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This form is used by sponsors to notify the CACFP State Agency of any changes to Day Care Home Providers information, including adding, transferring, dropping, or modifying providers.
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How to fill out Child and Adult Care Food Program Change Form
01
Obtain the Child and Adult Care Food Program Change Form from the appropriate agency.
02
Fill in the program name at the top of the form.
03
Enter your facility's name, address, and contact information.
04
Complete the section regarding the type of change being requested (e.g., meal pattern changes, ownership changes).
05
Provide details of the changes, including effective dates and reasons for the change.
06
Ensure that you have all required signatures, including the authorized representative.
07
Review the form for completeness and accuracy.
08
Submit the completed form to your local Child and Adult Care Food Program office.
Who needs Child and Adult Care Food Program Change Form?
01
Childcare providers participating in the Child and Adult Care Food Program.
02
Adult day care centers that receive assistance through the program.
03
Facilities that need to report changes in their meal service or operations.
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What is Child and Adult Care Food Program Change Form?
The Child and Adult Care Food Program Change Form is a document used by participants in the Child and Adult Care Food Program (CACFP) to report changes in their program status, eligibility, or information relevant to the program.
Who is required to file Child and Adult Care Food Program Change Form?
Providers and organizations participating in the CACFP are required to file the Change Form whenever there are significant changes in their situations, including changes in ownership, facility location, or the number of children or adults being cared for.
How to fill out Child and Adult Care Food Program Change Form?
To fill out the Change Form, participants must provide updated information accurately in the designated fields, ensure that all changes are clearly documented, and submit the form according to the guidelines provided by the CACFP.
What is the purpose of Child and Adult Care Food Program Change Form?
The purpose of the Change Form is to keep the CACFP updated with accurate and current information, ensuring compliance with eligibility requirements and facilitating proper program administration.
What information must be reported on Child and Adult Care Food Program Change Form?
The form requires reporting information such as changes in facility ownership, address, contact information, number of enrolled participants, and any other relevant changes such as menu modifications or program operations.
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