Presentation on theme: "1 Child and Adult Care Food Program Adult Day Care Programs 2008 Training."— Presentation transcript:
1 Child and Adult Care Food Program Adult Day Care Programs 2008 Training
2 State Agency Staff Shodie Akin, Program SpecialistAnn-Marie Martin, Program Specialist Child Nutrition Services Child and Adult Care Food Program Tonia Haggard, Ed. Prog. AssistantJo Dawson, Project Coordinator CACFPCommodity Food Distribution
3 Eligibility To participating in the Child and Adult Care Food Program, a program must: Be public or private non-profit or for-profit with 25% of participants meeting low income guidelines (Medicaid, Title XIX or XX of Social Security Act) Provide non-residential day care Be licensed or approved by the Federal, State or local licensing authorities
4 Eligibility Be a community based program Provide services to functionally impaired disabled adults 18 years or older, or to persons 60 years of age or older. Develop an individual plan of care for each functionally impaired adult participant Offer a structured, comprehensive, program that provides a variety of health, social, and related services.
5 Eligibility Definitions: Adult participant: a person who is functionally impaired or over 60 years of age. Functionally impaired adults: Chronically impaired disabled persons 18 years or older. These include victims of Alzheimers disease and related disorders with neurological or organic brain dysfunction. Functionally impaired are physically, mentally impaired to the extent that their capacity for independence and their ability to carry out activities of daily living are markedly limited.
6 Update & Renewal Centers renew every 3 years Coincide with Administrative Review Updates & Renewals due October 1 7 CFR 226.6(b)(2)
7 Renewal (every 3 years) All Centers need to submit to the state agency by October 1 st : Sponsor Renewal Sheet (includes mgmt. plan) Site Sheet(s) Certification Statement CACFP User Authorization Date & Method of Media Release Rate Percentage Certification
8 Update (2 years between renewal) All Centers need to submit to the state agency by October 1 st : Sponsor Update Sheet Site Sheet(s) Approval to Continue CACFP User Authorization Date & Method of Media Release Rate Percentage Certification
9 What if you miss the deadline? CNS has 30 days to approve a completed Update or Renewal packet from Center The October claim will not be paid until the Renewal/Update is approved
11 Eligibility Participants are categorically eligible for FREE meals if they receive food stamps, aid from the Food Distribution Program on Indian reservations (FDPIR) Supplemental Security Income (SSI) or Medicaid benefits.
12 Rate Percentages Certification Four Steps: 1.) Collecting the Family Size-Income Data: Distribute sample Letter to Participant & the Income Eligibility form. Distribution may begin any time after July 1st. Eligibility must be based on information reported on the Income Eligibility Form
13 Rate Percentages Certification 2.) Establish the 30-day study period & Attendance Roster: 30-day period must be established to determine the total attendance at the center. All participants who attend the center during the study period must be counted & recorded on the attendance roster.
14 Rate Percentages Certification 3.) Categorizing & Approving the Income Eligibility Forms: Must be signed & dated by the participant or guardian after July 1st. Determination by the center cant be done after the study period. A participant will be counted as paid if the form is not signed by self/guardian
15 Rate Percentages Certification 4.) Documenting the Certification Statement. A file folder containing, the following back-up should be kept at the center each year. Copy of Certification Statement Original roster of all enrolled participants Approved Income Eligibility Form for each participant Copy of attendance records for the study period
16 Rate Percentages Certification Centers are required to collect & submit this information only once a year. 30 day study – between July-November Need certification to process October claim Centers may submit additional Certification Statement at any time during the year, if a center feels that it would be to their advantage.
17 Rate Percentages Certification Common errors in Blended Rate Certification Process: Including adults who are enrolled but did not attend during the 30-day period. Including only adults who have a Income Statement on file instead of all who attended during the 30-day period.
