SNMCS State, Local & Tribal Governments

F1. GROUPS 1, 2, 3—SFA DIRECTOR SURVEY

This page has been left blank for double-sided copying.

ID#: | | | | | | | | |

SFA:

City and State:

OMB Clearance Number: 0584-xxxx

Expiration Date: xx/xx/xxxx

School Nutrition and Meal Cost Study

School Food Authority Director Survey

February 28, 2014

Sponsored by:

U.S. Department of Agriculture

Food and Nutrition Service

School 1:

School 2:

School 3:

School 4:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 50 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.

F

INSTRUCTIONS

 Please answer all of the questions.

 If you have any questions about the study or about completing this survey, please do not hesitate to contact the study team by email at [email protected] or by phone at 1-xxx-xxx-xxxx (toll-free).

The information you provide will be used only for statistical purposes. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002, your responses will not be disclosed in identifiable form without your consent.

Under the Healthy, Hunger-Free Kids Act of 2010, participation in this study is mandatory. We thank you for your cooperation and participation in this very important study.

OR ASSISTANCE CALL TOLL FREE: 1-xxx-xxx-xxxx

0 . Which of the following school types does your SFA include?

mark all that apply

1 □ Elementary schools

2 □ Middle schools

3 □ High schools

4 □ Other schools

If your School Food Authority (SFA) was selected for onsite data collection, please complete questions 1 through 8 about the schools listed. If your SFA was not selected for onsite data collection, please go to question 9.

NAMES OF SCHOOLS	SCHOOL 1 NAME MPR ID LEVEL	SCHOOL 2 NAME MPR ID LEVEL	SCHOOL 3 NAME MPR ID LEVEL	SCHOOL 4 NAME MPR ID LEVEL
1. How many students in SCHOOL are approved for free meals in the 2014-2015 school year?	| | | | |	| | | | |	| | | | |	| | | | |
2. How many students in SCHOOL are approved for reduced-price meals in the 2014-2015 school year?	| | | | |	| | | | |	| | | | |	| | | | |
3. As of October 31 of the current school year, what was the total enrollment at SCHOOL?	| | | | |	| | | | |	| | | | |	| | | | |
4. What grade groups were used when planning NSLP/lunch menus for SCHOOL for the 2014-2015 school year?	mark one only 1 ¨ Grades K-5 2 ¨ Grades K-8 3 ¨ Grades K-12 4 ¨ Grades 6-8 5 ¨ Grades 6-12 6 ¨ Grades 9-12	mark one only 1 ¨ Grades K-5 2 ¨ Grades K-8 3 ¨ Grades K-12 4 ¨ Grades 6-8 5 ¨ Grades 6-12 6 ¨ Grades 9-12	mark one only 1 ¨ Grades K-5 2 ¨ Grades K-8 3 ¨ Grades K-12 4 ¨ Grades 6-8 5 ¨ Grades 6-12 6 ¨ Grades 9-12	mark one only 1 ¨ Grades K-5 2 ¨ Grades K-8 3 ¨ Grades K-12 4 ¨ Grades 6-8 5 ¨ Grades 6-12 6 ¨ Grades 9-12
5. Does SCHOOL participate in the School Breakfast Program (SBP)?	1 ¨ Yes 0 ¨ No GO TO Q8	1 ¨ Yes 0 ¨ No GO TO Q8	1 ¨ Yes 0 ¨ No GO TO Q8	1 ¨ Yes 0 ¨ No GO TO Q8

NAMES OF SCHOOLS	SCHOOL 1 NAME MPR ID LEVEL	SCHOOL 2 NAME MPR ID LEVEL	SCHOOL 3 NAME MPR ID LEVEL	SCHOOL 4 NAME MPR ID LEVEL
6. What grade groups were used when planning SBP/ breakfast menus for SCHOOL for the 2014-2015 school year?	mark one only 1 ¨ Grades K-5 2 ¨ Grades K-8 3 ¨ Grades K-12 4 ¨ Grades 6-8 5 ¨ Grades 6-12 6 ¨ Grades 9-12	mark one only 1 ¨ Grades K-5 2 ¨ Grades K-8 3 ¨ Grades K-12 4 ¨ Grades 6-8 5 ¨ Grades 6-12 6 ¨ Grades 9-12	mark one only 1 ¨ Grades K-5 2 ¨ Grades K-8 3 ¨ Grades K-12 4 ¨ Grades 6-8 5 ¨ Grades 6-12 6 ¨ Grades 9-12	mark one only 1 ¨ Grades K-5 2 ¨ Grades K-8 3 ¨ Grades K-12 4 ¨ Grades 6-8 5 ¨ Grades 6-12 6 ¨ Grades 9-12
7. Does SCHOOL offer universal-free breakfast?	1 ¨ Yes 0 ¨ No	1 ¨ Yes 0 ¨ No	1 ¨ Yes 0 ¨ No	1 ¨ Yes 0 ¨ No
8. Does SCHOOL operate under Provision 2 or Provision 3 for either the NSLP or SBP, or does it participate in the Community Eligibility Provision? NOTE: Provision 2 schools serve meals at no charge to all children as determined by application once every three years. Provision 3 schools serve meals at no charge to all children regardless of eligibility status. Community Eligibility Provision schools serve meals at no charge to all children based on large proportions of children certified for free school meals through means other than a household application.	mark all that apply 1 ¨ Provision 2 for NSLP 2 ¨ Provision 2 for SBP 3 ¨ Provision 3 for NSLP 4 ¨ Provision 3 for SBP 5 ¨ Community Eligibility Provision n ¨ None of these	mark all that apply 1 ¨ Provision 2 for NSLP 2 ¨ Provision 2 for SBP 3 ¨ Provision 3 for NSLP 4 ¨ Provision 3 for SBP 5 ¨ Community Eligibility Provision n ¨ None of these	mark all that apply 1 ¨ Provision 2 for NSLP 2 ¨ Provision 2 for SBP 3 ¨ Provision 3 for NSLP 4 ¨ Provision 3 for SBP 5 ¨ Community Eligibility Provision n ¨ None of these	mark all that apply 1 ¨ Provision 2 for NSLP 2 ¨ Provision 2 for SBP 3 ¨ Provision 3 for NSLP 4 ¨ Provision 3 for SBP 5 ¨ Community Eligibility Provision n ¨ None of these

