35. Reconciliation of Units: The purpose of this question is to reconcile the total number of units, by service, reimbursed from ARMS to the total number of units recorded on the ZGA- 903 (turnaround documents). With nutrition staff, reconcile a sample month of units by completing the following: F. Explain any difference between units reimbursed by ARMS (A) and adjusted units recorded (E): N.A. Yes No 36. Two individuals open, and record consumer contributions. 37. The person making deposits is different from the people counting and recording contributions. 38. Verify program income reported in ARMS: The amount of program income in ARMS for the month of is the same as the program amount in the agency's General Ledger for the same referenced date. If not, explain.
N.A. Yes No 9. Approved menu is posted in meal preparation area of nutrition site. 10. Approved menu is served on day of site visit. 11. If the approved menu is not served on day of visit, reviewer observes that caterer has sent appropriate notification of menu changes. 12. On day of visit, food prepared off-site is received by staff or a trained volunteer, who document meal arrival time and sign the delivery ticket. Food temperatures are taken and recorded if food is held in warming or refrigeration equipment prior to serving. 13. The areas where food is handled or served are clean and in good repair. 14. The Health Department sanitation permit is posted in a visible location at nutrition site. 15. Prior to serving congregate meals, home-delivered meals are individually plated, packaged, and transported immediately. 16. In general, packaging and transport equipment appears to be in good repair, and capable of maintaining food temperatures and protecting food from potential contamination. Comments? 17. If frozen meals are provided, they are dated with the date delivered to the nutrition program. 18. Note observations about food presentation and palatability based on direct experience or interactions with clients on day of site visit. 19. Note observations the perceived eligibility of clients in attendance on day of site/route visit: 20. On day of site/route visit, compare meals prepared or received, meals served, and meals unserved: ________Meals ordered ________Meals prepared or received Meals served ________Meals unserved N.A. Yes No 21. Contributions are counted and recorded at the site by two individuals. If Home delivered only, may be counted at a central office. If not, describe the procedures observed:
ATTACHMENT C: NCDAAS CLIENT RECORD REVIEW AND UNIT VERIFICATION WORKSHEET Page of CONGREGATE NUTRITION – NSIP ONLY DATE OF ASSESSMENT__________________ AGENCY__________________________________ AND YEAR REVIEWED_________________________________ Reviewer should select a random sample of clients from each Site/Route/Worker Code and include one or more special eligibility clients (if any). Attach to this worksheet the Units of Service Verification Report used to select the sample of clients and units. Identify on this report the persons sampled and the month(s) reviewed. Also attach copies of other worksheets, such as copies of the ZGA-903 or comparable document. List on the reverse side of this worksheet the clients and specific dates for which units could not be verified, if applicable. Provide a copy to the agency during the exit interview of both of this completed worksheet if unverified units are found. CLIENT NAME S/R/W Code Eligible client? If special eligibility, state documentation reviewed. Date of most recent CRF? DOA-101 CRF is complete ? CRF updated at least every 12 months? # units reported # units verified # units to be adjusted in ARMS UNITS NOT VERIFIED = Total units reported for all clients in month reviewed = THIS REPRESENTS % OF TOTAL UNITS REPORTED FOR THE MONTH REVIEWED. If 10% or more, expand sample and select another month to review. Signature of reviewer(s) Date________________________