Administrative Review Off-Site AssessmentTool
Administrative Review Off-siteAssessmentToolInstructions
GeneralInstructions/Intent
TheOff-SiteAssessment Toolis a questionnaire for sponsors, who are being reviewed this year, to fill out regarding how the school district or organization operates the child nutrition programs. It is the first document of the review. The tool covers all the areas that will be monitored during the on-site phase of the review. Thistoolisdesigned todecreasetheamountof timeneededfortheon-siteportion of thereview by providing both ODE - CNP and the Sponsorwith essentialinformation. The information about the Sponsor’s policies, procedures and practices helpsthereviewerto focuson any areasof non-complianceand target anycorrective action or technicalassistance that maybenecessary.
Throughout the Tool you will see the term School Food Authority (SFA) this means Sponsor.
The sections and questions in dark gray marked “ODEwill complete“will be completed by your Child Nutrition Specialist based on a phone interview.
Statements in italics are provided as clarification to assist in providing a response.
Please answer all questions as they apply to the Child Nutrition Program operationalpolicies, procedures and practices in your organization. Use the boxes below each question to make the response.
Note:
The numbering is not continuous on purpose. Example:Question 122 is followed by question 200.
.
Administrative ReviewOff-Site Assessment Tool
Administrative Review Off-Site AssessmentTool
Sponsor Name:CNPweb Agreement Number:
School Year: 2013-2014
CNP Program Contact Name:
Phone Number:
Email:
SectionII: MealAccessandReimbursement
Module:Certification andBenefitIssuance
100. / Whoisthedeterminingofficialfor certifyinghousehold applications?
(Namesand/orposition titles)
The determining official is the same as the Eligibility Official. This position reviews each incoming application to ensure that the household has submitted a complete application. If the application is complete, the official must then determine whether the household is categorically eligible or income eligible for meal benefits based on the information provided on the application.
Namesand/orposition titles:
101. / IstheSFArequired toconductanIndependentReview of
Applications?
An independentreview or second check of applications is required during verification when applications are manually determined. / YES / NO
Response:
102. / IftheSFAisa Residential ChildCareInstitution(RCCI),arethereany day students?
Mark The appropriate box below.
Day Students are non-residential, and participate in NSLP/SBP.
NotanRCCI
RCCI,withdaystudents
RCCI,withoutdaystudents
103. / Read definitions below before answering questions.
DoestheSFAusean electronicormanualapplication approval system?
DoestheSFAusean electronicormanualbenefitissuance system? / Electronic / Manual or Combination
Electronic application systemmeanshousehold applicationsaresubmitted bythehousehold through a
web-basedor scanned application system. Thesystem haslimited tovirtuallynomanual dataentry by theSFA. RecordsarekeptattheSFAelectronically. All directcertificationmatchesattheSFAlevel are completed witha data upload and computer match.
Manual or Combination application systemmeanshousehold applicationsaresubmitted bythehousehold tothe SFA. SFA completes eligibilitydetermination and directcertificationmatchesandentersdatamanuallyintoa systemand/or keepswritten records.Hard copyrecordsarekepton fileattheSFA.
Electronic benefitissuancesystemmeansthatthetransferof a student’sbenefitstothePointofService documentiscompleted through a computerized system.Thesystem haslimitedtovirtually nomanual data entrybytheSFA;however,updatesto benefitsmay bemademanuallyin electronicsystem. Benefitissuanceidentification and rostersarekeptelectronically.
Manual benefitissuancesystemmeansthatthetransfer ofa student’sbenefits tothe POS documentis completed manuallybythe SFA. All updatestobenefitsaremademanuallybytheSFA. Benefit issuanceidentificationandrostersaremanuallydeveloped. Hard copyrecordsarekept onfileatthe SFA.
Combination benefit issuance system means the SFA hasimplemented an electronicsystem,butoneormoreaspect ofthebenefitissuance processis conductedmanually(i.e.,the SFA hasan electronicbenefitissuancesystemat mostsites,but utilizesrosters/tickets/tokens oranyother benefitissuancemethod atsomesitesand SFA staffmust manuallymakeupdatestothosealternatesystems), thereviewerwill considerita manual/ combinationsystem.
104. / Atthebeginningof theschoolyear,how isbenefitstatushandledforchildrenwhohave not submitted an application forthe current schoolyear?
Response:
105. / How longdoestheapplicationapprovaltakefrom thedate theSFAreceives the application fromthehousehold?
Include in the response your practice for date stamping receipt and prioritizing applications.
