Module 19. Appendix G

Welcome to Module 18 that will cover Adult
Care in the CACFP. The information can be found in Appendix G of
the CACFP Administrative manual. To participate in CACFP, adult day care
participants must be at least 60 years of age or
under age 60 if disabled or functionally The center must have an individual plan of
care for each enrolled participant who is
functionally impaired. Meals served to adult participants must follow
the adult CACFP meal pattern that will be
discussed later in this lesson. Adult care centers must keep the following
CACFP records: daily dated menus; food production records;
attendance; and meal participation records. These records are discussed in Modules 2 and
3. Adult care centers must also keep
documentation of disability for participants
under age 60; documentation of age or birthdate; and
documentation that the participant is enrolled in
the adult care program. Adult care organizations must conduct their
own self-monitoring reviews to evaluate
compliance with CACFP requirements. Any areas of non-compliance identified on
these reviews must be promptly corrected. Modules 9 and 14 that cover Chapter 7 and
Appendix B provide more information on this
requirement. Adult care centers have several CACFP
provisions that differ from those required of
other centers. The differences will be discussed in the
remainder of this presentation. Meals served to adult participants must follow
the adult meal pattern. We will review the CACFP adult meal pattern in
detail. Breakfast must be comprised of 4 components. I cup of fluid milk; ½ cup of vegetables, fruit, or
portions of both; and
2 oz equivalents of grains Meat and meat alternates may be used to meet
the entire grains requirement at breakfast a
maximum of three times per week. One ounce of meat and meat alternates is
equal to one ounce equivalent of grains. Lunch must be comprised of 5 components. I cup of fluid milk; a 2 ounce equivalent serving
of meat or meat alternate; ½ cup of vegetables; ½ cup of fruit or a second
vegetable; and 2 ounce equivalents of grains. Supper must be comprised of 4 components: a 2 ounce equivalent serving of meat or meat
alternate; ½ cup of vegetables; ½ cup of fruit or second vegetable; and 2
ounce equivalents of grains. Milk is an optional component at supper. And finally, snacks must include 2 of the 5
following components: 1 cup of fluid milk; a one ounce equivalent
serving of meat or meat alternate; ½ cup vegetables; ½ cup of fruit; and 1 oz
equivalent of grains. Only one of the two snack components may be
a beverage. At breakfast, lunch, and snack, milk must be
low-fat (1%) or fat-free (skim), flavored or unflavored. Yogurt may be served in place of milk one time
per day when yogurt is not used as a meat
alternate in the same meal, and must contain less than 23 grams of total
sugars per 6 ounces. Water must be available at all meals, but must
not replace any required meal component. It is recommended to serve water at meals or
snacks when yogurt substitutes for milk. Pasteurized full-strength juice may only be
used to meet the vegetable or fruit requirement
one time per day, including snack. A vegetable may be used to meet the entire
fruit requirement. When two vegetables are served at lunch or
supper, two different kinds of vegetables must
be served. At least one serving of grains per day must be
whole grain-rich across all eating occasions at
each site. Grain-based desserts do not count towards
meeting the grain requirement. To summarize the differences between the
adult meal pattern and child meal pattern: Yogurt may be served in place of milk up to
one time per day; milk is an optional component at supper; and
two ounce equivalents of grain are required at
breakfast, lunch and supper. Offer versus serve is an option in adult day
care centers. This means enrolled adults have the choice to
decline certain foods at each meal. At breakfast, three required components plus
one additional creditable food item must be
offered, for a total of four different food items. One item may be declined. At lunch and supper, five components must be
offered. Two components may be declined; the adult
must receive three components. All components must be served at snack and
none may be declined. Instructions or signs must be available to let
supervisors and participants know what
choices make up a reimbursable meal. All components must be pre-portioned and
someone must supervise to ensure that
participants receive the required number of components
and meal participation is correctly recorded. The organization must inform the State agency
on the IowaCNP site application if they will be
using offer versus serve. While adult care center participants must be
enrolled in the adult care program, adult centers are not required to collect or
update CACFP enrollment forms. Adult care center sponsors are also not
required to collect household contacts. The following forms are different for adult care
centers versus childcare: The menu form is different. An adult menu form is available in Chapter 2
and Appendix G. The income application and household letter
are different as well. The adult forms are in Chapter 3a, Appendix G,
and Download Forms. Another difference is that adult participants are
categorically eligible for free meals if they receive Medicaid and supplemental
security income or SSI. The programs do not qualify children for free
meals. Let’s take a look at the adult income
application. If a participant or any family member receives
food assistance, SSI, or Medicaid, they must fill in their name and case number,
then sign, and date the form. They do not need to complete Part 2. Providing information about racial or ethnic
background is voluntary, but if participants do not self-report, the
organization must make a determination. If a participant or household member does not
receive Food Assistance, SSI, or Medicaid, but their household is at or below the income
eligibility guidelines for reduced-price meals,
they may fill in Part 2 of the form. The participant and/or any other people who
live in the household and depend on them for
financial support must be listed. If the people who live with the adult participant
are not financially dependent on them, they do not have to be included on this form,
unless the participant is married. If married, the spouse must be listed. In addition to name, each household member’s
age and monthly gross income must be listed
under the applicable column. The last four digits of the social security
number of the adult household member that
signs the form must be listed. f an adult signing the form does not have a
social security number, they must check the box, “I do not have a
social security number.” The form must be signed and dated by the
participant, guardian, or household member. Participants may qualify for free or reduced-
price meals at any time during the year. If they have a decrease in income, an increase
in family size, or start receiving Food
Assistance, SSI, or Medicaid benefits, they Eligibility for free, reduced or paid meals must
be determined on the form and it must be
signed and dated by center personnel before it An income eligibility form is valid from the
beginning of the month in which it was signed
or approved until one year later. For example, if the income application was
signed July 15, 2018, it would be effective from
July 1, 2018 through July 30, 2019. The center must use either the date signed or
the date approved consistently for all
applications. If the application isn’t approved until the
second month after being signed, the application is effective in the month it is
approved. This concludes the lesson on Adult Care in the
CACFP. If you have questions, please contact
your CACFP consultant or the State Agency. Contact information can be found in the front of
the CACFP Administrative Manual.

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