Dss Form 3306 PDF Details

In efforts to ensure children in less privileged communities receive nutritious meals during the summer months when school programs are on hiatus, the South Carolina Department of Social Services initiates the Summer Food Service Program for Children (SFSP), operationalized through essential instruments like the DSS Form 3306. This pivotal form, requiring completion in duplicate for each feeding site managed by an applicant, acts as a lifeline that connects eligible children to the sustenance they need. With its detailed sections spanning site information, sponsor details, the logistical dimensions of meal service, and eligibility documentation among others, DSS Form 3306 meticulously gathers all necessary data to facilitate the program's successful conduct. By covering aspects such as the type of site (ranging from open sites to licensed day care centers), documentation for establishing economic need, operational dates, meal service logistics, and policies for indoor or outdoor feeding under varying weather conditions, this form underpins the operational framework for delivering meals to children. Additionally, it emphasizes compliance with federal guidelines by mandating the inclusion of non-discrimination clauses, thereby ensuring that every child, irrespective of their background, has access to food services. Through requiring applicants to certify the truthfulness of the information provided, the form also aligns with broader accountability mechanisms overseeing the disbursement of federal funds for social services. Furthermore, its structure accommodates a diverse array of meal service arrangements, highlighting the program's adaptability in meeting the nutritional needs of children across different settings — from schools to camps and beyond.

QuestionAnswer
Form NameDss Form 3306
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesJAN, SCDSS, SMSA, YY

Form Preview Example

Total No. of Eligible Children Participating: (Estimate)
B. Operating Days of the Week:

South Carolina Department of Social Services

Summer Food Service Program for Children (SFSP)

SITE INFORMATION APPLICATION

Instructions: Complete in duplicate for each feeding site which will be administered by the applicant. Attach one copy to DSS Form 1625, “Sponsor Application for Participation.” Retain a copy for your file. If more space is needed, continue on a plain sheet of paper, numbering each item and attach to the Site Application. A Site Information Application must be submitted and approved before meals served at the site are eligible for reimbursement.

1.

Name of Sponsor:

 

 

Agreement Number:

 

 

Site Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the site located in a

Is the site located in a rural

 

 

 

 

 

 

 

 

standard metropolitan

pocket within SMSA?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

statistical area (SMSA)?

 

 

 

 

 

 

 

 

 

 

 

 

Yes

No

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

Name and Address of Food Service Site: (Include Zip Code)

 

 

Name of Site Supervisor: (If unknown at this time, provide

 

 

 

 

 

 

 

 

to SCDSS Office prior to beginning of operation.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

County in Which Site is Located:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Did this site participate in any prior year’s Summer Food Service Program?

Yes

No

 

 

 

 

 

If yes, list name of sponsor and year of participation:

 

 

 

 

 

 

 

 

 

 

 

4. Indicate other USDA programs in which the site participates.

None

National School Lunch

School Breakfast

(Sites in the Special Milk Program (SMP) are not eligible for the SFSP.)

Child/Adult Care Food

Food Distribution

SMP

5.Type of Site: (Check all that apply.)

A.

Open Site

C.

Migrant Site

E.

Enrolled Site

G. Homeless Site

B.

Residential Camp

D.

Nonresidential Camp

F.

NYSP Site

H. Licensed Day Care Center/Home

6.If the answer to item 5 is “A” or “C” please check one of the following to document that the local areas from which the site draws its attendance are areas in which poor economic conditions exist, as defined by the program regulations.

Documentation from public or nonprofit private schools located nearest the site. Name of School:

Documentation from departments of welfare, education or zoning commissions. Documentation from organization determined by the state agency as a migrant organization. Census tract information.

Documentation attached or indicate the year the above documentation was submitted:

7.If the answer to item 5 is “B”, “D” or “E”:

(a)Attach a copy of the form that is or will be used to document each enrolled child’s eligibility for reduced-price school meals.

(b)For camps only, indicate the number of children eligible for reduced-price meals and the total number of children partici -

pating at this site for each session. (If this information is unavailable at this time, it must be provided to the SCDSS prior to the submission of the Claim for Reimbursement for each session.)

Total No. of Children Participating: (Estimate)

8. A. Period of Operation of Food Service:

Beginning

Closing

 

Number of Operating Days

 

 

 

Date

Date

 

 

 

 

 

 

(MM/DD/YY)

(MM/DD/YY)

May

Jun

July

Aug

Sep

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Check each day that this site will operate, and if a camp, attach a copy of your camping schedule.)

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

C. Indicate date(s) this site will be closed:

DSS Form 3306 (JAN 01) Edition of FEB 00 is obsolete.

