APPENDIX A1.4
MIXED SPONSORS
Mixed Sponsor Survey Instrument
General Characteristics of Your Organization as a CACFP Sponsor
This section asks about your organization and your relationship with the Child and Adult Care Food Program (CACFP) as well as other programs.
1. Is your organization a private not-for-profit, private for-profit, or is it a public agency, school or school district?
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)
Social service agency 
Child care agency 
Head Start grantee, delegate agency, or
administering agency 
Charitable organization 
Local education agency 
School 
College or university 
Religious organization 
Tribal organization 
U.S. Military 
YMCA or YWCA 
Other 
(Please specify)
3. In what year did your organization first become a CACFP sponsor?
|___|___|___|___|
4. How many adult day centers did your organization claim in October 2014?
Number of adult day centers |___|___|___|
5. Which of the following describes the geographic area served by your CACFP sponsorship? (Check one box)
Part of a town or city 
One or more towns or cities, but not an entire
county 
An entire county 
A group of counties 
Entire state 
Other 
(Please specify)
6. Approximately what percentage of the child care sites that your organization sponsors are located in a tribal area?
|___|___|___| %
7. In addition to the CACFP, does your organization participate in any other USDA food and nutrition programs?
Yes 
No   GO TO QUESTION 8
7a. In which of the following USDA food and nutrition programs does your organization participate? (Check all that apply)
National School Lunch Program 
School Breakfast Program 
Summer Food Service Program 
Special Milk Program 
Fresh Fruits and Vegetables Program 
Special Supplemental Nutrition Program for
Women, Infants and Children (WIC) 
Commodity Supplemental Food Program 
USDA Commodities Program 
The Emergency Food Assistance Program
(TEFAP) 
Supplemental Nutrition Assistance Program
(SNAP) Nutrition Education 
Other program 
(Please specify)
8. Does your organization administer or provide any services that are not funded by USDA?
Yes 
No   GO TO QUESTION 9
8a. Which of the following types of non-USDA funded services does your organization administer or provide? (Check all that apply)
Child care locator/finder 
Child care subsidies 
Child care staff training and professional
development 
Technical assistance/coaching/mentoring for
quality improvement 
Outside school hours program 
Home visiting 
Parent support and education 
Nutrition and/or health education 
Early intervention services (Part C for children
with or at-risk of developmental disabilities) 
Community recreation program 
Adult day care program 
Domestic violence shelter 
Food pantry or soup kitchen 
Other 
(Please specify)
Training and Assistance Provided by Your State CACFP Agency
In this section, we are interested in training and technical assistance provided by your State CACFP Agency and on what CACFP-related topics it would be helpful to receive more training or assistance.
9. During the past 12 months, did your State CACFP Agency provide a mandatory annual training to you or anyone else on your staff?
Yes 
No   GO TO QUESTION 10
9a. What was the format of this training? (Check one box)
Web-based 
In-person group classes or workshops 
Self-study 
One-on-one 
Other 
(Please specify)
9b. What topics were covered in this training?
CACFP meal requirements 
CACFP administrative requirements 
CACFP monitoring requirements 
Center and/or provider applications 
Preparing and filing monthly reimbursement
claims 
Administrative reimbursement 
For-profit center eligibility 
Family/Child eligibility determination 
Tiering rules for family day care homes 
Serious deficiencies 
Maintaining confidentiality 
USDA civil rights requirements 
Food purchasing 
Menu planning 
Food preparation 
Food safety/food service operations 
Nutrition 
Physical activity in child care 
Obesity prevention 
Best practices in child care 
Staff wellness 
Parent relations 
Recognizing abuse and neglect 
Other 
(Please specify)
9c. How satisfied are you with this training?
Very satisfied 
Satisfied 
Neither satisfied or dissatisfied 
Dissatisfied 
Very dissatisfied 
10. During the past 12 months, has your State CACFP Agency provided you or your staff any additional training?
Yes 
No   GO TO QUESTION 11
10a. What was the most common format of this training? (Check one box)
Web-based 
In-person group classes or workshops 
Self-study 
One-on-one 
Other 
(Please specify)
10b. What topics were covered in this additional training? (Check all that apply)
CACFP meal requirements 
CACFP administrative requirements 
CACFP monitoring requirements 
Center and/or provider applications 
Preparing and filing monthly reimbursement
claims 
Administrative reimbursement 
For-profit center eligibility 
Family/Child eligibility determination 
Tiering rules for family day care homes 
Serious deficiencies 
Maintaining confidentiality 
USDA civil rights requirements 
Food purchasing 
Menu planning 
Food preparation 
Food safety/food service operations 
Nutrition 
Physical activity in child care 
Obesity prevention 
Best practices in child care 
Staff wellness 
Parent relations 
Recognizing abuse and neglect 
Other 
(Please specify)
10c. How satisfied are you with this additional training?
Very satisfied 
Satisfied 
Neither satisfied or dissatisfied 
Dissatisfied 
Very dissatisfied 
11. During the past 12 months, have you received any technical assistance from your State CACFP Agency?
Yes 
No   GO TO QUESTION 12
11a. On what topics did you receive technical assistance from your State CACFP Agency? (Check all that apply)
Menu planning/sample menus 
Food vendor contracts 
Staff training 
Recruitment and retention of CACFP
sites 
Budgeting assistance 