9. Which of the following methods does your SFA use to certify students to receive free or reduced-price meals?

mark all that apply

1 □ Household applications

2 □ Direct certification

3 □ All students receive meals at no charge without a certification process

4 □ Other (Specify)

10. How many school districts are in your SFA?

| | | | DISTRICTS

11. How many public and charter schools in your SFA do any of the following? If your SFA does not have public or charter schools, or none do an activity, please write “0.”

Note: Provision 2 schools serve meals at no charge to all children as determined by application once every four years and make eligibility determinations in the first year. Provision 3 schools serve meals at no charge to all children regardless of eligibility status for four-year periods. Schools participating in the Community Eligibility Provision schools serve meals at no charge to all children based on large proportions of children certified for free school meals through means other than a household application. School gardens include those that are used for nutrition education and/or food service purposes.

	Number of Public Schools	Number of Charter Schools
a. Operate under Provision 2 for the National School Lunch Program (NSLP)	| | | |	| | | |
b. Operate under Provision 2 for the School Breakfast Program (SBP)	| | | |	| | | |
c. Operate under Provision 3 for the NSLP	| | | |	| | | |
d. Operate under Provision 3 for the SBP	| | | |	| | | |
e. Participate in the Community Eligibility Provision	| | | |	| | | |
f. Offer reimbursable afterschool snacks through the NSLP	| | | |	| | | |
g. Operate a school garden	| | | |	| | | |

12. As of October 31 of the current school year, what was the total enrollment at all charter schools in your SFA?

| | | | , | | | | TOTAL ENROLLMENT

1 □ No charter schools in SFA GO TO Q.14a

13. Is your SFA a charter school management company?

1 □ Yes

0 □ No

14a. Are the following practices used in setting prices for components of reimbursable meals that are sold a la carte in elementary schools?

1 □ No reimbursable components sold a la carte other than milk in elementary schools GO TO Q.14b

	YES	NO
a. More healthful foods and beverages are discounted (for example, fruit priced lower than baked goods)	1 □	0 □
b. Foods and beverages sold as second servings are priced lower for students who select a reimbursable meal (for example, second entrées, side dishes)	1 □	0 □
c. Less healthful foods and beverages are offered at “premium” prices (for example, French fries, desserts)	1 □	0 □
d. Components of a reimbursable meal that are also sold a la carte are priced so that combination of the components are priced higher than a reimbursable meal	1 □	0 □

14b. Are the following practices used in setting prices for components of reimbursable meals that are sold a la carte in middle schools?

1 □ No reimbursable components sold a la carte other than milk in middle schools GO TO Q.14c

	YES	NO
a. More healthful foods and beverages are discounted (for example, fruit priced lower than baked goods)	1 □	0 □
b. Foods and beverages sold as second servings are priced lower for students who select a reimbursable meal (for example, second entrées, side dishes)	1 □	0 □
c. Less healthful foods and beverages are offered at “premium” prices (for example, French fries, desserts)	1 □	0 □
d. Components of a reimbursable meal that are also sold a la carte are priced so that combination of the components are priced higher than a reimbursable meal	1 □	0 □

14c. Are the following practices used in setting prices for components of reimbursable meals that are sold a la carte in high schools?

1 □ No reimbursable components sold a la carte other than milk in high schools GO TO Q.14d

	YES	NO
a. More healthful foods and beverages are discounted (for example, fruit priced lower than baked goods)	1 □	0 □
b. Foods and beverages sold as second servings are priced lower for students who select a reimbursable meal (for example, second entrées, side dishes)	1 □	0 □
c. Less healthful foods and beverages are offered at “premium” prices (for example, French fries, desserts)	1 □	0 □
d. Components of a reimbursable meal that are also sold a la carte are priced so that combination of the components are priced higher than a reimbursable meal	1 □	0 □

14d. Are the following practices used in setting prices for components of reimbursable meals that are sold a la carte in other schools?

