CEO Meal Count Edit Form

							SAMPLE FORMAT - Distributed by ISBE for SFA discretionary use
only. Format may be modified and/or copied to meet specific
National School Lunch Program recordkeeping needs. Do not                  CEO MEAL COUNT EDIT FORM
return to ISBE.
NAME OF SCHOOL                                                         MONTH


                                                   NUMBER OF MEALS SERVED ON A DAILY BASIS
      Date                 Total Breakfasts Served                 Total Lunches Served                  Comments




  TOTALS                               0                                    0
ENROLLMENT:                                    AVERAGE DAILY ATTENDANCE (ADA):      ADA %:

                                                                                                    #DIV/0!
FREE CLAIMING %:                                                       PAID CLAIMING %:                  100.00%
FREE ELIGIBLES DURING                                                  PAID ELIGIBLES DURING
THE MONTH:                                            0                THE MONTH:                             0
Attendance-Adjusted             NUMBER OF ENROLLED ELIGIBLES           ADA%                     =
Eligibles:                                            0                         #DIV/0!                  #DIV/0!
                                ATTENDANCE-ADJUSTED ENROLLED           Number of Serving Days   =
Maximum Number of               ELIGIBLES
Breakfasts:
                                                 #DIV/0!                           0                     #DIV/0!
                                ATTENDANCE-ADJUSTED ENROLLED           Number of Serving Days   =
Maximum Number of               ELIGIBLES
Lunches:
                                                 #DIV/0!                           0                     #DIV/0!
  TOTAL BREAKFASTS  FREE BREAKFASTS                                                    PAID BREAKFASTS
    TO BE CLAIMED       CLAIMED:
                                                                      0                    CLAIMED:                 0
TOTAL LUNCHES TO BE  FREE LUNCHES                                                       PAID LUNCHES
      CLAIMED           CLAIMED:
                                                                      0                    CLAIMED:                 0
ISBE Nutrition - CEO Meal Count Edit Form (8/11)
                                                       CEO MEAL COUNT EDIT FORM
                                                                Instructions
1. Fill in name of site. A meal count edit form needs to be completed for each site within a school food authority.
2. Fill in the claim month.

NUMBER OF MEALS CLAIMED ON A DAILY BASIS
3. Record the date and the number of breakfasts and lunches served for each day in the claim month.

ENROLLMENT AND AVERAGE DAILY ATTENDANCE
4. Record the highest enrollment. Enrollment is the number of students enrolled at the site who are eligible to participate in th
    National School Lunch Program. This enrollment figure may or may not exclude pre-kindergarten, special education, etc
    depending on access and enrollment in your district.
5. Record the average daily attendance. The average daily attendance is determined by adding the total number of students i
    attendance every day during a month and dividing that total by the total number of school days in that month.

AVERAGE DAILY ATTENDANCE PERCENTAGE
6. To calculate the average daily attendance percentage divide the average daily attendance by enrollment or total days presen
    divided by total days enrolled.

FREE AND PAID CLAIMING PERCENTAGES
7. Record the predetermined Community Eligibility Option (CEO) free and paid percentages.


FREE AND PAID ELIGIBLES DURING THE MONTH
8. The number of free and paid eligibles is determined by obtaining the CEO free and paid percentages times enrollment for th
    claim month.

ATTENDANCE-ADJUSTED ELIGIBLES
9. Attendance-adjusted eligibles is the average daily attendance percentage times the number of enrolled eligibles. Multiply th
    average daily attendance percentage by the number of enrolled eligibles to arrive at the attendance-adjusted eligibles.

MAXIMUM NUMBER OF MEALS
10. Calculate the maximum number of meals by filling in the number of attendance-adjusted eligibles and multiplying the numbe
    of serving days for the claim month. Serving days are determined by counting the number of days meals were served.

TOTAL BREAKFASTS AND LUNCHES TO BE CLAIMED
11. Free breakfasts and lunches claimed, shows the number meals that should be claimed in the free category of the monthl
    claim. It is calculated by multiplying the total meals served by the CEO free percentage. Paid meals claimed, shows th
    number meals that should be claimed in the paid category of the monthly claim. It is calculated by multiplying the total meal
    served by the CEO paid percentage.

UPON COMPLETING THE FORM, YOU SHOULD:
1. Compare the number of enrolled eligibles to the number of meals served on a daily basis. If on any day the number of meal
    served is higher than the number of eligibles, you must lower the number of meals served to the number of eligibles o
    document the reason the number of meals served exceeds the maximum number of eligibles.
2. Compare the attendance-adjusted eligibles to the number of meals served on a daily basis. If the number of meals served i
    consistently higher than the attendance-adjusted eligibles, this could signify a possible problem with your counting an
    recording procedures.
3. Compare the maximum number of meals to the total number of meals claimed; if the total number of meals served is highe
    than the maximum number of meals, you must either document the reason or you must adjust your meals claimed to th
    maximum meals allowed.
4. When reviewing daily numbers look for indications of possible problems such as
      - patterns of numbers or repetition of numbers,
      - counts which equal the number of eligibles,
      - meal counts equal to the number of meals delivered for satellite or vended sites, and
      - identical counts for breakfast and lunch.
O MEAL COUNT EDIT FORM
     Instructions
 completed for each site within a school food authority.




ches served for each day in the claim month.



mber of students enrolled at the site who are eligible to participate in the
gure may or may not exclude pre-kindergarten, special education, etc.

daily attendance is determined by adding the total number of students in
at total by the total number of school days in that month.



e divide the average daily attendance by enrollment or total days present




n (CEO) free and paid percentages.



by obtaining the CEO free and paid percentages times enrollment for the




endance percentage times the number of enrolled eligibles. Multiply the
of enrolled eligibles to arrive at the attendance-adjusted eligibles.



  the number of attendance-adjusted eligibles and multiplying the number
e determined by counting the number of days meals were served.

ED
umber meals that should be claimed in the free category of the monthly
 ls served by the CEO free percentage. Paid meals claimed, shows the
 egory of the monthly claim. It is calculated by multiplying the total meals




ber of meals served on a daily basis. If on any day the number of meals
 must lower the number of meals served to the number of eligibles or
xceeds the maximum number of eligibles.
mber of meals served on a daily basis. If the number of meals served is
eligibles, this could signify a possible problem with your counting and

 number of meals claimed; if the total number of meals served is higher
her document the reason or you must adjust your meals claimed to the

 ossible problems such as



 ed for satellite or vended sites, and