Servicios de comidas del CACFP en los programas Head Start

(En inglés)

CACFP Meal Services in Head Start Programs

Nydia Ntouda: Today, we have Marco Beltran. He's the senior program specialist with the Office of Head Start. He's joining us and will introduce our presenters today. Marco?

Marco Beltran: Thank you, Nydia. On behalf of the Office of Head Start, I want to welcome you to the Child and Adult Care Food Program, Meal Services in Head Start Programs webinar. As Nydia said, my name is Dr. Marco Beltran, and I am the senior health lead in the Office of Head Start. As you all know, together, Head Start and CACFP contributes to the wellness, healthy growth, and development of young children.

And this webinar will provide resources and information on how to implement CACFP in your program. I am so glad that you are here with us today, and now, I would like to introduce you to our presenters. I am so pleased that our food and nutrition services colleagues are with us today.

I would like to introduce you to, first, Melissa Daigle Katz, who is a program analyst with the Food and Nutrition Service Child Nutrition Program in the Program Development Division and works on policy for the Child and Adult Care Food Program and the Summer Food Service Program. Some of her current projects include developing technical assistance on racial and ethnic data collection, updating applications and handbooks, and responding to state waiver requests. Before her role in child nutrition, Melissa worked in the Supplemental Nutrition Assistance Program.

Next, I want to introduce you to Carolina Martinez, who is a program analyst with the Food and Nutrition Service Child Nutrition Programs, Policy, and Program Development Division. Prior to joining F&S, Carolina worked with the District of Columbia government. She had oversight of the district's seven school-based health centers, which provide comprehensive primary care services to students to ensure that every student has access to the care that they need to lead healthier lives.

Next is Erica Nelson, who is a program analyst at USDA Food and Nutrition Services. After earning her bachelor's degree, Erica spent a decade in state government, providing compliance oversight of federal child care programs, including the subsidized child care and Child and Adult Food Program. She also had the opportunity to develop relationships with Early Head Start and Head Start programs in Washington DC.

I am also pleased to introduce you to the National Center on Health, Behavioral Health, and Safety staff. First, I want to introduce you to Anne Hemmer, who is the training and technical assistance associate and co-nutrition lead for the National Center on Health, Behavioral Health, and Safety. She is a registered dietitian who has served as a Head Start health manager, a nutrition manager, and a nutrition consultant for Early Head Start. Before joining the center, she was an Office of Head Start region one system specialist, where she worked on state level systems initiatives on topics such as IMIL, or I am moving, I am learning.

Finally, I'm going to introduce you to Nicole Patterson, who is a Caring for Our Children content manager and health and safety specialist with the National Resource Center and co-nutrition lead for the National Center on Health, Behavioral Health, and Safety. She is a member of the Academy of Nutrition and Dietetics and credentialed with the Commission on Dietetic Registration. Nicole's nutrition-focused experience includes developing wellness-based programs and family education classes to establish critical skills in reading food labels, healthy shopping on the budget, and proper portion sizes. Without further ado, I want to, once again, welcome you, and now I would like to turn it over to Nicole Patterson.

Nicole Patterson: Thank you, Dr. Beltran. First, I want to go over a couple of the objectives. We know so many children currently live in food insecure homes. Implementing the Child and Adult Care Food Program or CACFP meal patterns and Head Start programs helps to ensure that children receive wholesome and nutritious meals. Some objectives that we'll cover today include acknowledging the importance and value of the CACFP to provide those healthy and balanced meals. We'll review those CACFP meal patterns for infants and children. Then we'll outline requirements for record keeping and reimbursement of meals and snacks as well.

The goal of the USDA's Child and Adult Care Food Program or CACFP is to improve the health and nutrition of children in the program while promoting the development of good eating habits through nutrition education. Implementing the CACFP meal patterns helps to ensure children receive wholesome and nutritious meals. We know many Head Start children live in communities where access to affordable, fresh, nutritious food can be a challenge.

CACFP helps make it possible for programs to offer children wholesome meals and snacks while in care. The meal patterns themselves focus on providing a variety of nutrient dense foods, including whole grains, a variety of fruits, vegetables, fat free foods, low-fat dairy products. Milk is provided daily, and all while reducing added sugar intake and saturated fats. Really, CACFP plus healthy meals supports a child's development and learning.

Additionally, this webinar was developed with the awareness that programs providing CACFP meals and snacks are facing various supply chain disruptions, which are causing cancellation of food deliveries, food product shortages, and increased food and supply prices. All this can put an extra stress on planning and providing those adequate but also reimbursable meals.

The National Center for Health, Behavioral Health, and Safety began seeing a flood of questions and requests from programs regarding how to navigate these issues while still providing, again, those healthy and reimbursable meals. This prompted a survey through MyPeers asking program staff which areas of CACFP they currently struggled with or simply wanted more information. Then lastly, today's webinar includes information on responsive feeding, which is really an attentive way of feeding young children, including watching for hunger, satiety, or fullness cues as well.

We're proud to bring you this webinar that will provide suggestions, strategies, resources that programs can consider when providing, again, those nutrition services and CACFP meals in Head Start programs. With that, I want to go ahead and turn it over to Carolina Martinez, who's going to talk about the CACFP policy updates.

Carolina Martinez: Thank you so much, Nicole. Hello and welcome. My name is Carolina Martinez, and I am here today with my colleagues Melissa Daigle Katz and Erica Nelson. We are all program analysts at the USDA Food and Nutrition Service. We are really happy to be here with you today to talk about what's new in the Child and Adult Care Food Program or CACFP as we call it.

For this presentation, we are going to focus on how CACFP has operated during the COVID-19 pandemic and how it will operate as we transition back to normal operations. We'll also review record keeping and reimbursement expectations, address some hot topics, walk through some new nutrition resources and answer your questions. With that, let's get started.

CACFP providers play a critical role in supporting nutrition security, which is having consistent access to safe, healthy, and affordable food and beverages to promote optimal health and well-being. Serving nutritious meals is incredibly important. We have the opportunity to positively impact our participants' health in the long term.

Our goal is to not only provide healthy meals for children, which each and every one of you is doing and making a significant impact, but to teach kids early in life about the importance of good nutrition and healthy behaviors. Again, thank you for all that you do. Now, we'll move on to our updates about what's been going on in CACFP policy. On the next slide, we'd like to give you an introduction to policy to get started.

We'd like to give you a quick overview of how policies are made and how policy flexibilities can be allowed. First, all federal policy starts with statute. These are the laws passed by Congress and signed by the President. The statute is the ultimate authority of our programs. The statute in the case of CACFP is the National School Lunch Act. This is the law that allows funding for this program. Next, we have our regulations.

These are developed by USDA through the notice and comment rulemaking process. This means that all aspects of the regulations were initially proposed. USDA took public comments, and the final regulations were developed based on those comments. The purpose of the regulations is to explain how a federal agency will implement the statute.

