Spreadsheet: 0090f0d7-682c-4fa5-bb20-9afb6369198b
Sheet: Sheet1

Is Your NON-dairy Beverage allowed for Use in CACFP?
 |  |  |  |  |  | Beverage Name ____________________________________________
Institution/Facility Name |  |  |  |  |  |  |  |  | Agreement # |  |  |  |  | Date Completed
Locate Nutrition facts label on Non-dairy beverage container.  (Look for a label similar in appearance to label below on the left.)
Record the name of Non-dairy beverage under page title.
Record in column 5 the percentage of Daily Value (DV) of each nutrient from the nutrition facts label.  If values are already shown as grams, milligrams, micrograms
or International Units, enter the number in column 6.  You may need to double click in your computer.
Calculate the numeric value of each nutrient by multiplying the Daily Value in column 2 by the percentage on the label.  Example: If you recorded 30% DV for
Calcium in column 5, then multiply 1000 mg x 0.30 to equal 300 mg.  Record 300 mg in column 6.
Compare results of column 6 to column 8.  If all amounts equal or exceed the numbers in column 8, the non-dairy beverage is acceptable for CACFP use.  If all
 | numbers are not equal to or exceed the value of column 8, the product may not be used.
Keep copy of product label and copy of this worksheet to support your non-dairy beverage choice only if your beverage meets the requirements.
 |  |  |  |  |  | Column 1 | Column 2 | Column 3 | Column 4 | Column 5 | Column 6 | Column 53 | Column 7 | Column 8 | Column 9 | Column 10
 |  |  |  |  |  | Nutrient | Daily Value* | Unit | Percentage | Percentage | Enter | calculate | Nutrient | Non-Dairy Beverage | Units per | Meets
 |  |  |  |  |  |  |  |  |  | Value | Nutrient | B x E | Data | Allowed Nutritional | 8 oz Cup | Equivalency?
 |  |  |  |  |  |  |  |  |  |  | Data |  | Equivalent | Equivalency**
 |  |  |  |  |  |  |  |  |  | INPUT | INPUT
 |  |  |  |  |  | Calcium | 1000 | mg | % DV = |  |  |  |  | 276 | mg per 8 oz.
 |  |  |  |  |  | Magnesium | 400 | mg | % DV = |  |  |  |  | 24 | mg per 8 oz.
 |  |  |  |  |  | Phosphorus | 1000 | mg | % DV = |  |  |  |  | 222 | mg per 8 oz.
 |  |  |  |  |  | Potassium | 3500 | mg | % DV = |  |  |  |  | 349 | mg per 8 oz.
 |  |  |  |  |  | Protein | 50 | g | % DV = |  |  |  |  | 8 | g per 8 oz.
 |  |  |  |  |  | [NAME] | 1.7 | mg | % DV = |  |  |  |  | 0.44 | mg per 8 oz.
 |  |  |  |  |  | Vitamin A | 5000 | IU | % DV = |  |  |  |  | 500 | IU per 8 oz.
 |  |  |  |  |  | [NAME] | 6 | mcg | % DV = |  |  |  |  | 1.1 | [NAME] 8 oz.
 |  |  |  |  |  | Vitamin D | 400 | IU | % DV = |  |  |  |  | 100 | IU per 8 oz.
 |  |  |  |  |  |  |  |  | YOUR PRODUCT MEETS THE REQUIREMENTS?
g=grams, mg=milligrams, [NAME]micrograms, IU=International Units
*This Daily Value based on caloric intake of 2,000 calories.  Taken from FDA Appendix F, Guidance for Industry.
** 7 C.F.R. 210.10(m) (3)
Note: At the time of this printing, 8th Continent Original Soymilk qualified as an acceptable non-dairy beverage for CACFP use.  Please be aware that manufacturers
may change formulas at any time.  Check the Nutrition Facts regularly for any changes in Daily Values.
