State Agencies

APPENDIX A2: State Agency Data Request
Materials

A. State Agency Data Request Script

CHILD AND ADULT FOOD CARE PROGRAM
(CACFP) MEAL CLAIMS ASSESSMENT
ICF Macro
Attn: Erika Gordon, Project Director
11785 Beltsville Drive, Suite 300
Calverton, MD 20705
Tel: (800) 840-8248

Public reporting burden for this collection of information is estimated to average 10 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless
it displays a currently valid OMB control number. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S.
Department of Agriculture, Food and Nutrition Services, Office of Research and Analysis, Room 1014,
Alexandria, VA 22302 ATTN: PRA (0584-xxxx*). Do not return the completed form to this address.

Form Approved
OMB No: 0584-NEW
Expiration Date: xx/xx/xxxx

STATE AGENCY DATA REQUEST SCRIPT
A. [INTRODUCTION]: Hello, my name is ______________. I’m calling from ICF Macro, on behalf of
the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS), to verify that you have
received the letter recently sent you concerning the CACFP Meal Claims Assessment Study, that FNS
is conducting. I am calling today to follow up on that letter, to answer your potential questions, and to
speak with you regarding our request for the information listed in the letter. Do you have a few
minutes now?
1.

Yes—[PROCEED TO SECTION B.]

2.

No—[Obtain callback date and time]: Is there a better time when we can speak sometime this
week, in the next 2 days?
CALLBACK DATE: _______________ CALLBACK TIME: _______________

Thank you for your time. I will call you back on _____ [DAY]/ _____ [TIME] to discuss the study.
B. Before we begin, is there someone in your organization, other than yourself, that you would like to
designate as the study contact for this data collection?
1.

Respondent will serve as study contact. [GO TO SECTION D.]

2.

Respondent designates someone else. [ENTER CONTACT INFORMATION IN
TABLE BELOW.]

Name:
Title:
Address: (if different from
organization’s address)
Telephone Number:
Fax:
E-mail Address:

Would you like me to review our study data collection needs with you or should we contact
_____________ [CONTACT NAME JUST GIVEN] directly about the study?
1. Respondent wants you to tell them about the study Æ[GO TO SECTION D.]
2. Respondent wants you to call the designated study contact—Respond:
Thank you for your time. I will contact ____________ [CONTACT NAME] about the study. Have a
nice day!

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Form Approved
OMB No: 0584-NEW
Expiration Date: xx/xx/xxxx
[INSTRUCTION: UPDATE CONTACT DATABASE TO REFLECT NEW CONTACT
INFORMATION. SEND STATE DATA REQUEST LETTER TO STUDY CONTACT VIA
E-MAIL. MAKE SURE TO CHANGE CONTACT’S NAME ON LETTER BEFORE SENDING
IT OUT. SCHEDULE A TIME FOR YOU TO GET IN TOUCH WITH DESIGNATED STUDY
CONTACT WITHIN 2 DAYS OF SENDING E-MAIL.]
C. [INTRODUCTION FOR ALL CALLBACKS]: Hello, this is ______________ from ICF Macro.
I’m calling you back as we had previously scheduled to discuss the Food and Nutrition Service (FNS)
assessment of meal claiming errors in the Child and Adult Care Food Program (CACFP). I would like
to follow up on the letter [or E-MAIL] we sent to you earlier this week, to answer questions you may
have, and to speak with you about our request for the information listed in the letter/e-mail.
D. [EXPLANATION OF STUDY]. The study is being conducted in two phases: (1) a feasibility study,
and (2) a follow-up national expanded data collection effort. The feasibility study will test the ability
to use a parent-recall interview to validate meal claims made by family day care homes (FDCHs).
Using similar procedures as the monitoring visit typically conducted by the sponsor, a one-time 2-day
in-home observation will be conducted at the selected FDCHs to collect the number of children being
served meals and the type of meals being served as a part of the feasibility study. Selected sponsors
and FDCHs will then be asked to provide monthly meal claim data for a 3-month period, to be used in
analysis. Using a random sampling methodology based on the number of FDCHs in each State during
Fiscal Year 2010, [STATE] was selected to participate in this important study.
[INSTRUCTION: REVIEW WITH STATE CONTACT EACH OF THE 4 ITEMS
REQUESTED IN THE LETTER]. We would like to request information specific to your State, so
that preliminary tasks in this study can be completed. We are asking you for the following
information:
9 A list of CACFP sponsors (including a full address) in the State as of [MONTH 2011]; the
number of FDCHs supported by each of these sponsors, by tier, if possible.
9 The total number of FDCHs participating in the CACFP in [STATE] as of [MONTH 2011] that
are eligible for meal reimbursement. [INSTRUCTION—CLARIFY IF NECESSARY:
We would like the total number of FDCHs that each sponsor supports as of MONTH 2011 who
were eligible to file a meal claim.]
9 A count of the total number of active FDCHs that participate in CACFP in [STATE] as of
[MONTH 2011].
9 A copy of current existing guidelines that your State provides to sponsors who participate in the
CACFP, including guidelines and procedures for sponsors and FDCHs that pertain to the
completion, submission, and verification of monthly meal claims for reimbursement. This would
include any special guidance provided to sponsors to assist them with meal claiming, reporting,
and editing of FDCH-submitted claims. We also want to find out the rules/guidance/procedures
on licensing capacities of FDCHs in your State. [INSTRUCTION—CLARIFY IF
NECESSARY]: We would like information on the maximum number of children a FDCH is
allowed to have in its care at one time. If this is determined by a formula, please provide that
information to us.]

