial continuation of the services contemplated uy this contract, then the parties shall be discharged from any further obligations created nder the terms of this contract, except for the equitable settlement of the respective accrued interest or obligations, including audit findings, incurred up to the date of termination. C, This contract may be canceled by mutual consent. However, if such mutual consent cannot be attained, then and in that event, either party to this contract may consider it to be canceled Without cause by giving thirty (30) days notice in writing to the other party and this contract f Shall thereupon be canceled upon the expiration of such thirty (30) day period. Nothing in this paragraph shall be construed to prohibit immediate cancellation pursuant to above oarasraohs A and/or B. II. VI. CERTIFICATIONS A. Immigration Reform and Control Act of 1986 - The contractor agrees to comply with the requirements of the Immigration Reform and Control Act of 1986 .regarding employment verification and retention of verification forms for any individuals hired after November 6, 1986, who will perform any labor or services under this contract. B. Regarding Debarment, Suspension, Ineligibility, or Voluntarily Exclusion For Covered Contracts - The contractor certifies, by execution of this agreement, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating in this contract by any federal department or agency or by the State of Texas. By making this certification the contractor agrees to the following terms: 1. The above certification is a material representation of fact upon which reliance was placed when this contract was entered into. If it is later determined that the contractor knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Department of Health and Human Services, United States Department of Agriculture or other federal department or agency, or the Texas Department of Human Services may pursue available remedies, including suspension and/or debarment. 2. The contractor shall provide immediate written notice to the person to which this certification is submitted if at any time the contractor learns that the certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. The words "covered contract," "debarred," "suspended," "ineligible," "participant," "person," "principal," "proposal," and "voluntarily excluded," as used in this certification have meanings based upon materials in the Definitions and Coverage sections of federal rules implementing Executive Order 12549. Usage is as defined in the attachment. 4. The contractor agrees by submitting this certification that, should the proposed covered contract be entered into, it shall not knowingly enter into any subcontract with a person who is debarred, suspended, declared' ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Department of Health and Human Services, United States Department of Agriculture or other federal department or agency, and/or the Texas Department of Human Services, as applicable. 5. The contractor further agrees by submitting this certification that it will include TDHS Form 2046 titled "Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion for Covered Contracts" without modification, in all covered subcontracts and in solicitations for all. covered subcontracts. 6. A contractor may rely upon a certification of a subcontractor that is not debarred, suspended, ineligible, or voluntarily excluded from the covered contract, unless it knows that the certification is erroneous. A contractor must, at a minimum, obtain certifications from its covered subcontractors upon each subcontract's initiation and upon each renewal. VI. CERTIFICATIONS (continued) 7. Nothing contained in all the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this certification document. The knowledge and information of a contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 8. Except for contracts authorized under paragraph 4 of these terms, if a contractor in a covered contract knowingly enters into a covered subcontract with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, Department of Health and Human Services, United States Department of Agriculture, or other federal department or agency, as applicable, and/or the Texas Department of Human Services may pursue available remedies, including suspension and/or debarment. C. Regarding Federal Lobbying - This certification applies only to this contract and is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The contractor certifies, to the best of his or her knowledge and belief, that: 1. No federally appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, or the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2. If any funds other than federally appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer employee of any agency, a member of congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this federally funded contract, subcontract, subgrant, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. 3. The contractor shall require that the language of this certification be included in the award documents for all covered subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all covered subrecipients shall certify and disclose accordingly. The contractor certifies that all information submitted pursuant to this agreement Is true and correct. The contractor understands that the deliberate misrepresentation or withholding of information is a violation of this contract and may result in prosecution under applicable state and federal statutes. Non School Sponsors - Page 5 VII. EFFECTIVE DATE AND SIGNATURES For the faithful performance of the terms of this contract, the parties hereto in their capacities stated, affix their signatures and bind themselves. City of Denton Name of the Contracting Organization (Please Print or Type) of the contracting organization Lloyd Harrell Name of the authorized representative of the contracting organization (Please Print or Type) City Manager Title Please print or type, in the spaces provided above, the name and title of the authorized representative signing this agreement on behalf of the contracting organization. Effective Dates: Lo TEXASDEPARTMENT OF HUMAW ERVICES through Date: Revised February 1994 Non School Sponsors - Page 6 Teas DeDeronent of Human services SUMMER FOOD SERVICE PROGRAM FOR CHILDREN --FOR DHSUSE ONLY SITE INFORMATION -n(° %> �R r t Name of Faod Semce Site Telepnone No. Ima NC) Village East Apartments_ 817) 566-8125 Aotlrem of Site (seeeL City. State. ZIP) ' 1700 Village East Denton, Texas 76201 Penotl of Operation of F000 Serv,ce ( 'I IYler.