Skip to main content

2019 NYSED SFSP Attachments

Listed by Program Function

Understanding Program Basics:

Definition of Program Terms Att. 1
Glossary of Acronyms Att. 2
Proactive Planning and Checklist Att. 3
Meal Pattern Att.4
Exception to Meal Component Requirements for Jewish Institutions Att. 5
SFSP Federal Guidance Att. 6
SFSP Site Definitions and Eligibility Documentation Att. 7

Getting Started- Application and Planning:

Agreement to Furnish Food Service Att. 8
Food Service Equipment Needs Att. 9
Income Eligibility Form for the Summer Food Service Program Att. 10
Income Eligibility Guidelines Att. 11
Site Selection Worksheet Att. 12
Sponsor/Site Agreement Att. 13
Training Checklists and Sign-in Sheets Att. 14

Managing the Meal Service:

Meal Count Worksheet for Camps  Att. 15
Inventory Control Sheet Att. 16
Program Worksheet for Camp Sponsors Att. 17
Meal Count (Daily) Att. 18
Meal Count (Daily Tick Sheet) Att. 19
Meal Count (Weekly/Consolidated) Att. 20
Meal Count (Consolidated for 1st and 2nd Meals) Att. 21
Meal Count (Weekly to Claim) Att. 22
Food Production Record Att. 23
Field Trip Notification Form Att. 24
Job Description-Cook Att. 25

Recordkeeping, Cost Accounting and Claiming:

Checklist of Records Att. 26
Mileage Record Att. 27
Time Report Att. 29
Summary of Administrative Expenses Att. 30
Worksheet for Cost of Food Used Att. 31
Child Nutrition Mgmt. System Password Application Att. 33
Budget Revision Form Att. 34
Site Review Checklist Att. 35
Administrative Review Checklist Att. 36
Reimbursement Worksheet for Vended Sponsors: Urban *(TBD) Att. 37
Reimbursement Worksheet for Self-prep Sponsors *(TBD) Att. 38
New Site Information Sheet: Non Camp Sites Att. 39
New Site Information Sheet: Camp Sites Att. 40
Federal Contract Provisions Att. 41
Pre-Operational Visit Form Att. 42
First Week Visit Form Att. 43
Four Week Site Review Form Att. 44
Racial Ethnic Data Att. 46
Allowable Administrative & Operating costs Att. 47
2019 Reimbursement Rates *(TBD) Att. 48
Media Release Att. 49
Parent Letter Att. 50
Notification Letter  Att. 51

 

USDA Nondiscrimination Statement

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. 

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter 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;

(2)     fax: (202) 690-7442; or

(3)     email: program.intake@usda.gov.

This institution is an equal opportunity provider.

Los demás programas de asistencia nutricional del FNS, las agencias estatales y locales, y sus beneficiarios secundarios, deben publicar el siguiente Aviso de No Discriminación:

De conformidad con la Ley Federal de Derechos Civiles y los reglamentos y políticas de derechos civiles del Departamento de Agricultura de los EE. UU. (USDA, por sus siglas en ingles), se prohíbe que el USDA, sus agencias, oficinas, empleados e instituciones que participan o administran programas del USDA discriminen sobre la base de raza, color, nacionalidad, sexo, discapacidad, edad, o en represalia o venganza por actividades previas de derechos civiles en algún programa o actividad realizados o financiados por el USDA.

Las personas con discapacidades que necesiten medios alternativos para la comunicación de la información del programa (por ejemplo, sistema Braille, letras grandes, cintas de audio, lenguaje de seas americano, etc.), deben ponerse en contacto con la agencia (estatal o local) en la que solicitaron los beneficios. Las personas sordas, con dificultades de audición o discapacidades del habla pueden comunicarse con el USDA por medio del Federal Relay Service [Servicio Federal de Retransmisión] al (800) 877-8339. Además, la información del programa se puede proporcionar en otros idiomas.

Para presentar una denuncia de discriminación, complete el Formulario de Denuncia de Discriminación del Programa del USDA, (AD-3027) que está disponible en linea en:http://www.ocio.usda.gov/sites/default/files/docs/2012/Spanish_Form_508_Compliant_6_8_12_0.pdf. y en cualquier oficina del USDA, o bien escriba una carta dirigida al USDA e incluya en la carta toda la información solicitada en el formulario. Para solicitar una copia del formulario de denuncia, llame al (866) 632-9992. Haga llegar su formulario lleno o carta al USDA por:

(1)     correo: U.S. Department of Agriculture
         Office of the Assistant Secretary for Civil Rights
         1400 Independence Avenue, SW
         Washington, D.C. 20250-9410;

(2)     fax: (202) 690-7442; o

(3)     correo electrónicoprogram.intake@usda.gov.

Esta institución es un proveedor que ofrece igualdad de oportunidades.

Top