Finally, we have guidance. This category can include USDA policy memos and instructions and handbooks. These are used to provide additional clarity to the regulations. If people want to change the CACFP rules, they advocate to Congress to write laws that amend our statute, which allows us to write new regulations and guidance. Going through that process usually takes years.

Now, on the next slide, we'll see about flexibility. Sometimes a state needs some flexibility on a rule in the short term. The National School Lunch Act Section 12(l) allows USDA to grant waivers. A waiver is permission to not follow a rule for specific circumstances. We refer to these waivers as 12(l) waivers. Section 12(l) waiver authority can be used for individual, state, or eligible service providers. It can not be used to issue nationwide waivers. A state has to request the waiver from USDA.

USDA can approve the waiver if the waiver request supports the purpose of the program, and the request demonstrate that the waiver will not increase costs to the federal government. However, there are some things that USDA cannot waive. They include but are not limited to the nutritional content of meals or snacks and federal reimbursement rates. There are more provisions that the Secretary cannot waive. Please refer to the National School Lunch Act for more information.

Next, early in the pandemic, in March 2020, Congress first provided USDA with the authority to issue nationwide waivers for all the child nutrition programs through the Families First Coronavirus Response Act of 2020, which is the FFCRA. Instead of states having to apply for individual 12(l) waivers – state waivers, USDA could determine which flexibilities were needed to continue safely serving kids.

We then granted all the states and territories the ability to apply these flexibilities to their programs. Unfortunately, that emergency authority expires at the end of the school year, and Congress did not extend it. This means that we have to go back to providing flexibilities through the 12(l) waiver process, and that affects which waivers we can offer for this summer and the upcoming school year.

The policy flexibilities that you see listed on this slide are probably familiar to you, since they were offered through nationwide waivers during school year 2021 and 2022. They include flexing meal service time restrictions, which allowed you to serve more than one meal at a time; non-congregate meal service, which allowed children to take meals home with them; allowing parents and guardians to pick up meals for children; allowing monitoring flexibilities, such as the ability to make monitoring visits offsite; area eligibility for family day care home providers, which allowed all day care homes to qualify for the higher tier one reimbursement rate, no matter where they were located; and meal pattern flexibilities, which help to respond to supply chain issues.

Like I mentioned earlier, they expire at the end of the school year, which is June 30, 2022. Some of these flexibilities, the ones in green, are available for school year 2022-2023 for states that request them through the individual 12(l) waiver process that we discussed. These include waivers for non-congregate meals, meal times, parent guardian pickup, and offsite monitoring. Our expectation is that these waivers will only be used when congregant meal service is limited to COVID-19. Local program operators in collaboration with the state agency are best positioned to determine to what extent these waivers are needed. Check with your state to see if any of these waivers will be available to you and how they may be used.

The flexibilities in the orange will not be available in the coming school year, as the 12(l) authority doesn't allow USDA to grant waivers that increase costs to the federal government or make changes to the meal pattern. In summary, now that our nationwide waiver authority has expired, we are beginning to transition back to how we operated before the public health emergency.

Now, on the next slide, we'll see that, as far as waiver of the meal pattern requirements, we have heard that it was really helpful for responding to supply chain issues, and we’re glad to have been able to offer it. However, as we just mentioned, the waiver is no longer available.

We want you to know that there are some existing flexibilities available to state agencies as they monitor meal pattern compliance. The flexibilities allow states the discretion to provide technical assistance in lieu of taking physical action when they see meal pattern noncompliance due to supply chain disruptions. For more information on how these flexibilities will be used in your state going forward, make sure to check in with your state contact.

Also, if you're concerned about how well the reimbursement rates meet your needs as prices rise, we do want to highlight the good news that the CACFP reimbursement rate adjustments are effective in July. The reimbursement rates are always based on the consumer price index, which reflects the cost of food. We are expecting to see an increase in the rates.

On the next slide, we have a few more tips for CACFP operators who are facing supply chain disruptions resulting in the cancellation of food deliveries, food product shortages, or increased food and supply prices. First, whenever possible, communicate with any vendors you buy food from to ensure you have the most up to date information on emerging supply chain issues. Place orders as early as possible and forecast your food needs for longer periods.

We also suggest that you identify alternate sources of supplies, such as grocery stores. Consider appropriate substitutions within the same meal components and use the food buying guide for child nutrition programs. We'll make sure to provide a link to a fact sheet on the USDA website to keep you well informed. All right. With that, we're going to go ahead and move on to Melissa, who is going to walk us through some of the hot topics in CACFP for Head Start providers.

Nydia: Melissa, you're muted.

Melissa Daigle Katz: I apologize for that. We have heard that Head Start providers would like guidance on providing meal pattern accommodations when requested by parents. CACFP rules allow you to make modifications for children with disabilities on a case by case basis. If a requested modification doesn't meet the meal pattern, the parent must provide a written statement from a state licensed health care professional, like a physician or nurse practitioner. This is required in order for you to claim the meal for reimbursement.

The written statement should include a description of the child's physical or mental impairment, that you understand how it restricts their diet. It should also include an explanation of what must be done to accommodate the disability, including suggested substitutions.

You can choose to meet their requests for accommodation without a medical statement if the requested modifications are within the meal pattern. You're not required to provide the exact substitution or other modification that's requested. For instance, if a child needs a gluten free bread, you don't have to provide the particular brand of bread, just a bread that's gluten free.

However, you must work with the parent or guardian to offer a reasonable modification that effectively accommodates the child's disability. In fact, we strongly encourage providers to take a team approach and include other Head Start staff with training in this area, such as nurses or registered dietitians. We have a policy memo with guidance on the subject, and we'll make sure that you get a link to it. Next slide?

We've also heard that you have questions about responding to requests from parents to make meal accommodations based on religious needs or parental preferences. F&S strongly encourages providers to work with families to ensure that their children receive meals that meet their needs, including for religious reasons or for the parent's preference. All substitutions and modifications must meet the meal pattern. If the Head Start center serves a meal that doesn't meet the meal pattern for a non-disability, then the center would not be able to claim the meal for reimbursement.

Accommodating requests just for milk substitutions is its own hot topic lately. CACFP allows milk substitutions under certain circumstances. If parents request a milk substitute that's for a non-disability reason and it's nutritionally equivalent to milk, you can provide that substitution, and the meal will be reimbursable. A medical statement is not required. Starting July 1, 2022, that includes lactose free milk and reduced lactose milk.

You're probably wondering what it means for a beverage to be nutritionally equivalent to milk. It means that it meets F&S' standards for vitamins, minerals, and protein. If parents request a milk substitute that is not nutritionally equivalent to milk, a signed medical statement which states the recommended substitution is required for the meal to be reimbursed. Now, let's transition to Erica for a discussion of meal reimbursements and record keeping requirements.

Erica Nelson: Thank you, Melissa. We received your questions about CACFP reimbursements. Based on your inquiries, we want to demystify how reimbursements are calculated. The Child and Adult Care Food Program is not a dollar for dollar reimbursement program. The USDA does not reimburse program operators for the full cost of the food service program. Instead, the USDA issues reimbursement for eligible meals to offset the full cost of serving children nutritious meals. The formula for calculating the monthly reimbursement is the number of meals claimed by type, like breakfast or snack, multiplied by the appropriate reimbursement rate as determined by children's eligibility.