Computer support 
Other 
(Please specify)
11b. How satisfied are you with the technical assistance available from your State CACFP Agency?
Very satisfied 
Satisfied 
Neither satisfied or dissatisfied 
Dissatisfied 
Very dissatisfied 
12. Are there any food, nutrition or CACFP-related topics on which you would like to receive more training or assistance?
Yes 
No   GO TO QUESTION 13
12a. On what topics would you like to receive more training or assistance? (Check all that apply)
Menu planning/sample menus 
Food vendor contracts 
Staff training 
Recruitment and retention of CACFP
sites 
Budgeting 
Computer support 
Training our CACFP sites 
Networking with other sponsors in my
state 
Other 
(Please specify)
| Electronic Systems You Use for CACFP | 
This section asks about any electronic systems that you use to manage your CACFP claims.
13. Does your organization use an electronic system or systems to check CACFP reimbursement claims?
Yes 
No   GO TO QUESTION 14
13a. Were any of the electronic systems you use for CACFP developed in house?
Yes 
No 
13b. Were any of the electronic systems you use for CACFP developed by your State CACFP Agency?
Yes 
No 
13c. Are any of the electronic systems you use for CACFP commercial systems?
Yes 
No   GO TO QUESTION 14
13e. What are the names of the commercial automated systems you use for CACFP? (Check all that apply)
Minute Menu 
Nutrition Manager 
Procare 
Child Watch 
ChildPlus 
AccuTrack 
Maggey Deluxe 
Other 
(Please specify)
Don’t know 
CACFP Staffing
This section asks about the total number of people employed by your organization and how many of those work on the CACFP. Please do not include any of your organization’s employees who work primarily at the sites you sponsor.
14. How many employees (counting part- and full-time staff equally) work in your organization?
Total number of employees |___|___|___|___|
14a. How many of these employees work on the CACFP on a regular basis?
Number of employees |___|___|___|
14b. How many of these employees who work on the CACFP on a regular basis work with family day care homes?
Number of employees |___|___|___|
14c. How many of these employees who work on the CACFP on a regular basis work with child care centers?
Number of employees |___|___|___|
14d. How many of these employees who work on the CACFP on a regular basis work with Head Start centers?
Number of employees |___|___|___|
The following questions ask about turnover of the staff who worked on the CACFP on a regular basis in 2014.
15. Have any of the staff who worked on the CACFP on a regular basis in 2014 left your organization?
Yes 
No   GO TO QUESTION 16
15a. How many of these staff have left?
Number of staff |___|___|
15b. How many of these staff have been replaced?
Number of staff |___|___|
The next three questions ask about staff time spent on CACFP. For a typical month, please estimate the percentage of the total time spent by your staff on specific CACFP functions.
16. In a typical month, of the total time your staff spends on CACFP, approximately what percentage is spent on processing claims and reimbursements?
Less than 10% 
10% - 25% 
26% - 50% 
51% - 75% 
More than 75% 
17. In a typical month, of the total time your staff spends on CACFP, approximately what percentage is spent on monitoring and training?
Less than 10% 
10% - 25% 
26% - 50% 
51% - 75% 
More than 75% 
18. In a typical month, of the total time your staff spends on CACFP, approximately what percentage is spent on outreach?
Less than 10% 
10% - 25% 
26% - 50% 
51% - 75% 
More than 75% 
19. Does your organization’s CACFP employ anyone who has a degree or formal training in nutrition?
Yes 
No   GO TO QUESTION 20
19a. Are any of these individuals registered dietitians (R.D.) or registered dietitian nutritionists (RDN)?
Yes 
No 
Don’t know 
Satisfaction with State CACFP Agency
20. Please rate your level of satisfaction with your State CACFP Agency on the following factors: (Circle one number for each factor)
| Factor | Very Satisfied | Satisfied | Neither Satisfied nor Dissatisfied | Dissatisfied | Very Dissatisfied | Don’t Know | Not Applicable | 
| a. Processing your organization’s initial application | 1 | 2 | 3 | 4 | 5 | -8 | -9 | 
| b. Processing and payment of claims | 1 | 2 | 3 | 4 | 5 | -8 | -9 | 
| c. Review of your organization | 1 | 2 | 3 | 4 | 5 | -8 | -9 | 
| d. Annual contract renewal process, including budget and management plan renewal | 1 | 2 | 3 | 4 | 5 | -8 | -9 | 
| e. Use of technology | 1 | 2 | 3 | 4 | 5 | -8 | -9 | 
| f. Support of your organization’s use of technology for the CACFP | 1 | 2 | 3 | 4 | 5 | -8 | -9 | 
| g. Support for recruiting new centers or family day care homes | 1 | 2 | 3 | 4 | 5 | -8 | -9 | 
Sponsors’ Perceptions of the CACFP
21. The following is a list of possible benefits of the CACFP. Please rank the three benefits you consider to be the most important, with “1” being the most important, “2” being the second most important, and “3” being the third most important. (Rank 3)
Rank
CACFP provides nutritious meals to children |___|
CACFP teaches child care program and
providers to plan and prepare nutritious meals |___|
CACFP feeds children who would otherwise
have limited access to nutritious food |___|
CACFP helps children develop healthy eating
habits |___|
CACFP keeps down the cost of child care |___|
CACFP helps parents learn the importance of
healthy eating |___|
CACFP helps child care programs stay in
business |___|
CACFP is an important part of the social safety
net for children and families |___|
CACFP facilitates child care center or family
day care home recruitment |___|
22. Overall, how would you rate your burden level to meet CACFP requirements? Think of burden as the amount of time and effort put into meeting the requirements.
 
