Child and Adult Care Food Program

Nutrition and Wllnss Programs Illinois Stat Board of Education 100 North First Strt (W270) Springfild, Illinois 62777-0001 Child and Adult Car Food Program Day Car Homs Srious Dficincy Procss Dcmbr 2013

1100 SERIOUS DEFICIENCY PROCESS 1110 PROCEDURES 1111 Trmination of Agrmnt for Caus/Convninc and Corrctiv Action Procdurs 1112 Actions That May Lad To Srious Dficincy - Outlin of th Actions - Additional Tool 1113 Procdurs for Houshold Contact & 5-Day Rconciliation - Sampl 1/1113 Houshold Contact Covr Mmo - Sampl 2/1113 Houshold Contact Qustionnair - Sampl 3/1113 Houshold Tlphon Contact Script 1114 Srious Dficincy Notification Procdurs -Sampl Lttr 1/1114 Notic of Noncomplianc and Corrctiv Action -Sampl Lttr 2/1114 Notic of Srious Dficincy -Sampl Lttr 3/1114 Succssful Corrctiv Action, Tmporary Dfrmnt of Srious Dficincy -Sampl Lttr 4/1114 Notic of Proposd Trmination and Proposd Disqualification -Sampl Lttr 5/1114 Tmporary Dfrmnt of Srious Dficincy, Proposd Trmination, and Proposd Disqualification (aftr providr wins appal) -Sampl Lttr 6/1114 Notic of Trmination and Disqualification (aftr sponsor wins appal) -Sampl Lttr 7/1114 Notic of Trmination and Disqualification (following failur to appal) 1115 Suspnsion of Participation for Day Car Homs -Sampl Lttr 8/1115 Combind Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification Notic: Imminnt Thrat to Halth or Safty -Sampl Lttr 9/1115 Tmporary Dfrmnt of Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification: Imminnt Thrat to Halth or Safty (aftr providr wins appal) -Sampl Lttr 10/1115 Notic of Trmination and Disqualification: Imminnt Thrat to Halth or Safty (aftr sponsor wins appal) -Sampl Lttr 11/1115 Notic of Trmination and Disqualification: Imminnt Thrat to Halth or Safty (following failur to appal) 1116 Administrativ Rviw (Appal) Procss 1117 Placmnt on th National Disqualifid List 1118 Guidlins for R-Entry to th Child and Adult Car Food Program - Sampl Tmplat Monitoring Plan for R-Entring Providrs 1120 SERIOUS DEFICIENCY LOG 1121 ADDENDUM 2

1100 SERIOUS DEFICIENCY PROCESS Ovrviw In ordr to participat in th Child and Adult Car Food Program (CACFP), a day car hom must oprat undr th auspics of and ntr into a writtn agrmnt with an approvd sponsoring organization. Th agrmnt must spcify th rights and rsponsibilitis of both partis which includ, but ar not limitd to, th right of th sponsoring organization to trminat th agrmnt for caus and th rquirmnt that th day car hom comply with th fdral rgulations govrning th program. Public Law 106-224, th Agricultural Risk Protction Act (ARPA) of 2000, mad significant changs to th procdurs involvd in trminating participation of day car homs (providrs) in th CACFP. For th first tim, it givs providrs th opportunity to rqust an Administrativ Rviw (also rfrrd to as an Appal) prior to trmination of thir agrmnt to participat by th sponsoring organization. This appal right is only rquird whn th trmination is for caus. Anothr form of trmination, which is trmination for convninc, is prmittd, and it dos not rquir th sponsors to offr an appal to th providr in ths situations. Sponsoring organizations ar rquird to provid th day car hom providrs proposd for trmination and disqualification an administrativ rviw (appal). In th past, th sponsoring organizations offrd and providd ths srvics to th providrs. Ths rqusts ar now procssd through th srvics of a consulting firm who acts as th Administrativ Rviw Official (ARO). Th ARO is an impartial and indpndnt prson not involvd in th dcision to trminat th homs participation. Th procdurs to b usd ar consistnt with 7CFR226.6(l). Sponsoring organizations must follow th procdurs for trmination including th corrctiv action procss, th srious dficincy procss, and th suspnsion of participation and providr appal rights outlind in this documnt. Within th organization, th Excutiv Dirctor or a dsignatd srious dficincy spcialist is authorizd to sign a Srious Dficincy notic. 3

1110 PROCEDURES 1111 Trmination of Agrmnt for Caus/Convninc and Corrctiv Action Procdurs A sponsoring organization (sponsor) must initiat action to trminat th agrmnt of a day car hom (providr) for caus in th opration of th Child and Adult Car Food Program if th sponsor dtrmins th providr committd on or mor srious dficincy(is) listd blow. Whthr a problm riss to th lvl of a srious dficincy is takn into considrations. Upon making a srious dficincy dtrmination, if th providr dos not tak action to fully and prmanntly corrct th srious dficincy within th allottd tim, th providr s agrmnt must b trminatd. List of Srious Dficincis 1. Submission of fals information on th application (sponsor/providr agrmnt). 7 CFR Part 226.16(l)(2)(i). 2. Submission of fals claims for rimbursmnt. 7 CFR Part 226.16(l)(2)(ii). 3. Simultanous participation undr mor than on sponsoring organization. 7 CFR Part 226.16 (l)(2)(iii). 4. Srving mals that do not mt th mal pattrn. 7 CFR Part 226.16(l)(2)(iv). 5. Failur to kp rquird rcords (mals, attndanc, tc). 7 CFR Part 226.16(l)(2)(v). 6. Conduct or conditions that thratn th halth or safty of th childrn in car, or th public halth or safty. 7 CFR Part 226.16(l)(2)(vi). 7. A dtrmination that th providr has bn convictd of any activity that occurrd during th past svn yars and indicatd a lack of businss intgrity. A lack of businss intgrity includs fraud, antitrust violations, mbzzlmnt, thft, forgry, bribry, falsification or dstruction of rcords, making fals statmnts, rciving stoln proprty, making fals claims, obstruction of justic, or any othr activity indicating a lack of businss intgrity as dfind by th agncy, or th concalmnt of such a conviction. 7 CFR Part 226.16(l)(2)(vii). 8. Failur to participat in training. 7 CFR Part 226.16(l)(2)(viii). 9. Any othr circumstanc rlatd to non-prformanc undr th sponsor/providr agrmnt as spcifid by th sponsor or th Stat agncy. 7 CFR Part 226.16(l)(2)(ix). Corrctiv Action Procdurs It is th rsponsibility of th sponsoring organization to provid sufficint training and tchnical assistanc during th pr-approval and 30-day follow-up visits to assur succssful participation for all providrs. Tchnical assistanc must b providd and documntd during th arly stags of program participation. Corrctiv action procdurs may tak into considration th following spcial, xtnuating circumstancs: nw participants on th program, languag barrirs, litracy barrirs, or othr 4

documntd spcial circumstancs. Ths circumstancs may rquir xtra tchnical assistanc. Onc a problm is idntifid, xtra tchnical assistanc must b providd and documntd. Tchnical assistanc may continu as long as providrs ar showing improvmnt. Documntation must indicat whn th providr has compltd corrctiv action or, if no improvmnt is mad, th providr must b dclard sriously dficint. If during a rviw th sponsor monitor idntifis that corrctiv action is rquird, a corrctiv action statmnt must b writtn on th rviw form and th providr must sign th rviw to show h/sh agrs to th corrctiv action. If th sponsor, through offic rviw of providr documnts, idntifis th providr nds a Corrctiv Action Plan, th sponsor must notify th providr, in writing, that h/sh has som dficincis in th opration of CACFP as shown in Sampl Lttr 1/1114 - Notic of Noncomplianc and Corrctiv Action. If th corrctiv action takn by th family day car hom is accptd, and it is latr dtrmind that th corrctiv action was not prmannt and complt, th sponsoring organization must mov dirctly to issuing a Notic of Proposd Trmination and Disqualification as shown in Sampl Lttr 4/1114 Notic of Proposd Trmination and Proposd Disqualification. Trmination for Convninc (S Part 2 of Actions That May Lad to Srious Dficincy) 5

1112 Actions That May Lad to Srious Dficincy This documnt has bn dvlopd by th Illinois Stat Board of Education (ISBE). Th actions prscribd in this documnt must b followd by Child and Adult Car Food Program Sponsoring Organizations (SO) to nsur all day car hom providrs ar tratd consistntly. It is vry important that SO adhr to this procss du to th strict rquirmnts of trminating a day car hom providr for svn (7) yars. Monitoring staff from ISBE will rviw SO procdurs to nsur this procss is followd. It is th rsponsibility of sponsoring organizations to provid sufficint training and tchnical assistanc during th introductory rviw, four- wk follow-up rviw, and all rviws during th fiscal yar to nsur succssful participation for all providrs. Tchnical assistanc must b documntd and providd during program participation. SO hav diffrnt formats whn finding problms at th monitoring rviw. Som SO wish to writ a dtaild lttr such as Sampl Lttr 1/1114 in th Srious Dficincy Handbook, to clarify th problms. Most SO choos to writ thir findings and th dtaild corrctiv action to b conductd by th providr right on th monitoring rviw forms th providr signs. This allviats snding an additional lttr. An additional tool (chart) is addd to this rvision. This chart is prpard to assist th SO in th stps of th srious dficincy procss. It shows th nin (9) catgoris of srious dficincis for caus as listd in 7CFR226.16(l)(2). Th various findings or scnarios ar shown and thn classifid in a particular catgory. (Not: Thr may b som cass whr findings may vary in classification; and for as of us, th narrativ vrsion and th chart cross-rfrnc ach othr). 6

Part 1: TERMINATION FOR CAUSE Submission of Fals Claims 7CFR 226.16(l)(2)(ii); Failur to Kp Rquird Rcords 7CFR 226.16(I)(2)(v); Noncomplianc With Mal Pattrn 7CFR 226.16(I)(2)(iv); Any Othr Circumstanc Rlatd to Nonprformanc 7CFR 226.16(I)(2)(ix) ACTIONS (v) Mnu and mal participation did not match thos rcordd on th mnu form First Occurrnc Dduct mals at tim of visit or day(s) of s Provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR - (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct unannouncd follow up rviw Scond Occurrnc Dduct mals Provid tchnical assistanc and corrctiv action - On th rviw form, th monitor writs th providr s agrd upon corrctiv actions to prmanntly corrct th findings. (Providr signs rviw form.) Bgin Sriously Dficint (S.D.) Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) (ii)-mal not srvd at tim of rviw, but claimd all othr days (Includs mals srvd at supprs, vning snacks, tc.) First Occurrnc If providr can supply adquat justification, rturn to rgular rviw procss If providr cannot supply adquat justification, provid tchnical assistanc and corrctiv action - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct unannouncd follow up rviw 7

Submission of Fals Claims 7CFR 226.16(l)(2)(ii); Failur to Kp Rquird Rcords 7CFR 226.16(I)(2)(v); Noncomplianc With Mal Pattrn 7CFR 226.16(I)(2)(iv); Any Othr Circumstanc Rlatd to Nonprformanc 7CFR 226.16(I)(2)(ix)... CONTINUED Scond Occurrnc If providr can supply adquat justification, rturn to rgular rviw procss If providr cannot supply adquat justification, provid tchnical assistanc and corrctiv action - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct houshold contacts o If contacts show misrprsntation of rcords, bgin S. D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) o If contacts show rcords ar corrct, providr rturns to rgular rviw procss (ix)- At rviw, monitor was unabl to obsrv all childrn in attndanc during shift chang First Occurrnc If providr can supply adquat justification, rturn to rgular rviw procss If providr cannot supply adquat justification, provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR - (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct unannouncd Follow-Up Rviw Conduct houshold contact Scond Occurrnc If monitor is abl to obsrv all childrn in attndanc at unannouncd Follow-Up Rviw, rturn to rgular rviw procss If monitor is still unabl to obsrv all childrn in attndanc at unannouncd Follow-Up Rviw, provid tchnical assistanc - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) 8

