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Run: CACFP Meal Count and Point-of-Service Tally Form

Track CACFP meals at the point of service with a form built for reimbursement claims, meal-category counts, and supervisor review. Use it to capture only the...

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Site and Service Session Information

Site Name (required)

Service Date (required)

Program Type (required)

Meal Service Period (required)

Service Start Time

Service End Time

Point-of-Service Meal Counts

Infant Meals Served (required)

Child Meals Served (required)

Adult Meals Served (required)

Second Meals or Seconds Served (required)

Non-Reimbursable Meals Served (required)

Meal Category Details

Infant Formula or Breast Milk Used

Yes No N/A

Infant Meal Type

Meals Requiring Special Dietary Accommodation

Meal Pattern Exception Documented

Attestation and Review

Submitter Name (required)

Submitter Role (required)

I certify that this meal count was recorded at the point of service and reflects meals actually served. (required)

Yes No N/A

Supervisor Name

Supervisor Approval

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Email (required)

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