No burden at all 
 
GO TO QUESTION 29
Very low burden 
Low burden 
Neither high nor low 
High burden 
Very high burden 
23. How would you rate the level of burden for your organization for performing CACFP enrollment activities?
 
No burden at all 
 
GO TO QUESTION 24
Very low burden 
Low burden 
Neither high nor low 
High burden 
Very high burden 
23a. Thinking about the CACFP enrollment activities performed by your organization, which one do you find the most burdensome? (Check one box)
Determining free/reduced and paid
meal eligibility for children in child
care centers 
Processing parent income eligibility
applications for family day care homes 
Determining tiering status for family
day care homes 
Processing new center or home
applications 
Other 
(Please specify)
24. How would you rate the level of burden for your organization for performing CACFP claiming activities?
 
No burden at all 
 
GO TO QUESTION 25
Very low burden 
Low burden 
Neither high nor low 
High burden 
Very high burden 
24a. Thinking about the CACFP activities related to claiming performed by your organization, which one do you find the most burdensome? (Check one box)
Training child care sites on CACFP
recordkeeping requirements 
Reviewing claims 
Preparing and filing monthly
reimbursement claims 
Awaiting payment from the state 
Processing provider payments 
Other 
(Please specify)
25. How would you rate the level of burden for your organization to comply with CACFP menu requirements?
 
No burden at all 
 
GO TO QUESTION 26
Very low burden 
Low burden 
Neither high nor low 
High burden 
Very high burden 
25a. Thinking about the activities related to the CACFP menu requirements performed by your organization, which one do you find the most burdensome?
Training child care sites on CACFP
meal pattern requirements 
Training child care sites on the
allowable number of daily meals and
snacks per child 
Reviewing provider menus 
Other 
(Please specify)
26. How would your rate the level of burden for your organization for performing activities related to CACFP monitoring?
 
No burden at all 
 
GO TO QUESTION 27
Very low burden 
Low burden 
Neither high nor low 
High burden 
Very high burden 
26a. Thinking about the activities related to CACFP monitoring performed by your organization, which one do you find the most burdensome?
Conducting required monitoring visits 
Conducting 5-day reconciliations 
Following up on serious deficiencies 
Other 
(Please specify)
27. How would your rate the level of burden for your organization for performing CACFP recordkeeping?
 