1 □ No reimbursable components sold a la carte other than milk in other schools GO TO Q.15

	YES	NO
a. More healthful foods and beverages are discounted (for example, fruit priced lower than baked goods)	1 □	0 □
b. Foods and beverages sold as second servings are priced lower for students who select a reimbursable meal (for example, second entrées, side dishes)	1 □	0 □
c. Less healthful foods and beverages are offered at “premium” prices (for example, French fries, desserts)	1 □	0 □
d. Components of a reimbursable meal that are also sold a la carte are priced so that combination of the components are priced higher than a reimbursable meal	1 □	0 □

15. SFAs that are certified for compliance with the new meal requirements receive an additional 6 cents reimbursement per NSLP reimbursable lunch. What is your SFA’s current certification status?

mark one only

1 □ Certified for additional 6 cents reimbursement

2 □ Certification decision is pending

3 □ Application for certification was denied

4 □ Certification was revoked

5 □ SFA has not applied for certification

6 □ Some other status (Specify)

16. Since school year (SY) 2012-2013, has your SFA received any food service operations training or technical assistance (TA) to implement the new meal requirements? Please do not include training or TA that you or your SFA supervisory/management staff may have provided to school-level staff.

1 □ Yes

0 □ No GO TO Q.19

17. Since SY 2012-2013, which of the following types of food service operations training or TA have you received? For each type of training or TA you received, please indicate who provided it.

	MARK ALL THAT APPLY PER ROW
training/ta topic	FNS Regional Office provided training or TA	State Child Nutrition agency provided training or TA	A private contractor provided training or TA	National Foodservice Management Institute provided training or TA	Other ENTITY or person provided training or TA	NO TRAININg OR TA PROVIDED
a. Menu planning	1 □	2 □	3 □	4 □	5 □	6 □
b. Nutrition education	1 □	2 □	3 □	4 □	5 □	6 □
c. General nutrition	1 □	2 □	3 □	4 □	5 □	6 □
d. Food production	1 □	2 □	3 □	4 □	5 □	6 □
e. Food serving	1 □	2 □	3 □	4 □	5 □	6 □
f. Cashiering/point-of-service	1 □	2 □	3 □	4 □	5 □	6 □
g. Food purchasing	1 □	2 □	3 □	4 □	5 □	6 □
h. Receiving and storage	1 □	2 □	3 □	4 □	5 □	6 □
i. Food safety	1 □	2 □	3 □	4 □	5 □	6 □
j. Verifying free/ reduced meal applications	1 □	2 □	3 □	4 □	5 □	6 □
k. Program and human resource management	1 □	2 □	3 □	4 □	5 □	6 □
l. Financial management	1 □	2 □	3 □	4 □	5 □	6 □
m. Staff training	1 □	2 □	3 □	4 □	5 □	6 □
n. Facilities and equipment planning	1 □	2 □	3 □	4 □	5 □	6 □
o. Communications, marketing, and/or public relations	1 □	2 □	3 □	4 □	5 □	6 □
p. Other (Specify)	1 □	2 □	3 □	4 □	5 □	6 □

18. Using a scale of 1 to 5, where 1=not at all adequate and 5=more than adequate, please rate the overall adequacy of the training or TA you received to implement the new meal requirements.

N ot at all adequate				more than adequate
1 □	2 □	3 □	4 □	5 □

19. Following is a list of potential challenges that SFAs may face in being able to fully implement (if not certified) or maintain compliance with (if certified) the new meal requirements. On a scale of 1 to 5, where
1=not a challenge and 5=a significant challenge, please rate the degree to which each is currently a challenge in your SFA.

	MARK ONE PER ROW
	Not a challenge				A significant challenge
a. Understanding the new meal requirements	1 □	2 □	3 □	4 □	5 □
b. Availability of foods to meet the new meal requirements	1 □	2 □	3 □	4 □	5 □
c. Cost of foods to meet the new meal requirements	1 □	2 □	3 □	4 □	5 □
d. Needing to offer different portion sizes to different grade groups	1 □	2 □	3 □	4 □	5 □
e. Needing additional staff or labor hours	1 □	2 □	3 □	4 □	5 □
f. Training of staff	1 □	2 □	3 □	4 □	5 □
g. Needing additional equipment	1 □	2 □	3 □	4 □	5 □
h. Needing to remodel or upgrade kitchens	1 □	2 □	3 □	4 □	5 □
i. Other (Specify)	1 □	2 □	3 □	4 □	5 □

20. How helpful do you think the new meals requirements have been to your SFA in achieving the following underlying goals?