Submission of Fals Claims 7CFR 226.16(l)(2)(ii); Failur to Kp Rquird Rcords 7CFR 226.16(I)(2)(v); Noncomplianc With Mal Pattrn 7CFR 226.16(I)(2)(iv); Any Othr Circumstanc Rlatd to Nonprformanc 7CFR 226.16(I)(2)(ix)... CONTINUED (ii)- Inappropriat claiming on holidays First Occurrnc Dduct mals at day of visit or day(s) of Provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR - (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Scond Occurrnc Dduct mals at day of visit or day(s) of Provid tchnical assistanc and corrctiv action - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct houshold contacts o If contacts show misrprsntation of rcords, bgin S. D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) o If contacts show rcords ar corrct, providr rturns to rgular rviw procss (ii)- Fiv-Day Rconciliation Rsults Fwr than normally claimd or no childrn prsnt whn monitor rviw is conductd; providr s rcords show childrn ar attnding and claimd vryday First Occurrnc If providr can supply adquat justification, rturn to rgular rviw procss If providr cannot supply adquat justification, provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR -(2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form). Conduct follow unannouncd follow-up rviw Scond Occurrnc If unannouncd Follow-Up Rviw can supply adquat justification, rturn to rgular rviw procss If unannouncd Follow-Up Rviw cannot supply adquat justification, provid tchnical assistanc and corrctiv action - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) 9

Conduct houshold contacts o If contacts show misrprsntation of rcords, bgin S. D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) o If contacts show rcords ar corrct, providr rturns to rgular rviw procss Failur to Kp Rquird Rcords 7CFR 226.10(d); 7CFR 226.16(); 226.18(d--g) and 226.16(l)(2)(v) ACTIONS (v)- Paprwork not up-to-dat First Occurrnc Dduct mals rtroactiv to tim of discrpancy Provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR - (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct unannouncd Follow-Up Rviw Scond Occurrnc Dduct mals rtroactiv to tim of discrpancy If unannouncd Follow-Up Rviw shows paprwork is up to dat, rturn to rgular rviw cycl If unannouncd Follow-Up Rviw shows paprwork is not up to dat, provid tchnical assistanc and corrctiv action - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) (v)- Mal counts rcordd in advanc First Occurrnc Dduct mals rtroactiv to tim of discrpancy Provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action, OR - (2) Writ on rviw form agrd upon corrctiv actions by th providr to prmanntly corrct (Providr signs rviw form.) Conduct unannouncd Follow-Up Rviw Scond Occurrnc Dduct mals rtroactiv to tim of discrpancy 10

If unannouncd Follow-Up Rviw shows mal counts ar not bing rcordd in advanc, rturn to rgular rviw cycl If unannouncd Follow-Up Rviw shows mal counts ar still bing rcordd in advanc, provid tchnical assistanc - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) (v)- Substitut cargivr/assistant did not hav accss to paprwork whn providr was not at hom and rviw was bing conductd First Occurrnc Dduct mals rtroactiv to tim of discrpancy Provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR - (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct follow up rviw Scond Occurrnc Dduct mals rtroactiv to tim of discrpancy Provid tchnical assistanc and corrctiv action - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) Any othr circumstanc rlatd to nonprformanc 7CFR226.16(l)(2)(ix); Failur to Comply With Monitoring Rquirmnts 7 CFR226.18(b) ACTIONS (ix)- Providr not hom for attmptd monitoring rviw whn providr is supposd to b srving a mal. Providr did not contact Sponsor. (Sponsor can only dduct whn monitor conducts rviw at th providr s prscribd mal srvic tim) First Occurrnc Dduct mals (Dductions should only b for th mal srvic that should hav bn srvd during attmptd rviw.) Provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action, or 11

- (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct an unannouncd Follow-Up Rviw Scond Occurrnc Dduct mals (Dductions should only b for th mal srvic that should hav bn srvd during attmptd rviw.) Conduct houshold contacts o If contacts show thr is no childrn bgin S. D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) o If contacts show childrn ar thr, snd S.D. lttr for providr not bing at hom during tim of thir mal srvic and was warnd twic. (Lttr must b snt within 30 days.) (ix)- Providr did not allow monitor to conduct a rviw First Occurrnc Dduct mals from dat of attmptd monitoring rviw to bginning of rviw month Provid tchnical assistanc by informing providr that h/sh will los rimbursmnt from dat of attmptd rviw back to th bginning of th month and it this occurs again, h/sh will b considrd S.D. Monitor must xplain that th providr signd an agrmnt to allow monitoring rviws to b conductd. If providr still will not allow a monitoring rviw, monitor must complt rviw form noting dtails of th. A lttr must b snt out to th providr immdiatly rqusting a corrctiv action stating how this will not occur again. Scond Occurrnc Dduct mals from dat of attmptd monitoring rviw to bginning of rviw month. Provid tchnical assistanc by informing providr that h/sh will los rimbursmnt from dat of attmptd rviw back to th bginning of th month and this is th scond and h/sh will b considrd S.D. Monitor must xplain that th providr signd an agrmnt to allow monitoring rviws to b conductd. Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) 12

Failur to Comply With Monitoring Rquirmnts 7 CFR226.18(b)... CONTINUED ACTIONS (ix)- Mal obsrvation missd by monitor bcaus th mal was srvd arlir; providr did not follow mal tims listd on Sit Information Sht First Occurrnc If providr has changd hr mal tims, monitor must collct nw mal tims and submit to sponsoring organization. Provid tchnical assistanc and corrctiv action -(1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR -(2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct follow up rviw Scond Occurrnc Provid tchnical assistanc and corrctiv action - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) (viii)- Providr would not allow training First Occurrnc Provid tchnical assistanc by xplaining thr is a minimum rquirmnt of two hours of annual training and inform th providr that h/sh has signd th providr agrmnt to agr to hav training. Monitor must try to mt providr s schdul to conduct training in his/hr hom Try to rschdul, monitor must submit to sponsor that training could not b conductd and has rschdul dat Scond Occurrnc If providr will not cooprat a scond tim for th training, inform providr that sh will b considrd S.D. Bgin S.D. Procss, snd sampl lttr #2 (Lttr must b snt within 30 days.) 13

Claiming Mals Srvd Ovr th Providr s Licns Capacity and Not Following Licnsing Rquirmnts to Participants 7CFR 226.18(); Submission of Fals Claims 7CFR226.16(l)(2)(v); Any Othr Circumstanc Rlatd to Nonprformanc 7CFR 226.16(l)(2)(ix) ACTIONS (ix)- Rcordd attndanc shows numbr of childrn prsnt is ovr licns capacity or numbr of childrn obsrvd at monitoring rviw was ovr capacity (as vrifid from nrollmnt forms). Assistant not prsnt whn numbr of childrn prsnt is ovr capacity. First Occurrnc Dduct mals if at a monitoring rviw and rport to Dpartmnt of Childrn and Family Srvics (DCFS) Provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR - (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) If conducting a rviw of mnus and mal attndanc shts, dduct mals Scond Occurrnc Dduct mals if at monitoring rviw and rport to DCFS Provid tchnical assistanc and corrctiv action - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) 14

Any Othr Circumstanc Rlatd to Nonprformanc 7CFR 226.16(l)(2)(ix); Conduct or conditions that thratn th halth and safty of childrn and occupants 7CFR226.16(l)(2)(vi); Submission of fals information on th application 7CFR226.16(l)(2)(i) ACTIONS (ix)- Did not inform sponsoring organization of changs in licns,.g., licns rvokd, movd and no nw licns Dduct mals rtroactiv to discrpancy Rport to DCFS Suspnd immdiatly - (1) Snd suspnsion lttr and S.D. (Us Sampl Lttr #8/1115). Lttr must b snt within 30 days. Must not pay rimbursmnt (This procss should b compltd prior to 120 days, maximum amount of tim for suspnding funds.) (vi)- Childrn s halth or safty is at risk at monitoring rviw or during any notifid circumstancs Rport to DCFS Suspnd immdiatly On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Snd suspnsion lttr and S.D. lttr at sam tim (Us Sampl Lttr #8/1115) Must not pay rimbursmnt (This procss should b compltd prior to 120 days, maximum amount of tim for suspnding funds.) Stay onsit until th authoritis arriv. (i)- Providr did not provid accurat information on th Houshold Incom Eligibility Application or in th sit shts. First Occurrnc Dduct mals rtroactivly Provid tchnical assistanc and documnt corrctiv action on rviw form. Providr signs form. - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action. Conduct houshold contact Scond Occurrnc Dduct mals rtroactivly Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) 15

Submission of Fals Claims 7CFR 226.16(l)(2)(ii) (ii)- Providr s own childrn claimd without outsid-nrolld childrn in attndanc First Occurrnc Dduct mals rtroactiv to discrpancy Provid tchnical assistanc and corrctiv action - (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR - (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct follow up visit Scond Occurrnc Dduct mals rtroactiv to discrpancy Provid tchnical assistanc - On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) Srving Mals That Do Not Mt Mal Pattrn 7CFR 226.20 and 226.16(l)(2)(iv) ACTIONS (iv)- Mnus missing mal componnt(s) obsrvd at monitoring rviw, in adquat portion sizs, combination foods missing labl vrification. First Occurrnc Dduct mals at day of visit or day(s) of s Provid tchnical assistanc and corrctiv action (1) Snd sampl lttr #1 dtailing findings and obtain providr s corrctiv action OR (2) On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Conduct follow up visit 16

Scond Occurrnc Dduct mals at day of visit or day(s) of s On th rviw form, writ th providr s agrd upon corrctiv actions to prmanntly corrct th findings (Providr signs rviw form.) Bgin S.D. Procss and snd sampl lttr #2 (Lttr must b snt within 30 days.) Whn Not to Us Srious Dficincy Procss Part 2: Trmination for Convninc 7CFR226.18(b)(8): (Th right of th Sponsoring Organization or th day car hom to trminat th agrmnt for caus or, subjct to stipulations by th Stat Agncy. Sponsoring Organization should includ in thir Providr Handbook a cod of conduct rgarding this option. Providrs must b givn nough tim to contact a nw sponsoring organization so thy will not hav a brak in thir rimbursmnt.) ACTIONS (1). Providr movs out of ara covrd by th sponsoring organization (2). Providr continus to b vrbally abusiv and thratning during monitoring visits and tlphon contacts. 17

Child and Adult Car Food Program Nutrition and Wllnss Programs Illinois Stat Board of Education 100 N First St., Springfild IL 62777 P g Exampls of Findings or Scnarios Corrctiv Action At offic, snd Lttr #1. Provid & doc TA & obtain CA Provid & doc TA. At rviw, writ CA on rv form (providr signs form) At day of visit or day(s) of Dduct Mals From day of rviw to 1st of month Rtroactiv to tim of discrpanc y Conduct unannounc d follow-up rviw Conduct Houshold Contact Contacts disagr w/ providr' s rcords Contacts agr w/ providr's rcord, rturn to rgular rviw Rport to DCFS SD Start Snd SD Notic Sampl Ltr #2 w/in 30 days of finding. Rqust CA Suspnd immdiatl y & snd Ltr #8 ; withhold paymnt. Appal offrd to providr 15 Providr did not provid accurat information in th Houshold Incom Eligibility Application or in th sit shts 1st 1st 1st 1st 1st 2nd 8 Mal not srvd at tim of rviw, but claimd all othr days (includs mals srvd at suppr, vning snacks, tc.). If providr can justify, rturn to rgular rviw; othrwis, provid TA. 1st 2nd 2nd 2nd 10 Inappropriat claiming on holidays. 1st s s 1st 1st 2nd 2nd 2nd 10 5- Day Rconciliation Rsultsfwr than normally claimd or no childrn prsnt during rviw, but providr s rcords show childrn ar attnding and claimd vry day. 226.16(d)(4)(ii) 1st s 1st 2nd 2nd 2nd 16 Providr's own childrn claimd without outsid nrolld childrn in attndanc 1st s 1st 2nd

