Daily Participation Record and Monthly Meal Count Summary_ CACFP

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Daily Participation Record and Monthly Meal Count Summary_ CACFP Powered By Docstoc
					                         Daily Participation Record and Monthly Meal Count Summary
                         Child and Adult Care Food Program (Adult Care Component)

Month ______________________________________                                                    Site_________________________________

          Date              Breakfast A.M. Snack                Lunch         P.M. Snack         Supper         Additional Snack       Attendance
            1
            2
            3
            4
            5
            6
            7
            8
            9
           10
           11
           12
           13
           14
           15
           16
           17
           18
           19
           20
           21
           22
           23
           24
           25
           26
           27
           28
           29
           30
           31
        TOTAL                           0                 0               0                 0               0                      0                0
         ADA**                                                                                                                          #DIV/0!

Meal Counts:               Record meal counts of only eligible adult participants at the time of meal service.
**ADA:                     (1) Add total attendance of eligible adults for each day site was open and serving meals.
                           (2) Divide total by # of days of service.
                           (3) Round any fractions up to the next whole number.
Guidance Memorandum 9A, revision date 7/09
See the DPI CACFP website at http://dpi.wi.gov/fns/adultmemos.html for an electronic version of this form to download and print.

				
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