26902-000•
Witt, AUG - 3 2000
AccountantAUG
CALIFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM
2000 RENEWAL APPLICATION/AGREEMENT
NSD 8041 (2/00)
PLEASE PRINT OR TYPE ALL INFORMATION
26902
Agreement Number
19-81908V
RETURN TO:
California Department of Education
Nutrition Services Division
560 J Street, Suite 270
Sacramento, CA 95814-2342
Attention: Summer Food Service Program Unit
1. NAME OF SPONSOR: Cit0 f Long Beach
NAME OF CONTACT PERSON:
Department of Parks, Recreation & Marine
Cindy Graber
ADDRESS OF SPONSOR (INCLUDE STREET cI Y, COUNTY, AND ZIP PLUS FOUR):
ltd. Long Beach
NAME OF AUTHORIZED REPRESENTATIVE:
FAX NUMBER:
Henry Taboada
( 562 )570-1107
2. Method of meal service (check one or more):
❑ Self -preparation
U Vended
5. Dates of operation:
From: 6/26/00 To: 8/25/00
6. Would you like to receive an:
3. If vended, provide name(s) of vendor and attach a copy of the Operational costs advance?
Food Service Agreement or Invitation for Bid Packet. U Yes ❑ No
Lang R P a r h I n i f i P d S r. h n n l f1 i s t r i r t Administrative costs advance?
3333 Airport Way ® Yes ❑ No
Long Beach, CA 90806
If self -preparation, provide name(s) amyl VEbof�FORM 7. Does the agency receive at least $300,000 in federal
kitchen (attach list if necessary): funds? If yes, indicate your agency's fiscal year.
(Private nonprofit and Indian Tribes only)
20 O -D
L. a N ity Attorney ❑Yes ❑ No ®N/A Fiscal Year /
4. Number and type of sites:
Rural # Urban #
42
8. Do you wish to receive commodity foods?
CITY Ai.C;':_. M Yes ❑ No
The California Department of Education (CDE) and the Agency whose name and address appear above renew their Agreement to Participate
and to comply with 7 CFR Part 225. This includes all requirements developed pursuant to and imposed by those regulations as outlined in
the original Agreement between CDE and the Agency, which incorporates all amendments, Schedule A, and the Meal Pattern (Schedule B).
The Agency assures CDE it will continue to adhere to all of the requirements and responsibilities as agreed to in the original Agreement and
will follow all Nutrition Services Division policies and guidance. Comply with Title VI of the Civil Rights Act of 1964, Title IX of the Education
Amendments of 1973, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and USDA's regulations concerning
nondiscrimination (7 CRF Parts 15a and 15b). Comply with applicable Office of Management and Budget Circulars A21, A87, A102, A110,
A122 and A133. Comply with Uniform Federal Assistance (7 CFR Part 3015) and Debarment and Lobbying requirements (7 CFR Parts 3017
and 3018). CDE will continue to adhere to all of the requirements and responsibilities as agreed to in the original Agreement and as outlined
in 7 CFR Part 225.
I hereby certify all information contained in this document is true and correct to the best of my knowledge.
SIGNATURE OF AUTHORIZED REPRESENTATIVE: TiTLE: DATE:
M515TANT CITY MANAGER �"•! -O0
(i'(,=CiT1r-^ r'YrRSUANT CALIFORNIA DEPARTMENT OF EDUCATION USE ONLY
SO' 301 OF COMMODITY ELIGIBLE
THE , CHARTER. )9Yes ONO
APPROVAL BY NUTRITION SERVICES DIVISION
Janice Hunt, Manager
Summer Food Service Program Unit
Nutrition Services Division �� 3 O v�
APP OED I DATE
TELEPHONE (916) 327-6465 MESSAGE LINE (800) 333-5675 FAX (800) 333-5775
Y CALIFORNIA DEPARTMENT OF EDUCATION SUMMER FOOD SERVICE PROGRAM UNIT
NUTRITION SERVICES DIVISION
RENEWAL NSD 8040-B
AGENCY NAME Clty Of Long Beach
MANAGEMENT PLAN
1. Staffing Pattern: List below all administrative staff who will be involved with management, food
services, training, and monitoring of the SFSP.' =
PRINT EMPLOYEE NAME AND SPECIFIC DUTIES SFSP TRAINING DATES
POSITION
Bert Srack Superintendent 6/14/00
Cindy Graber Coordinator 3/9/00
Jess Gibson Lead Monitor 6/20./00
Robert 01mos Monitor 6/14/00
Linda Sprague Monitor 6/14/00
By signing this Renewal Application/Agreement you are agreeing to do the following:
2. Conduct a preoperational visit at each new site, and sites that had problems during the previous
year to determine the adequacy and suitability for food service? All preoperational visits must be
documented and kept on file for California Department of Education (CDE) to review.
3. Visit all sites at least once during the first week of operation.
4. Review all sites at least once during the first 4 weeks of program operation. If a site operates less
than 4 weeks, conduct at least one review.
5. You will conduct additional monitoring visits to sites as necessary to assure compliance with
program requirements. Documentation must be kept on file for CDE to review.
6 You agree to accept final administrative and financial responsibilities for operations of the SFSP at
each site.
7. You agree to retain SFSP records for three (3) years after the end of the fiscal year to which they
pertain.
8. If you operate an enrolled site, day camp or residential camp, you agree to collect and maintain the
income eligibility documentation of participants. If you will not be using the forms, provided by the
SFSP (Attachment B-1), please submit a copy of your proposed form for approval.
CALIFORNIA DEPARTMENT OF EDUCATION Agency Name: City o f Long Beach
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT Agreement Number: 19-81908V
RENEWAL NSD 8041-C (2/00)
SUMMER FOOD SERVICE PROGRAM
2000 BUDGET INFORMATION
Federal regulations require sponsors to submit a budget for State agency review and approval.
In the event that costs exceed anticipated revenue, sponsors should have other funding sources to pay the difference.
Sponsors may submit a revised budget for administrative costs as needed.
PROGRAM COSTS
The sponsor is reimbursed for actual cost or meals times the
applicable operating rates, whichever is lesser of the two.
GENERAL OPERATING COSTS
Food
$413, 042
Food labor
$ 25,184
Facilities/utilities
$
Food transportation to sites
$
Nonfood supplies
$ 7,500
Other (specify)
$
TOTAL
$445.'72'6
The sponsor is reimbursed for actual cost, meals times the
applicable administrative rate or the approved budget,
whichever is the lesser of the three.
ADMINISTRATIVE COSTS
Salaries/wages
$ 5,080
Office supplies
$ 300
Facilities/utilities
$ 2,432
Transportation
$ 1,600
'Indirect costs rate:
$
Other (specify)
$
TOTAL
$
'Attach indirect cost documentation for costs that are associated wltn the above aamlmstrauve uuayeL.
CONTRACTS
Is there a rental agreement, lease, or contract for any of the costs listed above? ❑ Yes a No
If yes, list and attach a copy:
INCOME
Will meals be sold to adults who are not SFSP staff? ❑ Yes 3 No
If yes, list price to be charged for each meal:
Breakfast Snack Lunch Dinner
List any anticipated income to the program, by type:
Donations/Grant Income:
Operational Administration Unspecified
RATES
Formula for meal rate projections:
Number of operating days (OD) X average dailyparticipation ADP X meal rate (MR) = total
OPERATING RATES
OD
I X
ADP
X
MR
=
TOTAL
Breakfast
X
X
=
$
Snack
X
X
=
$
Lunch
44
1 X
4814
X
12.18
=
$ 461 759
Dinner
X
X
=
$
TOTAL
$ 461 , 759
ADMINISTRATIVE RATES
OD'
X
ADP
X I
MR
=
TOTAL
Breakfast
X
X
=
$
Snack
X
X
='$
Lunch
44
X
4814
X
1 .19
=1$40,245
Dinner
X
X
=
$
TOTAL
-$40,245
CALIFORNIA DEPARTMENT OF EDUCATION SUMMER FOOD SERVICE PROGRAM UNIT
NUTRITION SERVICES DIVISION (NSD 8050-C) (2/00)
MEDIA RELEASE CERTIFICATION
Use the following format for your media/public release or send this form to announce your site
location(s):
Check the box(es) that apply and insert the name, address and meal service time(s) of each of
your site(s) in the appropriate section. Attach an additional sheet of paper if necessary.
OPEN SITES:
❑ Agency name: see attachment announces the sponsorship
of the SFSP. Free meals will be made available to all attending children under 19 years of
age. The United States Department of Agriculture (USDA) and the California Department of
Education's Nutrition Services Division (NSD) prohibit discrimination in all their programs
and activities on the basis of race, color, national origin, gender, religion, age, or disability.
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-
W, Whitten Building, 14"' and Independence Avenue, SW, Washington, DC 202507-9410 or
call (202) 720-5964 (voice and TDD). The USDA and the NSD are equal opportunity
providers and employers.
Enter site name, address, meal service times and dates below, or attach a list.
OPEN ENROLLED SITES:
❑ Agency name: announces the sponsorship
of the SFSP. Due to , a limited number of meals will
(security, safety, capacity or control)
be made available to attending children under 19 years of age at no cost on a first come,
first serve basis. The United States Department of Agriculture (USDA) and the California
Department of Education's Nutrition Services Division (NSD) prohibit discrimination in all
their programs and activities on the basis of race, color, national origin, gender, religion,
age, or disability.
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-
W, Whitten Building, 14"' and Independence Avenue, SW, Washington, DC 20250-9410 or
call (202) 720-5964 (voice and TDD). The USDA and the NSD are equal opportunity
providers and employers.
Enter site name, address, meal service times and dates below, or attach a list.
CALIFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
(2/00)
ENROLLED SITES, CAMPS AND AGENCIES WITH SITES OTHER THAN OPEN SITES:
❑ Agency name: announces the sponsorship
of the SFSP. Free meals will be made available to all eligible enrolled children. The United
States Department of Agriculture (USDA) and the California Department of Education's
Nutrition Services Division (NSD) prohibit discrimination in all their programs and activities
on the basis of race, color, national origin, gender, religion, age, or disability.
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-
W, Whitten Building, 14u' and Independence Avenue, SW, Washington, DC 20250-9410 or
call (202) 720-5964 (voice and TDD). The USDA and the NSD are equal opportunity
providers and employers.
Children who are members of households receiving food stamps or benefits from a food
distribution program on an Indian reservation, or are recipients of California Work
Opportunity and Responsibility to Kids Act (CaIWORKs) are automatically eligible to receive
free meal benefits. Children from households with incomes at or below the income eligibility
guidelines attached are also eligible for free meal benefits.
Enter enrolled site name, address, meal service times and dates below, or attach a list.
Income Eligibility Guidelines
Effective Summer 2000
FAMILY SIZE
YEAR
MONTH
WEEK
1
$15,244
$1,271
$294
2
20,461
1,706
394
3
25,678
2,140
494
4
30,895
2,575
595
5
36,112
3,010
695
6
41,329
3,445
795
7
46,546
3,879
896
8
51,763
4,314
996
For each
+5,217
+435
+101
additional
family member
add:
CALIFORNIA DEPARTMENT OF EDUCATION SUMMER FOOD SERVICE PROGRAM UNIT
NUTRITION SERVICES DIVISION SCHEDULE D (NSD 805(-D) (2100)
FREE MEAL POLICY STATEMENT
The authorized representative certifies that all children at the sites described on the site information
sheets will be served the same meals at no separate charge regardless of race, color, national origin,
gender, religion, age, or disability.
The free meal policy statement must be signed by all new sponsors and by any returning sponsors
who have substantive changes in their original. site document(s) (e.g. from open to'enrolled).
SIGNATURE OF AUTHORIZED REPRESENTATIVE: w AGENCY NAME: DATE:
.�•l�•00
ASSISTANT CITY MANAGER
APPROVED AS TO FORM EXECUTED PURSUANT
S .20pp TO SECTION 301 OF
ROBERT E. S: -I NN N, CIV Attorney
THE CITY CHARTER•
Ey-� -- - ,_-------------
DE WY CI6Y ATkC- -'
M
Date. June 15,
1999 �
FOR IMMEDIATE RELEASE
Contact: Terry McAlpine, ine, 562/570-3232
The Benefits Are Endless.. TM
Long Beach Parks, Recreation & Marine sponsors
U.S.D.A. summer food service for children
The City of Long Beach Department of Parks, Recreation and Marine will once again sponsor the
Summer Food Service Program for children, beginning.June 26. Free meals will be available to all
attending children, under 19 years of age. The United State Department of Agriculture (USDA) and the
California Department of Education's Nutrition Service Division (NSD) prohibit discrimination in all their
programs and activities on the basis of to race, color, national origin, gender, religion, age, disability,
political beliefs, sexual orientation, and marital or family status.
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-
W, Whitten Building, 14th and Independence Avenue, SW, Washington, DC 20250-9410 or call (202)
720-5964 (voice and TDD). The USDA and the NSD are equal opportunity provider and employer.
The following Long Beach parks and facilities will serve meals:
Admiral Kidd Park
Coolidge Park
MacArthur Park
Scherer Park
2125 Santa Fe Ave.
352 E. Neece St.
1321 E. Anaheim St.
4600 Long Beach Bl.
11:30 a.m.-12:30 p.m.
12:15 a.m.-12:45 p.m.
11:45 a.m: 12:45 p.m.
12:30-1:30 p.m.
Bixby Park
130 Cherry Ave.
12:15-1:15 p.m.
Cal Community Center
1550 M.L. King Ave.
11:30 a.m.-12:30 p.m.
Cesar E. Chavez Park
401 Golden Ave.
12-1 p.m.
Cherry Park
1901 E. 45th St.
11:45-12:45 p.m.
DeForest Park
6255 DeForest
.12-12:30 p.m.
Drake Park
951 Maine Ave.
12:15 -1:15 p.m.
Heartwell Park
5801 E. Parkcrest St.
11-11:30 a.m.
Houghton Park
6301 Myrtle Ave.
11:30 a.m.-12:30 p.m.
M.L. King, Jr. Park
1950 Lemon Ave.
11:15 a.m.-12:15 p.m.
Orizaba Park
Orizaba and Spalding
12:30-1:15 p.m.
Pan American Park
5157 Centralia St.
11:15 a.m.-12:15 p.m.
Ramona Park
3301 E. 65th St.
11:15 a.m.-12:15 p.m.
Silverado Park
1545 W. 31st St.
11 a.m.-12 p.m.
Somerset Park
1500 E. Carson St.
11:30 a.m.-12:30 p.m.
Springdale Apartment
Community Center
2095 Spring St.
11:15 a.m.-12:15 p.m.
Stearns Champions
4520 E. 23rd St.
12:30-1:30 p.m.
LF
Summer Food Service
�2-2-2-2
Veterans Park
101 E. 28th St.
11-11:45 a.m.
Washington Youth Ctr.
1430 Pacific Ave.
12-12:30 p.m.
14th Street Park
Chestnut & 14th St.
12-12:30 p.m.
Antioch Missionary
Church, 1535 Gundry
11:45 a.m.-12:45 p.m.
Eastman/Fairfield
Boys & Girls Club
700 E. Del Amo Bl.
12:45-1:45 p.m.
West Branch
Boys & Girls Club
1835 W. Willard
11:45 a.m.-12:45 p.m.
Calvary Chapel of
North Long Beach
5722 Lime Ave.
11:45 a.m.-12:45 p.m.
Carmelitos Community
Boys & Girls Club
1000 1/2 Via Wanda
12-1 p.m.
First Congregational
Church of LB
909 Pine Ave.
11:45 a.m.-12:45 p.m.
241 Cedar Ave.
12:15-1:15 p.m.
First Southern Baptist
Church
5640 Orange Ave.
11:45 a.m.-12:15 p.m.
First United Methodist
Church
507 Pacific Ave.
12:15-12:45 p.m.
Lakewood First
Presbyterian Church
3955 Studebaker Rd.
11-11:30 a.m.
Pacific Baptist Church
2474 Pacific Ave.
11:15 a.m.-12:15 p.m.
In Signal Hill, lunches will be served 12:30 -1 p.m. at Hillbrook Park Church
V
Second Samoan
Congregational Church
655 Cedar Ave.
12:15-1 p.m.
True Gospel
Missionary Baptist
Church
2060 Santa Fe Ave
11:30 a.m.-12 noon
Wesley United
Methodist Church
1100 Freeman Ave.
12:30-1 p.m.
YMCA
600 Long Beach Bl.
11:30 a.m: 12:30 p.m.
1875 Temple Ave., and Signal Hill Park, 2175 Cherry Ave. In Paramount, lunches will be served 11:15
a.m.-12:15 pm. at Love of God Fellowship Church, 8721 Paseo St.
For more information on the Summer Food Program, call (
-30-
CAUFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NS0 8051 0=)
SUMMER FOOD SERVICE PROGRAM
SITE INFORMATION SHEET
SITE NAME:
First United Methodist Church
SITE ADDRESS (STREET, CITY, ZIP + 4):
507 Pacific Ave.
Long Beach 90802
1. Period of operation:
6/26/00 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes 3 No
3. Pre -approval visit made (new site
or previous site with problems)?
0 Yes ❑ No
If no, date of planned visit:
4. Days per week to operate:
S M TU W TH F S
❑®M®®®❑
List dates site will be closed:
7/4/00
A
AGENCY NAME: City of Long Beach
Department of Parks, Rec. & marine
SITE NUMBER:
AGREEMENT NUMBER: 19-81908V
CONTACT PERSON: Linda Stouffer
TELEPHONE NUMBER: (
COEDS USE ONLY
INITIAL APPROVAL DATE ELIGIBILITY YEAR
Meal ADP Start/End
Time
L 50 12:1512:45
6. Number of operating days:
October
April
November
May
December
5 June
January
20 July
February
19 August
March
September
7. a. Method of meal service and
site type:
® Urban ❑ Rural
❑ Self -prep ® Vended
b. If vended, name of vendor:
Loncr Beach Unified
School District
8. Are you using the SFSP Meal
Pattern?
Z1 Yes ❑ No
If no, which school menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes ® No
Open only to enrolled summer
school students?
❑ Yes 0 No
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
$� N/A
11. Provide the name of school
district and school from which
the site'draws its attendance:
District: Lona Beach 0-D
School: E d i s o n Elem.
98.8%
AGREEMENT NUMBER: 19-81908V
CAUFORNIA DEPARTMENT OF EDUCATION SITE NUMBER:
NSD 8051 (1/00)
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IN EACH COLUMN.
Eligibility
Site Type
12. ®Open Site Recreation IM School Data 50% receiving
❑ Free/Reduce priced meals
or School
Census Track/Housing
❑ Open/enrolled site ❑ Indian Reservation ❑
If open/enrolled, explain the ❑ Migrant Authority
❑ ❑Bureau of Indian Affairs
reason: Homeless
® Other Corn nscn o'h Owf-�a� ❑Migrant Organization Letter
15. If site is "open". indicate the geographic area to be served.
South West Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site su ervisor(s) will call the Lonq Beach SFSP office to report any meal
order adjustments for the following day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
-77--T. RTTRT), s truck no more an one our . prior to meal serving time. eals
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Sc..re. � ndoo•
Site Type
Eligibility
13. ❑ Closed Enrolled Site
❑ Recreation
❑
❑
Eligibility Applications
Letter
or
❑ Educational
Migrant
❑ Camp
❑ Migrant
❑
Roster
(Homeless Sites Only)
❑ Indian Reservation
❑ Homeless
❑ Other
Site Type
Eligibility
14. ❑ National Youth Sports
Closed Enrolled
❑
❑
School Data
Census Track
Program (NYSP)
❑
Eligibility Applications
❑
Letter Verifying Participants
Meet DHHS Income
Guidelines
15. If site is "open". indicate the geographic area to be served.
South West Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site su ervisor(s) will call the Lonq Beach SFSP office to report any meal
order adjustments for the following day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
-77--T. RTTRT), s truck no more an one our . prior to meal serving time. eals
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Sc..re. � ndoo•
MONTHLY SCHOOL STATUS UPDATE
Month/Year: 10/99
Loc
Name
Days A.D.A.
Enroll
__Free
Reduced
Denied
__Paid
404
____________
ALVARADO ELEMENT
21
_
0
491
324
393
74
117
36
51
104
171
406
ROBINSON ELEMENT
21
0
0
992
849
820
17
39
538
407
INTERNATIONAL EL
21
0
1,184
997
160
86
272
410
ADDAMS ELEMENTAR
21
0
757
209
84
30
404
411
AVALON ELEMENTAR
21
0
1,155
926
159
68
401
412
BARTON ELEMENTAR
21
0
873
498
186
93
273
413
BIRNEY ELEMENTAR
21
21
645
344
75
58
274
414
BIXBY ELEMENTARY
.0
0
423
307
67
39
143
415
BRYANT ELEMENTAR
21
0
540
309
49
35
260
416
417
BUFFUM SCHOOL
BURBANK ELEMENTA
21
21
0
751
669
61
9
649
418
BURCHAM ELEMENTA
21
0
793
512
71
28
46
35
302
686
419
BURNETT ELEMENTA
21
0
0.
883
412
750
195
76
58
199
420
BURROUGHS ELEMEN
21
0
651
293
50
46
387
421
CARVER ELEMENTAR
21
0
780
367
66
39
460
422
CLEVELAND ELEMEN
21
0
1,167
199
68
38
542
423 CUBBERLEY ELEMEN
21
908_
_ =":� 20�
�=._12'-646Y-
424^nEDISON-.ELEMENTAR
_.---.21_.::_9$..g%�o
0
_.����_
643
.�877r
395
59
.
30
227
425
EMERSON ELEMENTA
21
0
443
165
53
29
279
427
FREMONT ELEMENTA
21
0
733
145
33
33
637
428
GANT ELEMENTARY'
GARFIELD ELEM
21
21
0
1,296
1,010
232
151
243
429
430
E.