19 Rate Percentage Process Rate % Category% times Meals Meals by Category Federal Rate Reimbursement by Rate 60% Free.60 x 250 lunches % Reduced Price.30 x 250 lunches % Paid.10 x 250 lunches.38 Total Based on 250 Lunches
20 Rate Percentage Process Rate % Category% times Meals Meals by Category Federal Rate Reimbursement by Rate 60% Free.60 x 250 lunches % Reduced Price.30 x 250 lunches % Paid.10 x 250 lunches Total Based on 250 Lunches
21 Rate Percentage Process Rate % Category% times Meals Meals by Category Federal Rate Reimbursement by Rate 60% Free.60 x 250 lunches 150 X 4.01= $ % Reduced Price.30 x 250 lunches 75 X 3.61= $ % Paid.10 x 250 lunches 25 X.38= $9.50 Total$ Based on 250 Lunches
22 Licensing Requirements When renewing license, CACFP must receive a copy 15 day grace period May be found Seriously Deficient if current license not on file Not all programs are required to be licensed 7 CFR 226.6(d)(1)(i)
23 Media Release To announce their participation in the CACFP and to affirm that all adults are treated equally. Providers must submit a Public Release to the local media. Providers are not required to pay a fee but is required to show that one has been submitted.
24 USDA Commodities Bulk products available through USDA based on average daily attendance Centers may select commodities and place order February each year Products are delivered in fall Recommended for centers with an ADA of 50 If center opts out of commodities, may receive $ for every reimbursable lunch and supper
25 Child Nutrition Program (CNP) Database CNP Web User Request form Will receive User ID & Password Change your password FY2008 – Claim submission FY2009 – Renewals/Updates & Claims
26 Child Nutrition Program (CNP) Database On-line claiming Type in URL address –
27 Child Nutrition Program (CNP) Database
28 Child Nutrition Program (CNP) Database
29 Child Nutrition Program (CNP) Database
30 Child Nutrition Program (CNP) Database SAMPLE CACFP SPONSOR
31 Child Nutrition Program (CNP) Database SAMPLE CACFP SPONSOR
32 Find your program Ignore Homes 4,5,6) Certification numbers - Sponsor enters on October claim. (Only CNS can update these numbers) 1) Number of Centers 2) ADA 3) Operating Days 8) Meal Counts in the appropriate category
33 CNP Database Claim Submission
34 CNP Database Claim Submission
35 CNP Database Claim Submission Disregard the Home categories
36 Child Nutrition Program (CNP) Database Check that you certify you claim is true and correct Click Submit when ready and CNS will process
39 Child Nutrition Program (CNP) Database Next Steps: CNS checks and approves claim CNS sends claim to EED Finance Department EED Finance pays claim Center can check status of claim on-line
40 Civil Rights Compliance
41 What Is Discrimination? Discrimination is defined as different treatment which makes a distinction of one person or a group of persons from others; either intentionally, by neglect, or by the actions or lack of actions based on….
42 Protected Classes Race Color Sex Age National Origin Disability
43 Civil Rights Laws Title VI of the Civil Rights Act of Race, Color, National Origin Title IX of Education Amendments of Sex Section 504 of Rehab. Act of Disability Age Discrimination Act of Age Civil Rights Restoration Act of Race, Color, National Origin
44 Heart of Civil Rights Act No person in the United States shall on the grounds of race, color, or national origin be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal Financial Assistance.
45 8 Areas of Compliance Public Notification System Data Collection Training Compliance Reviews Civil Rights Complaints Assurances Limited English Proficiency Religious Organizations
46 8 Areas of Compliance Public Notification System All sponsors and their sites must display in a prominent place the And Justice For All, nondiscrimination poster. Available through State Agency or online at All sponsors must have the capability of providing informational materials in the appropriate translation concerning the availability and nutritional benefits of the CACFP The nondiscrimination statement should be included, in full, on all materials regarding the CACFP that are produced for public notification.
47 Nondiscrimination Statement In accordance with Federal law and U. S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age or disability. To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, DC or call (202) (voice and TDD). USDA is an equal opportunity provider and employer.
48 Too Big? If space is an issue, you can use the mini- statement: USDA is an equal opportunity provider.
49 8 Areas of Compliance Data Collection Each program must ensure that racial/ethnic data are collected each year and maintained on file for 3 years + the current year This data must include the number of children actually participating and the estimated number of potential eligible children by racial/ethnic category. Sources to determine the number of potentially eligible children include census data or public school enrollment data. Visual identification may be used by sponsors and providers to determine a childs racial/ethnic category or the parents may be asked to identify the racial/ethnic group of their child. Form available on our website at:
50 8 Areas of Compliance Civil Rights Training State agencies are responsible for training local agencies on an annual basis Local agencies are responsible for training subrecipients, including frontline staff who interact with applicants or participants on an annual basis
51 Civil Rights Training All staff should receive training on all aspects of civil rights compliance. Staff should be able to identify a civil rights complaint if received. They should know what to do if they receive a complaint. Understand that it is the basic right of the individual to file a complaint.