	MARK ONE PER ROW
	Not at all HELPFUL	SOMEWHAT HELPFUL	VERY HELPFUL	SFA WAS ALREADY ACHIEVING THIS GOAL
a. Improving the nutritional quality of the meals offered	1 □	2 □	3 □	4 □
b. Increasing children’s consumption of whole grains	1 □	2 □	3 □	4 □
c. Increasing children’s consumption of dark green and red/orange vegetables	1 □	2 □	3 □	4 □
d. Increasing children’s consumption of beans/peas	1 □	2 □	3 □	4 □
e. Increasing children’s consumption of fruit (not counting fruit juice)	1 □	2 □	3 □	4 □
f. Increasing children’s consumption of skim or low-fat milks	1 □	2 □	3 □	4 □
g. Decreasing children’s sodium intakes	1 □	2 □	3 □	4 □
h. Meeting (but not exceeding) children’s calorie requirements	1 □	2 □	3 □	4 □

21. Competitive foods are all foods and beverages other than reimbursable meals available for sale to students on the school campus during the school day. USDA issued new rules that define nutrition standards for all foods and beverages sold on school campuses during the school day. These rules went into effect in SY 2014-2015.

Do elementary, middle, or high schools in your SFA have nutrition standards for competitive foods that exceed the new federal requirements?

	MARK ONE PER ROW
	YES	NO	NO COMPETITIVE FOODS
a. Elementary schools	1 □	0 □	n □
b. Middle schools	1 □	0 □	n □
c. High schools	1 □	0 □	n □

22. To what extent have the nutrition guidelines for competitive foods been implemented in your SFA?

MARK ONE ONLY

1 □ Fully implemented GO TO Q.24

2 □ Partially implemented

3 □ Not at all implemented

4 □ No competitive foods available in the SFA GO TO Q.24

d □ Don’t know

23. Following is a list of potential challenges to being able to fully implement the new nutrition standards for competitive foods. Using a scale of 1 to 5, where 1=not a challenge and 5=a significant challenge, please rate the degree to which each is a challenge in your SFA.

	MARK ONE PER ROW
	Not a challenge				A significant challenge
a. Understanding the new nutrition standards for competitive foods	1 □	2 □	3 □	4 □	5 □
b. Availability of competitive foods that meet the new nutrition standards	1 □	2 □	3 □	4 □	5 □
c. Cost of competitive foods that meet the new nutrition standards	1 □	2 □	3 □	4 □	5 □
d. Student acceptance of competitive foods that meet the new nutrition standards	1 □	2 □	3 □	4 □	5 □
e. School faculty and staff reactions to the competitive foods that meet the new nutrition standards	1 □	2 □	3 □	4 □	5 □
f. Other (Specify)	1 □	2 □	3 □	4 □	5 □

24. Are all menus planned at the district level?

1 □ Yes GO TO Q.26

0 □ No

25. Which types of schools plan their own menus?

MARK ALL THAT APPLY

1 □ Elementary schools

2 □ Middle schools

3 □ High schools

4 □ Other (Specify)

GO TO Q.27

26. Does your district use cycle menus?

1 □ Yes

0 □ No GO TO Q.28

27. Do elementary, middle, or high schools use cycle menus?

MARK ALL THAT APPLY

1 □ Elementary schools

2 □ Middle schools

3 □ High schools

0 □ None

28. Does your district conduct nutrient analysis of menus?

1 □ Yes

0 □ No

29. Since school year 2012-2013 when the new meal patterns and nutrition standards for school meals went into effect, have you used any of the following USDA resources or guidance materials in planning menus, developing or modifying recipes, or developing purchasing specifications?

MARK ALL THAT APPLY

1 □ Offer Versus Serve Guidance for the National School Lunch Program and the School Breakfast Program

2 □ Fact Sheets for Healthier School Meals (for example, Serve More Whole Grains or Trim Trans Fat)

3 □ Recipes for Healthy Kids Cookbook

4 □ Food Buying Guide for Child Nutrition Programs Revised for School Meals

5 □ Fruits and Vegetables Galore

6 □ HealthierUS School Challenge Whole Grains Resource

7 □ New School Lunch and Breakfast Recipes/Tool Kit for Healthy School Meals

8 □ Nutrient Analysis Protocols: How to Analyze Menus for USDA’s School Meals Programs

9 □ USDA Recipes for Schools

10 □ National Food Service Management Institute’s Equipment Purchasing and Facility Design for School Nutrition Programs

11 □ National Food Service Management Institute’s Procurement in the 21st Century

12 □ Other (Specify)

0 □ None of the above

30. Who in your district has primary responsibility for determining which foods are purchased commercially (excludes USDA donated foods)?

MARK ONE ONLY

1 □ SFA or district food service director or manager

2 □ Procurement specialist or other member of SFA staff

3 □ Business manager/purchasing agent or other district staff

4 □ Kitchen/cafeteria manager or lead/head cook

5 □ Other (Specify)

31. Do any of the schools in your SFA offer foods from national or regional brand-name or chain restaurants, such as McDonald’s, Burger King, Taco Bell, Pizza Hut, Domino’s, or Subway?

