Nutrition Services District Questionnaire
Form ApprovedOMB No: 0920-0445Expiration Date: 08/31/2016Nutrition ServicesDistrict QuestionnaireSchool Health Policies and Practices Study 2016Attn: Alice Roberts, Project Director530 Gaither Road, Suite 500Rockville, MD 20850Tel: (800) 287-1815Public reporting burden for this collection of information is estimated to average 35 minutes per response,including the time for reviewing instructions, searching existing data sources, gathering and maintaining the dataneeded, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and aperson is not required to respond to a collection of information unless it displays a currently valid OMB controlnumber. Send comments regarding this burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden to: CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE,Mailstop D-74, Atlanta, GA 30333; Attention PRA (0920-0445).Nutrition Services District Questionnaire—Public Use Version
Nutrition ServicesDistrict QuestionnaireQuestionsGeneral Information . 1-3Food Ordering . 4-6Food Preparation . 7-12Collaboration and Promotion . 13-20Evaluation . 21-22District Wellness Policy. 23-29Staffing and Professional Development. 30-39Nutrition Services and Child Nutrition Requirements and Recommendations . 40-65District Food Service Director . 66-70Nutrition Services District Questionnaire—Public Use Version
Special InstructionsTHIS QUESTIONNAIRE WILL BE ADMINISTERED USING WEB-BASED SURVEYTECHNOLOGY. AS THE RESPONDENTS SELECT THEIR RESPONSES TO THEQUESTIONS, THE APPLICATION WILL NAVIGATE COMPLEX SKIP PATTERNSBASED ON PREVIOUS RESPONSES AND PERFORM OTHER USEFUL FUNCTIONS.COMMENTS APPEARING IN THE MARGIN REPRESENT ADDITIONALCLARIFICATION ON THE QUESTION OR THE SPECIFIC TERMINOLOGY USED. THISTEXT WILL APPEAR ON-SCREEN UNDER THE MAIN QUESTION TEXT. THEPROGRAMMING SPECIFICATIONS FOR THE SURVEY ARE NOT INCLUDED IN THEIRENTIRETY IN THIS PRINTED VERSION OF THE QUESTIONNAIRE.1. This questionnaire focuses on your district’s written policies and practices regardingnutrition services.2. For the purposes of this questionnaire, “policy” means any law, rule, regulation,administrative order, or similar kind of mandate issued by the local school board or otherlocal agency with authority over schools in your district. SHPPS is most interested in whatis required by the district, not what is recommended or contained in non-binding guidancedocuments, unless the question specifically asks about recommendations.3. For the purposes of this questionnaire, “adopted a policy” means either that the district has itsown policy or that the district follows a policy established at the federal or state level,including any law, rule, regulation, administrative order, or similar kind of mandate.4. If a district policy is written in such a way that it requires schools to develop and adopt theirown policies on a given topic, for the purposes of this questionnaire, please consider it thesame as a district-wide requirement.5. Districts may sometimes grant policy exceptions or waivers, but please answer each questionbased on what is considered the general policy and standard practice.Nutrition Services District Questionnaire—Public Use Version
General InformationThe first questions ask for general information about nutrition services in your district.1.Do any schools in your district participate in the .YesNoa. National School Lunch Program (NSLP)? . 1 .2b. National School Lunch Program After-School SnackProgram? .1 .2c. School Breakfast Program (SBP)? .1 .2d. After-School Supper Program? .1 .22.Commented [HELP1]: USDA is the United States Departmentof Agriculture.Last summer, did your district sponsor the USDA Summer Food Service Program in anyschools in your district?Commented [HELP2]: This program is also known as theSeamless Summer Option.Yes .1No.23.Who operates the nutrition services program for the district?School district .1Food service management company .2Other .3Nutrition Services District Questionnaire—Public Use Version1
