Forms for CACFP Adult Day Care Centers

Page 4 of 4

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

• Monitoring Review Form for CACFP Centers

• Monitoring Review Form for CACFP Centers

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

• Production Record for Adult Centers: Any Meal (PDF)

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

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

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

• Sample Household Letter for Nonpricing Adult Day Care Centers

• Sample Household Letter for Nonpricing Adult Day Care Centers