1. CACFP Civil Rights Recordkeeping Requirements Wisconsin Department of Public Instruction Child and Adult Care Food Program (CACFP) Guidance Memorandum #8 http://fns.dpi.wi.gov/fns_centermemos

2. “…And Justice For All” Display the 11”x17” size “…And Justice For All” poster Post at each site Visible to the public

3. ABC CCC Sally Smith, Director 123 Alphabet Street Small Town, WI 54321 608-123-4567 Parental Notification Flier Sally Smith, Director ABC Day Care ABC Alphabet Street Small Town, WI 54321 608-123-4567 Print agency contact information

4. Translated Materials Parental Notification Flier (Building for the Future), Parent Letter and Household Size Income Statement, Meal Pattern, Enrollment Forms, etc. –Spanish and Hmong http://fns.dpi.wi.gov/fns_cacfptranslations http://fns.dpi.wi.gov/fns_cacfptranslations Parental Notification Flier (Building for the Future) –Arabic, Chinese, French, Haitian-Creole, Japanese, Khmer, Lao, Portuguese, Russian, Thai, and Vietnamese (available upon request)

5. Non-Discrimination Statement Informational materials and sources that inform the public about the CACFP must contain a non-discrimination statement Parent Handbook

6. Non-Discrimination Statement T he U.S Department of Agriculture prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.) If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov. program.intake@usda.gov Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (Spanish). USDA is an equal opportunity provider and employer provider and employer.

7. Non-Discrimination Statement Full statement in English and Spanish in GM 8C Nondiscrimination Statement with Complaint Filing Procedure (on GM website listed under GM 8) Small publications (i.e. brochure, handout): “USDA is an equal opportunity provider and employer.” Do not use either of these statements: “This institution is an equal opportunity provider and employer” “The [insert name of agency] is an equal opportunity…..”

8. Ethnic & Racial Data Collection Identification –Self-identification / self-reporting –Visual identification Collect annually Maintain documentation for three years plus current year

9. Ethnic & Racial Data Collection Collect ethnic data first, then racial data 1.Ethnic categories: 1.Hispanic or Latino 2.Non-Hispanic or Non-Latino 2.Racial categories 1.American Indian or Alaskan Native 2.Asian 3.Black or African American 4.Native Hawaiian or other Pacific Islander 5.White

10. Ethnic and Racial Data Collection Form ABC Child Care Center 123 Alphabet Street, Small Town 54321 3 25 2 3 8 0 15 10/5/xxSally Smith Complete separate form for each site

11. Annual Civil Rights Training Train staff who interact with program applicants/ participants, and people who supervise them Documentation –Staff who received training –Topics covered/agenda –Date training completed Civil Rights PowerPoint training handout that may be used: http://fns.dpi.wi.gov/fns_training#cacfp

12. Annual Civil Rights Training Subject matter must include, but not be limited to: –Collection and use of data, –Effective public notification systems, –Complaint procedures, –Requirements for reasonable accommodation of persons with disabilities, –Requirements for language assistance, –Conflict resolution, and –Customer service

13. Right to File a Complaint All written or verbal complaints alleging discrimination on the basis of protected classes shall be filed within 180 days More Information –GM #8 –http://www.ascr.usda.gov/complaint_filing_cust.htmlhttp://www.ascr.usda.gov/complaint_filing_cust.html

14. The U.S Department of Agriculture prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.) If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov. http://www.ascr.usda.gov/complaint_filing_cust.html program.intake@usda.gov Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (Spanish). USDA is an equal opportunity provider and employer.