GOMPERS ELEMENTA
21
0
.859
550
71
73
165
361
310
431
GRANT ELEMENTARY
21
0
1,556
1,157
330
208
91
286
432
HARTE ELEMENTARY
21
0
1,273
1,000
467
93
110
357
433
HENRY ELEMENTARY
21
0
0
839
670
406
137
71
266
434
HOLMES ELEMENTAR
21
0
718
574
50
45
211
435
KELLER ELEMENTAR
21
0
867
691
76
70
1
436
KING ELEMENTARY
21
0
830
705
49
48
243
437
LAFAYETTE ELEMEN
21
0
663
601
28
6
546
438
LEE ELEMENTARY
21
0
1,001
881
56
83
143
439
LINCOLN ELEMENTA
21
0
961
303
110
59
637
440
LONGFELLOW ELEME
21
0
465
143
70
46
294
441
LOS CERRITOS ELE
21
0
646
129
36
27
539
442
LOWELL ELEMENTAR
21
0
958
567
70
92
362
443
MACARTHUR ELEMEN
21
0
690
230
85
62
437
444
MADISON ELEMENTA
21
0
468
314
92
33
116
445
446
MANN ELEMENTARY
MCKINLEY ELEMENT
21
21
0
1,150
950
111
48
330
447
MONROE ELEMENTAR
21
0
658
407
747
59
215
32
106
258
237
448
MUIR ELEMENTARY
21
0
1,026
84
19
23
221
449
NAPLES ELEMENTAR
21
0
0
302
700
285
59
33
436
450
PRISK ELEMENTARY
21
0
880
549
129
72
351
451
RILEY ELEMENTARY
21
0
925
875
34
9
800
452
ROOSEVELT ELEMEN
21
0
918
755
112
49
126
453
SIGNAL HILL ELEM
21
0
728
618
54
116
123
454
STEVENSON ELEMEN
21
0
1,210
809
199
74
361
455
SUTTER ELEMENTAR
21
0
635
563
37
10
388
457
TUCKER ELEMENTAR
21
0
865
199
80
41
715
458
TWAIN ELEMENTARY
21
0
757
580
107
32
525
459
WEBSTER ELEMENTA
21
Name Days A.D.A. Enroll Free Reduced Denied Paid
460 WHITTIER ELEMENT 21 0 1,225 954 52 21 652
461 WILLARD ELEMENTA 21 0 786 724 42 20 684
462 WEST GARFIELD EL 21 0 0 0 0 0 0
463 TINCHER ELEMENTA 21 0 928 464 92 55 270
464 HUDSON ELEMENTAR 21 0 1,136 490 150 89 149
465 NEWCOMB ELEMENTA 21 0 1,082 118 51 35 471
466 KETTERING ELEMEN 21 0 420 194 27 16 233
467 BUTLER ELEMENTAR 21 0 695 272 41 20 64
492 Colin L. Powell 21 0 989 431 103 79 239
611 FRANKLIN MIDDLE 21 0 1,145 986 26 48 608
612 HAMILTON MIDDLE 21 0 1,283 910 163 105 214
613 HUGHES MIDDLE SC 21 0 1,512 543 199 91 977
614 JEFFERSON MIDDLE 21 0 1,073 917 114 64 319
615 BANCROFT MIDDLE 21 0 1,290 476 136 55 765
616 LINDBERGH MIDDLE 21 0 1,161 939 109 53 180
617 MARSHALL MIDDLE 21 0 1,354 860 117 47 421
618 ROGERS MIDDLE SC 21 0 809 315 85 19 497
619 STANFORD MIDDLE 21 0 1,282 528 124 87 758
620 STEPHENS MIDDLE 21 0.. 1,396 995 253 118 403
622 WASHINGTON MIDDL 21 0 1,103 1,030 25 53 512
624 DEMILLE MIDDLE S 21 0 1,270 882 145 38 407
625 HOOVER MIDDLE SC 21 0 1,115 606 188 26 554
626 HILL MIDDLE SCHO 21 ..0. 1,067 788 107 32 342
627 BUTLER ACADEMY 21 0 0 0 0 0 0
628 NEWCOMB ACADEMY 21 0 0 0 0 0 0
629 CUBBERLEY ACADEM 21 0 0 0 0 0 0
630 HUDSON ACADEMY 21 0 0 0 0 0 0
631 ROBINSON ACADAMY 21 0 0 0 0 0 0
632 Tincher Preparat 21 0 0 0 0 0 0
633 Colin L. Powell 21 0 0 0 0 0 0
641 CALIFORNIA ACADE 21 0 577 151 76 35 366
642 CONSTELLATION CO 21 0 168 149 17 7 8
647 8TH GRADE ACADEM 21 0 283 216 20 14 137
652 JORDAN HIGH SCHO 21 0 3,922 2,351 359 121 2,470
653 LAKEWOOD HIGH SC 21 0 4,162 1,551 223 45 3,234
654 POLYTECHNIC HIGH 21 0 4,191 1,978 161 58 2,617
655 SAVANNAH ACADEMY 21 0 0 0 0 0 0
656 WILSON HIGH SCHO 21 0 3,483 1,649 149 41 2,434
657 CABRILLO HIGH SC 21 0 1,663 998 119 54 946
658 MILLIKAN HIGH SC 21 0 4,417 1,844 253 53 3,236
670 PAAL 21 0 441 335 14 3 338
671 AVALON MIDDLE & 21 0 0 0 0 0 0
682 REID SENIOR AND 21 0 447 386 19 15 261
Totals: 0 89,462 52,873 8,340 4,404 43,843
CAUFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NSD 80510 =)
SUMMER FOOD SERVICE PROGRAM
SITE INFORMATION SHEET
SITE NAME:
Second Samoan Congregational Church
SITE ADDRESS (STREET, CITY, ZIP + 4):
655 Cedar Ave.
Long Beach 90802
1. Period of operation:
6/26/00 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes 131 No
3. Pre -approval visit made (new site
or previous site with problems)?
U Yes ❑ No
If no, date of planned visit:
4. Days per week to operate:
S M TU W TH F S
01@13®®®❑
List dates site will be closed:
7/4/00
5.
AGENCY NAME: City of Long Beach
Departm.en o Parks, Rec.& Marine
SITE NUMBER:
AGREEMENT NUMBER: 19-81908V
CONTACT PERSON: Ron Degrate
TELEPHONE NUMBER: (
COEDS USE ONLY i
INITIAL APPROVALDATE ELIGIBILITY YEAR i
Meal ' ADP Start/End
Time
L 100 12:1511:00
I
6. Number of operating days:
October April
November May
December 5 June
_January 20 July
February 19 August
March September
7. a. Method of meal'service and
site type:
® Urban ❑ Rural
❑ Self -prep ® Vended
b. If vended, name of vendor:
Long Beach Unified
School District
8. Are you using the SFSP Meal
Pattern?
10 Yes ❑ No
If no, which school menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes ZI No
Open only to enrolled summer
school students?
❑ Yes M *No
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
l� N/A
11. Provide the name of schooi
district and school from which
the site draws its attendance:
District: Lona Beach r1Sn
School: Edison E1 em.
98.8%
CALIFORNIA DEPARTMENT OF EDUCATION AGREEMENT NUMBER: 19-81908V
NSD 8051 (1/00) SITE NUMBER:
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IW EACH COLUMN.
Site Type Eligibility
12. 0 Open Site C1 Recreation (a School Data 50% receiving .
Free/Reduce priced meals
or C1 School
C3Open/enrolled site ❑ Indian Reservation ❑ Census Track/Housing
If open/enrolled, explain the C1 Migrant
Authority
reason: C1 Homeless ❑Bureau of Indian Affairs
El Other &,nmttn,4m O ti -react, ❑Migrant Organization Letter
15. If site is "open". indicate the geographic area to be served.
South/West Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report -any meal
order adjustment for the following day(s)- or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
t e s ruc no more an one our prior to meal servii g time. Meals
will be stored in dense styrofoam containers to ensure correct tem -p.
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Meals will be served under a canopy.
Site Type
Eligibility
13. ❑ Closed Enrolled Site
❑ Recreation
❑
❑
Eligibility Applications
Letter
or
❑ Educational
Migrant
❑ Camp
❑ Migrant
❑
Roster
(Homeless Sites Only)
❑ Indian Reservation
❑ Homeless
❑ Other
Site Type
Eligibility
14. ❑ National Youth Sports
Closed Enrolled
❑
School Data
Program (NYSP)
❑
Census Track
❑
Eligibility Applications
❑
Letter Verifying Participants
Meet DHHS Income
Guidelines
15. If site is "open". indicate the geographic area to be served.
South/West Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report -any meal
order adjustment for the following day(s)- or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
t e s ruc no more an one our prior to meal servii g time. Meals
will be stored in dense styrofoam containers to ensure correct tem -p.
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Meals will be served under a canopy.
MONTHLY SCHOOL STATUS UPDATE
Month/Year: 10/99
Days s A.D.A.
Enroll
Free Reduced
Denied
Paid
Loc
Name
___
___ ____
______ ______
404
ALVARADO ELEMENT
____
21
0
491
324
393
74
117
36
51
104
171
406
ROBINSON ELEMENT
21
0
0
992
849
820
17
39
538
407
INTERNATIONAL EL
21
0
1,184
997
160
86
272
410
ADDAMS ELEMENTAR
21
0
757
209
84
30
404
411
AVALON ELEMENTAR
21
0
1,155
926
159
68
401
412
BARTON ELEMENTAR
21
0
873
498
186
93
273
413
BIRNEY ELEMENTAR
21
0
645
344
75
58
274
414
BIXBY ELEMENTARY
21
0
423
307
67
39
143
415
BRYANT ELEMENTAR
21
0
540
309
49
35
260
416
BUFFUM SCHOOL
21
0
751
669
61
9
649
417
BURBANK ELEMENTA
21
0
793
512
71
46
302
418
BURCHAM ELEMENTA
21
0
883
750
28
35
686
419
BURNETT ELEMENTA
21
0.
412
195
76
58
199
420
BURROUGHS ELEMEN
21
0,
651
293
50
46
387
421
CARVER ELEMENTAR
21
0
780
367
66
39
460
422
CLEVELAND ELEMEN
21
0
1,167
199
68
38
542
423
424ya
CUBBERLEY ELEMEN
`EDISOI�I: EI,i l 'AR
21
_.'_21_ ..9.$;8 0 908.
.� 8'17 T.: �.r
20�
� x'.12 :M..
x..30 227
425 "'kMERSON ELEMENTA
21
0
643
395
165
59
53
29
279
427
FREMONT ELEMENTA
21
0
0
443
733
145
33
33
637
428
GANT ELEMENTARY
21
21
0
1,296
1,010
232
151
243
429
E. GARFIELD ELEM
0
859
550
71
73
361
430
GOMPERS ELEMENTA
21
0
1,556
1,157
330
165
310
431
GRANT ELEMENTARY
21
0
1,273
1,000
208
91
286
432
HARTE ELEMENTARY
21
0
839
467
93
110
357
433
HENRY ELEMENTARY
21
0
670
406
137
71
266
434
HOLMES ELEMENTAR
21
0
718
574
50
45
211
435
KELLER ELEMENTAR
21
0
867
691
76
70
1
436
KING ELEMENTARY
21
0
830
705
49
48"
243
437
LAFAYETTE ELEMEN
21
0
663
601
28
6
546
438
LEE ELEMENTARY
21
0
1,001
881
56
83
143
439
LINCOLN ELEMENTA
21
0
961
303
1 0
59
637
440
LONGFELLOW ELEME
21
0
465
143
70
7
46
294
441
LOS CERRITOS ELE
21
0
646
129
36
27
539
442
LOWELL ELEMENTAR
21
0
958
567
70
92
362
443
MACARTHUR ELEMEN
21
0
690
230
85
62
437
444
MADISON ELEMENTA
21
0
468
314
92
33
116
445
MANN ELEMENTARY
21
0
1,150
950
111
48
330
446
MCKINLEY ELEMENT
21
0
658
407
59
32
258
447
MONROE ELEMENTAR
21
0
1,026
747
215
106
237
448
MUIR ELEMENTARY
21
0
302
84
19
23
221
449
NAPLES ELEMENTAR
21
0
700
285
59
33
436
450
PRISK ELEMENTARY
21
0
880
549
129
72
351
451
RILEY ELEMENTARY
21
0
925
875
34
9
800
452
ROOSEVELT ELEMEN
21
0
918
755
112
49
126
453
SIGNAL HILL ELEM
21
0
728
618
54
116
123
454
STEVENSON ELEMEN
21
0
1,210
809
199
74
361
455
SUTTER ELEMENTAR
21
0
635
388
457
TUCKER ELEMENTAR
21
0
865
199
80 11
715
458
TWAIN ELEMENTARY
21
0
757
580
107
32
525
459
WEBSTER ELEMENTA
21
Name Days A.D.A. Enroll Free Reduced Denied --Paid
------------------ ---- ------ ------ ----- --------
460 WHITTIER ELEMENT 21 0 1,225 954 52 21 652
461 WILLARD ELEMENTA 21 0 786 724 42 20 684
462 WEST GARFIELD EL 21 0 0 0 00 0
463 TINCHER ELEMENTA 21 0 928 464 92 55 270
464 HUDSON ELEMENTAR 21 0 1,136 490 150 89 149
465 NEWCOMB ELEMENTA 21 0 1,082 118 51 35 471
466 KETTERING ELEMEN 21 0 420 194 27 16 233
467 BUTLER ELEMENTAR 21 0 695 272 41 20 64
492 Colin L. Powell 21 0 989 431 103 79 239
611 FRANKLIN MIDDLE 21 0 1,145 986 26 48 608
612 HAMILTON MIDDLE 21 0 1,283 910 163 105 214
613 HUGHES MIDDLE SC 21 0 1,512 543 199 91 977
614 JEFFERSON MIDDLE 21 0 '' 1,073 917 114 64 319
615 BANCROFT MIDDLE 21 0 1,290 476 136 55 765
616 LINDBERGH MIDDLE 21 0 1,161 939 109 53 180
617 MARSHALL MIDDLE 21 0 1,354 860 117 47 421
618 ROGERS MIDDLE SC 21 0 809 315 85 19 497
619 STANFORD MIDDLE 21 0 1,282 528 124 87 758
620 STEPHENS MIDDLE 21 0.._ 1,396 995 253 118 403
622 WASHINGTON MIDDL 21 0 1,103 1,030 25 53 512
624 DEMILLE MIDDLE S 21 0 1,270 882 145 38 407
625 HOOVER MIDDLE SC 21 0 1,115 606 188 26 554
626 HILL MIDDLE SCHO 21 •..0. 1,067 788 8 8 107 328 3428
627 BUTLER ACADEMY 21 0 0 p 0 p 0
628 NEWCOMB ACADEMY 21 0 0 p p p 0
629 CUBBERLEY ACADEM 21 0 0 0 0 0 p
630 HUDSON ACADEMY 21 0 p 0 p 0
631 ROBINSON ACADAMY 21 0 0 0 p p p
632 Tincher Preparat 21 0 p 0 0 0
633 Colin L. Powell 21 0 0
641 CALIFORNIA ACADE 21 0 577 151 76 35 366
642 CONSTELLATION CO 21 0 168 149 17 7 8
647 8TH GRADE ACADEM 21 0 283 216 20 14 137
2,470
652 JORDAN HIGH SCHO 21 0 3,922 2,351 359 121 _
653 LAKEWOOD HIGH SC 21 0 4,162 1,551 223 45 3,234
654 POLYTECHNIC HIGH 21 0 4,191 1,9788 1618 580 2,6170
655 SAVANNAH ACADEMY 21 0 0
656 WILSON HIGH SCHO 21 0 3,483 1,649 149 41 2,434
657 CABRILLO HIGH SC 21 0 1,663 998 119 54 946
658 MILLIKAN HIGH SC 21 0 4,417 1,844 253 53 3,236
670 PAAL 21 0 441 335 14 3 3388
671 AVALON MIDDLE & 21 0 0 0 0 0
682 REID SENIOR AND 21 0 447 386 19 15 261
Totals: 0 89,462 52,873 8,340 4,404 43,843
•\✓
1
CALIFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NSD 8051 (1100)
SUMMER FOOD SERVICE PROGRAM
SITE INFORMATION SHEET
SITE NAME:
Cesar E. Chavez Park
SITE ADDRESS (STREET, CITY, ZIP + 4):
401 Golden Ave.
Long Beach 90802
1. Period of operation:
6/26/00 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes ® No
3. Pre -approval visit made (new site
or previous site with problems)?
® Yes ❑ No
If no, date of planned visit:
4. Days per week to operate:
S M TU W TH F S
❑ @ a @ @ 9 ❑
List dates site will be closed:
7/4/00
5.
AGENCY NAME: City of Long Beach
Departmen -F--o-f Parks, Red. N marine
SITE NUMBER:
AGREEMENT NUMBER:
CONTACT PERSON:
19-81908V
TELEPHONE NUMBER: (
CDE'S USE ONLY
INITIAL APPROVAL'dATE ELIGIBILITY YEAR
Meal ADP Start/End
Time
L "x.00 12:15/ 1: 15
I
6. Number of operating days:
October April
November May
December 5 June
January 20 July
February 19 August
March September
7. a. Method of meal'service and
site type:
® Urban 0 Rural
❑ Self -prep ® Vended
b. If vended, name of vendor:
Long Beach Unified
School District
8. Are you using the SFSP Meal
Pattern?
E2 Yes ❑ No
If no, which school menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes ® No
Open only to enrolled summer
school students?
❑ Yes M No
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
N/A
11. Provide the name of school
district and school from which
the site draws its attendance:
District: Long Beach USD
School:Edison Elementar
f8.!9%
AGREEMENT NUMBER' 19-81908V
CALIFORNIA DEPARTMENT OF EDUCATION SITE NUMBER:
NSD 8051 (1/00)
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IN EACH COLUMN.
Site Type Eligibility
12. ®_Open Site ®Recreation ®School Data 50% receiving
❑ School Free/Reduce priced meals
or
❑ Open/enrolled site ❑ Indian Reservation ❑ Census Track/Housing
If open/enrolled, explain the C3 Migrant Authority
reason: Homeless ❑Bureau of Indian Affairs
❑ Other ❑ Migrant Organization Letter
15. If site is "open", indicate the geographic area to be served.
South/West Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report any meal
order adjustment for the following
day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will have meals delivered by the LBUSD's truck no more than one hour
cotaesetsuegreeae s ore in
—prior to
enrcorct tm erture.
18.
Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Serve under building overhang and under can
Site Type
Eligibility
13. ❑ Closed Enrolled Site
❑ Recreation
❑
Eligibility Applications
or
❑ Educational
❑
Migrant Letter
❑ Camp
❑ Migrant
❑
Roster
(Homeless Sites Only)
❑ Indian Reservation
❑ Homeless
❑ Other
Site Type
Eligibility
14. ❑ National Youth Sports
Closed Enrolled
❑
❑
School Data
Census Track
Program (NYSP)
❑
Eligibility Applications
❑
Letter Verifying Participants
Meet DHHS Income
Guidelines
15. If site is "open", indicate the geographic area to be served.
South/West Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report any meal
order adjustment for the following
day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will have meals delivered by the LBUSD's truck no more than one hour
cotaesetsuegreeae s ore in
—prior to
enrcorct tm erture.
18.
Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Serve under building overhang and under can
MONTHLY SCHOOL STATUS UPDATE
Month/Year: 10/99
Days
A.D.A.
Enroll
Free
Reduced
Denied
Paid
Loc
Name
_----- ------
404
ALVARADO ELEMENT
----
21
--
0
491
324
393
74
117
36
51
104
171
406
ROBINSON ELEMENT
21
0
0
992
849
820
17
39
538
407
INTERNATIONAL EL
21
0
1,184
997
160
86
272
410
ADDAMS ELEMENTAR
21
0
757
209
84
30
404
411
AVALON ELEMENTAR
21
0
1,155
926
159
68
401
412
BARTON ELEMENTAR
21
0
873
498
186 ..
93
273
413
BIRNEY ELEMENTAR
21
0
645
344
75
58
274
414
BIXBY ELEMENTARY
21
0
423
307
67
39
143
415
BRYANT ELEMENTAR
21
0
540
309
49
35
260
416
BUFFUM SCHOOL
21
0
751
669
61
9
649
417
BURBANK ELEMENTA
21
0
793
512
71
46
302
418
BURCHAM ELEMENTA
21
0
883
750
28
35
686
419
BURNETT ELEMENTA
21
0.
412
195
76
58
199
420
BURROUGHS ELEMEN
21
0
651
293
50
46
387
421
CARVER ELEMENTAR
21
0
780
367
66
39
460
422
CLEVELAND ELEMEN
21
0
1,167
199
68
38
542
423
CUBBERLEY ELEMEN
-ELEMENTAR_
21
�._21�-
98.8 --
-- 908
64.6>
424
425
`EDISON..-.
