CACFP Agreement #____________
This institution is an equal opportunity provider.
CACFP-3696C (12/16) PAGE 1 OF 1
FOOD PRODUCTION RECORD –LUNCH-SNACK-SUPPER
Date____________________________________
MEAL PATTERN FOOD ITEMS SERVING SIZE # SERVINGS PREPARED
TYPE AND AMOUNTS USED
LUNCH – Must serve all 5 components 1. Milk 1.
1.
2. Vegetable 2.
2.
Fresh Frozen Canned
3. Fruit or Vegetable 3.
3.
Fresh Frozen Canned
4. Grains/Bread 4. 4.
5. Meat/Meat Alternate 5. 5.
Other (not required)
SNACK – Must serve 2 different components Milk
Vegetable
Fruit
Grains/Bread
Meat/Meat Alternate
1.
1.
2.
2.
Other (not required)
SUPPER – Must serve all 5 components 1. Milk 1.
1.
2. Vegetable 2.
2.
Fresh Frozen Canned
3. Fruit or Vegetable 3.
3.
Fresh Frozen Canned
4. Grains/Bread 4. 4.
5. Meat/Meat Alternate 5. 5.
Other (not required)
