HomeMy WebLinkAboutPre-Operational Site VisitRequirement: FLORIDA DEPARTMENT OF EDUCATION
Must be completed prior to the FOOD AND NUTRITION MANAGEMENT
beginning of Prograin Operation-_ _ SUMMER FOOD SERVICE PROGRAM
at this site. A copy must be provided SPONSOR PRE -OPERATIONAL SITE VISIT
to the State Agency.
04-089 p
Agreement Number
Site Number
LEMON Cit
Site Kame
1. Sponsor's Name: City o f Miami
Address of sponsor's food service site: 444 S _ W - 2 Aye-
ve_Name
Nameof sponsor representative:-- - -
Nameof person interviewed: Gwendolyn Kitchen
2. Type of Site: (Check one)
X Recreation Center/Park School (Public) *Child Care Facility
Church School (Private) Other (Specify)
Community Center Housing Development
3. Does the site receive meals or funds from any other source (i.e., DOH) for meals? Yes No _ X
4. Estimated number of children the site could serve: 1 2 0
Estimated number of personnel needed to supervise site: 5
Number of personnel sponsor plans to have at site: 5
5. Does site have (Check if "yes")
*_ Shelter X Place to keep site records X Place to store food boxes
X Refrigeration (all meals) X Air conditioning X Garbage facilities
*_ Refrigeration (leftovers) _,K_Telephone X Restroom
6. Are facilities adequate for an organized meal service? Yes X No
7. What is the site plan to maintain food temperature from delivery to meat service?
Meal s/Pnnd wi 1 1 hP G nr r3 in a refrigerat--nr until usage is needed.
8. Method of Meat Service:
Local Education Authority (LEA) On-site self -preparation X Food Service Management Company (FSMC)
Satellite self -preparation Other (Explain)
9. Is staff available at site to receive early deliveries, if vended? Yes What time? 8 = 0 0 am
10. Is this site within walking distance to another approved SFSP site**? Nn If yes, how will you ensure children do not receive meals
from both sites?
11. Does sponsor reviewer recommend approval of site? Yes X No , Provides justification to your response below.
Lemon City Park is located in a Low In -Come community where a nutrition
food program is needed during the summer while the kids are out out of
s C4P4riot receive funds from Department of Health for children at this site.
** An approved SFSP site under your sponsorship or another sponsor
Signature ponZe tative
?(
SFSP- F9
Revised 10/11/06
Signature, Site Supervisor
Date of Visit
Distribution: 1-Original/Sponsor; 2-Yellow/DOE SFSP Staff, 3-Pink/Site Supervisor