Children who are determined eligible for Head Start enrollment are determined categorically free in the CACFP. That means meals served and claimed at Head Start facilities are reimbursed at the highest rate. This chart shows you the current reimbursement rates. As Carolina pointed out, reimbursement rates are effective from July 1 to June 30 annually. Meals claimed during that period will be reimbursed at the rate that is in effect for that year.

Now, let's look at some record keeping requirements. Record keeping is a key element of CACFP compliance. It is vital to have records and documentation that support claims for reimbursement on file and available for review or audit by the state agency and representatives of the USDA. In the next few slides, we'll highlight the most important aspects of CACFP record keeping requirements.

CACFP institutions must maintain orderly and efficient record keeping and filing systems. Records must be maintained for a minimum of three years after the end of the fiscal year to which they pertain or until any audits or investigations of that year's records have been closed.

Records of past corrections of serious deficiencies should also be kept on file and used to assist the center in maintaining the procedures that were approved for implementation. Meal service records includes all the documentation required to validate a claim for reimbursement. These records are used to compile the data reported on a claim. This includes meal counts by type, infant and child menus for all meal types, daily attendance, and child enrollment and eligibility.

To reduce the burden of paperwork, children who are determined eligible for enrollment in Head Start facilities are eligible for free meal benefits under the CACFP. Operators do not need to obtain additional income eligibility information, like an income eligibility statement. Head Start operators are encouraged to use an electronic data collection and maintenance system for enrollment that includes the required CACFP enrollment information, like children's names, dates of birth, days and times of care, eligibility determinations, civil rights data, and parent guardian contact information.

Moving on. Program operators will demonstrate responsible and effective fiscal management by maintaining documentation of allowable operating costs and administrative costs. This includes invoices and itemized receipts for food, non-food supplies, and purchase services. In addition, for food service and administrative labor, operators will maintain time and attendance logs and payroll records. Approved budgets and budget amendments should be on file to further demonstrate effective fiscal planning for operating the CACFP.

Sponsoring organizations and institutions are required to conduct staff and facility staff training upon employment and annually thereafter. These trainings must be documented by recording dates of trainings, locations, CACFP topics discussed, and names of center personnel in attendance. It is not required – but is considered a best practice – to also record how the training was facilitated and who the facilitators were.

For example, if staff complete a training module on the Institute of Child Nutrition's web page, you may note that the training was an online module facilitated by the ICN. Sponsoring organizations are required to conduct and document facility site monitoring. Facility site monitoring forms and documentation of corrective action must be kept on file. Monitoring form templates may be provided by your state agency.

Be sure that all monitoring form templates used by your institution have been approved by the state agency. In addition to these USDA requirements, CACFP operators are responsible for adhering to state agency requirements. This may include documentation of milk audits, photos of product labels to support whole grain rich items and sugar limits in yogurt and breakfast cereal, or state agency specific forms and templates.

Additional records that need to be up to date and on file include the institution's management plan. The management plan is the operational manual that Head Start facilities develop for how the CACFP will be implemented. This includes all written standard operating procedures for the CACFP and staff roles and responsibilities. Following the management plan will ensure the facility will remain in compliance and avoid findings during a review.

Record keeping can look different from facility to facility. It is important to remember that the requirement is to have records on file and available for review. That's the “what.” There are some options for how those records are maintained. F&S does not endorse any of the methods listed. It is solely up to the institution's discretion with approval from the state agency and sponsoring organization.

For example, some facilities may choose to implement mobile technology for meal counting, where staff responsible for recording meal counts enter the data into a tablet or other mobile device at the time of service. Other facilities may choose to use analog methods, such as paper templates and three ring binders. Whichever methods you determine are best for your facility, be sure to consult with the state agency and/or your sponsoring organization for approval and technical assistance. Melissa?

Melissa: Thank you, Erica. Now, let's transition to highlighting some technical assistance resources that we think you'll find helpful. Through our Team Nutrition Initiative, we continue to provide tools to help program operators put meal pattern requirements into practice. Today, we have close to 250 training worksheets, slide presentations, meal planning guides and interactive activities, videos, standardized recipes, and more.

We've also been working to provide Spanish language versions of the resources and to translate the whole Team Nutrition website into Spanish. Meanwhile, our popular CACFP Halftime webinars regularly draw thousands of attendees and cover hot topics on CACFP menu planning in both English and Spanish. We hope that you have the opportunity to participate, and you can always find recordings on our Team Nutrition website. The address is shown here.

You may also be interested in checking out Team Nutrition's educational resources, such as the Nibbles for Health family newsletters and Grow It, Try It, Like It for family child care settings, which can help you engage children and families in learning about nutrition. Today, almost 500 CACFP sponsoring organizations and independent child care centers have joined Team Nutrition's CACFP Organizational Network. If your organization has not yet signed up, I encourage you to do so. Member organizations receive exclusive communications and resources from Team Nutrition.

We have a few resources that are new are coming down the pike from Team Nutrition that I think you'll be excited about. First, Team Nutrition recently released Let's Make a Snack, CACFP's snack menu planner for children 3 through 18 years of age. This publication shows CACFP operators how to incorporate elements of menu planning to provide reimbursable snacks that are nutritious, appealing, and affordable, including 20 new standardized recipes for children ages 3 through 18.

Team Nutrition also has a breakfast menu planner in the works, which is expected to be available online in English and Spanish this summer. Just like the snack menu planner, this resource will assist you as you plan reimbursable breakfasts that are tasty and healthy and provide some additional new standardized recipes. Also, the Crediting Handbook for CACFP, a complement to the food buying guide, was just revised.

This handbook is a technical assistance handbook that provides child care providers with the most current guidance for planning meals that follow the meal pattern requirements and the dietary guidelines. Beyond the exciting work that our Team Nutrition initiative conducts, we also strive to periodically update our policy guidance for sponsors and state agencies so that you're able to administer your programs using the most up to date information.

This summer, Team Nutrition plans to release the CACFP milk requirements Job Aid, which will help you quickly identify what type of milk you may offer participants based on their age. Again, F&S wants to thank you for all you do. Your perseverance and your dedication were essential to ensuring that children had access to healthy meals throughout what has been and continues to be one of the most challenging times we have faced. We appreciate your hard work and your commitment.

Nicole: Thank you, Melissa. I want to – this is Nicole Patterson again. I want to go ahead and just talk to you about the CACFP meal patterns, go over the CACFP meal patterns, and really go back to the basics. The first thing I want to really stress is the importance of your state agency contacts. Please know who your state agency contact is, and please don't hesitate to reach out, ask them questions. This could help improve your CACFP reviews and audits as well.

