APPENDIX A2.5
AT-RISK CENTERS
At-Risk Center Survey Instrument
IMPORTANT:
When completing this questionnaire, please think ONLY of the site at the address listed in the cover letter that came with the questionnaire packet.
Base your answers on your experiences with CACFP at this site only.
We may ask some questions for which you don’t have the answer. If that’s the case, please contact your sponsoring organization, someone else in your organization, or other appropriate person to get the information. Thanks in advance for doing so!
General Background on Your Site
1. Is your organization private not-for-profit, for-profit, or is it a public agency, school, or school district? (Check one box)
Private, not-for-profit 
Private for-profit 
Public agency, school, or school district 
2. Which of the following best describes your organization? (Check one box)
Child care center 
Head Start center 
Public school 
Private school 
School food authority 
Housing authority facility/site 
Homeless center 
Parks and recreation facility 
Multi-purpose community center 
YMCA or YWCA 
Boys & Girls Club 
Salvation Army site 
United Way organization 
Faith-based organization 
21st Century Community Learning Center 
Police Athletic League 
Food bank 
Tribal organization 
Other 
(Please specify)
3. Is the site where you provide At-Risk meals and/or snacks licensed as a child care center?
Yes 
No 
4. Do children attending the afterschool program at your site enroll or is attendance on a “drop in” basis?
All children must enroll 
All children attend on a drop in basis 
Some children enroll and some attend on a
drop-in basis 
5. Which of the following age groups do you serve in your afterschool program?
0-12 months 
1 and 2 years 
3 through 5 years 
6 through 9 years 
10 through 12 years 
13 through 18 years 
6. What kinds of educational and enrichment programming does the afterschool component of your site offer to the children? (Check all that apply)
Recreation 
Nutrition education on healthy eating 
Education on growing healthy foods 
Good citizenship 
Anti-bullying 
Arts education 
Physical education 
General academic assistance 
Academic tutoring on specific subjects 
Other 
(Please specify)
History of Your Site’s CACFP Participation and
Experience at Initial Enrollment in At-Risk CACFP
7. In what year did your site first begin participating in any part of the CACFP?
|___|___|___|___|
Don’t know 
8. Have you ever claimed any afterschool snacks in the At-Risk CACFP?
We currently claim At-Risk afterschool snacks 
We claimed At-Risk afterschool snacks in the
past but not currently 
We have never claimed At-Risk afterschool
snacks   GO TO QUESTION 9
8a. In what year did your site start claiming afterschool snacks in the At-Risk CACFP?
|___|___|___|___|
Don’t know 
9. Have you ever claimed any afterschool meals in the At-Risk CACFP?
We currently claim At-Risk afterschool meals 
We claimed At-Risk afterschool meals in the
past but not currently 
We have never claimed At-Risk afterschool
meals   GO TO QUESTION 10
9a. In what year did your site start claiming afterschool meals in the At-Risk CACFP?
|___|___|___|___|
Don’t know 
Please answer the remainder of the questions in this section thinking back to when you first applied to participate in the At-Risk CACFP.
10. How did you first find out about the At-Risk CACFP? (Check one box)
In a local newspaper 
On the radio 
Posters, Flyers or brochures 
From an advocacy organization 
From a friend 
Someone contacted me from the State agency 
Someone contacted me from a CACFP
sponsoring organization 
From the organization that administers my site 
Social media 
Other 
(Please specify)
Don’t know 
11. The following is a list of possible reasons why organizations might want to participate in the At-Risk CACFP. Please rank the three reasons you consider to be most important, with “1” being the most important, “2” being the second most important, and “3” being the third most important reason your organization participates. (Rank 3)
Rank
Allows us to provide food to children who are at risk
of hunger |___|
Supports afterschool enrichment programming |___|
Less paperwork requirements than non-At-Risk CACFP |___|
Area eligibility instead of individual eligibility |___|
Does not require us to meet licensing requirements,
just health and safety requirements |___|
Higher reimbursement than non-At-Risk child care
CACFP |___|
Individual enrollment is not required |___|
Can serve older children in At-Risk CACFP than
in non-At-Risk child care CACFP |___|
Teaches me and my staff to plan and prepare
nutritious meals |___|
Helps children develop healthy eating habits |___|
Other |___|
(Please specify)
12. How difficult would you say it was for your site to apply and be determined eligible to claim At-Risk afterschool meals and snacks?
