TCK Preliminary Assessment

We look forward to getting to know you better as we help walk you through the process of transitioning your school meal program. The detailed information below will help us determine how to best assist your transition. Please fill out the application below as completely as possible. We'll review carefully and follow up with you once it's received.

Name of School

Contact Name

Contact Email

SECTION ONE: Food Content and Waste

a. Current food provider

b. Nutritional content of school meals

i. Breakfast

	Monday	Tuesday	Wednesday	Thursday	Friday
Calories
Sugar
Fat
Sodium

ii. Lunch

	Monday	Tuesday	Wednesday	Thursday	Friday
Calories
Sugar
Fat
Sodium

iii. Snack

	Monday	Tuesday	Wednesday	Thursday	Friday
Calories
Sugar
Fat
Sodium

c. Percentage of local and organic ingredients in current school lunch program (if available)

- Local

- Organic

d. Photos of current school meals (attach two photos each of breakfast, lunch and snacks)

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- Breakfast

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- Breakfast

No File Chosen

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- Lunch

No File Chosen

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- Lunch

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- Snacks

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- Snacks

e. Time allocated for meals

- Breakfast

- Lunch

- Snacks

f. One month of menus/recipes if applicable (attach)

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g. Characterization of school lunch program (please include three positives and three negatives)

Three Positive Attributes of School Lunch Program

Three Negative Attributes of School Lunch Program

h. List of local food providers (attached)

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i. Amount of waste from food program

One week of garbage weight (after breakfast)

Day	Monday	Tuesday	Wednesday	Thursday	Friday
Weight (lbs)

One week of garbage weight (after lunch)

Day	Monday	Tuesday	Wednesday	Thursday	Friday
Weight (lbs)

One week of garbage weight (after snacks)

Day	Monday	Tuesday	Wednesday	Thursday	Friday
Weight (lbs)

SECTION TWO: Student Body Demographics

a. Number of students at school

b. Number of students served last year (total)

- Breakfast (#)

- Lunch (#)

- Snacks (#)

- Total (#)

c. Number of students who eat breakfast

- Free breakfast (#)

- Reduced breakfast (#)

- Paid breakfast (#)

- Total (#)

d. Number of students who eat lunch

- Free lunch (#)

- Reduced lunch (#)

- Paid lunch (#)

- Total (#)

SECTION THREE: Costs

a. Annual budget for school food program

b. Annual budget breakdown

i. Food costs

ii. Supplies

iii. Admin

iv. Annual portion of maintenance allocated for food service/ dining hall

v. Annual waste disposal fees

vi. Other expenses related to food service (specify)

c. Student cost per meal for current school food program

i. Breakfast $ ______________ per student

ii. Lunch $ _________________ per student

iii. Snacks $_________________ per student

d. School cost per meal for current food program

i. Breakfast $_____________ per student

ii. Lunch $ _________________ per student

iii. Snacks $_________________ per student

SECTION FOUR: Kitchen Assessment

a. Do you have a kitchen?

If yes, please attach diagram (can be hand drawn) and dimensions

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b. What large equipment is in your kitchen? (name each piece and describe)

c. What smallwares are in your kitchen?

d. What service items are in your kitchen?

e. Other information we should know about your kitchen infrastructure

SECTION FIVE: Garden and Nutrition Curriculum

a. Do you have a school garden?

If yes, please provide garden specs:

Square footage

List of Items grown:

Please describe how the school garden fits into the school curriculum (provide sample curriculum as attachment)

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b. Do you teach nutrition?

If yes, please describe how the nutrition program fits into the school curriculum (provide sample curriculum as attachment)

No File Chosen

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c. Do you have a culinary program?

If yes, please describe how the culinary program fits into the school curriculum (provide sample curriculum as attachment)

No File Chosen

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SECTION SIX: Parent Participation

a. Are parents involved in any of the following volunteer opportunities for the current food program

Food Prep Food Service Clean Up

If yes, to what extent? Please describe your volunteer framework and how many parents participate

Save and Resume Later

Progress