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RELEASE: Updated CACFP Site/Provider Review Forms

Published: 26 days ago
" TDA has updated four CACFP Site/Provider forms to reflect the prohibition of using visual observation to obtain racial/ethnic data of child and adult participants.
"
TDA has updated four CACFP Site/Provider forms to reflect the prohibition of using visual observation to obtain racial/ethnic data of child and adult participants. The form instructions have been updated, and the data collection table now contains columns for Unknown in the event a site is unable to obtain racial/ethnic data per their documented processes/tools. The four forms updated are:

• H1602 – Adult Day Care Center Review Form
• H1606 – Child Care Center Review Form
• H1606-AT – At-Risk Center Review Form
• H1607 – Day Care Home Provider Review Form

Updated forms are available on the CACFP Administration/Forms SquareMeals
(https://squaremeals.org/Programs/Child-and-Adult-Care-Food-Program/Administration-Forms)

 

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Assistance available in English and Spanish. Please call 877-TEX-MEAL (877-839-6325) for help.

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

1. Mail:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or
2. Fax: (833) 256-1665 or (202) 690-7442; or
 
This institution is an equal opportunity provider.
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