Pg Exampls of Findings or Scnarios Corrctiv Action At offic, snd Sampl Lttr #1. Provid & doc TA Provid TA. Snd Ltr#1 or writ CA on rv form (providr signs form) At day of visit or day(s) of Dduct Mals From day of rviw to 1st of month Rtroactiv to tim of discrpanc y Conduct unannounc d follow-up rviw Conduct Houshold Contact Contacts disagr w/ providr' s rcords Contacts agr w/ providr's rcord, rturn to rgular rviw Rport to DCFS SD Start Snd SD Notic Sampl Ltr #2 w/in 30 days of finding. Rqust CA Suspnd immdiatl y & snd Ltr #8 ; withhold paymnt. Appal offrd to providr x 16 7 10 A providr is found to b participating in 2 diffrnt sponsors Mnus missing mal componnts obsrvd at rviw, inadquat portion sizs, combination foods missing labl vrification. Ex. Pr-packagd foods not mting mal componnt rquirmnt Mnu & mal participation did not match thos rcordd on th mnu form Paprwork not up to dat (i.., attnd of childrn srvd not rcordd, mnus not rcordd daily). If follow-up rviw is ok, rturn to rgular rviw. 1st 1st 1st 1st s 1st 1st 1st 1st 2nd 2nd 2nd 2nd 10 11 x x Mal counts rcordd in advanc - (all mals rcordd in advanc nd to b dductd) Substitut cargivr did not hav accss to paprwork whn providr was not hom during rviw. DCFS Sction 406.11 Mal counts and/or mnu ar not availabl on sit Th currnt month's + th prvious 12 months' rcords (nrollmnt, mal typs, attndanc, tc.) not on fil. Not: Th rmaining 2 yars of rcords could b offsit & should b accssibl at a rasonabl tim. 1st 1st 1st 1st 1st 1st s s s 1st 1st 1st 1st s 2nd 2nd 2nd 2nd 19

P g Exampls of Findings or Scnarios Corrctiv Action At offic, snd Sampl Lttr #1. Provid & doc TA Provid TA. Snd Ltr#1 or writ CA on rv form (providr signs form) At day of visit or day(s) of Dduct Mals From day of rviw to 1st of month Rtroactiv to tim of discrpanc y Conduct unannounc d follow-up rviw Conduct Houshold Contact Contacts disagr w/ providr' s rcords Contacts agr w/ providr's rcord, rturn to rgular rviw Rport to DCFS SD Start Snd SD Notic Sampl Ltr #2 w/in 30 days of finding. Rqust CA Suspnd immdiatl y & snd Ltr #8 ; withhold paymnt. Appal offrd to providr x x 15 x x Currnt nrollmnt forms ar missing on fil or forms missing ndd information (Rx, spcial dit, formula waivrs, tc.) 1st Childrn ar lft unsuprvisd; childrn show signs of bing abusd-inflicting physical punishmnt. Stay onsit until authoritis arriv Childrn's halth or safty at risk at monitoring rviw or during any notifid circumstancs. 226.16(l)(4). Stay onsit until authoritis arriv Providr appars incohrnt & unawar of childrn and thir safty. Call 911. Stay onsit until authoritis arriv. (Monitoring handbook) A providr pladd guilty to flony that occurrd during th past 7 yars 1st 1st s 1st Must not pay rimbursmnt (procss to b compltd in 120 days max to suspnd funds) 1st s 1st 1st 1st 1st 2nd 1st 1st 1st 1st 1st 13 Providr would not allow training. 226.16(d)(2) 1st - Provid tch assistanc & xplain th rqd min rqt of 2 hrs of annual training as agrd upon in th Sponsor/Providr Prmannt Agrmnt. Monitor must mt providr schdul and rschdul training. 2nd 20

P g Exampls of Findings or Scnarios Corrctiv Action At offic, snd Sampl Lttr #1. Provid & doc TA Provid TA. Snd Ltr#1 or writ CA on rv form (providr signs form) At day of visit or day(s) of Dduct Mals From day of rviw to 1st of month Rtroactiv to tim of discrpanc y Conduct unannounc d follow-up rviw Conduct Houshold Contact Contacts disagr w/ providr' s rcords Contacts agr w/ providr's rcord, rturn to rgular rviw Rport to DCFS SD Start Snd SD Notic Sampl Ltr #2 w/in 30 days of finding. Rqust CA Suspnd immdiatl y & snd Ltr #8 ; withhold paymnt. Appal offrd to providr 11 Providr not hom for attmptd monitoring rviw whn providr is supposd to b srving a mal. Providr did not contact sponsor. 7CFR226.18(b)(14). Sponsor can only dduct if monitor conducts rviw at th providr's prscribd mal srvic tim. 7CFR 226.18(b)(1) 1st 1st Only for th mal that shd hav bn srvd at tim of rviw 1st 2nd 13 Providr did not allow monitor to conduct a rviw. Inform providr that h/sh will los rimbursmnt from dat of attmptd rviw back to th bginning of th month, & if this occurs again, h/sh will b considrd SD. Monitor must xplain that this is in th prmannt agrmnt that h/sh signd with th SO. 1st 2nd 13 Mal obsrvation missd by monitor bcaus mal was srvd arlir; providr did not follow mal tims listd on Sit Information Sht. If providr has changd mal tims, monitor must collct nw mal tims & submit to SO. 1st 1st 2nd 21

14 Rcordd attndanc shows # of childrn prsnt is ovr capacity, # of childrn obsrvd during rviw ovr capacity (as vrifid from nrollmnt forms). Assistant not prsnt whn # of childrn prsnt is ovr capacity. 1st 1st 2nd P g Exampls of Findings or Scnarios Corrctiv Action At offic, snd Sampl Lttr #1. Provid & doc TA Provid TA. Snd Ltr#1 or writ CA on rv form (providr signs form) At day of visit or day(s) of Dduct Mals From day of rviw to 1st of month Rtroactiv to tim of discrpanc y Conduct unannounc d follow-up rviw Conduct Houshold Contact Contacts disagr w/ providr' s rcords Contacts agr w/ providr's rcord, rturn to rgular rviw Rport to DCFS SD Start Snd SD Notic Sampl Ltr #2 w/in 30 days of finding. Rqust CA Suspnd immdiatl y & snd Ltr #8 ; withhold paymnt. Appal offrd to providr 9 At rviw, monitor was unabl to obsrv all childrn in attndanc during shift chang. If providr can justify, rturn to rgular rviw; othrwis, provid tchnical assistanc. 1st (whn providr cannot justify) 1st (if unjustifiabl), & 2nd. If follow-up rviw is ok, rturn to rgular rviw. 2nd occurnc 2nd occurnc 15 Did not inform Sponsor of changs in licns,.g. licns rvokd, movd and no nw licns. Maximum tim of suspnding funds - 120 days. 1st 1st 1st 1st - Snd Sampl Ltr 8 - Comb Suspnsion, SD & T&D 22

1113 Procdurs for Houshold Contact and 5-Day Rconciliation Purpos: To dvlop a systm sponsoring organizations (SO) will us for houshold contacts in its monitoring of family day car homs. Dscription: Houshold contact mans a contact mad by a sponsoring organization or a Stat agncy to an adult mmbr of a houshold with a child in a family day car hom. Th purpos of th contact is to vrify th attndanc and nrollmnt of th child and th spcific mal srvic(s) th child routinly rcivs whil in car. 7CFR226.6(m)(5). Sponsoring organizations should contact housholds whn on or mor of th following situations occur: Mal counts ar inconsistnt with attndanc rcords. A larg numbr of wknd, night, and/or holiday mals and snacks ar claimd for rimbursmnt. Prior fiv-day mal counts ar a grat dal highr than th attndanc on th day of rviw. As a rsult of th fiv-day rconciliation, a significant numbr of mals srvd and claimd do not corrspond to th information on th nrollmnt forms. Procdurs Ensur sponsoring organizations includ parnt/guardian contact information on th mandatory nrollmnt forms. Dcid if th houshold contact will b conductd by tlphon or mail via Unitd Stats Postal Srvic (USPS). Complt a copy of th tlphon script for vry prson if th contact will b mad via th tlphon. Complt a copy of th houshold contact mmo and qustionnair for ach contact if th contact will b mad via mail. Th mmo must includ a du dat. A copy of th script or th contact mmo and th contact(s) will b kpt on fil and should includ th nams of all SO staff that workd on th houshold contact. Ensur all information rcivd is documntd and maintaind on fil. Snd houshold contacts via crtifid Unitd Stats Postal Srvic (USPS) mail. Collct and analyz th information submittd by th housholds within on wk of rcipt. Dtrmin if thr is a non-complianc issu with th day car hom. Is th hom in complianc? If not, dos th non-complianc rquir som typ of Corrctiv Action Plan? Snd appropriat corrspondnc to th hom. Ensur all corrctiv action is timly. Sponsoring organization will b rquird to adapt this procdur to its own organization and will b rquird to amnd thir Managmnt Plan. A sponsoring organization may dvlop its own houshold contact mmos, qustionnairs, and scripts; howvr, ths must b submittd to th Illinois Stat Board of Education for approval. (S Sampls 1-3/1113 for sampl mmos, tc.).

SAMPLE 1/1113 HOUSEHOLD CONTACT COVER MEMO To: Parnts/Guardians of Childrn Enrolld at <NAME OF PROVIDER S DAY CARE HOME> From: <NAME OF SPONSORING ORGANIZATION> Dat: <CURRENT DATE> R: Child and Adult Car Food Program Houshold Contact Your child(rn) s day car hom participats in th Child and Adult Car Food Program (CACFP). Through th CACFP, your child(rn) should rciv Unitd Stats Dpartmnt of Agricultur (USDA)-approvd mals and snacks. In ordr to masur th succss of this program, [insrt th nam of th sponsoring organization] rqusts you tak a fw minuts to hlp us do a bttr job for your child(rn). Plas complt th nclosd CACFP Houshold Contact Form. Your prompt rspons (within fiv days) nsurs two things: 1. Your child(rn) will continu to rciv nutritious mals and snacks. 2. Your cargivr will continu to rciv financial support from th USDA. Plas rad and complt th form. Aftr signing and dating th form, plas rturn it in th nclosd slf-addrssd, stampd nvlop. Your rply is ndd vn if your child is no longr in car. Your coopration will hlp th CACFP provid quality srvic to th day car homs participating in th program. Thank you for your tim and coopration. Th U.S. Dpartmnt of Agricultur prohibits discrimination against its customrs, mploys, and applicants for mploymnt on th bass of rac, color, national origin, ag, disability, sx, gndr idntity, rligion, rprisal, and whr applicabl, political blifs, marital status, familial or parntal status, sxual orintation, or all or part of an individual s incom is drivd from any public assistanc program, or protctd gntic information in mploymnt or in any program or activity conductd or fundd by th Dpartmnt. (Not all prohibitd bass will apply to all programs and/or mploymnt activitis). If you wish to fil a Civil Rights program complaint of discrimination, complt th USDA Program Discrimination Complaint Form, found onlin at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA offic, or call (866)632-9992 to rqust th form. You may also writ a lttr containing all of th information rqustd in th form. Snd your compltd complaint form or lttr to us by mail at U.S. Dpartmnt of Agricultur, Dirctor, Offic of Adjudication, 1400 Indpndnc Avnu, S.W., Washington, D.C. 20250-9410, by fax (202)690-7442 or mail at program.intak@usda.gov. Individuals who ar daf, hard of haring or hav spch disabilitis may contact USDA through th Fdral Rlay Srvic at (800) 877-8339, or (800) 845-6136 (Spanish). USDA is an qual opportunity providr and mployr. 24