-noJaayfyr)Number Of 0 May }June Juy Au0• Sept. 6/6/94 through: 8/12/94 orating Days j 19 20 10 ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp She Serving Primarily Migrant Children Other Site 1. Indicate Type of Site: ❑ A. (serving one to four meals) ❑ C. (serving one to four meals) x❑ E. (serving one to four meals) Nonesldentiai Camp She Serving Primarily Homeless Children ❑ S.(serving one to four meals) ❑ D. (serving one to tour meals) 2. List ALL Counties served by this site: Denton 3. A. Is your site open: ........................ ................... . .. ... .. . . ..... ...... ❑ Yes [EN B. Is your site enrolled? ........................... .. ............... ........ ..... .......................... _ Q Yes ❑ N C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced 100% price meals for the site (SFSP Handbook, Chapter II) ................... ... D. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: E. For enrolled sites, Form 1531 will be used to document eligibility. If the enrolled site used school data, list the school used to document the F. What is the percentage of free or reduced price meals for the sfte7 .................... ...:.. _ ................. 100% 4. Did the site participate in previous years' SFSP? (SFSP Handbook Chapter ff) --: a ..::........................... ❑Yes 0 Nc If Yes, give name of contracting organization, 5. Monitoring Plan (SFSP Handbook, Chapter III): Enter date of monitoring review to be conducted within: 8 June 72 - July 20, August 10 6. Meal Service Period Information (SFSP Handbook Chapter II): TYPES OF MEALS NUMBER OF ELIGIBLE CHILDREN TO BE SERVED• MEAL SERVICE TIME BEGINNING ENDING Breakfast ��. - A.M. Supplement Lunch 125 ( 12:00 p.m. 1:00 P.M. P.M. Supplement Supper •Tnu mlonnawn a mnvoerw ov OHS when semna me ecorovea meal semen ievel. (SFSP Hana000s. Cnai)W II) 7. Method of Food Preparation by Contracting Organization Handbook, Chapter II) Food Authority n Food Service Management Company (Includes All Year Form 1507/ jl 8. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook, Chap: ❑Cafeteria -style Children are Seated Children Line Up Meal Service ❑ and are Given Meals ® and Pick Up Meals ❑ Other. S. List site personnel who will be involved to any extent in the meal service. (SFSP Handbook, Chapter II): TITLE OF POSITION NO. IN POSITION SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Supervisor 1 Supervise and assist with distribution of meals, monitor and maintain meal temperature, stie clean—up, and other duties as assigned Site Helper/Server 2 Assist site supervisor 10. Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) 0 Indoor Meal Meal Service Service ❑ WIII Be Cancelled ❑ Other. 11. If the site feeds primarily homelwss children, what methods are used to ensure that money, food stamps, or in kind services are required. for meals? N/A 12. Are meals delivered to the she?..................................................................... LIYes IF YES, COMPLETE ITEMS 13, 14, & 15. IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. II): ® Site Personnel WIII Contact Administrative Site Personnel WIII Communicate Staff, Who WIII Contact Vendor ❑ Directly With Vendor 14, Will delivery be within one hour of the food service period? (SFSP Handbook, Chapter II) ..................... 2 Yes ❑ If no, describe arrangements within standards prescribed by local health authorities,for deliveryand holding of meals until time of servi 15. If there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter III): Stored in Refrigerator Thrown Away Returned to Vendor ® and Served the Next Day ❑ at the Site El for Disposal ❑ Other. iawinformation on this form I ue and correct to the best of my knowledge. I certify that this site has been visit apabill a d facilities fo a meal service planned for the number of children anticipated. I know that deliber: or with tlIng of In Ion may result in prosecution under applicable state and federal statutes. Name of Contracting Agency ' S 19 (City .of Denton 1W of Comracung Organ Ian Date Name of Of cam (Please type or City Manager FOR A E OHS LJJ PProved ❑ Denied; reason: USE ONLY TOIe &gnalure—DHS Repfesanubve Date Foirn 15071January 19 Texas Dsoarm»nt FOR DHSUSE ONLY of Hunnar, services SUMMER FOOD SERVICE PROGRAM FOR CHILDREN SITE INFORMATION "TX [IR 17t Telephone No. (inc. A/C) Name of Food Service Site Borman Elementary School 817 566-8125 Adarass of She (Street, Chy, State, ZIP) 1201 Parvin Denton, Texas 76201 PerwO of Opronof FooevicJMay AJune July Aug. Sept, ae NumbeA D From 6/6/94 through: 7/1/94 1 oratingUays: 1 r _ iv r i ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp SHe Serving Primarily Migrant Children Other Site 1. Indicate Type of Site: ❑ A (serving one to four meals) ❑ C. (serving one to four meals) Q E. (serving one to four meals) Nonesidential Camp She Serving Primarily Homeless Children ❑ B. (serving one to four meals) ❑ D. (serving one to four meals) 2. List ALL Counties served by this site: Denton 3. A. Is your site open: ................................................. .. * . .. ..... * ........... ...... ❑ Yes Q N B. Is your site enrolled? .............. ...... ............. ......... ........ ........... ............... I ....... I ®Yes E] N C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced 100% price meals for the site (SFSP Handbook, Chapter 11) .................... ... .............. . . D. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: E. For enrolled sites, Forth 1531 will be used to document eligibility. If the enrolled site used school data, list the school used to document the F. What is the percentage of free or reduced price meals for the site? ....................................... ..... 100% 4. Did the site participate in previous years' SFSP? (SFSP Handbook Chapter tlJ -::' ..::.... ................... . []Yes ©Nt If Yes, give name of contracting organization` 5. Monitorino Plan (SFSP Handbook, Chapter 111): Enter date of monitoring review to be conducted within: June 8 1 June 22 R. Meal Service Per.od Information (SFSP Handbook Chapter II): TYPES OF MEALS NUMBER OF ELIGIBLE CHILDREN TO BE SERVED, MEAL SERVICE TIME BEGINNING ENDING Breakfast A.M. Supplement Lunch 125 11:45 a.m. 12:45 p.m. P.M. Supplement Supper ..�_- ----- ----.......e.. ...a•i .....w mval. ISFFP NnmeeeK. CtlBnler In 7. Method of Food Preparation by Handbook, Chapter II) On Site ❑ Central Kitchen I ® Using School Food Authority U Food All Year Form 1507/P 8. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook, Chap: ❑Cafeteria -style Children are Seated Children Line Up Meal Service ❑ and are Given Meals ® and Pick Up Meals ❑ Other: S. List site personnel who will be involved to any extent in the meal service. (SFSP Handbook, Chapter II): TITLE OF POSITION NO. IN PosrrlON SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Supervisor 1 Supervise and assist with distributionof meals, monitor and maintain meal temperature, site clean—up, and other duties as assigned Site Helper/ Server 2 Assist site supervisor 10. Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) Indoor Meal Meal Service ® Service ❑ WIII Be Cancelled ❑ Other. 11. If the site feeds primarily homelwss children, what methods are used to ensure that money, food stamps, or in kind services are required for meals? N/A 12, Are meals delivered to the site?.....................................................................� Yes IF YES, COMPLETE ITEMS 13, 14, a 15. IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. il): r Site Personnel WIII Contact Administrative Site Personnel Will Communicate IJ Staff, Who WIII Contact Vendor ❑ Directly With Vendor 14. Will delivery be within one hour of the food service period? (SFSP Handbook, Chapter II) ..................... � Yes If no, describe arrangements within standards prescribed by local health authorities for delivery and holding of meals until time of servic'.. 15. If there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter III): Stored in Refrigerator Thrown Away Retumed to Vendor © and Served the Next Day ❑ at the Site ❑tor Disposal ❑ Other. 4 ERTIFY tha the informatlon on this form Is tr a and correct to the best of my knowledge. I certify that this site has been visit and that It h he capability enfaclilties formeal service planned forthe number of children anticipated. I know that delibermisrepres tion or with g of I o n may result in prosecution under applicable state and federal statutes. of Contracting Agency City of Denton ignalur aal of Comracun6 Orga,a tan Data Name of 0Mclel (please type FOR OHS L._JAppmved ❑Denied; USE . ONLY Title Dale City Manager 'etas Deparanent FOR'DHS US )I Human semms SUMMER FOOD SERVICE PROGRAM FOR CHILDREN SITE INFORMATION - Name of Food Service site I (817) 566-8125 atnnines Elementary School Address pt she (JII 04 �•.y, --I — r 820 Sun Valley Denton, Texas 76201 (mMay A June A Juty t, AUD. sepL Penotl of Operation of Footl Service oJtlayrymoJ r.-tlaylYrJ Number of OP- �t I) 19 I) 1 II) From 6/6/94 through: 7/1/94 eratingDays: y r i ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp Site Serving Primarily Migrant Children Other Site EX 1. Indicate Type of Site: ❑ A.(serving one to tour meals) ❑ C.(serving one to four meals) E. (serving one to four meals) Nonesidentlal Camp She Serving Primarily Homeless Children ❑ S.(serving one to four meals) ❑ D.(serving one to four meals) 2. List ALL counties served by this site: Denton N 3. A. Is your site open: ............. _........_ ❑Yes [ENO f ©Yes []No B. Is your site enrolled? ................................................................................ C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced 100% % price meals for the site (SFSP Handbook, Chapter II) .................... .. . D. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: E. For enrolled sites, Forth 1531 will be used to document eligibility. If the enrolled site used school data, list the school used to document the 100 % F. What is the percentage of free or reduced -price meals for the site? ................... ....... .. .. .. 4. Did the site participate In previous years' SFSP? (SFSP Handbook, Chapter II) .................. .................. ❑Yes No 5. 3 If Yes, give name of contracting Monitoring Plan (SFSP Handbook Chapter III): Enter date of monitoring review to De conoumuu witilm. 4 First Week of Operation 9. Rrst Four Weeks of Operation C. Additional Reviews June 8 1 June 22 Meal Service Yenoa mrormaaon tarar TYPES OF MEALS nanuuwn, t,„aP.=, NUMBER OF ELIGIBLE CHILDREN TO BE SERVED' ..r MEAL SERVICE TIME BEGINNING ENDING Breakfast A.M. Supplement, Lunch 40 11:45 a.m. 12:45 p.m. P.M. Supplement Supper 'Tnls Inlomlawn IS ,bnsa°eree Dy UnJ wren oem,ry u A y Wlv I',oa ^�••^•^ •• •-•• .-. _. .._.___ _._ -. 7. Method of Food Preparation by Contracting Organization (SFSP Handbook, Chapter II) On Site []Central Kitchen Using School Food Authority ❑ Food Service Manaaement Company (Includes All Year Form 1507fPage Z B. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook Chapter IF, Cafeteria -style Children are Seated Children Line Up ❑ Meal Service ❑ and are Given Meals ❑R and Pick Up Meals ❑ Other: 9. List site personnel who will be involved to any extent in the meal service. (SFSP Handbook, Chapter 11): TITLE OF, POSITION NO. IN PosrTIDN I SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Supervisor 1 Supervise and assist with distribution of meals, monitor and maintain meal temperature, site clean—up, and other duties as assigned Site Helper/Server 1 Assist site supervisor 10. Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) Indoor Meal Meal Service © Service ❑ WIII Be Cancelled ❑ Other. 11. If the site feeds primarily homelwss children, what methods are used to ensure that money, food stamps, or in kind services are not required for meals? A 12. Are meals delivered to the site?..................................................................... � Yes ❑ No IF YES, COMPLETE ITEMS 13, 14, & 15. IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. 11): Site Personnel WIII Contact Administrative Site Personnel Will Communicate ' © Staff, Who Will Contact Vendor ❑ Directly With Vendor 14. Will delivery be within one hour of the food service period? (SFSP Handbook, Chapter II) ..................... R❑ Yes ❑ No If no, describe arrangements within standards prescribed by local health authorities for delivery and holding of meals until time of service: 15. 