| Appendix D: FDP State Agency File Upload Templates v1 02192021 | |||||||||||||||||||||||||||||||||||||||||
| Field Name | FNS WIC ID | State WIC ID | FNS Number | Name | DBA | Chain Store Num | Street Num | Street Name | Suite or Unit | City | State | Zip Code | County | No Physical Address | Location Description | Latitude | Longitude | Unauthorized Store | Peer Group | Initial Auth Date | Food Delivery Method | Retail Category | Contractor | Online Ordering Options | Num of Store Registers | Store Sq Ft | WIC Only | Mobile Vendor | Online Vendor | Status | Assessed For Participant Access | Participant Access Reasons | Denial Reason | Other Denial Reason | Agreement Start Date | Agreement End Date | Agreement Termination Date | Termination Reason | Other Termination Reason | Num of Stores Owned | Num of Other WIC Vendors |
| Field Type | Text | Text | Number | Text | Text | Text | Text | Text | Text | Text | Picklist | Text | Text | Boolean | Text | Number | Number | Boolean | Picklist | Date | Picklist | Picklist | Text | Picklist | Number | Number | Boolean | Boolean | Boolean | Picklist | Boolean | Picklist | Picklist | Text | Date | Date | Date | Picklist | Text | Number | Number |
| Field Length | 18 | 32 | 7 | 60 | 60 | 8 | 20 | 100 | 100 | 40 | 2 | 10 | 40 | 3 | 255 | 10-digit, 6 decimal places | 10-digit, 6 decimal places | 3 | Custom Policy Setting will be entered from State agency data entry/input. | Date Length | See Valid Values below | See Valid Values below | 40 | See Valid Values below | 4 | 6 | 3 | 3 | 3 | See Valid Values below | 3 | See Valid Values below | See Valid Values below | 100 | Date Length | Date Length | Date Length | See Valid Values below | 100 | 4 | 7 |
| Example Data | a2Q2J00000kMQKX | 4545 | 1234567 | Scott's Bakery | Scott's Bakery | #100 | 333 | Willow St | 100 | McLean | VA | 20155 | Fairfax | Yes | In parking lot | 123.110101 | 1464.345055 | No | Other (See Picklist Values below) | 10/10/2020 | Retail | Farmers' Market | Pharmacy | Delivery | 2 | 2400 | Yes | No | Yes | Authorized | No | Failed to meet business integrity selection criterion | Other | Test Denial Reason test | 1/1/2020 | 1/1/2020 | 1/1/2020 | Other | Test Other Termination Reason | 1 | 3 |
| Is Mandatory for FDE Upload? | - No (if New FDE) - Yes (if exisitng FDE) |
- No (if FDE is not Retail) - Yes (if Retail FDE has an Agreement Start date ) |
No | Yes | No | No | No | No | No | No | No | No | No | No | No | No | No | No | No | No | Yes | No | No | No | No | No | No | No | No | Yes | No | No | No | No | No | No | No | No | No | No | No |
| Field Description | Unique Salesforce identifier for the vendor record | The State agency generated ID for this record. | The FNS Number provided by SNAP, if applicable. | Full legal business name. | The 'doing business as' (DBA) name, if applicable. | The vendor's chain store number, if applicable | Street Number of the vendor's address | Street Name of the vendor's address | Suite or Unit Number of the vendor's address | City of the vendor's address | State of the vendor's address | Zip Code (Zip or Zip +4) of the vendor's address | County of the vendor's address | Indicates if the store does not have an exact address or easily definable physical location. | The description of the store’s exact location if no exact address can be provided. | The latitude coordinates for this address. | The longitude coordinates for this address. | Indicates if this store was investigated by the SA but is not a WIC authorized store. | Peer group values can be created in Policy Settings and will contain custom values from State agency data entry/input. | The date of the vendor’s initial authorization. | The food delivery method this entity operates under to ensure WIC participants have access to supplemental foods. | The category of food delivery entity within the retail food delivery system. | The type of food delivery entity within either the home or direct distribution food delivery system. | Multi-picklist: can have more than 1 value selected | The number of cash registers at the store location. | The square footage of the store location. | Indicates if this vendor provides only WIC foods or identifies as a WIC only store. | Indicates if this vendor is authorized as a mobile vendor. | Indicates if this vendor operates solely online (i.e., does not have a fixed location/storefront). | The current status of the vendor’s agreement. | Indicates if this vendor was assessed for participant access during this fiscal year. | The reason(s) the vendor was determined necessary for participant access. | The reason why the store’s application was denied. | The specific reason the store’s application was denied if “Other” was cited as a denial reason. | Agreement Start Date | Agreement End Date | Agreement Termination Date | The reason why the vendor agreement was terminated. | The specific reason the vendor’s agreement was terminated if “Other” was cited as a termination reason. | The total number of stores owned by the same ownership. | The number of other WIC authorized vendors by the same ownership. |
