Mississippi Fruit and Vegetable Pilot – Monthly Site Coordinator Log

Section 1 – Program Activities

The following questions pertain to the implementation of Mississippi Fruit and Vegetable Pilot (MFVP) at your school during the previous month. Please work with the MFVP Program Coordinator to complete and submit this form to ______(project coordinator) via fax or mail by the 15th of the month for the previous month (i.e., by November 15thfor the month of October).

School:______

Name of individual completing this form:______

Report for the month of: October November December January

February March AprilMay

  1. What grade levels were served fruit and vegetablesas part of the MFVP during this month?

(Mark all that apply.)

K 1 2 3 4 56

78 9 10 11 12

2. Who was the MFVP produce purchasedfrom during this month?(Mark all that apply.)

DoD Fresh Local produce company Food service vendors Other:______

3. Where was MFVPproduce distributed to students during this month? (Mark all that apply.)

Classroom Central quad Hallway Gymnasium Bus line

Sports field Cafeteria Other: ______

4. What methods were used to distribute MFVP produce during this month, and how well did these methods workfor reaching students? (Mark all that apply.)

Method of Distribution / How well did this method work for reaching students?
Not at Somewhat Very
all well well well
A la carte in the cafeteria / 1 2 3 4 5
Stationary cart, kiosk, stand or rack / 1 2 3 4 5
Moving cart / 1 2 3 4 5
Baskets or trays / 1 2 3 4 5
Other______/ 1 2 3 4 5
Other______/ 1 2 3 4 5

This evaluation tool was developed by the Mississippi Department of Education with technical assistance from the Division of Adolescent and School Health of the U.S. Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

5. Whenwas MFVP produce distributedto students during this month, and how well did these times workfor reaching students? (Mark all that apply.)

Times of Distribution / How well did this time work for reaching students?
Not at Somewhat Very
all well well well
Before school / 1 2 3 4 5
Morning break / 1 2 3 4 5
Afternoon break / 1 2 3 4 5
Lunch / 1 2 3 4 5
Afterschool / 1 2 3 4 5
Other:______/ 1 2 3 4 5
Other:______/ 1 2 3 4 5

6. Were there any special MFVP promotional or educational activities this month? Yes No

If YES, please describethe activities and whowas reached.(Mark all that apply.)

MFVP Promotional or Educational
Activities / Descriptionand Main Topic(s) Covered / Grade Levels Reached (K, 4, 8, etc.) / Others Reached (parents, teachers, community, etc.)
Food tastings
Assembly/Fair
Announcements
Print materials
Other media
Classroom activities or lessons on MFVP
Other:______
Other:______

7. Were thereanyother nutrition-related promotional oreducational activities this month?

Yes No

If YES, please describe the activities and who was reached. (Mark all that apply.)

Nutrition Promotional or Educational Activities / Description and Main Topic(s) Covered / Grade Levels (K, 4, 8, etc.) / Others Reached (parents, teachers, community, etc.)
Food tastings
Assembly/Fair
Announcements
Print materials
Other media
Classroom lessons/ curriculum on nutrition
Other:______
Other:______

8. Were parents involved in implementing MFVP at your school during this month?

Yes No If YES, please answer the following:

What type of tasks did they do? (e.g., helping with preparation, distribution, etc.) / About how many parents helped? / About how many hours did they help?

9. Were community members and/or organizations involved in implementing MFVP at your

schoolduring this month? Yes No If YES, please answer the following:

What type of tasks did they do? (e.g., helping with preparation, distribution, etc.) / About how many people helped? / About how many hours did they help?

10. What successes have you had with MFVP during this month?

______

______

______

11. What challenges have you had with MFVP during this month?

______

______

______

12. Overall, how would you rate the implementation of MFVP at your school during this month?

1 2 3 4 5

Poor Fair Good Excellent Not

Distributing

F & V Yet

13. Please use the following space to provide any other comments about MFVP at your school during this month:

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