Special Diets in CACFP Adult Day Care Centers

Policy for Meal Modifications


Developing Policy  |   Standard Operating Procedures (SOPs)
Assessment and Action Planning Resources


Developing Policy

A written policy ensures a comprehensive approach to meeting the federal and state laws for meal modifications and is essential for addressing the specific dietary needs of all participants. Meal modification policies:

  • provide clear guidelines for participants, their guardians/caregivers, and staff;
  • ensure consistent practices at all sites and among all staff;
  • document compliance with federal and state requirements and best practices;
  • educate participants and their guardians/caregivers regarding the adult day care center's practices and procedures; and
  • provide a basis to evaluate the meal modifications process and staff performance.

A written policy is essential for providing structure, consistency, and clarity for everyone involved. The strategies below assist CACFP adult day care centers with policy development. Priority areas include assessing current operations, developing standard operating procedures (SOPs), providing staff training, and ensuring consistent communication.

  • Identify the personnel and resources needed for planning, developing, implementing, and evaluating the policy and SOPs for meal modifications.
  • Conduct a self-assessment of the adult day care center's current policies, practices, and procedures for meal modifications.
  • Identify the essential practices to implement in the food service program and the adult day care center environment and determine where SOPs are necessary.
  • Develop an action plan to address the practices needing attention, as identified by the adult day care center's self-assessment. When developing action plans for SOPs, start with the most important practices. The CSDE’s action planning form and sample action plans can assist with this process.
  • Develop SOPs by writing down the actual steps taken when performing the specific task. When using sample SOPs from organizations or other programs, customize the information to local needs and resources.
  • Identify the training needs of CACFP staff regarding meal modifications for participants with special dietary needs. Provide annual and ongoing staff training, as appropriate.
  • Identify effective communication strategies among adult day care center staff, and between the adult day care center and adult participants (or their guardians/caregivers), to ensure everyone is aware of the CACFP adult day care center’s policy and SOPs for meal modifications. Incorporate these strategies into the SOPs and provide staff training and guidance on how to implement them.
  • Implement monitoring procedures to ensure that meal modifications are reasonable, appropriate, and meet each participant’s specific dietary needs; and that all staff consistently follow the adult day care center’s policy and SOPs for meal modifications. Review the policy and SOPs for meal modifications at least annually, and make changes as needed.

For guidance on developing polices and SOPs, refer to section 4 of the CSDE's Guide to Meal Modifications in CACFP Adult Day Care Centers.

Standard Operating Procedures (SOPs)

SOPs are detailed explanations of how to implement a policy through specific practices or tasks. They standardize the process and provide step-by-step instructions that enable everyone to perform the task in a consistent manner. This ensures that all school staff follow the same procedures each time. Potential SOPs for meal modifications include:

  • preparing foods for different types of special diets, such as texture modifications, food allergies, celiac disease, and diabetes;
  • reviewing menus, reading food labels, and making nutrition information available to participants (when age appropriate), parents/guardians, health consultants, and other appropriate staff, as needed;
  • cleaning to prevent cross-contact of possible allergens;  
  • handwashing to prevent cross-contact of possible food allergens; 
  • ensuring that CACFP facility staff and food service staff regularly communicate and collaborate regarding the planning and implementation of meal modifications for participants whose disability restricts their diet;
  • obtaining consultation services (such as a registered dietitian) as needed, to plan meals and snacks for participants whose disability restricts their diet; and 
  • training for food service staff, substitutes, and all applicable CACFP facility staff involved with planning, preparing, and serving CACFP meals and snacks.

The CSDE’s Sample Standard Operating Procedure (SOP) for Meal Modifications in Child Care Facilities in the CACFP provides an example of a general SOP for meal modifications. The resources below were developed for schools but provide guidance that adult day care centers may modify.

Sample SOPs

Assessment and Action Planning Resources