May 10, 2013
School Nutrition Program (SNP) Self-Assessment Review Form
Contracting Entity (CE) Name: / CE ID Number: / Date:Check the response that best reflects the common practices of the Contracting Entity (CE). / Practice in Place? / RecordsRetained to Support Rating?
Yes / No / N/A / Yes / No
Application/Agreement, ARM, Section 2
Eligibility
- Is the Reviewing Official the same person as stated on the CE application in TX-UNPS?
- Is the Hearing Official stated in the notification letters to households the same person as stated on theCE application in Texas Unified Nutrition Programs Systems (TX-UNPS)?
- Is the Hearing Official a person who is not involved in the determination, confirmation, and/or verification process?
- Is the collection procedure in use at each serving site the same as the approved collection procedure stated in the policy statement for free and reduced-price meals (Attachment B)?
- Is a copy of the policy statement for free and reduced-price meals available to each site in the CE?
Medium of Exchange for Free, Reduced-price, and Paid Meals
- Is the medium of exchange coded to prevent overt identification of children receiving free and reduced-price meals?
- Is the medium of exchange available through prepayment or charging thus making free and reduced-price meals recipients appear as children who have prepaid or charged?
- Is the medium of exchangedistributed using a common location at a common time for all children to obtain their tickets or tokens?
- Is the medium of exchangecollected in a manner that ensures that the same procedures are used for free, reduced-price, and paid meal categories?
Media Release
- Did the CE send out a public release to the media and community/grass roots organizations that includes the letter to parents, application form, and the complete income eligibility guidelines?
- Was a copy of the newspaper article or the fax letter of transmittal page, along with the media package, retained by the CE?
Site Information
- Has the CE updated the site application of all siteswith their total enrollment, eligible children, percentages, and other information in TX-UNPS?
Comments:
Eligibility, ARM, Section 4
Applications
- Are the CE’s free and reduced-price meals applications readily retrievable by site?
- Were the current application, notice/letter to households and eligibility guidelines used by each CE site?
- Does the CE provide categorical eligibility—SNAP, TANF, FDPIR, foster, homeless, migrant, runaway, Head Start, and Early Head Start?
Information Provided to Parents or Guardians
- Are all households given a free and reduced-price meal application at the beginning of the school year with an explanation of eligibility requirements?
- Are foreign language translations available or is a translator available?
Review of Applications for Accuracy
- Do all income applications include the name(s) of children (s) for whom application is made?
- Do all income applications include thenames of all household members?
- Do all income applications include thesignature of an adult household member?
- Do all income applications include thelast four digits of the social security number of the head of household or adult completing the form or an indication that he/she does not have one?
- Do all income applications include theincome of each household member, by source?
- Do all income applications show thenoincome boxes checked for each household member that does not have income?
SNAP/TANF Applications
- Do all SNAP/TANF applications include name(s) of children?
- Do all SNAP/TANF applications include valid SNAP/TANF identifiers?
- Do all SNAP/TANF applications include the signature of an adult household member?
- Is the CE using a multi-child or multi-use application?
- Was the correct eligibility determination made for each application processed?
- Are all children in each household receiving the same level of benefits?
Direct Certification
- Is theCE using Direct Certification (DC) procedures?
- Is an original DC list kept on file at the CE?
- Is the CE updating the second list as needed?
- Is the CE updating the DC list quarterly?
- Are benefits being issues for the entire year?
- Is the CE maintaining each year’s DC list for 5 years for public and charter schools?
- Are Texas Department of Health and Human Service (HHSC) letters used for DC on file for 5 years for public and charter schools or 3 years for private and non-profit organizations?
- Is the Notice of Predetermined Eligibility sent to the parent or guardian of each directly certified child?
- Does the Notice of Predetermined Eligibility include the following information:
- Their children are eligible for free meals?
- No further application is required?
- Households should notify the CE if they do not want their children to receive free benefits?
- Is the date that the notice is sent noted beside the name of the child on the DC list or elsewhere?
Comments:
Verification, ARM, Section 6
- Based on the count taken of approved meal applications on file on October 1, were an adequate number of meals applications selected for verification?
- Did the CE conduct the Error Prone method of verification?
Reviewing for Accuracy
- Were the applications reviewed for accuracy?
- If the application was incorrectly approved, did the household receive an adverse action letter?
- Was a new application pulled for verification?
- Did the Confirming Official sign on the application?
- Is the Confirming Official signature different from the Reviewing Official signature?
Technology Based Verification System
- Has the CE requested a waiver to review applications as part of the verification process?
- Does the CE have the approved waiver letter on file?
Verification Process
- Was all required documentation obtained during the verification process?
- Were four (4) consecutive weeks used to determine household’s income?
