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

Included Fields

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

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  Monitor Name:

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  Provider Name:

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  Provider Number

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  Review Type:

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  Review Type Continued:

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  Date of Visit:

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  Visit Start Time:

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  The provider is currently?

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  Is the provider currently DHS listed?

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  Licensed capacity?

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  Are all of the children present on the annually updated enrollment list?

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  Are enrollment forms available for all children present?

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  Do enrollment times on the children's enrollment forms correspond to the children present?

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  Are enrollment forms available for new children?

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  Are children being claimed for meals that they are not enrolled for?

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  Is the provider keeping copies of all enrollment forms?

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  Additional comments regarding enrollment:

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  Meal Observed

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  Are Infants present at the meal?

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  Are Non-Infants present at the meal?

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  Beginning time of meal observed:

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  Will you be performing a 5 Day Meal Reconciliation?

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  Using your Master Food List, indicate what food items you observed the infants eating.

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  Meat/Alternate or Infant Cereal 8-11 Months.

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  Fruit or Vegetable, 8-11 Months.

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  Iron Fortified Infant Cereal, 4-7 Months

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  Fruit or Vegetable, 4-7 Months

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  Indicate if the infants had breast milk or formula.

• ...and More!