Philadelphia's Quarter Back for Local Application Early Care and Education Site Name: Is your ECE site a sponsor of the CACFP? Meaning: Do you receive reimbursement directly from the Commonwealth of Pennsylvania for your child nutrition program?YesNoSponsor Agreement Number Food Service Contact Name PhoneEmail Second Contact Name PhoneEmail Number of Children Served What percentage of children in your program are eligible for free or reduced price meals? Please check one.0%1-9%10-24%25-49%50-74%75-99%100%What percentage of children in your program identify as each race? (total must add to 100%): American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Other Pacific Islander, White, More than One Race, OtherWhat percentage of your children identify as American Indian? What percentage of your children identify as Asian? What percentage of your children identify as Black/African American? What percentage of your children identify as Native Hawaiian/Other Pacific Islander? What percentage of your children identify as White? What percentage of your children identify as More than One Race? What percentage of your children identify with a category not listed above? What percentage of children in your program identify as Hispanic/Latinx? What percentage of children in your program identify as not Hispanic/Latinx? Number of breakfasts provided daily Number of lunches provided daily Number of suppers provided daily Did you purchase Pennsylvania-grown fruits and vegetables during the 2021-2022 school year?YesNoUnsurePlease estimate the dollar amount spent on Pennsylvania-grown fruits and vegetables during the 2021-2022 school year Please check the Pennsylvania-grown fruit and vegetables you purchased during the last school year Sweet Potatoes Mushrooms Leafy Greens Asparagus Strawberries Beets Tomatoes Peppers Apples Winter Squash Cabbage Broccoli Potatoes Other Check the type of vendor(s) from which you purchase Pennsylvania-grown fruits and vegetables Direct Farm Farmers Market Food Hub or Farmer Cooperative Broadline Distributor Produce Distributor Grocery Store Other None Unsure Please describe your team’s background and readiness regarding purchasing Pennsylvania-grown fruits and vegetables. What would help you start or expand purchases of Pennsylvania-grown fruits and vegetables?What farm to ECE activities has your ECE site participated in within the last year? Check all that apply. Planted or worked with children in an edible garden at your site Conducted field trips to farms, gardens, and/or farmers markets Hosted a farmer visit Hosted a chef visit Held taste tests and/or cooking demonstration of locally produced foods Held taste tests and/or cooking demonstrations of garden grown food Celebrated National Farm to School Month (October) Hosted farm to ECE related community events (including families) Educated children about locally grown food, how food grows and/or where it comes from Served locally grown food in meals, snacks, or taste tests Worked with local producers/processors to develop a specific food product using local food for your site Promoted locally produced foods in general at the site (e.g. via signs, posters) Hosted a special event or day related to food and farms Facilitated children’s families access to locally grown foods at home Other Please describe the above activities checked. This is a chance to share about the depth and quality of farm to ECE activities rather than the number/quantity of activities.Please describe current partnerships related to farm to ECE.What amount of funding do you request? Please multiply the number of meals you plan to serve from October 1, 2022 through June 30, 2023 that will include a Pennsylvania grown product by .25. Please see supplementary materials for examples. Please describe your future goals related to purchasing, serving and highlighting Pennsylvania-grown items on your menus.Please describe your future goals related to farm to ECE activities at your site.Please share how the funding from this program could help you reach your goals. Philadelphia’s Quarter Back for Local Application Early Care and Education Site Name: Is your ECE site a sponsor of the CACFP? Meaning: Do you receive reimbursement directly from the Commonwealth of Pennsylvania for your child nutrition program?YesNoSponsor Agreement Number Food Service Contact Name PhoneEmail Second Contact Name PhoneEmail Number of Children Served What percentage of children in your program are eligible for free or reduced price meals? Please check one.0%1-9%10-24%25-49%50-74%75-99%100%What percentage of children in your program identify as each race? (total must add to 100%): American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Other Pacific Islander, White, More than One Race, OtherWhat percentage of your children identify as American Indian? What percentage of your children identify as Asian? What percentage of your children identify as Black/African American? What percentage of your children identify as Native Hawaiian/Other Pacific Islander? What percentage of your children identify as White? What percentage of your children identify as More than One Race? What percentage of your children identify with a category not listed above? What percentage of children in your program identify as Hispanic/Latinx? What percentage of children in your program identify as not Hispanic/Latinx? Number of breakfasts provided daily Number of lunches provided daily Number of suppers provided daily Did you purchase Pennsylvania-grown fruits and vegetables during the 2021-2022 school year?YesNoUnsurePlease estimate the dollar amount spent on Pennsylvania-grown fruits and vegetables during the 2021-2022 school year Please check the Pennsylvania-grown fruit and vegetables you purchased during the last school year Sweet Potatoes Mushrooms Leafy Greens Asparagus Strawberries Beets Tomatoes Peppers Apples Winter Squash Cabbage Broccoli Potatoes Other Check the type of vendor(s) from which you purchase Pennsylvania-grown fruits and vegetables Direct Farm Farmers Market Food Hub or Farmer Cooperative Broadline Distributor Produce Distributor Grocery Store Other None Unsure Please describe your team’s background and readiness regarding purchasing Pennsylvania-grown fruits and vegetables. What would help you start or expand purchases of Pennsylvania-grown fruits and vegetables?What farm to ECE activities has your ECE site participated in within the last year? Check all that apply. Planted or worked with children in an edible garden at your site Conducted field trips to farms, gardens, and/or farmers markets Hosted a farmer visit Hosted a chef visit Held taste tests and/or cooking demonstration of locally produced foods Held taste tests and/or cooking demonstrations of garden grown food Celebrated National Farm to School Month (October) Hosted farm to ECE related community events (including families) Educated children about locally grown food, how food grows and/or where it comes from Served locally grown food in meals, snacks, or taste tests Worked with local producers/processors to develop a specific food product using local food for your site Promoted locally produced foods in general at the site (e.g. via signs, posters) Hosted a special event or day related to food and farms Facilitated children’s families access to locally grown foods at home Other Please describe the above activities checked. This is a chance to share about the depth and quality of farm to ECE activities rather than the number/quantity of activities.Please describe current partnerships related to farm to ECE.What amount of funding do you request? Please multiply the number of meals you plan to serve from October 1, 2022 through June 30, 2023 that will include a Pennsylvania grown product by .25. Please see supplementary materials for examples. Please describe your future goals related to purchasing, serving and highlighting Pennsylvania-grown items on your menus.Please describe your future goals related to farm to ECE activities at your site.Please share how the funding from this program could help you reach your goals.