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Form Approved
OMB No: 0584-NEW
Expiration Date: xx/xx/xxxx

E. We would like to receive this information in an electronic format if possible. Are the data available as
Excel or Word files?
1. Yes—[PROVIDE THE STUDY’S E-MAIL ADDRESS; GO TO ITEM F.]
2. No—[IF NO]: If the files are in paper format, please use the postage-paid mailer you received
with our letter. We’d like to have your data by _____ [DATE] (1-week preference for
receiving information).
F. If you are able to send the information electronically, you can submit it by e-mail to
[email protected]. We’d like to have your data by _________ [DATE] (7-day preference
for receiving information). I’d like to give you my personal e-mail address in case there are any
questions or concerns about this request—[email protected]. Additionally, our toll-free study
assistance number is 1-800-840-8248 and study team members are available between 8:30 a.m. and
5:30 p.m. We also have a fax number for the study—1-XXX-XXX-XXXX. I’d also like to confirm
your e-mail address so I can confirm receipt of your data via e-mail and by telephone.
______________________________ [E-MAIL ADDRESS]
G. [CLOSING]: Thank you for providing the data for this very important study.

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B. State Agency Follow-up Call for
Missing Data Script

CHILD AND ADULT FOOD CARE PROGRAM
(CACFP) MEAL CLAIMS ASSESSMENT
ICF Macro
Attn: Erika Gordon, Project Director
11785 Beltsville Drive, Suite 300
Calverton, MD 20705
Tel: (800) 840-8248

Public reporting burden for this collection of information is estimated to average 30 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless
it displays a currently valid OMB control number. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S.
Department of Agriculture, Food and Nutrition Services, Office of Research and Analysis, Room 1014,
Alexandria, VA 22302 ATTN: PRA (0584-xxxx*). Do not return the completed form to this address.

