After School Snack Program On-Site Monitoring Review

Review must be completed School Food Authority (SFA) twice per year. 
The first review must occur within the first 4 weeks of snack service. Maintain form locally.
Agency/District: 
	Date of First Review:

Date of Second Review:
	
Site/School:
	Arrival Time:                   Departure Time: 
	
What time does school end?	What time are snacks served?	
Today’s Snack Menu (Record All Food Items Served and Serving Sizes)

	
	YES	NO	
1.  Are the snacks claimed only in approved after school programs?  
     Specify the after school program(s):
			
2. If the site has less than 50% free/reduced price eligible, are snacks claimed in the correct eligibility category? 			
3. If applicable, does the After School Snack Program have the appropriate free and reduced price meal documentation? 			
4. Does the meal counting system prevent overt identification of students’ eligibility status?			
5.  Is there an accurate point of service accountability system for counting snacks?			
6. Are snacks counts recorded at the time they are served? Is only one snack per day per child allowed? 			
7.  How many snacks are provided on the day of the visit?  ______________
     What is the reviewer’s count on the day of the visit? _______________   
     If there are significant differences in the counts, why is this occurring? 

			
8.  Does the snack menu meet the snack meal pattern requirements? Does the planned snack menu meet snack meal pattern requirements? 			
9. Are production records complete for each day? 			
10.  Do all snacks claimed for reimbursement on the day of visit meet meal pattern requirements? 			
11. Is water available to children or accessible from source adjacent to serving area?  			
12. Are snacks properly prepared, held, served, and stored within proper food safety practices?			
13. Is paperwork maintained for 7 years? 			
14. Has staff been trained on acceptable sanitation, meal counting procedure, and what constitutes a reimbursable snack? Is this training documented with topics, dates, and signatures? 			
15. Is corrective action required? 			
16.  If you answered YES to question #15, what is the corrective action?  When will it be corrected and by whom?  Explain:

			

Monitor’s Name and Title
	Date:	Site Staff Name and Title

	Date:	
Monitor’s Signature		Site Staff Name and Title