SAMPLE 2/1113 HOUSEHOLD CONTACT QUESTIONNAIRE For Offic Us Only Nam of Providr Sit Numbr Dat Compltd Writtn or Tlphon Form Compltd By Child s Nam Parnt/guardian: Plas complt information blow. Plas complt th calndar blow for th month of. Indicat th days your child was in attndanc by marking with an X. Wk of Sunday Monday Tusday Wdnsday Thursday Friday Saturday 1. What ar th normal days your child is in attndanc? Plas circl: SU M T W TH F SA 2. List th normal hours your child is in attndanc: 3. If your child gos to school and lavs from th day car hom, list th tim th child lavs for school and list th tim th child rturns from school to th day car hom: 4. What mals/snacks dos your child normally at at th hom? Plas chck all that apply. Early snack Brakfast AM snack Lunch PM snack Suppr Evning snack 5. Did any xcptions occur during th abov month? Plas xplain. PENALTIES FOR MISREPRESENTATION: I crtify all of th abov information is tru and corrct. I undrstand this information is bing givn for th rcipt of Fdral funds, authorizd officials may vrify th information, and dlibrat misrprsntation may subjct m to proscution undr applicabl Stat and Fdral laws. Signatur of Parnt/Guardian Dat Printd Nam Hom Phon Addrss Work Phon 25

SAMPLE 3/1113 HOUSEHOLD TELEPHONE CONTACT SCRIPT Good morning (or good aftrnoon). This is (nam) from (nam of your organization) Is [Mr., Mrs., Ms.] availabl? I work with th Child and Adult Car Food Program which is a fdrally fundd program that nabls your child(rn) s day car hom providr to srv nutritious mals to th childrn in his/hr car. Occasionally, w rviw rcords to nsur accuracy and to maintain th intgrity of th program. To assist us, I nd to ask you a fw qustions about (nam of child or childrn ) s attndanc and mal participation at (nam of providr ) s day car hom. Ask qustions and complt CACFP Houshold Contact Qustionnair at this tim. Do you hav any qustions or commnts about th Child and Adult Car Food Program? Thank you for your tim. I apprciat your coopration. DATE OF CONTACT TIME OF CONTACT 26

1114 Srious Dficincy Notification Procdurs If th sponsor dtrmins that th day car hom has committd on or mor srious dficincis outlind in Sub-sction 1111, th sponsor must us th following procdurs to provid th providr notic of th srious dficincy (is) and offr an opportunity to tak corrctiv action. If, howvr, th srious dficincy (is) constituts an imminnt thrat to th halth or safty of th occupants, or th day car hom has ngagd in activitis that thratn th public halth or safty, th sponsor must follow th procdurs outlind in Sub-sction 1115, Suspnsion of Participation for Day Car Homs. Procdurs 1. Th sponsor will thoroughly invstigat and documnt th srious dficincy (is). This procss may includ, but is not limitd to, houshold contact for th vrification of nrollmnt and attndanc information. Rfr to Sampl Lttr 1 (Attachmnt 1/1114) Notic of Noncomplianc and Corrctiv Action. This lttr is usd whn issus aris outsid th monitoring rviw procss. This allows th sponsor to track how many tims th providr has sriously dficint problms. 2. Th sponsor will notify th providr, in writing, that h/sh has bn found to b sriously dficint. Rfr to Sampl Lttr 2 (Attachmnt 2/1114) Notic of Srious Dficincy. Th sponsor must provid a copy of th Notic of Srious Dficincy to th stat agncy. Th notic will includ: Srious dficincy(is) Actions to b takn by th providr to corrct th dficincy(is) Allottd tim to corrct th srious dficincy (is) (This must b as soon as possibl, but must not xcd 30 days.) Notification that th srious dficincy dtrmination is not subjct to Administrativ Rviw (Appal) Notification that failur to fully and prmanntly corrct th srious dficincy(is) within th allottd timfram will rsult in th sponsor's proposd trmination of th providr's agrmnt and disqualification of th providr Notification that th providr's voluntary trmination of its agrmnt with th sponsor aftr having bn notifid that h/sh is sriously dficint will still rsult in th providr's formal trmination by th sponsor and placmnt on th National Disqualifid List 3. Th sponsor will provid tchnical assistanc as appropriat in th aras idntifid as srious dficincy (is). Succssful Corrctiv Action If th providr corrcts th srious dficincy (is) to th sponsor's satisfaction within th allottd timfram, th sponsor will notify th providr that th dtrmination of srious dficincy has bn tmporarily dfrrd. Rfr to Sampl Lttr 3 (Attachmnt 3/1114) Succssful Corrctiv Actions, Tmporary Dfrmnt of Srious Dficincy. Th sponsor must provid a copy of this notic to th stat agncy. 27

Unsuccssful Corrctiv Action Proposd Trmination and Proposd Disqualification If th providr fails to implmnt timly corrctiv action to fully and prmanntly corrct th srious dficincy (is) citd, th sponsor will issu a notic proposing to trminat th providr's agrmnt for caus. Rfr to Sampl Lttr 4 (Attachmnt 4/1114) Notic of Proposd Trmination and Proposd Disqualification. Th sponsor will provid a copy of this notic to th stat agncy. Th notic will: Provid xplanation of th providr's opportunity for an Administrativ Rviw (Appal) of th proposd trmination and th procdurs to follow to rqust such appal. Inform th providr h/sh may continu to participat and rciv program rimbursmnt for ligibl mals srvd until th appal concluds. Inform th providr trmination of th agrmnt will rsult in th day car hom's trmination for caus and disqualification. Stat that if th providr sks to voluntarily trminat th agrmnt with th sponsor aftr rciving th Notic of Proposd Trmination, th hom will still b placd on th National Disqualifid List. If an Administrativ Rviw (Appal) is rqustd, th sponsor will follow ISBE s Administrativ Rviw (Appal) procdurs for family day car homs. If th Administrativ Rviw (Appal) Official ovrturns th sponsor's proposd actions, formal notification will b usd to tmporarily dfr th srious dficincy. Rfr to Sampl Lttr 5 (Attachmnt 5/1114) Tmporary Dfrmnt of Srious Dficincy, Proposd Trmination, and Proposd Disqualification (aftr providr wins appal). Th sponsor will provid a copy of this notic to th stat agncy. Agrmnt Trmination and Disqualification Th sponsor will immdiatly trminat th day car hom's agrmnt and disqualify th providr whn th Administrativ Rviw (Appal) Official upholds th sponsor's proposd trmination and proposd disqualification. At th sam tim, th Notic of Trmination and Disqualification is issud to th providr. Rfr to Sampl Lttr 6 (Attachmnt 6/1114) Notic of Trmination and Disqualification (aftr sponsor wins appal). Th sponsor will provid a copy of this notic to th stat agncy. If th providr dos not rqust an Administrativ Rviw, th sponsor will immdiatly trminat th providr's agrmnt and disqualify th hom whn th opportunity to rqust th Administrativ Rviw (Appal) xpirs. At th sam tim, th Notic of Trmination and Disqualification is issud to th providr. Rfr to Sampl Lttr 7 (Attachmnt 7/1114) Notic of Trmination and Disqualification (following failur to appal). Th sponsor will provid a copy of this notic to th stat agncy. Th stat agncy will rport th nam of th trminatd and disqualifid providr to th fdral govrnmnt thus placing his/hr nam on th National Disqualifid List. Program Paymnts During Srious Dficincy Procss Th sponsor will continu to pay any valid Claims for Rimbursmnt for ligibl mals srvd until th srious dficincy(is) is corrctd or th day car hom's agrmnt is trminatd, including th priod of any Administrativ Rviw (Appal). 28

Sampl Lttr 1/1114 Sampl Lttr 1: Notic of Noncomplianc and Corrctiv Action NOTE: This lttr should b usd whn issus aris outsid th monitoring rviw procss. It will allow th sponsor to track how many tims th providr has sriously dficint problms. Corrctiv Action <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # > Dar <PROVIDER>: Th following may b caus for trmination of th agrmnt to participat in th Child and Adult Car Food Program (CACFP). Sponsor must pick th aras that support thir concrns. 1. Submission of fals information on th application (Sponsor/Providr Agrmnt) (7 CFR Part 226.16[l][2][i]) 2. Submission of fals Claims for Rimbursmnt (7 CFR Part 226.16[l][2][ii]) 3. Simultanous participation undr mor than on sponsoring organization (7 CFR Part 226.16[l][2][iii]) 4. Noncomplianc with th program mal pattrn (7 CFR Part 226.16[l][2][iv]) 5. Failur to kp rquird rcords (7 CFR Part 226.16[l][2][v]) 6. Conduct or conditions that thratn th halth or safty of a child(rn) in car or th public s halth or safty (7 CFR Part 226.16[l][2][vi]) 7. A dtrmination that th providr has bn convictd of any activity that occurrd during th past svn yars and indicatd a lack of businss intgrity. A lack of businss intgrity includs fraud, antitrust violations, mbzzlmnt, thft, forgry, bribry, falsification or dstruction of rcords, making fals statmnts, rciving stoln proprty, making fals claims, obstruction of justic, or any othr activity indicating a lack of businss intgrity as dfind by th stat agncy, or th concalmnt of such a conviction. (7 CFR Part 226.16[l][2][vii]) 8. Failur to participat in training (7 CFR Part 226.16[l][2][viii]) 9. Any othr circumstanc rlatd to non-prformanc undr th Sponsor/Providr Agrmnt as spcifid by th sponsor or th stat agncy. This may includ, but not b limitd to, continuous submission of lat and/or incomplt Claims for Rimbursmnt and failur to comply with civil rights laws. (7 CFR Part 226.16[l][2][ix]) 29

Sampl Lttr 1/1114 Notic of Noncomplianc and Corrctiv Action Pag 2 Spcify th typ of noncomplianc: Th following corrctiv action must b submittd by <DATE>: 1. 2. 3. Tchnical assistanc to prvnt rcurrnc of th problm(s) was providd at monitoring visits and/or training and/or on <DATE> Bcaus of th aras of noncomplianc notd, your CACFP day car opration will b closly monitord and parnts may b contactd for vrification of information. Failur to prmanntly implmnt th corrctiv action will rsult in a Notic of Srious Dficincy and may rsult in trmination of your agrmnt for caus. During th initial corrctiv action procss, you will not b allowd to transfr to anothr sponsor. If you withdraw from th CACFP bfor th procss is compltd, you will not b abl to participat in th CACFP with any sponsor in any stat. W rsrv th right to also issu a Notic of Srious Dficincy and bgin th trmination procss for caus. If you ar trminatd for caus, your nam will b forwardd for placmnt on th National Disqualifid List. You will hav th right to appal th Intnt to Trminat for Caus. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 30

Sampl Lttr 2/1114 Sampl Lttr 2/1114: Notic of Srious Dficincy NOTE: This lttr must b snt by crtifid mail with a rturn rcipt via Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR 226.2 (dfinition of th trm NOTICE) in th rgulations. Notic of Srious Dficincy <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # Dar <PROVIDER>: This lttr concrns th <BRIEF DESCRIPTION OF THE BASIS FOR THE SERIOUS DEFICIENCY DETERMINATION REVIEW, HOUSEHOLD CONTACT, ETC. AND DATE>. Basd on th abov, w hav dtrmind you ar sriously dficint in your opration of th Child and Adult Car Food Program (CACFP). If you do not fully and prmanntly corrct all of th srious dficincis and submit writtn documntation of th corrctiv action by th du dat, w will: Propos to trminat your agrmnt to participat in th CACFP for caus AND Propos to disqualify you from futur CACFP participation. In addition, if you voluntarily trminat your agrmnt aftr rciving this lttr, w will propos to disqualify you from futur CACFP participation. If disqualifid, you will b placd on th National Disqualifid List (NDL). Whil on th NDL, you will not b abl to participat in th CACFP as a day car hom providr. In addition, you will not b abl to srv as a principal in any CACFP institution or facility. You will rmain on th NDL until such tim as th Stat agncy dtrmins th srious dficincis hav bn corrctd or until svn yars aftr your disqualification. Howvr, if any dbt rlating to th srious dficincis has not bn rpaid, you will rmain on th NDL until th dbt has bn rpaid. Ths actions ar bing takn pursuant to 7CFR Part 226.16(l) of CACFP rgulations. <EACH SERIOUS DEFICIENCY DISCUSSED MUST INCLUDE A CITATION TO THE RELEVANT SERIOUS DEFICIENCY IN THE REGULATIONS AT 226.16(l)(2). IF THE SERIOUS DEFICIENCY IS NOT SPECIFICALLY LISTED, CITE 226.16(l)(2)(ix) "ANY OTHER CIRCUMSTANCE RELATED TO NONPERFORMANCE UNDER THE SPONSORING ORGANIZATION-DAY CARE HOME AGREEMENT.")> 31