No burden at all 
 
GO TO QUESTION 28
Very low burden 
Low burden 
Neither high nor low 
High burden 
Very high burden 
27a. Thinking about the activities related to CACFP recordkeeping performed by your organization, which one do you find the most burdensome? (Check one box)
Completing annual budget and
management plan renewal process 
Utilizing automated systems 
Maintaining both paper and electronic
records 
Inconsistent interpretation of federal
CACFP rules 
Total CACFP paperwork 
Other 
(Please specify)
28. How would you rate the level of burden for your organization for performing outreach to new CACFP sites?
 
No burden at all 
 
GO TO QUESTION 29
Very low burden 
Low burden 
Neither high nor low 
High burden 
Very high burden 
28a. Thinking about the CACFP outreach activities performed by your organization, which one do you find the most burdensome? (Check one box)
Identifying potential sites 
Conducting pre-approval visits 
Other 
(Please specify)
29. Based on your experience, do you think any areas of the CACFP need to be improved?
Yes 
No   GO TO QUESTION 30
29a. What suggestions do you have for improving CACFP?
Family Day Care Homes
30. In October 2014, did your organization sponsor any family day care homes?
Yes 
No   GO TO QUESTION 48 ON
PAGE 21
31. In October 2014, how many family day care homes did your organization claim for CACFP?
Number of family day care homes |___|___|___|
32. What was your sponsorship’s total administrative reimbursements from CACFP for sponsoring family day care homes in October 2014? (Include only USDA/CACFP reimbursements. Do not include any additional state reimbursements.)
$ |___|___|___| , |___|___|___|
33. Approximately what percentage of your organization’s total funding for administrative functions comes from CACFP administrative reimbursements for sponsoring family day care homes?
|___|___| %
Training Your Own Organization’s Staff on Tiering
34. When your organization trains your staff on how to assign family day care homes a tiering level, on which topics do you provide training? (Check all that apply)
Informing new family day care homes about
tiering 
Obtaining/using school boundary data 
Obtaining/using census tract data 
Reviewing provider income eligibility
applications 
Reviewing provider eligibility for other means-
tested programs 
Other topics 
(Please specify)
We do not train staff on how to assign family
day care homes a tiering level 
Training Your Organization Provided for Family Day Care Homes
In this section, we are interested in the CACFP-related training your organization provided to family day care homes during the past 12 months. In your responses, do not include any informal training you or your staff provided during monitoring visits or in response to individual requests for assistance.
35. During the past 12 months, did your organization provide any CACFP related training for family day care home providers you sponsor?
Yes 
No   GO TO QUESTION 36
35a. What was the most common format that your organization used to provide CACFP training for family day care home providers? (Check one box)
Web-based 
In-person group classes or workshops 
Self-study 
One-on-one 
Other 
(Please specify)
35b. Thinking about a typical family day care home that you sponsor, how many times in the past 12 months did your organization provide CACFP training for that home?
Number of times |___|___|
35c. Which of the following topics were covered in your CACFP trainings for family day care home providers? (Check all that apply)
CACFP meal requirements 
CACFP recordkeeping requirements 
Preparing and filing monthly reimbursement
claims 
Tiering rules for family day care homes 
CACFP monitoring requirements 
Defining serious deficiencies 
Maintaining confidentiality 
USDA civil rights requirements 
Appeals process for serious deficiencies 
Food purchasing 
Menu planning 
Food preparation 
Food safety/food service operations 
Nutrition 
Physical activity in child care 
Obesity prevention 
Best practices in child care 
Staff wellness 
Parent relations 
Recognizing abuse and neglect 
Other 
(Please specify)
Monitoring Visits to Family Day Care Homes
This section is about CACFP monitoring visits your organization has conducted to family day care homes.
36. For a typical family day care home, how many times per year does your organization usually conduct CACFP monitoring visits?
Times per year |___|___|
37. For a typical family day care home that is not a new site, how many of the visits each year are announced before the visit?
Number of monitoring visits
announced before the visit |___|___|