Very difficult 
Somewhat difficult 
Not difficult at all   GO TO QUESTION 13
Don’t know 
12a. What factors posed barriers to your initial enrollment? (Check all that apply)
Area eligibility rules 
State and local health and safety requirements 
Program enrichment activities requirement 
Documenting licensing/registration status 
Documenting funding and staffing 
Meal pattern requirements 
Determining how to budget for meals 
Not enough cooking staff 
Limited food preparation space 
Limited food storage space 
No experience planning or preparing CACFP
meals 
No experience with food service contracts
(vended meals) 
Other 
(Please specify)
IMPORTANT NOTE: Please answer Question 13 if prior to claiming At-Risk CACFP meals your site provided only afterschool snacks. All other respondents should go to Question 14.
13. When you began participating in the At-Risk CACFP for afterschool meals, what were the three greatest challenges that you faced? (Check 3 boxes)
We experienced no challenges   GO TO QUESTION 14
Learning how to plan menus 
Determining how much food to purchase or
prepare 
Finding enough food storage space 
Storing foods at the correct temperature 
Finding food preparation space 
Planning a kitchen 
Meeting food sanitation requirements 
Hiring skilled food service workers 
Training staff to serve meals 
Meal clean up 
Budgeting meals 
Completing CACFP food service records 
Recordkeeping (other than food service
records) 
Training staff to assure our site’s compliance
with CACFP rules 
Other 
(Please specify)
Don’t know 
Your Site’s Schedule and At-Risk Afterschool Meal/Snack Service
14. In October 2014, to how many children did you serve CACFP At-Risk afterschool meals and/or snacks?
Total number of children served |___|___|___|
15. In October 2014, what was the total number of each type of afterschool meal and snack that your site claimed in the At-Risk CACFP?
At-Risk breakfast |___|___|___|___|___|
At-Risk lunch |___|___|___|___|___|
At-Risk supper |___|___|___|___|___|
At-Risk snack |___|___|___|___|___|
16. On weekdays when school is in session, which days and hours does your site usually operate after school care? If it is usually closed on a particular day of the week for after school hours, please check “My site is usually closed after school on that day.”
| Day of the Week | Start time(AM/PM) | End time(AM/PM) | My site is usually closed after school on that day | 
| Monday | |___|___| : |___|___| AM/PM | |___|___| : |___|___| AM/PM |  | 
| Tuesday | |___|___| : |___|___| AM/PM | |___|___| : |___|___| AM/PM |  | 
| Wednesday | |___|___| : |___|___| AM/PM | |___|___| : |___|___| AM/PM |  | 
| Thursday | |___|___| : |___|___| AM/PM | |___|___| : |___|___| AM/PM |  | 
| Friday | |___|___| : |___|___| AM/PM | |___|___| : |___|___| AM/PM |  | 
17. On the weekdays you operate when school is in session, which of the following afterschool meals and snacks does your site usually claim in the At-Risk CACFP? (Check all that apply)
At-Risk lunch 
At-Risk supper 
At-Risk snack 
18. During the school year, does your site provide services to children on weekdays when school is not in session, such as during school vacations and/or teacher training days?
Yes 
No   GO TO QUESTION 19
18a. During the school year, on weekdays when school is not in session, what hours does your site provide services to children? (Circle AM or PM)
Start Time: |___|___| : |___|___| AM or PM
End Time: |___|___| : |___|___| AM or PM
18b. During the school year, on weekdays when school is not in session, which of the following afterschool meals and snacks does your site usually claim in the At-Risk CACFP? (Check all that apply)
At-Risk breakfast 
At-Risk lunch 
At-Risk supper 
At-Risk snack 
19. During the school year, does your site provide services to children on weekend days?
Yes 
No   GO TO QUESTION 20
19a. On weekends during the school year, which days and hours does your site provide services to children? If it is usually closed on Saturday or Sunday, please check “My site is usually closed on that day.”
| Day of the Week | Start time(AM/PM) | End time(AM/PM) | My site is usually closed on that day | 
| Saturday | |___|___| : |___|___| AM/PM | |___|___| : |___|___| AM/PM |  | 
| Sunday | |___|___| : |___|___| AM/PM | |___|___| : |___|___| AM/PM |  | 
19b. On weekends during the school year, which of the following afterschool meals and snacks does your site usually claim in the At-Risk CACFP? (Check all that apply)
At-Risk breakfast 
At-Risk lunch 
At-Risk supper 
At-Risk snack 
20. Are all, some, or none of your At-Risk afterschool meals prepared by another organization (e.g. a food bank, commercial food service vendor, or CACFP sponsor) and provided to your site as “ready to serve?” (By “ready to serve” we mean you can serve the meal as it was prepared for you with only minimal work such as heating it up or cutting it into portion sizes.)