Response:
106. / WithintheSFA,whohasaccess totheapplicationswithin thesystem? (Namesand/orposition titles)
List the Namesand/orposition titles of those who have access to individual student eligibility data:
107. / When andhow arehouseholdsnotified of students’certifiedeligibility?
How aredeniedhouseholdsnotified?
Response:
Notification of Benefits:
Notification of Denial:
108. / Whoisthehearing official? (Nameand/orposition title)
The hearing official must be an individual who was not connected with the approval or verification process who responds to appeals when a household appeals a reduction or termination of benefits.
Namesand/orposition titles:
109. / Ifthe SFA hasanelectronicapplicationapproval system(See Definitions on Question 103):
a)How arerecordsmaintained andforhow long?
b)Describe theback-up to the electronic-basedapprovalsystem.
c)Listthemethod used toobtain householdsignature.
Household signature could be hand-written signature on a scanned application or a number of defined data elements that make an electronic application unique.
Response:
110. / Whoat theSFAreceivesthedirectcertificationdocumentsfromthestateorlocalagency andwhoisresponsible forissuingand updatingthebenefitlist:
Program / Name/title ofperson receiving DCdocuments / Name/title ofperson issuing directcertification benefitstostudents
SNAP
TANF / No Direct Certification from ODE / NA
FDPIR / No Direct Certification from ODE / NA
Homeless
Migrant
FosterChildren
HeadStart
EvenStart
111. / DoestheSFAusethedirectcertification notificationletter provided by theStateagency?
Ifno, doestheletter contain allrequired informationand isit approved by theStateagency? Please enclose a copy of the letter used. / YES / NO
Response:
112. / What istheSFA’sprocedureforextendingfreeschoolmealeligibility toall childrenwho aremembersof ahousehold in whichonepersonin that household isreceivingSNAP, TANF,orFDPIR benefits?
Response:
113. / Doesthe benefit issuancesystemidentify howeligibility was determined?
(e.g., throughapplication, directcertification – SNAP only,Homeless/Runaway, Migrant, Foster, TANF, FDPIR, Extended Benefitsetc.) / YES / NO
Response:
114. / Whohasaccesstothe benefitissuancesystemand/ordocumentation?(Namesand/orposition titles)
Benefit Issuance system means electronic point of service. Documentation means a roster or list.
Namesand/orposition titles:
115. / How arebenefitsissuedand distributedtostudents?
(e.g.,via electronic systemwithcodenumbersforstudents,ticketsystem, roster)
Response:
116. / How iseligibilitydeterminationstransferred tothebenefitissuancedocument?
Explain how the F, R, and P status get from the application or certification determination to the Point of Service?
Response:
117. / How arebenefit issuancedocument(s) transferredtothepoint of servicesystem?
This answer may be the same as 116 in a networked system with an electronic Point of Service.
Response:
118. / How iseligibility statusupdatesmade tothepoint ofservicebenefit issuance document(s)?
Response:
119. / How frequently are updatesmadetothepointof servicebenefitissuancedocument(s)?
Response:
120. / Doesthe benefit Issuancedocumentindicatethedate changes weremadein thesystem?
System refers to either electronic or Manual/Combination. / YES / NO
121. / How andwhenarethe followingchangesmade tothepoint ofservicebenefitissuance
document:
•new students
•transferstudents
•withdrawn students
•30day carryoverof prioreligibility
Response:
122. / Isthereaback-upsystem for updatingbenefitissuance document(s)?
Ifyes,describetheback-upsystemforupdatingbenefitissuance document(s) / YES / NO
Response:
SectionII: MealAccessandReimbursement
Module:Verification200. / ODE will complete
Obtain acopy oftheSFA’smost recently submittedFNS742 (VerificationSummary Report) / YES / NO
a.Did theSFA choose thecorrectverification samplesize?
b.Did theSFAverifythecorrect numberof applicationsbased on theirverificationsamplesize?
c.Wasthemostrecent report timely and accurate?
Ifno,isthisarecurringproblem?
201. / WhoservesastheSFA’sverifyingofficial? (Nameand/orposition title)
The verifying official confirms the eligibility for free or reduced price benefits under the National School Lunch Program or School Breakfast Program. This includes income eligibility and all other information provided on the application form. The Verifying Official may be the same as the Eligibility Official.
Nameand/orposition title:
202. / Whoservesasthe confirmingofficial?
The confirming official or software checks the original eligibilitydetermination on applications selected for verification. If using an official, he/she must be different than the eligibility official.