Food OrderingThe next questions ask about the food ordering process in your district.4.Does your district nutrition services program have primary responsibility for decidingwhich foods to order for any schools in your district?Yes .1No.25. SKIP TO THEINTRODUCTION TO Q7Does your district purchase foods from local or regional growers or producers?Yes .1No.26.Do your district’s food procurement contracts specifically address YesNoCommented [HELP3]: Food safety is the prevention ofunintentional contamination of food that can cause illness.a. Food safety? .1 .2b. Hazard Analysis and Critical Control Points (HACCP)? .1 .2Commented [HELP4]: “A la carte foods” are items soldindividually rather than as part of a complete meal.c. Nutritional standards for a la carte foods? .1 .2d. Preference for locally or regionally grown foods? .1 .2e. Cooking methods for precooked items, for examplebaked instead of deep fried? .1 .2Commented [HELP5]: For the purposes of this question, “deepfried” includes foods that have been par-fried, pre-fried, or flashfried and are baked on site, such as French fries or breaded chickenproducts.f. Use of whole grain-rich foods? .1 .2g. Use of low-sodium canned products? .1 .2Commented [HELP6]: A whole grain-rich food must contain atleast 51 percent whole grains and the remaining grain content of theproduct must be enriched.h. Limiting artificial colors, sweeteners, andpreservatives? .1 .2Nutrition Services District Questionnaire—Public Use Version2
Food PreparationThe next questions ask about the food preparation process.The first question asks about cooking food. Please think about the actual cooking of the food, notjust the reheating of food that was previously prepared.7.Does your district nutrition services program have primary responsibility for cooking foodsfor schools in your district, for example in a central kitchen?Commented [HELP7]: Includes menu and recipe developmentas well as food preparation.Yes .1No.2 SKIP TO THEINTRODUCTION TO Q13The next questions ask about substituting one type of ingredient for another.8.During the past 30 days, when preparing food for schools in your district, how often NeverRarelySometimesAlmostAlways orAlwaysa. Were non-stick spray or pan liners usedinstead of grease or oil? . 1 . 2 . 3 . 4b. Was olive or canola oil used instead ofshortening, butter, or margarine? . 1 . 2 . 3 . 4c. Were part-skim or low-fat cheese usedinstead of regular cheese? . 1 . 2 . 3 . 4Commented [HELP8]: For the purposes of this question, “lowfat” means 1% fat or less.d. Were skim, low-fat, soy, or nonfatdry milk used instead of whole milk? . 1 . 2 . 3 . 4Commented [HELP9]: For the purposes of this question, “lowfat” means 1% fat or less.e. Were ground turkey or lean groundbeef used instead of regularground beef?. 1 . 2 . 3 . 4f. Were cooked dried beans, cannedbeans, soy products, or other meatextenders used instead of meat? . 1 . 2 . 3 . 4g. Were fresh or frozen vegetables usedinstead of canned? . 1 . 2 . 3 . 4h. Was fresh or frozen fruit usedinstead of canned? . 1 . 2 . 3 . 4i. Was canned fruit packed in light syrup orjuice used instead of canned fruit packed inheavy syrup? . 1 . 2 . 3 . 4Nutrition Services District Questionnaire—Public Use Version3
Food Preparation(QUESTION 8 CONTINUED)NeverRarelySometimesAlmostAlways orAlwaysj. Were low-sodium canned vegetablesused instead of regular cannedvegetables? . 1 . 2 . 3 . 4k. Were other seasonings used insteadof salt? . 1 . 2 . 3 . 4l. Were low-fat or nonfat yogurt,mayonnaise, or sour cream usedinstead of regular mayonnaise, sourcream, or creamy salad dressings? . 1 . 2 . 3 . 4Commented [HELP10]: For the purposes of this question, “lowfat” means 1% fat or less.m. Were whole grain-rich foods used insteadof non-whole grain-rich foods? . 1 . 2 . 3 . 4Commented [HELP11]: A whole grain-rich food must containat least 51 percent whole grains and the remaining grain content ofthe product must be enriched.The next questions ask about reducing the amount of an ingredient rather than replacing itwith another ingredient.9.During the past 30 days, when preparing foods for schools in your district,how often was NeverRarelySometimesAlmostAlways orAlwaysa. The amount of sugar called for inrecipes reduced or were low-sugarrecipes used? . 1 . 2 . 3 . 4b. The amount of saturated fats and oils calledfor in recipes reduced? . 1 . 2 . 3 . 4c. The amount of salt called forin recipes reduced or werelow-sodium recipes used? . 1 . 2 . 3 . 4Nutrition Services District Questionnaire—Public Use Version4
Food PreparationThe next question asks about techniques that might have been used when preparing food forschools in your district.10.During the past 30 days, how often was NeverRarelySometimesDistrictuses onlyAlmost precookedAlwaysmeat/or Alwayspoultrya. Meat roasted, baked, orbroiled rather than fried? .1.2.3.4.5b. Meat or poultry roasted on arack so fat would drain? .1.2.3.4.5c. Fat drained from browned meat? .1.2.3.4.5d. Fat trimmed from meat or leanmeat used .1.2.3.4.5e. Skin removed from poultry orskinless poultry used? .1.2.3.4.5f. Solid fat spooned from chilledmeat or poultry broth? .1.2.3.4g. Fat skimmed off warm broth,soup, stew, or gravy? .1.2.3.4The next question asks about techniques that might have been used when preparing vegetablesfor schools in your district.11.During the past 30 days, how often were NeverRarelySometimesAlmostAlways orAlwaysa. Potatoes boiled, mashed, or baked,rather than fried or deep fried?. 1 . 2 . 3 . 4Commented [HELP12]: For the purposes of this question,“deep fried,” means foods that are deep fried on site as well as thosethat have been par-fried, pre-fried, or flash fried and are baked onsite, such as French fries.b. Other vegetables steamed or baked? . 1 . 2 . 3 . 4c. Vegetables prepared without usingbutter, margarine, or a cheese orcreamy sauce? . 1 . 2 . 3 . 4d. Canned vegetables and/or beansrinsed? . 1 . 2 . 3 . 4Nutrition Services District Questionnaire—Public Use Version5
