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CACFP Home Monitoring Form (Child Care Home) - Connecticut Mobile App

This form records information required for Connecticut CACFP Monitors who visit child care homes. This form automatically populates review date, review times and can obtain GPS data. The reviewer has the option to capture a picture of the meal and perform a 5 day reconciliation (depending on the Connecticut Sponsor's requirements). Reviewer and Provider signatures are also included in this form, and other features can be easily added as needed.

Be sure to check out this and our other customizable CACFP Mobile Apps to help you save time and streamline important processes.

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Take a peek inside the CACFP Home Monitoring Form (Child Care Home) - Connecticut Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

Monitor Name:
Provider Name:
Provider Number
Review Type:
Review Type Continued:
Date of Visit:
Visit Start Time:
The provider is currently?
Is the provider currently DHS listed?
Licensed capacity?
Are all of the children present on the annually updated enrollment list?
Are enrollment forms available for all children present?
Do enrollment times on the children's enrollment forms correspond to the children present?
Are enrollment forms available for new children?
Are children being claimed for meals that they are not enrolled for?
Is the provider keeping copies of all enrollment forms?
Additional comments regarding enrollment:
Meal Observed
Are Infants present at the meal?
Are Non-Infants present at the meal?
Beginning time of meal observed:
Will you be performing a 5 Day Meal Reconciliation?
Using your Master Food List, indicate what food items you observed the infants eating.
Meat/Alternate or Infant Cereal 8-11 Months.
Fruit or Vegetable, 8-11 Months.
Iron Fortified Infant Cereal, 4-7 Months
Fruit or Vegetable, 4-7 Months
Indicate if the infants had breast milk or formula.
...and More!