EMERSON ELEMENTA
-�
21
0
643
395
59
30
29
227
279
427
FREMONT ELEMENTA
21
01
443
733
165
145
53
33
33
637
428
GANT ELEMENTARY
21
21
0
0
1,296
1,010
232
151
243
429
E. GARFIELD ELEM
0
859
550
71
73
361
430
GOMPERS ELEMENTA
21
0
1,556
1,157
330
165
310
431
GRANT ELEMENTARY
21
0
1,273
1,000
208
91
286
432
HARTE ELEMENTARY
21
0
839
467
93
110
357
433
HENRY ELEMENTARY
21
0
670
406
137
71
266
434
HOLMES ELEMENTAR
21
p
718
574
50
45
211
435
KELLER ELEMENTAR
21
0
867
691
76
70
1
436
KING ELEMENTARY
21
0
830
705
49
48'
243
437
LAFAYETTE ELEMEN
21
0
663
601
28
6
546
438
LEE ELEMENTARY
21
0
1,001
881
56
83
143
439
LINCOLN ELEMENTA
21
0
61
303
110
46
294
440
LONGFELLOW ELEME
21
0
465
4
143
70
441
LOS CERRITOS ELE
21
0
646
129
36
27
539
442
LOWELL ELEMENTAR
21
0
958
567
70
92
362
443
MACARTHUR ELEMEN
21
0
690
230
85
62
437
444
MADISON ELEMENTA
21
0
468
314
92
33
116
445
MANN ELEMENTARY
21
0
1,150
950
ill
48
330
446
MCKINLEY ELEMENT
21
0
658
407
59
32
258
447
MONROE ELEMENTAR
21
0
1,026
747
215
106
237
448
MUIR ELEMENTARY
21
0
302
84
19
23
221
449
NAPLES ELEMENTAR
21
0
700
285
59
33
436
450
PRISK ELEMENTARY
21
0
880
549
129
72
351
451
RILEY ELEMENTARY
21
0
925
875
34
9
800
452
ROOSEVELT ELEMEN
21
0
918
755
112
49
126
453
SIGNAL HILL ELEM
21
0
728
618
54
116
123
454
STEVENSON ELEMEN
21
0
1,
809
199
74
361
455
SUTTER ELEMENTAR
21
p
635
635
563
37
10
388
457
TUCKER ELEMENTAR
21
0
865
199
41
715
458
TWAIN ELEMENTARY
21
0
757
580
10077
32
525
459
WEBSTER ELEMENTA
21
Days A.D.A.Enroll Free Reduced Denied Paid
Name --- -------------------' --
0 1,225 954 52 21 652
460 WHITTIER ELEMENT 21 0 786 724 42 20 684
461 WILLARD ELEMENTA 21 0 0 0
0 6 0
462 WEST GARFIELD EL 21 0 928 464 92 55 270
463 TINCHER ELEMENTA 21 0 1,136 490 150 89 149
464 HUDSON ELEMENTAR 21 0 1,082 118 51 35 471.
465 NEWCOMB ELEMENTA 21 0 420 194 27 16 233
466 KETTERING ELEMEN 21 0 695 272 41 20 64
467 BUTLER ELEMENTAR 21 03 79 239
0 989 431 1
492 Colin L. Powell 21 0 1,145 986 03 48 608
611 FRANKLIN MIDDLE 21
26
612 HAMILTON MIDDLE 21 0 1,283 910 163 105 214
613 HUGHES MIDDLE SC 21 0 1,512 543 199 91 977
114 64 319
614 JEFFERSON MIDDLE 21 0 1,073 917 136 55 765
615 BANCROFT MIDDLE 21 0 1,290 476
0 1,161 939 109 53 180
616 LINDBERGH MIDDLE 21
0 1,354 860 117 47 421
617 MARSHALL MIDDLE 21 0 809 315 85 19 497
618 ROGERS MIDDLE SC 21 0 1,282 528 124 87 758
619 STANFORD MIDDLE 21
0. 1,396 995 253 118 403
620 STEPHENS MIDDLE 21
0 1,103 1,030 25
622 WASHINGTON MIDDL 21 38
0 1,270 882 145 407
624 DEMILLE MIDDLE S 21 :
625 HOOVER MIDDLE SC 21 0 1,115 606 188 26 554 342
626 HILL MIDDLE SOHO 21 0.. 1,067 788 107 32
21 0 0 0 0 0 0
627 BUTLER ACADEMY
0 0 0 0 p 0
628 NEWCOMB ACADEMY 21 0 0 0 0 0 0
21
629 CUBBERLEY ACADEM 21 0 0 0 0 0 0
630 HUDSON ACADEMY 0 0 0 0 0 0
631 ROBINSON ACADAMY 21 0 0 0 0 0 0
632 Tincher Preparat 21 0 0 0 0 0 0
633 Colin L. Powell 21 0 577 150 76 35 366
641 CALIFORNIA ACADE 21 0 168 149 17 7 8
642 CONSTELLATION CO 21 0 283 216 20 14 137
647 STH GRADE ACADEM 21
652 JORDAN HIGH SOHO 21 0 3,922 2,351 359 121 _ 2,470
4
653 LAKEWOOD HIGH SC 21 0 4,162 1,551 223 588 3,234
0 4,191 1,978 161 2,617
654 POLYTECHNIC HIGH 21 0 0 0 0 0 0
655 SAVANNAH ACADEMY 21 0 3,483 1,649 149 41 2,434
656 WILSON HIGH SCHO 21
657 CABRILLO HIGH SC 21 0 1,663 998 119 54 946
658 MILLIKAN HIGH SC 21 0 4,417 1,844 253 53 3 338
670 PAAL 21 0 441 335 14 0
0
671 AVALON MIDDLE & 21 0 0 0 0447 386 19 15 261
682 REID SENIOR AND 21 0
Totals: 0 89,462 52,873 8,340 4,404 43,843
CQ '2,1
CALIFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NS08051 (1100)
SUMMER FOOD SERVICE PROGRAM
SITE INFORMATION SHEET
SITE NAME:
14th Street Park
SITE ADDRESS (STREET, CITY, ZIP + 4):
Chestnut/14th Street
Long Beach 90813
1. Period of operation:
6/26/00 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes ® No
3. Pre -approval visit made (new site
or previous site with problems)?
® Yes ❑ No
If no, date of planned visit:
4. Days per week to operate:
S M TU W TH F S
❑El®®.Ela❑
List dates site will be closed:
5.
AGENCY NAME: City of Lona Beach
Department of Parks, Rec. & Marine
SITE NUMBER:
AGREEMENT NUMBER: 19-81908V
0
CONTACT PERSON:
Vea111efet Tuner
TELEPHONE NUMBER: (
USE ONLY
INITIAL APPROVALDATE ELIGIBILITY YtAK
Meal ADP Start/End
Time
L 80 12:Od 12:30
. I /
6. Number of operating days:
October
April
November
May
December
5 June
January
_.Lo July
February
19 August
March
September
7. a. Method of meal service and
site type:
18 Urban ❑ Rural
❑ Self -prep 14 Vended
b. If vended, name of vendor:
Lona Beach Unified
School District
8. Are you using the SFSP Meal
Pattern?
S Yes ❑ No
If no, which school menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes V No
Open only to enrolled summer
school students?
❑ Yes a No
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
N/A
11. Provide the name of school
district and school from which
the site draws its attendance:
District: Lona Beach USD
School: Washington
Middle 96%
CALIFORNIA DEPARTMENT OF EDUCATION
AGREEMENT NUMBER: 19-81908V
9-81908VSITE
Eligibility
SITENUMBER:
NSD 8051 (1/00)
❑
Recreation
❑
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IN EACH COWAN.
or
❑
Site Type
Eligibility
Migrant Letter
❑ Camp
12. � Open Site
15
Recreation
❑School Data 50% receiving
Free/Reduce priced meals
or
❑ Open/enrolled site
❑School
❑
Indian Reservation
13 Census Track/Housing
If open/enrolled, explain the
C3
Migrant
Authority
❑Bureau of Indian Affairs
reason:
Homeless
❑ Migrant Organization Letter
Other
❑
Other
15. If site is "open", indicate the geographic area to be served.
South West Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSp office to report any meal
order adjustment for the following da (s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
the LBUSD's truck no more than one our prior to mea serving ime. ea s
11 be stored in dense styrofoam containers to ensure correct temp.
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Will not serve at park site Direct children to Washington Youth Center.
Site Type
Eligibility
13. ❑ Closed Enrolled Site
❑
Recreation
❑
Eligibility Applications
or
❑
Educational
❑
Migrant Letter
❑ Camp
❑
Migrant
❑
Roster
(Homeless Sites Only)
❑
Indian Reservation
❑
Homeless
❑
Other
Site Type
Eligibility
14. ❑ National Youth Sports
Closed Enrolled
❑
School Data
Program (NYSP)
❑
Census Track
❑
Eligibility Applications
❑
Letter Verifying Participants
Meet DHHS Income
Guidelines
15. If site is "open", indicate the geographic area to be served.
South West Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSp office to report any meal
order adjustment for the following da (s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
the LBUSD's truck no more than one our prior to mea serving ime. ea s
11 be stored in dense styrofoam containers to ensure correct temp.
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Will not serve at park site Direct children to Washington Youth Center.
Name Days A.D.A. Enroll Free Reduced Denied Paid
460 WHITTIER ELEMENT 21 0 1,225 954 52 21 652
461 WILLARD ELEMENTA 21 0 786 724 42 20 684
462 WEST GARFIELD EL 21 0 0 0 0 0 0
463 TINCHER ELEMENTA 21 0 928 464 92 55 270
464 HUDSON ELEMENTAR 21 0 1,136 490 150 89 149
465 NEWCOMB ELEMENTA 21 0 1,082 118 51 35 471
466 KETTERING ELEMEN 21 0 420 194 27 16 233
467 BUTLER ELEMENTAR 21 0 695 272 41 20 64
492 Colin L. Powell 21 0 989 431 103 79 239
611 FRANKLIN MIDDLE 21 0 1,145 986 26 48 608
612 HAMILTON MIDDLE 21 0 1,283 910 163 105 214
613 HUGHES MIDDLE SC 21 0 1,512 543 199 91 977
614 JEFFERSON MIDDLE 21 0•• 1,073 917 114 64 319
615 BANCROFT MIDDLE 21 0 1,290 476 136 55 765
616 LINDBERGH MIDDLE 21 0 1,161 939 109 53 180
617 MARSHALL MIDDLE 21 0 1,354 860 117 47 421
618 ROGERS MIDDLE SC 21 0 809 315 85 19 497
619 STANFORD MIDDLE 21 0 1,282 528 124 87 758
620 STEPHENS MIDDLE 21 0, 1,396 995 253 118 403
622 WASHINGTONMIDDL,a 0$1,`1031,, 030
_51
624 DEMILLE MIDDLE S 21 0 1,270 882 145 38 _. 407
625 HOOVER MIDDLE SC 21 0 11115 606 188 26 554
626 HILL MIDDLE SCHO 21 0 1,067 788 107 32 342
627 BUTLER ACADEMY 21 0 0 0 0 0 0
628 NEWCOMB ACADEMY 21 0 0 0 0 0 0
629 CUBBERLEY ACADEM 21 0 0 0 0 0 0
630 HUDSON ACADEMY 21 0 0 0 0 0 0
631 ROBINSON ACADAMY 21 0 0 0 0 0 0
632 Tincher Preparat 21 0 0 0 0 0 0
633 Colin L. Powell 21 0 0 0 0 0 0
641 CALIFORNIA ACADE 21 0 577 151 76 35 366
642 CONSTELLATION CO 21 0 168 149 17 7 8
647 8TH GRADE ACADEM 21 0 283 216 20 14 137
652 JORDAN HIGH SCHO 21 0 3,922 2,351 359 121 2,470
653 LAKEWOOD HIGH SC 21 0 4,162 1,551 223 45 3,234
654 POLYTECHNIC HIGH 21 0 4,191 1,978 161 58 2,617
655 SAVANNAH ACADEMY 21 0 0 0 0 0 0
656 WILSON HIGH SCHO 21 0 3,483 1,649 149 41 2,434
657 CABRILLO HIGH SC 21 0 1,663 998 119 54 946
658 MILLIKAN HIGH SC 21 0 4,417 1,844 253 53 3,236
670 PAAL 21 0 441 335 14 3 338
671 AVALON MIDDLE & 21 0 0 0 0 0 0
682 REID SENIOR AND 21 0 447 386 19 15 261
Totals: 0 89,462 52,873 8,340 4,404 43,843
MONTHLY SCHOOL S TATUS UPDATE
Month/Year: 10/99
Days
A_D_A_
Enroll
Reduced.
Denied
Paid
Loc
Name____________
__Free
404
ALVARADO ELEMENT
21
0
491
324
393
74
117
36
51
104
171
406
ROBINSON ELEMENT
21
0
0
992
849
820
17
39
538
407
INTERNATIONAL EL
21
0
1,184
997
160
86
272
410
ADDAMS ELEMENTAR
21
0
757
209
84
30
404
411
AVALON ELEMENTAR
21
21
0
1,155
926
159
68
401
412
BARTON ELEMENTAR
0
873
498
186
93
273
413
BIRNEY ELEMENTAR
21
0-
645
344
75
58
274
414
BIXBY ELEMENTARY
21
0
423
307
67
39
143
415
BRYANT ELEMENTAR
21
0
540
309
49
35
260
416
BUFFUM SCHOOL
21
0
751
669
61
9
649
417
BURBANK ELEMENTA
21
0
793
512
71
46
302
418
BURCHAM ELEMENTA
21
0
883
750
28
35
686
419
BURNETT ELEMENTA
21
0..
412
195
76
58
199
420
BURROUGHS ELEMEN
21
0
651
293
50
46
387
421
CARVER ELEMENTAR
21
0
780
367
66
39
460
422
CLEVELAND ELEMEN
21
0
1,167
199
68
38
542
423
CUBBERLEY ELEMEN
21
..0-
908
877
20
12
646
424
EDISON ELEMENTAR
21
0
643
395
59
30
227
425
EMERSON ELEMENTA
21
0
443
165
53
29
279
427
FREMONT ELEMENTA
21
0
733
145
33
33
637
428
GANT ELEMENTARY
21
21
0
1,296
1,010
232
151
243
429
E. GARFIELD ELEM
0
859
550
71
73
361
430
GOMPERS ELEMENTA
21
0
1,556
1,157
330
165
310
431
GRANT ELEMENTARY
21
0
1,39
1,000
208
91
286
432
HARTE ELEMENTARY
21
0
839
8
467
93
110
357
433
HENRY ELEMENTARY
21
0
670
406
137
71
266
434
HOLMES ELEMENTAR
21
0
718
574
50
45
211
435
KELLER ELEMENTAR
21
0
867
691
76
70
1
436
KING ELEMENTARY
21
0
830
705
49
48
243
437
LAFAYETTE ELEMEN
21
0
663
601
28
6
546
438
LEE ELEMENTARY
21
0
1,001
881
56
83
143
439
LINCOLN ELEMENTA
21
0
961
303
110
59
637
440
LONGFELLOW ELEME
21
0
465
143
70
46
294
441
LOS CERRITOS ELE
21
0
646
129
36
27
539
442
LOWELL ELEMENTAR
21
0
958
567
70
92
362
443
MACARTHUR ELEMEN
21
0
690
230
85
62
437
444
MADISON ELEMENTA
21
0
468
314
92
33
116
445
MANN ELEMENTARY
21
21
0
1,150
950
111
48
330
446
MCKINLEY ELEMENT
0
658
407
59
32
258
447
MONROE ELEMENTAR
21
0
1,026
747
215
106
237
448
MUIR ELEMENTARY
21
0
302
84
19
23
221
449
NAPLES ELEMENTAR
21
0
700
285
59
33
436
450
PRISK ELEMENTARY
21
0
880
549
129
72
351
451
RILEY ELEMENTARY
21
0
925
875
34
9
800
452
ROOSEVELT ELEMEN
21
0
918
755
112
49
126
453
SIGNAL HILL ELEM
21
0
728
618
54
116
123
454
STEVENSON ELEMEN
21
0
1,210
809
199
74
361
455
SUTTER ELEMENTAR
21
0
635
563
37
10
388
457
TUCKER ELEMENTAR
21
0
865
199
80
41
715
458
TWAIN ELEMENTARY
21
0
757
580
107
32
525
459
WEBSTER ELEMENTA
21
CAUFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NSD 80510 100)
AGENCY NAME: City of Long Beach
De'partmenE of Parks, Rec. & Marine
SITE NUMBER:
SUMMER FOOD SERVICE PROGRAM AGREEMENT NUMBER: 19-81908V
SITE INFORMATION SHEET
SITE NAME:
Pacific Baptist Church
SITE ADDRESS (STREET, CITY, ZIP + 4):
2474 Pacific Ave.
Long Beach 90803
1. Period of operation:
6/26/00 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes ® No
3. Pre -approval visit made (new site
or previous site with problems)?
UYes .❑No
If no, date of planned visit:
4. Days per week to operate:
S M TU W TH F S
❑®®®®®❑
List dates site will be closed:
7/4/00
5.
i CONTACT PERSON: Alma Meyers
TELEPHONE NUMBER: (
INITIAL
Meal ADP Start/End
Time
L 150 11:15/12:1
I
6. Number of operating days:
October
April
November
May
December
5 June
January
20 July
February
19 August
March
September
7. a. Method of meal'service and
site type:
® Urban ❑ Rural
❑ Self -prep ® Vended
b. If vended, name of vendor:
Long Beach Unified
School District
S USE ONLY
APPROVACDATE ELIGIBILITY YEAR
S. Are you using the SFSP Meal
Pattern?
M Yes ❑ No
If no, which school menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes El No
Open only to enrolled summer
school students?
❑ Yes ® 'No
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
N/A
11. Provide the name of schoo,
district and school from which
the site draws its attendance:
DistdctLong Beach USD
School:Robinson Elem.
51.49
CALIFORNIA DEPARTMENT OF EDUCATION AGREEMENT NUMBER: 19-81908V
NSD 8051 (1/00) SITE NUMBER:
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IN EACH COLUMN.
Site Type Eligibility
12. ® Open Site ❑ Recreation ® School Data 50% receiving
or ❑ School Free/Reduce priced meals
❑ Open/enrolled site ❑ Indian Reservation ❑ Census Track/Housing
If open/enrolled, explain the ❑ Migrant Authority
reason: ❑ Homeless ❑ Bureau of Indian Affairs
® Other ❑ Migrant Organization Letter
15. If site is "open"., indicate the geographic area to be served.
Central Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report any meal
order adjustment for the following day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will have meals delivered by the LBUSD's truck no more than one hour
grior,to meal serving time. Meals will be stored in dense styrofoam
ontarc to ensure correct temperature
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Site Type
Eligibility
13. ❑ Closed Enrolled Site
❑ Recreation
❑
Eligibility Applications
or
❑ Educational
❑
Migrant Letter
❑ Camp
❑ Migrant
❑ Indian Reservation
❑
Roster
(Homeless Sites Only)
❑ Homeless
❑ Other
Site Type
Eligibility
14. ❑ National Youth Sports
Closed Enrolled
❑
School Data
Program (NYSP)
❑
Census Track
❑
Eligibility Applications
❑
Letter Verifying Participants
Meet DHHS Income
Guidelines
15. If site is "open"., indicate the geographic area to be served.
Central Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report any meal
order adjustment for the following day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will have meals delivered by the LBUSD's truck no more than one hour
grior,to meal serving time. Meals will be stored in dense styrofoam
ontarc to ensure correct temperature
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
MONTHLY SCHOOL S T A T U S UPDATE
Month/Year: 10/99
Loc
Name
Days A.D.A.
Enroll
__
Free
Reduced. Denied
__Paid
____________
404 ALVARADO ELEMENT
_
21 0
21� Sl.y7.:_0�;�
491
_
49,92
324
74
1 17.
�,.��
36
104
40q
ROBiNSON-ELEMENT _
0
849
_. _..393
820
.,
17
a39
538
407
INTERNATIONAL EL21
21
0
1,184
997
160
86
272
410
ADDAMS ELEMENTAR
0
757
209
84
30
404
4'11
AVALON ELEMENTAR
21
21
0
1,155
926
159
68
401
412
BARTON ELEMENTAR
0
873
498
186
93
273
413
BIRNEY ELEMENTAR
21
0,*
645
344
75
58
274
414
BIXBY ELEMENTARY
21
0
423
307
67
39
143
415
BRYANT ELEMENTAR
21
0
540
309
49
35
260
416
BUFFUM SCHOOL
21
21
0
751
669
61
9
649
417
BURBANK ELEMENTA
0
793
512
71
46
302
418
BURCHAM ELEMENTA
21
0
883
750
28
35
686
419
BURNETT ELEMENTA
21
0.,
412
195
76
58
199
420
BURROUGHS ELEMEN
21
0
651
293
50
46
387
421
CARVER ELEMENTAR
21
0
780
367
66
39
460
422
CLEVELAND ELEMEN
21
0
1,167
199
68
38
542
423
CUBBERLEY ELEMEN
21
..0-
908
877
20
12
646
424
EDISON ELEMENTAR
21
0
643
395
59
30
227
425
EMERSON ELEMENTA
21
0
443
165
53
29
279
427
FREMONT ELEMENTA21
0
733
145
33
33
637
428
429
GANT ELEMENTARY
E. GARFIELD ELEM
21
21
0
1,296
1,010
232
151
243
430
GOMPERS ELEMENTA
21
0
0
859
1,556
. 550
1,157
71
330
73
165
361
310
431
GRANT ELEMENTARY
21
21
0
1,273
1,000
208
91
286
432
HARTE ELEMENTARY
0
839
467
93
110
357
433
HENRY ELEMENTARY
21
0
670
406
137
71
266
434
HOLMES ELEMENTAR
21
0
718
574
50
45
211
435
KELLER ELEMENTAR
21
0
867
691
76
70
1
436
KING ELEMENTARY
21
0
830
705
49
48
243
437
LAFAYETTE ELEMEN
21
0
663
601
28
6
546
438
LEE ELEMENTARY
21
21
0
1,001
881
56
83
143
439
LINCOLN ELEMENTA
0
961
303
110
59
637
440
LONGFELLOW ELEME
21
0
465
143
70
46
294
441
LOS CERRITOS ELE
21
0
646
129
36
27
539
442
LOWELL ELEMENTAR
21
0
958
567
70
92
362
443
MACARTHUR ELEMEN
21
0
690
230
85
62
437
444
MADISON ELEMENTA
21
0
468
314
92
33
116
445
MANN ELEMENTARY
21
21
0
1,150
950
111
48
330
446
MCKINLEY ELEMENT
0
658
407
59
32
258
447
MONROE ELEMENTAR
21
0
1,026
747
215
106
237
448
MUIR ELEMENTARY
21
0
302
84
19
23
221
449
NAPLES ELEMENTAR
21
0
700
285
59
33
436
450
PRISK ELEMENTARY
21
0
880
549
129
72
351
451
RILEY ELEMENTARY
21
0
925
875
34
9
800
452
ROOSEVELT ELEMEN
21
0
918
755
112
49
126
453
SIGNAL HILL ELEM
21
0
728.
