wisconsin department of public instruction child and adult care food program child care institutions...
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Wisconsin Department of Public Instruction
Child and Adult Care Food Program
• Child Care Institutions• Outside of School Hours
Care Centers
Maintaining the Household Size-Income Record (HSIR)
Guidance Memorandum #1C:http://fns.dpi.wi.gov/fns_centermemos
Household Size-Income Record
HSIR good for one year
Complete new HSIR each fiscal year (starting October 1st)
DO NOT create a new copy each month
Print or save each month as documentation for that month’s claim
Household Size-Income Record
Complete HSIR each month to report total # of FRN on the respective month’s claim
File income statements in same order as HSIR
CONFIDENTIAL
Enrollment Policy
Defines what children to include on monthly claim
Collected as part of the
annual CACFP Contract
Sample policies in Guidance Memorandum #6
Enrollment Policy Examples
Reasonable and Measurable
1. In attendance at least one time in the month.
2. Has attended at least once in the past 3 months. After an attendance lapse of 3 months, the child is dropped from the enrollment list.
3. The center maintains a vacant opening in anticipation of the child’s future attendance at the center.
Household Size-Income Record
List every enrolled child on HSIR according to your center’s enrollment policy including:– Infants– School-age children attending before and after-
school– 4K participants
Compare attendance records to HSIR
Household Size-Income Record
List children’s names in alphabetical order, last name first
Use children’s FULL names, not initials or nicknames
Names on the HSIR should match names on enrollment forms, income statements and attendance records
Household Size-Income Record Obtain need category (N,R,F) for each child
from HSIS’s Indicate need category of each enrolled child
on HSIR with N, R, F or X
When a Child Leaves the Center
When a child is no longer enrolled, do not mark in any need category for the first month after the child has terminated from the center – Draw a line through the months or leave blank
Never remove or discard an income statement
Never erase a name from the HSIR
Adding Newly Enrolled Children to the HSIR
Paper copy of HSIR: add new children’s names to bottom of form
Excel HSIR: add new children alphabetically by inserting rows
Press on the row number (on the left hand side) and select Insert and then Rows from the top menu
This will add a row above the row you have clicked on
HSIR Edit Checks
1. Compare children on HSIR to attendance records
2. Check need category and approval date from “For Center Use Only" box on each HSIS to need category on HSIR
3. Check that need category is in the correct column for each child
HSIR Edit Checks
4. Double check the "Totals" row for each column of need category if completing HSIR by hand
5. Double check the totals for each need category on the monthly claim to assure they have been recorded from the correct column of the HSIR
6. Print off a copy of the Excel HSIR each month
What’s Next: Completing the CACFP Reimbursement Claim
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 protected]. 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.