Meal Pattern Waiver Submission (updated November 2020)

United States Department of Agriculture (USDA) has extended the nationwide waiver to waive the requirements to serve meals that meet the meal pattern requirements for the National School Lunch Program (NSLP)/School Breakfast Program (COVID-19: Child Nutrition Response #36) through June 30, 2021 and for the Summer Food Service Program (SFSP)/Summer Seamless Option (SSO) (COVID-19: Child Nutrition Response #63) through June 30, 2021. Program operators are expected and strongly encouraged to maintain and meet nutrition standards for each Program to the greatest extent possible.

Complete the fields below to submit a meal pattern waiver for the Program currently being operated. Program operators must indicate what food components/meal pattern requirements were not met for a specific timeframe.

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* 1. For which Child Nutrition Program is the waiver submitted?

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* 2. For what TIMEFRAME are you submitting this waiver?
If submitting a waiver for a single instance of not meeting a daily meal pattern requirement, the start date and end date selected will both be the same date.

Start Date (MM/DD/YYYY)

Date

End Date (MM/DD/YYYY)

Date

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* 3. SFA/Sponsor Name:

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* 4. Community Organization Name:

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* 5. Operator First and Last Name:

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* 6. Operator Title:

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* 7. Meal pattern waiver requested for Breakfast. (Select all that apply)

Milk not present

Milk variety or fat content not met

Fruit not present or insufficient quantity

More than half of the weekly fruit requirement served was 100% juice

Grain not present or insufficient quantity

Whole grain-rich weekly requirement not met

Age/Grade Group requirement not met

Target 2 Weekly Sodium requirement not met

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* 8. Meal pattern waiver requested for Lunch/Supper (At-Risk). (Select all that apply)

Milk not present

Milk variety or fat content not met

Fruit not present or insufficient quantity

More than half of the weekly fruit requirement served was 100% juice

Vegetable not present or insufficient quantity

Vegetable subgroup weekly requirement not met

Meat/Meat Alternate not present or insufficient quantity

Grain not present or insufficient quantity

Whole grain-rich weekly requirement not met

Age/Grade Group requirement not met

Target 2 Weekly Sodium requirement not met

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* 9. Meal pattern waiver requested for snack (ASCSP/At-Risk).

Component not present or insufficient quantity

Please specify missing/insufficient component below:

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* 10. Please indicate the reason(s) for submitting the waiver. (Check all that apply)

Item(s) not available for purchase (must describe efforts taken to serve alternative food items below)

Purchased item(s) cannot be delivered (must describe efforts taken to serve alternative food items below)

Purchased item(s) cannot be delivered timely (must describe efforts taken to serve alternative food items below)

Inability to meet the National School Lunch Program meal pattern due to court ruling (must provide justification below)

Access to safe and nutritious food impacted by a learning plan/food service model (must describe learning plan/food service model below)

Meal Pattern Waiver Submission (updated November 2020)

Question Title

* 1. For which Child Nutrition Program is the waiver submitted?

Question Title

* 2. For what TIMEFRAME are you submitting this waiver? If submitting a waiver for a single instance of not meeting a daily meal pattern requirement, the start date and end date selected will both be the same date.

Question Title

* 3. SFA/Sponsor Name:

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* 4. Community Organization Name:

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* 5. Operator First and Last Name:

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* 6. Operator Title:

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* 7. Meal pattern waiver requested for Breakfast. (Select all that apply)

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* 8. Meal pattern waiver requested for Lunch/Supper (At-Risk). (Select all that apply)

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* 9. Meal pattern waiver requested for snack (ASCSP/At-Risk).

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* 10. Please indicate the reason(s) for submitting the waiver. (Check all that apply)

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* 11. Please provide justification below to support the reason(s) for the waiver.

* 2. For what TIMEFRAME are you submitting this waiver?
If submitting a waiver for a single instance of not meeting a daily meal pattern requirement, the start date and end date selected will both be the same date.