Forms for CACFP Adult Day Care Centers

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• CACFP Standardized Recipe Form

• CACFP Civil Rights Pre-award Survey

• CACFP Enrollment Form for Adult Centers

• Food Safety: Alternate QFO Statement

• Food Safety: Food Service Employee Training Record for Sanitation and Food Safety (PDF)

• Food Safety: On-site Training Record for Sanitation and Food Safety (PDF)

• Food Safety: Qualified Food Operator (QFO) Responsibilities for Connecticut Child Nutrition Programs

• Food Safety: Refrigerator and Freezer Temperature Control Record (PDF)

• Income Eligibility Application Form for Adult Day Care Centers

• Income Eligibility Application Form for Adult Day Care Centers

• Income Eligibility Application Form for Adult Day Care Centers Instructions

• Income Eligibility Application Form for Adult Day Care Centers Instructions

• Income Guidelines for Child Nutrition Programs

  Information on the income guidelines for determining the eligibility of participants for free and reduced-price meals and milk in the U.S. Department of Agriculture's Child Nutrition Programs.

• Production Record for Adult Centers: Lunch and Snack (AM or PM) (PDF)

• Medical Statement for Meal Modifications in CACFP Adult Day Care Centers