MAINE Department of Education	
CHILD NUTRITION PROGRAMS	
	SCHOOL NUTRITION PROGRAM 
AFTER SCHOOL SNACK SITE MONITORING REVIEW	

Review must be completed twice per year.  The first review must occur within the first 4 weeks of snack service.  Maintain form locally.

AGENCY/DISTRICT:

DATE OF FIRST REVIEW:

DATE OF SECOND REVIEW:

SITE/SCHOOL: | ARRIVAL TIME:
SITE STAFF RESPONSIBLE FOR MEAL COUNTS: | DEPARTURE TIME:
What time does school end? | What time are snacks served?
Today’s Snack Menu (Record All Food Items Served and Serving Sizes)
| YES | NO

1.   Are the snacks claimed only in approved after school programs?  
      Specify the after school program(s):

2.   If the site has less than 50% free/reduced price eligible, does the after school program have the appropriate applications and rosters on file so all snacks are correctly claimed categorically? | |
3.   Is there an accurate point of service accountability for counting snacks? | |

4.  How many snacks are provided on the day of the visit?  ______________
     What is the reviewer’s count on the day of the visit? _______________   
     If there are significant differences in the counts, why is this occurring?

5.	Does the site have an appropriate and accurate system to document daily attendance? | |
6.   Does the snack menu meet the snack meal pattern requirements? | |
6.   Do all snacks claimed for reimbursement on the day of visit meet meal pattern requirements? | |
7.	Is corrective action required? | |
8.   If you answered YES to question #7, what is the corrective action?  When will it be corrected and by whom?  Explain: | |

Monitor’s Name | Date of Review
Monitor’s Signature | Monitor’s Title