All At-Risk meals are provided to us by another
organization “ready to serve” 
Some At-Risk meals are provided to us “ready to serve”
and some meals are prepared on site 
No At-Risk meals are provided to us “ready to serve;”
all At-Risk meals are prepared at our site   GO TO QUESTION 21
20a. Where are most of the At-Risk afterschool meals you serve prepared? (Check one box)
At a central kitchen of my organization
or my CACFP sponsor 
A local school that is not my sponsor 
A commercial food service vendor 
A local restaurant or delicatessen with
a catering permit 
At a food bank or emergency kitchen 
At a homeless shelter 
At another community site 
Other 
(Please specify)
Don’t know 
21. Do the At-Risk afterschool meals you serve usually include only cold foods, only hot foods, or both hot and cold foods?
Only cold foods 
Only hot foods 
Both hot and cold foods 
Your Site’s Participation in Non-At-Risk CACFP
The next few questions ask specifically about the meals and snacks your site may claim in the non-At-Risk child care part of CACFP.
IMPORTANT NOTE: We may ask some questions for which you don’t have the answer. If that’s the case, please contact your sponsoring organization, someone else in your organization, or other appropriate person to get the information. Thanks in advance for doing so!
22. Do you claim any meals and/or snacks in non-At-Risk child care CACFP?
Yes 
No   GO TO QUESTION 27
23. On weekdays during the school year, which of the following meals and snacks does your site usually claim in non-At-Risk child care CACFP? (Check all that apply)
We don’t claim any non-At-Risk meals and
snacks on weekdays 
Breakfast 
Morning snack 
Lunch 
Afternoon snack 
Supper 
Evening Snack 
24. On weekends during the school year, which of the following meals and snacks does your site usually claim in non-At-Risk child care CACFP? (Check all that apply)
We don’t claim any non-At-Risk meals and
snacks on weekends 
Breakfast 
Morning snack 
Lunch 
Afternoon snack 
Supper 
Evening snack 
25. For which of the following age groups does your organization claim meals and/or snacks in non-At-Risk child care CACFP? (Check all that apply)
0-12 months 
1 and 2 years 
3 through 5 years 
6 through 9 years 
10 through 12 years 
26. Do you currently face any challenges participating in both the At-Risk and non-At-Risk child care CACFP?
Yes 
No   GO TO QUESTION 27
26a. What are the two biggest challenges your site faces participating in both the At-Risk and non-At-Risk child care CACFP? (Check up to 2 boxes)
Maintaining separate meal counts for both
parts of CACFP 
Maintaining two systems of eligibility 
Training staff on differences in recordkeeping
for both parts of CACFP 
Claiming under At-Risk and non-At-Risk parts
of CACFP during the school year and only
non-At-Risk child care CACFP during the
summer 
Budgeting when some meals are paid at the
free rate and others at a mix of free, reduced
and paid rates 
Other 
(Please specify)
Outreach
27. Does your organization conduct any outreach efforts to promote participation in your afterschool meals/snacks program?
Yes 
No   GO TO QUESTION 28
27a. What kinds of outreach methods has your organization used? (Check all that apply)
Press releases 
Flyers/brochures at local schools 
Flyers /brochures at local libraries 
Flyers/brochures at local stores 
Social media 
Other 
(Please specify)
28. Do other organizations conduct outreach to promote participation in your afterschool meals/snacks program?
Yes 
 
 
GO TO QUESTION 29
No 
Don’t know 
28a. What other organizations conduct outreach for your afterschool meals/snacks program?
My CACFP sponsor 
Advocacy organizations 
Local schools 
Religious organizations 
Food banks 
Local community organizations 
Other 
(Please specify)
29. Which of the outreach methods do you think have been the most effective in bringing children into your afterschool meals/snacks program? (Check all that apply)
No outreach has been conducted for our
afterschool meals/snacks program 
Press releases 
Distributing flyers/brochures at local schools 
Distributing flyers/brochures at local libraries 
Distributing flyers/brochures at local stores 
Outreach by advocacy organizations 
Outreach by local schools 
Outreach by religious organizations 
Other organizations that serve families in our
community 
Social media 
Other 
(Please specify)
Non-CACFP Supports for Meals and Snacks
30. Currently, does this site receive any non-CACFP food, funding, or in-kind supports to purchase, prepare or serve the meals and/or snacks you serve after school, on weekends, or during school holidays?
Yes 
No   GO TO QUESTION 31
30a. In what year did you start receiving this food, funding or in-kind supports to purchase, prepare or serve meals and snacks in your program?
|___|___|___|___|
Don’t know 
30b. From which non-CACFP sources do you currently receive food, funding or in-kind supports for these purposes? (Check all that apply)
From emergency food assistance programs
such as food banks, food pantries or soup
kitchens 
From funding for housing or shelter services 
From Head Start or Early Head Start
programming 
From charitable organizations 
From my organization’s operating budget 
From fundraising efforts specifically for food 
donations 
Fees charged to parents 
Other 
(Please specify)
Training and Support on At-Risk CACFP
In the following questions, we’re interested in the training and other assistance that your CACFP sponsor and/or State CACFP agency provided to you on the At-Risk CACFP during the past 12 months, as well as on what topics it would be helpful to receive more training or assistance.