52 8 Areas of Compliance Compliance Reviews There are three types of Compliance Reviews… Pre-award Compliance Reviews Routine Compliance Reviews Special Compliance Reviews
53 8 Areas of Compliance Civil Rights Complaints Right to file a complaint: Any Person alleging discrimination based on race, color, national origin, sex, age, or disability has a right to file a complaint within 180 days of the alleged discriminatory action. Acceptance: All civil rights complaints, written or verbal, shall be accepted and forwarded to the Civil Rights Division of the USDA Food and Nutrition Service.
54 The following information should be included in a Civil Rights Complaint…. Name, address, and telephone number of the complainant. Specific location and name of the entity delivering the service or benefit. Nature of the incident or action that led the complainant to feel discrimination was a factor, or an example of the method of administration which is having an effect on the public, potential participants, or participants. The basis on which the complainant feels discrimination exists (race, color, national origin, sex, age or disability) The names, titles, and business addresses of persons who may have knowledge of the discriminatory action. The date(s) during which the alleged discriminatory actions occurred, or if continuing, the duration of such actions.
55 8 Areas of Compliance Assurances A civil rights assurance shall be incorporated in all agreements between State agencies and sponsors. State agencies are responsible for reviewing, approving, and monitoring State agency/sponsor agreements.
56 8 Areas of Compliance Limited English Proficiency Where a significant number or proportion of the population eligible to be served needs service or information in a language other than English in order to be informed of or to participate in the program, the recipient shall take reasonable steps to provide information in the appropriate language to such persons.
57 Limited English Proficiency Recipients of Federal financial assistance have a responsibility to take reasonable steps to ensure meaningful access to their programs and activities by persons with limited English proficiency. Factors to consider in determining what is reasonable: Number of LEP individuals participating in the Program. Frequency of contact with the Program. Nature and importance of the Program. Resources available. For more information on LEP go to:
58 8 Areas of Compliance Religious Organizations Equal opportunities for religious organizations Ensures a level playing field for the participation of faith-based organizations and other community organizations in the USDA programs
59 Religious Organizations This is accomplished by: Prohibiting discrimination on the basis of religion, religious belief, or religious character in the administration of Federal funds Allowing a religious organization that participates in USDA programs to retain its independence and continue to carryout its mission, provided that direct USDA funds do not support any inherently religious activities such as worship or religious instruction.
60 Religious Organizations This is accomplished by: Clarifying that faith-based organizations can use space in their facilities to provide USDA-funded service without removing religious art, icons, scriptures, or other religious symbols; and Ensuring that no organization that receives direct financial assistance from USDA can discriminate against a program beneficiary on the basis of religion or religious belief.
61 Final Words on Civil Rights Memories of our lives, of our works and our deeds will continue in others who believe and act for fairness and justice Rosa Parks
62 Site Review Requirements
63 Site Review Site Reviews must be completed 3 times per year most sites Cannot have 6 months between site reviews Director or Site Supervisor must conduct reviews. Must be a procedure in place to follow-up on any areas of non-compliance. Conduct during meal service. Variety of meal service be reviewed over the course of a year. Form available on CNS website at
65 To access forms click Child and Adult Care Food Program To access CNP Database click CNP Web Login
67 Click on CACFP Forms
72 (by state or federal agency) Administrative Reviews (by state or federal agency)
73 Core Review Elements Recordkeeping Meal counts Administrative costs/non-profit meal service Licensing and approval Instructions, guidance and handbooks Observation of meal service Cycle Menus/Production Records Program, civil rights requirements 7 CFR 226.6(m)(3)
74 Follow-up Reviews If found Seriously Deficient, the state agency may perform follow-up review Unannounced Target corrective action issued, but may be more comprehensive 7 CFR 226.6(m)(3)
