NOTIFICATION LETTER TO GRASSROOTS ORGANIZATIONS - Nutrition Department - ISBE 67-58 (9/24)

Oct 10, 2026

Notification letter for grassroots organizations to provide Civil Rights Requirement details for participation in the Child and Adult Care Food Program (CACFP). Explains that CACFP is a Federal program offering monetary reimbursement to facilities to provide healthier meals and snacks for children, and requests key institution and facility information, including dates, operating times, and facility addresses. Includes nondiscrimination assurances and instructions for alternative communication and for filing program discrimination complaints through Form AD-3027 or USDA contact channels.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Civil Rights Requirement and Purpose

CACFP Participation Notification

Required Organization and Facility Information

Nondiscrimination Statement and Accessibility

How to File a Discrimination Complaint

NOTIFICATION LETTER TO GRASSROOTS ORGANIZATIONS 100 North First Street, W-270 Springfield, Illinois 62777-0001 NUTRITION DEPARTMENT Instructions: Civil Rights Requirement—Enter the correct information found in parenthesis and in the chart below. Provide this information to grassroots organizations that interact directly with individuals who may benefit from your services. Grassroots organizations include advocacy organizations, community action programs, civic organizations, migrant groups, religious organizations, neighborhood councils, or other similar groups. This information can be communicated by Internet, newspaper article, radio and television announcements, letters, leaflets, brochures, or bulletins. (Grassroots Organization’s Name) (Date) (Organization’s Address) (City, State, ZIP Code) Dear Sir or Madam: This is to notify your organization that (Name of CACFP Institution and Complete Address) plans to participate in the Child and Adult Care Food Program (CACFP) . CACFP is a Federal program that provides monetary reimbursement to facilities so they can offer healthier meals and snacks to children. CACFP plays a vital role in providing for the nutritional needs of children. We plan to offer CACFP beginning , from in a: (Anticipated Begin Date) (Time Open-Time Close) Licensed child care center, Head Start, or Pre-K program Supervised before and/or after-school program Homeless shelter Name and Addresses of Facilities: _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity. Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g. , Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: [https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint](https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint)Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by: 1. mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; or 2. fax: (833) 256-1665 or (202) 690-7442; or [3.](3. email:)[ email:](3. email:) [program.intake@usda.gov](program.intake@usda.gov) This institution is an equal opportunity provider. Please share this information

FAQs

What program is the notification letter related to?

The letter notifies organizations about participation in the Child and Adult Care Food Program (CACFP). It states CACFP is a Federal program providing monetary reimbursement so facilities can offer healthier meals and snacks to children.

What information must grassroots organizations provide in the letter’s placeholders?

Organizations must enter the grassroots organization’s name, date, and address, along with the CACFP institution name and complete address, anticipated begin date and operating hours, and the names and addresses of participating facilities.

How can someone file a discrimination complaint for this program?

A complainant should complete Form AD-3027 (USDA Program Discrimination Complaint Form) obtained online, from any USDA office, by calling the listed number, or by writing to USDA. The submission must include the complainant’s contact details and a written description of the alleged discriminatory action with sufficient detail.

Oct 10, 2026

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