Food PreparationCommented [HELP13]: HACCP is Hazard Analysis andCritical Control Points.HACCP-based recipes are those that include critical control points, such as cooking, andassociated critical limits, such as time and temperature, in their directions. They are designed toreduce the risk of food contamination and bacterial growth that could lead to foodborne illness.For example, HACCP-based recipe directions might read, “Cook the chicken to at least165 degrees Fahrenheit for at least 15 seconds.”12.During the past 30 days, how often did your district use Hazard Analysis and CriticalControl Points (HACCP)-based recipes?Never.1Rarely .2Sometimes .3Almost always or always .4Nutrition Services District Questionnaire—Public Use Version6
Collaboration and PromotionThe next question asks about district participation in farm to school activities. Farm to schoolactivities connect schools and local farms, with the objectives of serving local and healthfulfoods in school cafeterias or classrooms while supporting small- and medium-sized local andregional farmers.13.Commented [HELP14]: Farm to school activities might includeschool gardens, marketing/promoting local food in the cafeteria,farm tours, or classroom-based nutrition lessons that connectseasonal foods to local farms.Does your district participate in any farm to school activities?Yes .1No.2The next questions ask about collaboration on nutrition services activities with other districtlevel staff and outside organizations.14.During the past 12 months, have district-level nutrition services staff worked on schoolnutrition services activities with district-level YesNoCommented [HELP15]: “Worked on school nutrition servicesactivities with” means collaborated with on nutrition servicesactivities or worked with to coordinate nutrition services activities.No districtlevel staffin this areaa. Health education staff? .1.2.3b. Physical education staff?.1.2.3c. Health services staff? .1.2.3d. Counseling, psychological, or social servicesstaff?.1.2.3Nutrition Services District Questionnaire—Public Use Version7
Collaboration and Promotion15.During the past 12 months, have district-level nutrition services staff worked on schoolnutrition services or nutrition activities with staff from YesCommented [HELP16]: “Worked on school nutrition servicesactivities with” means collaborated with on nutrition servicesactivities or worked with to coordinate nutrition services activities.Noa. A health organization, such as the American HeartAssociation or the American Cancer Society?.1 .2b. A local or state chapter of the School Nutrition Association? .1 .2c. The state agriculture department? .1 .2d. The state health department? .1 .2e. A local health department? .1 .2f. A local mental health or social services agency?.1 .2g. A local college or university? .1 .2h. A local business?.1 .2i. A food commodity organization, such as theDairy Council or produce growers association? .1 .2j. A non-governmental organization promoting farm toschool activities? .1 .2k. A county cooperative extension office? .1 .2l. A Supplemental Nutrition Assistance Program-Education(SNAP-Ed) implementing agency? .1 .2Commented [HELP17]: A food policy council brings togetherstakeholders from diverse food-related sectors to examine how thefood system is operating and to develop recommendations on how toimprove it.m. A food policy council? .1 .2n. A local hospital? .1 .2o. A local service club, such as the Rotary Club? .1 .2p. A local youth organization, such as theBoys and Girls Clubs? .1 .2q. A local anti-hunger organization, such as a food bank? .1 .2Nutrition Services District Questionnaire—Public Use Version8