Your CACFP state agency contacts are on your side, and they want to see you succeed. They can provide you with additional training, resources, and support as well. Also, just note that your state agency contact may reside in various state agencies, such as your State Department of Education, maybe a Department of Public Health and Human Services as well. It will vary based on your state. They can really be a great resource for CACFP approved recipes, meal ideas, and so on.

The information reflected that I'm going to talk about reflects the updated CACFP meal pattern requirements, which became in effect in October of 2017. These updates allow for more opportunities to increase a child's nutrition. Meal and snacks include a better variety of fruits and vegetables, more whole grains, less added sugars, less saturated fats. They really lead to higher quality meals served in programs through the CACFP.

Really, all of this helps young children learn healthy eating habits early that they can carry on with them later on in their lives as well. The meal pattern should be thought of as a guide to help programs build healthy meals and also balanced meals and snacks as well. The meal patterns break down breakfast, lunch, supper, and then snacks as well. They're all broken down into required food group components, which come together to build those balanced and nutritious meals and snacks.

This means that, when provided all these important components, children are provided daily the energy, the nutrients that they need to grow, develop, be physically active, and so on. Let's take a look at each of these meal pattern components, just really quick, in terms of the nutrition associated with that. In the milk category, milk provides good carbohydrates, a good amount of protein. Calcium – super important for children and their growing bones – potassium, and then a number of vitamins and minerals, especially vitamin D and vitamin A.

The meat, meat alternate component, protein, we'll see protein in that component, super important for growing and healing. Sources of that can be beef, lean beef, lean meats in general, fish, poultry, eggs, dairy products, cheese, yogurt, and so on. But we can also think about plant-based sources in that meat alternate as well. Beans, legumes, tofu, and so on.

Then in vegetables, vegetables are low in calories, but they're high in dietary fibers and nutrients. Vegetables, we think of foliage. There's a lot of folate, magnesium, potassium, and a number of vitamins and minerals as well. Fruits are very similar, nutritionally, but they tend to be higher in natural sugars.

We want to focus more on those vegetables versus fruits, but fruits are still very important to include daily. And then lastly, grains. Grains, we think of wheat, rice, oatmeal, barley, going to be super high in those healthy dietary fibers, a number of B vitamins and minerals as well.

All right. Let's go ahead and get into some meal patterns. These are the CACFP meal patterns, and I'm going to discuss them each individually based on meals, snacks, and then the different age categories. You'll notice that the CACFP meal patterns are separated by age. You'll see, in green, toddlers ages 1 to 2, and in the orange, preschool aged children, ages 3 to 5. And just note that children under 12 months will follow the infant meal patterns, which I'll talk about a little bit later.

This is the CACFP meal pattern for breakfast. You'll see that, again toddlers ages 1 to 2, they have required components for milk, fruits or vegetables, and grains. Milk, the minimum requirement is 1/2 a cup or 4 fluid ounces. Vegetables or fruits, 1/4 cup. This can be 1/4 cup of fruit or vegetable or portions of both, as long as they meet that minimum requirement of 1/4 of a cup or quarter cup.

Then for grains, 1/2 an ounce equivalent of grains. Then for preschool children ages 3 to 5, we see those minimum requirements increase just slightly. Milk for ages 3 to 5 will be 3/4 of a cup or roughly 6 fluid ounces. Fruits and vegetables, 1/2 a cup total. Again, fruit or vegetable at 1/2 a cup or portions of both at a minimum of 1/2 a cup. Then grains, you'll see 1/2 ounce equivalent there as well.

What's really great about breakfast is there is an option to include protein. To allow for some flexibility in the meal planning, programs can substitute a meat or meat alternate for the entire grain component at breakfast up to three times a week. Just remember that one ounce of a meat – meat alternate is equal to one ounce of a grain. You're able to switch that out up to three times a week.

All right. Now we have the CACFP meal pattern for lunch or supper. Again, separated out by age. For toddlers ages 1 to 2, you'll see all five of those meal patterns there. It is required that program serve all five of those meal patterns during lunch or supper. For breakfast, 1/2 a cup of milk, 4 ounces, for protein, 1 ounce equivalent of protein, vegetables, 1/8 of a cup, fruit, 1/8 of a cup as well. Then grains, that 1/2 ounce equivalent.

Then for preschool aged children, 3 to 5, again, you'll see slightly more. Based on their growth development and physical activity, they'll need a little bit more. Milk, 3/4 of a cup, 6 fluid ounces. Their protein will increase a little bit to 1 and 1/2 ounce equivalent of protein. Their fruit and vegetable intake should increase as well to 1/4 cup for each of those, fruits and vegetables each. And then your grains at half ounce equivalent of grain as well.

Next is the CACFP meal pattern for snacks. Toddlers and children ages 1 to 5 all have the same meal pattern. You'll notice that the categories are just for all age groups in this one, because 1 to 2 and 3 to 5 are the same. For this one, it's a little bit different. Programs are able to choose any two of the five components to be a reimbursable meal.

The meal patterns are as follows. Milk, the requirement is at least 1/2 a cup. Again, 4 fluid ounces. Protein, 1/2 a ounce equivalent of protein. Vegetable and fruits are each 1/2 cup, each. Then the grain component is at 1/2 an ounce equivalent of grain. Again, programs can choose two of the five components to provide a reimbursable snack. Again, a protein and a fruit, a grain and a vegetable, and so on.

One great resource that I want to share with you if you haven't already started using it or gotten yourself familiar with this is the Food Buying Guide. The Food Buying Guide is the principal resource to determine the contribution that foods make towards the meal pattern requirements for a CACFP. This can also be used for other child nutrition programs as well. This is for foods produced on site or purchased commercially as well.

This resource is essential for helping programs really decide how much food should be purchased and also how much should be served to provide those reimbursable components during meals and snacks. The Food Buying Guide is available in a number of formats. You can get an interactive web-based tool, a mobile app, or it can be downloaded as a PDF. We've provided the link there for you to access the Food Buying Guide on the slide. We've also provided it in your resource handout as well.

Then next we have the Crediting Handbook. This is probably one of my favorite resources to go to in terms of trying to figure out how to credit items that you may be serving for your meals and snacks. This handbook is a supplementary resource to the Food Buying Guide and contains additional information on credible foods served in your programs. Again, the link for this resource is provided on the slide, and we've also provided it for you on your resource handout. OK?

Now for the infant meal patterns. The infant meal patterns take into consideration a baby's usual eating habits. On the slide, you can see just a quick overview of the meal patterns. Again, it's separated by the type of meal or snack – breakfast, lunch, supper, snacks. Then we see it separated out by age of that infant as well. Birth through 5 months, and then 6 through 11 months as well. Next we're going to go ahead and go into those a little bit more in depth.

The CACFP infant meal pattern, this one is for breast milk and infant formula. Again, you'll notice it's separated by age. Infants birth through 5 months, if it's a breakfast or lunch, those infants should be provided at least 4 to 6 fluid ounces of breast milk or formula. For a snack, same thing, 4 to 6 ounces there as well. For the older infants, ages 6 through 11 months, those amounts will increase slightly.

