WestVirginiaChildandAdultCareFoodProgram
On‐SiteProductionRecord
Actual Number Served
Bkfst
AM
Snack
Lunch
PM
Snack
Supper
EVE
Snack
NameofSponsor/Site:
Date(Day/Month/Year):
1–2Years:
Completedby:
3–5Years:
Requirements:
1.
Menusmustbemaintainedonaseparatedocument;
2.
Menusandproductionrecordsmustmatchandreflectactualmealservice.
6–12Years:
TotalMealsServed:
(#
)NumberofChildrenPlannedforMinimumServingSize/TotalAmountNeeded
Total
Amount
Prepared
Amount
Leftover
1–2Years 3–5Years 6–12Years
Components MenuItems
#of
Children
Serving
Size
Total
Amount
Needed
#of
Children
Serving
Size
Total
Amount
Needed
#of
Children
Serving
Size
Total
Amount
Needed
Breakfast
3components
Milk
Whole
1%orSkim
Fruit/Vegetable
Grain/Bread
Meat/MeatAlternate
Other:
Lunch/Supper
5components
Milk
Whole
1%orSkim
Vegetable
Fruit
Grain/Bread
Meat/MeatAlternate
Other:
AM/PMSnacks
2components
Milk
Whole
1%orSkim
Vegetable
Fruit
Grain/Bread
Meat/MeatAlternate
Other:
WVDEOCNRevisedSummer2016
Notes:
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