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Dss Form 1613-1 - Internal Controls - South Carolina Department Of Social Services - Child And Adult Care Food Program

South Carolina Department of Social Services

Child and Adult Care Food Program

INTERNAL CONTROLS

Institution:

Agreement No.:

Information Current as of:

Accounting System

1. Does the institution use a paper ledger or accounting software?

Paper Ledger

Accounting Software

2. If accounting software is used, please list what type:

3. What back-up system is used in the event that the accounting system is not available (theft, property damage,

system crash, etc.)?

4. Will the institution use a separate bank account for CACFP monies?

Yes

5. How will CACFP funds be tracked separately from other institutional funds?

(CACFP institutions are required to either use the

Summary of Expense form or set up a CACFP fund account within the institutions’s accounting system that will track both the revenue and

expenses for the food service.)

6. What procedure(s) do you use to ensure accuracy when reviewing CACFP records?

7. If your organization participates in any other federally funded programs, please check the appropriate box(es) and

specify the amount received per month in the space provided. If you check other, please specify program(s) name in

the space provided.

ABC $

Medicaid $

Other $

Program Name:

Other $

Program Name:

Name of Authorized Representative:

Signature of Authorized Representative:

Date:

DSS Form 1613-1 (JUN 10)

Dss Form 1613-1 - Internal Controls - South Carolina Department Of Social Services - Child And Adult Care Food Program