Form H1654 PDF Details

In the realm of Texas adult day care centers, the H1654 form serves as a crucial tool for ensuring that daily nutritional needs are met and documented in compliance with state requirements. Introduced by the Texas Department of Agriculture in February 2008, this form is designed to meticulously record the daily menu provided to adults in care facilities. It facilitates a structured approach to meal planning and reporting, covering multiple meals and snacks throughout the day including breakfast, AM snack, lunch, PM snack, supper, and an evening snack. The form requires detailed information about the meal type, menu, food items used, the amount prepared, leftovers, and the number of individuals served, making a distinction between enrolled program adults and non-program adults. This structured documentation is vital for maintaining the quality and quantity of food served in these centers, ensuring a balanced diet is provided, and meeting the regulatory standards set forth for adult care facilities. Furthermore, the allowance for reporting leftovers, exclusive to programs that offer versus serve, adds a layer of flexibility and efficiency in managing food resources. The comprehensive nature of the H1654 form underscores its importance in the daily operations of adult day care centers, laying a foundation for health and wellness through meticulous meal planning and reporting.

QuestionAnswer
Form NameForm H1654
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesContracting, texas department of agriculture form h1654, servings, TX

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Texas Department of

Adult Day Care Centers

Form H1654

Agriculture

Daily Menu Record

February 2008

Name of Contracting Organization

Name of Facility

Program (TX) No.

TX -

Date

1.

Meal Type

Food Components

2.

Menu

3.

Food Items Used

4.

Amount

Prepared

5.

Leftovers*

6.Number Served Enrolled Program Non-prog. Adults Adults Adults

Breakfast

1.Milk

2.Vegetables/Fruits

3.Grains/Breads (2 servings required)

Number of Complete Seconds

AM Snack (choose 2)

1.Milk

2.Vegetables/Fruits

3.Grains/Breads

4.Meat/Meat Alternates

Number of Complete Seconds

Lunch

1.Milk

2.Vegetables/Fruits (two or more)

3.Grains/Breads (two servings required)

4.Meat/Meat Alternates

Number of Complete Seconds

* Only programs using Offer vs. Serve may use leftovers.

continued on page 2

Form H1654

Page 2/02-2008

Adult Day Care Centers

Daily Menu Record (continued)

1.

Meal Type

2.

Menu

3.

Food Items Used

4.

Amount

5.

Leftovers*

6.Number Served Enrolled Program Non-prog. Adults Adults Adults

PM Snack (choose 2)

1.Milk

2.Vegetables/Fruits

3.Grains/Breads

4.Meat/Meat Alternates

Number of Complete Seconds

Supper

1.Vegetables/Fruits (two or more)

2.Grains/Breads (two servings required)

3.Meat/Meat Alternates

Number of Complete Seconds

Evening Snack (choose 2)

1.Milk

2.Vegetables/Fruits

3.Grains/Breads

4.Meat/Meat Alternates

Number of Complete Seconds

* Only programs using Offer vs. Serve may use leftovers.