Daily Meal Count Sheet - California Department of Education



California department of education Field Services Unit

NUTRITION SERVICES DIVISION AUGUST 2008

DAILY MEAL COUNT SHEET

(Meal count by client)

Agency Name: Site Name: Month & Year:

Mark an "X" to indicate the client was served a complete meal. Leave the box blank if no meal was served to the client.

Take and record meal count only after meals have been served, during or at the conclusion of each meal service. Enter staff meals on "Staff Meal Count” form.

| |1 |2 |3 |4 |5 |6 |7 |8 |9 |10 |11 |12 |13 |14 |15 |16 |17 |18 |19 |20 |21 |22 |23 |24 |25 |26 |27 |28 |29 |30 |31 | | |Client Name |B | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |L | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |School Attended |S1 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |D | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Client Name |B | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |L | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |School Attended |S1 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |D | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Client Name |B | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |L | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |School Attended |S1 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |D | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Client Name |B | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |L | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |School Attended |S1 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |D | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Client Name |B | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |L | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |School Attended |S1 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |D | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Client Name |B | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |L | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |School Attended |S1 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |D | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Total | |TOTAL BREAKFAST | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |TOTAL LUNCH | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |TOTAL SNACK* | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |TOTAL DINNER | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |1 Snacks may only be claimed on days the client has participated in the supervised scheduled after-school enrichment activity.

Use letter codes to indicate type of non-school day: W = Weekend; V= Vacation; H= Holiday; I = In-service day

California department of education Field Services Unit

NUTRITION SERVICES DIVISION AUGUST 2008

STAFF MEAL COUNT SHEET

Agency Name: Site Name: Month & Year:

Take and record meal count only after meals have been served, during or at the conclusion of each meal service.

|1 |2 |3 |4 |5 |6 |7 |8 |9 |10 |11 |12 |13 |14 |15 |16 |17 |18 |19 |20 |21 |22 |23 |24 |25 |26 |27 |28 |29 |30 |31 |Total | |Breakfast | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Lunch | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Snack | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Dinner | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |

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