CACFP Adult Day Care Centers

Forms

 The date in italics after each document is the most current revision date.

A   B   C   D   E   F   G   H   I   J   K   L   M   N   O   P   Q   R   S   T   U   V   X   Y   Z  

A

Authorized Signatures

• Authorized Signatures Change Form and Instructions  December 2025

C

Crediting Worksheets

• Worksheet for Crediting Cooked Breakfast Cereals in the Child and Adult Care Food Program   January 2026
• Worksheet for Crediting Ready-to-eat (RTE) Breakfast Cereals in the Child and Adult Care Food Program   January 2026
• Worksheet for Crediting Cooked Breakfast Cereals in the Child and Adult Care Food Program   January 2026

Civil Rights 

• Civil Rights Requirements for the CACFP (CSDE's Civil Rights for Child Nutrition Programs webpage) 

E

Enrollment Form

• CACFP Enrollment Form for Adult Day Care Centers  April 2026

F

Food Safety

• Refrigerator and Freezer Temperature Control Record   September 2023

I

Income and Expenditure Report

• Form: CACFP Nonprofit Status Income and Expenditure Report for Child Day Care Centers, Emergency Shelters, At-risk Afterschool Programs, and Adult Day Care Centers  February 2026
• Instructions: Instructions for CACFP Nonprofit Status Income and Expenditure Report for Child Day Care Centers, Emergency Shelters, At-risk Afterschool Programs, and Adult Day Care Centers  February 2026

Income Eligibility

• Income Guidelines for Child Nutrition Programs (CSDE webpage)
• Income Eligibility Form
  • English: Income Eligibility Application Form for Adult Day Care Centers April 2026
  • Spanish: Solicitud de elegibilidad según los ingresos para los centros de cuidado diurno para adultos April 2026
• Income Eligibility Form Instructions
  • English: Instructions for the Income Eligibility Application Form for Adult Day Care Centers April 2026
  • Spanish: Instrucciones para completar la solicitud de elegibilidad según los ingresos para los centros de cuidado diurno para adultos  April 2026
• Household Letter for Nonpricing Adult Day Care Centers 
  • CACFP Household Letter for Adult Day Care Centers  April 2026
  • Spanish: Programa de Alimentos para el Cuidado de Niños y Adultos (CACFP) carta para hogar familiar para los centros de cuidado diurno para adultos April 2026

M

Medical Statements

• Medical Statements (CSDE's Special Diets in the Child and Adult Care Food Program webpage) 

Menu Forms

• Menu Forms ("Menu Forms and Production Records" section of CSDE's Meal Patterns for the CACFP webpage) 

Monitoring

• Monitoring Review Form for CACFP Centers  April 2026

P

Production Records

• Production Records ("Menu Forms and Production Records" section of CSDE's Meal Patterns for the CACFP webpage)  

S

Standardized Recipes

• Standardized Recipe Form for the CACFP  January 2026