For breakfast, lunch, and supper, again, infants 6 to 11 months, 6 to 8 fluid ounces of breast milk or formula. Then for a snack, those infants 6 through 11 should be served about 2 to 4 fluid ounces of breast milk or formula. Just keep in mind that infants are fed based on their hunger and satiety cues and should be fed in a similar fashion as they would be fed at home. Always consult with families so that you're feeding the infants very similar to how their regular feeding would occur.

Now, solid foods. Around 6 months of age, infants begin being introduced to solid foods. This is accounted for in the CACFP infant meal patterns. For breakfast, lunch, or supper, the older infants ages 6 to 11 months can be given certain solid foods. They can be provided or served up to 1/2 ounce equivalent of an infant cereal or up to 4 tablespoons of a meat, fish, poultry, egg, bean, or pea type of food product.

Again, remember these are infants. It would be mashed, pureed types of foods [Inaudible]. Then up to 2 ounces of cheese, or up to 4 ounces of cottage cheese, or up to 4 ounces of – or about 1/2 a cup of yogurt. Just remember that a combination of the above is acceptable to provide for those infants as well. Then along with that, up to 2 tablespoons of a vegetable or a fruit is also included in that infant meal pattern.

Then we'll see similar requirements for snacks. CACFP infant meal pattern for snack, again, ages 6 to 11 months, up to a 1/2 ounce equivalent of bread, or a 1/4 ounce equivalent of crackers, or a 1/2 ounce equivalent of an infant cereal, or a 1/4 ounce equivalent of a ready to eat breakfast cereal. And then along with that, a fruit or vegetable, up to 2 tablespoons of a fruit or vegetable. Again, a combination of those is acceptable as well.

Some infant feeding best practices. First, I want to call out the feeding infants in the Child and Adult Care Food Program resource. This is a really great resource for all things feeding infants. I highly encourage programs to look at that resource and get used to it. It's great for a number of questions that you may have as well. We've provided the link to that resource on the slide. And it's also included in your resource handout as well.

Just some best practices for infants when it comes to feeding. We want to encourage and support breastfeeding. This includes arrangements for mothers to breastfeed their infants comfortably should they choose to do. Then infant formula and breast milk is fed solely to children 0 to 12 months. Children younger than 12 months should not be consuming anything like cow's milk or any other types of foods – or liquids, I should say. Solely that infant formula and breast milk.

Next, infants, again, are fed on cue. We're looking at those feeding and satiety cues or fullness cues. We don't want to feed infants past their point of fullness. We want to hold infants while feeding them. We don't want to prop bottles. Then when it comes to including solids, we want to make a plan for safety, appropriately introducing those solids to infants. This should be always in consultation with families and the child's primary care provider as well.

Just remember, introducing of solids is usually done around 6 months, no sooner than 4 months without any type of written permission from the family and the primary care provider. We also don't want to be mixing anything with infant bottles. No cereals, fruit, fruit juices, any of that stuff should be mixed with formula or breast milk. Then again, serving those mashed fruits and vegetables and those first foods as well. Then lastly, no fruit juice for children under 12 months as well. This is all included in the CACFP meal patterns also. Again, if you have any other additional questions, you can refer to that resource feeding infants in the Child and Adult Care Food Program.

All right. Next, again, these are some common CACFP questions that the National Center received from that MyPeer survey that we put out in terms of questions and comments that programs have when it comes to CACFP. The first one being, “Why are a cheese stick, a fruit, and a milk sufficient for breakfast?”

If we remember, going back to that meal pattern for breakfast, a cheese stick – a 1 ounce cheese stick – is equivalent to a 1 ounce meat alternate in that protein component. That would be adequate for meeting that single component. Then if we had a fruit, making sure that the minimum component for that or the portion for that would be a 1/4 cup. Then the milk served at 1/2 a cup or 4 fluid ounces in meeting the minimum meal pattern requirements for that breakfast.

While this doesn't seem like a lot, a cheese stick, a fruit, and a milk, it would be sufficient for the CACFP patterns, again, depending on the age of the child. That's for a child ages 1 to 2. Again, when you're planning meals, and programs are noticing that maybe a cheese stick, a fruit, and a milk is just not filling up a child for breakfast as it should, getting more creative in your planning and providing more of those foods that tap into a child's fullness a little bit more can definitely be more beneficial.

The next question, “Can yogurt be served at breakfast as a smoothie?” The answer is yes. Yogurt may be served in a drinkable form and credited toward the milk – the meat alternate component, if you use a credible yogurt and your own standardized smoothie recipe. Again, the yogurt has to be within those added sugar limitations to be used in that recipe.

“What about milk? Can you credit milk at breakfast in a smoothie?” The answer to that one is also yes. The volume of fluid milk in each portion of smoothie is credible if the smoothie contains at least 1/4 cup or 2 fluid ounces of milk, which is the minimum serving size for milk. The milk must also meet the fat standards that you're serving as well. When a smoothie contains less than the amount of milk required in the meal pattern, additional milk must be offered as well to make up for that minimum requirement of milk at breakfast. OK?

Then, I'm going to actually just skip over that grain equivalent question really quick. I'm going to jump to the religious considerations. “What are religious considerations and other accommodations?” I just want to reiterate that the Head Start performance standards state that programs must design and implement nutrition services that are culturally and developmentally appropriate. They must meet the needs of and accommodate the feeding requirements of each child, including children with special dietary needs and children with disabilities. Please use that multi-team approach, nutritionists, dietitians, that can help to create a well-balanced menu in your program as well.

Some other types of questions that I've gotten in terms of the religious considerations. “We have several participants that attend our program that cannot eat certain foods because of religious reasons. Can we claim these participants?” Yes. You can provide substitutions that can be made to accommodate those religious dietary restrictions within those existing meal pattern requirements. Again, as we talked about, if a child maybe cannot drink milk for religious reasons or ethical reasons, you can reimburse those as long as the non-dairy beverage that's provided in place of milk is nutritionally equivalent to cow's milk.

Again, a parent or guardian must provide a written request for that non-dairy or non-cow's milk beverage substitute. Then again, if you have any questions regarding claiming of meals or reimbursement, please remember to contact your state agency or sponsoring organization. Always check with your state's CACFP program on how to proceed.

Then the last question, “Can you provide more information on grain equivalents? Please explain and discuss the new grain ounce equivalent requirement.” I'm actually going to provide you with a number of great resources for this. Grains must now be credited using ounce equivalents in the CACFP. What's ounce equivalents? Ounce equivalents are important to understand and can be helpful when planning meals and snacks. This information is useful for programs wanting to use foods that they may not have used in the past, especially for experiencing these shortages of food and maybe needing to use different types of foods that we may not have used before. Programs should become familiar with ounce equivalence to ensure the proper portions of foods are provided. Listed on this slide are various helpful resources.

An easy way to ensure grains are being credited is to use the food buying guide for child nutrition programs, exhibit A in the grains tool. The exhibit A grains tool allows users to search their grain product and enter the serving size as listed on the product label. The tool then determines the ounce equivalent or grain bread serving for the grain product, as well as the amount of the grain product to serve to obtain that specific meal pattern contribution.

