Hathaway Building, 2Nd Floor, 2300 Capitol Avenue

Wyoming Department of Education is an equal opportunity provider. opportunity equal an is Education of Department Wyoming

for the current year and the next three succeeding years. years. succeeding three next the and year current the for

or kitchen manager. The completed attachments should be filed with yearly records and kept on file file on kept and records yearly with filed be should attachments completed The manager. kitchen or

service concerns and can be completed by the school administrator and/or the food service director director service food the and/or administrator school the by completed be can and concerns service

procedures. Attachment 2 does not have a mandatory deadline but reviews a combination of food food of combination a reviews but deadline mandatory a have not does 2 Attachment procedures.

1 must be completed by the Authorized Representative to review meal counting and claiming claiming and counting meal review to Representative Authorized the by completed be must 1

aspects of the Nutrition Programs whether there is only one site or multiple serving sites. Attachment sites. serving multiple or site one only is there whether Programs Nutrition the of aspects

Attachment 2 is an optional review form that can be completed to review all all review to completed be can that form review optional an is 2 Attachment served. are meals

1 February by annually completed be must 1 Attachment minimum, a At for each location where where location each for

for each day of operation. [7CFR 210.8 (a)(1)]. 210.8 [7CFR operation. of day each for

yields the actual number of reimbursable free, reduced price, and paid lunches, respectively, served served respectively, lunches, paid and price, reduced free, reimbursable of number actual the yields

by the state agency under section 7CFR 210.7 (c) and that the counting system, as implemented, implemented, as system, counting the that and (c) 210.7 7CFR section under agency state the by

Each on-site review shall ensure that the school’s claim is based on the counting system authorized authorized system counting the on based is claim school’s the that ensure shall review on-site Each

conducts a follow-up on-site review to determine that the corrective action resolved the problems. problems. the resolved action corrective the that determine to review on-site follow-up a conducts

authority shall: ensure the school implements corrective action; and, within 45 days of the review, review, the of days 45 within and, action; corrective implements school the ensure shall: authority

the review discloses problems with a school’s meal counting or claiming procedures, the school food food school the procedures, claiming or counting meal school’s a with problems discloses review the

1 February to prior place take shall review on-site The jurisdiction. of each school year. Further, if if Further, year. school each of

one on-site review of the lunch counting and claiming system employed by each school under its its under school each by employed system claiming and counting lunch the of review on-site one

On-site reviews: Every school year, each each year, school Every reviews: On-site shall perform no less than than less no perform shall school one than more with LEA

website.

your Nutrition Services file. The memo is also available on the Wyoming Department of Education Education of Department Wyoming the on available also is memo The file. Services Nutrition your

This information should be shared with school food service staff and the original should be placed in in placed be should original the and staff service food school with shared be should information This

Nutrition Programs Consultant Programs Nutrition

FROM: Terry Walling Terry FROM:

than one serving site serving one than

TO: Food Service Directors and Business Managers of Districts/Schools/RCCIs with more with Districts/Schools/RCCIs of Managers Business and Directors Service Food TO:

System Count Meal School the of Assessment

SUBJECT: On-Site Review Form Form Review On-Site SUBJECT:

DATE: January 3, 2014 3, January DATE:

edu.wyoming.gov

Phone: 307-777-7675 | Fax: 307-777-6234 | Website: | 307-777-6234 Fax: | 307-777-7675 Phone:

Cheyenne, WY 82002 WY Cheyenne,

Hathaway Building, 2nd Floor, 2300 Capitol Avenue Capitol 2300 Floor, 2nd Building, Hathaway

Richard Crandall, Director Crandall, Richard Wyoming Department of Education of Department Wyoming

14. Are there procedures for meal counting and claiming claiming and counting meal for procedures there Are 14.

totaled and consolidated? consolidated? and totaled

13. If claims are aggregated, are the meal counts correctly correctly counts meal the are aggregated, are claims If 13.

Care Program? Care

completed for current school year for the After School After the for year school current for completed

12. Have two on-site monitoring review forms been been forms review monitoring on-site two Have 12.

documented?