1 □ Yes

0 □ No GO TO Q.35

32. Are these foods offered in reimbursable meals only, sold a la carte only, or used in both reimbursable meals and a la carte sales?

MARK ONLY ONE

1 □ Reimbursable meals only

2 □ A la carte only

3 □ Both

33. Which types of schools offer these items?

MARK ALL THAT APPLY

1 □ Elementary schools

2 □ Middle schools

3 □ High schools

4 □ Other (Specify grades)

| | | to | | |

34. From which of the following national or regional brand-name or chain restaurants are items offered?

MARK ALL THAT APPLY

1 □ Arby’s

2 □ Burger King

3 □ Chick-fil-A

4 □ Domino’s Pizza

5 □ Little Caesar’s Pizza

6 □ McDonald’s

7 □ Papa John’s Pizza

8 □ Pizza Hut

9 □ Subway

10 □ Taco Bell

11 □ Other (Specify)

35. Is your school district or are any schools in your district engaged in a “pouring rights” contract, that is, a long-term contract with a beverage company that establishes the company as a sole source vendor for beverages in the district or in the school? Count beverages sold by school food service as well as those sold in vending machines or other venues not controlled by school food service.

MARK ONLY ONE

1 □ Yes, district-wide

2 □ Yes, some schools

0 □ No GO TO Q.37

36. Does the beverage contract limit the types or brands of beverages that can be sold in school food service areas?

1 □ Yes

0 □ No

37. Does your district purchase any locally-grown or produced foods through the “State Farm to School” program or other arrangements?

MARK ONLY ONE

1 □ Yes, through the “State Farm to School” program

2 □ Yes, through another arrangement

0 □ No

38. Does your SFA participate with other SFAs in a food purchasing cooperative?

1 □ Yes

0 □ No

39. What is the dollar amount of your SFA’s USDA donated food entitlement for SY 2014-2015?

$ | | | , | | | | , | | | |.00 DOLLARS

d □ Don’t know

40. In dollars, how much of your SFA’s donated food entitlement for SY 2014-2015 was spent on processed end products that incorporate USDA Foods?

$ | | | , | | | | , | | | |.00 DOLLARS

d □ Don’t know

41. Does your SFA apply part of your USDA Foods entitlement or use cash reimbursements to purchase fruits and vegetables through the U.S. Department of Defense “DoD Fresh” program?

1 □ Yes

0 □ No

42. Does your district use food purchasing specifications that include specific requirements for any of the following? Please do not include information requests to vendors or purchasing cooperatives as specific requirements in the specifications.

	MARK ONE PER ROW
	YES	NO
a. Calories	1 □	0 □
b. Total fat	1 □	0 □
c. Saturated fat	1 □	0 □
d. Trans fat	1 □	0 □
e. Sodium	1 □	0 □
f. Total or added sugar	1 □	0 □
g. Fiber	1 □	0 □
h. Whole grains	1 □	0 □
i. Other (Specify)	1 □	0 □
j. Other (Specify)	1 □	0 □

If Q42d=1, please go to Q43. Otherwise, go to Q44.

43. Did your district’s food purchasing specifications for SY 2014-2015 require that all commercially prepared foods and ingredients contain zero grams of trans fat per serving?

1 □ Yes

0 □ No

44. For all commercially prepared foods and ingredients acquired during SY 2014-2015, do the nutrition labels or manufacturer’s specifications indicate that the products contains zero grams of trans fat per serving?

1 □ Yes

0 □ No

45. Does your SFA use Alliance for a Healthier Generation or other similar tools for selecting and purchasing healthier foods?

1 □ Yes

0 □ No

46. What funds are used to buy new capital equipment or replace or repair aging equipment? Capital equipment purchases are usually at least $5,000 and can be depreciated over time.

MARK ALL THAT APPLY

1 □ SFA budget

2 □ USDA grant

3 □ State grant

4 □ Local education agency funds

5 □ School funds

6 □ Fundraiser

7 □ Other (Specify)

n □ SFA is not responsible for capital costs for equipment purchases

d □ Don’t know

47. Since the start of SY 2012-2013, has your SFA purchased any new equipment to implement the new meal patterns and nutrient requirements for school meals?

1 □ Yes

0 □ No

d □ Don’t know

48. Across the following service functions, has equipment been purchased for any kitchens in your SFA since SY 2012-2013 to implement the new meal patterns and nutrient requirements?