11 there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter III): % Stored in Refrigerator Thrown Away Retumed to Vendor and Served the Next Day ❑ at the site ❑ for Disposal ❑ Other. I CERTIFY that the Information on this form rue and correct to the best of my knowledge. I certify that this site has been visited and that !t has capability and tacilitles he meal service planned for the number of children anticipated. I know that deliberate misrepresentor wit9hho I g of atlon may result In prosecution under applicable state and federal statutes. / I A Name of Contracting Agency (� 1 City of Denton Sig tine fficial of Comracting Orgaroation Date N2nle Ct UMClal (Please type or print) Title l Lloyd Harrell I City Manager FOR ❑Approved ❑Denied; "'IS use ONLY I Title Signature—DHS Rep,esentan,. Date Texas DepaMient of Humeri Services SUMMER FOOD SERVICE PROGRAM FOR CHILDREN FOR OHS ONLY SITE INFORMATION" �R Name of Foad Servwe Site 7elepnone No. (inc. AiC) Owsley Neighborhood (817) 566-8125 Address of She (Street, Cay. Slate, ZIP) Stella St. Denton, Texas 76201 Perron of Operaoonof Food Semca (=,Idaytyc-rtaJtlayryr.) eNr bar oI O Mey June Jury Aup. Sept From: 6/6/94 through: 8 12 r94 eratngDayso- 19 Y 20 10 ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp She Serving Primarily Migrant Children Other Site 1. Indicate Type of Site: ❑ A. (serving one to four meals) ❑ C. (serving one to four meals) ® E. (serving one to four meals) Nonesldential Camp She Serving Primarily Homeless Children ❑ B. (serving one to four meals) CID, (serving one to four meals) 2. List ALL Counties served by this site: Denton 3. A. Is your site open: ................... .. ... ..... . .... .. ... ..... ....... ......... ® Yes [IN B. Is your site enrolled?..................................................................................... Eyes [EN C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced 19% price meals for the site (SFSP Handbook, Chapter 11) ...... ............... _ _ ....... I ..... . D. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: N/A E. For enrolled sites, Form 1531 will be used to document eligibility. If the enrolled site used school data, list the school used to document the F. What is the percentage of free or reduced -price meals for the site? ............................................ 100% 4. Did the site participate in previous years' SFSP? (SFSP Handbook Chapter fly --:: � :..::.... :.......... ........... X❑Yes ❑ N If Yes, give name of contracting organization City of Denton 5. Monitoring Plan (SFSP Handbook, Chapter III): Enter date of monitoring review to be conducted within: A. First weak of Upernoon o. rum rout neeea ev{wmuun June 8 June 22 July 20, August 10 6. Meal Service Period Information (SFSP Handbook Chapter II): TYPES OF MEALS NUMBER OF ELIGIBLE CHILDREN TO BE SERVED' MEAL SERVICE TIME BEGINNING ENDING Breakfast-'. A.M. Supplement Lunch 50 12:00 p.m. 1:00 P.M. P.M. Supplement Supper ,...__—___..�_.... iccco -- aria,,,.. in 7. Method of Food Preparation by Contracting Organization (SFSP Handbook, Chapter II) 717reparaoon Vended n On Site n Central Kitchen I M Usino School Food Authority ❑ Food Service Management Company (Includes All Year Contracts) Ferro 15071P: '.. 8. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook, Chap; ❑Cafeteria -style Children are Seatedfx7 Children Line Up Meal Service ❑ and are Given Meals and Pick Up Meals ❑ Other: 9. List site personnel who will be Involved to any extent in the meal service. (SFSP Handbook, Chapter II): TITLE OF POSITION NO. IN POSITION SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Su erviosr 1 Supervise and assist with distribution of meal monitor and maintain meal temperature, site clean—up and other duties as assigned Site Hel er/Server 1 Assist site supervisor 10. Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) 0 Indoor Meal Meal Service Service ❑ WIII Be Cancelled ❑ Other. 11. If the site feeds primarily homelwss children, what methods are used to ensure that money, food stamps, or in kind services are required for meals? N/A 12. Are meals delivered to the site?..................................................................... LN Yes IF YES, COMPLETE ITEMS 13, 14, & 15, IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. II):', Site Personnel Will Contact Administrative Site Personnel WIII Communicate X Staff, Who Will Contact Vendor ❑ Directly With Vendor 14. Will delivery be within one hour of the food service period? (SFSP Handbook, Chapter 11) ..................... 0 Yes ❑ t If no, describe arrangements within standards prescribed by local health authorities for delivery and holding of meals until time of servic 15. If there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter III); Stored In Refrigerator Thrown Away Returned to Vendor © and Served the Next Day ❑ at the Site ❑ for Disposal ❑ Other. i CERTIFY that the Information on this form r Is ue and correct to the best of my knowledge. I certify that this site has been visit and that It h the capability and facilities fc a meal service planned for the number of children anticipated. I know that deflbe miss es tlon or wit h ding of of tion may result In prosecution under applicable state and federal statutes. Name of Contracting Agency 5 City of Denton gnat e--OfAtlal f Comnctin9 Organtiltton Date Name Of Oftitial (Please trn9 Or Llovd Harrell FOR FNs JApproved ❑Denied; reason: USE ONLY Title Signature —DNS Reprasenutive Date . A i O u gQ' Rg3a� A�+ N •w • ,Q O ■ 3 (pSM� 3 O w p s sS a WHY cxR��}Rw USA � � .1Oor oo N0 If $ .• �sR" � has^se ss s d K N 0 -O n ss` M o rc A r o x pRg b 0 ^pe � 7 qAr 8 V {{�� pp.. OO yNypp� N 1.WUp NWp �Wyp P+PVNR VOOOOOOOOPpO000NPONO00V �P N �N O OOOOPPP VVim�// pp..p y1N �y �y N Megrim IN mHNONNONONS N ONNj+OHO<O��CV v z;v NOV.(P.(wW Y Mail R;m : 00000 �000 /O.O Oy ONOi��1�:`:�����0 ri ^i�� Y •pj Spj waft� n l N+. 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VNV NN Y 1pU.NN � per. y� O O Oxa+�N NP VpVPOOV A �+Rb" S N o000NP0o++ ��. f Tows Deoarvnefu - of Human Servlus SUMMER FOOD SERVICE PROGRAM FOR CHILDREN :FOR IONS USE ONLY m SITE INFORMATION "7 "Q R ❑ I Temepnone No. (mu A/D) Name DI Food Service Site - TWU Clubhous Program 817 566-8125 Hufford Fenod of Oparseon of Food Semra (MJdaYn'r.�4dayA'rd Number of Op- may From 6/6/94 through 8/12 /94 orating Days: 19 20 10 ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp Site Serving Primarily Migrant Children Other Site 1. Indicate Type of Site: []A. (serving one to four meals) ❑ c.(serving one to four meals) E]E. ( one to tour meals) ) Nonesidential Camp She Serving Primarily Homeless Children ❑ B.(serving one to four meals) ❑ D.(serving one to four meals) 2. List All counties served by this site: Denton 3. A. Is your site open: .................... ............. .............. ............. ... .. I ... I ............ [E Yes El B. Is your site enrolled?...................................................................................... ❑Yes Q N C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced 19 % price meals for the site (SFSP Handbook Chapter II) ....................... ................. . D. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: E. For enrolled sites, Form 1531 will be used to document eligibility. If the enrolled site used school data, list the school used to document the 100% F. What is the percentage of free or reduced -price meals for the site? .................... ..... ............, 4. Did the site participate in previous years' SFSP? (SFSP Handbook Chapter tlr:'::::..:...... .................. ..... QYes ❑ Nf If Yes, give name of contracting organization* City of Denton 5. Monitorinq Plan (SFSP Handbook, Chapter III): Enter date of monitoring review to be conducted within: June 8 June 22 s. Meal Service Period Information (SFSP Handbook Chapter II): July 20, August 10 TYPES OF MEALS NUMBER OF ELIGIBLE CHILDREN TO BE SERVED' MEAL SERVICE TIME BEGINNING - ENDING Breakfast A.M. Supplement Lunch 30 12:00 p.m. 1:00 P.M. P.M. Supplement Supper -1 nu miormaaen a eorwdered Dy unb when semng ere appmD eo mean aar .e a,--�..�«,..�....- 7. Method of Food Preparation by Contracting Organization (SFSP Handbook, Chapter II) On Site 71 Central Kitchen 1 71 Using School Food Authority 0 Food Service Management Company (Includes All Year Form 15071P. 8. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook, Chap: ❑Cafeteria style Children are Seated Children Line Up Meal Service ❑ and are Given Meals © and Pick Up Meals ❑ Other: 9. List site personnel who will be involved to any extent in the meal service. (SFSP Handbook, Chapter II): TITLE OF POSITION NO. IN POSITION I SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Supervisor 1 Supervise and assist with distribution of meals, monitor and maintain meal temperature', site clean—up, and othe duties as assigned 10. Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) Indoor Meal Meal Service Service ❑ Will Be Cancelled ❑ Other. 11. If the site feeds primarily homelvess children, what methods are used to ensure that money, food stamps, or in kind services are required for meals? - N/A 12. Are meals delivered to the she?..................................................................... ® Yes ❑ IF YES, COMPLETE ITEMS 13, 10, 8, 15. IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. II): ©Site Personnel WIII Contact Administrative Site Personnel WIII Communicate Staff, Who WIII Contact Vendor ❑ Directly With Vendor C ' 14. Will delivery be within one hour of the food service period? (SFSP Handbook, Chapter II) ..................... Yes 't', If no, describe arrangements within standards prescribed by local health authorities for delivery and holding of meals until time of servi:'.. 15. If there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter III): ❑R Stored In Refrigerator Thrown Away Returned to Vendor and Served the Next Day ❑ at the Site ❑ for Disposal ❑Other. I CERTIFY the the informatlon on this form IsAle and correct to the best of my knowledge. I certify that this site has been visit and that It h the capablil 4anfacilities or a meal service planned for the number of children anticipated. I know that calibers misr res anon or with of inf on may result in prosecution under applicablestate and federal statutes. of Contracting Agency City of Denton 9nalure—OlncialofCamgani twn - Dais Name or Ott= (please type or pnng Title Llo d Harrell City Manager FOR DHS--Approved El Denied; reason: USE ONLY Title , S,gNlure—DHS Represenutive Date . t���= RA'" l; _; 0410002��� i;{ gyp=� RgAone a_ g ,np wa q°wVLQ »_'._-.».M �..,6 QQQ,.■ , ...cQnwwxQ �. ,��,�^r�'pip pi wMwM w0q°O'all a N �N w wite7 O»1Zw " .»..v ..i w low j O �y NpNp pyyp���� VV ..pp VV VV VV �y N NO MWPNN VO.O+NVV NOOOO 0 0000 NO ��O SAP NN T ee" let^ - eeI » ae• - ae; ee» �"� a7°°° " aka_4 a�aaxaga_'saka_,. „ „_ �� war' w�q q.'._ 3i�r %we° m fi=*4 • 7'.. 7'q w� 7'q 7'O' yO� c,ta A K� ins y1 b�b� � n, ; O O P O O p O O O+ O V O p N ONe V ] n Sc r: m < �A ppqp ..pp n eeO N P O O O O V O O O N OV O Nay Y1 P V N P J J N N O �1 O^� 'w 7 O >•7 � MNMNNVI VI A��i i �yC� �'N ■f OIc�S >•wtzg i,gop: n ■ 'I S y A ^_w» m ^4"yC�� 7M_7 iT w � y pp1 � PPO+SVVWK m » Aw T x M N �p .pV oy_ B pp.p pp 00 COZ ON O{MNN OWOO NONN � K OO OPOO WNO WP.O b R9Lyn�3»ii; � 6 w g w O N.p•+�j� O.OWNM 111 i.�io x�VVVw yy���i op8 M�N�0O ONd'O� � Nww�rw«xxxxwww�%"ix"' ���««nrn +++ 755NN N VNNONMw •� •V1N0 NOVNNOVNN V• N• 7 C�NO•.p�$$Y�BIMM•8�y8�yy��Y8Y1�y��y8y��y��t§8§ yY�•�� �01V•.NOI•�YN.O VMNNyIry•N.O V �•NN 1• N ON ++ +NNr� SyS +IV+• oeWn�u41PMv.o O�MV oo.Do�wo�iiiO7i COw� o r yPy��p+p.. ��yy y� yyp. yy��IIJJpp 1� VO OOWPVOWPMV+Op.W0O�PNPI•.NOpNP� 1R Ny �6+p .p p�Yi J•+ OOO p�0OOOpOpO�VOO.+OSVWVnOOC Imo+ if �,� VCj KS� a �:_ ^n +N R RZ H�+ N NONP NS P NM01 16 N •( n nnn� � wnnw�� „� r r ii iS 36 ti m N OWM N O COP I^•P+V A � VPVN .Y- P OWNW V+ p. pp.. 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O_ O T 00000t00000000�TG �3,�R;°- a 338 N5 !oR'�1rSRo;�KoRnk"a�w'wwaaaaaa0u aaxn FIR• 00�0 np �4 i; 33 T O 10 wsiaaaa NVM7jPWwi.�i+'o�'.WN•o5.�i�id�oovwi��o����� ° ,~ •�• p y�pp.8 x �.1 yip y� y�p� V 1V O SPSPPn < PNS�PPW�N I�P�N�+NWPNPMWP+��NY1�0+d � VOOO+P m<s +N `NN Law 0vjNc, ^ N•O0N0 N ,1�1 N0O0N0 N , P N0O0N0 NC(� S 1 , 00 Rnw�n° RRRow�� �R'.R ^°<c� 101 ,W �� a r`n�o Siif�°n 6ii��R Sssa�',�a 6ss�°,m 6soa� �f�'a + r5i -C�� wa 7 qz ON aM ? gaa gam �m + ;n AN m 3r i O_ a -Oi px p �� • am nN '� • n G A OWI� N wN M P NOVW+v NVP, OONOOn OO�OP+ Cc:YWI rs IW, 1A11 f Qn■ Np • O T ypyp�� VV p pp., + Y P MV a NN'On+ OOVVP OONOO OONW N piNO+ • N d Tows DoPaAmaMt of Human SarAWS SUMMER FOOD SERVICE PROGRAM FOR CHILDREN SITE INFORMATION Denia Park 817) 566-8125 R 1001 Parvin Denton 'Texas /ocvi May rune Jury Aug. saP Perwd of Opemtlon of Food Semce (moJneyryc-moJdayM•) Number of 0 f From: 6/6/94 through 8/12/94 eratingDays: Y 19 20 10 ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp Site Serving Primarily Migrant Children Other Site 1. Indicate Type of Site: ❑ A. (serving one to four meals) ❑ C. (serving one to four meals) 0 E. (serving one to four meals) Nonesldendal Camp Site Serving Primarily Homeless Children ❑ B. (serving one to four meals) ❑ D. (serving one to four meals) 2. List ALL Counties served by this site: Denton 3. A. Is your site open:........... ................... Q Yes ❑ N ........................................................... B. Is your site enrolled?...................................................................................... []Yes © N C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced 64% price meals for the site (SFSP Handbook, Chapter II) ...................... . D. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: N/A E. For enrolled sites, Form 1531 will be used to document eligibility. If the enrolled site used school data, list the school used to document the F. What is the percentage of free or reduced -price meals for the site? ........................ .................. 100% 4. Did the site participate in previous years' SFSP? (SFSP Handbook,' Chapter fl) --::: r..::....:.................... Q Yes ❑ N If Yes, give name of contracting organization City of Denton 5. Monitoring Plan (SFSP Handbook, Chapter III): Enter date of monitoring review to be conducted within: a rIMI weea 01 .. - June 8 June 22 July 20, August 10 6. Meal Service Perod Information (SFSP Handbook, Chapter II): TYPES OF MEALS NUMBEROF ELIGIBLE CHILDREN TO BE SERVED* MEAL SERVICE TIME BEGINNING ENDING Breakfast A.M. Supplement Lunch 40 12:00 p.m. 1:00 p.m. P.M. Supplement Supper 7. Method of Food Preparation by Contracting Organization (SFSP Handbook, Chapter Iq Site I ICentral All 4, � Form 7sowp 8. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook, Chap; ❑Cafeteria -style Children are Seated Children Line Up Meal Service ❑ and are Given Meals and Pick Up Meals ❑ Other. 9. List site personnel who will be involved to any extent in the meal service. (SFSP Handbook, Chapter II): TITLE OF POSITION NO. IN POSITION SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Supervisor 1 Supervise and assist distribution of meals, monitor and maintain meal temperature, site clean—up, and other duties as assigned 10. Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) 0 Indoor Meal Meal Service Service ❑ WIII Be Cancelled ❑ Other. 11. If the site feeds primarily homelwss children, what methods are used to ensure that money, food stamps, or in kind services are required for meals? 12. Are meals delivered to the she?..................................................................... ® Yes C IF YES, COMPLETE ITEMS 13, 14, 8, 15. IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. II): ®Site Personnel Will Contact Administrative Site Personnel WIII Communicate Staff, Who WIII Contact Vendor ❑ Directly With Vendor 14. Will delivery be within one hour of the food service period? (SFSP Handbook, Chapter II) ..................... OYes ❑' If no, describe arrangements within standards prescribed by local health authorities fordeliveryand holding of meals until time of serv•ic 15. If there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter III): ❑R Stored in Refrigerator Thrown Away Returned to and Served the Next Day ❑ at the Site ❑for DisVendor posal ❑ Other. i SERTIFY that the Information on this forth Is true and correct to the best of my knowledge. I certify that this site has been visit and that 1t has t apabllity and facilities for the meal serya planned for the number of children anticipated. I know that delibera misrepresent n or withholdin of Information ma It In prosecution under applicable state and federal statutes. I Name of Dontracang Agency /f (� rj qjq City of Denton Signawre—OMcial of ComracnnB Organnion Date Name of Ott" (please type or pnnn ..._ FOR nr� DHs JApproved L�Denled; reason: USE ONLY &gnawre—OHS Represenuiiva Dale Tide ,.:Lo Q512 402 2004 T A C A A [Moog raba m 1. incl i ad Povsrtt► Staves to 1979: 1900—toe. 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N Awiw7wwblrr-.. tM 61 b 1lotM IM a a 3p7 42 3r n IM nN - 11 - g°h11mhmioNMG��aMin — pM w a7 11 11 3yy 13 7 a 11f 76 vet 14 - p - ...-.-. NI a H a 48 b w 33 IINmrNar N Ya at wrr WaAY�rb1mpMV low w al W M IIa >ti Ifa a1 1M74 M n 1rn wi M. hmwrOdrap1w41waaAAmled.. IN 4"1 IM i! fM M too 11Y 12" Itl 3M na tl 17M aL 3itf a 3" 11u 31f°1I1 n i41M3 H - - � - IWrlAlra........... °io"`wlww.i:�1iA.. i pMMM1 3LLLWW111w��� ' 1pr4i f°nil 3u 31yf 3a M is 1 /afi t� i 14ii f _ s :. 1p Ism M l..a. - 31D1 1 !N al 3 w f 1p31s 1 i1a3 f n13► 1 ypn► �� U4 - tlfMtarwwr a fp IIO 11 177 119 M In p - NN.mrw.... 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H I l M W 41 IM St M - no a „ la 14 6 II If 43 b 11 - 7 4 - NOON N lm NIOM v1aw wmn Im Nr441wr r.N. pm" w Y aralrr 13 a iht i 1 1uj s4.1- ifs "A u 1 443.3 33.1 17.6 - 1Ao+ yw�ry ...............-.. lrbw I73 rwmr N yww 0IM .._.. 1,`.7 1104;1 YA iil a:l Is - �150 yyoM bw 103 �! 7f:1 w ul 6`00.A 110I:i - CENSUS T s—eea nuuefAnr waeTx. tEY.. SMSA'__ _ - Form 1507/P. 8. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook, Chap; Cafeteria style Children are Seated Children Line Up ❑ Meal Service ❑ and are Given Meals ® and Pick Up Meals ❑ Other. 9. List site personnel who will be involved to any extent in the meal service. (SFSP Handbook, Chapter II): TITLE OF POSITION No. IN POSITION SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Su ervisor 1 Supervise and assist distribution of meals, monitor and maintain meal temperature, site clean—up and other duties assigned Site Helper/server 1 Assist site supervisor 10, Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) ©Indoor Meal Meal Service Service ❑ WIII Be Cancelled ❑Other. 11. If the site feeds primarily homelwss children, what methods are used to ensure that money, food stamps, or in kind services are required for meals? N/A 12. Are meals delivered to the site? .................................................. ❑ Yes E: ................... R IF YES, COMPLETE ITEMS 13, 14, & 15. IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. 11): Site Personnel WIII Contact Administrative - Site Personnel WIII Communicate Staff, Who WIII Contact Vendor ❑ Directly With Vendor 14. Will delivery be within one hour of the food service period? (SFSP Handbook, Chapter 11) ..................... ❑ Yes ❑ t It no, describe arrangements within standards prescribed by local health authorities for delivery and holding of meals until time of servic 15. If there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter III): ®Stored in Refrigerator Thrown Away Returned to Vendor and Served the Next Day ❑ at the Site ❑ for Disposal ❑ Other. I CERTIFY that he information on this forth Is true d correct to the best of my knowledge. I certify that this site has been visit+ and that It he he capability and fac (ties for the mAal service planned for the number of children anticipated. I know that dellbera Inisre a Ion or wlthholdi g f informati ay result In prosecution under applicable state and federal statutes. Name of Contracting Agenry 5 R City of Denton Si Iv dal Iff confiaciind Organi¢atbn Date Name of Otedal (please type or Pnnp T'ele Lloy& Harrell City Manager FOR ohs Approved ❑ Denied; reason:' USE I ONLY I Title I I i Sigruture—OMS Representative Date Texas Depanment of Humm� Servioaa SUMMER FOOD SERVICE PROGRAM FOR CHILDREN '•-FOR OHS USE ONn SITE INFORMATION ry Phoenix Park Wood Street Period of operation cI Food service (=4oeyM•�4dayNrd Number of Op• May June ,wiy wv. L. 6/6/94 through: 8/12/94 eratingDays: 19 _ 20 10 ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp Site Serving Primarily Migrant Children Other Site 1. Indicate Type of Site: ❑ A. (serving one to four meals) ❑ C.