Completing the CACFP Reimbursement Claim Wisconsin Department of Public Instruction Child and Adult Care Food Program Child Care Institutions Outside of School Hours Care Centers Guidance Memorandum #3C

Claim Documentation −Household Size Income Statements −Household Size-Income Record −Time of Service Meal Count Records −Attendance Records −Days of Operation −Dated Menus −Production Records −Infant Meal Records, if applicable −Recipes −Child Nutrition Labels/Product Analysis Sheets −Original Food Receipts, Invoices etc.

Claim Due Dates Claim submission deadline of 60 days after the end of the claim month

Claiming MonthLast Day for Online Submission JanuaryApril 1 (March 31 on leap years) FebruaryApril 29 MarchMay 30 AprilJune 29 MayJuly 30 JuneAugust 29 JulySeptember 29 AugustOctober 30 SeptemberNovember 29 OctoberDecember 30 NovemberJanuary 29 DecemberMarch 1 (February 29 on leap years) Claim Deadline Dates Guidance Memorandum #3C:

On-Line Claiming Required Maintain confirmation page from the internet claim site

Online Confirmation Page

I. Child and Adult Care Food Program Enrollment Data Enrollment Data

I. Child and Adult Care Food Program Enrollment Data Enrollment Data

For-Profit Centers Monthly eligibility requirement 25% of the children must be county-funded (W2 Child Care Assistance) or 25% must be determined as free or reduced Failure to meet the 25% means the center cannot be reimbursed

II. Participation Data Participation Data 1 23

Average Daily Attendance Use daily attendance records, NOT meal counts Total children in attendance days of operation = ADA Round all fractions up to the next whole number

Participation Data 5. Number of sites 6. Number of days of service 7. Average Daily Attendance II. Participation Data  22

II. Participation Data Number of Meals Served to Children

II. Participation Data Number of Meals Served to Children

Claiming Meals for Reimbursement 2 meals and 1 snack or 2 snacks and 1 meal per child per day Greater than 3 Meals Record Guidance Memorandum #9C

Site Participation Data for Sponsoring Organizations ABC Child Care 1 ABC Child Care

Participation Data: Sponsoring Organizations

The U.S Department of Agriculture prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.) If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at or at any USDA office, or call (866) to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C , by fax (202) or at Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) ; or (800) (Spanish). USDA is an equal opportunity provider and employer.