- Was a follow-up done on non-responsive households?
- Was the follow-up notification documented and signed on the application?
- Was the verification process completed by November 15?
- Is the verification process documented on the application?
- Is the information collected through the verification process documented on the CE’s Verification Notification Summary Form?[1]
- Does the CE have a Verification Notification Summary Form completed and on file?
- Is an individual verification formused for each application?
- Are households whose benefits must be reduced or terminated given the required 10-day notification prior to the change?
Comments:
Counting and Claiming, ARM, Section 7
Counting
- Is the count taken by category at the point-of-service?
- If the cashier is at the beginning of the line, is there a monitor stationed at the end of line who removes any meal from the count that does not contain sufficient components in order to claim reimbursement?
- In family-style meal service, does the supervising adult ensure the minimum required portions are available on the table including milk?
- Is there a system in place to ensure that the second meals are not claimed for reimbursement?
- Is there a trained substitute cashier or counter?
- After viewing the collection procedure in operation, does it appear that it yields an accurate count by category?
- Is the count by category that is taken on the line the same as that reported on the daily record?
- Is the count by category comparable to the counts taken in that month or the previous month?
- Does a report run from the point-of-sale show that meals were served and what levels of benefits are provided to participants?
- Are the adult meals or a la carte sales recorded separately from the meals counted for children by category?
- If there is more than one serving line, are the counts from all lines property consolidated?
Master Roster/List
- Is the master roster/list current?
- Do the names on the list of eligible children match approved applications on file and the categorically eligible list (DC, foster, homeless, migrant,runaway, Head Start, and Early Head Start)?
- If more than one master roster/list is used, are all lists the same?
Updating Master Roster/List
- Are changes due to withdrawals, transfers, etc., reflected on the list or on another tracking document dated and initialed by responsible person?
- Is the count of eligible children updated on a daily basis or in a timely manner?
- Are attendance-adjusted eligible children by category compared to daily meal counts for each school (Accuclaim edit check)?
Accuracy in Counting
- When the daily menu counts by category exceed the Average Daily Attendance (ADA), is the validity of the count examined and documented prior to the submission of the claim?
- Are counts on the daily record of meals served that
- Reflect patterns of numbers?
- Repetition of numbers?
- Constant counts by category?
- Served count equal to delivered count?
- Identical counts for breakfast and lunch?
- One hundred (100) percent participation?
- Category counts exceeding the number of eligible children?
- Are prepaid and charged meals counted on the day served, not the day the money is collected?
- Are participants issued one original and a minimum of three replacement meal tickets?
- Are special meal arrangements allowed before a child is charged for fourth replacement ticket?
- Are all meals claimed intended to be eaten on campus or school-sponsored field trips or events?
- Is an onsite self-review of the lunch meal (or breakfast for breakfast only schools) counting and claiming procedure completed and documented prior to February 1, unless the CE has only one feeding site?
- When preparing the monthly reimbursement claim, is the number of meals claimed by category for all sites correctly?
- If corrective action was required after an onsite review, is a follow-up review conducted within 45 days to ensure that corrective action was taken?
Comments:
Breakfast and Lunch Programs, ARM, Sections 8, 8N, and 9
Food-Based Menu Planning
- Is each of the required food components offered on every lunch menu?
- Is each of the required food items offered on every breakfast menu?
- Have all CE recipes been checked to ensure that they actually contribute the expected yield per serving?[2]
Fruit and Vegetables
- Do CEs offer only 100% juice products?
- Is full-strength fruit or vegetable juice contributing no more than one-half (½) of the required serving size of fruit of vegetable component for lunch for the week?
Grains
- Are the required number of grain servings offered each week?
- Does the amount of grain servings per day meet the daily minimum for the age/grade group?
- Does the number of grain servings per week meet the minimum and maximum for the age/grade group?
Meat/Meat Alternate
- Are the required number of meat/meat alternate servings offered each week?
- Does the amount of meat/meat alternate servings per day meet the daily minimum for the age/grade group?
- Does the number of meat/meat alternate servings per week meet the minimum and maximum for the age/grade group?
Milk
- Does the CE offer a variety of milk that is fat free and 1% low-fat milk?
- Is the 1% low-fat milk unflavored?
- Is the variety of milk offered on every reimbursable line throughout the entire serving period?
- Is each child permitted to select from the fat free or 1% low-fat milk choices?
Menu Planning
- Does the documentation show the appropriate age/grade groups?
- Have the menus and nutrient standards been planned to reflect the correct age/grade grouping?
- Do portion sizes of the serving menu appear to match portion sizes of the planned menu?
- Is the menu meeting the required nutrient standards for calories, saturated and transfat, and all other nutritional requirements[3] by age/grade groups for the week?
