The Chaffey College Child Development Center participates in the Child and Adult Care Food Program (CACFP) offered by the United States Department of Agriculture (USDA) and serves meals at no separate charge to all enrolled children. The reimbursement received from the CACFP helps with our food costs, and therefore, enables us to keep our fees for care as low as possible.
If your household currently receives benefits under the CalFresh Program; the California Work Opportunity and Responsibility for Kids (CalWORKs); the Kinship Guardianship Assistance Payment Program(Kin-GAP); or the Food Distribution Program on Indian Reservations (FDPIR), you only need to list your current CalFresh, CalWORKs,
Kin-GAP, or FDPIR case number on the Meal Benefit Form. You must also have an adult sign and date the Meal Benefit Form.
However, if your household does not receive benefits under CalFresh, CalWORKs, Kin-GAP, or FDPIR, please complete the Meal Benefit Form and make sure you:
provide the names of all household members and their income by source; and
have an adult sign, date, and provide the last four digits of his or her social security number, or check the box "Check here if no Social Security Number" if the adult does not have a social security number.
For All Households:
The USDA defines a household as a group of related or unrelated individuals (not residents of a boarding house or an institution) who are living as one economic unit (i.e., sharing living expenses). Therefore, the income reported on the Meal Benefit Form must include the gross income of all members of your household, by source.
The income you report must be the total gross income received last month, listed by source for each household member. If last month's income does not accurately reflect your circumstances, you may provide a projection of your monthly income. If no significant change has occurred, you may use last year's income as a basis to make this projection. If your household's income is equal to or less than the amounts indicated for your household's size on the attached Income Chart, the center receives a higher level of reimbursement for meals served to your child(ren).
Once properly approved for free or reduced-price benefits, whether through income or proof of benefits as supported by a current CalFresh, CalWORKs, Kin-GAP, or FDPIR case number, your child(ren) will remain eligible for those benefits for 12 months.
For households with foster children, please contact us for additional information.
Confidentiality of Information on the Meal Benefit Form:
We will use the information on the form to decide the level of reimbursement our center is eligible to receive. We will place the Meal Benefit Form in our food program files and keep the information confidential. Only upon your request, will we share the information on your form with officials of other child nutrition, health, and education programs so they can use it to determine benefits for those programs.
The U.S. Department of Agriculture prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.)
If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at email@example.com.
Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (Spanish).
“USDA is an equal opportunity provider and employer.”
Thank you for your cooperation. If you have any questions or need assistance in filling out the Meal Benefit Form, please contact us at 909-652-6875.
ELIGIBILITY SCALE FOR FREE AND REDUCED-PRICE MEALS
INCOME ELIGIBILITY GUIDELINES JULY 1, 2013 THROUGH JUNE 30, 2014
The eligibility scale is for determining participating children's eligibility category for federal meal reimbursement if they are not recipients of CalFresh (formerly Food Stamps), CalWORKS, Kin-GAP, or FDPIR benefits. Participants from households with total gross incomes at or below the following levels may be eligible for free or reduced-price reimbursement rates.
INCOME ELIGIBILITY SCALE
GROSS INCOME OF HOUSEHOLD
EVERY TWO WEEKS
TWICE PER MONTH
for each additional family member, add:
* The term “household” means a group of related or unrelated individuals who are not residents of an institution or boarding house
but who are living as one economic unit, sharing housing and all significant income and expenses.
Note: Children that are recipients of the following programs are automatically eligible for the free reimbursement rate:
CalFresh Program (formerly known as Food Stamps)
California Work Opportunity and Responsibility to Kids Program (CalWORKs)
Food Distribution Program on Indian Reservation (FDPIR)
Foster Care Program
Head Start or Even Start
Kinship Guardianship Assistance Payment (Kin-GAP)
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call 800-795-3272 or 202-720-6382 (TTY). USDA is an equal opportunity provider and employer.
For more information about the child care food program at the Chaffey College Child Development Center contact front office staff at 909/652-6875.