	MARK ONE PER ROW
	YES	NO
a. Receiving and storage (for example, platforms and hand trucks, scales, or walk-in refrigerators/freezers)	1 □	0 □
b. Food preparation (for example, slicers, food processors, utility carts, stainless steel work tables, or combi ovens)	1 □	0 □
c. Holding and transportation (for example, refrigerated or non-refrigerated trucks, hot holding mobile carts, or walk-in coolers [separate from receiving/storage refrigerators])	1 □	0 □
d. Salad or fruit/vegetable bars	1 □	0 □
e. Other meal service equipment (for example, mobile milk coolers, steam table pans or serving portion utensils	1 □	0 □

49. Which of the following stakeholders were consulted when developing the local wellness policy?

MARK ALL THAT APPLY

1 □ SFA director

2 □ Superintendent or other district staff

3 □ School board members

4 □ School principals or other administrative staff

5 □ School foodservice staff

6 □ Student nutrition advisory council

7 □ Community nutrition advisory council

8 □ School nurse or other school health professionals

9 □ Dietitian or nutritionist

10 □ Physical education or health teachers

11 □ Other teachers

12 □ Parents

13 □ Students

14 □ Other community members

15 □ Stakeholders were not consulted when developing the local wellness policy

16 □ Other (Specify)

n □ School district does not have a local wellness policy

d □ Don’t know

50. If the district’s designated wellness coordinator has another job in the district, what is his or her other job title?

MARK ONE ONLY

1 □ District administrator

2 □ School administrator

3 □ School nurse

4 □ Foodservice staff

5 □ Other nutrition professional

6 □ Health, physical education, or nutrition teacher

7 □ Coach or athletic director

8 □ Other teacher

9 □ Other (Specify)

10 □ District’s designated wellness coordinator does not have another job in the district

n □ District does not have a designated wellness coordinator

51. Following is a list of potential and required wellness policy components. For each, please indicate whether the component is addressed in your district wellness policy and, if so, the extent to which the wellness policy components have been implemented.

	MARK ONE RESPONSE PER ROW
	ADDRESSED IN POLICY AND FULLY IMPLEMENTED	ADDRESSED IN POLICY AND PARTIALLY IMPLEMENTED	STILL BEING PLANNED	NOT ADDRESSED IN POLICY
a. Nutrition education	1 □	2 □	3 □	4 □
b. Nutrition promotion	1 □	2 □	3 □	4 □
c. Physical education (PE)	1 □	2 □	3 □	4 □
d. Daily physical activity (outside of PE)	1 □	2 □	3 □	4 □
e. Restrictions on the use of food or food coupons as student rewards	1 □	2 □	3 □	4 □
f. Access to competitive foods during school hours	1 □	2 □	3 □	4 □
g. Minimum amount of time for students to eat lunch	1 □	2 □	3 □	4 □
h. Staff wellness program	1 □	2 □	3 □	4 □
i. Plan for measuring implementation of the policy, including the extent in compliance with the policy	1 □	2 □	3 □	4 □
j. Plan for describing the progress made towards attaining the goals of the policy	1 □	2 □	3 □	4 □
k. Plan for informing the public about the wellness policy content and implementation	1 □	2 □	3 □	4 □

52. Does your district wellness policy include nutrition standards for foods and beverages offered in school meals that exceed current federal requirements? If so, to what extent have the standards been implemented?

MARK ONE ONLY

1 □ Have standards that exceed federal requirements and they are fully implemented

2 □ Have standards that exceed federal requirements and they are partially implemented

3 □ Will have standards that exceed federal requirements, but they are still being planned

4 □ Do not have standards that exceed federal requirements

53. Does your district wellness policy include nutrition standards for foods and beverages offered in afterschool snacks or sold in other school settings (for example, fundraising activities, a la carte, vending machines, school stores, or other non-food service venues) that exceed current federal requirements? If so, to what extent have the standards been implemented?

MARK ONE ONLY

1 □ Have standards that exceed federal requirements and they are fully implemented

2 □ Have standards that exceed federal requirements and they are partially implemented

3 □ Will have standards that exceed federal requirements but they are still being planned

4 □ Do not have standards that exceed federal requirements

54. Does your district wellness policy include nutrition standards for foods and beverages offered in classroom or school celebrations or in staff or parent meetings? If so, to what extent have the standards been implemented?

	mark one response per row
SCHOOL SETTING	HAVE STANDARDS AND THEY ARE FULLY IMPLEMENTED	HAVE STANDARDS AND THEY ARE PARTIALLY IMPLEMENTED	STANDARDS STILL BEING PLANNED	NO STANDARDS	NOT AVAILABLE/ ALLOWED IN DISTRICT
a. Foods and beverages served at classroom or school celebrations	1 □	2 □	3 □	4 □	5 □
b. Foods and beverages served at staff or parent meetings	1 □	2 □	3 □	4 □	5 □

55. Has your district ever evaluated the effects of the wellness policy?

1 □ Yes

0 □ No GO TO Q.59

56. What data sources has your district used to evaluate the wellness policy?

MARK ALL THAT APPLY

1 □ Student surveys or interviews

2 □ Parent surveys or interviews

3 □ School faculty or staff surveys or interviews

4 □ School foodservice staff surveys or interviews

5 □ School food sales data

6 □ School, cafeteria, classroom, or gym observations

7 □ Student height, weight, or body composition measures

8 □ Staff height, weight, or body composition measures

9 □ Other (Specify)

57. Through which of the following channels were evaluation findings reported?

MARK ALL THAT APPLY

1 □ Report to State Education or Child Nutrition agency

2 □ Publicly available report or report summary

3 □ District or school website

4 □ School menu or newsletter

5 □ Parent-Teacher Association/Organization meeting

6 □ Local news media

7 □ Other (Specify)

58. For each of the following wellness policy components, please indicate the extent to which the evaluation found schools in your SFA to be in compliance with the component.

