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.
Foster Children:
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.
Nondiscrimination Statement:
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD).
This explains what to do if you believe you have been treated unfairly. In accordance with Federal law and U.S. Department of Agriculture policy, this agency is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability.
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights,
Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington DC 20250-9410, or call 202-720-5964 (voice and TDD). 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, 2011 THROUGH JUNE 30, 2012
FREE ELIGIBILITY SCALE (130% OF FEDERAL POVERTY GUIDELINES)
REDUCED-PRICE ELIGIBILITY SCALE (185% OF FEDERAL POVERTY GUIDELINES)
HOUSEHOLD SIZE*
ANNUAL
MONTH
TWICE PER MONTH
EVERY TWO WEEKS
WEEK
ANNUAL
MONTH
TWICE PER MONTH
EVERY TWO WEEKS
WEEK
1
$ 13,520
$ 1,127
$ 564
$ 550
$ 260
$ 19,240
$ 1,604
$ 802
$ 740
$ 370
2
18,200
1,517
759
700
350
25,900
2,159
1,080
997
499
3
22,880
1,907
954
880
440
32,560
2,714
1,357
1,253
627
4
27,560
2,297
1,149
1,060
530
39,220
3,269
1,635
1,509
755
5
32,240
2,687
1,344
1,240
620
45,880
3,824
1,912
1,765
883
6
36,920
3,077
1,539
1,420
710
52,540
4,379
2,190
2,021
1,011
7
41,600
3,467
1,734
1,600
800
59,200
4,934
2,467
2,277
1,139
8
46,280
3,857
1,929
1,780
890
65,860
5,499
2,745
2,534
1,267
for each additional family member, add:
$ 4,680
$ 390
$ 195
$ 180
$ 90
$ 6,660
$ 555
$ 278
$ 257
$ 129
* Household is synonymous with family and 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.
THIS SCALE DOES NOT APPLY TO HOUSEHOLDS THAT RECEIVE CALFRESH, KIN-GAP,
OR FDPIR BENEFITS OR CHILDREN WHO ARE RECIPIENTS OF CALWORKS. THOSE
CHILDREN ARE AUTOMATICALLY ELIGIBLE FOR FREE MEAL BENEFITS.
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.
Location and Hours
The Chaffey College Child Development Center is located on the corner of Haven Avenue and Wilson Street at the northwest corner of the Rancho Cucamonga campus.
Chaffey College Child Development Center
5885 Haven Avenue
Rancho Cucamonga
CA 91737-3002
CHAFFEY COLLEGE • 5885 Haven Avenue, Rancho Cucamonga, CA 91737-3002 • 909/652-6000
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