2025 Food & Fun Summer Food Service Program (SFSP) Site Agreement & Memorandum of Understanding

YMCA Food & Fun Summer Food Service Program (SFSP) 2025 Site Agreement & Memorandum of Understanding J.A. Henry Community YMCA

REACHING OUR FULL POTENTIAL TOGETHER: The Y believes that all children deserve the opportunity to reach their full potential, and nothing is more fundamental in this effort than having consistent access to healthy meals.
We have a responsibility to the communities that we live, work and play in, to develop lifelong habits in youth that yield healthy futures. Driven by our commitment and cause, the Y has pledged to not only ensure that children receive access to nutritious foods, but to also educate them about healthy choices and model healthy behaviors. Through the YMCA Food & Fun Program, the Y is leading the charge as a Child Nutrition Program sponsor and vendor to provide meals that are rich in fresh fruits and vegetables, whole grains, free from fried foods, and low in added sugar.
YMCA Food & Fun Summer Food Service Program (SFSP) 2025 Site Agreement & Memorandum of Understanding J.A. Henry Community YMCA

Instructions: Please complete the entire application. Incomplete applications will not be processed. This application is due March 28, 2025. Submission after the due date may result in delayed meal service for your site.
Site Information
Organization Name*
Program Name*
Program Address (Street, City, State, Zip)*

Contact Information*

	Name	Phone Number	Email Address
Primary Contact (Required)
Secondary Contact (Required)
Delivery/Pickup Contact (Required)

The YMCA is able to provide supper to after school and break camp programs throughout the school year. Would your site be interested in participating in school year meals?*

YesNoPotentially, with more information
The YMCA is also able to provide meals on the weekends. Would your site be interested in participating in the weekend meals?*

YesNoPotentially, with more information
Would your site be interested in using the Cartewheel Meal Counter app for meal counting?*

YesNoPotentially, with more information
Are you located in an active school building?*

YesNo
If yes, provide the license capacity:*
If no, please type N/A
Does program site have access to a functioning restroom with a sink for hand washing?*

YesNo
Name of closest public school?*
Have you participated in the SFSP before?*

YesNo
Is program participation determined by enrollment or drop-ins?*

EnrollmentDrop-In
Meal Information

The YMCA is able to provide lunch OR supper to summer sites. Sites are able to get breakfast OR snack in addition to lunch/supper if they are interested. Please indicate preferred meals and service times below.
Days of Meal Operation*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
What meals would you like to serve this summer? You may only select one of these due to the limitations of our grant.*

Breakfast onlyBreakfast + AM snackBreakfast + LunchBreakfast + PM snackLunch onlyLunch + PM snackSupper onlySupper + PM snack

Please describe where meals will be served at your location:*
Please provide the name and a brief description of the program including activities:*
Program Dates

Please provide the start and end date of your program.
Start Date*

MonthDayYear
TO
End Date*

MonthDayYear
Date
What are your program hours?*

Hour Minutes

AM/PM Option
To*

Hour Minutes

AM/PM Option
Is this site serving meals outside?*

YesNo
If yes, what are the alternate arrangements in case of inclement weather?*
If no, please type N/A
Does your site have a refrigeration unit that can accommodate the number of meals you would like to serve?*

YesNo
If yes, please describe the type of refrigeration unit you have (i.e., house unit, commercial 2-door unit, walk-in, etc.) and how many meals do you expect the refrigeration unit to hold?*
If no, please type N/A
PROGRAM PROCEDURE AND REQUIREMENTS

The primary site contact is responsible for initialing the following portions of the site requirements. If you have any questions about the policies and procedures listed below, please contact the YMCA Food & Fun Office.