11. Are school level edit checks completed and completed checks edit level school Are 11.

correctly totaled and recorded? and totaled correctly

10. Are daily counts for all serving lines, meal periods, etc., etc., periods, meal lines, serving all for counts daily Are 10.

school’s claim for reimbursement? for claim school’s

9. Is the point of service meal count used to determine the the determine to used count meal service of point the Is 9.

8. Does the system prevent overt identification? overt prevent system the Does 8.

requirements?)

second meals that are sold, meals that don’t meet meal meal meet don’t that meals sold, are that meals second

(distinguishing them from reimbursable meals, i.e., i.e., meals, reimbursable from them (distinguishing

7. Is there a method of recording non-reimbursable meals meals non-reimbursable recording of method a there Is 7.

6. Is the method for counting meals by category accurate? category by meals counting for method the Is 6.

served in the classroom.) the in served

cannot be completed in the classroom unless the meal is meal the unless classroom the in completed be cannot

Services approved alternate policy? (Meal counts counts (Meal policy? alternate approved Services

the point of service requirement or with the Nutrition Nutrition the with or requirement service of point the

5. Is the method used for counting meals in compliance with compliance in meals counting for used method the Is 5.

the appropriate personnel? personnel? appropriate the

4. Is a current eligibility list maintained and available only to to only available and maintained list eligibility current a Is 4.

person?

3. Is someone trained as a backup for the meal count count meal the for backup a as trained someone Is 3.

Charged and/or prepaid meals? prepaid and/or Charged

Field trips? Field

Student worker meals? worker Student

Incomplete meals? Incomplete

Second meals? Second

A la carte sales? carte la A

Offer vs. Serve? vs. Offer

Adult guest’s meals? guest’s Adult

Visiting student meals? student Visiting

Lost, stolen, forgotten, or destroyed tickets, tokens, ID’s, ID’s, tokens, tickets, destroyed or forgotten, stolen, Lost,

2. Does this person know the school’s policies for handling: for policies school’s the know person this Does 2.

with the Nutrition Services approved policy? approved Services Nutrition the with

whether offer vs. serve is implemented in compliance compliance in implemented is serve vs. offer whether

and and pattern meal the for served meals reimbursable

1. Can the person responsible for monitoring meals identify identify meals monitoring for responsible person the Can 1.

Meal Count and Claiming and Count Meal

N/A NO YES AREAS REVIEW COMMENTS

Date: SCHOOL: LEA:

On-Site Monitoring Required Worksheet Required Monitoring On-Site Attachment 1 Attachment

. Has the LEA discontinued collecting meal benefit benefit meal collecting discontinued LEA the Has . 29

For Provision 3 Agencies 3 Provision For (Not a Base Year) Base a (Not

offered by WDE Nutrition Programs for the current school school current the for Programs Nutrition WDE by offered

. Have administrative staff attended an approved training training approved an attended staff administrative Have . 28

monthly claims?) claims?) monthly

year monthly percentages chart used when submitting the the submitting when used chart percentages monthly year

that were established during the base year? (Is the base base the (Is year? base the during established were that

. Does the LEA report meal counts based on percentages percentages on based counts meal report LEA the Does . 27

(Records must be kept longer than three years.) three than longer kept be must (Records

. Are the applications from a base year still available? available? still year base a from applications the Are . 26

record meal counts by student names? student by counts meal record

. Does the meal count person know they do NOT have to to have NOT do they know person count meal the Does . 25

collected for student meals.) student for collected

. Is the program a non-pricing program? (no money is being being is money (no program? non-pricing a program the Is . 24

has selected a reimbursable meal? reimbursable a selected has

. Is the meal count person checking to be sure each student student each sure be to checking person count meal the Is . 23

applications on a yearly basis? yearly a on applications

. Has the LEA discontinued collecting meal benefit benefit meal collecting discontinued LEA the Has . 22

(Not a Base Year) Base a (Not Agencies 2 Provision For

REVIEW AREAS REVIEW COMMENTS N/A NO YES

needed?