75 CACFP Training by CNS Annual attendance is required Offered through distance delivery May be found Seriously Deficient for non- attendance USDA Policy Memo 04-03
76 CACFP Training by center staff Annual training must be conducted on-site Records of training must include: Attendee names Agenda Date of training Location of training 7 CFR (d)(2)(3)
77 CACFP Training All CNS CACFP training presentations available on-line for center use at:
78 CACFP Training Annual training must be conducted on-site Records of training must include: Attendee names Agenda Date of training Location of training CNS training PowerPoint available online at: 7 CFR ( 3)(12) 7 CFR (d)(2)
79 Claim for Reimbursement Due in to the state agency within 60 days of the claim month (within 10 days preferred) Additional 30 days for upward amendment On-line claim must be submitted by authorized representative Paper claim needs original signature of authorized representative
80 Recordkeeping All records must be maintained Current + 3 years Fiscal Year File & Monthly Files Fiscal Year: Certification Statement Enrollment and Eligibility Records Training Records Civil Rights Compliance Site Reviews (self-monitoring)
81 Recordkeeping Monthly Files Cycle Menu Records & Working Menu Records Meal Count Records Production Records (if using) Daily Attendance Records Documentation of non-profit food service
82 CACFP Program Year CACFP October 1 – September 30 October New Year begins November - March Center Review Cycle April Center Spring Training June – September Renewal & Update period September Fall Training
83 Reimbursement Meals claimed under part C of Title 111 of the Older Americans Act of 1965 cannot be claimed for CACFP reimbursement
84 Nutritional Needs Every older adult has a unique set of nutrition needs that may be influenced by sensory losses, oral health problems, chronic illness or disability, and the use of multiple medications. Providing nutritious meals and snacks can improve overall health
85 Resources Available
86 Nutrition and Aging Special Considerations: Protein malnutrition Dehydration Unplanned weight loss Difficulties chewing and swallowing Sensory losses
87 Energy Nutrients Carbohydrates: found in grains, fruits and vegetables Protein: found in meat, fish poultry, dried beans and peas and dairy products Fats: found in butter, oils, salad dressings and are a part of most protein sources
88 Vitamins and Minerals Older adults may have increased needs due to: Decreased utilization Multiple medications Lack of variety in diet
89 Fiber Older adults need adequate amounts to help aid in digestion and prevent constipation caused by inactivity, poor diet, inadequate fluid intake or medications. Chewing, swallowing or dental problems may decrease intake.
90 Fluids Aging impacts the sensory system so older adults do not feel thirsty Problems with continence may impede fluid intake Dehydration can produce an array of cognitive and physical changes
91 Individual Plan of Care Nutrition Assessment is a component of the plan of care and screens for problems. It should be completed at the time of admission to the CACFP. Participants with nutrition problems may require intervention by a registered dietitian, speech therapist or other health care practitioner
92 Liberalized Diets Diets that are highly restrictive and deny favorite foods can result in poor dietary intakes and unplanned weight loss Quality of life can be enhanced with a more liberal approach to therapeutic diets Check with MD or RD for problem participants.
93 Respect for Nutrition Needs It is important for CACFP employees to understand participants cultural and dietary requirements. Schedule theme meals, holiday celebrations, and incorporate favorites into the menu.
94 Meeting Special Nutrition Needs Food substitutions for medical reasons can be made only when there is a written statement from a medical authority Documentation of the medical need and lists of alternate foods must be kept on file
95 Types of Meal Service Centers may use traditional line service – cafeteria style line Meals may be pre-plated or served from a line or to the table Meals may be provided by a vendor or catered from a satellite kitchen Centers may choose to serve meals in a family-style setting.
96 Energy Nutrients Protein Older adults need slightly more protein because they utilize from food less efficiently May require more to use for repairing tissues Tend to eat smaller portions and meat may be difficult to chew or swallow
97 Offer vs Serve Meal Service OPTIONAL This option can increase food consumption and decrease waste. Participants are given the opportunity to select foods at each meal.