YMCA FOOD & FUN PROCEDURES

Incurs the upfront cost of all meals, food and supplies and operations of the YMCA Self Prep Kitchen
- Reviews food orders on a weekly basis and contacts site regarding questionable orders.
- Reviews invoices and compares to food delivery tickets to identify discrepancies.
- Manages meal program budget.
Provides meals and/or supper to eligible sites
- Ensures that all menu items are in compliance with USDA requirements and HEPA standards.
Processes paperwork and submits claims for reimbursement

Completes all site visits and monitoring requirements set forth by USDA & Tennessee's Department of Human Service (DHS)

Reviews reported numbers from previous day
- Make adjustments to orders if needed.
- Follow up with site staff that do not report their information.
Provides coaching and on-site and/or online training to meal program sites

Provides meal program training for staff and volunteers
- Trainings are offered at a variety of times and dates to maximize staff attendance.
Site Requirements to Receive Food

Please initial under the statements below.
Attend a YMCA SFSP Training Session (online or in-person)
Sites serving 50+ children will be required to have at least four (4) representatives attend training. *
Please initial above.
All sites will be required to send at least two (2) representatives attend training.*
Please initial above.
All sites will follow all USDA, SFSP, and YMCA rules, regulations, and guidelines as outlined at training. *
Please initial above.
Communicate Any Turnover In Trained Staff
Update the YMCA when new staff are hired and ensure they complete the appropriate training.*
Please initial above.
Complete A Signed Site Agreement

Update information on an as-needed basis. All changes must be submitted to the Food Program Office Admin & Program Director.
Place orders by 4:00 pm each day for the following day using approved order methods.
Site staff complete meal counts at point of service via the Daily Meal Count Form.*
Please initial above.
Site staff are responsible for reporting the number of meals delivered and served on a daily basis. Site staff will pick up all meals from the YMCA's central kitchen.*
Please initial above.
Weekly Tasks

Please initial under the statements below.
Each Monday, review information from the previous week to ensure that: The delivery ticket has been signed and updated, paper daily meal count forms are filled out accurately & signed, the previous week's information is scanned to the Food Program Office Manager & Program Director, and that Site Leads are responsible for ensuring that hard copy paperwork is delivered to the YMCA.*
Please initial above.
Meal service will be suspended if: Site staff do not mark meals at the point of service, sites fail to communicate closures, meal adjustments, staff turnover, or other relevant changes, sites are not in compliance with paperwork deadlines, or if sites fail to address corrective action steps given by the state or YMCA.*
Please initial above.
The term of the Agreement is from the signed date below through August 31, 2024. During the life of this agreement the meal program site cannot enter into an agreement with any other sponsor for the program(s). Any equipment provided by the YMCA of Metropolitan Chattanooga will be reclaimed and moved to another location when deemed necessary. In the event that the program is continued beyond its initial term, the terms of this Agreement shall remain in force unless modified. This document is a temporary contract that is legal and binding.
PRIMARY CONTACT SIGNATURE*

Clear
DATE*

MonthDayYear
Date
SECONDARY CONTACT SIGNATURE*

Clear
DATE*

MonthDayYear
Date
YMCA Food & Fun Program Director Signature

Clear
Received on:

MonthDayYear
Date
In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at:https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11 28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant's name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation.

This institution is an equal opportunity provider.

For questions, contact Sam Kamely, Program Director at 423-468-1456 or Laura Horne, Senior Program Director at 423-805-3361
Would you like to receive a copy of your submission?*

YesNo
Email Address*
Should be Empty:

	Meals	Start Time	End Time	Maximum Number of Meals Served
Breakfast
AM Snack

	Meals	Start Time	End Time	Maximum Number of Meals Served
Breakfast
Lunch

	Meals	Start Time	End Time	Maximum Number of Meals Served
Breakfast
PM Snack

	Meals	Start Time	End Time	Maximum Number of Meals Served
Lunch
PM Snack

	Meals	Start Time	End Time	Maximum Number of Meals Served
PM Snack
Supper

YMCA Food & Fun Summer Food Service Program (SFSP) 2025 Site Agreement & Memorandum of Understanding J.A. Henry Community YMCA

Site Information

Meal Information

Program Dates

Site Requirements to Receive Food

Attend a YMCA SFSP Training Session (online or in-person)

Communicate Any Turnover In Trained Staff

Complete A Signed Site Agreement

Place orders by 4:00 pm each day for the following day using approved order methods.

Weekly Tasks