(Nameand/orposition titleorsoftwareusedisacceptable)
Nameand/orposition titleorsoftwareusedisacceptable:
203. / Describe theSFA’sverification process.
Response:
204. / Has theSFAcompleted theSA’sverification training? Listwhoand when.
The training is available through ilearn as part of the NSLP Annual training / YES / NO
Response:
205. / DoestheSFAusean electronicsystemtoidentifyerror-proneapplications?
Ifyes,whatsoftwaredoes theSFAuse? / YES / NO
Response:
Module:MealCounting andClaiming
300. / DoestheSFAusean electronicormanualsystemtocountand consolidatereimbursablemeals? / Electronic / Manual/ Combination
ElectronicSystem meansmeal countsaregenerated byan automatedPointof Service (POS)systemthat mayconnecttotheclaimfor reimbursement. Electronicsystemshavetheabilitytoidentifya student’s benefitcategory,tally dailymeal counts,transfer dailymeal countstotheSFA,total school meal counts for theSFA and/or creates upload file for reimbursement claimin CNPweb. Thesystemis limitedtovirtuallyNOMANUAL data entryatthePOS.Meal countsarekeptelectronically.
Manual Systemmeansmeal countsaregenerated bya manualPointof Servicesystem.Meal countsare manuallytallied,consolidated and transferred totheSFA. ConsolidationofmealcountsbytheSFA is completed manually. Hardcopyrecordsarekepton file.
Combination System meanstheSFA hasimplemented an electronicsystem,butoneormoreaspect ofthebenefitissuance processisconductedmanually(i.e.,the SFA hasan electronicPOS,bututilizesaroster atan alternate servicelocation and SFA staff manuallyentersmeal countsfromthealternateservicelocation),the reviewerwill consideritamanual/combination system.
301. / How doestheSFA’spointofservicesystemidentify astudent’s eligibility?
Includealltypesof distinctcountingmethods(e.g.,check-off list forgrades 1-3,ticketsforgrades4-8).
Response:
302. / DoestheSFAhaveabackupsystemto theirprimary mealcountingand claimingsystemshould theprimarysystem fail/not operate?
What is the procedure if the computer is down at meal service or the person who takes to meal count is out?
IfYES,describebackupsystem. / YES / NO
Response:
303. / How oftenarecashiersandsubstitute cashierstrained on themealcountingand claimingsystem (including thebackupsystem)?
Response:
304. / Attheendofmealservice, howdoestheSFAobtainthedaily mealcountsby category fromeachschool’spoint(s) ofservice?
If school meal counts are not transferred to the central office daily, how and when are the counts reported?
This question is about the mechanics of getting the daily meal counts to the central office, e.g. on demand network transfer; automated batch file, or courier.
Response:
305. / What aretheSFA’smeal countingand claimingproceduresforthefollowingsituations
(asapplicable):
a)Offervs. Serve? / Breakfast:
Lunch:
b)Incomplete/Non-Reimbursable
Meals?
c)Second Meals?
d) Visitingstudent meals?
e)Adultand non-student meals?
f)Studentworkermeals?
g)Alacarte?
h)Fieldtrips?
i)Lost,stolen,misused,forgotten or destroyed tickets,tokens,IDs,andPINS?
j)Chargedand/orpre-billed/prepaid meals?
k)Studentswithout fundstopayfor meals?
l)New studentswithout approved certification of freeorreduced- pricebenefits?
306. / What proceduresareusedasinternal controlstoensurethemeal countsdonot exceed enrollment orattendanceadjustedenrollment?
Internal controls include daily edit checks.
Response:
307. / Electronic Systems Only: See Question 300 for definition
Aremeal countsautomatically consolidated?
IfYES,doesthesoftwareprogramcontain edit checksandinternal controls?
IfNO,whenand how areeditchecksandinternalcontrols completed? / YES / NO / N/A
Response:
308. / Havealternatepointsof servicebeenapproved by theState Agency?
Are all points of service at the end of the line after all meal components have been offered to the student? If no, have all alternate points of service been approved by ODE - CNP this school year? If no, please submit annual POS exception form to ODE-CNP for consideration.The form is located on the CNP web packet tab. / YES / NO / N/A
Response:
309. / Describe thenumberandtypesofalternatepointsofserviceoperatingduringeachmeal service(e.g.,mealsinclassrooms,bus, hallways, kiosks or carts).
Alternate points of service in this question include other locations than the cafeteria or main serving area.
Response:
310. / Ifaschoolhasmorethan onemealserviceline, how doesthepointofservicesystem prevent duplicateorsecond mealsfrombeingclaimed?