(serving one to four meals) 0 E. (serving one to four meals) Nonesidential Camp She Serving Primarily Homeless Children ❑ B. (serving one to four meals) ❑ D.(serving one to four meals) 2. List ALL counties served bythis site: Denton 3. A. Is your site open: ...................... ... ..... ........... .... ......... ........... ...... Eyes ❑ N B. Is your site enrolled?...................................................................................... Eyes Q N C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced 31% price meals for the site (SFSP Handbook Chapter II) ....................... . ............... . D. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: N/A E. For enrolled sites, Form 1531 will be used to document eligibility. If the enrolled site used school data, list the school used to document the F. What is the percentage of free or reduced price meals for the site? ............................................ 100% 4. Did the site participate in previous years' SFSP? (SFSP Handbook Chapter tlr:-: ::..::.... ..................... [EYes ❑ N If Yes, give name of contracting organization,City of Denton 5. Monitoring Plan (SFSP Handbook, Chapter III): Enter date of monitoring review to be conducted within: June 8 1 June 22 1 July 20, August 10 6. Meal Service Per.od Information (SFSP Handbook Chapter II): TYPES OF MEALS NUMBER OF ELIGIBLE CHILDREN TO BE SERVED• MEAL SERVICE TIME BEGINNING ENDING Breakfast A.M. Supplement Lunch 100 12:00 p.m. 1:00 P.M. P.M. Supplement Supper Tnu inlonnatwn u ao wrw ay ohs when semna ne eoomvw meal saNm level. (SFSP Hando & Cnuiar In 7. Method of Food Preparation Organization (SFSP Handbook, Kitchen I M Using School Food Authority ❑ Food Service Management Company Qncludes All Year N t0 w `a w r�u N r nnn aw— NNE Vj BOO M PPP eeP�N EstillM ��bo VeVoopo�.pe��oeooeyel1�wya e��eyyevoe�o^d Nr aeeeo�5� V N i i �ONONNONON NOYiN+O�OtlVPN1�lNOVPNWr O ON e O rR T :'=i 000poppo�oyo�0000yyoNNo�fi�Lii�L:3os� 3R Sg"T� a aa� N R�TiRPo�O�V1�0nZMwZMZZZnnnn[(r��(( •ZTNr N .I Rw N 5� him `qRl �. .CNi �111 �`i110i rYiiRw OMO FB z '`� a •} gw we* wM wZwwwwZ'w wbbbw x �:T on nn N i s N YJ p�p1TYT N ■ N y{y1yy ��pp pp�� ��yy py�1����pyp lyyyw� pp��Spq N�yGp.�pp �p N�y pp�� py�yy�� OR � NrNyyi�� N I� ���pp++�� �NT OYIPRVO+eOPWOWWn+NPU1NwVfNne0I0�V�.^. O �w w n�r yy11OO�N • X pI�1 e pN ffioa:o'o met ONOO 00 'w1 �_ A NON�S� N$N�519 NON�S; M�N�S. NON�A ,Si �. � T 0007 OOOIIGG,ffs nnO KnnO R <""o O gp p. �00 lM l 00 9 wp0.0 � Z MIsc10 I�NO Rory Z1 Ot 3MRdn� SwANOnN :�:p jgRti0r�,� 60�i°�' 60M1i0 X? -}iw QwNww7 MwNw�w MNNeS gwpwr NP»°° W NN M N n y 1 Ij ...Oppp pp�� .bp' OH f1 P +Fkl OON+. 00000 00,000 PVONN OaR P+N W NI 10 COW! p bb y1 p■^• 00000 OO1000 Ptgw+� OewuoiN N O s,. w yO .�// yypp���yyl1yyyp� ��pp�pNQp�yy11"Np� M OP ONPOV p�$oNVN S ORi^i`"^21O:ii w: 00 ONV 08 0.00 O� ■f1� OQr. w yrowl VPNrWN+O Z{� lizMoo+.� K N + OOe00 00009 VA{•iiPM r - IN. •r� H N• N Nu,lvi ; 000000 �. Rr�� K^ K ^ ^ A 0 swoo �Zwww + K ryi K p VOPNP Texas peParanent of Human S�s SUMMER FOOD SERVICE PROGRAM FOR CHILDREN SITE INFORMATION Civic 321 E.'McKinne Penf�rog%1;4 Sa�Ithrogh• 81/12I94 I Number of Op - From: mar 19 r20 eating Days: 10 ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp She Serving Primarily Migrant Children Other Site 1. Indicate Type of Site: ❑ A.(serving one to four meals) ❑ C. (serving one to four meals) ® E. (serving one to four meals) Nonesidential Camp She Serving Primarily Homeless Children ❑ B. (serving one to four meals) ❑ D. (serving one to four meals) 2. List ALL counties served by this site: Denton 3. A. Is your site open: ............................... ......... . .. .. .. ... © Yes ❑ h B. Is your site enrolled?..................................................................................... ❑Yes © h C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced 19% price meals for the site (SFSP Handbook Chapter II) ....................... _ ............ D. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: N/A E. For enrolled sites, Form 1531 wfll be used to document eligibility. If the enrolled site used school data, list the school used to document the F. What is the percentage of free or reduced -price meals for the site? ............................. 100% 4. Did the site participate in previous years' SFSP? (SFSP Handbook Chapter fly-.7:.............. .... ................ QYes ❑ N If Yes, give name of contracting organization, City of Denton 5. Monitoring Plan (SFSP Enter date of monitoring review to be conducted within: 6. Meal Service Period Information (SFSP Handbook Chapter II): TYPES OF MEALS NUMBER OF ELIGIBLE CHILDREN TO BE SERVED' MEAL SERVICE TIME BEGINNING ENDING Breakfast A.M. Supplement Lunch 50 12:00 p.m. 1:00 P.M. P.M. Supplement Supper 7. Method of Food Handbook, Chapter On Site 7 Central Kitchen I Pq Usina School Food Authority n Food Service Management Company (includes All Year Contracts) Penn 1S071P '. 8. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook, Chap:'.. ❑Cafeteria -style Children are Seated Children Line Up Meal Service ❑ and are Given Meals X and Pick Up Meals ❑ Other. 9. List site personnel who will be involved to any extent in the meal service. (SFSP Handbook. Chanter III: TITLE OF POSITION NO. IN PoSmom SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Supervisor 1 Supervise and assist with distribution of meals, monitor and maintain meal tem erature, site clean—up, and other duties as assigned Site Helper/Server 1 Assist site supervisor 10. Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) 0 Indoor ServiceMeal ❑ WillBe Meal Service ❑ Other. 