	MARK ONE PER ROW
	schools are not in compliance					schools are in compliance		NOT in wellness policy/Not EVALUATED
a. Nutrition promotion	1 □	2 □		3 □	4 □		5 □	n □
b. Nutrition education	1 □	2 □		3 □	4 □		5 □	n □
c. Physical education (PE)	1 □	2 □		3 □	4 □		5 □	n □
d. Daily physical activity (outside of PE)	1 □	2 □		3 □	4 □		5 □	n □
e. Restrictions on the use of food or food coupons as student rewards	1 □	2 □		3 □	4 □		5 □	n □
f. Access to competitive foods during school hours	1 □	2 □		3 □	4 □		5 □	n □
g. Minimum amount of time for students to eat lunch	1 □	2 □		3 □	4 □		5 □	n □
h. Staff wellness program	1 □	2 □		3 □	4 □		5 □	n □
i. Plan for measuring implementation of the policy	1 □	2 □		3 □	4 □		5 □	n □
j. Plan for describing the progress made towards attaining the goals of the policy	1 □	2 □		3 □	4 □		5 □	n □
k. Plan for informing the public about the wellness policy content and implementation	1 □	2 □		3 □	4 □		5 □	n □

59. Which of the following communication channels does your SFA use to promote USDA-reimbursable meals?

MARK ALL THAT APPLY

1 □ Send home menus/flyers/newsletters

2 □ Email information to parents

3 □ Post information in schools (for example, on bulletin boards or on cafeteria lines)

4 □ Post information online (for example, on district/school website)

5 □ Broadcast information on TV

6 □ Broadcast information on the radio

7 □ Post information in local newspapers

8 □ Other (Specify)

60. Have you or has anyone on your staff engaged in any of the following activities?

MARK ALL THAT APPLY

1 □ Conducted a taste test activity with students

2 □ Involved students in planning school meal menus

3 □ Involved students in naming items offered

4 □ Attended a Parent/Teacher Association/Organization or other parent group meeting to discuss the school meal program

5 □ Conducted a nutrition education activity in the classroom

6 □ Conducted a nutrition education activity in the food service area

7 □ Set up a booth at a school event to promote/inform about school meals (for example, a family night or parent-teacher conference night)

8 □ Met with teachers to explain school meal program or discuss how program can work with classroom teachers

9 □ Discussed student food allergies with school nurse or classroom teachers

10 □ Participated in a school or district meeting about the local wellness policy

11 □ Shared information about the school meal program with a nutrition advisory council

12 □ Met with an advisory group to plan or assess nutrition education or promotion activities

13 □ Invited family members to consume a school meal

14 □ Invited community members to plan or promote school meals (for example, local chefs, farmers, dietitians/nutritionists, Cooperative Extension agents, local sports figures, police officers, firefighters, or other local heroes)

15 □ Presented information about school meals to a local civic or community service group (for example, a chamber of commerce, Lions Club, Rotary International, or a similar organization)

61. (If at least one school in Q.11f) Which of the following entities operates the afterschool programs for which your SFA provides snacks?

MARK ALL THAT APPLY

1 □ School district/individual schools

2 □ YMCA/YWCA

3 □ Community action agency

4 □ Parent-Teacher Association/Organization

5 □ Church-affiliated organization

6 □ Child care agency

7 □ Community park/recreation department

8 □ Other (Specify)

d □ Don’t know

62. Does your school district currently use a food service management company (FSMC) to perform any food service functions?

1 □ Yes

0 □ No GO TO Q.66

63. Which entity, the SFA, the FSMC, or both, is responsible for the following food service functions?

	MARK ONE PER ROW
	SFA	FSMC	Both
a. Preparing reimbursable meals	1 □	2 □	3 □
b. Serving reimbursable meals	1 □	2 □	3 □
c. Menu planning	1 □	2 □	3 □
d. Providing equipment or facilities for food preparation	1 □	2 □	3 □
e. Activities supporting food service such as food purchasing, inventory and storage, or nutrition education	1 □	2 □	3 □
f. Vendor payment	1 □	2 □	3 □
g. Certification and verification of eligibility for free or reduced-price meals	1 □	2 □	3 □
h. FSMC personnel management	1 □	2 □	3 □

64. On what basis is the FSMC fee determined?

MARK ONLY ONE

1 □ Flat administrative fee

2 □ Per-meal fee

3 □ Combination of administrative fee and per-meal fee

4 □ Percentage of total cafeteria sales

5 □ Some other arrangement (Specify)

d □ Don’t know

65. Who monitors the performance of the FSMC?

MARK ALL THAT APPLY

1 □ School district business manager

2 □ School food authority

3 □ Superintendent

4 □ School principal

5 □ School board

6 □ Some other arrangement (Specify)

7 □ Not applicable – not monitored

d □ Don’t know

66. Has your school district changed prices for reduced-price or full-price lunches or breakfasts since school year 2012-2013?

