Skip to main content
California Department of Education Logo

CACFP Administrative Manual Section 4.3

Child and Adult Care Food Program Administrative Manual Section 4.3: Meal Benefit Form for Providers.

Table of Contents
Terms, Definitions, and Acronyms

Section 4: Day Care Home Reimbursement Determination

4.3 Meal Benefit Form for Providers

If a home does not qualify for Tier I reimbursement through area eligibility, the sponsor may try qualifying the home by determining if the DCH provider is income or categorically eligible. To make this determination, the sponsor must have the provider complete a Meal Benefit Form (MBF) for Providers.

Categorical Eligibility

A provider’s home is categorically eligible for Tier I benefits if he or she is a member of a household that receives:

  • CalFresh benefits;

  • California Work Opportunity and Responsibility to Kids (CalWORKs) payments; or

  • Food Distribution Program on Indian Reservations (FDPIR) benefits

The MBF for Providers for a categorically eligible provider must contain the following information:

  • Provider’s name

  • Case number for CalFresh, CalWORKs, or FDPIR

  • Signature of the provider

Household income and the last four digits of the social security number (SSN) of the provider are not required.

Income Eligibility

A provider’s home can be categorized as eligible for Tier I reimbursement if the provider’s household size and income falls within the limits of the USDA Income Eligibility Guidelines.

The MBF for an income eligible provider must contain the following information:

  • Provider’s name

  • Names of all household members and, if applicable, their sources of income

  • Provider’s signature

  • The last four digits of the SSN of the provider or checks the box that says Check here if no SSN

Certification

The MBF for Provider must also contain the sponsor’s certification at the end of the last page, which consists of the following:

  • Check eligibility status: Tier I or Tier II

  • Total annual household income, if applicable

  • Categorical Eligibility, if applicable

  • Provider eligible for Tier I reimbursement: Yes or No

  • Provider’s own child(ren) eligible for Tier I reimbursement: Yes or No

  • Printed name and signature of the eligibility official

  • Certification date for eligibility
Duration of Provider’s Income or Categorical Eligibility Determination

Determinations of eligibility for Tier I reimbursement, by either categorical or income eligibility, are valid from the first day of the month in which the determination is made. A certified MBF for Provider is valid from the beginning effective date until the last day of the same calendar month in the following calendar year. For example, a MBF for Provider certified for an established provider on September 10, of the current calendar year is valid from September 1, of the current year until September 30, of the following calendar year.

Verification of Provider’s Income or Categorical Eligibility

Sponsors must verify that the information submitted for a categorically or income eligible provider is accurate.

Acceptable written evidence to verify a provider’s categorical eligibility includes copies of:

  • A current notice of eligibility for CalFresh benefits

  • An award letter from CalWORKS or FDPIR

An identification card for the benefit program is not an acceptable form of verification unless the card contains an expiration date.

Acceptable written evidence to verify a provider’s income eligibility includes copies of:

  • Pay or wage stubs from employers or a letter from employers confirming wages

  • Tax forms

A collateral contact should be used only in cases when the provider has not been able to provide adequate written evidence. The provider may designate a collateral contact outside the household who is knowledgeable about the household's circumstances and can give verbal confirmation of the household's income or receipt of eligible benefits.

Collateral contacts include employers, social service agencies, migrant workers agencies, and religious or civic organizations. The collateral contact should not be someone who might be affected by the provider's receipt of Tier I reimbursement instead of the lower Tier II rates—such as a family member or other relative, neighbor, or household of the children in the provider's care.

A sponsor may make the verification with the collateral contact in person or by phone, and must document all collateral contacts by date.

Provider’s Own Children

A Provider’s own children are any children who reside in the household (i.e., economic unit), such as the provider’s own children by birth or adoption, foster care, grandchildren, or housemates’ children who are part of the economic unit.

Meals served to the provider’s own children can be reimbursed only if the provider is determined to be categorically or income eligible for Tier I reimbursement. Tier II reimbursement for meals served to the provider’s own children is not allowed. Additionally, a DCH determined as Tier I by area eligibility does not qualify the DCH to receive reimbursement for meals served to the provider’s own children. 

Eligibility Criteria for Provider’s Own

The provider’s own children may be eligible for reimbursement if the following criteria are met:

  1. The children meet the age requirements

  2. The children are part of the provider’s household

  3. At least one enrolled, eligible, nonresident child is present and eating the same meal(s) claimed for reimbursement

  4. The provider is income or categorically eligible for Tier I reimbursement; this is not applicable to automatically eligible children
Categorical Eligibility of Provider’s Own

If the provider’s own children are categorically eligible for Tier I reimbursement, the entire household qualifies for the Tier I reimbursement; thereby qualifying the provider’s home as Tier I.

Automatic Eligibility of Provider’s Own

The automatic eligibility of a provider’s own child only qualifies that child for Tier I reimbursement. The automatic eligibility of Tier I for the child does not transfer to the home. The provider must still fill out a MBF for Provider and try to qualify for Tier I via categorical or income eligibility. 

Meals served to the provider’s own automatically eligible children are reimbursed at a Tier I rate, in a Tier I home, or Tier II High, in a Tier II home. Meals and snacks are reimbursable at the higher rates if the eligibility criteria for provider’s own is met.