11. If the site feeds primarily homelwss children, what methods are used to ensure that money, food stamps, or in kind services are required for meals? N/A 12. Are meals delivered to the she?..................................................................... © Yes IF YES, COMPLETE ITEMS 13, 14, It 15. IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means Of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. II): 0 Site Personnel WIII Contact Administrative Site Personnel WIII Communicate Staff, Who WIII Contact Vendor ❑ Directly With Vendor 14. Will delivery be within, one hour of the food service period? (SFSP Handbook, Chapter II) ..................... © Yes 711 If no, describe arrangements within standards prescribed by local health authorities,for delivery and holding of meals until time of servi 15. If there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter III): % Stored In Refrigerator Thrown Away Returned to Vendor and Served the Next Day ❑ at the Site ❑ for Disposal ❑other. I CERTIFY that the information on this form is Kue and correct to the best of my knowledge. I certify that this site has been visit and that It hoe the capability and f cllities f r e meal service planned for the number of children anticipated. I know that deltber misr tation or vvIthhoJldIrj6 of Into Ion may result in prosecution under applicable state and federal statutes, Name of Contracting Agency City of Denton gnat a—OMc&w of Comnctinp or—g—m—igil6n Date Name of Official (please type or pnne nlle'. Lloyd Harrell City Manager FOR ❑ Approved ❑ Danletl; reason: DHS USE ONLY Title t Sig -'.' —OHS Relxesenutive Dale ap?jml A O n M ■ O pn a Y (1 a a Wy1 P VpuN bra: �m gip( a� T A r �pPP NPe 1Q m T s " IIJJ yy��IIJJ N N VV pys� pw pw pw NO0 OOOOOOOOOOOPPPNN �OONPd VP VOOOOOPO .NO NtlNNONOMONON Ny.�.O..�O.O.V.P�.N.w NSO � °•N N+ na 000IPO ��O wO W0 I0�0sob:s:s "a �6.O����� pSS R...1(((�� w.n(oR�(�...•(((vin(i���•ry(((O...1�[[[� •o...iry(((�'O wp p a a r w a a N+� � S„ Oppppp+a apON ppa PM O NWNVWNWNNO:IPA w +Ww N.pv a V�O.O.O+•�P6 R I�5w r� A �A Ns.'we, "+T x m +• M 9 S� n jt P N��`PPN�N�PI•NR+NWPMPWWP+N+N WO-�O � VOOp+P TrN AgsY W A N P WV aw NON�S NON��� NON�S� NON�Sa NON�S5 ��Aq op.0O16,1v00°+g■00°16,�s �doo I.OwNfl p 07A'J`■tl M ROwN] M ROwN M ROwN iA No 3a qZ0 gap e � R NOVM+ OWNVP OOV1OO OO.O?� WWVVV T tp{pN� VV ..pp. 1NV pp,� tauy Q N �II'On+ OOVVP OCuCQ OONMN OPNO� n s I N » A p aa..j gQ»�•Qw 7 oilw wS7 nn 0,16" o�.J p �� vPMHwNm x wA�AA '� �T��• � ,�01�'O � �~RC TN MwwwnM M p n , nA �..� ^•( �p C "l5< � 'ASS ». �pJ» �����5� N 7M� 4•�F»^,�_ 0. 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SUMMER FOOD SERVICE PROGRAM FOR CHILDREN SITE INFORMATION MLK Recreation Center 1 (817) 566-8125 Address of She (SU"4 city, State, LP) ' 1300 Wilson Denton, Texas 76205 Penod of Operation of Food Samoe (=o day(yr.-mo4aytyr.) Nember of OIII May June July Aug. Sept. From: 6/6/94 through: 8/12/94 eratingDays: 4 19 20 10 ATTACH A MAP WITH THE SITE SERVICE AREA IDENTIFIED Residential Camp She Serving Primarily Migrant Children Other Site 1. Indicate Type of Site: ❑ A. (serving one to four meals) ❑ C. (serving one to four meals) ® E. (serving one to four meals) Nonesidential Camp She Serving Primarily Homeless Children ❑ B.(serving one to four meals) ❑ D.(serving one to four meals) 2. List ALL counties served by this site: Denton 3. A. Is your site open: ........................................................ ..... . .... EYES ❑ N B. Is your site enrolled?...................................................................................... Dyes 0 N C. Site Eligibility: Enter the percentage of children eligible for free and/or reduced price meals for the site (SFSP Handbook ... Chapter II) .................... ..............� 0. If open sites, submit documentation supporting this percentage figure. For open sites using school data, list the schools used to document site eligibility, as applicable: E. For enrolled sites, Form 1531 will be used to document eligibility. If the enrolled site used school data, list the school used to document the site: F. What is the percentage of free or reduced -price meals for the site? ....................................... ... . 100% 4. Did the site participate in previous years' SFSP? (SFSP Handbook Chapter H) r.: ...................... ❑Yes 0 N If Yes, give name of contracting organizabom S. Monitoring Plan (SFSP Handbook, Chapter 111): Enter date of monitoring review to be conducted within: it June-22 6. Meal Service Period Information (SFSP Handbook Chapter II): July 20, August 10 TYPES OF MEALS NUMBER OF ELIGIBLE CHILDREN TO BE SERVED' MEAL SERVICE TIME BEGINNING ENDING Breakfast A.M. Supplement Lunch 75 12:00 p.m. 1:00 P.M. P.M. Supplement Supper, 7. Method of Food Preparation by Contracting Organization (SFSP Handbook, Chapter II) sell•Pre=awn Vended ❑ On Site, ❑ Central Kitchen I © Using School Food Authority ❑ Food Service Management Company (Includes All Year Contracts) from 15071E B. Indicate the system to be used for the serving of meals and the supervision of children during meal service period (SFSP Handbook, Chap ❑Cafeteria -style Children are Seated Children Line Up Meal Service ❑ and are Given Meals R❑ and Pick Up Meals ❑ Other. 9. List site personnel who will be involved to any extent in the meal service. (SFSP Handbook, Chapter II): TITLE OF POSITION NO. IN POSITION SPECIFIC FOOD SERVICE PROGRAM DUTIES Site Supervisor 1 Supervise and 'assist with distribution of meals monitor and maintain meal temperature, site clean—up, and other duties as assigned Site Helper/Server 1 Assist site supervisor 10. Indicate what provisions will be made for meal service during periods of inclement weather (SFSP Handbook, Chapter II) ®Indoor Meal Meal Service Service ❑ WIII Be Cancelled ❑ Other. 11. If the site feeds primarily homelwss children, what methods are used to ensure that money, food stamps, or in kind services are required for meals? 12. Are meals delivered to the site?..................................................................... 0 Yes ❑ IF YES, COMPLETE ITEMS 13, 14, & 15. IF NO, FORM IS COMPLETE EXCEPT FOR CERTIFICATION AT BOTTOM. 13. Indicate the means of communication with the vendor which will be used to adjust meal deliveries. (SFSP Handbook, Chap. II): Site Personnel WIII Contact Administrative Site Personnel Will Communicate Staff, Who WIII Contact Vendor ❑ Directly With Vendor 14. Will delivery be within one hour of the food service period? (SFSP Handbook, Chapter II) ..................... IX Yes If no, describe arrangements within standards prescribed by local health authorities for delivery and holding of meals until time of sere: 15. If there is an excess of meals delivered, meals will be (SFSP Handbook, Chapter ill): EZStored in Refrigerator Thrown Away Returned to Vendor and Served the Next Day ❑ at the Site ❑ for Disposal ❑ Other. I CEERTIFY that the Information on this forth Is t e and correct to the best of my knowledge.I certify that this site has been visa, and that It the capability d facilities for meal service planned for the number of children anticipated. I know that dellber mist c es tation or withho tl g of Info n may result In prosecution under applicable state and federal statutes. 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