HomeMy WebLinkAbout066000 - General - Contract - Educational Potential VerifiedCSC No. 66000
Memorandum of Understanding
Education Potential Verified
Child and Adult Care Food Program
This Memorandum of Understanding (MOU) defines the relationship and responsibilities of
Education Potential Verified and City of Fort Worth in regards to their collaboration on
the CACFP After School Meal Service Program.
Overview
Education Potential Verified receives funding from the Texas Department of Agriculture
(TDA) to provide nutritious meals to children 1-18 years old during the school year. All
program sites must meet state and local health and safety standards; be operated by a
non-profit entity; have a Child Care license or exemption; and be located in an eligible low
income area. Education Potential Verified and the CACFP site understand that no benefit can
be provided to a for-profit entity and that all site staff are trained as a volunteer
representative of Education Potential Verified and will ensure that all program rules and
regulations are followed.
Education Potential Verified contracts with a Food Service Management Company that
prepares meals in a certified kitchen. Sites must have adequate refrigeration space to store
cold meals upon delivery and until meal service time, as well as store leftover meals for use
the following day. Sites must maintain meals at 41 degrees Fahrenheit or below until meals
are served, or serve meals within an hour of delivery.
Responsibilities of Education Potential Verified
• Manage relationship with TDA, including but not limited to submitting site
applications, site changes, and other required documentation.
• Deliver quality meals to the site.
• Manage relationships and compliance with food vendors related to menu approval,
delivery schedules and timeliness, and quality assurance.
• Provide training to site staff regarding TDA regulations.
• Support and monitor sites through site visits, open communication, and technical
assistance.
• Ensure that all sites are in compliance with TDA regulations regarding food safety,
meal service, and documentation of meals served.
Responsibilities of City of Fort Worth
• Serve meals to children 1-18 years old at approved locations and times.
• Attend mandatory training prior to program start date and adhere to all TDA and civil
rights requirements.
• Serve one meal to each child during approved meal times.
• Maintain site's record keeping, copy of delivery receipts and meal counts/attendance
records and report daily usage through electronic or paper forms.
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Memorandum of Understanding
Education Potential Verified
Child and Adult Care Food Program
Submit program information and changes to Education Potential Verified with 2 -week
prior notice to event (including but not limited to changes in meals times, meal
types, any closures, and serving dates.)
Sites Covered
The following program sites are included in this agreement.
Site Name
Address
Andrew Doc Session
Community Center
201 S. Sylvania Ave., Fort Worth 76111
Atatiana Carr -Jefferson
Community Center at Hillside
1201 East Maddox Ave., Fort Worth 76104
Chisholm Trail Community
Center
4936 McPherson Blvd., Fort Worth 76123
Como Community Center
4660 Home St., Fort Worth 76107
Diamond Hill Community
Center
1700 NE 37th St., Fort Worth 76106
Eugene McCray Community
Center
4932 Wilbarger St., Fort Worth 76119
Greenbriar Community Center
5200 Hemphill St., Fort Worth 76115
Handley Meadowbrook
Community Center
6201 Beaty St., Fort Worth 76112
Highland Hills Community
Center
1600 Glasgow Rd., Fort Worth 76134
Martin Luther King Jr.
Community Center
5565 Truman Dr., Fort Worth 76112
Northside Community Center
1100 NW 18th St., Fort Worth 76164
North Tri-Ethnic Community
Center
2950 Roosevelt Ave., Fort Worth 76106
R.D. Evans Community Center
3242 Lackland Rd., Fort Worth 76116
Riverside Community Center
3700 E. Belknap St., Fort Worth 76111
Southside Community Center
at Hazel Harvey Peace
818 Missouri Avenue, Fort Worth 76104
Southwest Community Center
6300 Welch Ave., Fort Worth 76133
Thomas Place Community
Center
4237 Lafayette Ave., Fort Worth 76107
Victory Forest Community
Center
3427 Hemphill St., Fort Worth 76110
Worth Heights Community
Center
3551 New York Ave., Fort Worth 76110
Memorandum of Understanding
Education Potential Verified
Child and Adult Care Food Program
Termination of Acireement
Once signed this agreement is binding through September 30, 2027 and can only be
terminated for cause and with approval from TDA.