31. During the past 12 months, did you and/or your staff receive training from your CACFP sponsor and/or State Agency on any topics specific to At-Risk CACFP?
Yes 
No   GO TO QUESTION 32
31a. During the past 12 months, what was the most common format that your CACFP sponsor used to provide this training? (Check one box)
Web-based 
In-person group classes or workshops 
One-on-one 
Other 
(Please specify)
31b. During the past 12 months, on which of the following At-Risk CACFP-related topics have you and/or your staff received training from your CACFP sponsor and/or State Agency? (Check all that apply)
Requirements specific to At-Risk CACFP 
CACFP meal requirements 
CACFP recordkeeping requirements 
Preparing and filing monthly reimbursement
claims 
At-Risk area eligibility 
Coordination of recordkeeping between your
non-At-Risk and At-Risk CACFP 
CACFP monitoring requirements 
Health and safety standards 
Serious deficiencies 
Maintaining confidentiality 
USDA civil rights requirements 
Food purchasing 
Menu planning 
Food preparation 
Food safety/food service operations 
Nutrition 
Physical activity 
Obesity prevention 
Best practices in after school programs 
Staff wellness 
Parent relations 
Recognizing abuse and neglect 
Other 
(Please specify)
31c. How satisfied are you with the training your site received from your CACFP sponsor and/or State Agency on the At-Risk CACFP?
Very satisfied 
Satisfied 
Neither satisfied nor dissatisfied 
Dissatisfied 
Very dissatisfied 
32. During the past 12 months, have you received any technical assistance regarding At-Risk CACFP from your CACFP sponsor and/or State CACFP Agency?
Yes 
No   GO TO QUESTION 33
32a. On what topics did you receive technical assistance from your CACFP sponsor and/or State CACFP Agency? (Check all that apply)
Menu planning/sample menus 
Food vendor contracts 
Staff training 
Budgeting 
Computer support 
Other 
(Please specify)
32b. How satisfied are you with the technical assistance available from your CACFP sponsor specific to At-Risk CACFP?
Very satisfied 
Satisfied 
Neither satisfied nor dissatisfied 
Dissatisfied 
Very dissatisfied 
33. Has your CACFP sponsor or State agency provided you any tools or materials that have helped you to meet the requirements of the At-Risk CACFP?
Yes 
No   GO TO QUESTION 34
33a. Please briefly describe these tools or materials.
Summer Programming
34. During Summer 2014, was your afterschool site open for any programming for children?
Yes 
No   GO TO QUESTION 38
35. During Summer 2014, on a typical day approximately how many children attended your site?
Number of children |___|___|___|
36. Is your afterschool program site in an area with a 12- month school year?
Yes 
No   GO TO QUESTION 37
36a. During Summer 2014, did you claim any meals and/or snacks from the At-Risk CACFP?
Yes 
No 
37. During Summer 2014, did you operate as a site for the Summer Food Service Program?
Yes   GO TO QUESTION 39
No 
37a. What are the two main factors that prevented you from being a Summer Food Service Program site? (Check up to 2 boxes)
State agency approval 
Challenges in obtaining licensing or health and
safety approval 
Staffing limitations 
Lack of transportation for the children 
Lack of sufficient programming space 
There are one or more Summer Food Service
sites in the area 
Have never considered participating in the
Summer Food Service Program 
The Summer Food Service Program and
CACFP program operate out of two different
agencies in my State 
Other 
(Please specify)
Just not interested in participating   GO TO QUESTION 39
Don’t know 
38. Would you like to be a site for the Summer Food Service Program?
Yes 
No   GO TO QUESTION 39
38a. What kind of information and/or help would you need to consider becoming a site for the Summer Food Service Program?
| Suggestions for Improving At-Risk CACFP | 
39. Do you need more training or tools to help you implement At-Risk CACFP?
Yes 
 
 
GO TO QUESTION 40
No 
Don’t know 
39a. On which of the following topics does your site need more training or tools to help you implement At-Risk CACFP?
How to plan menus/sample menus 
Food purchasing 
Food storage 
Preparing healthy, child-friendly meals 
Contracting for vended meals 
Food service budgeting 
Other 
(Please specify)
40. Based on your experience, do you think any other areas of At-Risk CACFP need to be improved?
Yes 
No   Thank you!
40a. What suggestions do you have for improving At-Risk CACFP?
Thank you for completing the questionnaire. Please return it in the enclosed postage-paid envelope to:
CACFP Sponsor and Provider Study
Westat
1600 Research Blvd.
Rm. _____
Rockville, MD 20850
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Annmarie Winkler | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-26 |