38. For a typical family day care home, approximately how many minutes is the average CACFP monitoring visit your organization conducts?
Number of minutes |___|___|___|
39. Which of the following are the two most important enrollment-related areas reviewed during your organization’s CACFP monitoring visits with family day care homes? (Check 2 boxes)
Child care license is current 
Health and safety guidelines followed 
A current enrollment record exists for each
child present, including provider's own 
Children in attendance less than or equal to
licensed capacity 
Food allergies documented 
Other 
(Please specify)
40. Which of the following are the two most important claiming-related areas reviewed during your organization’s CACFP monitoring visits with family day care homes? (Check 2 boxes)
Existence and accuracy of daily attendance
records 
Number of meals claimed compared to
licensed capacity 
Meal counts and menus are recorded daily 
5-day reconciliation 
Menu exists for each meal claimed, including
infant meals 
Menu production records are completed with
quantities 
Infant menu complies with CACFP meal
requirements 
Food receipts support menu 
Other 
(Please specify)
41. Which of the following are the two most important meal-related areas observed and reviewed during your organization’s CACFP monitoring visits with family day care homes? (Check 2 boxes)
Observed meal meets CACFP meal pattern
requirements 
Appropriate type of milk served to children 
Drinking water available throughout the day 
Meals served match menu 
Time of day meals and snacks served 
Type of meal service (family style vs. plated) 
Safe food handling practices observed 
Food allergies accommodated 
Other 
(Please specify)
42. Other than meeting CACFP monitoring requirements, what is the main reason that your organization conducts monitoring visits with family day care homes? (Check one box)
Follow-up on corrective actions taken for
deficiencies 
Ensure nutritious meals and snacks are being
served 
Combine training and technical assistance
with monitoring 
Check in to make certain that provider is
pleased with the service provided by the
sponsor 
CACFP provider requested a sponsor visit for
help with some issue 
Other 
(Please specify)
43. When your organization conducts monitoring visits with family day care homes, what are the three most common deficiencies found that require corrective action? (Check 3 boxes)
Submission of false information on the
application 
Submission of false claims for reimbursement 
Simultaneous participation under more than
one sponsoring organization 
Non-compliance with CACFP meal pattern 
Failure to keep required records 
Failure to fill out menu production records
correctly 
Conduct or conditions that threaten the health
or safety of a child (or children) in care 
Water not available to children on request 
Number of children present is more than
provider’s licensed capacity 
Provider not present 
Other 
(Please specify)
44. Do you serve any family day care homes where the provider or staff do not speak English?
Yes 
No   GO TO QUESTION 45
44a. Does your organization conduct any monitoring visits, reviews, or trainings in any languages other than English?
Yes 
No 
Barriers to CACFP Participation for Family Day Care Homes
45. Do you collect information from family day care home providers who have left your CACFP to determine the reasons why they left?
Yes 
No   GO TO QUESTION 46
45a. How does your organization collect this information?
Questionnaires or other forms when
homes leave the program 
Interviews with family day care home
providers when they leave the
program 
Anecdotal information 
Studies or evaluations 
Other ways 
(Please specify)
46. What do you think are two most common reasons family day care homes leave the CACFP? (Check 2 boxes)
Paperwork burden too high 
Not enough low-income children enrolled 
Difficult to comply with meal requirements 
Unannounced site monitoring visits 
Serious deficiency process 
Meal reimbursement rates are too low 
Family day care home closed 
Family day care home lost license 
Other reason 
(Please specify)
47. Other than program reimbursement levels, what do you think are the two greatest barriers to increasing CACFP participation among family day care homes? (Check 2 boxes)
Paperwork burden for parent applications 
Other paperwork burden related to CACFP 
Application process is too complicated 
Takes too much time to apply and be approved 
Providers’ reluctance to participate in
government programs 
Providers don’t want people coming into their
homes 
Other 
(Please specify)
 
