Sample Provider/Sponsoring Organization Permanent Agreement Form
SAMPLE
CHILD AND ADULT CARE FOOD PROGRAM
PROVIDER / SPONSORING ORGANIZATION AGREEMENT
This agreement, entered into this ______ day of ____________, 20_____, by and between ________________________ of _____________________________________
(Sponsoring Authority) (Sponsoring Authority's Address)
and ____________________________________________________________, specifies
(Provider's Name) (Provider's Mailing Address)
the rights and responsibilities of Provider and Sponsoring Organization as participants in the U.S. Department of Agriculture's (USDA), Child and Adult Care Food Program (CACFP).
This agreement will remain in effect as long as Provider annually applies to Sponsoring Organization for CACFP participation and Sponsoring Organization approves Provider’s application.
________________________________________________________________________
I. PROVIDER REQUIREMENTS
Provider agrees to:
1. Prepare and serve meals, of approved meal types, that meet CACFP meal requirements in 7 CFR 226.20 for the ages of children served.
2. Serve meals at no charge to enrolled children.
3. Maintain a valid family childcare home license.
4. Maintain on file documentation of each child’s enrollment and ensure that the documentation includes information on each child’s normal days and hours of care and the meals normally received while in care, is signed by a parent or legal guardian, and that the information for each child is updated annually by a parent or legal guardian.
5. Promptly inform Sponsoring Organization about any change in the number of enrolled children in the home and any change in status of the childcare license.
6. Maintain daily records of the:
a. Foods served to children at each meal service.
b. Number of meals meeting program requirements that are served to enrolled children at each meal service.
c. Number of enrolled children who are present each day.
Failure to maintain records shall be grounds for denial of reimbursement.
7. Claim reimbursement only for children who are currently enrolled for CACFP participation and only within the home’s licensed capacity of children. Claim reimbursement for meals served to provider’s own children living in the provider’s home only if:
a. Provider’s own children are enrolled and participating in the childcare program, and
b. Enrolled nonresident children are present and participating in the childcare program, and
c. Sponsoring Organization has approved provider to report provider’s own children based on USDA family size and income guidelines.
8. Claim reimbursement for no more than one meal served to each enrolled child at a meal service, up to a maximum of two meals and one snack or two snacks and one meal during a day.
9. Submit meal counts by children’s names and menu records to Sponsoring Organization each month by the due dates set by Sponsoring Organization.
10. Participate in program training prior to participation in program and at least annually thereafter as offered by Sponsoring Organization.
11. Provide access to CACFP meal service and records during the home’s hours of operation for review by representatives of Sponsoring Organization, the Minnesota Department of Education, and USDA. Visits will be made at least three times per year, either by appointment or unannounced.
12. Notify the Sponsoring Organization in advance when enrolled children will be out of the home during a meal service period. If this procedure is not followed and an unannounced review is conducted when the children are not present in the day care home, Sponsoring Organization will disallow claims for meals that would have been served during the unannounced review.
13. Participate in the CACFP only under this Sponsoring Organization unless this agreement has been terminated in accordance with Section IV.
14. Distribute to parents a copy of the Sponsoring Organization’s notice to parents, if so instructed by Sponsoring Organization.
15. Meet CACFP requirements for family childcare homes in program regulations (7 Code of Federal Regulations part 226) as specified by directives from Sponsoring Organization.
II. SPONSORING AUTHORITY REQUIREMENTS
Sponsoring Organization agrees to sponsor Provider for CACFP participation in accordance with federal regulations for CACFP (7 Code of Federal Regulations part 226) and directives from the Minnesota Department of Education.
Sponsoring Organization agrees to:
1. Train Provider in program requirements before Provider begins CACFP participation and offer additional training sessions at convenient times and places at least once a year.
2. Visit the home during the hours of childcare operations, either by appointment or unannounced, to review program operations including meal service and records.
3. Contact parents of enrolled children to verify attendance.
4. Respond to provider's requests for assistance.
5. Provide all required record keeping forms.
6. Subject to availability of federal funds, distribute to provider the full reimbursement for each meal served to enrolled children within five days of receipt of funds from the Minnesota Department of Education. (If with the provider's consent the Sponsoring Organization will incur costs for the provision of food or meals in behalf of the of the family child care home, the particulars of the arrangement must be inserted here.) Sponsoring Organization may withhold any Program payments that Sponsoring Organization has reason to believe are invalid due to false or erroneous meal counts submitted by Provider. Sponsoring Organization will not withhold Program payments to Provider for any other reason.
7. Charge no fee to the provider for CACFP sponsorship.
8. Inform Tier II homes of all options for receiving reimbursement for meals served to enrolled children. These options include:
a. Elect to have the Sponsoring Organization attempt to identify all income-eligible children enrolled in the home, through collection of Family Size/Income Data Sheets and/or possession by the Sponsoring Organization or home of other proof of a child or household’s participation in a categorically eligible program, and receive Tier I rates of reimbursement for the meals served to identified income-eligible children;
b. Elect to have the sponsoring organization identify only those children for whom the Sponsoring Organization or home maintains documentation of the child or household’s participation in a categorically eligible program, under the expanded categorical eligibility provision contained in 7 CFR 226.23(e)(1), and receive Tier I rates of reimbursement for the meals served to these children;
c. Receive Tier II rates of reimbursement for all meals served to enrolled children.
9. Collect applications and determine the eligibility of enrolled children for free or reduced-price meals, upon request of a Tier II home.
10. Provide an opportunity for Provider to request an administrative review (appeal) if Sponsoring Organization issues a notice of proposed termination of the home’s Program agreement or a notice of suspension of provider participation due to health and safety concerns, in accordance with 7 CFR 226.6(l)(2).
III. NONDISCRIMINATION
Provider and Sponsoring Organization agree to serve meals to all enrolled children without regard to race, color, national origin, sex, age, or disability.
IV. TERMINATION OF AGREEMENT
Provider or Sponsoring Organization may end this agreement for cause or, subject to stipulation by the Minnesota Department of Education, convenience. Noncompliance with the terms of this agreement, or failure to take prompt and full corrective action required by Sponsoring Organization, will result in cancellation of this agreement.
V. TRANSFER
Minnesota Department of Education policy allows providers, each October, to either renew their agreement with their Sponsoring Organization or enter into an agreement with a different Sponsoring Organization. Providers may transfer between Sponsoring Organizations in a month other than October only when the Minnesota Department of Education has approved the transfer due to extraordinary circumstances.
Provider and Sponsoring Organization certify that the information on this form is true and correct to the best of our knowledge and that we will comply with the rights and responsibilities outlined in this agreement.
_____________________ ________ __________________
PROVIDER'S SIGNATURE DATE PROVIDER’S DATE OF BIRTH
_______________________________ ____________
SPONSORING AUTHORITY DATE
REPRESENTATIVE'S SIGNATURE
_____________________________________________________________________
March 2005
MDE E-mail Updates