618
54
116
123
454
STEVENSON ELEMEN
21
0
1,210
809
199
74
361
455
SUTTER ELEMENTAR
21
0
635
563
37
10
388
457
TUCKER ELEMENTAR
21
0
865
199
80
41
715
458
TWAIN ELEMENTARY
21
0
757
580
107
32
525
459
WEBSTER ELEMENTA
21
Name Days A.D.A. Enroll Free Reduced Denied • Paid
460 WHITTIER ELEMENT 21 0 1,225 954 52 21 .652
461 WILLARD ELEMENTA 21 0 786 724 42 20 684
462 WEST GARFIELD EL 21 0 0 0 0 0 0
463 TINCHER ELEMENTA 21 0 928 464 92 55 270
464 HUDSON ELEMENTAR 21 0 1,136 490 150 89 149
465 NEWCOMB ELEMENTA 21 0 1,082 118 51 35 471
466 KETTERING ELEMEN 21 0 420 194 27 16 233
467 BUTLER ELEMENTAR 21 0 695 272 41 20 64
492 Colin L. Powell 21 0 989 431 103 79 239
611 FRANKLIN MIDDLE 21 0 1,145 986 26 48 608
612 HAMILTON MIDDLE 21 0 1,283 910 163 105 214
613 HUGHES MIDDLE SC 21 0 1,512 543 199 91 977
614 JEFFERSON MIDDLE 21 0•- 1,073 917 114 64 319
615 BANCROFT MIDDLE 21 0 1,290 476 136 55 765
616 LINDBERGH MIDDLE 21 0 1,161 939 109 53 180
617 MARSHALL MIDDLE 21 0 1,354 860 117 47 421
618 ROGERS MIDDLE SC 21 0 809 315 85 19 497
619 STANFORD MIDDLE 21 0 1,282 528 124 87 758
620 STEPHENS MIDDLE 21 0.. 1,396 995 253 118 403
622 WASHINGTON MIDDL 21 0 1,103 1,030 25. 53 512
624 DEMILLE MIDDLE S 21 0 1,270 882 145 38 407
625 HOOVER MIDDLE SC 21 0 1,115 606 188 26 554
626 HILL MIDDLE SOHO 21 ..G. 1,067 788 107 32 342
627 BUTLER ACADEMY 21 0 0 0 0 0 0
628 NEWCOMB ACADEMY 21 0 0 0 0 0 0
629 CUBBERLEY ACADEM 21 0 0 0 0 0 0
630 HUDSON ACADEMY 21 0 0 0 0 0 0
631 ROBINSON ACADAMY 21 0 0 0 0 0 0
632 Tincher Preparat 21 0 0 0 0 0 0
633 Colin L. Powell 21 0 0 0 0 0 0
641 CALIFORNIA ACADE 21 0 577 151 76 35 366
642 CONSTELLATION CO 21 0 168 149 17 7 8
647 8TH GRADE ACADEM 21 0 283 216 20 14 137
652 JORDAN HIGH SCHO 21 0 3,922 2,351 359 121 2,470
653 LAKEWOOD HIGH SC 21 0 4,162 1,551 223 45 3,234
654 POLYTECHNIC HIGH 21 0 4,191 1,978 161 58 2,617
655 SAVANNAH ACADEMY 21 0 0 0 0 0 0
656 WILSON HIGH SCHO 21 0 3,483 1,649 149 41 2,434
657 CABRILLO HIGH SC 21 0 1,663 998 119 54 946
658 MILLIKAN HIGH SC 21 0 4,417 1,844 253 53 3,236
670 PAAL 21 0 441 335 14 3 338
671 AVALON MIDDLE & 21 0 0 0 0 0 0
682 REID SENIOR AND 21 0 447 386 19 15 261
Totals: 0 89,462 52,873 8,340 4,404 43,843
(Q ( 2 ( 3
CALIFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NSD 30310 100)
SUMMER FOOD SERVICE PROGRAM
SITE INFORMATION SHEET
SITE NAME:
Love of God Fellowship Church
SITE ADDRESS (STREET, CITY, ZIP + 4):
8721 Paseo St.
Paramount 90723
1. Period of operation:
6/26/00 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes W No
3. Pre -approval visit made (new site
or previous site with problems)?
® Yes ❑ No
If no, date of planned visit:
4. Days per week to operate:
S M TU W TH F S
❑a0aaaQ
List dates site will be closed:
5.
AGENCY NAME:CitY of Long Beach
Department of Par s, Rec. & Marine
SITE NUMBER:
AGREEMENT NUMBER: 19-81908V
CONTACT PERSON: Pastor Sims
TELEPHONE NUMBER: (
INITIAL
Meal ADP Start/End
Time
L 300 11:1t 12:.1
I /
i
6. Number of operating days:
October April
November May
December 5 June
January 20 July
February 19 August
March September
7. a. Method of meal'service and
site type:
® Urban ❑ Rural
❑ Self -prep El Vended
iE'S USE ONLY
APPROVACOATE ELIGIBILITY YEAR
8. Are you using the SFSP Meal
Pattern?
Z Yes ❑ No
If no, which school menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes M No
Open only to enrolled summer
school students?
❑ Yes V (Vo
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
NIA
7/4/00 11. Provide the name of school
b. If vended, name of vendor: district and school from which
Long Beach Unified the site draws its attendance:
School District
District: Paramount USD
School: Alondra School
gy Z
CALIFORNIA DEPARTMENT OF EDUCATION AGREEMENT NUMBER: l9' 81108 V
NSD 8051 (1/00) SITE NUMBER:
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IN EACH COLUMN.
Site Type . Eligibility
12. Open Site ❑ Recreation School Data 50% receiving
or ❑ School Free/Reduce priced meals
❑ Open/enrolled site ❑ Indian Reservation ❑ Census Track/Housing
If open/enrolled, explain the ❑ Migrant Authority
reason: ❑ Homeless ❑ Bureau of Indian Affairs
® Other Co'n•n..n� OMfreaCl,
Migrant Organization Letter
15. If site is "open". indicate the geographic area to be served.
West Paramount
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report any meal
order adjustments for the following day(s) or to report site problems
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will ick u meals from nearbysite which will have meals delivered
vbthe s trucK no more an one our prior o mea serving ime,
.. ___i_,.,....... i._ --iiYG i'Cmn_
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in refrigerator on site premises until the
next day, or meals will be destroyed
19. Describe your plan for serving meals during inclement weather.
Serve indoors.
Site Type
Eligibility
13. ❑ Closed Enrolled Site
❑
Recreation
❑
Eligibility Applications
or
❑
Educational
❑
Migrant Letter
❑ Camp
❑
❑
Migrant .
Indian Reservation
❑
Roster
(Homeless Sites Only)
❑
Homeless
❑
Other
Site Type
Eligibility
14. ❑ National Youth Sports
Closed Enrolled
❑
School Data
Program (NYSP)
❑
Census Track
❑
Eligibility Applications
❑
Letter Verifying Participants
Meet DHHS Income
Guidelines
15. If site is "open". indicate the geographic area to be served.
West Paramount
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report any meal
order adjustments for the following day(s) or to report site problems
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will ick u meals from nearbysite which will have meals delivered
vbthe s trucK no more an one our prior o mea serving ime,
.. ___i_,.,....... i._ --iiYG i'Cmn_
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in refrigerator on site premises until the
next day, or meals will be destroyed
19. Describe your plan for serving meals during inclement weather.
Serve indoors.
MAY -08-2000 12:42 PUSD FOOD SERVICE
562 602 6031 P.01
Paramount Unified School District
TO:
Individi
FOOD SERVICE DEPARTMENT
8555 E. FLOWER ST.
PARAMOUNT, CA 90723
FAX TRANSMITTAL
Business Number.
Fax Number
FROM: Al ran G n ICLUI`Z.
DATE:
Total number of pages sent, including this sheet
If you have not received the correct number of pages,
please contact the sender at the following number:
Food Service (562) 602-6031
Fax Number
Food Service (562) 634-3905
COMMENTS:
• I ' n are ba - enin, in RYrd7710U7zt rchOOlr.
BOARD OF EDUCATI(3ti
LL1J . MOORE
pretidenI
BETTY) HARKLMA
Vkd Prendrnt
LINDA GARCIA
Mcmerr
VIVIAN HANSEN
.1lembe►
JANET M. MILLER
Member
MICHELE LAIC RE:N CE
Diund Srpenntamient
MAY -08-2000 12:42 PUSD FOOD SERVICE b
May 8, 2000
Ms. Cindy Graber
Per your request, here are Alondra's figures.
Enrollment: 1,422
Free: 1,032
Reduced: 162
Percentage: 84%
P.S.: These are March's figures, if you have any questions,
please don't hesitate to call me.
Alma Galaviz
(
TOTAL P.02
CAUFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NSD 8051 It=)
SUMMER FOOD SERVICE PROGRAM
SITE INFORMATION SHEET
SITE NAME:
First Southern Baptist Church
SITE ADDRESS (STREET, CITY, ZIP + 4):
5640 Orange Ave.
Long Beach 90805
1. Period of operation:
6/26/00 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes ® No
3. Pre -approval visit made (new site
or previous site with problems)?
® Yes ❑ No
If no, date of planned visit:
4. Days per week to operate:
S M TU W TH F S
❑ ® ® ® ® ® ❑
List dates site will be closed:
7/4/00
5.
AGENCY NAME: City of Long Beach
Department of Parks, Rec. & Marine
SITE NUMBER:
AGREEMENT NUMBER:
19-81908V
CONTACTPERSON: Mamie Carter
i
TELEPHONE NUMBER: (
INITIAL
Meal ADP Start/End
Time
L 50 11:45112:15
6. Number of operating days:
October April
November May
_December 5 June
January 20 JUIy
February 19 August
March September
7. a. Method of meal'service and
site type:
® Urban ❑ Rural
❑ Self -prep Vended
b. If vended, name of vendor:
Long Beach Unified
School District
CDE'S U5t UNLY
APPROVALDATE ELIGIBILITY YtAK
8. Are you using the SFSP Meal
Pattern?
J@ Yes ❑ No
if no, which school menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes Q§ No
Open only to enrolled summer
school students?
❑ Yes 19 IN -0
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
N/A
11. Provide the name of schooi
district and school from which
the site draws its attendance:
District:Long Beach USD
School:Harte E1 emen _ =
95%
CALIFORNIA DEPARTMENT OF EDUCATION
AGREEMENT NUMBER: 19-81908V
SITE
NUMBER:
NSD 8051 (1/00)
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IN EACH COLUMN.
Site Type
. Eligibility
12.0 Open Site
❑
Recreation
®
School Data 50% receiving
Free/Reduce priced meals
or
❑ Open/enrolled site
❑
❑
School
Indian Reservation
❑
Census Track/Housing
If open/enrolled, explain the
❑
Migrant
❑
Authority
Bureau of Indian Affairs
reason:
❑
Homeless
Other Cpmmun; �3 0� ��G4 Lt+
❑Migrant
Organization Letter
Site Type
Eligibility
13. ❑ Closed Enrolled Site
❑
Recreation
❑
Eligibility Applications
or
❑
Educational
❑
Migrant Letter
❑ Camp
❑
Migrant..
Roster
(Homeless Sites Only)
❑
Indian Reservation
❑
Homeless
❑
Other
Site Type
Eligibility
14. ❑ National Youth Sports
Closed Enrolled
❑
School Data
Program (NYSP)
❑
Census Track
❑
Eligibility Applications
❑
Letter.Verifying Participants
Meet DHHS Income
Guidelines
15. If site is "open", indicate the geographic area to be served.
North Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office to report any meal
order adjustments for the following day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
e s truck no more--t-Han one hour prior to..meal serving time. Meals
will be stored in dense ;tiyrufnam c•nni-ai nary i -n an anra 1-amn
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day, or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Serve indoors.
MONTHLY SCHOOL STATUS UPDATE
Month/Year: 10/99
Loc
Name
Days
A.D.A.
Enroll
Free Reduced
Denied
Paid
---
404
----------------
ALVARADO ELEMENT
----
21
------
0
------
491
324
74
36
104-
ROBINSON ELEMENT
21
0
992
393
117
51
171
.406
407
INTERNATIONAL EL
21
0
849
820
17
39
538
410
ADDAMS ELEMENTAR
21
0
1,184
997
160
86
272
411
AVALON ELEMENTAR
21
0
757
209
84
30
404
412
BARTON ELEMENTAR
21
0
1,155
926
159
68
401
413
BIRNEY ELEMENTAR
21
0
873
498
186
93
273
414
BIXBY ELEMENTARY
21
0.
645
344
75
58
274
415
BRYANT ELEMENTAR
21
0
423
307
67
39
143
416
BUFFUM SCHOOL
21
0
540
309
49
35
260
417
BURBANK ELEMENTA
21
0
751
669
61
9
649
418
BURCHAM ELEMENTA
21
0
793
512
71
46
302
419
BURNETT ELEMENTA
21
0
883
750
28
35
686
420
BURROUGHS ELEMEN
21
0.
412
195
76
58
199
421
CARVER ELEMENTAR
21
0
651
293
50
46
387
422
CLEVELAND ELEMEN
21
0
780
367
66
39
460
423
CUBBERLEY ELEMEN
21
0
1,167
199
68
38
542
424
EDISON ELEMENTAR
21
0
908
877
20
12
646
425
EMERSON ELEMENTA
21
0
643
395
59
30
227
427
FREMONT ELEMENTA
21
0
443
165
53
29
279
428
GANT ELEMENTARY
21
0
733
145
33
33
637
429
E. GARFIELD ELEM
21
0
1,296
1,010
232
151
243
430
GOMPERS ELEMENTA
21
0
859
550
71
73
361
431
GRANT ELEMENTARY
21
0.,
1,556
1,157
330
165
310
:432^,aYA�'E ELENlENTARY�211'S%vOv�1�,2_7_3ra��1,000_
r.�
208��__�91
—_286)
433
HENRY ELEMENTARY
21
0
839
467
93
110
357
434
HOLMES ELEMENTAR
21
0
670
406
137
71
266
435
KELLER ELEMENTAR
21
0
718
574
50
45
211
436
KING ELEMENTARY
21
0
867
691
76
49
70
48
1
243
437
LAFAYETTE ELEMEN
21
0
830
705
28
6
546
438
LEE ELEMENTARY
21
0
0
663
1,001
601
881
56
83
143
439
LINCOLN ELEMENTA
21
0
961
303
110
59
637
440
LONGFELLOW ELEME
21
0
465
143
70
46
294
441
LOS CERRITOS ELE
21
0
646
129
36
27
539
442
LOWELL ELEMENTAR
21
0
958
567
70
92
362
443
MACARTHUR ELEMEN
21
0
690
230
85
62
437
444
MADISON ELEMENTA
21
0
468
314
92
33
116
445
446
MANN ELEMENTARY
MCKINLEY ELEMENT
21
21
0
1,150
950
111
48
330
447
MONROE ELEMENTAR
21
0
658
407
59
215
32
106
258
237
448
MUIR ELEMENTARY
21
0
1,026
747
84
19
23
221
449
NAPLES ELEMENTAR
21
0
0
302
700
285
59
33
436
450
PRISK ELEMENTARY
21
0
880
549
129
72
351
451
RILEY ELEMENTARY
21
0
925
875
34
9
800
452
ROOSEVELT ELEMEN
21
0
918
755
112
49
126
453
SIGNAL HILL ELEM
21
0
728
618
54
116
123
454
STEVENSON ELEMEN
21
0
1,210
809
199
74
361
455
SUTTER ELEMENTAR
21
0
635
563
37
10
388
457
TUCKER ELEMENTAR
21
0
865
199
80
41
715
458
TWAIN ELEMENTARY
21
0
757
580
107
32
525
459
WEBSTER ELEMENTA
21
Days A.D.A.Enroll Free Reduced Denied Paid
is Name ------------- ------ ------
460 WHITTIER ELEMENT 21
0 1,225 954 52 21 652
461 WILLARD ELEMENTA 21 0 786 724 42 20 68
0 0 0 0 0
462 WEST GARFIELD EL 21
463 TINCHER ELEMENTA 21 0 928 4 92 55 270
464 HUDSON ELEMENTAR 21 0 1,136 49900 150 89 149
0 1,082 118 51 35 471
465 NEWCOMB ELEMENTA 21
466 KETTERING ELEMEN 21 0 420 194 27 16 233
467 BUTLER ELEMENTAR 21 0 695 272 41 20 64
492 Colin L. Powell 21 0 989 431 103 79 239
611 FRANKLIN MIDDLE 21 0 1,145 986 26 48 608
61.2 HAMILTON MIDDLE 21 0 1,283 910 163 105 214
613 HUGHES MIDDLE SC 21 0 1,512 543 199 91 977
614 JEFFERSON MIDDLE 21 0 1,073 917 114 64 319
615 Bp,NCROFT MIDDLE 21 0 1,290 476 136 55 765
616 LINDBERGH MIDDLE 21 0 1,161 939 109 53 180
617 MARSHALL MIDDLE 21 0 1,354 860 117 47 421
618 ROGERS MIDDLE SC 21 0 809 315 85 19 497
619 STANFORD MIDDLE 21 0 1,282 528 124 87 758
620 STEPHENS MIDDLE 21 0. 1,396 995 253 118 403
622 WASHINGTON MIDDL 21 0 1,103 1,030 25 53 512
624 DEMILLE MIDDLE S 21 0 1,270 882 145 38 407
625 HOOVER MIDDLE SC. 21 0 1,115 606 188 26 554
626 HILL MIDDLE SCHO 21 0 1,067 788 107 32 3422
627 BUTLER ACADEMY 21 0 0 0 0 0
p p p 0
628 NEWCOMB ACADEMY 21 0 0 0 p 0 p
629 CUBBERLEY ACADEM 21 0 0 0 0 0 0
630 HUDSON ACADEMY 21 0 0 0 0 0 p
631 ROBINSON ACADAMY 21 0 0 0 0 p 0
632 Tincher Preparat 21 0 0 0 0 p 0
633 Colin L. Powell 21
641 CALIFORNIA ACADE 21 0 577 151 76 35 3668
642 CONSTELLATION CO 21 0 168 149 17
647 STH GRADE ACADEM 21 0 283 216 20 14 137
652 JORDAN HIGH SCHO 21 0 3,922 2,351 359 121 2,470
653 LAKEWOOD HIGH SC 21, 0 4,162 1,551 223 45 3,234
654 POLYTECHNIC HIGH 21 0 4,1911 1,9782 1610 580 2,6170
655 SAVANNAH ACADEMY 21 p
656 WILSON HIGH SCHO 21 0 3,483 1,649 149 41 2, 946
657 CABRILLO HIGH SC 21 0 1,663 998 119 54 946
658 MILLIKAN HIGH SC 21 0 4,417 1,844 253 53 3,236
670 PAAL 21 0 441 335 14 33 3388
671 AVALON MIDDLE & 21 0 0 0 0
0 447 386 19 15 261
682 REID SENIOR AND 21
Totals: 0 89,462 52,873 8,340 4,404 43,843
c�l�(3
CAUFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NSD 9051 0=11
SUMMER FOOD SERVICE PROGRAM
SITE INFORMATION SHEET
SITE NAME:
Lakewood First Presbyterian Church
SITE ADDRESS (STREET, CITY, ZIP + 4):
3955 Studebaker Rd.
Long Beach 90808
1. Period of operation:
6/26/00 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes M No
3. Pre -approval visit made (new site
or previous site with problems)?
® Yes ❑ No
If no, date of planned visit:
4. Days per week to operate:
S M TU W TH F S-
❑Et®®®a❑
List dates site will be closed:
A
AGENCY NAME: City of Lona Beach
Department of Parks, Rec. & Marine
SITE NUMBER:
AGREEMENT NUMBER: 19-81908V
CONTACT PERSON: Rev. McIntosh
TELEPHONE NUMBER: (
COEDS USE ONLY
INITIAL APPROVALDATE ELIGIBILITY YEAK
Meal ADP Start/End
Time
L 30 11:00111:30
I
6. Number of operating days:
October
April
November
May
December
5 June
January
20 July
February
19 August
March
September
7. a. Method of meal service and
site type:
C Urban ❑ Rural
❑ Self -prep Vended
8. Are you using the SFSP Meal
Pattern?
® Yes ❑ No
If no, which school menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes QR No -
Open only to enrolled summer
school students?
❑ Yes a No
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
® N/A
7/4/00 11. Provide the name of school
b. If vended, name of vendor: district and school from which
Lonq Beach Unified the site draws its attendance:
School District
DiStriCt:Lona Beach Ttsn
School: DeMi 1 1 e Middle
School 81%
CALIFORNIA DEPARTMENT OF EDUCATION AGREEMENT NUMBER: 19-81908V
NSD 8051 (1/00) SITE NUMBER:
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IN EACH COLUMN.
Site Type Eligibility
12. El Open Site ❑ Recreation ® School Data 50% receiving
or ❑ School Free/Reduce priced meals
❑ Open/enrolled site ❑ Indian Reservation ❑ Census Track/Housing
If open/enrolled, explain the ❑ Migrant Authority
reason: ❑ Homeless ❑ Bureau of Indian Affairs
Other Cgmmi l;� Ok•Ficacti
Migrant Organization Letter
15. If site is "open", indicate the geographic area to be served.
East Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office•to report any meal
order adjustment for the following day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
the LBUSD's truck no more than one hour prior to meal serving time. Meals
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the -
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Serve indoors.
Site Type
Eligibility
13. ❑ Closed Enrolled Site
❑
Recreation
❑
Eligibility Applications
or
❑
Educational
❑
Migrant Letter
O Camp
❑
Migrant
❑
Roster
(Homeless Sites Only)
❑
Indian Reservation
❑
Homeless
❑
' Other
Site Type
Eligibility
14. ❑ National Youth Sports
Closed Enrolled
❑
School Data
Program (NYSP)
❑
Census Track
❑
Eligibility Applications
❑
Letter Verifying Participants
Meet DHHS Income.