 
GO TO QUESTION 48
Eligible homes already participate 
Don’t know 
47a. Do you have any suggestions for reducing or eliminating these barriers to CACFP participation?
Yes 
No   GO TO QUESTION 48
47b. What are your suggestions for reducing or eliminating these barriers to CACFP participation?
Child Care Centers
48. In October 2014, did your organization sponsor any child care centers?
Yes 
No   GO TO QUESTION 65 ON
PAGE 27
49. In October 2014, how many total sites did your organization claim for CACFP? Do not count any adult care CACFP sites or Head Start/Early Head Start centers that you might sponsor.
Total sites |___|___|___|
49a. How many of these sites were not-for-profit child care centers?
Nonprofit centers |___|___|___|
49b. How many of these sites were for-profit (Title XX) child care centers?
For-profit centers |___|___|___|
49c. How many of these sites were “outside of school hours” centers?
Number of centers |___|___|___|
49d. How many of these sites participated in the At-Risk CACFP?
Number of centers |___|___|___|
49e. How many of these sites were “emergency shelter” sites?
Number of centers |___|___|___|
50. How much did your organization receive for all CACFP reimbursable meals and snacks served in child care centers in October 2014? (Include only USDA/CACFP reimbursements. Do not include any additional state reimbursements.)
$ |___|___|___| , |___|___|___|
51. Did your organization retain any of these meal reimbursements to offset the cost of administering the CACFP for these centers?
Yes 
No   GO TO QUESTION 52
51a. In October 2014, how much of these meal reimbursements did your organization retain to offset the cost of administering the CACFP for these centers?
$ |___|___|___| , |___|___|___|
51b. Approximately what percentage of your organization’s total funding for administrative functions comes from money retained from CACFP meal reimbursements for child care centers?
|___|___| %
Training Your Organization Provided for Child Care Centers
In this section, we are interested in the CACFP-related training your organization provided to child care center staff during the past 12 months. In your responses, do not include any informal training you or your staff provided during monitoring visits or in response to individual requests for assistance.
52. During the past 12 months, did your organization provide any CACFP related training for any of the staff at the child care centers you sponsor?
Yes 
No   GO TO QUESTION 53
52a. What types of child care center staff received CACFP-related training? (Check all that apply)
Center administrators 
Classroom staff 
Food preparation staff 
Nutritionists (including RDs and RDNs) 
Other 
(Please specify)
52b. What was the most common format that your organization used to provide CACFP training for these staff? (Check one box)
Web-based 
In-person group classes or workshops 
Self-study 
One-on-one 
Other 
(Please specify)
52c. Thinking about a typical child care center site that you sponsor, how many times during the past 12 months did your organization provide CACFP training for that site?
Times in past 12 months |___|___|
52d. Which of the following topics were covered in your CACFP trainings for child care center staff? (Check all that apply)
CACFP meal requirements 
CACFP recordkeeping requirements 
Preparing and filing monthly reimbursement
claims 
Family/child eligibility determination 
CACFP monitoring requirements 
Defining serious deficiencies 
Maintaining confidentiality 
USDA civil rights requirements 
Appeals process for serious deficiencies 
Food purchasing 
Menu planning 
Food preparation 
Food safety/food service operations 
Nutrition 
Physical activity in child care 
Obesity prevention 
Best practices in child care 
Staff wellness 
Parent relations 
Recognizing abuse and neglect 
Other 
(Please specify)
Monitoring Visits to Child Care Centers
This section is about CACFP monitoring visits your organization has conducted to child care centers.
53. For a typical child care center, how many times per year does your organization usually conduct CACFP monitoring visits?
Times per year |___|___|
54. For a typical child care center that is not a new site, how many of the visits each year are announced before the visit?
Number of monitoring visits
announced before the visit |___|___|
55. For a typical child care center, approximately how many minutes is the average monitoring visit your organization conducts?