21. Are procedures in place to update eligibility status as as status eligibility update to place in procedures Are 21.

or procedures in place for a backup method? backup a for place in procedures or

20. If the LEA uses an electronic system, are there policies policies there are system, electronic an uses LEA the If 20.

to correspond with cash intake? cash with correspond to

19. Is it ensured that counts are not adjusted or “backed out” “backed or adjusted not are counts that ensured it Is 19.

18. Is cash reconciled daily and are differences recorded? differences are and daily reconciled cash Is 18.

17. Is there a second-party count of cashier’s cash intake? cash cashier’s of count second-party a there Is 17.

For Systems with Cash Intake Cash with Systems For

discrepancies accounted for)? accounted discrepancies

respectively, time an attendance factor (and any any (and factor attendance an time respectively,

eligible for free , reduced price and paid lunches, lunches, paid and price reduced , free for eligible

against the product of the number of students currently currently students of number the of product the against

daily counts of free, reduced price and paid lunches lunches paid and price reduced free, of counts daily

checks completed and documented which compare the the compare which documented and completed checks

16. If applicable according to 7 CFR 210.8(a)(3), are edit edit are 210.8(a)(3), CFR 7 to according applicable If 16.

Paid: Paid:

Reduced price: Reduced price: Reduced

Free: Free:

Today’s Meal Counts by Category by Counts Meal Today’s Category by Approved Students of Number

number of students eligible by category. category. by eligible students of number

today’s meal count be category and compare to the the to compare and category be count meal today’s

an accurate claim for reimbursement is made? Record Record made? is reimbursement for claim accurate an

the number of student eligible or in attendance and that and attendance in or eligible student of number the

established to ensure that daily counts do not exceed exceed not do counts daily that ensure to established

15. Are internal controls (edits, monitoring, etc ) etc monitoring, (edits, controls internal Are 15.

it? it?

available and do staff know when and how to implement to how and when know staff do and available

when the primary counting and claiming system is not not is system claiming and counting primary the when

Date Title Signature Manager or Director Service ood F

______

School Site Signature Signature Site School Date Title

______

: implemented date and school by

corrective action was required): required): was action corrective corrective action taken action corrective of Observations

Must be conducted within 45 days if if days 45 within conducted be Must ( Visit: Follow-Up

“no” answers.) “no”

Corrective Action Plan: Plan: Action Corrective (Recommended Corrective Action for above above for Action Corrective (Recommended

school year? school

training offered by WDE Nutrition Programs for the current current the for Programs Nutrition WDE by offered training

5. Have administrative staff participated in an approved approved an in participated staff administrative Have 5. 3

(Records must be kept longer than three years.) three than longer kept be must (Records

. Are the applications from the base year still available? available? still year base the from applications the Are . 34

record meal counts by student names? student by counts meal record

. Does the meal count person know they do NOT have to to have NOT do they know person count meal the Does . 33

rather by student names or actual meal counts? meal actual or names student by rather

enrollment using percentage factor established in base year year base in established factor percentage using enrollment

. Does the LEA submit monthly meal counts based on on based counts meal monthly submit LEA the Does . 32

collected for student meals.) student for collected

. Is the program a non-pricing program? (no money is being being is money (no program? non-pricing a program the Is . 31

has selected a reimbursable meal? reimbursable a selected has

. Is the meal count person checking to be sure each student student each sure be to checking person count meal the Is . 30 applications on a yearly basis? yearly a on applications

Explain “NO” answers in comments section. comments in answers “NO” Explain

High School High

School / Jr. Jr. / School

Middle Middle

Elementary

13. Is offer versus serve properly implemented? properly serve versus offer Is 13.

requirements?

12. Do the portion sizes appear to meet the minimum meal pattern pattern meal minimum the meet to appear sizes portion the Do 12.

commodities, foods on hand, adequate purchasing procedures? purchasing adequate hand, on foods commodities,

11. Are menus planned in advance to assure good use of of use good assure to advance in planned menus Are 11.

10. Does today’s menu have all required menu components? menu required all have menu today’s Does 10.

the Traditional meal pattern? pattern? meal Traditional the

9. Is the food service staff planning and preparing meals according to according meals preparing and planning staff service food the Is 9.

Meal Patterns Meal

dietician.) dietician.)

completed by a physician and a resource such as a local local a as such resource a and physician a by completed

students needing special diets? ( i.e., special diet request form form request diet special i.e., ( diets? special needing students

8. Does the SFA have policies and procedures for working with with working for procedures and policies have SFA the Does 8.

so they can easily access the cafeteria and tray lines? tray and cafeteria the access easily can they so

7. Are accommodations made for students with physical disabilities disabilities physical with students for made accommodations Are 7.