Guidelines
15. If site is "open", indicate the geographic area to be served.
East Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and other problems at the site.
Site supervisor(s) will call the Long Beach SFSP office•to report any meal
order adjustment for the following day(s) or to report site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will pick up meals from nearby site which will have meals delivered by
the LBUSD's truck no more than one hour prior to meal serving time. Meals
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the -
next day or meals will be destroyed.
19. Describe your plan for serving meals during inclement weather.
Serve indoors.
M ONTHLY SCHOOL STATUS UPDATE
Month/Year: 10/99
Loc
Name
Days
A.D.A.
Enroll
Free
-
Reduced
Denied
Paid
404
----------------
ALVARADO ELEMENT
----
21
------
0
------
491
324
74
36
104
406
ROBINSON ELEMENT
21
0
992
393
117
51
171
407
INTERNATIONAL EL
21
0
849
820
17
39
538
410
ADDAMS ELEMENTAR
21
0
1,184
997
160
86
272
411
AVALON ELEMENTAR
21
0
757
209
84
30
404
412
BARTON ELEMENTAR
21
0
1,155
926
159
68
401
413
BIRNEY ELEMENTAR
21
0
873
498
186
93
273
414
BIXBY ELEMENTARY
21
0
645
344
75
58
274
415
BRYANT ELEMENTAR
21
0
423
307
67
39
143
416
BUFFUM SCHOOL
21
0
540
309
49
35
260
417
BURBANK ELEMENTA
21
0
751
669
61
9
649
418
BURCHAM ELEMENTA
21
0
793
512
71
46
302
419
BURNETT ELEMENTA
21
0
883
750
28
35
686
420
BURROUGHS ELEMEN
21
0
412
195
76
58
199
421
CARVER ELEMENTAR
21
0*
651
293
50
46
387
460
'422
CLEVELAND ELEMEN
21
0
780
367
66
68
39
38
542
423
CUBBERLEY ELEMEN
21
0
1,167
199
424
EDISON ELEMENTAR
21
0
908
877
20
12
646
425
EMERSON ELEMENTA
21
0
643
395
59
30
227
427
FREMONT ELEMENTA
21
0
443
165
53
29
279
428
GANT ELEMENTARY_
21
0
733
145
33
33
637
429
E. GARFIELD ELEM
21
0
1,296
1,010
232
151
243
430
GOMPERS ELEMENTA
21
0
859
550
71
73
361
431
GRANT ELEMENTARY
21
0
1,556
1,157
330
165
310
432
HARTE ELEMENTARY
21
0
1,273
1,000
208
91
286
433
HENRY ELEMENTARY
21
0
839
467
93
110
357
266
434
HOLMES ELEMENTAR
21
0
670
406
137
50
71
45
211
435
KELLER ELEMENTAR
21
0
718
574
76
70
1
436
KING�ELEMENTARY
21
0
867
830
691
705
49
48
243
437
LAFAYETTE ELEMEN
21
0
0
663
601
28
6
546
438
439
LEE ELEMENTARY
LINCOLN ELEMENTA
21
21
0
1,001
881
56
83
143
440
LONGFELLOW ELEME
21
0
961
303
110
59
637
441
LOS CERRITOS ELE
21
0
465
646
143
129
70
36
46
27
294
539
442
LOWELL ELEMENTAR
21
0
0
958
567
70
92
362
443
MACARTHUR ELEMEN
21
0
690
230
85
62
437
444
MADISON ELEMENTA
21
0
468
314
92
33
116
445
446
MANN ELEMENTARY
MCKINLEY ELEMENT
21
21
0
1,150
950
ill
48
330
447
MONROE ELEMENTAR
21
0
658
407
747
59
215
32
106
258
237
448
MUIR ELEMENTARY
21
0
1,026
84
19
23
221
449
NAPLES ELEMENTAR
21
0
0
302
700
285
59
33
436
450
PRISK ELEMENTARY
21
0
880
549
129
72
351
451
RILEY ELEMENTARY
21
0
925
875
34
9
800
452
ROOSEVELT ELEMEN
21
0
918
755
112
49
126
453
SIGNAL HILL ELEM
21
0
728
618
54
116
123
454
STEVENSON ELEMEN
21
0
1,210
809
199
74
361
455
SUTTER ELEMENTAR
21
0
635
563
37
10
388
457
TUCKER ELEMENTAR
21
0
865
199
80
41
715
458
TWAIN ELEMENTARY
21
757
580
107
32
525
459
WEBSTER ELEMENTA
21
Q
�c Name Days A.D.A. Enroll Free Reduced Denied Paid
460 WHITTIER ELEMENT 21 0 1,225 954 52 21 652
461 WILLARD ELEMENTA 21 0 786 724 42 20 684
462 WEST GARFIELD EL 21 0 0 0 0 0 0
463 TINCHER ELEMENTA 21 0 928 464 92 55 270
464 HUDSON ELEMENTAR 21 0 1,136 490 150 89 149
465 NEWCOMB ELEMENTA 21 0 1,082 118 51 35 471
466 KETTERING ELEMEN 21 0 420 194 27 16 233
467 BUTLER ELEMENTAR 21 0 695 272 41 20 64
492 Colin L. Powell 21 0 989 431 103 79 239
611 FRANKLIN MIDDLE 21 0 1,145 986 26 48 608
612 HAMILTON MIDDLE 21 0 1,283 910 163 105 214
613 HUGHES MIDDLE SC 21 0 1,512 543 199 91 977
614 JEFFERSON MIDDLE 21 0 1,073 917 114 64 319
615 BANCROFT MIDDLE 21 0 1,290 476 136 55 765
616 LINDBERGH MIDDLE 21 0 1,161 939 109 53 180
617 MARSHALL MIDDLE 21 0 1,354 860 117 47 421
618 ROGERS MIDDLE SC 21 0 809 315 85 19 497
619 STANFORD MIDDLE 21 0 1,282 528 124 87 758
620 STEPHENS MIDDLE 21 0 1,396 995 253 118 403
622 WASHINGTON MIDDL 21 0 1,103 1 030 25 53 512
,r6.24,roVjM--L, ,E` MIDDLE S t°+ '. 21 +j: °j' gip ,1, 270S/7o 82 145 38 407
625 HOOVER MIDDLE SC 21 0 1,115 606 188 26 554
626 HILL MIDDLE SCHO 21 0 1,067 788 107 32 342
627 BUTLER ACADEMY 21 0 0 0 0 0 0
628 NEWCOMB ACADEMY 21 0 0 0 0 0 0
629 CUBBERLEY ACADEM 21 0 0 0 0 0 0
630 HUDSON ACADEMY 21 0 0 0 0 0 0
631 ROBINSON ACADAMY 21 0 0 0 0 0 0
632 Tincher Preparat 21 0 0 0 0 0 0
633 Colin L. Powell 21 0 0 0 0 0 0
641 CALIFORNIA ACADE 21 0 577 151 76 35 366
642 CONSTELLATION CO 21 0 168 149 17 7 8
647 8TH GRADE ACADEM 21 0 283 216 20 14 137
652 JORDAN HIGH SCHO 21 0 3,922 2,351 359 121 2,470
653 LAKEWOOD HIGH SC 21 0 4,162 1,551 223 45 3,234
654 POLYTECHNIC HIGH 21 0 4,191 1,978 161 58 2,617
655 SAVANNAH ACADEMY 21 0 0 0 0 0 0
656 WILSON HIGH SCHO 21 0 3,483 1,649 149 41 2,434
657 CABRILLO HIGH SC 21 0 1,663 998 119 54 946
658 MILLIKAN HIGH SC 21 0 4,417 1,844 253 53 3,236
670 PAAL 21 0 441 335 14 3 338
671 AVALON MIDDLE & 21 0 0 0 0 0 0
682 REID SENIOR AND 21 0 447 386 19 15 261
Totals: 0 89,462 52,873 8,340 4,404 43,843
I
CALIFORNIA DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
NSD 8051 (1100)
SUMMER FOOD SERVICE PROGRAM
SITE INFORMATION SHEET'
SITE NAME:
Calvary Chapel of North
Long Beach
SITE ADDRESS (STREET, CITY, ZIP + 4):,
5722 Lime Ave.
Long Beach 90805
1.. Period of operation:
6/26/001 8/25/00
Start date End date
2. Did site participate last year?
❑ Yes 0 No
3. Pre -approval visit made (new site
or previous site with problems)?
❑ Yes ® No
If no, date of planned visit:
/`1a ti A, 2.000
4. Days per week to operate:
S M TU W TH F S
❑ ® ® ® ® ® ❑
List dates site will be closed:
7/4/00
5.
AGENCY NAME: Ci.tv f Long Beal;h
Departmen o I
res, Rec. I Marine
SITE NUMBER:
AGREEMENT NUMBER: 19 - 819 0 8 V
I CONTACT PERSON: John lAtki nson
TELEPHONE NUMBER: (
CDE'S 6SE ONLY
INITIAL I APPI'OVAL DATE ELIGIBILITY YEAR
Meal ADP ' Start/End
Time
L ;100 ;11:45/12:4!
I I /
6. Number of operating days:
October April
November May
December 5 June
January _U July
February 19 August
March September
7. a. Method of meal'service and
site type:
® Urban ❑ Rural
❑ Self -prep ® Vended
b. If vended, name.of vendor:
Long Beach Unified
School District
8. ArI4 you using the SFSP Meal
Patern?
®1. Yes ❑ No
If no, which schddl menu
planning option are you using?
9. Is this site:
A licensed child care center?
❑ Yes ® No
Open only to enrolled summer
school students?
❑ Yes ® No
10. Site participates in:
❑ School Lunch/Breakfast
Program
❑ Child Care Food Program
® N/A
11. Provide the name of school
district and school from which
the site draws its attendance:
District:Long Beach USD
School:Lindbercfh Middle
School 909,1
CALIFORNIA DEPARTMENT OF EDUCATION AGREEMENT NUMBER: 19-81908V
NSD 8051 (1/00)
SITE NUMBER:
PAGE 2
SELECT ONE ROW. CHECK ONE BOX IN EACH COLUMN.
Site Type
Eligibility
12. 0 Open Site ❑ Recreation
® School Data 50% receiving
or ❑ School
Free/Reduce priced meals
❑ Open/enrolled site ❑ Indian Reservation
❑ Census Track/Housing
If open/enrolled, explain the 0 Migrant
Authority
reason: 0 Homeless
❑ Bureau of Indian Affairs
0 Other Commk,,,' w ®µfre t(A
❑ Migrant Organization Letter
Site Type
Eligibility
13. ❑ Closed Enrolled Site ❑ Recreation
❑ Eligibility Applications
or ❑ Educational
❑ Migrant Letter
❑ Camp ❑ Migrant
❑ Roster
❑ Indian Reservation
(Homeless Sites Only)
0 Homeless
❑ Other
Site Type
Eligibility
14. ❑ National Youth Sports Closed Enrolled
❑ School Data
Program (NYSP)
❑ Census Track
❑ Eligibility Applications
❑ Letter Verifying Participants
Meet DHHS Income
Guidelines
15. If site is "open", indicate the geographic area to be served.
,North Long Beach
16. Describe how the site supervisor(s) will communicate with the sponsor to adjust the number of meals
delivered in accordance with the daily attendance and -other problems at the site.
Site supervisor(s) will call the Long Beach SFSP
office to repo'rt�any meal
order adjustment for the following day(s) or to report
site problems.
17. Describe your plan for the receipt and storage of meals before the meal service time.
Site will have meals delivered by the LBUSD's truck no more than one hour
prior o mea serving time. Meals willa store
+.. n n rnrrort tamppratllrP__
in dense styrofoam
18. Describe your plan for the storage or disposal of leftover meals or components.
Excess meals will be stored in a refrigerator on site premises until the
next day or meals will be destroyed.
19. • Describe your plan for serving meals during inclement weather.
Serve indoors.
MONTHLY SCHOOL STATUS UPDATE
Loc Name
404 ALVARADO ELEMENT
406 ROBINSON ELEMENT
407 INTERNATIONAL EL
410 ADDAMS ELEMENTAR
411 AVALON ELEMENTAR
412 BARTON ELEMENTAR
413 BIRNEY ELEMENTAR
414 BIXBY ELEMENTARY
415 BRYANT ELEMENTAR
416 BUFFUM SCHOOL
417 BURBANK ELEMENTA
418 BURCHAM ELEMENTA
419 BURNETT ELEMENTA
420 BURROUGHS ELEMEN
421 CARVER ELEMENTAR
422 CLEVELAND ELEMEN
423 CUBBERLEY ELEMEN
424 EDISON ELEMENTAR
425 EMERSON ELEMENTA
427 FREMONT ELEMENTA
428 GANT ELEMENTARY
429 E. GARFIELD ELEM
430 GOMPERS ELEMENTA
431 GRANT ELEMENTARY
432 HARTE ELEMENTARY
433 HENRY ELEMENTARY
434 HOLMES ELEMENTAR
435 KELLER ELEMENTAR
436 KING ELEMENTARY
437 LAFAYETTE ELEMEN
438 LEE ELEMENTARY
439 LINCOLN ELEMENTA
440 LONGFELLOW ELEME
441 LOS CERRITOS ELE
442 LOWELL ELEMENTAR
443 MACARTHUR ELEMEN
444 MADISON ELEMENTA
445 MANN ELEMENTARY
446 MCKINLEY ELEMENT
447 MONROE ELEMENTAR
448 MUIR ELEMENTARY
449 NAPLES ELEMENTAR
450 PRISK ELEMENTARY
451 RILEY ELEMENTARY
452 ROOSEVELT ELEMEN
453 SIGNAL HILL ELEM
454 STEVENSON ELEMEN
455 SUTTER ELEMENTAR
457 TUCKER ELEMENTAR
458 TWAIN ELEMENTARY
459 WEBSTER ELEMENTA
Month/Year: 10/99
Days A.D.A. Enroll Free Reduced Denied
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
491
992
849
1,184
757
1,155
873
645
423
540
751
793
883
412
651
780
1,167
908
643
443
733
1,296
859
1,556
1,273
839
670
718
867
830
663
1,001
961
465
646
958
690
468
1,150
658
1,026
302
700
880
925
918
728
11210
635
865
757
324
393
820
997
209
926
498
344
307
309
669
512
750
195
293
367
199
877
395
165
145
1,010
550
1,157
1,000
467
406
574
691
705
601
881
303
143
129
567
230
314
950
407
747
84
285
549
875
755
618
809
563
199
580
74
117
17
160
84
159
186
75
67
49
61
71
28
76
50
66
68
20
59
53
33
232
71
330
208
93
137
50
76
49
28
56
110
70
36
70
85
92
111
59
215
19
59
129
34
112
54
199
37
80
107
36
51
39
86
30
68
93
58
39
35
9
46
35
58
46
39
38
12
30
29
33
151
73
165
91
110
71
45
70
48
6
83
59
46
27
92
62
33
48
32
106
23
33
72
9
49
116
74
10
41
32
Paid
104
171
538
272
404
401
273
274
143
260
649
302
686
199
387
460
542
646
227
279
637
243
361
310
286
357
266
211
1
243
546
143
637
294
539
362
437
116
330
258
237
221
436
351
800
126
123
361
388
715
525
Name Days A.D.A. Enroll Free Reduced Denied Paid
60 WHITTIER ELEMENT 21 0 1,225 954 52 21 652
461 WILLARD ELEMENTA 21 0 786 724 42 20 684
462 WEST GARFIELD EL 21 0 0 0 0 0 0
463 TINCHER ELEMENTA 21 0 928 464 92 55 270
464 HUDSON ELEMENTAR 21 0 1,136 490 150 89 149
465 NEWCOMB ELEMENTA 21 0 1,082 118 51 35 471
466 KETTERING ELEMEN 21 0 420 194 27 16 233
467 BUTLER ELEMENTAR 21 0 695 272 41 20 64
492 Colin L. Powell 21 0 989 431 103 79 239
611 FRANKLIN MIDDLE 21 0 1,145 986 26 48 608
612 HAMILTON MIDDLE 21 0 1,283 910 163 105 214
613 HUGHES MIDDLE SC 21 0 1,512 543 199 91 977
614 JEFFERSON MIDDLE 21 0 1,073 917 114 64 319
615 BANCROFT MIDDLE 21 0 1,290 476 136 55 765
616 LINDBERGH MIDDLE 21 0 1,161 ,277b939 109 53 180
617 MARSHALL MIDDLE 21 0 1,354 860 117 47 421
618 ROGERS MIDDLE SC 21 0 809 315 85 19 497
619 STANFORD MIDDLE 21 0 1,282 528 124 87 758
620 STEPHENS MIDDLE 21 0 1,396 995 253 118 403
622 WASHINGTON MIDDL 21 0 1,103 1,030 25 53 512
624 DEMILLE MIDDLE S 21 0 1,270 882 145 38 407
625 HOOVER MIDDLE SC 21 0 1,115 606 188 26 554
626 HILL MIDDLE SCHO 21 0 1,067 788 107 32 342
627 BUTLER ACADEMY 21 0 0 0 0 0 0
628 NEWCOMB ACADEMY 21 0 0 0 0 0 0
629 CUBBERLEY ACADEM 21 0 0 0 0 0 0
630 HUDSON ACADEMY 21 0 0 0 0 0 0
631 ROBINSON ACADAMY 21 0 0 0 0 0 0
632 Tincher Preparat 21 0 0 0 0 0 0
633 Colin L. Powell 21 0 0 0 0 0 0
641 CALIFORNIA ACADE 21 0 577 151 76 35 366
642 CONSTELLATION CO 21 0 168 149 17 7 8
647 8TH GRADE ACADEM 21 0 283 216 20 14 137
652 JORDAN HIGH SCHO 21 0 3,922 2,351 359 121 2,470
653 LAKEWOOD HIGH SC 21 0 4,162 1,551 223 45 3,234
654 POLYTECHNIC HIGH 21 0 4,191 1,978 161 58 2,617
655 SAVANNAH ACADEMY 21 0 0 0 0 0 0
656 WILSON HIGH SCHO 21 0 3,483 1,649 149 41 2,434
657 CABRILLO HIGH SC 21 0 1,663 998 119 54 946
658 MILLIKAN HIGH SC 21 0 4,417 1,844 253 53 3,236
670 PAAL 21 0 441 335 14 3 338
671 AVALON MIDDLE & 21 0 0 0 0 0 0
682 REID SENIOR AND 21 0 447 386 19 15 261
Totals: 0 89,462 52,873 8,340 4,404 43,843
CALIFORNIA DEPARTMENT OF EDUCATION
CHILD NUTRITION AND FOOD DISTRIBUTION DIVISION
-SUMMER FOOD SERVICE PROGRAM UNIT
SPONSOR SCHEDULE A - 2000 SUMMER FOOD SERVICE PROGRAM SITES
Page 1 of 7
19 - 81908V G156-00
Long Beach, City Of
Dept Of Parks And Rec-sfsp
2760 Studebaker Rd
Long Beach, CA 90815-1697
Contact Person: Tara -Kilpatrick
Phone: ( Fax: (562) 570-1107
Contact Name
Site# Site Name Phone Number Meal Type(c) Start Date Days of Operation (e)
(a) Site Address Type of Site (b) Site Type(d) End Date Meal StartDt EndDt StartTime EndTime ADP CAP
1 ` 1st Provide6&iMis nary Baptist Church Delor s I n C f �] ❑ ❑ ❑ ❑ ❑ ❑ _
\84YE Hill St
( ti� af-G
T W T F
(6) i Long Beach, CA
O
—
-2--- Admiral Kidd Park — - — -- - - ---
— Sherri Nixon — - -- `-- --
-- ❑ IRI N IR 9 9 ❑
L 6•26-00 V -25--w 11 1.30
/2: 30 /3a
2125 Santa Fe Ave
(
S M T W T. F S
—
(9) Long Beach, CA 90810-
O
—
3 Antioch Missionary Baptist Church
Rev Ken Dean Ch o,_i1 jn le -L-4
❑ ® ® ® ® ® ❑
L 6/41,00 Fl --Vv //: s
12-:05' 60
1535 Gundry Ave
(
S M T W T F S
—
(9) Long Beach, CA 90813-
O
4 Belmont Plaza Pool - Syetp
Kit Gable n, -r
❑ ❑ ❑ ❑
00 Olym aza
M T W T
—
(A) Long Beach, CA 90803-
M
- 5 Bixby Park ------ — --�----Roz
Boger- ------- - •------ -•---
U � (� � � � ❑
L. (,_�-00 g �-d0 1z%15
//l5 /d0
130 Cherry Ave
(
S M T W T F S
—
(9) Logn Beach, CA 90802-
O
6 Boys & Girls Club Of Lb - West Branch
Kaugaeft+ate Conn
L 6-15-00 $=2�-OD !_/, 4�
AI IV6- 7S
1835 W Willard
(
S M T W T F S
—
(9) Long Beach, CA 90807-
O
(7)=Eligibility Documentation Due in 2000
(8)=Eligibility Documentation Due in 2001
(CT)=Year Census Tract is available
(9)=Eligibility Documentation Due in 2002
(2000)=Eligibility Documentation Due in 2003
(EC)= Eligibility is Current
(b) E=Enrolled O=Open C=Camp
H=Homeless N=NYSP O/E=Open Enrolled
(first come first served)
(M)=Migrant
(c) Vended or Self Prep (d) Urban or Rural (e) B=Breakfast L=Lunch
D=Dinner S=Snack
Printed: 3/27100 11:17:17 AM
- CALIFORNIA DEPARTMENT OF EDUCATION
- CHILD NUTRITION AND FOOD DISTRIBUTION DIVISION
- SUMMER FOOD SERVICE PROGRAM UNIT
SPONSOR SCHEDULE A - 2000 SUMMER FOOD SERVICE PROGRAM SITES
Page 2 of 7
19 - 81908V G156-00
Long Beach, City Of
Dept Of Parks And Rec-sfsp
2760 Studebaker Rd
Long Beach, CA 90815-1697
Contact Person: Tara Kilpatrick
Phone: (
Fax: (562) 570-1107
Days of Operation (e)
Meal StartDt EndDt StartTime EndTime ADP CAP
❑ 5.� L
S M
8
Calvary Assembly Of God Church
Laverne Williams
til l "0-1-
11 [j I.