Form Approved
OMB No: 0584-NEW
Expiration Date: xx/xx/xxxx

STATE AGENCY FOLLOW-UP CALL FOR MISSING DATA SCRIPT
A. [INTRODUCTION]: Hello, my name is ______________. I’m calling from ICF Macro regarding the
Food and Nutrition Service (FNS) nationwide assessment of meal claiming in the Child and Adult
Care Food Program (CACFP). We spoke with you last week, on ________ [DATE], about our
specific data needs for this study. We have not yet received your data and want to make sure the
information has not been lost in transmission. Have you had the chance to send us your information?
1) Yes, information has been sent. [CONFIRM HOW DATA WAS ORIGINALLY
TRANSMITTED. IF SENT VIA SOFT PACK IN LAST 3 DAYS, GO TO A2.]
2) No, information not sent. [GO TO SECTION B.]
A1. Unfortunately, we have not received your information. Would it be possible for you to send the
information to us again? To confirm, our [E-MAIL ADDRESS/FAX NUMBER] is
[email protected] and 1-800-XXX-XXXX. You can send the data via e-mail, fax, or
FedEx. [CONFIRM METHOD FOR SENDING DATA: E-MAIL:____ FAX:_____
FEDEX:_______.]
[INSTRUCTION: IF INFORMATION CAN ONLY BE SENT VIA MAIL]. Please send your
information to us in care of [YOUR NAME], ICF Macro; 11785 Beltsville Drive, Suite 500;
Calverton, MD 20705. If possible, please send the information to us via FedEx. If you can send it to
us via FedEx, I will e-mail you a FedEx reimbursement form that you can complete and include in
your information packet so that our study can reimburse you for the cost. Will you be able to send the
information to us via FedEx? [CONFIRM RESPONDENT IS SENDING THE INFORMATION
VIA FEDEX]. When do you believe you can re-send the information to us _______ [DATE
INFORMATION WILL BE RE-SENT]? Thank you so much for re-sending us the information to us.
I will e-mail you to confirm that we have received the information. [CONFIRM RESPONDENT’S
E-MAIL ADDRESS: ____________________]. Thank you so much for your help on this important
study! Have a nice day!
I would also like to give you my personal e-mail address to ensure that the information gets to us; it is
[email protected]. Would it be possible for you to re-send the information today _______ [DATE
INFORMATION WILL BE RE-SENT]? Thank you so much for re-sending the information to us. I
will e-mail you to confirm that we have received the information. Thank you so much for your help
on this important study! Have a nice day!
A2. [INSTRUCTION: IF INFORMATION WAS SENT VIA FEDEX SOFT PACK WITHIN THE
LAST 2 DAYS]. Thank you for sending the information we have requested. I will look for the data
packet to arrive in the next couple of days. I will e-mail you to confirm that we have received your
information. Thank you so much for your help on this important study! Have a nice day!
1. B. [INSTRUCTION: RESPONDENT HAS NOT HAD THE TIME TO SEND THE
INFORMATION TO US OR IS STILL WORKING ON GATHERING THE
INFORMATION]. Receiving this information is a very important step in conducting this study.
This information is critical for us to be able to determine which sponsoring organizations and
family day care homes (FDCHs) should be contacted for the study. We realize that gathering the

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Form Approved
OMB No: 0584-NEW
Expiration Date: xx/xx/xxxx
data may be burdensome, but we really want to conduct a study that represents the experiences of
FDCHs from various sponsors, so that the full range of experiences can be represented. Would it
be possible to send this information to us by ______ [GIVE DATE DEADLINE 3 DAYS FROM
TODAY]? Please send the information to us in the format that is most convenient for you.
Again, our e-mail address is [email protected], or you can e-mail the information to me
personally at [email protected]. The data can also be faxed to us at 1-XXX-XXX-XXXX. You can
also use the self-addressed, pre-paid FedEx Soft Pack we provided to send the information to us.
[IF FEDEX SOFT PACK IS LOST/MISSING]: I will e-mail a FedEx reimbursement form to you
that you can complete and include in your information packet so that our study can reimburse you.
C. [IF RESPONDENT HAS QUESTIONS, NOTE WHAT RESPONDENT SAYS]:
_________________________________________________________________________________
_________________________________________________________________________________
_____________________________________________________________________________
[INSTRUCTION: PROVIDE RESPONSE TO THE RESPONDENT’S CONCERN BASED ON
THE ISSUE RAISED.]
ƒ

States were randomly selected to participate in this study. Those states with a large number of
sponsors and a subsequent large number of FDCHs are more likely to be selected.

ƒ

We have designed this study with FNS and Child Nutrition Services so it is conducted in the least
burdensome way for all parties, including State agencies, sponsors, and the FDCHs selected
to participate.

ƒ

The information we gather is important to FNS because it collects information that is required by
the Federal Government to continue offering meal reimbursement to FDCHs under the CACFP.

ƒ

FNS wishes to gather this information to be better informed on meal claim policies and
procedures enacted by States/sponsors nationwide.

ƒ

No information that we gather will be used to make a claim against an individual State/sponsor/
or FDCH. Identifying information will be kept confidential and all reporting will be done in an
aggregated form—not identifying anyone by name.

D. [INSTRUCTION: IF COOPERATION IS ATTAINED, REVIEW WITH STATE CONTACT
EACH OF THE 4 ITEMS REQUESTED IN THE LETTER]. I’d like to briefly review our
request; we are asking you for the following items:
ƒ

A list of CACFP sponsors (including a full address) in [STATE] as of [MONTH 2011]; and
the total number of FDCHs supported by each of these sponsors, by tiering level if possible;

ƒ

The total number of FDCHs participating in the CACFP in [STATE] as of [MONTH 2011]
that are eligible for meal reimbursement.