Sampl Lttr 2/1114- Notic of Srious Dficincy Pag 2 Corrctiv Action You must provid us writtn documntation that shows how you hav takn th corrctd stps for ach of th srious dficincis (problms citd in this lttr). Th documntation must b rcivd (not just postmarkd) by <CORRECTIVE ACTION DEADLINE>. If w do not rciv th documntation of your corrctiv action by th du dat, or if it is dtrmind you did not provid adquat writtn actions takn to fully and prmanntly corrct all of th srious dficincis, w will propos to trminat your CACFP agrmnt for caus and will propos to disqualify you. Summary You may not appal th srious dficincy dtrmination. Howvr, if w propos to trminat your agrmnt for caus or propos to disqualify you, you will b abl to appal thos actions and you will b advisd of your appal rights and th appal procdurs at that tim. You may continu to participat in th CACFP during th corrctiv action priod. W will pay any valid Claims for Rimbursmnt submittd by you for this priod. You must submit th claims by th normal dadlin. If w rciv th documntation of your corrctiv action by th du dat and dtrmin that it fully and prmanntly corrcts all of th srious dficincis, w will tmporarily dfr th srious dficincis. Howvr, if w find in th Follow-Up Rviw or any subsqunt rviw that any of ths srious dficincis hav not bn fully and prmanntly corrctd, w will immdiatly propos to trminat your agrmnt for caus and propos to disqualify you without any furthr opportunity for corrctiv action. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 32

Sampl Lttr 3/1114 Sampl Lttr 3/1114 Succssful Corrctiv Action, Tmporary Dfrmnt of Srious Dficincy NOTE: This lttr must b snt by crtifid mail with a rturn rcipt via Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of th trm NOTICE) in th rgulations. Tmporary Dfrmnt of Srious Dficincy <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH - ISBE SITE # > Dar <PROVIDER>: This lttr concrns <SPONSOR S NAME> dtrmination of your corrctiv action rspons to th Notic of Srious Dficincy datd <DATE OF LETTER>. Your rspons was rcivd within th rquird tim fram. You snt writtn actions dtailing how you hav prmanntly corrctd all th srious dficincis. Srious Dficincy Dtrmination Tmporarily Dfrrd Basd on th rviw of th documntation, w hav accptd your actions that hav fully corrctd th srious dficincis citd in th Srious Dficincy Notic. As a rsult, w hav tmporarily dfrrd th srious dficincy dtrmination as of th dat of this lttr. This also mans w will not propos to trminat your agrmnt for caus basd on this srious dficincy finding or propos to disqualify you on that basis. Summary If in any futur rviw, th monitoring staff discovrs on or any of ths sam srious dficincis hav not bn fully and prmanntly corrctd, w will immdiatly propos to trminat your agrmnt for caus and propos to disqualify you without any furthr opportunity for corrctiv action. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 33

Sampl Lttr 4/1114 Sampl Lttr 4/1114 Notic of Proposd Trmination and Proposd Disqualification NOTE: This lttr must b snt by crtifid mail with a rturn rcipt via Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of th trm NOTICE) in th rgulations. Notic of Proposd Trmination and Proposd Disqualification <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # > Dar <PROVIDER>: This lttr concrns th dtrmination in th <DATE OF NOTICE OF SERIOUS DEFICIENCY> lttr (Notic of Srious Dficincy) that you ar sriously dficint in your opration of th Child and Adult Car Food Program (CACFP). <CHOOSE ONE OF THE THREE SCENARIOS INSERT THE APPLICABLE PARAGRAPH, THEN DELETE THE OTHER TWO PARAGRAPHS> 1. W rcivd your documntation snt to us dtailing th corrctiv actions takn to corrct ths srious dficincis on <DATE>, bfor th corrctiv action dadlin. Th corrctiv action did not dtail how you will corrct th following problms listd in th Notic of Sriously Dficincy lttr datd <DATE OF LETTER>. <CITE REGULATIONS FOR EACH SERIOUS DEFICIENCY; COPY THIS INFORMATION FROM THE NOTICE OF SERIOUS DEFICIENCY LETTER.> 2. W did not rciv any writtn Corrctiv Action Plan that was du to <NAME OF SPONSOR> by <DUE DATE OF CORRECTIVE ACTION PLAN>. 3. Basd on our Follow-Up Rviw conductd on <DATE OF REVIEW>, it has bn dtrmind you hav not fully nor prmanntly corrctd th srious dficincis citd in th Notic of Srious Dficincy. <LIST THE SERIOUS DEFICIENCIES NOT CORRECTED.> Proposd Trmination and Proposd Disqualification As a rsult, w ar: Proposing to trminat your agrmnt to participat in th CACFP for caus ffctiv <DATE>, AND Proposing to disqualify you from futur CACFP participation ffctiv <DATE>. 34

Sampl Lttr 4/1114 Notic of Proposd Trmination and Proposd Disqualification Pag 2 [THE EFFECTIVE DATE FOR THE TERMINATION/DISQUALIFICATION MUST BE AFTER THE DEADLINE FOR REQUESTING AN APPEAL. IN ADDITION, THE EFFECTIVE DATE FOR THE DISQUALIFICATION SHOULD GENERALLY BE THE SAME AS THE AGREEMENT TERMINATION DATE, AND NOT EARLIER; OTHERWISE, THE PROVIDER COULD BE DISQUALIFIED AND INELIGIBLE TO PARTICIPATE BEFORE THE AGREEMENT IS TERMINATED.] In addition, if you voluntarily trminat your agrmnt aftr rciving this lttr, w will propos to disqualify you from futur CACFP participation. If disqualifid, you will b placd on th National Disqualifid List (NDL). Whil on th NDL, you will not b abl to participat in th CACFP as a day car hom providr. In addition, you will not b abl to srv as a principal in any CACFP institution or facility. You will rmain on th NDL until such tim as th Stat agncy dtrmins th srious dficincis hav bn corrctd or until svn yars aftr your disqualification. Howvr, if any dbt rlating to th srious dficincis has not bn rpaid, you will rmain on th National Disqualifid List until th dbt has bn rpaid. Ths actions ar bing takn pursuant to CACFP rgulation 7 CFR Part 226.16(l). Appal of Proposd Trmination and Proposd Disqualifications You may appal th proposd trmination of your agrmnt for caus and your proposd disqualification. A copy of th appal procdurs is nclosd. If you dcid to appal th proposd actions, mak sur you follow th appal procdurs xactly bcaus th failur to do so could rsult in th dnial of your rqust for an appal. If you appal th proposd trmination and th proposd disqualification, th proposd actions will not tak ffct until th haring official issus a dcision on th appal. If you do not mak a timly rqust for an appal, your agrmnt will b trminatd for caus on <DATE>. If you do not appal your proposd disqualification, you will b disqualifid from futur CACFP participation ffctiv <DATE> and placd on th National Disqualifid List for svn yars. You may continu to participat in th CACFP until <TERMINATION/DISQUALIFICATION EFFECTIVE DATE>, or if you appal th proposd actions, until th haring official issus a dcision on th appal. W will pay any valid Claims for Rimbursmnt submittd by you for this priod. You must submit th claims by th normal dadlin. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> nc: Appal Procdurs cc: Illinois Stat Board of Education 35

Sampl Lttr 5/1114 Sampl Lttr 5/1114 Tmporary Dfrmnt of Srious Dficincy, Proposd Trmination, and Proposd Disqualification (Aftr Providr Wins Appal) NOTE: This lttr must b snt by crtifid mail with a rturn rcipt via Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of trm NOTICE) in th rgulations. Tmporary Dfrmnt of Srious Dficincy, Proposd Trmination, and Proposd Disqualification <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # > Dar <PROVIDER>: This lttr concrns th <DATE OF NOTICE OF PROPOSED TERMINATION AND PROPOSED DISQUALIFICATION> lttr (Notic of Proposd Trmination and Proposd Disqualification) which proposd to trminat your agrmnt to participat in th Child and Adult Car Food Program (CACFP) for caus. In that lttr, w also proposd to disqualify you from furthr CACFP participation. Ths actions wr basd on th dtrmination in th <DATE OF NOTICE OF SERIOUS DEFICIENCY> lttr (Notic of Srious Dficincy) that you ar sriously dficint in your opration of th CACFP. You fild a timly appal of th proposd trmination and proposd disqualification. On <DATE OF HEARING OFFICIAL'S DECISION>, th Administrativ Rviw Official issud a dcision on th appal. In that dcision, both of our proposd actions wr ovrturnd. Srious Dficincy Dtrmination Tmporarily Dfrrd As a rsult, w tmporarily dfrrd th srious dficincy dtrmination as of <DATE OF REVIEW OFFICIAL'S DECISION> (th dat of th Administrativ Rviw Official's dcision). W ar also tmporarily dfrring th proposd trmination of your agrmnt for caus and your proposd disqualification as of th sam dat. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 36

Sampl Lttr 6/1114 Sampl Lttr 6/1114 Notic of Trmination and Disqualification (Aftr Sponsor Wins Appal) Not: This lttr must b snt by crtifid mail with a rturn rcipt via Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of th trm NOTICE) in th rgulations. Notic of Trmination and Disqualification <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # > Dar <PROVIDER>: This lttr concrns th <DATE OF NOTICE OF PROPOSED TERMINATION AND PROPOSED DISQUALIFICATION> lttr (Notic of Proposd Trmination and Proposd Disqualification), which proposd to trminat your agrmnt to participat in th Child and Adult Car Food Program (CACFP) for caus. In that lttr, w also proposd to disqualify you from furthr CACFP participation. Ths actions wr basd on th dtrmination in th <DATE OF NOTICE OF SERIOUS DEFICIENCY> lttr (Notic of Srious Dficincy) that you ar sriously dficint in your opration of th CACFP. You fild a timly appal of th proposd trmination and proposd disqualification. On <DATE OF APPEAL OFFICIAL'S DECISION>, th Administrativ Rviw Official issud a dcision on th appal. In that dcision, both of our proposd actions wr uphld. Trmination and Disqualification As a rsult, <INSERT NAME OF SPONSORING ORGANIZATION> is: Trminating your agrmnt to participat in th CACFP for caus ffctiv <DATE>, AND Disqualifying you from futur CACFP participation ffctiv <DATE>. [Th ffctiv dat for th disqualifications should gnrally b th sam as th agrmnt trmination dat, and not arlir; othrwis, th providr could b disqualifid and inligibl to participat bfor th agrmnt is trminatd.] In addition, if you voluntarily trminat your agrmnt aftr rciving this lttr, w will still procd with th actions to disqualify you from futur CACFP participation. 37

Sampl Lttr 6/1114 Notic of Trmination and Disqualification (Aftr Sponsor Wins Appal) Pag 2 Upon disqualification, you will b placd on th National Disqualifid List (NDL). Whil on th NDL, you will not b abl to participat in th CACFP as a day car hom providr. In addition, you will not b abl to srv as a principal in any CACFP institution or facility. You will rmain on th National Disqualifid List until such tim as th Stat agncy dtrmins th srious dficincis hav bn corrctd or until svn yars aftr your disqualification. Howvr, if any dbt rlating to th srious dficincis has not bn rpaid, you will rmain on th National Disqualifid List until th dbt has bn rpaid. Ths actions ar bing takn pursuant to CACFP rgulation 7 CFR 226.16(l). Summary W ar trminating your CACFP agrmnt for caus and disqualifying you. You may not appal th trmination of th agrmnt for caus or th disqualification. You may continu to participat in th CACFP until <TERMINATION/DISQUALIFICATION EFFECTIVE DATE>. Any valid Claims for Rimbursmnt submittd by you for this priod will b paid as long as th claims ar submittd within th normal timframs. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 38