| Valid Values | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 2-digit code of the State | N/A | N/A | N/A | N/A | N/A | N/A | N/A | Custom picklist values will be entered from State agency data entry/input. | N/A | Retail, Direct Distribution, Home Delivery | Regular Vendor, A50 - for profit, A50 - nonprofit, Pharmacy - only exempt infant formula/nutrionals, Commissary, Farmer, Farmers' market | Pharmacy, Non-Profit, Other Contractor | In-store or curbside pickup, Delivery, Transaction in the presence of cashier, Online transaction, | N/A | N/A | N/A | N/A | N/A | Authorized, Authorized with CMP, Authorized for participant access, Authorized with disaster waiver(s), Disqualified (and agreement terminated), Agreement expired, Agreement terminated, Application pending, Application denied, Never authorized | N/A | Failed to meet business integrity selection criterion, Failed to meet competitive price selection criterion, Failed to meet State agency selection criterion, Current SNAP disqualification/CMP for hardship, Serving a mandatory sanction from another WIC State agency | Failed to meet federal selection criteria, Failed to meet State agency selection criteria, Attempted to circumvent a sanction, Submitted application outside of timeframe, Withdrew application from WIC Program, Limiting criteria, Other | Required when Denial reason= 'Other' | N/A | N/A | N/A | Failed to continue to meet federal selection criteria, Failed to continue to meet State agency selection criteria, Failed to continue to meet terms of vendor agreement, Provided false information in connection with vendor application, Underwent a change in ownership, Underwent a change in location, Ceased operations, Voluntarily withdrew from WIC program, Other | Required when Termination reason= 'Other' | N/A | N/A |
| Formatting/Validation Notes | Not required for new Food Delivery Entities | Required for all Food Delivery Entities with an Agreement Start date and Retail Food Delivery Entities | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | XXXXX, XXXXX-XXXX |
Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Custom picklist values will be entered from State agency data entry/input. | Date muse be in the m/dd/yy format | Field Left blank intentionally | Required if Food Delivery Method= 'Retail' | Required if Food Delivery Method= 'Direct Distribution' or 'Home Delivery' | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Only available if Vendor Type is = 'A50 - for profit' or 'A50 - nonprofit' | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Date muse be in the m/dd/yy format | Date muse be in the m/dd/yy format | Date muse be in the m/dd/yy format | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally |
| Field Name | FNS WIC ID | State WIC ID | Fiscal Year | Auth on Oct 1 | Num of RMVs Completed This Year | High Risk | High Risk Reasons | State Risk Reasons | Training Date 1 | Training Type 1 | Training Format 1 | Training Date 2 | Training Type 2 | Training Format 2 |
| Appendix D: FDP State Agency File Upload Templates v1 02192021 | ||||||||||||||
| Field Type | ID | Text | Text | Boolean | Number | Boolean | Picklist | Text | Date | Picklist | Picklist | Date | Picklist | Picklist |
| Field Length | 18 | 32 | 4 | 3 | 2 | 3 | See Valid Values below | 50 | Date Length | See Valid Values below | See Valid Values below | Date Length | See Valid Values below | See Valid Values below |
| Example Data | a2Q2J00000kMQKX | 1234 | 2015 | Yes | 2 | Yes | Other - New Vendor | Some other State agency reason - small amount of variation in food instrument prices | 12/12/2010 | Interactive | Interactive - On-site cashier training | 12/12/2010 | Non Interactive | Not interactive - Video |
| Is Mandatory for Annual Data or Training Upload? | Yes | No | Yes | No | No | No | No | No | Yes | Yes | Yes | Yes | Yes | Yes |