Super helpful there. Next, programs can use grain charts. Post the grain charts in your kitchens when planning meals and snacks. I do have one of those pictured up there on the slide. It's an example of the grain chart that can be found in the USDA's resource called “Using Ounce Equivalents for Grains in the Child and Adult Care Food Program.” Again, this resource is included in your resource handout that we've provided you as well. This resource provides detailed information and grain charts that can be useful to have on hand when determining the required amount to be serving during meals and snacks. Then most importantly, making sure that they're credible and reimbursable.

Then lastly, practice calculating ounce equivalents. The USDA provides several practice worksheets including one called calculating ounce equivalents of grains in the Child and Adult Care Food Program. This worksheet can be used in training to give program staff the knowledge, skills, and expertise to implement these meal pattern requirements. We have provided you with that link and that information on your resource handout as well.

All right. And that brings us to healthy eating environment practices. I'm going to go ahead and turn it over to my colleague Anne Hemmer to talk to us about that.

Anne Hemmer: Thank you, Nicole and to all the other speakers. We're going to discuss an overview of how to create positive food and eating environments for children and some strategies adults may want to adopt. Next. Next slide, Nicole.

Here's some strategies you can try to help make mealtime a positive experience. We want to offer children each item, not force children to eat. Help children build their serving skills. Allow second helpings when all have been served, and use encouraging language during our meal service. Next.

This is a busy slide, but I developed it purposely for that reason. It's important to remember when thinking about meals that the food and the environment are equally important. You can utilize this information to help staff and families understand that meal time for children is not just an eating event. It's a learning opportunity to help children understand about food and eating, something they will do every day and continue after they leave us. Begin to help a child establish a lifelong healthy relationship with food and eating.

When we look at the meal environment side of the slide, on the left hand side, we want to make sure that children receive food that's appropriate to their developmental readiness, that we are feeding infants and children – as Nicole spoke about – on demand.

Food is encouraged but not forced. Enough time is allowed for children to eat at breakfast, at snack and at lunchtime. That caregivers and children eat together. That's how we want to try to start to establish a positive meal environment. Of course, we have to remember that food is involved in this meal time.

We want to make sure that a variety of food is served to broaden the child's experience. In Head Start, we accommodate families with different religious backgrounds. We serve food which considered cultural and ethnic – which considers cultural and ethnic preferences. As we've talked about, the food should be high in nutrients, low in fat, sugar, and salt, and not to use food as punishment or reward. Next, please, Nicole.

Let's think about how we teach children about food – the food that they're going to see during the meal. They're going to taste. They're going to touch. They're going to smell. The food that they're going to experience with their senses. How do we work with them with this? We can think of meal time as an opportunity to educate children, enhance their school readiness skills. Talking about the characteristics of food can help develop language. Teaching children to pour and serve themselves can enhance motor development.

Let's look at the menus and see how that can be used as a teaching opportunity. We can use the menus to discuss food during the meal time and continue these discussions during scheduled activities and routines throughout the day. We can use mealtime as a learning experience by involving children in conversations about the specific characteristics of the foods they are eating. The peas, what color are the peas? What shape are the peas? How did the peas grow? Where do they grow? Maybe including in the circle time prior to the meal a book about how foods are grown and how peas grow. Next slide.

We also want to think about planning meal times for success. We do this with other things. We want children to be successful. We want our adults to be successful. How do we plan meal times for success? Think about planned seating – seating that helps healthy role modeling and peer learning.

If you think about planned seating, you want to allow individualization for a child's success by seating maybe that hesitant child next to an encouraging adult or an encouraging peer. We want to use effective strategies to encourage children to try new foods. We're going to talk about that a little bit later, about introducing and trying new foods. Family style meal service, another way to promote successful meal times. I think in Head Start, we know about family meal style.

We want to let children serve themselves as appropriate, and again, that's a teaching opportunity to teach children how to serve themselves. This is something we want to initiate gradually, so staff and children can learn about this together. We want to have serving dishes on the table and teach children to serve themselves and to understand what a portion size is.

With family meal service, adults can model and develop key concepts for children's learning, including opportunities to try new foods and politely decline, understanding appropriate use of utensils, and assist with setting and cleaning the table after the meal. Other benefits include improved motor skills, self-confidence and expanded social skills. Next slide.

Again, to keep thinking about how children can learn around food and around mealtimes, we want to help children learn about their feelings of hunger and fullness. We want to support the children's satiety clues. Again, an opportunity to educate children about the concepts of eating, food, and nutrition.

Children can learn about how it feels to be hungry and full. Adults can teach children about the physical feeling they can recognize when they are hungry and when they are full. Try asking children the questions on the right hand side of the slide. Again, read books about nutrition. Do physical activity using music that has nutrition themes. We want to discuss with children, how do you feel when you're hungry and ready to eat? What does it feel like when you are full?

Thinking about, if we often said, “Eat more of that,” maybe say, “Are you full?” If we, at times, would say, “Can you eat one more bite?” Maybe instead say, “Have you had enough to eat at this point, at this meal, right now?” If we say, “Eat your vegetables before you can have your dessert,” maybe instead, “What does your tummy feel like? Does it have enough food? Would you like some more?”

Again, asking the questions and teaching about what it feels like, what your body feels like when it's hungry, and what your body feels like when it's full. I think this is such an exciting lesson for children. There are so many good resources and books around how to work with children around feelings of fullness and hunger. Next slide.

A concept that helps with self-regulation – and that's what we were talking about before with the self-regulation of having children understand whether they are hungry or full – a concept that promotes this is the division of responsibility of feeding in children. The division of responsibility promotes the idea that support in an appropriate eating environment children can naturally decide what they eat and self-regulate around the food. Process that staff and families can learn and carry out gradually with children from the youngest age.

Again, if this is a concept or this is a practice that you're not using at this point, there's a lot of great resources in the handout around this. This is something that is going to, again, take time and practice to learn this process. It reinforces adults to listen to and, again, educate, so children learn about their feelings of hunger and fullness. This concept was developed by Ellyn Satter who is a registered dietitian and a social worker. I just want to read a quote because she kind of took it all. The concept is kind of outlined well in this quote. I just want to read this quote from one of her books.

"Children want to eat, and they want to grow up and eat the foods adults eat. Beyond doing the adult part of structured sit down family style meals and snacks, adults don't have to do anything to get it to happen. Just be there and enjoy your own food. Keep in mind that grown up food is all new to children, and they have a lot to learn. For them, it is like any other skill, such as reading or bike riding.

They learn it bit by bit at their own pace because they want to. They will eat like a child. Some days a lot, other days not so much, only one or two foods, not everything at a meal perhaps. What they eat one day they may ignore the other. Try not to pressure children to eat certain amounts or types of food." I understand. I've been in the field for a long time. This is a tall order. Next slide, please.