6)
36 to C
Long Beach, CA
(
�•a jeWc iP a
S --Nr,
90810-
O
9
Cherry Park
James Jones
f y„('{.;c Y"11+S^4h
❑
6/11010 8125--,00 1:11 12;L/5-
1901 E 45th Street
(
(
S M
(9)
Long Beach, CA
90807-
O
—�
!`
11
Coolidge Park
Robbie Stuart
(]
G_ D _
352 Neece
(
k
S M
(9)
Long Beach, CA
90805-
O
1 � ®®❑
T W T F S
12
Deforest Park
/6S
Robbie Stuart
(1 A D.
6255 Deforest
(
13
Drake Park
Jose Olmos
951 Maine Ave
(
R 1K El
T W T F S
❑ ❑ ❑
T W
6 -26-00 $/ZS oo /(: 30 12:30
loo
---
--
d N1 ON ❑
T W T F S
j ® S R ❑
T W T F S
6/11010 8125--,00 1:11 12;L/5-
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70
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1 � ®®❑
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L
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/6S
(7)=Eligibility Documentation Due in 2000 (8)=Eligibility Documentation Due in 2001 (CT)=Year Census Tract is available
(9)=Eligibility Documentation Due in 2002 (2000)=Eligibility Documentation Due in 2003 (EC)= Eligibility is Current
(b) E=Enrolled O=Open C=Camp H=Homeless N=NYSP O/E=Open Enrolled (first come first served) (M)=Migrant
(c) Vended or Self Prep (d) Urban or Rural (e) B=Breakfast L=Lunch D=Dinner S=Snack
Printed: 3/27/00 11:17:17 AM
CALIFORNIA DEPARTMENT OF EDUCATION
CHILD NUTRITION AND FOOD DISTRIBUTION DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
SPONSOR SCHEDULE A - 2000 SUMMER FOOD SERVICE PROGRAM SITES
Page 3 of 7
Contact Name
19 - 81908V G156-00
Long Beach, City Of
Dept Of Parks And Rec-sfsp
2760 Studebaker Rd
Long Beach, CA 90815-1697
Contact Person: Tara Kilpatrick
Phone: ( Fax: (562) 570-1107
Site#
Site Name
Phone Number
Meal Type(c) Start Date
Days of Operation
(a)
Site Address
Type of Site (b)
Site Type(d) End Date
19
14
Eastman Fairfield Boys & Girls Club Of Long
700 E Del Almo Blvd
�ro
G/4 G.-: f firs - —
El ® ® DA X N El
(9)
Long Beach, CA 90813-
(
(
S M T W T F S
(9)
Long Beach, CA 90807-
O
(
(9)
Long Beach, CA 90806-
O
(7)=Eligibility Documentation Due in 2000 (8)=Eligibility Documentation Due in 2001
(9)=Eligibility Documentation Due in 2002 (2000)=Eligibility Documentation Due in 2003
■MON►y►_y■
■ ►` N ►!/ N ■
(e)
Meal StartDt EndDt
(CT)=Year Census Tract is available
(EC)= Eligibility is Current
(b) E=Enrolled O=Open C=Camp H=Homeless N=NYSP O/E=Open Enrolled (first come first served) (M)=Migrant
(c) Vended or Self Prep (d) Urban or Rural (e) B=Breakfast L=Lunch D=Dinner S=Snack
StartTime EndTime
111/00 /2:30 1 /:oo
4r/001 //:30 /2:3
ADP CAP
200
11 • vs- 12: ys 1 3s6
Printed: 3/27/00 11:17:18 AM
CALIFORNIA DEPARTMENT OF EDUCATION
CHILD NUTRITION AND FOOD DISTRIBUTION DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
SPONSOR SCHEDULE A - 2000 SUMMER FOOD SERVICE PROGRAM SITES
Page 4 of 7
Contact Name
Site# Site Name Phone Number Meal Type(c) Start Date
(a) Site Address Type of Site (b) Site Type(d) End Date
24 First Congregational Church Dorothy Baker -
909 Pine Ave (
(9) Long Beach, CA 90813- O
25 Ramona Park-4Ak-Oeat4f Tong 6ifson
3301 E 65th St ( J
(9) Long Beach, CA 90805- O
19 - 81908V G156-00
Long Beach, City Of
Dept Of Parks And Rec-sfsp
2760 Studebaker Rd
Long Beach, CA 90815-1697
Contact Person: Tara Kilpatrick
Phone: ( Fax: (562) 570-1107
Days of Operation
■ M O R .1 S ■
R❑
S M T W T.
F S
(e)
Meal StartDt EndDt StartTime EndTime ADP CAP
26 Scherer Parka
r —
Aobbie 51-,,404
-U M Da IX ® ® 0
4600long Beach Blvd
S M T W T F S
(9) Long Beach. 90805
0---
-----
Sherrie Nixon
L
-CA - - - -
27 Signal Hill Park
- -
na it-er
------ - . - -. --- ----
La kra Q,tfwt:/ur
—-----
1-J X 69 N 9 N ❑
1780 E Hill St
//: `i5' 1 /2: 4'r
L
G 00 2S oo /2 : 30
---
- 11
X ® ® N ❑
1 1 l-
r
28
Silverado Park
-----
Sherrie Nixon
L
42G Do 2 Oo //: 00
/,a ; 00
27;
1545 W 31st Street
(
29
Somerset Park
3arees-Jenes- Dolly 16j
80
/2:30
L
00 2.f 00 '30
1500 E Carson St
(
S M T W T F S
(9)
Long Beach, CA 90807-
O
(7)=Eligibility Documentation Due in 2000
(8)=Eligibility Documentation Due in 2001
(CT)=Year Census Tract is available
(9)=Eligibility Documentation Due in 2002
(2000)=Eligibility Documentation Due in 2003
(EC)= Eligibility is Current
(b)
E=Enrolled O=Open C=Camp
H=Homeless N=NYSP O/E=Open Enrolled
(first come first served) (M)=Migrant
(c)
Vended or Self Prep (d) Urban or Rural (e) B=Breakfast L=Lunch
D=Dinner S=Snack
Printed: 3/27/00 11:17:18 AM
CALIFORNIA DEPARTMENT OF EDUCATION
CHILD NUTRITION AND FOOD DISTRIBUTION DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
SPONSOR SCHEDULE A - 2000 SUMMER FOOD SERVICE PROGRAM SITES
Page 5 of 7
Contact Name
Site# Site Name Phone Number Meal Type(c) Start Date
(a) Site Address Type of Site (b) Site Type(d) End Date
Contact Person:
Phone:
Days of Operation (e)
Meal
19 - 81908V G156-00
Long Beach, City Of
Dept Of Parks And Rec-sfsp
2760 Studebaker Rd
Long Beach, CA 90815-1697
Tara Kilpatrick
( Fax: (562) 570-1107
StartDt EndDt StartTime EndTime ADP CAP
30
(9)
31
(9)
32
(9)
33
(9)
34
(9)
Springdale Apartment
2095 W Spring St
Long Beach, CA 90810-
Stearns Park
4520 E 23rd
Long Beach, CA 90815-
Syetp - Mural Project
340 E. Nieto & 5119 E. Colorado
Long Beach, CA 90804-
Veterans Park
101 E 28th St
Long Beach, CA 90806-
Washington Youth Center T
1430 Pacific
Long Beach, CA 90813-
Sherrie Nixon
(
Elyse Garcia
(
Heather Greene
(
Bonnie Hagen
(
Raymond Chavarria
(
O
❑ ®®®❑
S M T W T F S
S M T W T F S
❑ ❑ ® ® ® ® ❑
S M T W T F S
❑ tR
S M T W T F S
❑ gJ NJ 0,0 N ❑
S M T W T F S
L 8 .2S' O /: /S /2: /S
/70
_ /2: 30 1:30
8/2.7,0 /2 :00 /: gO
30
L fo 2L VO V25010//:so_ / f
120
L 2{. Oo $ 2So0 /2:00 /2;30
910
35
(9)
Wesley United Methodist Church
1100 Freeman Ave
Long Beach, CA 90804-
Rev C Cunnigan
(
0
❑ ® ® 9 Z 9 ❑
S M T W T F S
L
S Oo 2';" 00 f2:30 ;30
/00
(7)=Eligibility Documentation Due in 2000 (8)=Eligibility Documentation Due in 2001 (CT)=Year Census Tract is available
(9)=Eligibility Documentation Due in 2002 (2000)=Eligibility Documentation Due in 2003 (EC)= Eligibility is Current
(b) E=Enrolled O=Open C=Camp H=Homeless N=NYSP O/E=Open Enrolled (first come first served) (M)=Migrant
(c) Vended or Self Prep (d) Urban or Rural (e) B=Breakfast L=Lunch D=Dinner S=Snack
Printed: 3/27/0011:17:19 AM
CALIFORNIA DEPARTMENT OF EDUCATION
• CHILD NUTRITION AND FOOD DISTRIBUTION DIVISION
. SUMMER FOOD SERVICE PROGRAM UNIT
SPONSOR SCHEDULE A - 2000 SUMMER FOOD SERVICE PROGRAM SITES
Page 6 of 7
Site#
Site Name
(a)
Site Address
36
Ymca Of Greater Long Beach
600 Long Beach Blvd
(9)
Long Beach, CA
37
Carmelitos Community Center
851 Via Carmelitos
(9)
Long Beach, CA
90802 -
19 - 81908V G156-00
Long Beach, City Of
Dept Of Parks And Rec-sfsp
2760 Studebaker Rd
Long Beach, CA 90815-1697
Contact Person: Tara Kilpatrick
Phone: ( Fax: (562) 570-1107
Contact Name
Phone Number Meal Type(c) Start Date Days of Operation
Type of Site (b) Site Type(d) End Date
f Ci{ Sroa�to.� ❑ � � Q� ®� ❑
( J S M T W T F S
O
Pat r gb-n 4.,1tfix 6r%ffin
(
90805- O
38 Side ' e Center W;11 no f
544 Paramoun lvd (
Long Beach, CA 05- P4�f%Ci�ait
39 Cana unity Church W li no f-
332 Magnolia A
(,,-332
Long Beach, CA 90806- At
40 Ss od Samaritan Eddie Malesala
2452 Pacifi venue (
8) Long Beach, CA 90806-0000 O Par4 e• o&fe
41 True Gospel Missionary Baptist Church
2060 Santa Fe Avenue
(8) Long Beach, CA 90810-0000
DO_ ❑
M T�WT F
(e)
Meal StartDt EndDt StartTime EndTime
ri ❑❑❑__
M T W
M T WNT F
R AlmaNarshall L /j1a,-S44 /1 iJ X CS1 R1 ❑
S M T W T F S
O
/2:3
:oo
� 30 /2 :,90
(7)=Eligibility Documentation Due in 2000 (8)=Eligibility Documentation Due in 2001 (CT)=Year Census Tract is available
(9)=Eligibility Documentation Due in 2002 (2000)=Eligibility Documentation Due in 2003 (EC)= Eligibility is Current
(b) E=Enrolled O=Open C=Camp H=Homeless N=NYSP O/E=Open Enrolled (first come first served) (M)=Migrant
(c) Vended or Self Prep (d) Urban or Rural (e) B=Breakfast L=Lunch D=Dinner S=Snack
ADP CAP
90 l—
Printed: 3/27/00 11:17:19 AM
a
CALIFORNIA DEPARTMENT OF EDUCATION
CHILD NUTRITION AND FOOD DISTRIBUTION DIVISION
SUMMER FOOD SERVICE PROGRAM UNIT
SPONSOR SCHEDULE A - 2000 SUMMER FOOD SERVICE PROGRAM SITES
19 - 81908V G156-00
Long Beach, City Of
Dept Of Parks And Rec-sfsp
2760 Studebaker Rd
(7)=Eligibility Documentation Due in 2000 (8)=Eligibility Documentation Due in 2001 (CT)=Year Census Tract is available
(9)=Eligibility Documentation Due in 2002 (2000)=Eligibility Documentation Due in 2003 (EC)= Eligibility is Current
(b) E=Enrolled O=Open C=Camp H=Homeless N=NYSP O/E=Open Enrolled (first come first served) (M)=Migrant
(c) Vended or Self Prep (d) Urban or Rural (e) B=Breakfast L=Lunch D=Dinner S=Snack
Printed: 3/27/00 11:17:19 AM
Long Beach, CA 90815-1697
Page 7 of 7
Contact Person:
Tara Kilpatrick
Phone:
(562) 570-3535
Fax:
(562) 570-1107
Contact Name
Site#
Site Name
Phone Number
Meal Type(c) Start Date
Days of Operation (e)
(a)
Site Address
Type of Site (b)
Site Type(d) End Date
Meal
StartDt EndDt
StartTime
EndTime
ADP CAP
42
Orizaba Park
Bi l�y mope -
- ❑ ON Nog ❑
IT--
8 Y- op
/2:3o
--i. -15
/00 =
Orizaba/spaulding
(
S M T W T F S
(8)
Long Beach, CA
O
43
First Congregational Church (cedar)
9arothy-Baker
Al o l it TpAnSOA
L
6 2 00 Shy o0
/2;/,S
241 Cedar Avenue
(
44
Heartwell Park
-------
N'
Bewv Pt, -4 ho
❑ ® ® Ef 0 ❑
t.
4/2440 81.2 04;
5801 E Parkcrest St(
( ,
S M T W T F S
(9)
Long Beach, CA
90808-2060
O
45
Pan American Park
Tap Nixon
(J ®� ❑
L (oI�G✓00 8 �so0
//:/r
/1:/
9
5157 Centralia St
(
�`,46Pr ' emp hurch
Detri Mc Culley
W, ��' no f
❑ ❑ El El
5095 Long Beach 13
(
�4r�aCaPa�t
M T W F S
_
Long Beach, CA
90805-6345
O
47
STY et -mural Project (pal)
Heather Greene
will not
L ❑ 1-1 ❑
1205 Fr an
far-f;ci,piA
S M T T F
()
Long Beach, CK
90804-
M
(7)=Eligibility Documentation Due in 2000 (8)=Eligibility Documentation Due in 2001 (CT)=Year Census Tract is available
(9)=Eligibility Documentation Due in 2002 (2000)=Eligibility Documentation Due in 2003 (EC)= Eligibility is Current
(b) E=Enrolled O=Open C=Camp H=Homeless N=NYSP O/E=Open Enrolled (first come first served) (M)=Migrant
(c) Vended or Self Prep (d) Urban or Rural (e) B=Breakfast L=Lunch D=Dinner S=Snack
Printed: 3/27/00 11:17:19 AM
' LONG BEACH UNIFIED SCHOOL DISTRICT — FOOD SERVICE BRANCH Revised 3/31
LBUSD
Nutrltlon Servim PARICS M -a jrL_ 2,,
/AlUGIU,T ,,,,
K }� MEN Al❑ _`^
ATTENTION: ALL ADULTS III MENUS ARE SUBJECT TO CHANGE WITHOUT NOTICE.
How would you like to work in the cafeterias semng our LBUSD students?
Join the sub club! $9.09 per hour— 2 hours
Call (562) 426-2545 for further details or complete an application at the new location:
999 Atlantic Ave., Long Beach, CA 90813(building is at le St. and Atlantic Ave. Third Floor
MONDAY
August?
Bologna & Cheese on a
Round Bun
Pineapple Chunks
Orange Juice
Mustard Pkt
% Pint of Milk (1%)
August 14
Salami & Cheese on a
Kaiser Roll
Pineapple Sauce Cup
Fresh Nectarine
MustardlMayo Pkt
Pint of Chocolate Milk
August 21
Pastrami on a Kaiser Bun
Peach Cup
Apple Juice
Mustard Pkt
% Pint of Milk 1%
TUESDAY
August 1
Hamburger on a Bun OR
Bologna & Cheese on a Bagel
Peach Cup
Orange Juice
Mustard/Mayo Pkt
% Pint of Milk (1%)
% Pint of Milk 1%
August 8
Bean & Cheese Burrito OR
Pastrami & Cheese on a
Kaiser Bun
Apple Juice
Fresh Peach
Mustard Pkt
% Pint of Chocolate Milk
% Pint of Chocolate Milk
August 15
August 17
Turkey & Cheese Wrap OR
Turkey & Cheese Wrap OR
Peanut Butter & Jelly Sandwich
Pastrami & Cheese on
Wild Berry Juice
a Kaiser Bun
Mixed Fruit
Baby Carrots
Mustard/Mayo Pkt
Petite Banana
Chocolate Chip Cookie
Mustard Pkt
% Pint of Milk 1%
% Pint of Milk 1%
August 22
August24
Cheeseburger on a Bun
Assorted Sandwiches
Pure Applesauce Cup
Frozen Fruit Ice
Apple Slices
Fresh Nectarine
Mustard Pkt
Mustard/Mayo Pkt
% Pint of Chocolate Milk
WEDNESDAY
August 2
Peanut Butter & Jelly Sandwich
Pineapple Sauce Cup
Baby Carrots
Mustard/Mayo Pkt
% Pint of Chocolate Milk
August 9
Pepperoni Pizza Pack
Wild Berry Juice
Fresh Kiwi
Brownie
% Pint of Milk (1%)
August 16
Tostada Pack
Pineapple Sauce Cup
Orange Juice
Animal Cookies
% Pint of Chocolate Milk
August 23
Hero on a Mini Sub
Baby Carrots, Wild Berry Juice,
MustardlMayo Pkt, Chocolate Chip
Cookie, % Pint of Milk (1%)
For further informatin, consult the Internet at
www.lbusd.k12.ca.usMdsvc/nutritioncoverpage.htm
THURSDAY
August
Hamburger on a Bun OR
Turkey & Cheese on a Wheat Bun
Frozen Fruit Ice
Fresh Apple Slices
Mustard/Mayo Pkt
Chocolate Chip Cookie
% Pint of Milk 1%
August 10
Bean & Cheese Burrito OR
Turkey on a Round Bun
Frozen Fruit Ice
Baby Carrots
Mustard/Mayo Pkt
% Pint of Chocolate Milk
August 17
Turkey & Cheese Wrap OR
Pastrami & Cheese on
a Kaiser Bun
Baby Carrots
Petite Banana
Mustard Pkt
% Pint of Milk 1%
August24
Assorted Sandwiches
Frozen Fruit Ice
Fresh Nectarine
Mustard/Mayo Pkt
% Pint of Milk 1%
FRIDAY
August 4
Tostada Pack
Baby Carrots
Nectarine
Animal Cookies
% Pint of Chocolate Milk
August 11
Turkey Ham & Cheese
on a Sub Bun
Orange Juice
Mixed Fruit
Mustard Pkt
% Pint of Milk (1%)
August 25
Pepperoni Pizza Pack
Diced Pears
Orange Juice
% Pint of Chocolate Milk
�VBUSD LONG BEACH IJ VIFIED SCRIMOL DISTRICT -FOOD SERVICEBRANCTI Revised 3/31
' �11/�/t
Nutrition Services PARKS LURCH MERU JIVNIS UL
Serving Education Everyday
ATTENTION: ALL ADULTS III
How could you like to work in the cafeterias serving our LBUSD students?
Join the sub club! $9.09 per hour— 2 hours
Call (562) 426-2545 for further details or complete an application at the new location:
999 Atlantic Ave, Long Beach, CA 90813 (building is at 10 S& and AtlanticAve, Third Floor)
MONDAY
June 26
Turkey Ham Poor Boy,
Mustard Pkt, Diced Pears,
Baby Carrots,'/ Pint of Milk (1%)
July 3
Chicken & Swiss Cheese on Hoagie,
Wild Berry Juice, Peach Cup,
MustardlMayo Pkt, % Pint of
Chocolate Milk
July 10
Salami on Whole Wheat Bread,
Fresh Orange, Apple Juice, Mustard
Pkt, % Pint of Milk (1%)
July 17
Chicken & Swiss Cheese on Hoagie
Mustard Pkt, Pineapple Chunks,
Fresh Kiwi, Brownie,
% Pint of Chocolate Milk
July 24
Bologna on Whole Wheat Bread,
Nectarine, Wild Berry Juice,
Mustard/Mayo Pkt, Chocolate Chil
Cookie,'/ Pint of Milk 1%
TUESDAY
June 27
Bean & Cheese Burrito OR Bologna,
Salami & Cheese on a French Roll,
Mustard Pkt, Peach Cup, Fresh Kiwi,
% Pint of Chocolate Milk
July 4
JULY 4M HOLIDAY
(Independence Day)
% Pint of Milk (1%)
July 11 .
Grilled Cheese Sandwich OR
Turkey Ham Deli Sticks, Orange Juice,
Mixed Fruit, Mustard Pkt,
% Pint of Chocolate Milk
July 18
Grilled Cheese Sandwich OR
Peanut Butter & Jelly Sandwich,
Frozen Fruit Ice, Peach Cup,
'A Pint of Milk 1%
July 25
Chicken Patty on a Bun OR Turkey Ham
& Cheese Deli Sticks, Pineapple Sauce
Cup, Baby Carrots, Mustard PK
Trail Miy, % Pint of Chocolate Milk
WEDNESDAY
June 26
Pepperoni Pizza Pack,
Mixed Fruit Cup, Nectarine,
% Pint of Milk (196)
luly 5
Peanut Butter & Jelly Sandwich, .
Pineapple Sauce Cup, Orange Juice,
Chocolate Chip Cookie,
% Pint of Chocolate Milk
July 12
Bologna on Whole Wheat Roll, Wild
Berry Juice, Nectarine, Mustard PK
% Pint of Milk (1%)
July 19
Hero on a Mini Sub, Baby Carrots,
Mixed Fruit, Mustard Pkt,
% Pint of Chocolate Milk
July 26
Pepperoni Pizza Pack, Frozen Fruit Ice,
Peach Cup, % Pint of Milk (1%)
MENUS ARE SUBJECT TO CHANGE WITHOUT NOTICE.