Sampl Lttr 7/1114 Sampl Lttr 7/1114 Notic of Trmination and Disqualification (Following Failur to Appal) NOTE: This lttr must b snt by crtifid mail with a rturn rcipt via Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of th trm NOTICE) in th rgulations. Notic of Trmination and Disqualification <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # > Dar <PROVIDER>: This lttr concrns th <DATE OF NOTICE OF PROPOSED TERMINATION AND PROPOSED DISQUALIFICATION> lttr (Notic of Proposd Trmination and Proposd Disqualification), which proposd to trminat your agrmnt to participat in th Child and Adult Car Food Program (CACFP) for caus. In that lttr, <INSERT NAME OF SPONSORING ORGANIZATION> also proposd to disqualify you from furthr CACFP participation. Ths actions wr basd on th dtrmination in th <DATE OF SERIOUS DEFICIENCY NOTICE> lttr (Notic of Srious Dficincy) that you ar sriously dficint in your opration of th CACFP. You rcivd th Notic of Proposd Trmination and Proposd Disqualification on <DATE RECEIVED>. You had until <INSERT DEADLINE FOR REQUESTING AN APPEAL> to submit any rqusts for appals of th proposd actions. No rqust for appals was submittd by that dadlin. Trmination and Disqualification Bcaus th tim to rqust an appal has now xpird, w ar: Trminating your agrmnt to participat in th CACFP for caus ffctiv <DATE> AND Disqualifying you from futur CACFP participation ffctiv <DATE>. [Th ffctiv dat for th disqualification should gnrally b th sam as th agrmnt trmination dat, and not arlir; othrwis, th providr could b disqualifid and inligibl to participat bfor th agrmnt is trminatd.] In addition, if you voluntarily trminat your agrmnt aftr rciving this lttr, w will still procd with th actions to disqualify you from futur CACFP participation. 39

Sampl Lttr 7/1114 Notic of Trmination and Disqualification (Following Failur to Appal) Pag 2 Upon disqualification, you will b placd on th National Disqualifid List (NDL). Whil on th NDL, you will not b abl to participat in th CACFP as a day car hom providr. In addition, you will not b abl to srv as a principal in any CACFP institution or facility. You will rmain on th NDL until such tim as th Stat agncy dtrmins th srious dficincis hav bn corrctd or until svn yars aftr your disqualification. Howvr, if any dbt rlating to th srious dficincis has not bn rpaid, you will rmain on th National Disqualifid List until th dbt has bn rpaid. Ths actions ar bing takn pursuant to sction 226.16 of CACFP rgulation 7 CFR Part 226.(l)(4). Summary W ar trminating your CACFP agrmnt for caus and disqualifying you. You may not appal th trmination of th agrmnt for caus or th disqualification. You may continu to participat in th CACFP until <TERMINATION/DISQUALIFICATION EFFECTIVE DATE>. W will pay any valid Claims for Rimbursmnt submittd by you for this priod as long as you submit th claims within th normal tim fram. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 40

1115 Suspnsion of Participation for Day Car Homs Suspnsion of a providr's participation in th CACFP will occur if th srious dficincy(is) constituts an imminnt thrat to th halth and safty of participants, or th providr has ngagd in activitis that thratn th public s halth or safty. Imminnt thrats to halth or safty constitut srious dficincis; howvr, th sponsor will us th procdurs in this sction to provid notic of suspnsion and proposd trmination to th providr. If th stat or local halth or licnsing officials hav citd a providr for srious halth or safty violations, th sponsor will immdiatly suspnd th providr's CACFP participation prior to any formal action by th Dpartmnt of Childrn and Family Srvics to rvok th hom's licns. If th sponsor dtrmins thr is an imminnt thrat to th halth or safty of participants at th day car hom, or th providr has ngagd in activitis that thratn th public s halth or safty, th sponsor must immdiatly notify th Dpartmnt of Childrn and Family Srvics and tak action consistnt with thir rcommndations and rquirmnts. Notic of Suspnsion, Srious Dficincy, and Proposd Trmination Procdurs Th sponsor will notify th providr his/hr participation has bn suspndd, that th providr has bn dtrmind sriously dficint, and that th sponsor proposs to trminat th providr's agrmnt for caus. Rfr to Sampl Lttr 8 (Sampl Lttr 8/1115) Combind Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification Notic: Imminnt Thrat to Halth or Safty. Th sponsor will provid a copy of th notic to th stat agncy. Th notic will: Spcify th srious dficincy(is) found and th providr's opportunity for an Administrativ Rviw (Appal) of th proposd trmination, and th procdurs to follow to rqust such appal. Stat participation (including all program paymnts) will rmain suspndd until th Administrativ Rviw (Appal) concluds. Inform th providr if th Administrativ Rviw (Appal) Official ovrturns th suspnsion, th providr may claim rimbursmnt for ligibl mals srvd during th suspnsion. Inform th providr trmination of th hom's agrmnt will rsult in placmnt of th hom on th National Disqualifid List. Stat that if th providr sks to voluntarily trminat th agrmnt aftr rciving th Notic of Proposd Trmination, th hom will still b trminatd for caus and placd on th National Disqualifid List. If an Administrativ Rviw (Appal) is rqustd, th sponsor will follow th Administrativ Rviw (Appal) Procdurs for Family Day Car Homs (Sction 1116 of Handbook) dtaild in this documnt. If th Administrativ Rviw (Appal) Official ovrturns th sponsor's proposd actions, formal notification will b usd to tmporarily dfr th srious dficincy. Rfr to Sampl Lttr 9 (Sampl Lttr 9/1115) Tmporary Dfrmnt of Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification: Imminnt Thrat to Halth or Safty (aftr providr wins appal). Th sponsor will provid a copy of this notic to th stat agncy. 41

Agrmnt Trmination and Disqualification Th sponsor will immdiatly trminat th day car hom's agrmnt and disqualify th hom whn th Administrativ Rviw (Appal) Official upholds th sponsor's Proposd Trmination and Proposd Disqualification and issus th Notic of Trmination and Disqualification to th hom. Rfr to Sampl Lttr 10 (Sampl Lttr 10/1115) Notic of Trmination and Disqualification: Imminnt Thrat to Halth or Safty (aftr sponsor wins appal). Th sponsor will provid a copy of this notic to th stat agncy. If th providr dos not rqust an Administrativ Rviw (Appal), th sponsor will immdiatly trminat th providr's agrmnt and disqualify th hom whn th opportunity to rqust th Administrativ Rviw (Appal) xpirs. At th sam tim, th Notic of Trmination and Disqualification is issud to th hom. Rfr to Sampl Lttr 11 (Sampl Lttr 11/1115) Notic of Trmination and Disqualification: Imminnt Thrat to Halth or Safty (following failur to appal). Th sponsor will provid a copy of this notic to th stat agncy. Th stat agncy will rport th nam of th trminatd and disqualifid providr to th fdral govrnmnt thus placing his/hr nam on th National Disqualifid List. Program Paymnts during Suspnsion A sponsor is prohibitd from making program paymnts to a providr who has bn suspndd until an Administrativ Rviw (Appal) of th proposd trmination is compltd. If th suspndd providr prvails in th appal, th sponsor will rimburs him/hr for ligibl mals srvd during th suspnsion priod. 42

Sampl Lttr 8/1115 Sampl Lttr 8/1115 Combind Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification Notic: Imminnt Thrat to Halth or Safty NOTE: This lttr must b snt by crtifid mail with a rturn rcipt via Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of th trm NOTICE) in th rgulations. Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification Notic <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # > Dar <PROVIDER>: This lttr concrns th <BRIEF DESCRIPTION OF THE BASIS FOR THE SERIOUS DEFICIENCY DETERMINATION REVIEW, PARENT SURVEY, ETC., AND DATE> of your opration of th Child and Adult Car Food Program (CACFP). Srious Dficincy Dtrmination basd on th <REVIEW/PARENT SURVEY/ETC.>, <INSERT NAME OF SPONSORING ORGANIZATION> has dtrmind you ar sriously dficint in your opration of th CACFP. <IN THIS AREA, DOCUMENT WHAT WAS DETERMINED.> Suspnsion On of th srious dficincis idntifid is th imminnt thrat to th halth or safty of CACFP participants or th public (for dtails, s th dscription of th srious dficincis latr in this lttr). Bcaus of this imminnt risk, <INSERT NAME OF SPONSORING ORGANIZATION> is suspnding your CACFP participation (including all Program paymnts). Th suspnsion of CACFP participation (including all Program paymnts) will tak ffct on th dat of this lttr. This action is bing takn pursuant to CACFP rgulation 7 CFR Part 226.16(l)(4)(i-iv). Proposd Trmination and Proposd Disqualification W ar also: Proposing to trminat your agrmnt to participat in th CACFP for caus ffctiv <DATE>, AND Proposing to disqualify you from futur CACFP participation ffctiv <DATE>. 43

Sampl Lttr 8/1115 Prototyp Combind Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification Notic: Imminnt Thrat to Halth or Safty Pag 2 [Th ffctiv dat for th trmination/disqualification must b aftr th dadlin for rqusting an appal. In addition, th ffctiv dat for th disqualifications should gnrally b th sam as th agrmnt trmination dat, and not arlir; othrwis, th providr could b disqualifid and inligibl to participat bfor th agrmnt is trminatd.] In addition, if you voluntarily trminat your agrmnt aftr rciving this lttr, w will propos to disqualify you from futur CACFP participation. If disqualifid, you will b placd on th National Disqualifid List (NDL). Whil on th NDL, you will not b abl to participat in th CACFP as a day car hom providr. In addition, you will not b abl to srv as a principal in any CACFP institution or facility. You will rmain on th list until such tim as th Stat agncy dtrmins th srious dficincis hav bn corrctd or until svn yars aftr your disqualification. Howvr, if any dbt rlating to th srious dficincis has not bn rpaid, you will rmain on th National Disqualifid List until th dbt has bn rpaid. Ths actions ar bing takn pursuant to CACFP rgulation 7 CFR Part 226.16(l)(4)(i). Srious Dficincis Th following paragraphs dtail ach srious dficincy. <INSERT DISCUSSION OF SERIOUS DEFICIENCIES. EACH SERIOUS DEFICIENCY DISCUSSED MUST INCLUDE A CITATION TO THE RELEVANT SERIOUS DEFICIENCY IN THE REGULATIONS AT 7 CFR PART 226.16(l)(2). (IF THE SERIOUS DEFICIENCY IS NOT SPECIFICALLY LISTED, CITE 7 CFR PART 226.16(l)(2)(ix), "ANY OTHER CIRCUMSTANCE RELATED TO NON-PERFORMANCE UNDER THE SPONSORING ORGANIZATION-DAY CARE HOME AGREEMENT"). Appal of Suspnsion, Proposd Trmination, and Proposd Suspnsions You may appal th suspnsion, th proposd trmination of your agrmnt for caus, and your proposd disqualification. A copy of th appal procdurs is nclosd. If you dcid to appal th suspnsion or th proposd actions, mak sur you follow th appal procdurs xactly bcaus failur to do so could rsult in th dnial of your rqust for an appal. Summary Th suspnsion will rmain in ffct during th priod of any appal rqust and th Administrativ Rviw Official ovrturns th suspnsion, and any valid Claims for Rimbursmnt submittd by you for th priod of th suspnsion will b paid. As always, w will dny any portion of a claim that is dtrmind to b invalid. 44