6. Are single meal tickets available only to paid students? paid to only available tickets meal single Are 6.

or reduced price meals? meals? price reduced or

5. Are multiple meal tickets available only to children eligible for free free for eligible children to only available tickets meal multiple Are 5.

example, eligibility status does not show up on the screen) the on up show not does status eligibility example,

transactions, does the system prevent overt identification? (for (for identification? overt prevent system the does transactions,

4. When using a computer system for doing meal counts and cash cash and counts meal doing for system computer a using When 4.

numbers, obvious codes such as F,R,P; 1,2,3)? F,R,P; as such codes obvious numbers,

or reduced price meals (for example, color coding, symbols, symbols, coding, color example, (for meals price reduced or

a way that it is obvious to others which children are receiving free free receiving are children which others to obvious is it that way a

3. When using a name checklist in the lunchroom, is it coded in such such in coded it is lunchroom, the in checklist name a using When 3.

same choices as the paying children? paying the as choices same

2. Are children eligible for free or reduced price meals allowed all the the all allowed meals price reduced or free for eligible children Are 2.

they receive their meal? their receive they

community people as they proceed through the tray line or where where or line tray the through proceed they as people community

highly visible location that can be seen by students, faculty, and and faculty, students, by seen be can that location visible highly

1. Is the most current USDA/FNS “Justice for All” poster hung in a a in hung poster All” for “Justice USDA/FNS current most the Is 1.

Civil Rights Civil

School: Authority: Food School

On-Site Monitoring Optional Worksheet Optional Monitoring On-Site Attachment 2 Attachment

2. Are toxic or poisonous items stored away from food food from away stored items poisonous or toxic Are 2. 3

their refrigerator/cooler and freezer? and refrigerator/cooler their

31. Is the kitchen staff completing food temperature logs for for logs temperature food completing staff kitchen the Is 31.

procedures?

written food safety plan that itemizes standard operating operating standard itemizes that plan safety food written

30. Does the food service manager/director/head cook have a have cook manager/director/head service food the Does 30.

inspection report been corrected? been report inspection

29. Have errors that may have been cited on the last fire fire last the on cited been have may that errors Have 29.

health inspection report been corrected? been report inspection health

28. Have the errors that may have been cited on the last last the on cited been have may that errors the Have 28.

people to read? to people

highly visible location for students, staff or community community or staff students, for location visible highly

27. Is the most recent health/sanitation report posted in a a in posted report health/sanitation recent most the Is 27.

foods; total number of student and adult meals.) adult and student of number total foods;

adults, and ala carte; quantities for leftovers or added added or leftovers for quantities carte; ala and adults,

menu item and age group; planned portions for seconds, seconds, for portions planned group; age and item menu

completed daily? (for example, planned servings for each each for servings planned example, (for daily? completed

6. Are all sections of the daily production record being being record production daily the of sections all Are 6. 2

SA prototype, has it been approved for use by the SA? the by use for approved been it has prototype, SA the

25. If the food service is using a production record that is not not is that record production a using is service food the If 25.

Prototype)

appropriate for Traditional Menus? (SA Production Record Production (SA Menus? Traditional for appropriate

24. Is the staff using an approved production record form form record production approved an using staff the Is 24.

location, such as a 3-ring binder, in date order? order? date in binder, 3-ring a as such location,

23. Is the staff keeping daily production records in a safe safe a in records production daily keeping staff the Is 23.

is a daily production record provided? record production daily a is

22. If the SFA has an outside entity prepare the daily meals, meals, daily the prepare entity outside an has SFA the If 22.

menu record, a lunch menu record, a snack menu record) record) menu snack a record, menu lunch a record, menu

record for each meal service? (for example, a breakfast breakfast a example, (for service? meal each for record

21. Is the food service staff completing a daily production production daily a completing staff service food the Is 21.

Menu Production Records Production Menu

service.)

components must be available to students at point of of point at students to available be must components

milk cooler, salad bar, or specialty bar. All menu menu All bar. specialty or bar, salad cooler, milk

would be not considered extra items? (for example the the example (for items? extra considered not be would

lunch room after students go through the tray line that that line tray the through go students after room lunch

Are any of the required menu components located in the the in located components menu required the of any Are 20.