(For further information, consult the Internet at
www.lbusd.k12.ca.us/fdsvc/nutritioncoverpage.htm)
THURSDAY
June 29
Bean & Cheese Burrito OR Pastrami on
a Kaiser Bun, Apple Juice, Petite
Banana, Mustard Pkt,
% Pint of Chocolate Milk
July 6
Turkey Ham & Cheese Poor Boy, Frozen
Fruit Ice, Mustard PK Petite Banana,
% Pint of Milk (1%)
July 13
Grilled Cheese Sandwich OR
Assorted Sandwiches, Frozen Fruit Ice,
Petite Banana, Mustard/Mayo PK
Chocolate Chip Cookie,
% Pint of Chocolate Milk
July 20 -
Tostada Pack, Frozen Fruit Ice, Petite
Banana, Animal Crackers,
% Pint of Milk (1%)
July 27
Grilled Chicken Patty on a Bun OR
Turkey & Swiss Cheese on Hoagle,
Apple Juice, Mixed Fruit, Mustard/Mayo
Pid, % Pint of Chocolate Milk
K
FRIDAY
lune 30
Peanut Butter & Jelly Sandwich,
Apple Slices, Orange Juice,
% Pint of Milk (1%)
July 7
Bologna on Whole Wheat Roll,
Mustard Pkt, Baby Carrots, Nectarine,
Brownie Round,
% Pint of Chocolate Milk
July 14
Pepperoni Pizza Pack, Orange Juice,
Baby Carrots, Trail Mix,
% Pint of Milk (1%)
July 21
Turkey Ham & Cheese on a French
Roll, Wild Berry Juice, Apple Slices,
Mustard Pkt, % Pint of Chocolate Milk
July 28
Bologna, Salami & Cheese on a
French Roll, Pineapple Sauce Cu!.Orange Juice, Mustard/Mayo Pkt,
Brownie %Pint of Milk 1%
Z
1 AGREEMENT
2
3 THIS AGREEMENT is made and entered as of May 1, 2000 for reference
4 purposes only, pursuant to a minute order of the City Council of the City of Long Beach
s adopted in its meeting held on April 25, 2000, and in a minute order of the Board of
6 Education of the Long Beach Unified School District of Los Angeles County adopted in its
7 meeting held on , 2000, by and between the CITY OF LONG
s BEACH, a municipal corporation ("Sponsor"), and the LONG BEACH UNIFIED SCHOOL
9 DISTRICT OF LOS ANGELES COUNTY, a public school system created and authorized
10 by the California Constitution and City Charter ("Vendor").
.11 WHEREAS, the California Department of Education ("CDE") has made
12 available funds for a 2000 Summer Food Service Program for Children ("Program") to
b s o cost to eligible a o - A 13 provide meals at n children; and
Hag 14 WHEREAS, Sponsor anticipates entering an agreement with the CDE to
N
1s provide for the administration of the Program; and
WHEREAS, it has been determined that the Program will be conducted at
urn 1* 16
17 various locations throughout the City of Long Beach; and
18 WHEREAS, Sponsor desires to enter an agreement with Vendor for the
19 preparation of meals pursuant to and in implementation of the Program; and
20 WHEREAS, Vendor has a food service facility possessing the skills,
21 personnel and equipment necessary for the preparation of such meals;
22 NOW, THEREFORE, in consideration of the mutual terms and conditions
23 herein, the parties agree as follows:
24 1. VENDOR PREPARATION. Vendor shall prepare and place in containers
25 provided by Sponsor such meals described hereinafter as Sponsor may order from Vendor
26 in the manner hereinafter specified for the 2000 Summer Food Service Program for
27 Children. Vendor warrants that all meals prepared by it will be wholesome, suitable for
28 human consumption, and that Vendor shall meet all specifications and obligations under
the existing regulations of the CDE, or as amended, as are pertinent or applicable to the
2 2000 Summer Food Service Program for Children of the National School Lunch Act
3 (hereinafter "Regulations").
4 2. FEE. In consideration of the satisfactory performance of Vendor's
s obligations pursuant to this Agreement, Sponsor shall pay to Vendor the sum of $1.95 for
6 each lunch actually prepared for service at locations within the City of. Long Beach. The
7 quantity shall not exceed 10,000 such meals daily, except as may be mutually agreed by
s Sponsor and Vendor. The quantity shall be no less than seventy (70) lunches daily, except
9 as may be mutually agreed by Sponsor and Vendor. Sponsor's ordering of a quantity in
to excess of these amounts and Vendors delivery of such quantity shall constitute such
.11 mutual agreement. In no event shall Sponsor be held liable or be required to pay for any
12 meals which fail to meet the requirements of the Regulations, including those pertaining
I- GO requirements, such as meals of poor quality, unwholesome or spoiled
a m� � � 13 to CDE nutritional
14 meals or portions thereof, of damaged meals, or meals which otherwise fail to meet the
E °V ° is requirements set forth in this Agreement.
�+sV #J
ad,,r3ip�q�
Q F 16 3. PAYMENT. Sponsor shall pay Vendor for meals provided under this
17 Agreement within thirty (30) days after receipt of an invoice from Sponsor. Itis understood
18 that the CDE assumes no liability for payment of differences between the number of meals
19 delivered and prepared by Vendor and the number of meals served by the Sponsor that
20 are eligible for reimbursement.
21 4. SITES. Sponsor shall provide to Vendor a list of State agency approved
22 food service sites, along with the approved level for the number of meals which may be
23 claimed for reimbursement for each site and shall inform Vendor of all sites which have
24 been approved, cancelled, or terminated subsequent to the submission of the initial
2-9 approved site list and of any changes to the approved level of meal service for a site, within
26 twenty-four (24) hours after these site changes.
27 5. ORDERING. Sponsor shall order from Vendor, on a daily basis, the
2 s 1 number of meals needed, three (3) days in advance of service at locations within the City
2
7 1�. C i_ I V .. V
GITy CLE;SIi
L 0 N G DEACI-I. CfkLIF
00 !U#1 23 PH 4: 54
1 of Long Beach. Each daily order may be increased or decreased by Sponsor, but only if
2 1 Sponsor informs Vendor no later than 1:30 p.m. on the day prior to the day on which a
3
decrease or an increase is to take effect.
4
6. DELIVERY. Vendor shall deliver all meals prepared for service at thirty -
5
two (32) agreed upon locations identified on Attachment W within the City of Long Beach
6
designated by the Director of Parks, Recreation and Marine or his designee on the day of
7
the actual service of such meals or, at the option of the participating organization whose
s
site offer these meals, said organization may pick up the meals from Vendor if said
9
organization makes its own arrangements with Vendor to do so. Sponsor shall not be
10
liable in any way to said organizations with respect to such arrangements. Sponsor shall
.11
provide a minimum of one* food handler to receive meals at designated locations.
12
Additional food handlers shall be provided by Sponsor, if needed, as determined by
cam
0 - 9 13
Sponsor. Lunch deliveries shall be made no earlier than one (1) hour before the meal
0rj
o 14
service and time designated by the Sponsor and no later than the scheduled beginning of
N
E r a 15
the meal service. Any requests by Sponsor for delivery of lunches at other than these
x�3�a
H 16
times must be made a minimum of three (3) days in advance and said meals must be
o
17
picked up by Sponsor or the participating organization at Vendor's dock.
18
7. PREPARATION OF MEALS. ' All meals prepared by Vendor pursuant to
19
this Agreement shall conform to the Regulations. Vendor shall provide different daily
20
menus to prevent monotony in the meals.
21
A. Lunches. All lunches shall meet the requirements of the CDE
22
reimbursable lunch, described generally -as follows:
23
1. Eight (8) ounces of fluid milk.
24
2. Two (2) ounces (edible portion as served) of meat or meat alternate
25
(fish, cheese, one [1] egg, one-half [Y2] cup cooked dry beans or peas, four
26
[4] tablespoons of peanut butter), or an equivalent combination of these
27
foods.
28
3. Three-fourths (3/4) cup of two (2) or more fruits and/or vegetables.
3
1 A serving of full strength fruit juice may be counted to meet not more than
2 three-eighths (3/8) cup of this requirement.
3 4. One (1) slice of bread or equivalent made of whole grain or
4 enriched flour or meal.
5 B. Packa4in4.
6 1. Meals shall be packaged in bulk. Sponsor shall insure that all
7 components are served.
8 2. Each unit shall be capable of holding meals at a temperature of
9 32°F minimum, not to exceed 45°F maximum, fora period of three (3) hours.
10 3. All sandwiches shall be individually wrapped and sealed.
.11 4. An eight (8) ounce carton of fluid milk shall be supplied with each
a hi12 meal.
s Vendor shall provide lunches in accordance with the
A
o � � 13 8. MENU
3 °' 14 menu cycle mutually agreed upon in writing which maybe repeated for the duration of the
e° "
15 Program.
ab� aE 16
9. FOOD ANALYSIS. At the discretion of Vendor, and at its own expense,
s 17 Vendor shall send a random sampling of meals to a recognized laboratory for analysis of
1s portions, bacteria, coliform and plate counts.
19 10. HEALTH_ REGULATIONS. Vendor shall adhere to all applicable health
20 regulations at all times. Sponsor, State, and Federal program authorities shall have the.
21 right to inspect Vendor's premises and request formal inspection by health officials, if
22 deemed necessary. Failure to comply with applicable health requirements shall result in
23 the immediate termination of this Agreement.
24 11. PERMITS. Vendor shall obtain and maintain food handler's permits in
25 accordance with applicable requirements. Vendor shall ensure that its employees observe
26 sanitary food handling practices. Sponsor shall ensure that its employees and volunteers
27 observe sanitary food handling practices at serving sites. A letter notifying the City's
2s Department of Health and Human Services of this operation is on file.
4
1 12. HOLDING FACILITIES AND PACKAGING MATERIAL. Sponsor shall
2 provide satisfactory holding facilities, i.e., heavy styrofoam containers, etc. Packaging
3 material shall be of strength sufficient to prevent crushing of food.
4 13. QUALITY STANDARD. Quality standards shall adhere to State and local
5 specifications, and all meat and meat by-products shall come from plants inspected under
6 a federally -approved inspection plant.
7 14. TRANSPORTING AND FOOD SERVICE EQUIPMENT. All equipment
s used to transport the food and all other food service equipment shall be cleaned and
9 sanitized on a daily basis.
10 15. PACKAGING OF MEALS. Meals shall be packaged in bulk. Sponsor
• 11 shall see that all components are served.
12 16. PREPARATION AND' ASSEMBLY OF MEALS. Vendor shall prepare
o 13 meals under properly controlled temperatures. Assembly of meals shall include necessary
1- 14 eating utensils, napkins, condiments, etc. Vendor shall hold assembled meals in properly
o��� 9 P� P P Y
ei is refrigerated or heated areas, as appropriate, that meet sanitation standards. Sponsorshall
ae3 g_
a H 16 approve samples of finished meal packages, in accordance with menus provided, and
s 17 there shall be no deviation from the packaging presented and approved.
is 17. PRODUCTS. All products shall be manufactured and assembled in a
19 plant approved and inspected by the CDE, County of Los Angeles, or City of Long Beach
2o Department of Health and Human Services not more than twenty-four (24) hours prior to
21 delivery. Vendor shall furnish at its cost, upon request, a microbial analysis, a chemical
22 analysis, and a flavor analysis.
23 18. DONATED FOODS. Foods donated by the CDE shall be utilized as
24 practicable in the Program and in accordance with availability from the State.
25 19. ASSIGNMENT OF DONATED FOOD. Donated food received from the
26 CDE will be directed to Vendor and freight and handling costs will be billed to and paid by
27 Vendor.
28 20. COMPLETE MEALS. Vendor shall deliver complete meals only. If any
5
12
g ��� 13
Mg 14
O 15
o �
ac3 �
i^ of 16
17
18
19
20
21
22
23
24
25
26
27
2s
portion of a meal is undeliverable, unacceptable or missing, Sponsor shall disallow
payment for total meal unless needed items are delivered five (5) minutes prior to end of
serving time.
21. VERIFICATION. Sponsor shall verify the number of boxes as well as the
number of meals in each box, prior to meal services.
22. RECORDS. In addition to any other records, books, statements or
invoices required to be kept by Vendor pursuant to this Agreement, Vendor shall maintain
such records (supported by invoices, receipts, orother documenting evidence) as Sponsor
needs to meet its responsibilities for the Program. Vendor shall report such information
to Sponsor within ten (10) days after the end of each month.
Vendor shall keep full and accurate records in connection with the meals
covered by this Agreement. All such records shall be kept on file for three (3) years and
three (3) months after the end of the federal fiscal year to which they pertain, or any other
period which the U.S. Secretary of Agriculture may from time to time designate. Sponsor
or the auditors of the CDE, upon request, shall have access to all such records for audit
and review at a reasonable time and place. Sponsor's authorized representatives and the
representatives of the CDE shall have the right to conduct on-site review of the food
service operation.
23. TERM. The term of this Agreement shall commence at midnight on
June 26, 2000, and shall terminate at 11:59 p.m. on August 25, 2000, provided, however,
that either Sponsor or Vendor may terminate this Agreement by giving to the other party
at least seventy-two (72) hours prior notice. Meals shall be served Monday through Friday.
24. CONTINGENT ON STATE/FEDERAL AGREEMENTS. Sponsor and
Vendor understand and agree that this.Agreement is contingent upon the execution of
underlying agreements with the United States, or agencies thereof. Consequently, neither
Sponsor nor Vendor shall have any obligation to perform, and this Agreement shall be of
no force and effect, until such time as such underlying agreements have been duly
executed. Upon demand, Sponsor shall supply Vendor with copies thereof.
0
A
2
3
4
5
6
7
8
15
16
17
is
19
20
21
22
23
24
25
26
27
28
25. - HOLD HARMLESS. Vendor shall defend, indemnify and hold harmless
Sponsor, its agents, employees and officials against any and all claims, demands,
damages, losses, causes of action, liabilities, costs, suits, or expenses (including
reasonable attorney's fees) arising out of any act or omission of any officer, agent or
employee of Vendor, or resulting from the condition of any property owned or controlled
by Vendor. Sponsor shall defend, indemnify and hold harmless Vendor, its agents,
employees and officers against any and all claims, demands, damages, liabilities, costs,
suits or expenses (including reasonable attorney's fees) arising out of any act or omission
of any officer or employee of Sponsor or resulting from the condition of any property owned
or controlled by Sponsor.
26. STATUS 'OF VENDOR. Neither Vendor nor any of its officers,
I employees or agents are, nor shall they be deemed for any purpose, employees of
Sponsor nor shall they be entitled to any rights, benefits or privileges of Sponsor's
employees.
27. ASSIGNMENT. This Agreement shall not be assigned without the prior
I written consent of Sponsor's City Council. Any attempt by Vendor to assign any of its
duties, obligations and responsibilities shall be void, and shall render this Agreement void.
28. TIME OF ESSENCE. Time is of the essence hereunder.
29. NON-PERFORMANCE. If Vendor fails to perform any or all of the tasks
required by this Agreement, Sponsor reserves the right to perform such tasks in part or in
total. Sponsor may perform such tasks itself or by contracting with another Vendor.
If Sponsor performs a part of or the total of the tasks not performed by Vendor in either of
the aforementioned manners, Vendor shall be liable to and shall pay Sponsor for all costs
incurred in such performance. Sponsor shall not exercise any remedy available upon the
occurrence of Vendor's failure to perform until:
a. Sponsor gives notice to Vendor specifying any and all items of
non-performance to Vendor, and
b. Vendor shall have failed to correct the specified items of non -
7
1
performance within forty-eight (48) hours after receipt of such notice.
2
30. ADMINISTRATION. The City Manager, the Directorof Parks, Recreation
3
and Marine, or any other designee of the City Manager is authorized and directed, for and
4
on behalf of the City, to administer this Agreement and all related matters. Any decision
s
of the City Manager or his designee in connection herewith shall be final.
6
31. NOTICES. Unless otherwise required by the context or specific provision
7
of this Agreement, all notices hereunder shall be in writing and personally delivered or
s
deposited in the U.S. Postal Service, first-class, postage prepaid, to Sponsor at 2760
9
Studebaker Road, Long Beach, California 90815-1697 and to Vendor at 3333 East Airport
to
Way, Long Beach, California 90806 Attn: Russell M. Stovner. Notice shall be deemed
.11
given on the date deposited in the mail or on the date personal delivery is made, whichever
12
first occurs.
Ut,- a 13
32. INSURANCE. As a condition precedent to the effectiveness of this
'. ff
�o�o� 14
Agreement, Vendor shall procureand maintain at Vendors expense for the duration of this
9 P P
tag a 15
s
Agreement from an insurance company that is admitted to write insurance in California or
,� a
aN 16
from authorized non -admitted insurance companies that have ratings of or equivalent to
17
A:VIII by A.M. Best Company:
18
(a) Commercial general liability insurance (equivalent in scope to
19
ISO form CG 00 01 1185 or CG 00 01 11 88) in an amount not less than
20
One Million Dollars ($1,000,000) per occurrence and Two Million Dollars
21
($2,000,000) general aggregate. Such coverage shall include but not be
22
limited to broad form contractual, liability, cross liability, independent
23
contractors liability, and products and completed operations liability. The
24
City, its officials, employees and agents shall be named as additional
25
insureds by endorsement (on the City's endorsement form or on an
26
endorsement equivalent in scope to ISO form CG 20 10 11 85 or CG 20 26
27
1185), and this insurance shall contain no special limitations on the scope
28
of protection given to the City, its officials, employees and agents.
8
1
(b) Workers' compensation insurance as required by the California
2
Labor Code and employer's liability insurance in an amount not less than
3
One Million Dollars ($1,000,000) per accident.
4
(c) Commercial automobile liability insurance (equivalent in scope
5
to ISO form CA 00 01 06 92), covering Auto Symbol 1 (Any Auto), in an
6
amount not less than Five Hundred Thousand Dollars ($500,000) combined
7
single limit per accident.
s
Any self-insurance program, self-insured retention, or deductible must be
9
separately approved in writing by City's Risk Manager or designee and shall protect the
to
City, its officials, employees and agents in the same manner and to the same extent as
.11
they would have been protected had the policy or policies not contained retention
12
provisions. Each insurance policy shall be endorsed to state that coverage shall not be
stags
0 -1 a 13
suspended, voided or canceled by either party except after thirty (30) days prior written
s g-
14
S
notice to City, and shall be primary and not contributing to any other insurance or self -
e 1 15
insurance maintained by City, its officials, employees and agents.
F 16
Vendor shall require that all contractors and subcontractors which Vendor
o a
17
uses in the performance of services under this Agreement maintain insurance in
1s
compliance with this Section unless otherwise agreed in writing by City's Risk Manager or
19
designee.
20
Prior to the start of performance under this Agreement, Vendor shall deliver
21
to City certificates of insurance and required endorsements, including any insurance
22
required of Vendor's contractors and subcontractors, for approval as to sufficiency and
23
form. The certificates and endorsements shall contain the original signature of a person
24
authorized by that insurer to bind coverage on its behalf. In addition, Vendor shall, at least
25
thirty (30) days prior to expiration of the insurance required hereunder, furnish to the City
26
certificates of insurance and endorsements evidencing renewal of such insurance. City
27
reserves the right to require complete certified copies of all policies of Vendor or Vendor's
28
contractors or subcontractors, at anytime. Vendor shall make available to the City all
9
. 1
3
4
5
6
7
8
9
10
11
j
12
-a
om'al
13
o�ag
14
o
15
ae3gv
16
0
S
17
18
19
20
21
22
23
24
25
26
2i
2E
books, records and other information relating to the insurance coverage required herein
during normal business-hoLirs-
Any modification or waiver of the insurance requirements herein shall only
be made with the written approval of the City's Risk Manager or designee. The procuring
or existence of insurance shall not be construed or deemed as a limitation on liability
relating to Vendor's performance of services or as full performance of or compliance with
the indemnification provisions herein.
IN WITNESS WHEREOF, the parties hereto have caused these presents to
be duly executed with all the formalities required by law on the respective dates set forth
opposite their signatures.
,2000
LONG BEACH UNIFIED SCHOOL DISTRICT
OF LOS ANGELES COUNTY, a public
school system created and authorized by the
California Constitution and City Charter
By
Title:
"Vendor"
CITY OF LONG BEACH, a municipal corporation
, 2000 By City Manager
"Sponsor"
This Agreement is hereby approved as to form on , 2000.
ROBERT E. SHANNON, City Attorney
DFG:rmb4-18-2000(LBUNLA2000.RAG)00-01661
F..IHPPS\ctyLaw32\WPDOCS\D018\Pool \00010290.WPD
By Deputy
10
Attachmwt OV
"2000" SUMMER FOOD SERVICE PROGRAM! FOR CHILDREN
MEAL SERVICE SITES --_-- ��—
cmr sus_:
Admiral Kidd ParX
2125 Santa Fe Avenue
Long Beach, CA 90810
Baby Park
130 Cherry Avenue
Long Beach, CA 90802
California Community Center
1550 Martin Luther King Avenue
Long Beach, CA 90813
Cesar E. Chavez Park
401 Golden Avenue
Long Beach, CA 90802
Cherry Park
1901 E. 45th Street
Long Beach, CA 90807
Coolidge Park
352 E. Neece StrW
Long Beach, CA 90805
DeForest Park
6255 DeForest
Long Beach, CA 90805
Drake Park .