- Are all items on the served menu included in and accounted for on the planned menu and nutrient assessment?
- Does the planned menu and nutrient assessment meet the nutrition standards of the week?
- When serving smoothies, does the CE adhere to current guidance on smoothie food content?
- Are appropriate substitutions being made within the 2-week time frame?
- Is the menu-planning pattern well-advertised to the participants?
Nutrient Standard Menu Planning (Breakfast)
- Did TDA review and approve the menu planning system prior to implementation?[4]
- If the CE uses the Nutrient Standard Menu Planning System for breakfast, are menus analyzed using USDA-approved software?
- Is the CE serving the breakfast menu that has been analyzed by approved software?
Serving
- Are utensils that yield standard-sized servings used for portioning all menu items?
- If using Enhanced Food Based Menu Planning System for breakfast does only one grain-based dessert for grades K–12 count as a grains serving?
Water Availability
- Is potable water available to children in the food service area during meal service at no charge to children?
- Is the available potable water served plain with no flavoring or added food items?
Reimbursable Meal
- Does the cashier know the minimum number of food components thatchildren may select for a reimbursable meal?
- Are all required components offered in sufficient amounts before the cashier counts the meal as reimbursable?
- If the CE is operating under offer versus serve, is the child allowed to select her or his choice from the number of food items offered?
- Do children grades 9–12 have offer versus serve available to all children (not applicable to RCCIs)?
- Are children notified that extra sides taken will be charged?
Promoting Participation
- Does the CE conduct any activities to promote participation in the School Breakfast Program (SBP)?
- Have all barriers to participation in the SBP been removed?[5]
- Has the CE set targets for growth in the SBP?
- Has it met those targets to increase participation?
Production Records
- Is a CN Label or manufacturer’s specification, with regard to the contribution of all purchased-prepared meat/meat alternate food items, on file?[6]
- Are purchased-prepared items documented the same as those received, prepared, and served in all of the CE’s kitchens?[7]
- Are complete food production records maintained on all meals claimed for reimbursement including breakfasts, snacks, food bars, salad bars, and various other serving lines?
- Do production records show accurate case numbers, serving portions, and other required information?
- If breaded fruit and and/or vegetable products are used, is a CN Label or manufacturer’s specification regarding their contribution to the meal pattern on file?
Comments:
Afterschool Care Program, ARM, Section 10
- Does the CE follow the correct meal pattern?
- Does the CE self-review the program within the first 4 weeks of the program?
- Does the CE conduct a second self-review of the program before the end of the school year?
- Were the snacks claimed according to the site’s eligibility?
- Does the CE maintain daily participation records?
- Does the CE maintain food production records that are up to date and accessible for review?
- If the site requires a corrective action plan (CAP), is the plan completed and reviewed within 45 calendar days of the original site visit?
- Does the CE conduct any outreach to increase participation?
- Does the program include an educational enrichment activity?
Seamless Summer Option, ARM, Section 12
- Is the CE participating in the Seamless Summer Option?
- Does the CE follow the NSLP or SBP menu planning pattern?
- Does the CE have production records to show that a reimbursable meal hasbeen provided to children?
- Do the participating children meet the requirements for type of SSO site (i.e., camp, migrant, or open)?
- Has the CE advertised the Seamless Summer Option?
- Has the CE retained copies of media releases and out outreach documentation?
- Has the CE self-assessed[8] each summer site for meal counting, claiming, and meal patterns during summer operation?
Comments:
Special Dietary Needs, Section 13
- Are children with medical or special dietary needs provided access to program benefits as prescribed by regulations?
- Is a doctor or medical authority note on file if menu substitutions are made to a reimbursable meal for a child with special dietary needs?
Comments:
Financial, ARM, Section 14
Records Retention
- Are records maintained for the appropriate period of time?
- Five years for public or charter schools
- Three years for private schools or nonprofit organizations (RCCIs)?
- Are records readily retrievable?
- Are records available for review?
- Does the record keeping system separate program income by adult and children sales?
Fund Balance
- Was the remaining fund balance carried forward from last year to this year?
School Nutrition Program (SNP) funds:
- Are the CE net cash resources less than three months of operating expenses?
- If not less than three month’s operating expenses, is documentation on file explaining reasons for excess?
- Was a plan to reduce or use surplus resources submitted to TDA?
- Is interest earned on invested school nutrition program revenues credited to the CE account?
- Do all employees paid from the CE account have direct responsibility to the operation of programs?
- Do daily deposit slips balance with the bank’s monthly statement for the nonprofit CE account?
- Does the CE have documentation, including tracking of and a line item transfer from the general fund to child nutrition, for all bad debts?[9]
Comments:
Meal Pricing, ARM Section 15