NSLP Exemption Residential Child Care Institution (RCCI) Age/Grade Group Meal Pattern Exemption Request Form

Texas Department of Agriculture

Form | NSLP |RCCI | Age/Grade Exemption
September 19, 2018

Residential Child Care Institution (RCCI) Age/Grade Group Meal Pattern Exemption Request Form

A contracting entity (CE) that is a residential child care center (RCCI) may request flexibility to serve the same age/grade group meal pattern to all students if the following conditions exist:

The RCCI is a juvenile detention or correctional facility or can demonstrate operational limitations to separating age/grade groups.
The RCCI has a legitimate safety concern or State juvenile justice laws or regulations related to offering meals with varying amounts of food within the same meal period.

If an RCCI CE is approved for this exemption, the RCCI can make the following changes to the meal pattern:

Offer the same portion size to all students

The RCCI may serve all students the same meal pattern. The RCCI must serve the meal pattern for the highest age/grade group participating at the meal.

Offer a choice of milk over the week

The RCCI may meet the milk variety requirement by offering all students one choice of milk on some days of the week and a different choice of milk on other days of the week. All milk served must meet the specifications for fluid milk as described in the meal pattern.

If approved, this exemption is in effect until there is a change in one of the conditions required for this exemption.

Questions about the RCCI age/grade exemption may be submitted to TDA by email to SNPWaivers@TexasAgriculture.gov.
RCCI Age/Grade Exemption should be recorded in the subject line of the email.

To submit a request to TDA, please take the following actions:
- Complete the Residential Child Care Institution (RCCI) Age/Grade Group Meal Pattern Exemption Request Form located in the Texas Unified Nutrition Programs System (TX-UNPS), Download Forms/NSLP Exemptions and Waivers.
- Retain a copy of the submitted form for the CE’s records.
- Click Submit when the form is completed.

Part III. Attestation Statement

Check each of the following statements as true:
Authorized Representative*

I am an Authorized Representative (AR) of the Contracting Entity with an active TXUNPS User ID. (If you do not have an active USER ID, your UAM can submit the form.)
Document Retention*

I certify that the SNP has retained documentation related to the information submitted in this request for an exemption.
Name of person attesting to the information on this form:*

First NameLast Name
CE Phone Number*

Area CodePhone Number
Form Completion Date

MonthDayYear
Date
Title of Authorized Representative*
Email Address for Confirmation*
example@example.com
Alternate Email Address
example@example.com
Select Submit to send the form to TDA. It may take a few minutes for the form to submit depending on your connection speed. Please click Submit only once. You will receive a confirmation message when the submission is complete.
Should be Empty:

	Pre-Kindergarten	Grades K-5	Grades 6-8	Grades 9-12
Breakfast
Lunch

Residential Child Care Institution (RCCI) Age/Grade Group Meal Pattern Exemption Request Form

Residential Child Care Institution (RCCI) Age/Grade Group Meal Pattern Exemption Request Form

Part I. Contracting Entity (CE) Information

Part II. Status

Part III. Attestation Statement