The division of responsibility is that adults determine the what, what kind of foods are being served, the when, again, your scheduling and your timing of meals and snacks, and where, at appropriate-- with appropriate utensils, at appropriate tables and chairs. That's the adults responsibility. Then the child is responsible for determining how much and whether to eat. Again, this division of responsibility is a concept that if you're not doing now will take time and practice. There's a resource link on this slide. There's a lot of information.

There are videos about feeding children on the website. And this is all – the resource is also on your resource list. This may be a new concept to staff and families. We may need to learn how to do this and gradually adopt these concepts and practices. Again, this isn't something that you're just going to be able to turn around and do in a day or a week. Next slide.

Again, children – again, we want to have food and the concepts around food be a learning experience. Strategies to introduce new foods are tasting parties, nutrition themed books, nutrition themed music, visiting farmers markets, growing foods and gardens, food preparation activities, and family activities of trying new foods, sending home resources for families about trying new foods.

I just want to say one thing about tasting parties. We used to do those a lot a long time ago. I think they're a great way to introduce new foods. Again, with tasting parties and preschool children, there doesn't have to be a lot of food. You don't have to worry about the waste. For example, if you're going to taste apples, if you have a classroom of 18, 19, 20 children, three apples – two to three apples are plenty to use for a tasting party. Get a yellow apple. Get a red apple. Cut them into very, very thin slices and small pieces. Talk about – maybe read a book about apples, how they grow. Talk about what they look like, what they smell like. Very small pieces, and then allow children to taste or not to taste. But again, I know it's hard, especially with the way food is now in the shortages. We don't want to waste food. Again, tasting parties only require a very small amount of the food you're introducing or tasting. Next slide.

Here's some resources to promote gardening in early education environments and the benefits it is to children. Again, I want to read this because I think this is so important. This is a research-based quote. "The more engaged children become with hands-on food education, such as gardening and food preparation, the more likely they will prefer and routinely consume the fruits and vegetables." The first link on this slide is about growing, cooking fruits and vegetables in child care centers. There's also some other resources there in your resource handout.

I know a lot of you do this. A lot of you have gardens. A lot of you have outdoor gardens, indoor gardens, and grow food. Again, I think the research showing that when children not only grow the food but tend to the gardens and prepare the food, they prefer and routinely eat that food is a really important concept to remember. Next slide.

To summarize some strategies and how we can carry out, again, some of these concepts that may be new to you and may certainly take some time and some practice to get underway in your programs are to, again, go back to our own wellness. So important at this time to consider our own wellness around healthy eating, to create that positive food environment, that positive mealtime, positive eating environment, role modeling healthy behaviors and healthy eating.

We know when we've sat with children, they watch what we do as adults. They want to model what we do. if we can model healthy practice, that's so important for children. Support children's feelings of hunger and satiety. Have a lesson about, “How do you feel? Do you feel hungry? Do you feel full?” Read books about it. Do activities about it. Again, children have self-regulation, and we don't want to disrupt their self-regulation. We want to support their feelings of hunger and fullness.

Integrate food nutrition concepts into daily routines, every day, all the time. Nutrition isn't once a month. Nutrition isn't the flavor of the month. Nutrition isn't the idea of the week. Nutrition and food concepts using music, using physical activity routines with nutrition themes – all ways to integrate and to support healthy, positive mealtime and eating practices. Look up – if you're not familiar with and you haven't started to use, the division of responsibility is a concept that if you can integrate it into your programs – will leave children with a healthy and positive relationship with food.

Educate children about healthy eating practices. We've talked a lot about that, and make sure to follow up with your families. Everything you're doing with food, you know they're going to – children are going to go home and talk about what they're doing. Follow up with families, not just about the menu items, but also about the activities, about the books you're using, about the music you're using, and how you're integrating nutrition into your practices on a regular routine basis. Next slide.

Just a slide about the information memorandum that came out about the Supplemental Nutrition Assistance Program, SNAP benefit, as eligibility for Head Start. Again, resources are on your resource list about this and also a link in ECLKC about this. Very important way to make sure that our families are eligible for our program. Back to you, Nicole.

Nicole: Thanks, Anne. I think we'll go ahead and take some questions. Or I think we might have some pre-approved questions.

Steve: We have all kinds of questions. People are really, really engaged and had so many good questions. I'd like to start with one that's really timely, and this is for Melissa. Melissa, what is the USDA doing to help with the infant formula shortage? And while you're speaking, I'm going to pop some resources in the chat. Melissa, go right ahead.

Melissa: Thank you, Steve. We are aware that the ongoing infant formula shortage, which is due to supply chain issues, has worsened significantly due to the major formula recall in February of this year. And it has left many CACFP operators very concerned about access to formula and their options for safely feeding infants.

Guidance on the infant formula shortage for CACFP operators will be released very soon. And in the meantime, please reach out to your state agency for their help if you have immediate questions or concerns. And for more information, you can follow our progress on the infant formula safety issue at our webpage. And we've provided a link for that, Steve, that I think you're going to be showing to everyone with all the other links at the end of the presentation?

Steve: Yes, all the links are on the handout.

Melissa: Great. Fantastic.

Steve: They can access you. They can access their state CSP agency. Yeah, we put everything right on that one handout. The handout, for those of you that missed it, has been added to the chat a number of times, as well as a link to the handout if you prefer that. It will be sent within the next 48 hours, along with the recording and a link to the evaluation and certificate.

Thank you, Melissa, for that. We have some other questions. I wonder, Anne, if you might speak a little bit more about family style meals. People were asking a lot in relationship to COVID and having changed some of the work around family style meals. Anne, could you speak a little bit more about that?

Anne: Sure, Steve. Thank you. Again, you have to follow your regulations that are set up for your community or your state. That's of the utmost importance. The idea – really, the concept about family style meals are that the children's meals aren't plated. There are a number of ways that you can do family style meals. Again, it may – some of our restrictions may need to be lifted before we can get to the full content. But the idea is that children somehow serve themselves. We teach them the amount. They see all the food that's available at the meals. They see the food that's available at the meal.

They are allowed to serve some of it to themselves in an amount that is appropriate that they've been taught to serve. That we are sitting down in a cordial environment, and we have enough time to eat. It's about all those concepts that we spoke about for a positive meal environment, not just the fact that the meal is sitting out, that the food is sitting out, and the child is serving it. It's all about those other appropriate concepts that are happening. There's no punishment and reward. There's no negative discussion. There's no forcing children to eat.

It can also be, if you don't want it on the table, it can also be on a side table that can be served on their plate and then brought to another table, if that helps with the restrictions of having things at a common table. There's a lot of – Steve and I used to talk about this and teach about this a lot. There's a lot of flexibilities around it. It's more the concepts that are being met, rather than that you're doing one specific thing.

Steve: Thank you, Anne, much appreciated. We can talk about family style meals forever.

Anne: Forever, yes.

Steve: But it's way more than pouring and serving. I think that's sort of the bottom line. This question is for Nicole. There were some questions about serving size. This person is asking, did they hear that 3- to 5-year-olds need to have a minimum of 2 ounces of milk at breakfast? How would I know that instead of 6 ounces? Is that what – was that something that you said, Nicole?