reimbursement?

components so their meal can be claimed for for claimed be can meal their so components

students have selected the minimum number of menu menu of number minimum the selected have students

19. Does the meal count person look at each tray to be sure sure be to tray each at look person count meal the Does 19.

18. Are meal counts based only on tray or plate counts? plate or tray on only based counts meal Are 18.

all the required menu components? menu required the all

responsible at the end of the line to be sure each tray has has tray each sure be to line the of end the at responsible

beginning of the tray line, is there someone who is is who someone there is line, tray the of beginning

7. If approval has been given to do meal counts at the the at counts meal do to given been has approval If 7. 1

the end of the tray line? tray the of end the

16. Is the point of service and meal count person located at at located person count meal and service of point the Is 16.

15. Are daily meals claimed based on attendance records? attendance on based claimed meals daily Are 15.

meals is served? is meals

counts, or counts taken at any other location before the the before location other any at taken counts or counts,

14. Are daily meals claimed based on morning classroom classroom morning on based claimed meals daily Are 14.

Point of Service Reimbursable Meal Count Meal Reimbursable Service of Point

COMMENTS N/A NO YES AREAS REVIEW

Comments

confidential nature should be worked on or kept at home.) at kept or on worked be should nature confidential

store records at the school? (No work papers of of papers work (No school? the at records store

45. Is space available for food service staff to complete and and complete to staff service food for available space Is 45.

claims for loss of USDA Foods? USDA of loss for claims

4. Do program personnel know the procedures for submitting for procedures the know personnel program Do 4. 4

agency?

3. Are all foods stored in facilities belonging to the local local the to belonging facilities in stored foods all Are 3. 4

(FIFO)

2. Is first in, first out method of inventory rotation practiced? practiced? rotation inventory of method out first in, first Is 2. 4

should be lockable.) be should

theft, spoilage, or insect/rodent infestation? (Storeroom (Storeroom infestation? insect/rodent or spoilage, theft,

1. Are adequate safeguards in place to minimize or prevent prevent or minimize to place in safeguards adequate Are 1. 4

supply)

(an amount of stock which would exceed a 6 month month 6 a exceed would which stock of amount (an

0. Is there an excess supply of any USDA Foods product? product? Foods USDA any of supply excess an there Is 0. 4

. Is adequate space available for storage? storage? for available space adequate Is . 39

record of all USDA Foods that is up to date? to up is that Foods USDA all of record

8. Does the food service staff have a perpetual inventory inventory perpetual a have staff service food the Does 8. 3

commodities? If no, skip questions 37-44. questions skip no, If commodities?

37. Does the School Food Authority (SFA) receive receive (SFA) Authority Food School the Does 37.

USDA Food Distribution Food USDA

agency?

6. Are all foods stored in facilities belonging to the local local the to belonging facilities in stored foods all Are 6. 3

(FIFO)

5. Is first in, first out method of inventory rotation practiced? practiced? rotation inventory of method out first in, first Is 5. 3

should be lockable.) be should

theft, spoilage, or insect/rodent infestation? (Storeroom (Storeroom infestation? insect/rodent or spoilage, theft,

4. Are adequate safeguards in place to minimize or prevent prevent or minimize to place in safeguards adequate Are 4. 3

 Monitoring freezer temps during school breaks? school during temps freezer Monitoring

 Controlling unauthorized people/traffic in kitchen kitchen in people/traffic unauthorized Controlling

 When outside groups use the kitchen facilities? kitchen the use groups outside When

 Keeping food supply safe and secure? and safe supply food Keeping

 Controlling keys to kitchen and storage areas? storage and kitchen to keys Controlling

3. Does the SFA have policies and procedures in place for: place in procedures and policies have SFA the Does 3. 3 items? items?

School Food Authority Signature Authority Food School Date Title

______

School Site Signature Signature Site School Date Title

______

): implemented

( Visit: Follow-Up Corrective Action taken by school and date date and school by taken Action Corrective

: ) answers “NO”

Plan: Action Corrective Recommended Corrective Action for above above for Action Corrective Recommended (

comments section area.) section comments

need to be addressed at this time? (Describe in in (Describe time? this at addressed be to need 46. Are there any other food service program concerns that that concerns program service food other any there Are 46.