Sampl Lttr 8/1115 Combind Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification Notic: Imminnt Thrat to Halth or Safty Pag 3 If you appal th proposd trmination and th proposd disqualification, th proposd actions will not tak ffct until th Administrativ Rviw Official issus a dcision on th appals. If you do not mak a timly rqust for an appal, your agrmnt will b trminatd for caus on <DATE>. If you do not appal your proposd disqualification, you will b disqualifid from futur CACFP participation ffctiv <DATE> and placd on th National Disqualifid List. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE > Enc: Appal Procdurs cc: Illinois Stat Board of Education 45

Sampl Lttr 9/1115 Sampl Lttr 9/1115 Tmporary Dfrmnt of Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification: Imminnt Thrat to Halth or Safty (Aftr Providr Wins Appal) NOTE: This lttr must b snt by crtifid mail with a rturn rcipt by Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of th trm NOTICE) in th rgulations. Tmporary Dfrmnt of Srious Dficincy, Suspnsion, Proposd Trmination, and Proposd Disqualification <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # > Dar <PROVIDER>: This lttr concrns th <DATE OF COMBINED NOTICE> lttr, which suspndd your participation in th Child and Adult Car Food Program (CACFP). In that lttr, w also proposd to trminat your CACFP agrmnt for caus and proposd to disqualify you from furthr CACFP participation. Ths actions wr basd on th dtrmination in th <DATE OF COMBINED NOTICE> lttr (Notic Srious Dficincy) that you ar sriously dficint in your opration of th CACFP. You fild a timly appal of th suspnsion, proposd trmination, and proposd disqualification. On <DATE OF APPEAL OFFICIAL'S DECISION>, th Administrativ Rviw Official issud a dcision on all of th appals. In that dcision, th suspnsion and both of our proposd actions wr ovrturnd. As a rsult, w hav tmporarily dfrrd th srious dficincy dtrmination as of <DATE OF HEARING OFFICIAL'S DECISION> (th dat of th Administrativ Rviw Official's dcision). W ar also tmporarily dfrring th suspnsion, th proposd trmination of your agrmnt for caus, and your proposd disqualification as of th sam dat. Any valid Claims for Rimbursmnt submittd by you for th priod of th suspnsion will b paid. You must submit ths claims by <INSERT A DATE THAT WILL GIVE THE PROVIDER AN APPROPRIATE LENGTH OF TIME TO SUBMIT THESE CLAIMS>. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 46

Sampl Lttr 10/1115 Sampl Lttr 10/1115 Notic of Trmination and Disqualification: Imminnt Thrat to Halth or Safty (Aftr Sponsor Wins Appal) NOTE: This lttr must b snt by crtifid mail with a rturn rcipt via Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of trm NOTICE) in th rgulations. Notic of Trmination and Disqualification <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # Dar <PROVIDER>: This lttr concrns th <DATE OF COMBINED NOTICE> lttr, which suspndd your participation in th Child and Adult Car Food Program (CACFP). In that lttr, w also proposd to trminat your CACFP agrmnt for caus and proposd to disqualify you from furthr CACFP participation. Ths actions wr basd on th dtrmination in th <DATE OF COMBINED NOTICE> lttr (Notic of Srious Dficincy) that you ar sriously dficint in your opration of CACFP. You fild a timly appal of th suspnsion, proposd trmination, and proposd disqualification. On <DATE OF APPEAL OFFICIAL'S DECISION>, th Administrativ Rviw Official issud a dcision on all of th appals. In that dcision, th suspnsion and both of th proposd actions wr uphld. Trmination and Disqualification As a rsult of this dcision, w ar: Trminating your agrmnt to participat in th CACFP for caus ffctiv on th dat of this lttr, AND Disqualifying you from futur CACFP participation ffctiv on th dat of this lttr. [Bcaus th institution has alrady bn suspndd, th trmination should b mad ffctiv on th dat of this lttr. Th ffctiv dat for th disqualification should gnrally b th sam as th agrmnt trmination dat, and not arlir; othrwis, th providr could b disqualifid and inligibl to participat bfor th agrmnt is trminatd.] In addition, if you voluntarily trminat your agrmnt aftr rciving this lttr, w will still procd with th actions to disqualify you from futur CACFP participation. 47

Sampl Lttr 10/1115 Notic of Trmination and Disqualification: Imminnt Thrat to Halth or Safty (Aftr Sponsor Wins Appal) Pag 2 Upon disqualification, you will b placd on th National Disqualifid List (NDL). Whil on th NDL, you will not b abl to participat in th CACFP as a day car hom providr. In addition, you will not b abl to srv as a principal in any CACFP institution or facility. You will rmain on th NDL until such tim as th Stat agncy dtrmins th srious dficincis hav bn corrctd or until svn yars aftr your disqualification. Howvr, any dbt rlating to th srious dficincis has not bn rpaid; you will rmain on th National Disqualifid List until th dbt has bn rpaid. Ths actions ar bing takn pursuant to CACFP rgulation 7 CFR Part 226.16(l)(4)(i). Summary W ar trminating your CACFP agrmnt for caus and disqualifying you. You may not appal th trmination of your agrmnt for caus or your disqualification. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 48

Sampl Lttr 11/1115 Sampl Lttr 11/1115 Notic of Trmination and Disqualification: Imminnt Thrat to Halth or Safty (Following Failur to Appal) NOTE: This lttr must b snt by crtifid mail with a rturn rcipt vi Unitd Stats Postal Srvic or an quivalnt privat dlivry srvic (such as Fdral Exprss), facsimil, or mail as rquird by 7 CFR Part 226.2 (dfinition of th trm NOTICE) in th rgulations. Notic of Trmination and Disqualification <DATE> SENT CERTIFIED WITH RETURN RECEIPT <PROVIDER NAME> <PROVIDER STREET ADDRESS> <PROVIDER CITY, STATE ZIP CODE> <DATE OF BIRTH ISBE SITE # Dar <PROVIDER>: This lttr concrns th <DATE OF COMBINED NOTICE> lttr, which suspndd your participation in th Child and Adult Car Food Program (CACFP). In that lttr, <INSERT NAME OF SPONSORING ORGANIZATION> also proposd to trminat your CACFP agrmnt for caus and proposd to disqualify you from furthr CACFP participation. Ths actions wr basd on th dtrmination in our <DATE OF COMBINED NOTICE> lttr (Notic of Srious Dficincy) that you ar sriously dficint in your opration of th CACFP. You rcivd th <DATE OF COMBINED NOTICE> lttr on <DATE RECEIVED>. You had until <DEADLINE FOR REQUESTING APPEAL> to submit any rqust for an appal of th proposd actions. No rqust for an appal was submittd by that dadlin. Trmination and Disqualification Bcaus th tim to rqust an appal has now xpird, <NAME OF SPONSORING ORGANIZATION> is: Trminating your agrmnt to participat in th CACFP for caus ffctiv on th dat of this lttr, AND Disqualifying you from futur CACFP participation ffctiv on th dat of this lttr. [Bcaus th institution has alrady bn suspndd, th trmination should b mad ffctiv on th dat of this lttr. Th ffctiv dat for th disqualification should gnrally b th sam as th agrmnt trmination dat, and not arlir; othrwis, th providr could b disqualifid and inligibl to participat bfor th agrmnt is trminatd.] 49

Sampl Lttr 11/1115 Notic of Trmination and Disqualification: Imminnt Thrat to Halth or Safty (Following Failur to Appal) Pag 2 Upon disqualification, you will b placd on th National Disqualifid List. Whil on th list, you will not b abl to participat in CACFP as a day car hom providr. In addition, you will not b abl to srv as a principal in any CACFP institution or facility. You will rmain on th list until such tim as th Stat agncy dtrmins th srious dficincis hav bn corrctd or until svn yars aftr your disqualification. Howvr, if any dbt rlating to th srious dficincis has not bn rpaid, you will rmain on th National Disqualifid List until th dbt has bn rpaid. Ths actions ar bing takn pursuant to sction 226.16(l)(4)(i) of CACFP rgulation 7 CFR 226.16. Summary W ar trminating your CACFP agrmnt for caus and disqualifying you. You may not appal th trmination of your agrmnt for caus or your disqualification. Sincrly, <SPONSOR EMPLOYEE NAME AND TITLE> cc: Illinois Stat Board of Education 50

1116 Administrativ Rviw (Appal) Procss Th stat agncy has stablishd an Administrativ Rviw (Appal) procss in which th Administrativ Rviw Official (ARO) is an impartial and indpndnt prson not involvd in th dcision to trminat th Providr's participation. Actions Subjct to Administrativ Rviws (Appals) Th following appal procdurs stablishd in accordanc with 7 CFR Parts 226.6, 226.16, and 226.18 of th Child and Adult Car Food Program rgulations, as amndd by Public Law 106-224, shall b implmntd and will b offrd by th Illinois Stat Board of Education Nutrition Programs Division through an indpndnt contractor to any Providr whn th Sponsor (1) proposs to trminat its program agrmnt for caus, or (2) suspnds thir participation. Actions NOT Subjct to Administrativ Rviws (Appals) Nithr th Stat Agncy nor th Sponsor is rquird to offr an Administrativ Rviw (Appal) for rasons othr than thos listd abov. Providing th Administrativ Rviw (Appal) Procdur to Providrs Th Sponsor will provid a copy of th Administrativ Rviw (Appal) procdurs to ach Providr: Annually Whn th Sponsor taks any action subjct to an Administrativ Rviw (Appal) as dtaild abov Any tim upon rqust All family day car hom Providrs givn a Notic of Intnt to Trminat for Caus hav th right to appal (rqust an Administrativ Rviw). An appal is a procss by which an impartial and indpndnt Administrativ Rviw (Appal) Official rviws information providd by th Sponsoring Organization and th family day car hom Providr to dtrmin if procdurs wr followd and within th fdral and stat laws, rgulations, and policis and procdurs govrning th Child and Adult Car Food Program (CACFP). Purpos Th appal procdur allows day car hom Providrs participating in th CACFP an avnu of appal. A Providr may appal (rqust an Administrativ Rviw) whn th family day car hom Sponsoring Organization (SO): 1. Proposs trmination of th Providr s program participation. 2. Suspnds th Providr s agrmnt for program participation. 51

Notification, rqust, and procdur for haring: 1. Whnvr th Sponsoring Organization taks action that will affct th participation of a Providr in th CACFP, th SO will inform th Providr in writing of th action and th grounds upon which its dcision is basd. Th SO will advis th Providr of thir right to appal. 2. Th Providr may rfut th chargs by showing that th information th sponsor has is incorrct. Th Providr will supply writtn documntation to th Administrativ Rviw Official (ARO) to rviw. Th ARO will rviw only th writtn documntation/rcord unlss thr ar xtnuating circumstancs, as dfind by th ARO. If th ARO dtrmins an in-prson haring is warrantd, h/sh will notify both partis. Th ARO will st th tim and plac for th rviw of th Providr rcords and SO rcords, if thr is an in-prson haring. In most cass, thr is no in-prson haring. Th ARO rviws all th documnts and maks a dcision. 3. In th cas of an in-prson haring, failur of th Providr to appar at a schduld haring will forfit th Providr s right to appal. 4. Th Providr may rprsnt himslf/hrslf, may b rprsntd by anothr prson, or may rtain lgal counsl. 5. Th ARO will mak a dcision basd solly on information providd by th SO, th Providr, and on program rgulations, fdral and stat laws, and procdurs govrning th CACFP. 6. Th Providr may continu to oprat during an appal of proposd trmination unlss thr is vidnc of imminnt thrat or dangr to th halth or wlfar of th childrn. 7. Providrs continuing to oprat whil appaling th proposd trmination will b rimbursd for any ligibl mals srvd during th priod of th appal. 8. During th priod of th rviw by th ARO, th SO will not tak action to collct or offst any ovrpaymnt notd in th trmination lttr. 9. Th dcision by th ARO is th final administrativ dcision to b affordd th Providr. 10. If th Providr loss th appal, th trmination dat of th agrmnt is th dat of th haring official s dcision. 11. Upon trmination, th Providr will b placd on th National Disqualifid List. Onc includd in th list, a Providr will rmain on th list for svn (7) yars or until such tim as th Stat agncy dtrmins that th srious dficincis that ld to its placmnt on th list hav bn corrctd. If th Providr has an outstanding dbt to th program, h/sh will rmain on th list indfinitly or until CACFP funds hav bn rpaid. 52