Education Potential Verified and City of Fort Worth agree to the terms and criteria set
forth in this Memorandum of Understanding as indicated by the signatures of a responsible
officer of each organization as shown below.
10/5/2026
Education Potential Verified Authorized Representative Date
Lauren Steelman, Executive Director
��u�HaA 10/06/2026
Dana Burghdoff (Oct 6, 202 2:11:28 C
Authorized Representative
Dana Burghdoff
Print Name
FOR CITY OF FORT WORTH II'TERNAL PROCESSES:
Approval Recommended:
By:
Name:
Dave Lewis
Title:
Director
By:
Name:
Title:
Monique Hill
Assistant Director
Approved as to Form and Legality:
By:
Name=Hye Won Kim
Title: Assistant City Attorney
Contract Authorization:
XI&C: N/A
Date
Assistant City Manager
Title
Contract Compliance Manager:
By signing I acknowledge that I am the person
responsible for the monitoring and administration
of this contract, including ensuring all
performance and reporting requirenients-
s'ker x Zirdsley
By:
Name: Sheri Endslev
Title: District Superintendent
,o,,_
City Secretary:
By:
Name:
Title:
Jannette S- Goodall
City Secretary
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Chisholm Trail Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
4936 McPherson Blvd., Fort Worth, TX 76123
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Z71ii�'�
Dana Burghdoff (Oct 6, 202 2:11:28 C
IID1LsIJPIIWW
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Southside Community Center at Hazel Harvey Peace
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
818 Missouri Avenue, Fort Worth 76104
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Andrew Doc Session Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
201 S. Sylvania Ave., Fort Worth, TX 76111
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Dana Burghdoff (Oct 6, 202'72:11:28 CVFY
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Como Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
4660 Horne St., Fort Worth, TX 76107
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Diamond Hill Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
1700 NE 37th St., Fort Worth, TX 76106
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
771L?,`
Dana Burghdoff (Oct 6, 202'72;11:28 CVrY
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Eugene McCray Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
4932 Wilbarger St., Fort Worth 76119
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
7 'I` z 10/06/2026
Dana Burghdoff (Oct 6, 20272:11:28 C
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Greenbriar Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
5200 Hemphill St., Fort Worth, TX 76115
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Dana Burghdoff (Oct 6, 202'72:11:28 CIiy
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Handley Meadowbrook Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
6201 Beaty St., Fort Worth, TX 76112
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Z7"1a, //A���i✓
Dana Burghdoff (Oct 6, 20272:11:28 C
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Highland Hills Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
1600 Glasgow Rd., Fort Worth, TX 76134
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
10/06/2026
Dana Burghdoff (Oct 6, 2022:11:28 C
Signature — Child Care Site Representative
Assistant City Manager
Title — Child Care Site Representative
Date
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Atatiana Carr -Jefferson Community Center at Hillside
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
1201 East Maddox Ave., Fort Worth 76104
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
10/06/2026
Dana Burghdoff (Oct 6, 2022:11:28 C
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Martin Luther King Jr. Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
5565 Truman Dr., Fort Worth, TX 76112
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Z7lc�rofs��C��
Dana Burghdoff (Oct 6, 202 2:11:28 C
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
North Tri-Ethnic Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
2950 Roosevelt Ave., Fort Worth, TX 76106
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
10/06/2026
Dana Burghdoff (Oct 6, 2022:11:28 C
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Northside Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
1100 NW 18th St., Fort Worth, TX 76164
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
10/06/2026
Dana Burghdoff (Oct 6, 2022:11:28 C
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
R.D. Evans Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
3242 Lackland Rd., Fort Worth , TX 76116
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Dana Burghdoff (Oct 6, 202'72:11:28 C
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Riverside Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
3700 E. Belknap St., Fort Worth, TX 76111