Sponsor:

 

 

Site:

 

 

 

Approval Status:

 

 

Initials:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9. A. Describe the Meal Service Area:

 

 

 

 

 

 

 

 

 

 

How many children can eat at this site at one time?

 

 

Is there shift feeding?

Yes

No

B.Describe the Meal Service:

Instructions:

All applicants should complete this section. All Sponsors applying for camps should only list the number of eligible children to be served daily for which reimbursement for meals will be claimed under the Summer Food Service Program.

Types of Meals

Estimated Total

Estimate Number

Time of

For SCDSS Use:

Meal Service

to be Served

of Children

of Eligible Children

Approved Level of

 

 

 

 

to be Served

(Camps Only)

Begins

Ends

Meal Service

 

 

 

 

 

 

 

Breakfast

 

 

 

 

 

 

 

 

 

 

 

 

Snack:

AM

 

 

 

 

 

 

 

 

 

 

 

PM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lunch

 

 

 

 

 

Supper

C. Monitoring Schedule:

Pre-Operational Visit

First Week Review

Site Review

Dates:

10. A. How will meals be prepared for this site? (Check One)

 

 

Self-Preparation on Site

Agreement with School Food Service Authority

Sponsor Preparation at Central Kitchen Facility

Contract with Food Service Management Company

Sponsor Preparation at a School Food Service Facility

Other:

 

B. The Holding of Meals Until the Time of Meal Service: (Check One)

Served at Time of Delivery

Held in Refrigerator on Site

Served Within One Hour of Delivery

Other:

 

C. The Storage and Refrigeration of Excess Meals Until the Next Day or the Return of Excess Meals to the Vendor: (If Applicable)

Refrigerate Until the Next Day

Return to Sponsor

Other:

 

 

 

 

 

 

 

 

 

11. A. Is this site an indoor or outdoor site? (Check Appropriate Box)

Indoor

Outdoor

B. If an outdoor site, what is your policy for serving meals when weather prevents the outdoor service of meals?

Meal service will be cancelled.

Meals will be served at the following location:

Address:Description:

Note: Leaving meals with the children is not an option.

C. Is there a regularly scheduled activity?

Yes

No

If yes, list the types of activities provided or attach a schedule of daily activities.

I certify that this site has been visited and that the information on this form and subsequent attachments is true and correct to the best of my knowledge. I understand that this information is being given in connection with the receipt of federal funds and that deliberate misrepresentation may subject me to prosecution under applicable state and federal criminal statutes. The Program must be made available to all children regardless of sex, age, disability, race, color, religion or national origin.

 

Name and Title of Authorized Sponsor Representative (Please Print)

 

 

 

 

 

 

 

 

 

Signature of Authorized Sponsor Representative

Date

 

 

 

 

 

 

DSS Form 3306 (JAN 01) Edition of FEB 00 is obsolete.

PAGE 2

 

 

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The way to fill out South_Carolina stage 1

2. The third step would be to complete these fields: If the answer to item is A or C, draws its attendance are areas in, Name of School, cidcidcidcid Documentation from, Documentation attached or indicate, If the answer to item is B D or E, a Attach a copy of the form that, pating at this site for each, Total No of Children Participating, Total No of Eligible Children, A Period of Operation of Food, B Operating Days of the Week, Beginning Closing, Date Date, and Number of Operating Days.

a Attach a copy of the form that, cidcidcidcid Documentation from, and B Operating Days of the Week in South_Carolina

People often get some points incorrect when filling out a Attach a copy of the form that in this section. You need to revise everything you type in here.

3. The following part should be quite easy, Sponsor, Site, Approval Status, Initials, A Describe the Meal Service Area, How many children can eat at this, B Describe the Meal Service, Instructions All applicants should, Types of Meals, Estimated Total, to be Served, of Children to be Served, Estimate Number of Eligible, Camps Only, and Time of - all these fields will have to be completed here.

Approval Status, to be Served, and Camps Only inside South_Carolina

4. This next section requires some additional information. Ensure you complete all the necessary fields - B The Holding of Meals Until the, cidcidcidcid Served at Time of, cidcidcidcid Held in Refrigerator, C The Storage and Refrigeration of, cidcidcidcid Refrigerate Until the, cidcidcidcid Return to Sponsor, A Is this site an indoor or, B If an outdoor site what is your, cidcidcidcid Meal service will be, Address, Description, Note Leaving meals with the, C Is there a regularly scheduled, and If yes list the types of - to proceed further in your process!

The way to fill out South_Carolina step 4

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South_Carolina completion process explained (step 5)

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