Number of minutes |___|___|___|
56. Which of the following are the two most important enrollment-related areas reviewed during your organization’s CACFP monitoring visits with child care centers? (Check 2 boxes)
Child care license is current 
Health and safety guidelines followed 
A current enrollment record exists for each
child present, including provider's own 
Children in attendance less than or equal to
licensed capacity 
Food allergies documented 
Other 
(Please specify)
57. Which of the following are the two most important claiming and menu-related areas reviewed during your organization’s CACFP monitoring visits with child care centers? (Check 2 boxes)
Existence and accuracy of daily attendance
records 
Number of meals claimed compared to
licensed capacity 
Meal counts and menus are recorded daily 
5-day reconciliation 
Menu exists for each meal claimed, including
infant meals 
Menu production records are completed with
quantities 
Infant menu complies with CACFP meal
pattern requirements 
Food receipts support menu 
Other 
(Please specify)
58. Which of the following are the two most important meal-related areas observed and reviewed during your organization’s CACFP monitoring visits with child care centers? (Check 2 boxes)
Observed meal meets CACFP meal pattern
requirements 
Appropriate type of milk served to children 
Drinking water available throughout the day 
Meals served match menu 
Meals and snacks served match food available 
Time of day meals and snacks served 
Type of meal service (family style vs. plated) 
Safe food handling practices observed 
Food allergies accommodated 
Other 
(Please specify)
59. Other than meeting CACFP monitoring requirements, what is the main reason that your organization conducts monitoring visits to child care centers? (Check one box)
Follow-up on corrective actions taken for
deficiencies 
Ensure nutritious meals and snacks are being
served 
Combine training and technical assistance
with monitoring 
Check in to make certain that provider is
pleased with the service provided by the
sponsor 
Provider requested a sponsor visit for help
with some issue 
Other 
(Please specify)
60. When your organization conducts monitoring visits to child care centers, what are the three most common deficiencies found that requires corrective action? (Check 3 boxes)
Submission of false information on the
application 
Submission of false claims for reimbursement 
Simultaneous participation under more than
one sponsoring organization 
Non-compliance with CACFP meal pattern 
Failure to keep required records 
Failure to fill out menu production records
correctly 
Conduct or conditions that threaten the health
or safety of a child (or children) in care 
Water not available to children on request 
Number of children present is more than child
care center’s licensed capacity 
Other 
(Please specify)
61. Do you serve any child care centers where the provider or staff do not speak English?
Yes 
No   GO TO QUESTION 62
61a. Does your organization conduct any monitoring visits, reviews or trainings in any languages other than English?
Yes 
No 
Barriers to CACFP Participation for Child Care Centers
62. Do you collect information from child care centers who have left your CACFP to determine the reasons why they left?
Yes 
No   GO TO QUESTION 63
62a. How does your organization collect this information?
Questionnaires or other forms when
centers leave the program 
Interviews with center directors when
they leave the program 
Anecdotal information 
Studies or evaluations 
Other ways 
(Please specify)
63. What do you think are the two most common reasons child care centers leave the CACFP? (Check 2 boxes)
Paperwork burden too high 
Not enough low-income children enrolled 
Difficult to comply with meal requirements 
Unannounced site monitoring visits 
Serious deficiency process 
Meal reimbursement rates are too low 
Child care center lost license 
Child care center closed 
Other reason 
(Please specify)
Don’t know 
64. Other than program reimbursement levels, what do you think are the two greatest barriers to increasing CACFP participation among child care centers? (Check 2 boxes)
Paperwork burden for parent applications 
Other paperwork burden related to CACFP 
Application process is too complicated 
Takes too much time to apply and be approved 
Centers’ reluctance to participate in
government programs 
Other 
(Please specify)
 
