State, Local, and Tribal Government - State Child Nutrition Agency, SFA, and Schools

APPENDIX B3. SFA REQUEST FOR E-RECORDS (CEP SCHOOLS FOR ISP DATA ABSTRACTION)

FOR SFAS WITH AT LEAST ONE CEP SCHOOL

OMB Number: 0584-0530

Expiration Date: XX/XX/XXXX

Dear <<SFA CONTACT NAME>>,

Thank you for agreeing to participate in the third Access, Participation, Eligibility and Certification Study (APEC III) series.

As a reminder, the United States Department of Agriculture (USDA) Food and Nutrition Service (FNS) has contracted with Westat to conduct APEC III. APEC III is a research study, not an audit of any type. All information collected will be kept private to the extent provided by law and will not affect meal reimbursements or meal program benefits for any participating State agency, SFA, school, or household.

Next Steps

In order to complete the student records sampling, we request that you submit a data file (electronically via the APEC III Web Portal) with a complete list of students enrolled in the CEP school(s) sampled from your SFA for 2017-2018 school year. Your sampled CEP schools are:

[CEP SCHOOL 1 NAME], [SCHOOL 1 ADDRESS]

[CEPSCHOOL 2 NAME], [SCHOOL 2 ADDRESS]

[CEPSCHOOL 3 NAME], [SCHOOL 3 ADDRESS]

The data file should reflect the students enrolled in the base year, which is when the current identified student percentage (ISP) was determined. We request that you submit this file on/around [INSERT DATE]. The data file(s) should contain the following information for each student, by school:

1. Student Name

2. Student Date of Birth

3. Identified Student Status: Identified or Non Identified Certification

4. For Identified Students: Direct Certification Source (e.g., SNAP, TANF, etc.)

In addition, please provide the source documentation files/records used for direct certification to determine the ISP.

If you have questions, need assistance or foresee any issues with this request, please feel free to contact us at 1-855-820-6138 or [email protected].

Thank you in advance for your help and cooperation.

Sincerely,

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0584-0530. The time required for the SFA Director to provide this information collection is estimated to average 30 minutes per response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and complete and review the collection of information.

APEC III Research Team

MANUAL PROCESS FOR ABSTRACTION OF ISP RECORDS FOR CEP SCHOOLS

SUMMARY:

This is a “back up” manual process if the SFA does not respond to the electronic records request. This is expected to be used very seldom, if at all. This process will be completed by the data collector with no additional burden to the SFA.

In the event the list is not provided ahead of the scheduled visit, the data collector will then ask for this list in-person during the visit. At this time, the data collector will be responsible for requesting and procuring the list (either in electronic or in hard copy form) and sending it back to the home office (they will not conduct any data abstraction).

However, if the SFA does not allow the data collector to leave the office with the list, the data collector will then use the following CEP Data Abstraction Form to complete this process manually.

Purpose: Field data collectors will use the manual process to complete the CEP Data Abstraction Form at the SFA during phase one of data collection. This data will be used to determine ISP calculation error. After sampling, the data collector will review the source documents to confirm identified students are on the list. If necessary, data collectors will check to see if non-identified students are on the list. This information will be documented for each sampled student.

The data will be entered directly onto the web based data entry form on the laptop computer. Using a MiFi internet connection on their computer, the data will be automatically saved and transmitted. In the event the internet connectivity is not available, the data will be entered on hardcopy and later entered into the web based data entry form.

CEP DATA ABSTRACTION FORM (MANUAL PROCESS)

SFA Name and ID: | | | | | | | |

School Name and ID: | | | | | | | |

Section A. Data abstraction among identified students

1. Abstract data on 24 sampled students classified as identified students by the school.

1.				2.		3.
IDENTIFIED STUDENT SAMPLE				FOUND ON SOURCE DOCUMENT?		TYPE OF SOURCE DOCUMENT
LAST NAME	FIRST NAME	School ID	Student ID	YES	NO	SELECT FROM LIST OF 10 SOURCE DOCUMENTS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
Total Number

Section B. Data abstraction among non-identified students

1. Abstract data on 24 sampled students classified as non-identified students by the school.

1.				2.			3.
NON-IDENTIFIED STUDENT SAMPLE				FOUND ON SOURCE DOCUMENT?			TYPE OF SOURCE DOCUMENT
LAST NAME	FIRST NAME	School ID	Student ID	YES	NO		SELECT FROM LIST OF 10 SOURCE DOCUMENTS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
Total Number
C. DATA COLLECTOR SIGNATURE ______________________________________________________ DATA COLLECTOR ID |___|___| - |___|___|___|___|___|						DATE: | | | / | | | / | | | MONTH DAY YEAR

2