| Field Description | Unique Salesforce identifier for the vendor record | The State agency generated ID for this record. | The federal fiscal year for this record. | Indicates if this vendor was authorized by the SA as of October 1 of the fiscal year. | The number of routine monitoring visits (RMVs) conducted during this fiscal year. | Indicates if this vendor was identified as high risk this fiscal year. | High risk reasons that were identified for this vendor. | Any SA specific high risk reasons that were identified for this vendor. | Training Date | The type of training provided (e.g., Interactive, or non-interactive training?) | Please select the answer that best describes the training format. | Training Date | The type of training provided (e.g., Interactive, or non-interactive training?) | Please select the answer that best describes the training format. |
| Valid Values | N/A | N/A | N/A | N/A | N/A | N/A | Redemption - Extremely small amount of variation in food instrument prices, Redemption - Large percent of food instruments redeemed at same price, Redemption - Unusually high average food instrument prices, Redemption - Redeemed prices are higher than their price list, Volume - Large percent of high-priced food instruments, Volume - Volume of WIC business, Volume - Large increase of dollar volume of food instruments redeemed over time, Volume - Large percent of the area’s total WIC redemptions, Volume - WIC sales are an unusually high percentage of vendor’s total sales, Volume - High WIC to SNAP redemption ratio, Volume - WIC and SNAP Program sales are an unusually high percentage of total sales, Participant - Participant/other complaints, Participant - Large number of participants redeeming food instruments outside of their health service area, Participant - Large number of participants redeeming food instruments who are considered to be at high health risk, Non-EBT - Large number of food instruments with consecutive serial numbers, Non-EBT - Large percentage of manually issued food instruments, Non-EBT - Excessive number of returned checks due to errors, Other - Past history of violations and disqualifications, Other - Associations with known violators, Other - Multiple ownerships which include known violators, Other - Short on authorized food items or no inventory, Other - New Vendor, Other - Random Selection, Other - Multiple ownerships which include known violators, Other - Short on authorized food items or no inventory, Other - New Vendor, Other - Random Selection |
N/A | N/A | Interactive, Non Interactive | Interactive - On-site cashier training, Interactive - Off-site classroom training , Interactive - Train-the-trainer sessions, Not interactive - Newsletter , Not interactive - Video , Not interactive - Webinar , Not interactive - Other |
N/A | Non Interactive | Not interactive - Video |
| Formatting/ Validation Notes | Field Left blank intentionally | Compare against FNS WIC ID and should match | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Multi-picklist: can have more than 1 value selected | Field Left blank intentionally | After Annual data, the next 3 fields will be for each trainings. Date muse be in the m/dd/yy format | Field Left blank intentionally | Field Left blank intentionally | Date muse be in the m/dd/yy format | Field Left blank intentionally | Field Left blank intentionally |
| Appendix D: FDP State Agency File Upload Templates v1 02192021 | ||||||
| Field Name | FNS WIC ID | State WIC ID | Year | Month | Non-CVB amount | CVB amount |
| Field Type | ID | Text | Number | Picklist | Number | Number |
| Field Length | 18 | 32 | 4 | See Valid Values below | 9-digit, 2 decimal places | 9-digit, 2 decimal places |
| Example Data | a2Q2J00000kMQKX | 1234 | 2020 | JAN | 200.50 | 100.50 |
| Is Mandatory for Redemption Upload? | Yes | No | Yes | Yes | No | No |
| Field Description | Unique Salesforce identifier for the vendor record | The State agency generated ID for this record. | The calendar year for the transaction data provided. | The calendar month for the transaction data provided. | The total value of all Non-CVB redemptions in the calendar month. | The total value of all CVB redemptions in the calendar month. |
| Valid Values | N/A | N/A | N/A | January, February, March, April, May, June, July, August, September, October, November, December |
N/A | N/A |