Procdurs for Administrativ Rviw A. Notification: 1. Th Sponsoring Organization (SO) will snd th Providr th Notic of Proposd Trmination and Proposd Disqualification (Notic) by crtifid mail with rturn rcipts, or mail or facsimil with dlivry confirmation rcipts. Th dlivry confirmation or rturn rcipt of th Notic should b maintaind in fil. 2. Th Notic will inform th Providr, in writing, of: (1) th actions and th grounds on which th dcision to propos to trminat and disqualify th Providr was basd; and (2) his/hr right to appal. B. Appal Rqust: 1. Th SO must rciv th writtn appal rqust from th Providr no latr than svn (7) calndar days from th dat th Providr rcivd th Notic. Th Providr can snd th appal rqust by rgular mail, crtifid mail, mail, or facsimil. 2. Th SO will acknowldg rcipt of th appal rqust to th Providr within thr (3) calndar days from rcipt of th appal rqust and submit copis to ISBE and th Administrativ Rviw Official (ARO). Th acknowldgmnt lttr must indicat th dat that th appal rqust was rcivd. Th lttr must also includ th nam and addrss of th ARO. Th acknowldgmnt lttr must b snt by crtifid mail with a rturn rcipt, or mail or facsimil with dlivry confirmation. 3. Th SO will mak copis of th appal rqust and attach ths to th acknowldgmnt lttr that will b snt to ISBE and th ARO. 4. Th SO will nsur that a copy of th Proposd Trmination and Disqualification is snt to th ARO including any dirct attachmnts to th issus, and any list of supporting documntation with pag counts no latr than thr (3) calndar days aftr rcipt of th appal rqust lctronically, if possibl. No additional documntation will b accptd by th ARO aftr th du dat. 5. Th providr may rfut th chargs by showing that th information th sponsor has is incorrct. Th Providr may submit supporting documntation dirctly to th ARO. Th documntation must b rcivd by th ARO within svn (7) calndar days that h/sh rcivd th acknowldgmnt lttr from th SO. No additional documntation will b accptd aftr th du dat. If th ARO nds additional documntation or clarification, th ARO will contact th Providr. 6. In th cas of an in-prson haring, failur of th Providr to appar at th schduld haring will forfit th providr s right to appal. 7. Th Providr may rprsnt himslf/hrslf, may b rprsntd by anothr prson, or may rtain lgal counsl. 8. Upon rcipt of th acknowldgmnt lttr from th SO, ISBE will snd an mail to th ARO which will includ th contact information for th Providr and th SO. Th mail will also includ th du dat of th appal dcision. 53

9. If th du dat falls on a wknd or a holiday, th nxt businss day will b th du dat. C. Appal Procss 1. Th ARO will mak a dcision basd solly on information providd by th SO, th Providr, and on program rgulations, fdral and stat laws, and procdurs govrning th CACFP. 2. Each SO will hav a dsignatd contact and/or an altrnat contact prson for any qustions th ARO may hav. 3. Th ARO will issu a writtn final dcision to th Providr, th SO s xcutiv dirctor, and ISBE within thirty fiv (35) calndar days from th tim th SO rcivd th appal rqust from th Providr. 4. If th du dat falls on a wknd or a holiday, th nxt businss day will b th du dat. 5. Th Providr may continu to oprat during an appal of proposd trmination unlss thr is vidnc of imminnt thrat or dangr to th halth or wlfar of th childrn. 6. Providrs continuing to oprat whil appaling th proposd trmination will b rimbursd for any ligibl mals srvd during th priod of th appal. 7. During th priod of th rviw by th ARO, th SO will not tak action to collct or offst any ovrpaymnt notd in th trmination lttr. 8. Aftr th final dcision has bn issud, th ARO will snd all documnts usd in issuing th dcision (Appal Rcord) to th SO. Th ARO will also snd notification to ISBE that th Appal Rcord has bn snt. 9. Th dcision by th ARO is th final administrativ dtrmination to b affordd th Providr. 10. If th Providr loss th appal, th trmination dat of th agrmnt is th dat of th haring official s dcision. 11. Upon trmination, th Providr will b placd on th National Disqualifid List. Onc includd in th list, a Providr will rmain on th list for svn (7) yars or until such tim as th Stat agncy dtrmins that th srious dficincis that ld to its placmnt on th list hav bn corrctd. If th Providr has an outstanding dbt to th program, h/sh will rmain on th list indfinitly or until CACFP funds hav bn rpaid. D. Appal Procdurs- Notic of Suspnsion Whnvr a family day car hom sponsoring organization suspnds th participation of a Providr for imminnt thrat to th safty or halth of childrn, th Providr must b notifid both vrbally and in writing that its participation has bn suspndd, that th day car hom is sriously dficint, and that th sponsoring organization proposs to trminat th Providr s agrmnt for caus. Th notification in writing must b snt by crtifid mail via Unitd Stats Postal Srvic. 54

1. Th notic must spcify th srious dficincy(is) found and of th providr s opportunity for an appal of th proposd trmination. 2. Th writtn notic must inform th providr that participation, including all paymnts, will rmain suspndd until th appal is conductd. 3. Th writtn notic must inform th providr that if th ARO ovrturns th suspnsion, th providr may claim rimbursmnt for ligibl mals srvd during th suspnsion. 4. Th writtn notic must inform th providr that trmination of th agrmnt will rsult in bing listd on th National Disqualifid List. Th providr will rmain on this list for a priod of svn (7) yars unlss th providr ows mony, in which cas th providr will rmain on th list indfinitly or until CACFP funds hav bn rpaid. 5. Stat that if th providr sks to voluntarily trminat its agrmnt aftr rciving th Notic of Proposd Trmination, th providr will still b trminatd for caus and placd on th National Disqualifid List. 6. Th sam appal procdurs apply to thos providrs who ar issud a Notic of Suspnsion du to halth and safty issus [7 CFR 226.16(l)(2)(vi)]. 55

1117 Placmnt on th National Disqualifid List Providrs trminatd and disqualifid through th Srious Dficincy and Suspnsion of Participation procsss, will b placd on th National Disqualifid List [7 CFR Part 226.6(c)(7)(iv)(A)]. Whil on th list, th providr will not b abl to participat in th CACFP as a day car hom providr. In addition, th providr will not b abl to srv as a principal (hold a managmnt position or b an officr) in any CACFP institution or facility. Th providr will rmain on th list until such tim as ISBE dtrmins that: 1. Th conduct that was th basis for th srious dficincis has bn prmanntly corrctd, or 2. It has bn svn (7) yars from th dat of trmination and disqualification, and 3. Th providr has rpaid all funds rcivd for which h/sh was not ligibl. If any dbt rlating to th srious dficincis has not bn rpaid, th providr will rmain on th list until th dbt has bn rpaid. Th stat agncy and th sponsor will b abl to accss th databas to nsur providrs trminatd from th program ar not approvd for participation in th CACFP. Sponsors ar prohibitd from ntring into an agrmnt with any providr who has bn trminatd and disqualifid and is currntly on th National Disqualifid List. 56

1118 Guidlins for R-Entry to th Child and Adult Car Food Program Pr Child and Adult Car Food Program (CACFP) fdral rgulation 7 CFR Part 226.6(c)(7)(vi), onc includd on th National Disqualifid List (NDL) a trminatd day car hom providr will rmain on th NDL until such tim as th Stat agncy (Illinois Stat Board of Education) dtrmins that th srious dficincy(is) that ld to its placmnt on th NDL has(v) bn corrctd, or until svn yars hav lapsd sinc its agrmnt was trminatd for caus. Howvr, th providr will not b rmovd from th NDL until all dbt in th program is rpaid. Aftr th Stat agncy dtrmins th day car hom providr should b rmovd from th NDL, th Stat agncy will mak a rqust in writing to th Unitd Stats Dpartmnt of Agricultur Food and Nutrition Srvic (USDA-FNS) Midwst Rgional Offic for th day car hom providr s rmoval from th NDL. Upon rcipt of th USDA s approval of th rqust, th Illinois Stat Board of Education (ISBE), th sponsoring organization of choic, and th r-ntring providr assum th following rsponsibilitis: ISBE Providr Sponsoring Organization Must complt all CACFP Must nsur that providr has all application rquirmnts to th ncssary rquirmnts for participat again in th r-participation in th program program Will notify th day car hom providr in writing of its rmoval, including th rmoval dat as spcifid by USDA- FNS Midwst Rgional Offic Will nsur r-ntring providr is licnsd by th Dpartmnt of Childrn and Family Srvics (DCFS) or th Dpartmnt of Human Srvics (DHS) Will contact th sponsoring organization chosn by th providr to inform thm of thir rsponsibilitis for th rntring providr Stat monitor will conduct a visit during th 12-month startup priod to nsur that th srous dficincis that placd th providr on th NDL ar prmanntly corrctd Has th option to pick th sponsoring organization of his/hr choic Will inform ISBE of th sponsoring organization th providr has chosn bfor ntring into an agrmnt Th sponsor that placd th providr on th NDL is not obligatd to sign an agrmnt with th providr again Must prsnt to ISBE a uniqu monitoring plan to implmnt for th r-ntring providr. Th plan will includ but is not limitd to: - Conducting th first visit not latr than two wks aftr providr participats again in th program - During th 12-month opration, if th providr committd th sam srious dficincis that placd th providr on th NDL, th providr will b immdiatly proposd for trmination and disqualification - Othr srious dficincis during th 12-month priod and byond will b addrssd with th normal Sriously Dficint Procss - Sponsor should not sign-up a r-ntring providr without prior approval from ISBE 57

S A M P L E O N L Y Dat: MONITORING PLAN for R-Entring Providrs R-Entring Providr s Nam: Sit Numbr (Us ISBE numbr): Rason(s) providr was placd on th National Disqualifid List: (Rfr to th lttr snt by ISBE rgarding this providr): (ISBE rquirs that a rviw b conductd no latr than two wks aftr th Providr starts participating in th Program). Anticipatd Start Dat (as approvd by ISBE): Rviw to b conductd on or bfor: Plan of Action: Assignd Fild Monitor: Effctiv dat of this plan: Submittd by: (Nam of Sponsoring Organization) (Contact Prson) (Titl) CC: Fild Monitor 58

1120 SERIOUS DEFICIENCY LOG A sponsoring organization must includ in thir prmannt managmnt plan a Srious Dficincy Log. This log must show th following itms in ordr for th Illinois Stat Board of Education to vrify if its rcords ar in agrmnt with th sponsoring organization s rcords. Th Srious Dficincy Log must consist of th following: 1) Providr s Nam (includ alias, if applicabl) 2) Dat of Birth 3) Addrss (P.O. Box not accptabl) 4) Dat of Srious Dficincy Notic 5) Dat of Tmporary Dfrmnt of th Srious Dficincy 6) Dat of Notic of Proposd Trmination and Proposd Disqualification 7) Dat Appal Tmporarily Dfrrd Action 8) Dat of Trmination 9) Amount Owd (if any) 59

1121 ADDENDUM Th following pags wr rvisd to rflct som additions, dltions, and othr changs: 1). Sampl Lttr 2/1114 Notic of Srious Dficincy. Dltd statmnt undr Summary, third paragraph, first statmnt, thn an unannouncd followup rviw will b conductd to vrify th adquacy of th corrctiv action, and addd, w will tmporarily dfr th srious dficincy. 2). Sampl Lttr 3/1114 Succssful Corrctiv Action, Tmporary Dfrmnt of Srious Dficincy Undr Srious Dficincy Dtrmination Tmporarily Dfrrd, first paragraph, dltd, and th rsults of an unannouncd Follow-up rviw conductd on.. 60