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Signature — Child Care Site Representative
Assistant City Manager
Title — Child Care Site Representative
10/06/2026
Date
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Southwest Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
6300 Welch Ave., Fort Worth , TX 76133
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Dana Burghdoff (Oct 6, 202'72:11:28 C
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Thomas Place Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
4237 Lafayette Ave., Fort Worth, TX 76107
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
r?, Z 10/06/2026
Dana Burghdoff (Oct 6, 202'72:11:28 C
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Victory Forest Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
3427 Hemphill St., Fort Worth 76110
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
Z7"1a, //A���i✓
Dana Burghdoff (Oct 6, 20272:11:28 C
10/06/2026
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
Texas Department of Agriculture
May 2025
Page 1
Child and Adult Care Food Program
Permanent Agreement Between Sponsoring
Organization and Child Care Site
Name of Sponsoring Organization
CE ID
Education Potential Verified
06975
Address of Sponsoring Organization (Street, City, State, ZIP)
2862 Nagle St Suite A Dallas, TX 75220
Name of Child Care Site
Worth Heights Community Center
Physical Address of Child Care Site (Street, City, State, ZIP)
County Name
3551 New York Ave., Fort Worth, TX 76110
Tarrant
Mailing Address of Child Care Site, if different from physical address (Street, P.O. Box, City, State, ZIP)
Agreement
This permanent agreement specifies the rights and responsibilities of the above named Sponsoring Organization (Sponsor)
and the Child Care Site (Site) as participants in the Child and Adult Care Food Program (CACFP). By signing this permanent
agreement, both parties are bound by its terms and conditions from its beginning effective date until terminated.
Rights and Responsibilities of the Sponsor
The Sponsor agrees to accept final financial and administrative management of a proper, efficient, and effective food service,
and comply with all CACFP requirements, including the following:
1. Train child care Site staff according to CACFP requirements.
2. Provide technical assistance when problems are cited during monitoring visits, upon request from the Site, and as needed, and
scheduled at a time and place convenient to the Site staff.
3. Provide CACFP record -keeping forms to the Site at no charge, and ensure the Site maintains records on -site according to
CACFP record -keeping requirements.
4. Timely disburse any reimbursement payments, including advance payments, for meals to the Site within five working days of
receipt of payment from Texas Department of Agriculture (TDA) for the corresponding claim period.
5. Make no charge whatsoever to the Site for CACFP services.
6. Retain no more than 15% of the CACFP reimbursement (excluding cash -in -lieu) for allowable, actual administrative costs.
7. Ensure that all meals are served to enrolled/participating children without regard to race, color, national origin, sex, age or
disability in accordance with Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504
of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination.
8. Ensure that the Site complies with requirements for racial and ethnic participation data collection and public notification of the
nondiscrimination policy.
9. Ensure that all meals claimed for reimbursement are those served to children who are properly enrolled, if applicable and in
attendance at the meal service.
10. Ensure that all meals claimed meet CACFP requirements.
11. Claim reimbursement for no more than two meals and one snack, or one meal and two snacks, per child per day. If at -risk, claim
no more than one meal and one snack per child per day. Exception: Emergency shelters may claim reimbursement for three
meals or two meals and one snack per child per day.
12. Ensure Sponsor staff that conduct announced or unannounced monitoring reviews show photo identification to demonstrate they
are employees of the Sponsor.
13. Conduct announced and unannounced monitoring reviews of the Site's food program operation according to CACFP
requirements during the Site's normal hours of operation, including weekends, if applicable.
14. Submit the Site Application and any amendments on behalf of the Site to TDA in a timely manner.
15. Ensure the child care Site maintains a current license, if applicable.
16. Ensure an At -Risk Afterschool Care Center or Emergency Shelter maintains a current license or written verification of exemption
from the Texas Health and Human Services (HHSC), if applicable. If not subject to licensing, ensure completion of required local
health/sanitation and safety inspections.
