HomeMy WebLinkAboutSite VisitRequirement:
Must be completed prior to the
beginning of Program Operation
at this site. A copy must be provided
to the State Agency.
FLORIDA DEPARTMENT OF EDUCATION
FOOD AND NUTRITION MANAGEMENT
SUT1I1viER FOOD SERVICE PROGRAM
SPONSOR PRE -OPERATIONAL SITE VISIT
' Ai
Agreement Number
TBA
Site Number
Henderson Park
Site Name
1. Sponsor's Name: City of Miami
Address of sponsor's food service site: 791 N . W . 2 Street
Name ofsponsorrepresentative: Gwen Kitchen
Name ofperson interviewed: Mauro Bermudez
Position Title: Park Coordinator
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
X
4. Has this site been under another sponsor? Yes or No If yes, the sponsor was
5. Estimated number of children the site could serve: 25
Estimated number of personnel needed to supervise site: 3
Number of personnel sponsor plans to have at site: 3
6. Does site have (Check if "yes")
XShelter X Place to keep site records X Place to store food boxes
X Refrigeration (all meals) X Au conditioning X Garbage facilities
X Refrigeration (leftovers) X Telephone X Restroom
7. Are facilities adequate for an organized meal service? Yes X No
8. What is the site plan to maintain food temperature from delivery to meal service?
9. Method of Meal Service:
Local Education Authority (LEA) On-site self -preparation X Food Service Management Company (FSMC)
Satellite self -preparation Other (Explain)
10. Is staff available at site to receive early deliveries, if vended? Yes What time? 8 : 0 0 am
11. Is this site within walking distance to another approved SFSP site**? yes If yes, how will you ensure children do not receive meals
frombothsites? Camp enrollment and site activities leaving up to mealtime.
12. Does sponsor reviewer recommend approval of site? Yes X No Provide justification to your response below.
Signature, Sponsor Representative Signature, Site Supervisor Date of Visit
SFSP- F9 Distribution: 1-Orieinal/Sponsor: 2-Yellow/DOE SFSP Staff.. 3-Pink/Site Sunervisor a,t