98 Meal Requirements Centers may serve 2 meals and 1 snack or 2 snacks and one meal daily: Breakfast Lunch (midday meal) Supper (evening meal) Supplemental food (snack)
99 Breakfast Minimum Components Food ComponentPortionDescription Milk1 cupMilk, fluid Vegetables, Fruit or Juice½ cup Vegetables and/or fruit or Full-strength veg or fruit juice or an equivalent quantity of any combination of veg,fruit or juice Grains and Breads2 slices 2 servings 1 ½ cups or 2 oz 1 cup Bread or Cornbread, biscuits, rolls, muffins or Cold dry cereal or Cooked cereal or Cooked pasta or noodles Cereal grains or an equivalent combination Participant may decline one component
100 Lunch Minimum Components Food ComponentPortionDescription Milk1 cupMilk, fluid Vegetables, Fruit or Juice1 cup totalVegetables and/or fruits Grains/ Breads2 slices 2 servings or 2 oz 1 cup Bread or Cornbread, biscuits, rolls muffins Cooked pasta or noodles Cooked cereal grains or equivalent quantity of any combination of bread/alternates Meat or Meat Alternate2 oz 1 ½ cup 4 Tbsp 1 oz 8 oz Lean meat or poultry or fish Alternate protein products Cheese Egg (large) Cooked beans or peas Peanut butter or soynut butter or other nut or seed butters Peanuts or soynuts or other Yogurt, plain or flavored Participant may decline 2 components
101 Supper Minimum Components Only difference from Lunch meal pattern is that milk is not required. Participant may decline 2 of the 5 supper components
102 Snack Minimum Meal Components Combination of any two food components Reduced portion size requirements Fruit = ½ cup Bread/grains = 1 oz Meat = 1 oz Milk = 1 cup Example: 1 cup milk + 1 oz banana bread
103 Offer vs Serve Must offer all of the required meal components May decline one meal component at breakfast May decline up to two meal components at lunch and supper Does not apply to snack
104 Meal Service If using family style meal service Enough food must be placed on the table to provide the full required portion size for all participants.
105 Creditable Meals Exceptions to a reimbursable meal may be made for Allergy (needs signed medical statement) Religious Beliefs (needs signed waiver by religious leader) Exceptions not provided for family preference (i.e. vegetarian)
106 Meal Count Attendance versus Meal Count Separate logs Meal count at point of service (centers) If meal count is not current at review, meals will be disqualified for claim
107 Cycle Menu Option or Production Records All Centers must maintain Daily Production records or use the Cycle Menu Option
108 Cycle Menu Option 108 Menus will be reviewed during administrative review and technical assistance provided on-site Cycle may be 3-6 weeks CACFP may have 4 seasonal cycle menus Production records must still be maintained for infants in care
109 Cycle Menu Option 109 A substitute list must be maintained Substitutions should be entered on menu to reflect foods served Combination foods must have recipe on file with yields
110 Substitute List 110 Food items already on the menu do not need to be on the Substitution list. For Example: if last Mondays menu contained oranges and this Tuesdays menu called for pears and you ran out, oranges are permitable.
111 Substitute List 111 If a food item is not on the menu already but may be used for substitutions, it should be listed on the substitution list. For example: center tries to serve only fresh fruit or veggies but keeps several #10 cans of peaches in reserve. The canned peaches should be on the Substitution list
112 Substitution List 112 Combination Foods Substitution list should indicate what component(s) a food item is creditable. For example: Stew (meat, vegetable) Meatloaf (meat, grain) Taco (meat, grain) All combination foods need recipe w/analysis on file
113 Combination Foods 113 Commercial CN Label Manufacturer's analysis Homemade (HM) Standardized Recipe from USDA Centers Recipe plus analysis/yields Production Record
114 How do you identify a CN label? A CN label will always contain the following: The CN logo, which is a distinct border; A 6-digit product identification number; USDA/FNS authorization;and The month and year of approval. A CN Label Example: CN This 3.00 oz serving of raw beef patty provides when Cooked 2.00 oz equivalent meat for Child Nutrition Meal Pattern Requirements. (Use of this logo and statement Authorized by the Food and Nutrition Service, USDA ) CN Label
115 Combination Foods Combination foods at lunch and supper should only have 2 components that will be claimed For lunch/supper only 1 fruit/vegetable component can be represented in a combination food Additional food items in the combination food will count as extras 115
116 Standardized Recipes A standardized recipe is one that has been tried, adapted, and retried many times to be sure the food product is the same each time it is prepared. It will make the same number of servings each time it is prepared as long as: The exact procedures are followed The same type of equipment is used The ingrediants are of the same quality The quantity of ingrediants is the same
117 Standardized Recipes
118 Standardized Recipes Resources: Some wholesalers provide standardized recipes to customers National Food Service Management Institute Measuring Success with Standardized Recipes Building Quality Meals – Standardized Recipes and Portion Control USDA Recipes for Child Care USDA Recipes for Schools
119 Standardized Recipes More information available at e/resource/chapter7.pdf
120 Example of a standardized Recipe
121 Example of Yield
122 What about your own recipes? Recipes should be on file when listed on Cycle Menu or Substitution List Analyze the recipe to document creditable food components List portion sizes Easy conversion for number of participants
123 Recipe Analysis Worksheet available on state of Alaska website
124 Recipe Analysis Instructions 124 List all ingredients and the amount of each ingredient Use the Simplified Food Buying Guide or the Food Buying Guide for Child Nutrition Programs. Record the yields (meat/meat alternate in ounces, fruit/vegetable in ¼ cup servings and bread/bread alternate in ½ slice bread or equivalent. Determine the number of 1.5 ounce meat/meat alternate for children 3-5 years olds by dividing the total by 1.5 or by 2 to find number of servings for 6-12 year olds. Round the total for fruit/vegetables and bread/bread alternate down to the nearest whole number to find the number of servings.