17. Ensure that no person acting in any capacity on behalf of the Sponsor will enter any child care Site when participants are
present, if the person has been convicted of a felony or misdemeanor classified as an offense against the person or the family,
or public indecency, or a felony violation of any statute intended to control the possession or distribution of a substance included
in the Texas Controlled Substance Act (Chapter 481 of the Texas Health and Safety Code).
18. Immediately inform the health or licensing authority of any situation existing in child care sites that would threaten the health or
Texas Department of Agriculture May 2025
Page 2
safety of participants in attendance.
19. Ensure policies and procedures do not exclude or limit participation, benefits or activities of a Site on the basis of race, color,
national origin, sex, age or disability.
20. Take reasonable steps to provide and ensure services and information, both orally and in writing, are available to the Site in
appropriate languages other than English.
21. Accept final administrative responsibility for ensuring the Site takes reasonable steps to provide services and information, both
orally and in writing, in appropriate languages other than English.
22. Review the purchased meal vendor according to CACFP requirements, if the Site contracts for meals.
Rights and Responsibilities of the Child Care Site
The Site agrees to:
1. Record daily the:
a. menus, food items and quantity used to serve children;
b. meal type and meal count (taken at the point of service) served to each child; and
c. number of enrolled/participating children in attendance.
2. Claim only meals actually served during approved meal service times to children who are enrolled (or participate in an At -Risk
Afterschool Care Center, Outside -School -Hours Child Care (OSHCC) programs or reside in an Emergency Shelter) in child care,
in attendance and participating in the meal service.
3. Serve meals that meet the current CACFP meal pattern requirements for the ages of the children served.
4. Ensure that food is prepared and served in amounts sufficient for each enrolled child to have one reimbursable meal/snack at
each meal service.
5. Notify the Sponsor immediately if there is any change in the meal service, including days, times, and/or types of meals served.
6. Notify the Sponsor immediately of the names of children added or withdrawn from the child care enrollment. (Not applicable to
At -Risk Afterschool Care Centers, Emergency Shelters and OSHCC.)
7. Receive mandatory CACFP training prior to program participation and annually thereafter as required by TDA and the Sponsor.
8. Allow representative of the Sponsor, TDA, USDA and other state and federal officials to enter the Site, announced or
unannounced, to review CACFP operations and records during normal hours of child care operation. Individuals making such
reviews must show photo identification of their employment with one of these entities.
9. As required by the Sponsor, periodically submit meal records for Sponsor review.
10. Notify the Sponsor immediately if there is any change in the Site's licensing/approval status, update license as required by the
Texas Health and Human Services or other authority (if military or tribal), or if not subject to licensing, ensure completion of
required local health/sanitation and fire safety inspections, including correction of any violations cited.
11. Serve meals to all children without regard to race, color, national origin, sex, age or disability in accordance with Title VI of the
Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age
Discrimination Act of 1975, and USDA's regulations concerning nondiscrimination..
12. Serve snacks free of charge to all children participating in an At -Risk Afterschool Care Center.
13. Serve snacks free of charge to all eligible children residing in an Emergency Shelter.
14. Meet all local health and sanitary code requirements applicable to food service.
15. Participate with one Sponsor at a time.
16. Authorize the Sponsor to apply for participation in the CACFP on behalf of the child care Site.
17. Distribute a copy of the Sponsor's notice to parents if instructed by the Sponsor.
18. Provide education or enrichment activities for children participating in an At -Risk Afterschool Care Center.
19. Maintain records on -site relating to the Program according to CACFP record -keeping requirements; failure to do so is grounds
for denial of reimbursement.
