Oregon Department of Education-Child Nutrition Programs
New Meal Pattern Certification Checklist
(Revised 8-13-13)
Section 201 of the Healthy, Hunger-Free Kids Act (HHFKA) makes an additional .06 cents reimbursement available for meals meeting the updated meal pattern requirements. In order to be eligible to receive this new performance-based reimbursement, the Oregon Department of Education Child Nutrition Programs (ODE CNP) must certify that the Sponsor is in compliance with the requirements of the final meal pattern rule published in the Federal Register January 2012.
Sponsor Information (must be completed)Name of Sponsor: Agreement #: (In CNPweb)
Name of person submitting Certification Documentation:
Contact Information: Phone E-mail
Date Certification Submitted: Authorized Sponsor Signature______
Certification Week Submitted for: //to//
(Must be from a normal school week)
Method of submission: Email the completed packet for approval to School Nutrition Support Staff at:
Certification Checklist:
Please submit all of the following items on the checklist as one packet & include the Checklist in the packet
Description / Sponsor Use Only / ODE Use OnlySTEP 1 – All Sponsors submit
One week of menu(s) for each menu type offered, by grade group, forbreakfast & lunch:
Example:
NMP Lunch NMP Breakfast
K-5 K-5
K-8 K-8
6-8 6-8
9-12 9-12
K-12**(see step 2)
If one menu represents all grade groups that is acceptable.
Please send actual menu(s) posted to students / Menu Type
Lunch(indicate grade group type and
check box when complete)
Breakfast (indicate grade group type and
check box when complete)
If submitting additional menus,
please attach additional sheets. / Lunch-ODE Approval
Breakfast-ODE Approval
STEP 2 –
All Sponsors Submit USDA Menu Certification Worksheet for Breakfastfor a normal school week.
USDA Menu Certification Worksheet for each menu type forlunch for the normal school week. (Tabs 1-10 to show menu meets meal pattern and tabs 11 & 12 Simplified Nutrient Assessment to show menu meets nutrition standards of calories & saturated fat).
OR
Weekly report showing planned meal pattern is met and a Detailed Nutrient Analysis (using approved USDA software) of calories and saturated fat for each menu type for planned number of servings, in place of the USDA Lunch menu certification worksheets. / Menu Type
Breakfast (indicate grade group type and
check box when complete)
Lunch (indicate grade group type and
check box when complete) / Breakfast-ODE Approval
Lunch-ODE Approval
STEP 3
Completed and signed assurance form (attestation) that confirms:
- Compliance with all current and future meal pattern requirements
- Documentation is representative of the ongoing meal service within the SFA
- The minimum required food quantities for all
- All labels and/or product specifications for food products and ingredients used to prepare school meals indicate zero grams of trans fat per serving and component crediting;