Licensed For Profit Adult Care
Centers charging a separate fee for meals must print and complete the following form:
Submit with the Application
- A copy of current adult care license
- A copy of current contract with Medicare
Read and Use the Following Information/Resources
- Food Chart Adult, Five Meal Components and Crediting Handbook for the Child and Adult Care Food Program (Needed to complete menus)
- CACFP Income Eligibility Guidance for Adult Day Care Centers
The Child and Adult Care Food Program Income Eligibility Guidance for Adult Day Care Centers provides directions on how to categorize enrolled participants on the application form. Copy the Participant letter (page 5) and the Income Eligibility form (page 9) and send home to each participant/family member/legal guardian to complete. These Income Eligibility forms must be completed and on file for participants to be claimed in the free or reduced price category before you submit your claim. Estimates of the number in each category can be made for each category at the time of application.
Part of the application process is the scheduling of a pre-approval visit and Program orientation training at your location or agency. The pre-approval visit and training are required before the application can be approved. Once the completed application packet is received in the CACFP office you will be scheduled for the pre-approval visit and training.