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Contra Costa County Department of Aging and Adult Services Area Agency on Aging & Public Health Senior Nutrition Title lllC1 Congregate Meal Program Intake Form Fiscal Year 20222023NOTE: Items marked

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How to fill out iiic-1 congregate meal intake

01

Begin by obtaining the iiic-1 congregate meal intake form.

02

Fill out the personal information section including name, age, date, and contact information.

03

Provide information on dietary restrictions or preferences.

04

Record the meals consumed at the congregate meal site for the specified time period.

05

Sign and date the form before submitting it to the appropriate authority.

Who needs iiic-1 congregate meal intake?

01

Individuals who participate in congregate meal programs at designated sites.

02

Those who require assistance with meal planning or have dietary concerns that need to be addressed.

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What is iiic-1 congregate meal intake?

iiic-1 congregate meal intake is a form used to track and report the number of meals served to individuals at congregate meal sites.

Who is required to file iiic-1 congregate meal intake?

Organizations or entities that operate congregate meal sites are required to file iiic-1 congregate meal intake.

How to fill out iiic-1 congregate meal intake?

iiic-1 congregate meal intake can be filled out by recording the number of meals served, the date of service, and any other required information.

What is the purpose of iiic-1 congregate meal intake?

The purpose of iiic-1 congregate meal intake is to track the number of meals served at congregate meal sites and ensure compliance with program guidelines.

What information must be reported on iiic-1 congregate meal intake?

Information such as the number of meals served, date of service, demographic information of participants, and other relevant data must be reported on iiic-1 congregate meal intake.

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