951 Maine Avenue
Long Beach, CA 90813
Heartwell Park
5801 East Parkcrest Street
Long Beach, CA 90808
Houghton Park
6301 Myrtle Avenue
Long Beach, CA 90805
-1-
Attachment'19
MacArthur Park
= - __..... 1325 E. Anaheim Street_---------
- Long Beach, CA 90813
Martin Luther icing, Jr. Park
1950 Lemon Avenue _..
Long Beach, CA 90806
Orizaba Park
O&Aba/Spolding
Long Beach, CA 90804
Pan American Park
5157 Centralia St.
Long Beach, CA 90808
Ramona Park
3301 E. 65th Street
Long Beach, CA 90805
Scherer Park
4600 Long Beach Blvd.
Long Beach, CA 90805
Silverado Park
1545 West 31 at Street
Long Beach, CA 90810
Somerset Park
1500 E. Carson Street
Long Beach, CA 90807
Springdale Apartment Community Center
2095 Spring Street
Long Beach, CA 90810
Steams Park
4520 E. 23rd Street
Long Beach, CA 90815
SEP/Mural Project (Closed Site)
Special Services Building
340 Nieto
Long Beach, CA 9080
Veterans Park
101 E. 28th Street
Long Beach, CA 90806
-2-
. _ Attachment W. .
_ - - Washington Youth Center
1430 Pacific Avenue
Long Beach, CA 90813
147H Street Park _ ... .
Chestnut/ 10 St.
Long Beach, CA 90813
NON -CITY SITESINON-PROFIT ORGANIZATIONS
Antioch Missionary Baptist Church
1535 Gundry Avenue
Long Beach, CA 90813
Boys and Girls Clubs of Long Beach
700 East Dei Arno Boulevard
Long Beach, CA 90806
Meal Service Sites at.
Eastman/Fairfield Boys and Girls Club
700 East Del Amo Blvd.
Long Beach, CA 90806
West Branch Boys and Girls Club
1835 West Willard Street
Long Beach, CA 90810
Carmelitos Community Center Boys and Girls Club
1000'x4 Via Wanda
Long Beach, CA 80805
Calvary Chapel of North Long Beach
5722 Lime Ave.
Long Beach, CA 90805
Central Baptist Church of Long Beach
737 Magnolia Avenue
Long Beach. CA 90813
-3-
_ .. ..: Attachment"
First Congregational Church
909 Pine Avenue --
Long Beach, CA 90802
Meal Service sites at: _. _ __._............ _ _
909 Pine Avenue
Long Beach, CA 90802
241 Cedar Avenue
Long Beach, CA 90804 -
First Southern Baptist Church
5640 Orange Ave.
Long Beach, CA 90805
Lakewood First Presbyterian Church
3955 Studebaker Road
Long Beach, CA 90808
Long Beach Samoan Community Church
6857 Long Beach Boulevard
Long Beach, CA 90801
Pacific Baptist Church
2474 Pacific Avenue
Long Beach, CA 90806
Praise Temple Academy
5095 Long Beach Boulevard
Long Beach, CA 90805
Second Samoan Congregational Church
655 Cedar Avenue
Long Beach, CA 90802
St. John M.B. Church
741 E. I& Street
Long Beach, CA 90813
True Gospel Missionary Baptist Church
2060 Santa Fe Avenue
Long Beach, CA 90810
Wesley United Methodist Church
1100 Freeman Avenue
Long Beach, CA 90802
-4-
Attachment W
Willmore Urban Agency
- 5Q7 Pacific Avenue
----Long Beach, CA 90802
YMCA of Greater Long Beach
Buffum Downtown YMCA
600 Long Beach Boulevard _
Long Beach, CA 90802
SITES LOCATED OUTSIDE THE CITY OF LONG BEACH
City of Signal Hill
Hillbrook Patio
1875 Temple Avenue
Signal Hill, CA 90806
Signal Hill Park
2175 Cherry Avenue
Signal Hill, CA 90815
Love of God Fellowship Church
8721 Paseo Street
Paramount, CA 90723
CALIFORNM DEPARTMENT OF EDUCATION
NUTRITION SERVICES DIVISION
FOOD DISTRIBUTION PROGRAM
AGREEMENT FOR DISTRIBUTION
OF DONATED FOOD -
Q SLZAN1ER FOOD SERVICE PROGRAM
FDS -103 (1/00)
Return all copies to:
CALIFORNIA DEPARTMENT OF EDUCATION
Summer Food Service Program
560 J Street, Suite 270
Sacramento, CA 95814
Pursuant to the United States Department of Agriculture (USDA) regulations, 7 Code of Federal Regulations, Parts 225 and 250, the applicant identified
below, hereinafter called the recipient agency, hereby makes application for commodities donated by the Agriculture and Marketing Service, USDA, to the
Califormia Department of Education, hereinafter called the state agency, for use and disposition in accordance with the terms and conditions appearing on
the reverse side hereof~ which by reference are incorporated herein.
NAME OF FOOD SERVICE CONTACT PERSON TITLE TELEPHONE NO: (
FAXNO: 562) 570-1107
Ci nd_v Graber SFSP Coordinator E-mail address:
For the following statements, please check (✓) the appropriate response for the recipient agency.
ASSISTANT CITY MANAC -
THE CITY CHAF.TER.
Y
N
Y
N
I. In storage, preparation, and service of donated food, proper
5. Donated food will be shipped in accordance with the
sanitation and health standards will be maintained in
instructions on the food offering. Food is delivered only to
conformance with all applicable state, local laws and
X
the city in which the agency's administrative headquarters is
X
regulations. The agency will make certain that their facilities
located. Adequate facilities and personnel will be available
meet the storage standards as cited in the regulations.
at the shipping address to accept delivery. CDE will allow
the agency to pick up the food from the food distribution
2. The California Department of Education (CDE) will offer
commodities each year during the months of May through
center, if prior arras ements have been made.
6. An inventory system will be maintained which records all
September. The agency will be charged a shipping and
X
handling fee for each case or trait Payments will be made to
receipts, issuances, transfers, and disposal of donated foods.
X
CDE within 30 days of receipt of the invoice.
All reqs records will be retained for a period of three
3. Donated foods can only be used for the benefit of those persons
years from the close of the federal fiscal year to which they
eligible for meals provided in the Summer Food Service
X
pertain. At the close of the program, the agency will
Program (SFSP). Donated foods will not be transferred or used
complete and return a copy of the Ending Inventory Report
otherwise without prior approval from CDE. Donated foods
form provided by the food distribution (and retain a copy
will be transferred in a manner that best meets the interest of the
for their files). Any unused food will be transferred to a
SFSP. The agency is responsible for all costs associated with
National School Lunch Program (NSLP).
transferring food. Donated foods will not be sold or traded.
7. A School Food Authority (SFA) who has a current
4. Donated foods will be ordered in quantities that will be used
q
agreement with a food service vendor for the NSLP may
efficiently during the program period. Food held longer than
utilize the same vendor to provide meals for the SFSP, but a
six months is subject to spoilage and contamination for which
written agreement must be made with the food service
X
the agency will be held liable for paying the fair market value of
X
vendor and approved by CDE before the delivery of donated
the food. The agency will notify CDE when any loss of donated
food
foods occur.
RECIPIENT AGENCY AGREEMENT CERTIFICATION
STATE AGENCY APPROVAL
4 the agent authorized by the governing board of the recipient agency (or by the chief
administrative officer of the recipient agency which has no governing board) to enter into this
This application when approved by the state agency
agreement. certijy that the information presented is accurate and agree with the terms and
shall constitute an agreement which shall remain in
conditions of this agreement as they arepresented on the reverse side of this form.
full force and effect until written notice to the
contrary is given, as provided in the terms and
conditions on the reverse side of this form:
PRINT OR TYPE NAME OF AUTHORIZED RECIPIENT AGENCY REPRESENTATIVE
Henry Taboada
TITLE
TELEPHONE NUMBER
FOR&9Z4 EOE. M IIS ONiYr "
City Manager
VENDOR NUMBER19 819 0 8 V
—
APPROVALSIGNATtJItEOFAUriORIgDSrATEAC�t1CY� �g-� '
fRipRESFNrATIVE x 4 f zW
s
AGENCY NAME City of Long Beach
v n �tk s z
ADDRESSDepartment of Parks, Rec. & Marine
DAT$ ; F� s
2760 Studebaker Rd.54
i�-�.✓..IM.I�I L� na', Y -.:v „!.l'Q ..fes
Long Beach, CA 90815-1697
F 5
SIGNATURE OF AUTHORIZED RECIPIENT AGENCY REPRESENTATIVE DATE
SFSP APPROVAL h "DATE .
►
.� w-- t s x v�
ERECUTEA S
''' }
ASSISTANT CITY MANAC -
THE CITY CHAF.TER.
CITY OF LONG BEACH
DEPARTMENT OF PARKS, RECREATION & MARINE
2760 Studebaker Rd. • Long Beach, CA 90815 • (562) 570-3150
SENIOR SERVICES AND SPECIAL PROGRAMS
May 15, 2000
Janice Hunt
California Department of Education
Nutrition Services Division
Summer Food Service Program Unit
560 "J" Street, Suite 270
Sacramento, CA 95814-2342
Dear Ms. Hunt:
As in previous years, the City of Long Beach Department of Parks, Recreation and
Marine (Agreement #19-8190-8V) would like to request a waiver of the unitized meal
requirement set forth in the Summer Food Service Program for Children Regulations.
The City of Long Beach has contracted with the Long Beach Unified School District to
prepare and deliver the meals for the City's Summer Food Service Program for over
fifteen years. At our recent contract negotiations with the School District we were once
again advised that they do not have the capability of unitizing meals for the City's 2000
Summer Food Program. The School District will prepare and deliver the food to the
City's meal service locations with each menu item pre -wrapped and ready for
unitization. They will also provide the necessary boxes or bags to package the meals
for distribution to the children. The City will ensure that all meals distributed to children
are unitized as prescribed by Program regulations.
The City of Long Beach has agreed to these arrangements and feels it benefits our
program since it reduces the number of styrofoam delivery boxes required and permits
us to maintain the high quality of meals provided by the Long Beach Unified School
District.
Please be assured that all other contract requirements will be adhered to and all
children will receive a complete unitized meal as prescribed by the USDA and CDE
regulations.
Thank you for your consideration of this request. Should you have any questions or
concerns, please contact me at (
Sincerely,
Cindy Graber
Summer Food Service Program Coordinator
SITE NUMBER -:-
CITY OF LONG BEACH
DEPARTA'IENT OF PARKS, RECREATION AND MARINE
SUI DI,ER FOOD SERVICE PROGRAM PRE -OPERATIONAL VISIT
SITE NAME:
DATE OF VISIT:
ADDRESS:
CONTACT PERSON:
SITESUPERVISOR:
TYPE OF SITE:
CHURCH RECREATIONALCENTER
PARK
OTHER
ARE THE PRESENT FACILITIES ADEQUATE FOR AN ORGANIZED MEAL SERVICE?
YES NO IF NO., PLEASE EXPLAIN;
DOES THE SITE HAVE:
SHELTER FOR BAD WEATHER?
A PLACE TO STORE LEFTOVER MEALS?
A PLACE TO STORE MEAL RECORDS?
WHAT TYPE OF ORGANIZED ACTIVITIES ARE PLANNED AT THIS SITE?
LOCATION OF MEAL SERVICES AREA?
ARE THERE ADEQUATE SANITATION CONTAINERS?
HOW MANY STAFF/ VOLUNTEERS WILL BE ASSISTING WITH THE SFSP? - IF
AVAILABLE LIST NAMES AND FUNCTIONS:
COMMENTS:
SIGNATURE OF SFSP MONITOR/COORDINATOR DATE
3/94
t
r CITY OF LONG BEACH DEPARTMENT OF PARKS, RECREATION AND MARINE
SITE VISIT FORM
DATE OF VISIT
Sponsor
Site No.
Site Name
Address City
Arrival.Time
OPERATIONAL OBSERVATIONS
Site Supervisor
SIGNATURES
Agreement No.
Start Date
Telephone No.
State _
Departure Time _
Zip Code
CORRECTIVE ACTIONS TAKEN (IF.NECESSARY)
Sponsor Monitor/Representative
SFSP 1992
Approved Date
SFSP Coordinator
Sponsor
Site No..
Site Name
Address
Arrival Time
t
CITY OF LONG BEACH 15EPARTMENT OF PARKS, RECREATION AND MARINE
SITE VISIT FORM
DATE OF VISIT•:'
Agreement No.
Start Date
Telephone No.
City State Zip•Code
Departure Time
OPERATIONAL OBSERVATIONS
Site Supervisor
Approved /
SFSP Coordinator
CORRECTIVE ACTIONS TAKEN (IF NECESSARY)
SIGNATURES
Sponsor Monitor/Representative
Date
SFSP 1992
SITE NUMBER
CITY OF LONG BEACH DEPARTMENT OF PARKS, RECREATION & MARINE
SUMMER FOOD SERVICE PROGRAM MONITOR REVIEW
DATE OF VISIT
PART A: SITE INFORMATION
B: MEAL SERVICE - Actual
time of meal service
1.
Site Name
2.
Site Supervisor
3.
Meal Type
4.
Meal delivery time
5.
Monitor's arrival time
6.
Monitor's departure time
7.
Approved meal service time
8.
Approved Cap
9.
Today's menu
Leftovers or borrowed
10.
------------------------------------------------------------------------------------------------------
PART
B: MEAL SERVICE - Actual
time of meal service
Number
Number
1.
Meals ordered
7.
Meals served as 2nd
2.
Meals delivered
S.
Total meals served (6+7)
3.
Unacceptable meals
9.
Total leftovers
4.
Leftovers or borrowed
10.
Total children present
5.
Available meals (2-3+4)
11.
Any children not served
6.
Meals served as 1st
12.
Comments
----------------------------
PART C: VIOLATIONS OBSERVED
Number Number
1. Meals served to adult 4. Meals not served as a unit
(over 1S yrs) 5. Meals served over CAP
2. Meals taken off site 6. Other violation
3. Meal time violation 7. Acceptability of Meal
*Corrective action taken
PART D: SITE RECORDS
Yes No
1. Is the Non -Discrimination Poster posted?
2. Has the SFSP Site Supervisor attended training session? Date
3. Does Site Supervisor have a Site Supervisor Handbook?
4. Are meal orders and Daily Site Sheets maintained in an orderly manner?
5. Does the SFSP Site Supervisor know how to adjust meal orders?
6. Comments
I certify that the information provided above is true and complete.
Monitor: Date
I acknowledge receipt of a copy of this form.
SFSP Site Supervisor Date
Revised 6/96
SITE NUMBER`
'CITY OF LONG BEACH DEPARTMENT OF'PARKS, RECREATION & MARINE
SUMMER FOOD SERVICE PROGRAM MONITOR REVIEW
DATE.,10F VISIT
----------------------------------- ------------------------------------------------------------------
PART A: SITE INFORMATION
1. Site Name 2. Site Supervisor
3. Meal Type 4. Meal delivery time
i
5. Monitor's arrival time 6., Monitor's departure time
7. Approved meal service time 8. Approved Cap
9. Today's menu
------------------------------------------------------------7-----------------------------------------
PART B: MEAL SERVICE - Actual time of meal
service
-� Number
Number
1.
Meals ordered
7.
Meals served as 2nd
2.
Meals delivered
8.
Total meals served (6+7)
3.
Unacceptable meals
9.
Total leftovers
4.
Leftovers or borrowed
10.
Total children present
5.
Available meals (2-3+4)
11.
Any children not served
6.
Meals served as 1st
12.
Comments
----------------------------
PART C: VIOLATIONS OBSERVED
Number Number
1
1: Meals served to adult 4. Meals not served as a unit
(over 18 yrs) 5. Meals served over CAP
2. Meals taken off site 6. Other violation i
3. Meal time violation 7. Acceptability of Meal
*Corrective action taken
------------------------------------------------------------------------------------------------------
PART D: SITE RECORDS
Yes No
1. Is the Non -Discrimination Poster osted? 4
2. Has the SFSP Site Supervisor attended training session? Date
3. Does Site Supervisor have a Site Supervisor Handbook?
4. Are meal orders and Daily Site Sheets maintained in an orderly manner?
5. Does the SFSP Site Supervisor know how to adjust meal orders?
6. Comments
I certify that the information provided above is true and complete.
Monitor: 1 Date
I acknowledge receipt of a copy ofithis,form.
SFSP Site Supervisor
Revised 6/96
l
Date
CITY OF LONG BEACH DEPARTMENT OF PARKS, RECREATION A MARINE
SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
ETHNICITY DATA FORM
SITE NAME:
SITE NUMBER:
RACIAL/ETHNIC CATEGORY
NUMBER OF PARTICIPATING
CHILDREN
AMERICAN INDIAN OR ALASKAN
A person having origins
in any of the original
peoples of North America
and who maintains
cultural identification
through tribal
affiliation or community
recognition including
Aleuts and Eskimos.
ASIAN OR PACIFIC ISLANDER
A person having origins
in any of the original
peoples'of•the Far East,
Southeast Asia, the•
Indian subcontinent or
the Pacific Islands.
This includes China,
Japan, Korea, the
Philippines Islands,
Cambodia and Samoa.
BLACK (Not of Hispanic origin)
A person having origins
in the black racial
groups of Africa.
HISPANIC
A person of Mexican,
.Puerto Rican, Cuban,
Central or South
American, or other
Spanish culture or
origin, regardless of
race.
WHITE (Not of Hispanic origin)
A person having origins
in any of the original
people of Europe, North
Africa or the Middle
East.
SIGNATURE OF SFSP MONITOR DATE
Revise 4/94
Tally Sheet
First Meals Served Continued:
251 252 253 254 255 256 257 258 259 260 261 262 263 264 265
266 267 268 269 270 271 272 273 274 275 276 277 278 279 280
281- 282 283 284 285 286 287 288 289 290 291 292 293 294 295
296 297 298 .299 300 301 302 -303. 304 305 306 307 308 309 310
311 '312 313 314 315 316 317 318 '319 320 321 322 323 324 325
326 327 328 329 330 331 332 333 334 335 336 337 338 339 340
341 342 343 344 345 346 347 348 349 350 351 352 353 354 355
356 '357 358 359 360 361 362 363 364 365 366 367 368 369 370
371 372 373 374 375 376 377 378 379 380 381 382 383 384 385
386 387 388 389 390 391 .392 393 394 395 396 397 398 399 400
401 402 403 404 405 406 407 408 409 410 411 412 413 414 415
416 417 418 419 420 421 422 423 424 425 426 427 428 429 430
431 432 433 434 435 436 437 438 439 440 441 442 443 444 445
446 447 448 449 450 451 452 453 454 455 456 457 458 459 460-
461 462 -463 464..465 466 467 .468 469 470 471 472 473 474 475
476 477 478 479 480 481 482 483 484* 485 486 487 488 489 490
491 492 493 494 495 496 497 498 499 500
DAILY MEAL TALLY FORM
Date:
Site Name:
Meal Type:
Site Number:
Delivery Time:
Total Meals Ordered (refer of LBUSD Meal Order Form for this date):
First Meals Served:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
61 62 63 64 65 66 67 68 69 70 71 72 73 74 75.76 77 78 79 80
81 82 83 84* 85 86 87 88 89 90 91 92 93. 94 95 96 97 98 99 100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145 '
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230.
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
SECOND MEALS TO CHILDREN:
1 2 3 4 5 6 7 8 9 10
TOTAL FIRST MEALS
TOTAL SECOND MEALS +
TOTAL MEALS SERVED =
TOTAL UNACCEPTABLE MEALS -
TOTAL LEFTOVER MEALS (received meals - unacceptable meals)
Tally Sheet
SITE #
CITY OF LONG BEACH DEPARTMENT OF PARKS, RECREATION & MARINE
SUMMER FOOD SERVICE PROGRAM FOR CHILDREN
DATE:
SITE PHONE #:
MEALS ORDERED
I TIME OF DELIVERY
MEALS RECEIVED
UNACCEPTABLE MEALS* (explain below)
MEALS SAVED OR BORROWED**
I TOTAL MEALS AVAILABLE
CHILDREN IN ATTENDANCE
1ST MEAL SERVED
2ND MEAL SERVED
I TOTAL MEALS SERVED
LEFTOVER MEALS***
*What was unacceptable about the meals?
SITE NAME:
SITE SUPERVISOR:
**If meals were borrowed what site where they received from?
Site name: Site Number:
***What was done with the leftover meals? ❑ Saved for the next day:
❑ Sent to another SFSP site? (Site name:
Comments:
❑ Destroyed:
Site number: )
RECREATION STAFF HOURS (to be completed at the end of each meal service)
certify that the information provided above is true and complete to the best of my knowledge.
SFSP SITE SUPERVISOR SIGNATURE:
White: SFSP Administrative Office / Yellow: Site File
rev. 6/99
SITE #
° CITY OF LONG BEACH DEPARTMENT 6F PARKS, RECREATION & MARINE
S,UMMER`FOOD SERVICt POGRAM FOR CHILDREN
DATE: �. t' 'SITS NAME:.'
SITE PHONE #: SITE.SUPERVISOR:
MEALS ORDERED
TIME OF DELIVERY
MEALS RECEIVED
UNACCEPUBLE MEALS* (explain below)
MEALS SAVED OR, BORROWED**
TOTAL MEALS AVAILABLE
CHILDREN IN ATTENDANCE
1ST EAL SERVED
2ND MEAL SERVED
.:TOTAL MEALS SERVED
-LEFTOVER MEALS***'
*What was unacceptable about the meals?.
**If meals were borrowed what site where they received from?
Site name: Site Number: -
***What was bone with the leftover meals? ❑ Saved for the next day:
d Sent to another SFSP site? (Site name:
Comments:
O Destroyed: `?t
Site number:
RECREATION STAFF HOURS (to be completed at the end of each meal service)
BTAI=F. ASIS.....
...... ::.::::::.:.: :.::.;:LiNG1•; IrtR :::.::::.:. 't?'i'AL::I#i5't3..#B.:261T� fit? :.::::
I certify that the information provided above is true and complete to the best of my knowledge.
SFSP SITE SUPERVISOR SIGNATURE:
White: SFSP Administrative,Office /Yellow: Site File
rev. 6/99