(Sample) Is Your NON-dairy Beverage allowed for Use in CACFP?
 |  |  |  |  |  | Beverage Name ____________________________________________ |  | 8th Continent Original Soymilk___________
Institution/Facility Name_Kid time Daycare Center__          Agreement # _0000               Date Completed __December 16, 2011
Locate Nutrition facts label on Non-dairy beverage container.  (Look for a label similar in appearance to label below on the left.)
Record the name of Non-dairy beverage under page title.
Record in column 5 the percentage of Daily Value (DV) of each nutrient from the nutrition facts label.  If values are already shown as grams, milligrams, micrograms
or International Units, enter the number in column 6.  You may need to double click in your computer.
Calculate the numeric value of each nutrient by multiplying the Daily Value in column 2 by the percentage on the label.  Example: If you recorded 30% DV for
Calcium in column 5, then multiply 1000 mg x 0.30 to equal 300 mg.  Record 300 mg in column 6.
Compare results of column 6 to column 8.  If all amounts equal or exceed the numbers in column 8, the non-dairy beverage is acceptable for CACFP use.  If all
numbers are not equal to or exceed the value of column 8, the product may not be used.
Keep copy of product label and copy of this worksheet to support your non-dairy beverage choice only if your beverage meets the requirements.
 |  |  |  |  |  | Column 1 | Column 2 | Column 3 | Column 4 | Column 5 | Column 6 | Column 53 | Column 7 | Column 8 | Column 9 | Column 10
 |  |  |  |  |  | Nutrient | Daily Value* | Unit | Percentage | Percentage | Enter | calculate | Nutrient | Non-Dairy Beverage | Units per | Meets
 |  |  |  |  |  |  |  |  |  | Value | Nutrient | B x E | Data | Allowed Nutritional | 8 oz Cup | Equivalency?
 |  |  |  |  |  |  |  |  |  |  | Data |  | Equivalent | Equivalency**
 |  |  |  |  |  |  |  |  |  | INPUT | INPUT
 |  |  |  |  |  | Calcium | 1000 | mg | % DV = | 0.3 |  | 0 | 300 mg | 276 | mg per 8 oz. | YES
 |  |  |  |  |  | Magnesium | 400 | mg | % DV = | 0.06 |  | 0 | 24 mg | 24 | mg per 8 oz. | YES
 |  |  |  |  |  | Phosphorus | 1000 | mg | % DV = | 0.25 |  | 0 | 250 mg | 222 | mg per 8 oz. | YES
 |  |  |  |  |  | Potassium | 3500 | mg | % DV = |  | 360 | 0 | 360 mg | 349 | mg per 8 oz. | YES
 |  |  |  |  |  | Protein | 50 | g | % DV = |  | 8 | 0 | 8 g | 8 | g per 8 oz. | YES
 |  |  |  |  |  | [NAME] | 1.7 | mg | % DV = | 0.3 |  | 0 | 0.51 mg | 0.44 | mg per 8 oz. | YES
 |  |  |  |  |  | Vitamin A | 5000 | IU | % DV = | 0.1 |  | 0 | 500 IU | 500 | IU per 8 oz. | YES
 |  |  |  |  |  | [NAME] | 6 | mcg | % DV = | 0.2 |  | 0 | 1.2 mcg | 1.1 | [NAME] 8 oz. | YES
 |  |  |  |  |  | Vitamin D | 400 | IU | % DV = | 0.25 |  | 0 | 100 IU | 100 | IU per 8 oz. | YES
 |  |  |  |  |  |  |  |  | YOUR PRODUCT MEETS THE REQUIREMENTS?
 |  |  |  |  |  |  |  |  |  | YES
g=grams, mg=milligrams, [NAME]micrograms, IU=International Units
*This Daily Value based on caloric intake of 2,000 calories.  Taken from FDA Appendix F, Guidance for Industry.
** 7 C.F.R. 210.10(m) (3)
Note: At the time of this printing, 8th Continent Original Soymilk qualified as an acceptable non-dairy beverage for CACFP use.  Please be aware that manufacturers
may change formulas at any time.  Check the Nutrition Facts regularly for any changes in Daily Values.