Special Diets in CACFP Adult Day Care Centers

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Developing Policies for Special Diets in the CACFP  |   Standard Operating Procedures (SOPs)
Resources for Developing and Implementing Policies


Developing Policies for Meal Modifications

Written policies for meal modifications are important because they:

  • provide clear guidelines for adult 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 adult participants and their responsible family members regarding the CACFP adult day care center’s practices and procedures;
  • provide a basis to evaluate program activities and staff; and
  • demonstrate the adult day care center’s commitment to the health and well-being of adult participants.

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

  • Identify the staff and resources needed for planning, developing, implementing, and evaluating the policy and SOPs for modifications.
  • Conduct a self-assessment of the CACFP 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 CACFP adult day care center’s completed self-assessment. When developing action plans for policy and 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 adult day care centers, customize the information so it is specific to local needs and resources. 
  • Identify the training needs of CACFP adult day care center staff, and appropriate professional development on meal modifications for adult participants with special dietary needs. Provide annual and ongoing training for food service staff and other adult day care center staff, as appropriate.  
  • Identify effective communication strategies among CACFP 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 adult participant’s specific dietary needs; and that all staff responsible for planning, preparing, and serving meals and snacks consistently follows the CACFP 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.

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 follows 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 adult participants and responsible family members, recognized medical authorities, and other appropriate staff, as needed;
  • cleaning to prevent cross-contact of possible allergens;  
  • handwashing to prevent cross-contact of possible food allergens; and
  • ensuring that CACFP adult day care center staff and food service staff regularly communicate and collaborate regarding the planning and implementation of meal modifications for adult participants whose disability restricts their diet;
  • obtaining consultation services (such as a registered dietitian), as needed, to plan meals and snacks for adult participants whose disability restricts their diet; and 
  • training for food service staff, substitutes, and all applicable CACFP adult day care center staff involved with planning, preparing, and serving CACFP meals and snacks.

The CSDE’s Sample Standard Operating Procedure (SOP) for Meal Modifications in Adult Day Care Centers 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.

Resources for Developing and Implementing Policies