The provider’s own children are automatically eligible for Tier I reimbursement if they:

  • Participate in Head Start (HS) or Early Start (ES)

  • Are eligible for FRPM in the NSLP

  • Are homeless

  • Are migrant

  • Are a foster child

The following documentation can be accepted:

  • For HS or ES, an approved HS or ES application, a statement of HS or ES enrollment, or a list of children enrolled which is signed and dated by an HS or ES official.
  • For free-reduced priced meals in the NSLP, a certification letter of meal benefits signed and dated by a school official.
  • For homeless, a certification signed and dated by the homeless liaison or shelter director showing the child’s name, the effective date of participation, and the residence (i.e., shelter).
  • For migrant, a certification signed and dated by the local operating agency’s or school district’s Migrant Education Program coordinator.
  • Foster children must be legally placed in a home by an approved foster care agency. The provider’s home must be appropriately licensed by the State of California to care for foster children. Providers must maintain the foster care placement documents for record keeping.

If the above documentation is not available, or cannot be verified, the provider must list the child on the MBF for Provider and include the child as part of the household.

Reference: 7 CFR, sections 226.2, 226.15(f), 226.23(e)(1), 226.18(b), 226.18(e); MB USDA-CACFP-02-2012 Transmission of Household Income Information, MB 06-219 Eligibility of Day Care Home Provider’s Residential and/or Own Children; and USDA Eligibility Manual for School Meals, USDA Eligibility Guidance for Family Day Care Homes

Questions:   Kayla Christensen | kchristensen@cde.ca.gov | 916-324-6153
Last Reviewed: Friday, June 12, 2020
Related Content
  • CACFP Administrative Manual
    A guide to the Child and Adult Care Food Program (CACFP) critical compliance standards for centers and day care home (DCH) sponsors.
  • CACFP Eligibility, Guidance, Manuals, & Resources
    The most recent child care center, day care home, and adult day care sponsor eligibility materials, guidance, manuals, and resources needed for proper administration of the Child and Adult Care Food Program.
  • CACFP Manual Terms, Definitions, and Acronyms
    Child and Adult Care Food Program Administrative Manual Terms, Definitions, and Acronyms.
  • Child and Adult Care Food Program
    This web page includes background information, steps on how to apply, the Administrative Manual, meal pattern requirements, claiming information, policy guidance, compliance, trainings, resources, and contacts for program operators.
  • How to Apply to the CACFP
    Information on how to begin the application process for the Child and Adult Care Food Program.
Trending in Nutrition
No Trending items
Recently Posted in Nutrition
  • New Off-Site Monitoring Best Practices Fact Sheets (added 03-Dec-2020)
    California Department of Education Nutrition Services Division is pleased to share eight best practices fact sheets for conducting off-site monitoring of Child Nutrition Programs (CNP) during the COVID-19 pandemic.
  • Now in Spanish: Multicultural Child Care Recipes (added 03-Dec-2020)
    The California Department of Education is pleased to inform you that the following resource from U.S. Department of Agriculture (USDA) Team Nutrition (TN) is now available in Spanish.
  • CDFA Seeking Public Comment on Farm to School RFA (added 30-Nov-2020)
    The California Department of Food and Agriculture (CDFA) Office of Farm to Fork (F2F) is now seeking public comments regarding the 2021 Farm to School (F2S) Incubator Grant Program’s Request for Applications (RFA).
  • USDA Proposed Rule on Meal Flexibilities (added 30-Nov-2020)
    On November 24, 2020 the federal code of regulations was updated to restore the 2012 meal pattern guidelines and the USDA announced a proposed rule to reinstate those meal pattern flexibilities that were just vacated.
  • Tip Sheet: CACFP Meal Service During COVID-19 (added 24-Nov-2020)
    The California Department of Education (CDE) Nutrition Services Division has created a new tip sheet to assist Child and Adult Care Food Program (CACFP) Operators who are conducting meal service during the Novel Coronavirus (COVID-19) pandemic.

  • Use of FRPM Data for Funding Purposes 2020–21 (added 24-Nov-2020)
    This letter provides guidance to Local Education Agencies on the use of Free and Reduced-Price Meal (FRPM) applications for meal eligibility and funding purposes during the 2020–21 school year.
  • FRMP Requirements School Year 2020–21 (added 24-Nov-2020)
    Attachment to the Use of FRPM Data for Funding Purposes letter. Provides requirements for collecting free and reduced-price meal eligibility data used to determine supplemental and concentration grant funding based on meal program type.
  • COVID-19 Required Reporting CNP Assessment (added 20-Nov-2020)
    The USDA requires assessment information on the effectiveness of the waivers in providing improved services to program participants. The CDE NSD is requiring that program operators complete the CDE COVID-19 CNP Waivers Assessment survey.
  • 2020–21 CACFP Mandatory Training (added 20-Nov-2020)
    Announcement for the 2020–21 Child and Adult Care Food Program (CACFP) Mandatory Training.
  • Annual Sponsor Verification Report for 2020–21 (added 20-Nov-2020)
    On November 2, 2020, the U.S. Department of Agriculture (USDA) extended the School Food Authority (SFA) deadline to complete verification to February 28, 2021.