| Formatting/ Validation Notes | Not required for new Food Delivery Entities | Required for all Food Delivery Entities with an Agreement Start date and for Retail Food Delivery Entities | Field left blank intentionally | Field left blank intentionally | Field left blank intentionally | Field left blank intentionally |
| Appendix D: FDP State Agency File Upload Templates v1 02192021 | ||||||||||||||||||
| Field Name | FNS WIC ID | State WIC ID | Investigation Start Date | Investigation End Date | Investigation Status | Reason Closed | Investigation Outcome | Num of Compliance Buys | Inventory Audit Completed | Claim Amount | Admin Review Requested | Administrative Review Status or Outcome | Judicial Review Requested | Judicial Review Status or Outcome | Collections 1- Date Received | Amount | Collections 2- Date Received | Amount |
| Field Type | ID | Text | Date | Date | Picklist | Text | Boolean | Number | Boolean | Number | Boolean | Picklist | Boolean | Picklist | Date | Number(9,2) | Date | Number(9,2) |
| Field Length | 18 | 32 | Date Length | Date Length | See Valid Values below | 255 | 3 | 2 | 3 | 8-digit, 2 decimal places | 3 | See Valid Values below | 3 | See Valid Values below | Date Length | 9-digit, 2 decimal places | Date Length | 9-digit, 2 decimal places |
| Example | a2Q2J00000kMQKX | 21323 | 1/1/2020 | 1/1/2020 | Open | Store Closed | Yes | 2 | Yes | 2300.99 | Yes | Pending | No | Pending | 02/02/2020 | 10000.23 | 02/02/2020 | 10000.23 |
| Is Mandatory for Investigation or Claim Collection Upload? | Yes | No | Yes | No | Yes | No | No | No | No | No | No | No | No | No | No | No | No | No |
| Field Description | Unique Salesforce identifier for the vendor record | The State agency generated ID for this record. | Investigation Start Date | Investigation End Date | The current status of the investigation. Please note the “Closed” status indicates that the investigation was closed, but not completed per 246.12(j)(4). | The reason the investigation was closed but not completed. | Indicates if there was a Sanction or No Sanction outcome. | The total number of compliance buys conducted in the investigation. | Indicates if an inventory audit was conducted as part of the investigation. | The total amount of all claims established in this investigation. | Indicates if an Admin Review has been requested | Indicates the status of the Admin Review | Indicates if a Judicial Review has been requested | Indicates the status of the Judicial Review | The date the Collections was received | The amount collected in this payment. | The date the Collections was received | The amount collected in this payment. |
| Valid Values | N/A | N/A | N/A | N/A | Open, Completed, Closed. | store closed, store voluntarily withdrew, store DQ'ed by SNAP | N/A | N/A | N/A | N/A | N/A | Pending, Upheld, Overturned, Modified | N/A | Pending, Upheld, Overturned, Modified | N/A | N/A | N/A | N/A |
| Formatting/ Validation Notes | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Sanction, No Sanction | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally | Required, if ARR is Yes | Optional. Only available if AR.Administrative Review Outcome is valued. | Required, if JRR= Yes | Repeat collections for each investigation | Field Left blank intentionally | Field Left blank intentionally | Field Left blank intentionally |
| Field Name | FNS WIC ID | State WIC ID | Investigation Start Date | Violation | State Violation | Num of Violations | Pattern Established | Notification Sent | Documented Non-notification | |
| Field Type | ID | Text | Date | Picklist | Picklist | Number | Boolean | Boolean | Boolean | |
| Field Length | 18 | 32 | Date Length | See Valid Values below | Custom Policy Setting will be entered from State agency data entry/input. | 2 | 3 | 3 | 3 | |
| Appendix D: FDP State Agency File Upload Templates v1 02192021 | ||||||||||
| Example Data | a2Q2J00000kMQKX | 21323 | 1/1/2020 | Vendor Overcharge | Other (See Picklist Values below) | 2 | Yes | Yes | Yes | |
| Is Mandatory for Violations Upload? | Yes | No | Yes | Yes | No | Yes | No | No | No | |
| Field Description | Unique Salesforce identifier for the vendor record | The State agency generated ID for this record. | Investigation Start Date | The violations that result in mandatory vendor sanctions as outlined in 246.12(l)(1)(i-iv). | The vendor violations not specified in 246.12(l)(1)(i-iv), but included in the SA's sanction schedule. SA violations are defined in the Policy Settings area. | The total number of times this violation has been found during this investigation. | Indicates if a pattern of violations has been established for this violation. | Indicates if a notification of violation was sent for the initial instance of this violation. | Indicates if a notification of violation was not sent to the vendor. | |