Collaboration and PromotionThe next set of questions ask about activities that your district might do to promote schoolnutrition services among students and their families.16.During the past 12 months, has anyone from your district YesNoa. Made menus available to students?.1 .2b. Made information available to students on thenutrition and caloric content of foods available to them? .1 .2c. Made menus available to families of all students? .1 .2d. Made information available to families of allstudents on the nutrition and caloric content offoods available to students? .1 .2e. Made information about school nutrition services availableat community events? .1 .2Commented [HELP18]: For example, health and wellness fairsor community festivals.f. Led an activity about healthy eating for students? .1 .217.During the past 12 months, has your district recommended that schools use any of thefollowing strategies to increase school meal participation?YesNoa. Make healthful foods more visible.1 .2Commented [HELP19]: For example, placing fruits andvegetables near the cashier where they are easy to access.b. Improve the presentation of healthfulfoods in the cafeteria .1 .2Commented [HELP20]: For example, placing fruits in attractivefruit bowls instead of stainless steel serving trays.Commented [HELP21]: For example, hanging student artworkin the cafeteria or having teachers and administrators dine withstudents.c. Improve the lunchroom atmosphere .1 .2d. Offer grab-and-go meals .1 .2Commented [HELP22]: For example, surveying students toinform menu development or having student groups help developcreative names for menu items.e. Involve students in menu development and promotion .1 .2f. Involve students in taste tests of new menu items .1 .2Commented [HELP23]: Direct certification means that childrenliving in households receiving Supplemental Nutrition AssistanceProgram (SNAP)/Food Stamp benefits, Food Distribution Programon Indian Reservations (FDPIR) benefits, or Temporary Assistancefor Needy Families (TANF) cash assistance can bypass the standardapplication process and be “directly certified” for free school meals.18. Does your district use YesNoa. Direct certification to determine students’ eligibility forfree school meals?.1 .2Commented [HELP24]: The community eligibility provision isa reimbursement alternative for high poverty local educationalagencies and schools participating in the NSLP and SBP.Reimbursement is determined using a formula based on the numberof students certified without application for free school meals,instead of collecting individual applications for free and reducedprice meals.b. The community eligibility provision to offer free schoolmeals to all students? .1 .2Nutrition Services District Questionnaire—Public Use Version9
Collaboration and Promotion19.During the past 12 months, has anyone from your district provided ideas to schools YesNoa. On how to involve school nutrition services staff inclassrooms? .1 .2b. On how to use the cafeteria as a place wherestudents might learn about food safety, foodpreparation, or other nutrition-related topics? .1 .2Commented [HELP25]: Food safety is the prevention ofunintentional contamination of food that can cause illness.c. For nutrition-related special events? .1 .220.During the past 12 months, has anyone from your district provided assistance to schools forproviding meals for students YesNoa. With food allergies, sensitivities, or intolerances? .1 .2b. With chronic health conditions that require dietarymodification, such as diabetes?.1 .2c. Who are vegetarians? .1 .2Nutrition Services District Questionnaire—Public Use Version10
EvaluationThe next questions ask about different aspects of the school nutrition services program that mighthave been evaluated during the past two years.21.During the past two years, has anyone from your district measured or monitored each of thefollowing aspects of the nutrition services program?YesNoN/Aa. The number of students participatingin the nutrition services program .1.2b. The nutritional quality of school meals .1.2c. The nutritional quality of meals and snacks servedin after-school or extended day programs .1.2.3d. The amount of plate waste .1.2Commented [HELP26]: Food safety is the prevention ofunintentional contamination of food that can cause illness.e. Food safety procedures .1.222.During the past two years, have any of your district’s professional development or inservice programs for nutrition services staff been evaluated?Yes .1No .2District did not have any professionaldevelopment or in-service programs during thepast two years . .3Nutrition Services District Questionnaire—Public Use Version11