1 □ Yes

0 □ No

d □ Don’t know

67. Please indicate how meal prices changed in elementary schools:

1 □ Not applicable (no elementary schools in SFA) GO TO Q.68

	MARK ONE PER ROW
	INCREASED	DECREASED	NOT CHANGED	NO BREAKFAST
a. Reduced-price lunch	1 □	2 □	3 □
b. Full-price lunch	1 □	2 □	3 □
c. Reduced-price breakfast	1 □	2 □	3 □	0 □
d. Full-price breakfast	1 □	2 □	3 □	0 □

68. Please indicate how meal prices changed in middle schools:

1 □ Not applicable (no middle schools in SFA) GO TO Q.69

	MARK ONE PER ROW
	INCREASED	DECREASED	NOT CHANGED	NO BREAKFAST
a. Reduced-price lunch	1 □	2 □	3 □
b. Full-price lunch	1 □	2 □	3 □
c. Reduced-price breakfast	1 □	2 □	3 □	0 □
d. Full-price breakfast	1 □	2 □	3 □	0 □

69. Please indicate how meal prices changed in high schools:

1 □ Not applicable (no high schools in SFA) GO TO Q.70

	MARK ONE PER ROW
	INCREASED	DECREASED	NOT CHANGED	NO BREAKFAST
a. Reduced-price lunch	1 □	2 □	3 □
b. Full-price lunch	1 □	2 □	3 □
c. Reduced-price breakfast	1 □	2 □	3 □	0 □
d. Full-price breakfast	1 □	2 □	3 □	0 □

70. Which of the following factors does your school district consider in setting prices for a la carte items sold in school cafeterias?

MARK ALL THAT APPLY

1 □ No a la carte items sold in any school cafeteria GO TO Q.74

2 □ Food cost

3 □ Production labor cost (wages, benefits, etc.)

4 □ Other production costs (utilities, equipment, supplies, etc.)

5 □ Administrative or indirect costs

6 □ Incentive for student consumption of specific items (milk, etc.)

7 □ Incentive for student participation in reimbursable meal program

8 □ Ease of collecting payments

9 □ School principal

10 □ Other (Specify)

d □ Don’t know

71. Does your district set prices for a la carte items using a percentage markup or a fixed dollar markup on food or other costs?

1 □ Yes

0 □ No

d □ Don’t know

72. What costs are included in the base for calculating a la carte prices? The base is the amount to which the markup is added.

MARK ALL THAT APPLY

1 □ Food cost

2 □ Production labor

3 □ Other production costs

4 □ Administrative or indirect costs

5 □ Other (Specify)

d □ Don’t know

73. What is the amount of the percentage or dollar markup used for setting prices for a la carte foods? If you report as a percentage, please use your cost as the base (denominator) when figuring the percentage. Enter percentage or check if not applicable.

	PERCENTAGE OR DOLLAR MARKUP	NO SPECIFIED MARKUP	NOT APPLICABLE
a. Milk	| | | % or $ | | |	1 □	n □
b. Other items on reimbursable menu	| | | % or $ | | |	1 □	n □
c. Other (a la carte only) items	| | | % or $ | | |	1 □	n □

74. How long have you been a school food service director?

| | | YEARS OR | | | MONTHS

75. Do you receive health benefits for your SFA director position?

1 □ Yes

0 □ No

76. Approximately how many full-time SFA employees receive health benefits?

MARK ONLY ONE

1 □ All

2 □ Most

3 □ Some

4 □ None

d □ Don’t know

77. What is the highest grade or year of schooling you completed?

MARK ONLY ONE

1 □ Less than high school

2 □ High school

3 □ Some college, no degree

4 □ Associates degree

5 □ Bachelor’s degree

6 □ Master’s degree

7 □ Graduate credits beyond a Master’s degree

8 □ Doctorate

78. Is your degree in foods and nutrition, family and consumer sciences, nutrition education, food service management, culinary arts, business, or public/school administration?

1 □ Yes

0 □ No

79. Which of the following credentials do you hold?

MARK ALL THAT APPLY

1 □ Licensed Nutritionist or Dietitian

2 □ Registered Dietitian

3 □ School Nutrition Association Level 1 certification

4 □ School Nutrition Association Level 2 certification

5 □ School Nutrition Association Level 3 certification

6 □ School Nutrition Association, School Nutrition Specialist (SNS)

7 □ State food service certificate

8 □ Food safety certification, such as ServSafe, National Registry of Food Safety Professionals, Prometric Certified Professional Food Manager, or Learn2Serve

9 □ Health department certification

10 □ Certified dietary manager

11 □ Dietetic Technical Registered (DTR)

12 □ Other (Specify)

0 □ None of the above

80. Please share any additional comments you have about the school meals programs.

Thank you very much for taking the time to complete this survey.

Your assistance is greatly appreciated.