125 Recipe Analysis for Tuna Melt
126 Production Records Option 126 Production records must be kept for all meals claimed for reimbursement. Why? They document that all components were served and the right quantities were prepared to meet the meal pattern.
127 PRODUCTION RECORDS 127 What 5 items are required to be on every production record? 1. Date: Month, Day and Year 2. Menu: Include all items served 3. Items that meet the requirement for meal pattern/reimbursement 4. Meals: The number of child and adult meals served 5. Quantity: Total amount of food that was used in preparing the item
128 PRODUCTION RECORD CALCULATIONS 128 For each food: 1.Determine the serving size needed to meet the requirement. 2.Determine the total number of servings you need. Record in column: Number of Units 3.Look up the purchase unit in the food-buying guide. Record in column: Purchase Unit 4.Look up the number of servings you get out of the purchase Unit. Record in column: Servings Per Purchase Unit
129 PRODUCTION RECORD CALCULATIONS 129 For each food: 5. Determine how many purchase units you need by: Dividing the number of servings needed by the number of serving you will get from one purchase unit. Number of Units Serving Per Purchase Unit Record in column: Food Amount Needed
130 Production Records Menu: Hamburgers Buns Salad Apple Sauce Milk Prepared for: 10 adults 5 staff
140 Food Buying Guide for Child Nutrition Programs
143 Simplified Buying Guide SIMPLIFIED BUYING GUIDE For Child Care Food Programs
144 Health Safety & Sanitation Requirements State of Alaska Dept. of Environmental Conservation (DEC) Food Worker Cards Certified Food Protection Manager (CFPM)
145 Health Safety & Sanitation Requirements DEC Requirements All Food workers must have Food Worker Card (starting January 2008) On-line test site for Food Worker Card FAQs for Food Worker Cards in Alaska
146 Health Safety & Sanitation Requirements DEC Requirements One Certified Food Protection Manager (CFPM) will be required to be on staff One CFPM can represent all locations for multi- site programs if……
147 Health Safety & Sanitation Requirements DEC Requirements (Multi-Location) CFPM has a record on site at each location showing certification CFPM is involved in day to day activities, governs the activities and is responsible for activities CFPM has Food Safety Program in place for all food workers and enforces procedures
148 Health Safety & Sanitation Requirements DEC Requirements (Multi-Location) The person in charge can demonstrate his knowledge and produce all records during an inspection in the CFPMs absence. All Food Workers must hold a Food Handler Card on file at each location
149 Health Safety & Sanitation Requirements Municipality of Anchorage (Muni) Requirements Food Worker Cards not required Certified Limited Food Protection Manager 4 hour training Certified Limited Food Protection Manager 8 hour training
150 Health Safety & Sanitation Requirements Municipality of Anchorage (Muni) Requirements At least 1 Certified Food Protection Manager for each location Or At least 1 Certified Limited Food Protection Manager for each location Expires 3 years from date of issue
151 Health Safety & Sanitation Requirements Contact either DEC or Muni for your specific program – find out from the agency that oversees your center DEC CFPM Training Available: Muni Information Available:
154 Child and Adult Care Food Program Adult Day Care Programs