20. If the site is a child care center, or emergency shelter, or OSHCC: Obtain prior written approval from TDA before transferring to
another Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and September 30 to become effective
on the following October 1. Additionally, a Site may terminate this permanent agreement with its current Sponsor, with proper
notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Texas Department of Agriculture
May 2025
Page 3
21. If the site is an at -risk afterschool care center ONLY: Obtain prior written approval from TDA before transferring to another
Sponsor within the program year. Termination of this permanent agreement during the program year does not constitute
approval to transfer to another Sponsor. If the Site terminates this permanent agreement and wants to participate in the CACFP
again during the same program year, the Site may only participate with its current Sponsor unless the transfer is approved by
TDA. Exceptions: Each year a Site may transfer to a different Sponsor without TDA approval, if otherwise eligible to participate
in the CACFP, by signing a permanent agreement with a new Sponsor between June 1 and July 31 to become effective on no
earlier than August 1 of the same year. Additionally, a Site may terminate this permanent agreement with its current Sponsor,
with proper notice as outlined in Term and Termination below, and apply to participate with TDA at any time during the year.
Term and Termination
10/5/2026
This agreement is effective from: until terminated.
The Site will provide 30 days written notice if terminating this permanent agreement without the mutual consent of the Sponsor. If
terminating this permanent agreement due to transfer to another Sponsor during the applicable exception provided in #20 or #21
above, the Site will provide written notification as soon as possible.
The Sponsor will provide the Site 30 day's written notice if terminating this permanent agreement for mutual consent or for reasons
other than the Site's failure to meet the terms of this permanent agreement.
Certification
We, the undersigned, do hereby make and enter into this contract. By so doing, we do certify that the information contained
in this document to be true and correct to the best of our knowledge and is provided for the purpose of obtaining Federal
financial assistance. We do mutually agree to comply with the CACFP federal regulations (7 CFR Part 226, as amended),
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200, as
amended), and state policies and procedures as issued and amended by TDA. The Site does further agree to perform as
described in its application for participation in the CACFP (including approved amendments to the application). The Site
certifies it is not currently participating under any other sponsoring organization, has not been disqualified from
participation in the CACFP in Texas or any other state, and is not currently debarred or otherwise excluded from entering
into agreements for Federal funds. We understand that the deliberate misrepresentation or withholding of information may
result in prosecution under applicable State and Federal laws.
7iii,�u W2 `� 10/06/2026
Dana Burghdoff (Oct 6, 202 2:11:28 C
Signature — Child Care Site Representative Date
Assistant City Manager
Title — Child Care Site Representative
10/5/2026
Signature — Sponsoring Organization Authorized Representative Date
Executive Director
Title — Sponsoring Organization Authorized Representative
FORT WORTH®
City Secretary's Office
Contract Routing & Transmittal Slip
Contractor's Name: Education Potential Verified
Subject of the Agreement: MOU with Education Potential Verified for After School Meal Service Program
2026-2027.
M&C Approved by the Council? * Yes ❑ No II
If so, the M&C must be attached to the contract.
Is this an Amendment to an Existing contract? Yes ❑ No 0
If so, provide the original contract number and the amendment number.
Is the Contract "Permanent"? *Yes ❑ No 0
If unsure, see back page for permanent contract listing.
Is this entire contract Confidential? *Yes ❑ No 0 If only specific information is
Confidential, please list what information is Confidential and the page it is located.
Effective Date: 10/5/2026
If different from the approval date.
Expiration Date:
If applicable.
Is a 1295 Form required? * Yes ❑ No 21
*If so, please ensure it is attached to the approving M&C or attached to the contract.
Project Number: If applicable.
*Did you include a Text field on the contract to add the City Secretary Contract (CSC)
number? Yes 0 No 0
Contracts need to be routed for CSO processing in the following order:
1. Katherine Cenicola (Approver)
2. Jannette S. Goodall (Signer)
3. Allison Tidwell (Form Filler)
*Indicates the information is required and if the information is not provided, the contract will be
returned to the department.