 
GO TO QUESTION 65
Eligible centers already participate 
Don’t know 
64a. Do you have any suggestions for reducing or eliminating these barriers to CACFP participation?
Yes 
No   GO TO QUESTION 65
64b. What are your suggestions for reducing or eliminating these barriers to CACFP participation?
Head Start/Early Head Start Centers
IMPORTANT: When completing the Head Start/Early Head Start sections, please consider BOTH Head Start AND Early Head Start centers that your organization sponsors in the Child and Adult Care Food Program (CACFP). If your organization sponsors only one type of program (i.e., EITHER Head Start OR Early Head Start), base your responses on the one type.
65. In October 2014, did your organization sponsor any Head Start or Early Head Start centers?
Yes 
No   GO TO THANK YOU ON PAGE 32
66. In October 2014, how many Head Start and Early Head Start centers did your organization claim for CACFP?
Number of Head Start and Early
Head Start centers |___|___|___|
67. How much did your organization receive for all CACFP reimbursable meals and snacks served in Head Start and Early Head Start centers in October 2014? (Include only USDA/CACFP reimbursements. Do not include any additional state reimbursements.)
$ |___|___|___| , |___|___|___|
68. Did your organization retain any of these meal reimbursements to offset the cost of administering the CACFP for these Head Start and Early Head Start centers?
Yes 
No   GO TO QUESTION 69
68a. In October 2014, how much of these meal reimbursements did your organization retain to offset the cost of administering the CACFP for these Head Start centers?
$ |___|___|___| , |___|___|___|
68b. Approximately what percentage of your organization’s total funding for administrative functions comes from money retained from CACFP meal reimbursements for Head Start and Early Head Start centers?
|___|___| %
Training Your Organization Provided for Head Start and Early Head Start Centers
In this section, we are interested in the CACFP-related training your organization provided to Head Start and Early Head Start staff during the past 12 months. In your responses, do not include an informal training you or your staff provided during monitoring visits or in response to individual requests for assistance.
69. During the past 12 months, did your organization provide any CACFP related training for any of the staff at the Head Start and Early Head Start centers you sponsor?
Yes 
No   GO TO QUESTION 70
69a. What types of Head Start and Early Head Start center staff received your CACFP-related training? (Check all that apply)
Center administrators 
Classroom staff 
Food preparation staff 
Nutritionists (including RDs and RDNs) 
Other 
(Please specify)
69b. What was the most common format that your organization used to provide CACFP training for these staff? (Check one box)
Web-based 
In-person group classes or workshops 
Self-study 
One-on-one 
Other 
(Please specify)
69c. Thinking about a typical Head Start and Early Head Start center that you sponsor, how many times during the past 12 months did your organization provide CACFP training for that center?
Number of times |___|___|
69d. Which of the following topics were covered in your CACFP trainings for Head Start and Early Head Start center staff? (Check all that apply)
CACFP meal requirements 
CACFP recordkeeping requirements 
Preparing and filing monthly reimbursement
claims 
CACFP monitoring requirements 
Defining serious deficiencies 
Maintaining confidentiality 
USDA civil rights requirements 
Appeals process for serious deficiencies 
Food purchasing 
Menu planning 
Food preparation 
Food safety/food service operations 
Nutrition 
Physical activity in child care 
Obesity prevention 
Best practices in child care 
Staff wellness 
Parent relations 
Recognizing abuse and neglect 
Other 
(Please specify)
Monitoring Visits to Head Start Centers
This section is about CACFP monitoring visits your organization has conducted to Head Start and Early Head Start centers.
70. For a typical Head Start or Early Head Start center, how many times per year does your organization usually conduct CACFP monitoring visits?
Times per year |___|___|___|
71. For a typical Head Start or Early Head Start center that is not a new site, how many of the visits each year are announced before the visit?
Number of monitoring visits
announced before the visit |___|___|
72. For a typical Head Start or Early Head Start center, approximately how many minutes is the average monitoring visit your organization conducts?
Number of minutes |___|___|___|
73. Which of the following are the two most important enrollment-related areas reviewed during your organization’s CACFP monitoring visits with Head Start and Early Head Start centers? (Check 2 boxes)
Child care license is current 
Health and safety guidelines followed 
A current enrollment record exists for each
child present, including provider's own 
Children in attendance less than or equal to
licensed capacity 
Food allergies documented 
Other 
(Please specify)
74. Which of the following are the two most important claiming and menu-related areas reviewed during your organization’s CACFP monitoring visits with Head Start and Early Head Start centers? (Check 2 boxes)
Existence and accuracy of daily attendance
records 
Number of meals claimed compared to
licensed capacity 
Meal counts and menus are recorded daily 
5-day reconciliation 
Menu exists for each meal claimed, including
infant meals 
Menu production records are completed with
quantities 
Infant menu complies with CACFP meal
pattern requirements 
Food receipts support menu 
Other 
(Please specify)
75. Which of the following are the two most important meal-related areas observed and reviewed during your organization’s CACFP monitoring visits with Head Start and Early Head Start centers? (Check 2 boxes)
Observed meal meets CACFP meal pattern
requirements 
Appropriate type of milk served to children 
Drinking water available throughout the day 
Meals served match menu 
Time of day meals and snacks served 
Type of meal service (family style vs. plated) 
Safe food handling practices observed 
Food allergies accommodated 
Other 
(Please specify)
76. Other than meeting CACFP monitoring requirements, what is the main reason that your organization conducts monitoring visits with Head Start and Early Head Start centers? (Check one box)
Follow-up on corrective actions taken for
deficiencies 
Ensure nutritious meals and snacks are being
served 
Combine training and technical assistance
with monitoring 
Check in to make certain that provider is
pleased with the service provided by the
sponsor 
Provider requested a sponsor visit for help
with some issue 
Other 
(Please specify)
77. When your organization conducts monitoring visits to Head Start centers, what are the three most common deficiencies found that requires corrective action? (Check 3 boxes)
Submission of false claims for reimbursement 
Simultaneous participation under more than
one sponsoring organization 
Non-compliance with CACFP meal pattern 
Failure to keep required records 
Conduct or conditions that threaten the health
or safety of a child (or children) in care 
Conduct or conditions that threaten the public
health or safety 
Water not available to children on request 
Number of children present is more than Head
Start center’s licensed capacity 
Provider not present 
Other 
(Please specify)
78. Not including the first visit made to new sites, how often are CACFP monitoring visits provided to Head Start centers that you sponsor announced before the visit?
Never 
Less than 1/3 of visits 
Between 1/3 - 2/3 of visits 
More than 2/3 of visits, but not always 
Always 
79. Do you serve any Head Start and Early Head Start centers where the staff do not speak English?
Yes 
No   Thank you!
79a. Does your organization conduct any monitoring visits, reviews, or trainings in any languages other than English?
Yes 
No 
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
	A1.4-
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Annmarie Winkler | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-23 |