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Child and Adult Care Food Program

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Administration, Record Keeping & Finance

Food & Nutrition

Training Resources

USDA Resources

Administration, Record Keeping & Finance
Income Eligibility
NumberName/DescriptionDateFormat
 The following forms are for Fiscal Year 2018.
NS-402-GIncome Eligibility Guidelines for FY 2018 – guidelines effective July 1, 2017 – June 30, 2018.6/2017Adobe pdf
NS-100-CIncome Eligibility Form – Child Care Centers – FY 20186/2017Adobe pdf
NS-100-C SpanishSpanish Income Eligibility Form – Child Care Centers – FY 20187/2017Adobe pdf
NS-101-CIncome Eligibility Form – Instructions – Child Care Centers6/2017Adobe pdf
NS-101-C.aAttachment to Income Eligibility Form to add more enrolled children or household members. This may not be used without NS-101-C.6/2017Adobe pdf
NS-200-CIncome Eligibility Form – Adult Care Centers – FY 20174/2016Adobe pdf
NS-201-AIncome Eligibility Form – Instructions – Adult Care Centers4/2016Adobe pdf
NS-202-ACover Letter to Households – Adult Care Centers – FY 20174/2016Coming Soon
NS-204-AInstructions to Households – Adult Care Centers – FY 20174/2016Coming Soon
 Alternate Translations of USDA Income Eligibility Form4/5/2017Web
 Spanish translation – Income Eligibility Form5/2011Adobe pdf
 Pricing Programs: If you have a separate charge for meals, contact Nutrition Services for a different set of income eligibility letters & instructions.
Enrollment in CACFP
NS-105-CChild Enrollment Form – sample
children must be enrolled in CACFP annually
4/2015Adobe pdf
NS-106-CChild Enrollment Form – instructions to centers4/2015Adobe pdf
Meal Counts & Claims
 Record of Meals and Supplements Served (RMSS) – commonly referred to as “blue and white sheets” – 11″ x 17″ – request from Nutrition Services by email or phone (800) 731-2233 or (402) 471-248808/2006

Adobe pdf

11″ x 27″

NS-401-GMonthly Claim for Reimbursement Worksheet04/2009

Adobe pdf 
Microsoft Word
Microsoft Excel

NDE 28-017Claim for Reimbursement – Child Care Centers01/2011Adobe pdf
NDE 28-018Claim for Reimbursement – Adult Care Centers04/2009Adobe pdf
 Claim for Reimbursement
FY2015
 Requires User ID
New system
 W-9/ACHIRS W-9 and enrollment for direct deposit of claim reimbursement04/2014Adobe pdf
Online Application and Claims
NDE 01-033Computer Access Application and Agreement (application for ID and password)08/2014Adobe pdf
 Online Application Instruction Manual – for centers and sponsors with user ID04/2009Adobe pdf
 Online Claims Instruction Manual – for centers and sponsors with user ID09/2005Adobe pdf
 Training Registration Instruction Manual03/2015Adobe pdf
W-9/ACHIRS W-9 and enrollment for direct deposit of claim reimbursement04/2014Adobe pdf
NS-407-GCACFP Agreement, Parts II and III04/2017Adobe pdf
Informational brochures and handouts
 Getting Started on the CACFP – new sponsors/centers05/2006

Web
Adobe pdf

 What to Expect – Getting ready for a compliance review or audit07/2006Adobe pdf
Signature Pages
NDE 01-017
Page 7
Certificate of Authority (change in responsible individuals/principals)06/2017Adobe pdf
NDE 01-017
Page 8
Organization Representatives Signature Page06/2017Adobe pdf
NDE 01-033Computer Access Application and Agreement (application for ID and password)08/2014

Adobe pdf

Food Service Contracts – procurement
NS-404-GFood Service Contract Fillable Form – Complete package – instructions, contract, regulations, all attachments06/2017Adobe pdf
NS-404-GFood Service Contract – Complete package – instructions, contract, regulations, all attachments06/2017Adobe pdf
 Sample Delivery Ticket Adobe pdf
 Small Purchase Procurement (done annually)05/2014Adobe pdf
 Approved vendor list found here06/2017 
 Federal Regulations Adobe pdf
IMPORTANT: All contracts in excess of $150,000 per year must be submitted to and reviewed by Nutrition Services before they can be accepted and signed by the CACFP institution. Allow at least 10 working days for Nutrition Services to review the contract.
Administrative Tools
 Introduction to the CACFP – training manual for FY 201607/2015

Child care center – Adobe pdf

Adult Care Center – Adobe pdf

NS-405-GTime Certification Worksheet – use this to document time worked in CACFP if needed to prove nonprofit food service operation04/2009