ƒ

A copy of existing guidelines that your State provides to sponsors who participate in
the CACFP.

ƒ

Rules/guidance/procedures that your State provides to sponsors regarding the mandatory
monitoring visits of FDCHs they perform.

We look forward to receiving these data from your organization no later than [DATE 2011].

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Form Approved
OMB No: 0584-NEW
Expiration Date: xx/xx/xxxx

E. [INSTRUCTION: ONCE YOU HAVE CONFIRMED THE MEANS FOR SENDING THE
INFORMATION]. I look forward to receiving your information. I will e-mail you confirmation that
we have received your data packet. [CONFIRM RESPONDENT’S E-MAIL ADDRESS:
____________________]. Thank you so much with your help on this important study!
Have a nice day!

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C. State Agency Clarification of
Data Received Script

CHILD AND ADULT FOOD CARE PROGRAM
(CACFP) MEAL CLAIMS ASSESSMENT
ICF Macro
Attn: Erika Gordon, Project Director
11785 Beltsville Drive, Suite 300
Calverton, MD 20705
Tel: (800) 840-8248

Public reporting burden for this collection of information is estimated to average 20 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless
it displays a currently valid OMB control number. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S.
Department of Agriculture, Food and Nutrition Services, Office of Research and Analysis, Room 1014,
Alexandria, VA 22302 ATTN: PRA (0584-xxxx*). Do not return the completed form to this address.

Form Approved
OMB No: 0584-NEW
Expiration Date: xx/xx/xxxx

STATE AGENCY CLARIFICATION OF DATA RECEIVED SCRIPT
A. [INTRODUCTION]: Hello, my name is ______________. I’m calling from ICF Macro regarding
the Food and Nutrition Service (FNS) Child and Adult Care Food Program (CACFP) Assessment
Study. I would like to thank you for providing the data you recently sent to us. After reviewing the
information you sent, we would like to clarify some points with you. Do you have a few minutes
now?
1. Yes—[PROCEED TO APPROPRIATE QUESTION IN SECTION B.]
2. No—[OBTAIN CALLBACK DATE AND TIME]: When would be a better time for me to
call you tomorrow?
CALLBACK DATE: _______________ CALLBACK TIME: _______________
Thank you for your time. I will call you back on _____ [DAY] _____ [TIME] to discuss the study.
Have a nice day!
B. I would like to clarify:
[INSERT QUESTION PERTAINING TO
LICENSE CAPACITY]:

RESPONDENT’S RESPONSE:

QUESTION:

[INSERT QUESTION PERTAINING TO
TIERING STATUS]:

RESPONDENT’S RESPONSE:

QUESTION:

[INSERT QUESTION PERTAINING TO
MEAL CLAIMING]:

RESPONDENT’S RESPONSE:

QUESTION:

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Form Approved
OMB No: 0584-NEW
Expiration Date: xx/xx/xxxx

[INSERT QUESTION PERTAINING TO
TOTAL NUMBER OF SPONSORS/FDCHS]:

RESPONDENT’S RESPONSE:

QUESTION:

C. [INSTRUCTION—IF ADDITIONAL DATA ARE NEEDED]: We would like to receive the
information we just spoke about in an electronic format if possible. Are the data in Excel or Word?
1. Yes—[PROVIDE THE STUDY E-MAIL ADDRESS; GO TO SECTION D.]
2. No—[IF NO]: If the files are in paper format, please use the postage-paid mailer you received
with our letter to send them to us. We’d like to have your data by _____ [DATE] (3-day
preference for receiving information).
D. If you are able to send the information electronically, you can submit it by e-mail to
[email protected]. We’d like to have your data by _________ [DATE] (3-day preference
for receiving information). I’d like to give you my contact information in case there are any
questions or concerns about this request. I can be reached at [email protected]. If you have additional
questions or concerns, you can also call our toll-free study assistance number—1-800-840-8248,
between 8:30 a.m. and 5:30 p.m. We also have a fax number for the study—1-XXX-XXX-XXXX.
I’d also like to confirm your e-mail address so that I can confirm receipt of your data via e-mail
and by telephone. ______________________________ [E-MAIL ADDRESS]
E. Once again, thank you for providing us information for this important study and for clarifying our
question(s). Have a nice day!

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