| Valid Values | N/A | N/A | N/A | Trafficking Selling firearms, ammunition, explosives, and/or controlled substances Selling alcohol and/or tobacco products Claiming reimbursement in excess of the store's documented inventory Overcharging Receiving, transacting, and/or redeeming through unauthorized channels Charging for supplemental food not received by the participant Providing credit and/or non-food items (other than alcohol, tobacco products, cash, firearms, ammunition, explosives, or controlled substances) Providing unauthorized food items Charging for supplemental foods provided in excess of those in the benefit balance Providing prohibited incentive items State agency violation Providing prohibited incentive items State agency violation |
Custom picklist values will be entered from State agency data entry/input. | N/A | N/A | N/A | N/A | |
| Formatting/ Validation Notes | Field left blank intentionally | Field left blank intentionally | Used to identify Investigation | Num of violations is updated when new violations of the same type occur | Custom picklist values will be entered from State agency data entry/input. | Field left blank intentionally | Field left blank intentionally | Field left blank intentionally | Field left blank intentionally |
| Appendix D: FDP State Agency File Upload Templates v1 02192021 | ||||||||||||||||
| Field Name | FNS WIC ID | State WIC ID | Inv Start Date | Investigation Origin | WIC Sanction Type | SNAP Sanction Type | State Sanction | Disqualification Date | Disqualification Length | Date referred to SNAP | Date referred to WIC | CMP Amount | Administrative Fine Amount | |||
| Field Type | ID | Text | Date | Picklist | Picklist | Picklist | Picklist | Date | Picklist | Date | Date | Number | Number | |||
| Field Length | 18 | 32 | Date Length | See Valid Values below | See Valid Values below | See Valid Values below | Custom Policy Setting will be entered from State agency data entry/input. | Date Length | See Valid Values below | Date Length | Date Length | 9-digit, 2 decimal places | 9-digit, 2 decimal places | |||
| Example | a2Q2J00000kMQKX | 21323 | 9/10/2020 | WIC | State agency sanction | Permanent | Other (See Picklist Values below) | 10/10/2020 | 10 | 1/1/2020 | 1/1/2020 | 2300 | 4000.25 | |||
| Is Mandatory for Sanctions Upload? | Yes | No | Yes | Yes | No | No | No | No | No | No | No | No | No | |||
| Field Description | Unique Salesforce identifier for the vendor record | The State agency generated ID for this record. | Investigation Start Date | The originating Program (either SNAP or WIC) for this sanction. | The WIC sanction type being documented in this record. | The SNAP sanction type assessed by FNS SNAP. | SA sanctions can be set in the Policy Settings area. | The effective date of the disqualification. | The length of time of the disqualification. | The date the WIC SA referred this disqualification to FNS SNAP, if applicable. | The date FNS SNAP referred the disqualification to the WIC SA. | The total amount of any civil money penalty (CMP) assessed. Please update this field if the amount changes. | The total amount of any fine(s) assessed. Please update this field if the amount changes. | |||
| Valid Values | N/A | N/A | N/A | WIC, SNAP | Mandatory federal disqualification, CMP in lieu of disqualification, State agency sanction | SNAP reciprocal disqualification, CMP for hardship |
Custom picklist values will be entered from State agency data entry/input. | N/A | Permanent, 6 year, 3 year, 1 year, 1 months, 2 months, 3 months, 4 months, 5 months, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months |
N/A | N/A | N/A | N/A | |||
| Formatting/ Validation Notes | Field left blank intentionally | Field left blank intentionally | Used to lookup the existing investigation else create a new one | Where the sanction originated or authority to issue the sanction is traced | If origin= WIC, this field is required | If origin= SNAP, this field is required | Custom picklist values will be entered from State agency data entry/input. | Field left blank intentionally | Number of months | Field left blank intentionally | Field left blank intentionally | Field left blank intentionally | Field left blank intentionally |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |