[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-536935-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-536935-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","child-and-adult-care-food-program-day-care-home-sponsoring-organization-application-instructions-and-certification","Child and Adult Care Food Program Day Care Home Sponsoring Organization Application - Instructions and Certification","","Application instructions and certification form for the Illinois Child and Adult Care Food Program (CACFP). Requests sponsoring-organization identifying details, authorized representative and contact information, program operation dates, mailing and physical addresses, and FEIN. Includes selection sections for payment advance options and program categories, plus audit and publicly funded program disclosure requirements. Requires responses to fiscal-year audit questions and a compliance certification confirming integrity and adherence to Permanent Agreement responsibilities, with a noted $25,000 embezzlement-related fine.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/child-and-adult-care-food-program-day-care-home-sponsoring-organization-application-instructions-and-certification/536935/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/child-and-adult-care-food-program-day-care-home-sponsoring-organization-application-instructions-and-certification/536935.png","ImageObject",300,407,{"name":42,"@type":43},"Mary Man","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-10","2026-10-10",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What information must the sponsoring organization provide on the application?","Question",{"text":63,"@type":64},"The form requires the sponsoring organization’s complete official name and address, county for physical and mailing addresses, FEIN, authorized representative and contact person names and titles, and telephone and email details.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What audit questions must the organization answer?",{"text":68,"@type":64},"The organization must confirm whether it expends $750,000 or more in federal funds during its fiscal year and agree to submit required single-audit or documentation within the specified timeframe, including submission to the Federal Audit Clearinghouse.",{"name":70,"@type":61,"acceptedAnswer":71},"What does the certification require the sponsor representative to affirm?",{"text":72,"@type":64},"The sponsor certifies the information is true and correct, confirms the institution will comply with the Permanent Agreement rights and responsibilities, and agrees that key individuals have not been convicted for activities indicating lack of business integrity during the past seven years, with stated consequences for false certifications.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},536935,1791689550,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":30,"preview_page_count":4},7421720224475,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Use your \"Mouse\" or \"Tab\" key to move through the fields, and the mouse to mark check boxes. After completing last field, save document to hard drive to make future updates or click print button.  \n\n| FISCAL YEAR |\n| --- |\n| AGREEMENT NUMBER |\n\nILLINOIS STATE BOARD OF EDUCATION  \nNutrition and Wellness Programs Division  \n100 North First Street, W-270  \nSpringfield, Illinois 62777-0001  \n800-545-7892  \nFAX: 217-524-6124 TTY: 217-782-1900  \nChild and Adult Care Food Program DAY CARE HOME SPONSORING ORGANIZATION APPLICATION  \nINSTRUCTIONS: Submit all copies to the Illinois State Board of Education (address above).  \n1. NAME AND ADDRESS OF SPONSORING ORGANIZATION (Provide complete official name, street address, city, and zip. )  \n3. COUNTY FOR PHYSICAL ADDRESS  \n5. NAME OF AUTHORIZED REPRESENTATIVE  \n6. TELEPHONE (Include Area Code) (Ext. ) FAX (Include Area Code)  \n7. NAME OF CONTACT PERSON (If same as above, write same. )  \n8. TELEPHONE (Include Area Code) (Ext. ) FAX (Include Area Code)  \n9. FEIN NUMBER (Federal Employee ID\\#)  \n11. SPONSOR ELECTS TO RECEIVE (Check (􀀗) only one box. )􀃂  \n12. DAY CARE HOME SPONSOR REQUEST FOR ADVANCE (Check (􀀗) only one box. ) ADMINISTRATIVE PAYMENT 􀃂  \n13. FEWDHEATRALTYFPUENDOFSE/ONFTIFTICYEISOYFOMANAGEMUR ORGANEINTZATAINDON?B(UCDGEheckT(,A􀀗)-1a3p3pREQropriUateIRaEMreaE)NTS 􀃂  \n2. MAILING ADDRESS (If mailing address is the same as street address, write “Same.”)  \n4. COUNTY FOR MAILING ADDRESS  \nTITLE OF AUTHORIZED REPRESENTATIVE  \nE-MAIL ADDRESS  \nTITLE OF CONTACT PERSON  \nE-MAIL ADDRESS  \n10. PROGRAM OPERATION DATES  \nBEGINNING DATE   ENDING DATE   \nCash in Lieu of Government-Donated Commodities  \nFull Administrative Advance Payment  \nNot-For-Profit Faith Based  \nNot-For-Profit Secular  \nGovernment-Donated Commodities  \nNo Administrative Advance Payment  \nPublic Federal Agency  \n14. AUDIT INFORMATION  \nWhat is the end date of your organization's fiscal year?  \nNot complying with these audit requirements will result in determining your organization seriously deficient.  \n YES  NO 1. Will your organization expend $750,000 or more in federal funds during your organization's established fiscal year?  \n YES  NO 2. Do you agree to send this agency a copy of your organization's single audit, program-specific audit or appropriate written documentation as specified  \nin 2CFR200 within 30 days after receipt of auditor's report or within nine months of the end of the fiscal year, whichever is earlier?  \n YES  NO 3.Do you agree to submit a copy of the single audit to the Federal Audit Clearinghouse?  \n15. LIST PUBLICLY FUNDED PROGRAMS YOUR INSTITUTION (AND KEY INDIVIDUALS) HAS PARTICIPATED IN DURING THE PAST SEVEN YEARS.  \n YES  NO 1. Illinois State Board of Education-Child and Adult Care Food Program or other funding  \n YES  NO 2. Illinois Department of Human Services-Subsidized Child Care Benefits, Head Start or other funding  YES  NO 3. Department of Children and Family Services-Protective Care or other funding  \n4. Other    \n5. Other    \n6. Other    \n YES  NO 7. During the past seven years the institution (or key individuals involved in the management of the institution) was declared ineligible to participate in any publicly funded program because of violating that program's requirements.  \n YES  NO If yes, has the institution (or key individuals) been fully reinstated in or determined eligible for funding for that public program?  \n YES  NO If yes, mail a copy of the official documentation of that reinstatement to this agency and agree to the certification statement below.  \nIf no, your organization is not eligible to participate in CACFP. Please do not submit this application.  \n16. CERTIFICATION  \nI CERTIFY the information on this document is true and correct to the best of my knowledge, and this institution will comply with the rights and responsibilities outlined in the Permanent Agreement. I AGREE that neither the institution nor any ofits key individuals has been convicted during the past seve","cbCaiteE7lBaIlZB","https://ap.wps.com/l/cbCaiteE7lBaIlZB","pdf",276401,"English","# Child and Adult Care Food Program - Day Care Home Sponsoring Organization Application\n## Name and Address of Sponsoring Organization\n## Program Operation Dates\n## Sponsor Advance Payment Selection\n## Audit Information\n## Publicly Funded Programs (Past Seven Years)\n## Certification","[{\"question\":\"What information must the sponsoring organization provide on the application?\",\"answer\":\"The form requires the sponsoring organization’s complete official name and address, county for physical and mailing addresses, FEIN, authorized representative and contact person names and titles, and telephone and email details.\"},{\"question\":\"What audit questions must the organization answer?\",\"answer\":\"The organization must confirm whether it expends $750,000 or more in federal funds during its fiscal year and agree to submit required single-audit or documentation within the specified timeframe, including submission to the Federal Audit Clearinghouse.\"},{\"question\":\"What does the certification require the sponsor representative to affirm?\",\"answer\":\"The sponsor certifies the information is true and correct, confirms the institution will comply with the Permanent Agreement rights and responsibilities, and agrees that key individuals have not been convicted for activities indicating lack of business integrity during the past seven years, with stated consequences for false certifications.\"}]","Child and Adult Care Food Program Day Care Home Sponsoring Organization Application - Instructions and Certification | PDF",1791603618]