District Wellness PolicyThe Healthy, Hunger-Free Kids Act of 2010 requires school districts participating in federallysubsidized child nutrition programs (e.g., National School Lunch Program or School BreakfastProgram) to implement, review, and monitor a local wellness policy. The next questions askabout your district’s wellness policy.23.Commented [HELP27]: A wellness policy is defined as awritten plan that includes methods to promote student wellness,prevent and reduce childhood obesity, and provide assurance thatschool meals and other food and beverages sold on the schoolcampus during the school day meet the minimum federal standardsIs your district’s wellness policy made available to the public in the following ways?YesNoa. Posted on the district or school web sites .1 .2b. Sent home with students .1 .2c. Mailed to families .1 .2d. Emailed to families .1 .2e. Posted in schools .1 .2f. Published in the local newspaper or other media outlets .1 .2g. Shared through social media .1 .2Commented [HELP28]: For example, a parent-teacherassociation (PTA) meeting.h. Shared during meetings where parents are in attendance .1 .2i. Published in the district newsletter or in school publications .1 .2Commented [HELP29]: A document that outlines schoolpolicies, rules, regulations, and standards for behavior that studentsare expected to follow.j. Included in the student handbook .1 .224.In your district’s wellness policy, who is identified as the individual responsible forensuring compliance with the policy?No single individual is identified .1Superintendent .2Assistant superintendent .3District food service director(school food authority director) .4Other district-level staff member .5A school administrator .6A school-level faculty or staff member .7Nutrition Services District Questionnaire—Public Use Version12
District Wellness Policy25.When was the last time your district’s wellness policy was reviewed?Never .1During the past 12 months .2Between 1 and 3 years ago .3More than 3 years ago .426.When was the last time your district’s wellness policy was updated?Never .1During the past 12 months .
The next questions ask about collaboration on nutrition services activities with other district-level staff and outside organizations. 14. During the past 12 months, have district-level nutrition services staff worked on school nutrition services activities with district-level Commented [HELP15]: "Worked on school nutrition services
2 Questionnaire survey Survey research Rossi, P. H., et al. (2013). [4] 3 Questionnaire design A split questionnaire survey design Raghunathan, T. E., et al. (1995). [5] 4 Questionnaire design Designing a questionnaire Ballinger, C., et al. (1998). [6] 5 Questionnaire design Questionnaire design: the good, the bad and the pitfalls.
Designer Tool: Questionnaires Questionnaire(s) can be sourced from following three ways; my questionnaire (private) -only user that created can see it; questionnaire shared with me - private questionnaire that can be seen by other authorized users; public questionnaire -any user of Survey Solutions can see the questionnaire (not data) And create your survey questionnaire;
Table of Contents a. District 1 pg. 6 b. District 2 pg. 7 c. District 3 pg. 9 d. District 4 pg. 10 e. District 5 pg. 11 f. District 6 pg. 12 g. District 7 pg. 13 h. District 8 pg. 14 i. District 9 pg. 15 j. District 10 pg. 16 k. District 11 pg. 17 l. District 12 pg. 18 m. District 13 pg. 19 n. District 14 pg. 20
The Nutrition Care Process is defined in four steps: 1. Nutrition Assessment 2. Nutrition Diagnosis 3. Nutrition Intervention 4. Nutrition Monitoring & Evaluation The first component of the “Nutrition Assessment” is a screening of residents for those at risk for nutrition problems and is a candidate for further intervention. One of the
Nutrition during a woman's life From: ACC/SCN and IFPRI. 4th Report on the World Nutrition Situation: Nutrition Throughout the Life Cycle. Geneva: WHO, 2000. Nutrition during a woman's life From: ACC/SCN and IFPRI. 4th Report on the World Nutrition Situation: Nutrition Throughout the Life Cycle. Geneva: WHO, 2000.
Nutrition Evaluation: the systematic comparison of current findings with the previous status, nutrition intervention goals, effectiveness of overall nutrition care, or a reference standard Nutrition Care Outcomes: the results of nutrition care that are directly related to the nutrition diagnosis and the goals of the intervention plan
II. NUTRITION SERVICES A. Nutrition Education FY 2020 New Hampshire Page 2 of 17 1. Nutrition Education Plans (§246.11) a. The State agency develops and coordinates the nutrition education component with consideration of local agency plans, needs, and available nutrition education resources. (§246.11(c)(1)) Yes No b.
Anatomy and physiology for microblading techniques Unit reference number: L/615/6166 Level: 4 Guided Learning (GL) hours: 20 Overview The aim of this unit is to provide learners with the necessary underpinning knowledge of relevant human anatomy and physiology to enable them to perform effective and safe microblading services for eyebrow treatments. Learners will develop an understanding of .