Nicole: For breakfast, toddlers ages 1 to 2 should be served 1/2 a cup of milk, so 4 ounces. then preschool children 3 to 5 should be served 3/4 of a cup or 6 ounces. I don't know if that answers that.

Steve: Great. That 2 ounces was not –

Nicole: Right, yeah. That could – I think that might have been confused with the smoothie. The smoothie question that I had answered. There's a minimum of 2 ounces. If you serve milk or if you want to credit the milk during a smoothie for breakfast, then the minimum amount of milk in the smoothie has to be 2 ounces, fluid ounces of milk. But you still have to make up the rest of that milk by serving additional milk during breakfast. Does that make sense? You can still use the 4 ounces, 1/2 a cup in each portion of that. But that's the minimum – I think is where that confusion was – the minimum is 2 ounces for a smoothie.

Steve: OK. Thank you. OK. Back to our folks at USDA. This is for Erica. When can we trim down our redundant paperwork – oh, I love this question – like multi-sided visits? That form needs revision. Is that happening?

Erica: That's a very good question. Thank you for whoever submitted that. F&S recognizes that institutions are seeking ways to streamline operations and reduce the paperwork burden. However, state agencies are ultimately responsible for the oversight of monitoring form templates. Some state agencies may provide a template. Others may allow sponsoring organizations to use templates that they've developed internally. The important takeaway regarding this matter is that all monitoring form templates used by your institution must be approved by the state agency. You are encouraged to work with your state agency on possible revisions or the use of technological systems.

Steve: Thanks, Erica. This one's back to you, Nicole. Are you not allowed to serve two different vegetables instead of one vegetable and one fruit for lunch?

Nicole: Oh, good question. Yes. You may serve a second vegetable as either an extra food or count it towards the fruit component of lunch. This is because a second vegetable may count towards the fruit component at lunch if it's at least an 1/8 of a cup – again, depending on the age of children that you're serving. If you're serving children 1 to 2 years of age, it has to be at least an 1/8 of a cup of two different kinds of vegetables that are served.

For example, again, if your program serves children 6 years a 1/2 cup of roasted broccoli and 1/4 cup of roasted cauliflower can be served. The cauliflower would replace the fruit component and meet the minimum serving size required for the fruit component for those children. These are great questions. These are answered in that crediting handbook as well.

Steve: Oh, thank you for referring back to handbook. Yes. Terrific. Let me remind people, we have so many questions we're not going to get through them all. But we did put a address in the chat a number of times, health@ecetta.info. You can send a question there at any time, and we will respond. Carolina, this question's for you, and it really covers I think a lot of what people have asked about. It's about parents.

If a parent requests that their child does not receive an entire component of a meal based on personal preference, is that meal reimbursable? Can the parent choose to just not participate in CACFP? In other words, can they opt out of enrollment?

Carolina: Sure. Thank you for that question. You'll recall from the presentation that program operators can make substitutions that still fit the meal pattern for a parent's parental preferences for their child, ones that are not related to a disability. CACFP rules do not allow serving meals that are missing an entire component, like milk or grains, for personal preference reasons.

Parents cannot opt their child out of CACFP, as it is a child care center or home that participates in the CACFP, not the individual child. If the center or home serves a meal that is missing a component in a situation like this, then the child care provider would simply not claim that meal for reimbursement.

Steve: Thank you. Thank you. Melissa, can Head Start programs participate in the Fresh Fruit and Vegetable Program? There you are.

Melissa: The short answer is yes, they can, under certain circumstances. Let me get the list of circumstances up here.

For those of you who are actually not familiar with it, the Fresh Fruit and Vegetable Program is a federally assisted program that serves free fresh fruits and vegetables to kids at eligible elementary schools during the school day. Its goal is to introduce children to fresh fruits and vegetables, of course, and to include new and different varieties, and to help increase the overall acceptance and consumption of fresh, unprocessed produce amongst children.

If children are attending a Head Start program that's located in a school that participates in the Fresh Fruit and Vegetable Program, the Head Start program could also participate if the children are considered enrolled in the school and if they are in school on the days that the program is offered. Of course, that's a lot of ifs. If you have additional questions about it, we encourage you to contact your state agency. If your program is in a school, go ahead and talk to the school.

Steve: Thank you, Melissa. That one was new to me. It was good to hear that. I see a lot of people have noticed that the certificate only identifies one hour of training today. In the email that you'll get with the recording and the handout and the link to the evaluation, the corrected certificate will be sent to you. We've corrected it on our end, but it's not embedded yet. It's just – you'll get that in your follow up email. Everybody who registered, whether they attended today or not, will get that email.

Anne, this one's for you. Can teachers eat with the children during meal time?

Anne: Oh, teachers should eat with the children during meal time. I don't – I know, in Head Start – I don't know if they're talking about reimbursement. But as far as Head Start Performance Standards, family meal service, it says that the teachers sit with the children and eat. Again, portion wise, if that isn't enough for them, they can certainly bring their own food and eat on their break afterwards. But it is asked that the children and the adults sit at the same table and share the menu as much as they possibly can.

Steve: Thank you. Erica, this one's for you. What do you think about going mobile or virtual with meal counts using a product like ChildPlus? There were lots of questions about record keeping.

Erica: Sure. Thanks, and again, a great question. Record keeping can look different from facility to facility. It's important to remember that the requirement is to have the records. Now, how you get them, you have some options. F&S does not endorse any method over another. It's solely up to the institution's discretion and approval from the state agency and the sponsoring organization.

The example I gave during the presentation, some facilities may choose to implement mobile technology for meal counting, where staff responsible for counting meals record those meal counts at the time of service on a tablet or another mobile device. Other facilities may continue to use analog methods. Whichever method you determine is best for your facility, be sure to consult with your state agency and your sponsoring organization for approval and technical assistance.

Steve: Thank you so much, Erica, and I think that sort of contact your state agency, use the resources that are in the handout, are really great pieces of advice for folks that may not have gotten their questions answered but we know that they're out there. The answers are out there, and they're also available if you write to health@ecetta.info. Olivia will put that address back into the chat. And now, I'm going to turn it over to Nydia to close this out. Thank you, everybody.

Nydia: Thank you so much, once again, to our presenters, Nicole Patterson, Melissa Daigle Katz, Carolina Martinez, Anne Hemmer, and Erica Nelson. If you have any more questions – we know that there were many questions – if you have more questions, you may go to MyPeers or write to health@ecetta.info.

The evaluation URL, it will appear when the webinar ends. Do not close the Zoom platform, or you won't see the evaluation pop up. Remember that after submitting the evaluation, you will see a new URL. And this link will allow you to access, download, save, and print your certificate.

Thank you so much for your participation today. You can subscribe to our monthly list of resources using that same URL. You can find our resources in the health section of ECLKC or write us at the email address, health@ecetta.com. Thank you, and Kate, you can close the Zoom platform.

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