Day Care Centers
(All Brochures, Forms, Informational Charts, and Sample Menus are available below in PDF Format or may be requested by contacting the Child and Adult Care Food Program at our Toll Free Number: 1-800-942-3858). To view, print or save fill-in PDF documents, the latest Adobe Acrobat Reader must be installed on your computer.
Brochures
- At-risk After-school Snack/Supper Program (Publication No. 4363) (PDF)
- Spanish Version (PDF)
- Building for the Future (FNS-317)- (Notification to parents about CACFP and its benefits)
- English (PDF)
- Spanish Version (PDF)
- Arabic Version (PDF)
- Bengali Version (PDF)
- Chinese Version (PDF)
- Haitian Creole Version (PDF)
- Italian Version (PDF)
- Korean Version (PDF)
- Polish Version (PDF)
- Russian Version (PDF)
- Yiddish Version (PDF)
- Good Nutrition Pays (CACFP-4359) (PDF)
- Spanish Version (PDF)
- Together We Can Raise Healthy Children Brochure
Curricula, Guides and Informational Charts
- 2010 Census Data for New York State (PDF)
- At-Risk Eligible Public Schools in NYC (PDF)
- At-Risk Eligible Public Schools Outside NYC (PDF)
- Child Meal Pattern (Publication No. 1259) Chart indicating required components and minimum quantities of food for children 1-18 years old in care. (PDF)
- Arabic Version (PDF)
- Bengali Version (PDF)
- Chinese Version (PDF)
- French Version (PDF)
- Haitian-Creole Version (PDF)
- Italian Version (PDF)
- Korean Version (PDF)
- Polish Version (PDF)
- Russian Version (PDF)
- Spanish Version (PDF)
- Urdu Version (PDF)
- Yiddish Version (PDF)
- Claim Submission Deadline FFY 2022-2023 (PDF)
- Crediting Foods in CACFP (PDF)
- Arabic Version (PDF)
- Chinese Version (PDF)
- Haitian-Creole Version (PDF)
- Italian Version (PDF)
- Korean Version (PDF)
- Russian Version (PDF)
- Spanish Version (PDF)
- Urdu Version (PDF)
- Yiddish Version (PDF)
- FNS Core Nutrition Messages
USDA - Food and Nutrition Service (FNS), provides nutrition messages designed to deliver consistent and accurate information to help develop healthy eating patterns in young children. - Food Buying Guide for Child Nutrition Programs - Team Nutrition USDA Food and Nutrition Service - providing a guide to plan, purchase, prepare and serve nourishing meals.
- Income Guidelines for Day Care Centers (CACFP-3687) Chart indicating income criteria to qualify for free or reduced price meal reimbursement. FOR SPONSORING ORGANIZATION USE ONLY. (PDF)
- Infant Meal Pattern (Publication No. 1260) Chart indicating required components and minimum quantities of food for infants less than 1 year old in care. (PDF)
- Arabic Version (PDF)
- Bengali Version (PDF)
- Chinese Version (PDF)
- French Version (PDF)
- Haitian-Creole Version (PDF)
- Italian Version (PDF)
- Korean Version (PDF)
- Polish Version (PDF)
- Russian Version (PDF)
- Spanish Version (PDF)
- Urdu Version (PDF)
- Yiddish Version (PDF)
Forms
- Agreement Between the State and Sponsoring Organizations of Day Care Centers (DOH-3840) (PDF)
- Annual Update of CACFP Manual for Sponsors of Day Care Centers (CACFP-3979C) (PDF)
- Application for Participation of Individual Centers (DOH-3682) (PDF)
- Authorization for Online Health Commerce System (HCS) Account Creation (DOH-5158)(PDF)
- Board of Directors (DOH-5165) Formerly CACFP-4217 (PDF)
- Certificate of Authority Form (DOH-5168C) Formerly CACFP-3671C (PDF)
- Claim for Reimbursement for Sponsors of Day Care Centers (DOH-3703) PDF FILL-IN FORMAT - To submit monthly data for payment. (PDF)
- Daily Meal Count Record (CACFP-116) - Sample daily meal count sheet (PDF)
- Daily Meal Count - Snack and Supper (CACFP-128) - Sample daily meal count sheet for Snack and Supper (PDF)
- Food Production Record Instructions (CACFP-3696A) (PDF)
- Food Production Record - Breakfast, Snack, Lunch (CACFP-3696B) PDF FILL-IN FORMAT (PDF)
- Food Production Record - Lunch, Snack, Supper (CACFP-3696C) PDF FILL-IN FORMAT (PDF)
- Income Eligibility Application for Children (DOH-3688) - To determine eligibility for free or reduced priced meals for children in care. (PDF)
- Spanish (DOH-3688es) (PDF)
- Russian (DOH-3688ru) (PDF)
- Chinese (DOH-3688zh) (PDF)
- Infant Feeding Statement (CACFP-121) (PDF)
- Letter to Households (CACFP-3673) - Mandatory annual letter explaining the income eligibility applications and participant rights. (PDF)
- Spanish (CACFP-3673es) (PDF)
- Russian (CACFP-3673ru) (PDF)
- Chinese (CACFP-3673zh) (PDF)
- Arabic (CACFP-3673ar) (PDF)
- Monitoring Checklist for Day Care Centers (CACFP-4259) - Checklist used by sponsoring organizations to document required monitoring of centers. (PDF)
- Outside Employment Policy - Sample (CACFP-187) (PDF)
- Order Form for Sponsoring Organizations of Day Care Centers (CACFP-3718) PDF FILL-IN FORMAT (PDF)
- Participant Data Form (CACFP-3854C) - To annually collect racial-ethnic information of the children in care. (PDF)
- Reimbursement Rates For Day Care Centers (CACFP-124C) (PDF)
- Substitute Form W-9
NYS Office of the State Comptroller Substitute Form W-9 Request for Taxpayer Identification Number and Certification. - Vendor Contracts
- Extension of Vendor Contract to Provide Meals and/or Snacks (CACFP-141) (PDF)
- Invitation for Bid and Vendor Contract Packet (CACFP-143) - When vended meal purchases will be more than $250,000 (PDF)
- Vendor Contract $250,000 or Less (CACFP-142) - When vended meal purchases will be $250,000 or less (PDF)
