Kids Cafe SELF PREP PROGRAM Report

Kids Cafe Name:

Supervisor:
Name of the person filling out this report:
Number of children THIS MONTH who enrolled or visited your Kids Cafe
FOR THE FIRST TIME this school year:
Number of serving days this month for meals:
If zero please explain why no meals served:
Number of serving days this month for snacks:
Number of meals served:
Number of snacks served:
Number of snacks claimed for CACFP (if applicable):
Number of San Antonio Food Bank-sponsored nutrition lessons offered:
If zero please explain why not:
Number of non-SA Food Bank-sponsored nutrition lessons offered:
If zero please explain why not:
What enrichment activities to children were provided at this Kids Cafe
(check all that apply)?
Nutrition Education Athletics Gardening Life Skills
Job Training Computer Training Food Preparation/Safety Arts & Culture
Mentoring Community Service Projects Tutoring Other

To the best of your ability, please indicate the percentage of your total population served in each category below.
(Numbers must add up to 100 %.)

Age 0-4 Years (preschool)  %
Age 5-10 Years (elementary)  %
Age 11-15 Years (middle/junior)  %
Age 16-18 Years (high school)  %
Over 18 but still in high school  %

What five snack items/drinks do you most frequently serve at your Kids Cafe?
(Please enter most frequent first, followed by second most frequent, and so on)

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Comments:
 

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