Response:
311. / Atthesitelevel,how arethetotaldailymealcountsby category submittedtotheSFAfor consolidation?
This question is about the data that is submitted to the central office, e.g. total count by category or detail with student name and benefit category.
Response:
312. / Describe theSFA’sproceduresfor consolidatingdaily mealcounts by category foreach sitetoprocessthe claimforreimbursement,if applicable. Applies to manual claiming systems, including spreadsheet assisted systems.
Response:
SectionIII:Nutritional Quality and MealPattern
Module:Dietary Specifications andNutritionAnalysisODE will complete.
600. / Basedon theresultsof theMealComplianceRisk Assessment tool, whatsitehasbeen selected forthetargeted menureview?
Schoolselectedfortargeted menureview:
601. / How will theSAproceed withthetargetedmenureview?
Option1:CompletetheDietarySpecifications AssessmentTool
Option2:Validate Existing NutrientAnalysis
Option3:ConductNutrientAnalysis
Option4:UseFNS-approvedProcess UtilizingFNS-ApprovedMenu PlanningTools
602. / IfOption 1isselected,whatinitialrisk levelhasbeenassigned forthetargeted menu review sitebasedon theresultsof theDietary SpecificationsAssessment Tool?
SectionIV:Resource Management
700. / IstheSFA’senrollment40,000studentsormore? / YES / NO
701. / Did theSFAhaveanyfinancial findingsrelated tothechild nutrition programson previousadministrativereviews oraudits within thepast threeyears? / YES / NO
Response:
Module:Maintenance ofNonprofitSchool FoodService Account
702. / Did theSFA conduct ayear-endreview of totalrevenuesand expensestodetermine theschoolfoodservice nonprofitstatus? / YES / NO
Response:
703. / Did theSFAidentify year-endexpensesin excess ofrevenues? / YES / NO
Response:
704. / IftheSFAhad excessrevenuesat theend ofthe year,were surplusfunds transferredout of theschoolfood serviceaccount tosupport otheroperations? / YES / NO
Response:
705. / Did theSFA,in themost recent fiscalyear,completeaprocesstomeasureitscompliance withtherequirementtolimitnet cash resourcestoalevelat orbelowthreemonthsaverage expenditures? / YES / NO
Response:
706. / Did theSFAmaintain supportingrecordsthat documentits compliance with theaboveprocess? / YES / NO
Response:
Module:PaidLunchEquity
707. / Did theSFAuse theUSDA Paid LunchEquitytooltoevaluatepaid lunch prices?
Non-pricing sponsors would indicate No and write a response of “All sites offer lunch at no cost to students” / YES / NO
Response:
708. / Did theSFAincreaseitspaidlunch pricesif thetoolindicatedan increasein thepaidlunchprice wasrequired? / YES / NO
Response:
709. / Did theSFAusenon-Federalfundstosupport itspaidlunch prices? / YES / NO
Response:
710. / ODE will complete.
Did the SFA submit its most frequently charged paid lunch prices to the SA? / YES / NO
Comment:
Module:Revenue fromNon-program Foods
ODE will complete with Sponsor
711. / DoestheSFAusetheUSDARevenuefromNon-programFoods Tooltocalculateitsnon-programfoodcostsand non-program food revenue?
USDA Memo SP 39-2011 / YES / NO
Comment:
712. / WastheSFA’sproportionoftotalrevenuefrom thesaleof non-programfoodsto thetotalrevenueof theschoolfoodservice account equal toorgreaterthantheproportionof totalfoodcostsassociatedwithobtainingnon-programfoods tothetotal costsassociatedwithobtainingprogramand non-programfoods fromtheaccount? / YES / NO
Total Non-Program FoodRevenue Total Non-Program FoodCost
Total Program RevenueTotal PurchasedFoodCost
Comment:
Module:IndirectCosts
713. / Did theSFA chargetheschoolfoodserviceaccount forindirect costs?
Indirect Costs are those costs that are charged to the non-profit school food service account by allocation plan. It is okay if the account was not charged indirect costs. / YES / NO
Response:
714. / Did theLEA chargeindirectcostsat theStateAgency’sapproved rate? / YES / NO
Response:
Module:USDAFoods
715. / DoestheSchoolFood Authority receiveitsUSDAFoodsfroma purchasingagency,cooperativeordistributor? / YES / NO
Response: In Oregon all Brown Box USDA Foods are shipped from ODE.
716. / Does the School Food Authority or School Food Authority’s purchasing agency or cooperative diver USDA Food for processing / YES / NO
Response:
717. / Does the School Food Authority have a Food Service Management Company contract for food service and purchasing? / YES / NO
Response:
Module: Civil Rights
800. / What isthenon-discriminationstatement used forappropriateProgrammaterials (please provide exact language)?
Response:
801. / Provideacopy of theSchoolFood Authority’spublic release.
ODE does a press release for the state. If your organization does its own, please provide a copy.
802. / Is thereaneed forservices forLimited EnglishProficient(LEP)households?
If yes, what services does the SFA provide? / YES / NO
Response:
803. / What is the SFA’s procedure for receiving and processing complaints alleging discrimination within School Meal Programs?
If procedures are written, provide a copy.
Response:
804. / Has the SFA received any written or verbal complaints alleging discrimination in School Meals Programs in the current or prior school year?
If yes, please provide the following information: date, nature of complaint and agency complaint was reported to. / Yes / No
Response:
805. / How are students with special dietary needs accommodated?
Response:
806. / When was theSFA’smostrecent civilrightstrainingforstaff whointeractwithprogram applicantsor participants(i.e. cafeteriastaff,F/Rapplication approvalstaff) andtheir supervisors?
Whoattended thesetrainings?
What topicswerecoveredbythetraining?
Answer the questions by providingsupportingdocumentation, e.g. agenda and attendance
Response:
807. / How doestheSFAcollect racial/ethnic data? How oftenisthisinformation collected?
Providedocumentation tosupport theresponse.
This may be collected as part of the student enrollment process or on the Household Application for Meal Benefits
Response:
Module:SFA On-site Monitoring
900. / How doestheSFAensurethat allschoolsaremeetingprogramrequirements?
Respond to this question with respect to meal counting and claiming.
Response:
901. / WeretheSFA on-sitemonitoring reviewsforallsitescompleted prior toFebruary 1?
IfNO,wasanextensionrequested andapproved through the
StateAgency?(Not in regulation yet.)
Explainany “NO”response. / YES / NO
Response:
902. / Wereareasrequiringcorrectiveaction identified?
During site monitoring, did SFA identify areas requiring corrective action?
IfYES, wasafollow-upreview conducted within45daystoensure that correctiveaction wasimplemented? / YES / NO
Response:
Module:LocalSchool WellnessPolicy
1000. / Provideacopy of thecurrent LocalSchoolWellness Policy.
If the Wellness Policy is posted to the Web, provide the link.
Response:
1001. / How doesthe public know about theLocalSchoolWellnessPolicy?
Providedocumentation tosupport theresponse [orappropriateweb address(es)].
Response:
1002. / When andhow doesthereview and updateof theLocalSchoolWellnessPolicy occur? Providedocumentation tosupport theresponse [orappropriateweb address(es)].
Response:
1003. / Whoisinvolvedinreviewingand updatingtheLocalSchoolWellnessPolicy?
What istheirrelationshipwith theSFA?
Response:
1004. / How arepotentialstakeholdersmadeawareof theirabilitytoparticipatein the development,review,update,andimplementationoftheLocalSchoolWellnessPolicy?
Providedocumentation tosupport theresponse [orappropriateweb address(es)].
Stakeholders are: Students, Parents, PE teachers, School health Professionals, School Administrators, School Board members, & general public.
Response:
1005. / Provideacopy of themostrecent assessmenton theimplementation of theLocal
SchoolWellnessPolicy.
1006. / How doesthe public know about theresultsof themost recent assessmenton the implementationof theLocalSchoolWellnessPolicy?
Providedocumentation tosupport theresponse [orappropriateweb address(es)].
USDA Memo SP 42-2011
Response:
Module:SchoolBreakfastand SummerFood Service Program Outreach
1600. / How did theSFAinform familiesof theavailabilityof theSchoolBreakfast Programprior to,oratthebeginning,oftheschoolyearand provideremindersabout theavailabilityof theSchoolBreakfast Programthroughout theschoolyear?
USDA Memo SP 40-2011
Response:
1601. / How did theSFAinformeligiblefamiliesabouttheavailability and locationoffreemeals forstudentsviatheSummerFoodServiceProgram?
USDA Memo SP 15-2011
Response:
SectionVI: Other FederalPrograms
Indicate any other federal programs in which SFA participates.
These will be examined during this review
AfterschoolSnackProgram
SeamlessSummerOption
FreshFruitand Vegetable Program
SpecialMilk Program
Administrative ReviewOff-Site Assessment Tool