Adobe pdf
Excel

NS-406-GSample Site Review form – for sponsors of multiple sites04/2017Adobe pdf
NS-409-GAdministrative Review procedures – steps for submitting an administrative review (appeal) regarding NDE actions06/2017Adobe pdf
 Nebraska Household Contact System (for sponsors of more than one site)04/2005Adobe pdf
 Sample household survey letter and form (for sponsors of more than one site – this letter could also be used as a basis for telephone contacts)04/2005Microsoft Word
 NS-413-GCACFP Monthly Expenditures (use to track expenses)04/2012Adobe pdf
 CACFP Administrative Handbook – has your center participated on CACFP for several years? Is your CACFP 3-ring binder or part of it missing? Current contents may be downloaded here12/2011Web
 CACFP Handbook for Sponsors of Multiple Sites11/2008Adobe pdf
 Financial Viability Document4/2016Adobe pdf
Family Day Care Home Sponsors
 Applications, forms and resources for sponsors of family day care homes Web
 Locate a sponsor – find out which home sponsors serve your county Web
Food & Nutrition
NumberName/Description Format
 NEW! Crediting Handbook for CACFP (Effective July 1, 2014) – does not include infants04/2014Adobe pdf
NS-408-GCrediting Foods in the Child and Adult Care Food Program (Nebraska) – does include infants04/2008Adobe pdf
Grains ChartFormat
 NEW! Grain Chart08/2017Adobe pdf
NEW! Sample MenusFormat
 1 & 2 year olds08/2017Adobe pdf
 3 – 5 year olds08/2017Adobe pdf
 6 – 12 year olds & 13 – 18 year olds08/2017Adobe pdf
 Adults08/2017Adobe pdf
Food Charts
 NEW! Meal pattern for children, ages 1 – 12 06/2017Web
 NEW! Meal pattern for adults  06/2017Web
 NEW! Meal pattern for infants (birth up to first birthday)  06/2017Web
Approved Milk Substitutes
 Updated list of milk substitutes approved for use in CACFP 06/2017Adobe pdf
What’s Cookin’ II cookbook for family day care homes
 What’s Cookin’ II – recipes Link to Adobe pdf files
Farm to Preschool Network
 Seasonal Crop Tunnel Systems (clickable link) Adobe pdf
 

Buying Local Guide (clickable link)

 Adobe pdf
 Farm to Preschool Network (clickable link) Web
Menu Production Records
Select the version that best meets the needs of your center.
Child and Adult Care Centers
 NS-501-A Daily Production Record – This version allows for menu, foods used and quantity prepared for breakfast, morning snack, lunch, afternoon snack, supper and evening snack03/2017Adobe pdf
 NS-501-B Daily Production Record – This version allows for the menu, foods used, and total quantity prepared for breakfast, morning snack, lunch and afternoon snack03/2017Adobe pdf
 Cycle menu planner – requires 8 1/2″ x 14″ paper to print01/2005

Microsoft Word 
Adobe PDF

Feeding Infants
 Obligation to offer infant meals05/2002Adobe pdf
 NEW! Infant meal pattern06/2017Adobe pdf
 Infant Feeding Record 0-5 months06/2017Adobe pdf
 Infant Feeding Record 6-11 months06/2017Adobe pdf
 Developmental Readiness Form06/2017Adobe pdf
 Feeding Infants – A Guide for Use in the Child Nutrition Programs (USDA Publication FNS-258) Adobe pdf
 Additional resources on feeding infants Web
Breastfeeding Resources
 What’s in Breastmilk10/2016 
 Breastfeeding Facts4/2015 
Medical Statement Form
 Request for Special Meals and/or Accomodations4/2014 
Managing Food Allergies
 CDC Toolkit (clickable link)5/2015Web
Infant Production Records
You may select the set that works best in your child care center.
Set One: NS-502-A Weekly Infant Meal Records – Five days of meals may be recorded for an individual infant.12/2011Adobe pdf
Set Two: NS-502-B Daily Infant Meal Records – Meals served to several infants may be recorded for a full day.12/2011Adobe pdf
Training Resources
 NEW! Infant FY2017 New Meal Pattern Training PPT06/2017Adobe pdf
 NEW! FY2017 New Meal Pattern06/2017Adobe pdf
 Introduction to the CACFP – training manual for adult care centers08/2015

Adobe pdf

 CACFP Training Log – this may be used to document your CACFP staff training04/2007Adobe pdf
 Civil Rights Training2/2015Adobe pdf
USDA Resources
 USDA Food Buying Guide Link to Adobe pdf files
 Child Care Recipes from USDA Link to Adobe pdf files
 Nibbles for Health – from USDA Link to Adobe pdf files
USDA Regulation & Policy
 Federal Regulations01/01/2011Web
 USDA FNS CACFP Program Policy08/2014Web
 USDA Food & Nutrition Services Instructions Web
 USDA Policy Memos – from the Mountain Plains Region of USDA Web
 Questions and Answers – consolidated Q & A’s from the U.S. Department of Agriculture Mountain Plains Regional Office Web
WIC Resources
 WIC Brochure (English) – 2 pages 

Adobe pdf

 WIC Brochure (Spanish) – 2 pages 

Adobe pdf