Unhealthy Healthy Gum/Candy Machine □ Y □ N Dried or Fresh Fruit □ Y □ N Candy □ Y □ N Unsalted or Low salt Nuts/Seeds □ Y □ N Non-baked Chips □ Y □ N Baked Chips □ Y □ N Soda □ Y □ N Bottled Water □ Y □ N Alcohol □ Y □ N Other □ Y □ N Tobacco □ Y □ N □ Y □ N 3) Services Provided by Stores Service Yes/No Comment/Describe Accepts SNAP/EBT □ Y □ N Is there a sign? Inside/Outside Accepts WIC □ Y □ N Is there a sign? Inside/Outside Has Kitchen or Deli □ Y □ N Sells Heated Food □ Y □ N Sells Alcohol □ Y □ N Sells Cigarettes □ Y □ N Presence of Ad/Promotion at Food/Beverage Tobacco Alcohol At Checkout (can be seen/read) □ Y □ N □ Y □ N □ Y □ N Below Checkout level/on Floor □ Y □ N □ Y □ N □ Y □ N Hanging from ceiling □ Y □ N □ Y □ N □ Y □ N Outdoor advertising □ Y □ N □ Y □ N □ Y □ N Window advertising □ Y □ N □ Y □ N □ Y □ N What's advertised (Food/Bev ONLY) Healthy Unhealthy Signage promoting fresh produce visible from: Outside the Store? □ Y □ N □ N/A Inside the Store? □ Y □ N □ N/A 5) Is a separate section for healthy options? □ Y □ N If yes, is it visible from Front of Store? □ Y □ N 6) Is there a scale available for weighing produce? □ Y □ N 7) Please indicate of the following foods are available in the store Section A: Fruits and Vegetables Item Available? Price Visible? Comments/ Quality of Food (Note if food is rotting, damaged, or expired) □ Y □ N □ Y □ N Two types of fresh fruit □ Y □ N □ Y □ N Frozen (no sugar added) □ Y □ N □ Y □ N canned fruit (in 100% juice or water, no added sugar) □ Y □ N □ Y □ N Vegetables □ Y □ N □ Y □ N Two of fresh vegetables □ Y □ N □ Y □ N Canned veggies (no added salt) □ Y □ N □ Y □ N
frozen veggies (no added sauces) □ Y □ N □ Y □ N Is Produce Locally Grown? □ Yes □ Yes, but not all □ No, none of the fruits □ Don’t Know Section B: Grains and Cereals Item Available? Price Visible? Comments/Quality of Food (Note if food is rotting, damaged, or expired Whole Grain Bread (≥4 g fiber/serving) □ Y □ N □ Y □ N Rice □ Y □ N □ Y □ N Whole Wheat Pasta (≥5 g fiber) □ Y □ N □ Y □ N Whole Grain Cereals with ≤10 g sugar □ Y □ N □ Y □ N (dried or low sodium canned) □ Y □ N □ Y □ N Section C: Beverages Item Available? Price Visible? Comments/Quality of Food (Note if food is rotting, damaged, or expired) Skim Milk or 1% milk (unflavored) □ Y □ N □ Y □ N Gallon □ Y □ N □ Y □ N Half gallon □ Y □ N □ Y □ N Individual serving □ Y □ N □ Y □ N 100% Juice □ Y □ N □ Y □ N Gallon □ Y □ N □ Y □ N Half gallon □ Y □ N □ Y □ N Individual serving □ Y □ N □ Y □ N Bottled Water (plain or seltzer) □ Y □ N □ Y □ N Other sugar-free options □ Y □ N □ Y □ N Section D: Snacks Item Available? Price Visible? Comments/Quality of Food (Note if food is rotting, damaged, or expired) Whole Fresh fruit □ Y □ N □ Y □ N Dried fruit (no sugar added) □ Y □ N □ Y □ N Containers of cut fruit □ Y □ N □ Y □ N Containers of cut vegetables □ Y □ N □ Y □ N Low salt or Unsalted nuts/seeds □ Y □ N □ Y □ N Low salt or Unsalted Pretzels □ Y □ N □ Y □ N Low-fat, low sugar Yogurt □ Y □ N □ Y □ N Baked Chips □ Y □ N □ Y □ N Low fat/Low salt Popcorn □ Y □ N □ Y □ N Step 3, Useful Tool 3 Healthy Market Assessment Guidance
Orleans, MA 02653 (800) 675-1188 Plymouth WIC Program 123 Camelot Drive Plymouth, MA 02360 (508) 747-4933 Central Framingham/Waltham WIC Program 7 Bishop Street, 1st floor Framingham, MA 01702 (508) 620-1445 North Central WIC Program 375 Nichols Road Fitchburg, MA 01420 (978) 345-6272 x1 Central WIC Program 29 Pine Street Southbridge, MA 01550 (508) 765-0139 Worcester WIC Program 199 Chandler Street Worcester, MA 01610 (508) 762-5700 Northeast Lawrence WIC Program Greater Lawrence CAC 305 Essex Street Lawrence, MA 01840 (978) 681-4960 Lowell WIC Program 45-47 Kirk Street Second Floor Lowell, MA 01852 (978) 454-6397 Northern WIC Program 145 Essex Street Haverhill, MA 01832 (978) 374-2191 Shore WIC Program 20 Central Avenue, 2nd floor Lynn, MA 01901 (781) 599-7290 North Suburban WIC Program 239 Commercial Street Malden, MA 02148 (781) 338-7578 Southeast Brockton WIC Program 795 Pleasant Street Brockton, MA 02301 (508) 588-8241 Fall WIC Program 387 Quarry Street Fall River, MA 02723 (508) 679-9349 New Bedford WIC Program 874 Purchase Street New Bedford, MA (508) 997-1500 Quincy WIC Program 114 Whitwell Street Quincy, MA 02169 (617) 376-8701 Taunton/Attleboro WIC Program 1 Taunton Green Lower Level Taunton, MA 02780 (508) 823-6346 ext. 227 Western