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pdfFORM APPROVED OMB NO. 0584-0293
Expiration Date: XX/XX/XXXX
U.S. DEPARTMENT OF AGRICULTURE
FOOD AND NUTRITION SERVICE
FOOD DISTRIBUTION
COMMODITY ACCEPTABILITY PROGRESS (CAP)
REPORT
(FOR INSTITUTIONS AND HOUSEHOLDS)
NOTICE: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0293. The time required to
complete this information collection is estimated to average 50 hours per response, including the time required by the State Distributing
Agency (SDA)/Indian Tribal Organization (ITO) and recipient agencies (RAs)/households (HHS) for: (1) reviewing instructions; (2)
searching existing data sources; (3) collecting, consolidating and maintaining the survey data received from RAs/HHs; and (4)
submitting this report to the appropriate USDA Regional Office by the specified due date.
PURPOSE OF REPORT: The information provided in this report along with nutrition objectives, budgetary factors, and marketing
indicators will be used by USDA to: (1) make purchasing decisions regarding the forms and quantities of commodities to procure for
program participants for the following school/fiscal year; (2) develop new products desirable to program participants; (3) improve
commodity specifications to ensure that USDA commodities are acceptable to RAs and HHs; and (4) provide commodities which will
help program participants meet the Dietary Guidelines.
PLEASE COMPLETE THIS REPORT AND RETURN IT TO YOUR FNS REGIONAL OFFICE
BY APRIL 30
PART I - DISTRIBUTING AGENCY (DA)/INDIAN TRIBAL ORGANIZATION (ITO) INFORMATION
1. STATE NAME
2. DA/ITO 3 DIGIT CODE
3. REPORT MONTH/YEAR:
4 . PROGRAM IDENTIFICATION (Place an " X" Next To One Program ONLY)
Child & Adult Care Food Program
Commodity Supplemental Food Program
APRIL
Food Distribution Program On Indian Reservations
CALENDAR YEAR
National School Lunch Program
Nutrition Services Incentive Program
5A. NUMBER OF ELIGIBLE RAs/HHs
5B. NUMBER OF RAs/HHs SURVEYED
FORM FNS-663 (3-98) Previous Edition Obsolete
Electronic Form Version Designed in Adobe 7.1 version
SBU
5C. NUMBER OF RESPONDENT RAs/HHs
PAGE 1 of 9
PART II - PRODUCT ACCEPTANCE
6. "TOP 10" MOST HIGHLY ACCEPTABLE PRODUCTS - BY FOOD GROUP. Below is a list of commodities expected to be available in USDA food distribution programs
during this reporting period. FOR EACH FOOD GROUP, you may "X" up to TEN commodities receiving the "HIGHEST" evaluation scores by your RAs/HHs for this
program. If any of your "Top 10" commodities are not listed, please add the name(s) of the product in the space provided at the end of the appropriate food group. NOTE:
The DA/ITO may select fewer than 10 food items if no additional products were mentioned as frequently as the commodities selected for a particular food group. Please see
the example given in the instructions on the back of this form. Also, the item Nos. shown below correspond with the commodity names to be used by USDA when tabulating
the responses for item 6 ONLY. Also, please note that these item Nos. are NOT the same as the commodity codes printed in the FNS Commodity File Listing and MUST
appear exactly as specified below for each " Top 10" item to be included on this report.)
ITEM
NO.
MEAT
TOP 10 ITEM
PRODUC
TS ("x") NO.
TOP 10
PRODUC
TS ("x")
MEAT
101
BEEF 1 FRZ FINE GROUND 1# CHUBS
125
PORK FRZ GROUND 36 # CTN
102
BEEF 36 FRZ GROUND 36# CTN
126
PORK PATTIES RIB-SHAPED CK-SOC 36 # CTN
103
BEEF CABBED W/NJ 29 OZ CAN
127
PORK SAUSAGE PATTIES 1.5 OZ 36# CTN
104
BEEF COARSE GROUND 60# CTN
128
PORK SAUS PATTIES CK 3 OZ 36# CTN
105
BEEF MEATBALL STEW 15, 24 OZ CANS
129
PORK SAUS PATS CK 1.3 OZ-SOC 36# CTN
106
BEEF PATS ALL BEEF 36 # CTN
130
PORK SAUS PATS CK 2.6 OZ-SOC 36# CTN
107
BEEF PATS ALL BEEF COOKED-SOC 36# CTN
131
SALMON NUGGETS MINCED 40# CTN
108
BEEF PATS LEAN 36 # CTN
132
SALMON PINK 24-48/14.75 OZ CANS
109
BEEF PATS VPP 36 # CTN
133
TUNA CHK LT/WTR 12.25, 12.5, 66.5 OZ CNS
110
BEEF PATS VVP COOKED-SOC 36 # CTN
134
TURKEY BURGERS 36 # CTN
111
BEEF ROASTS SELECT/CHOICE 40# CTN
135
TURKEY GROUND 4/10# CTN
112
CHICKEN BREADED 30# CTN
136
TURKEY HAMS 95 % FAT FREE 40 # CTN
113
CHICKEN CANNED 29, 50 OZ CANS
137
TURKEY ROASTS 32, 48# CTN
114
CHICKEN CUT-UP 40# CTN
138
TURKEY CANNED 24/29 OZ CAN
115
CHICKEN DICED 40# CTN
139
TURKEY SAUSAGE CHUBS 30# CTN
116
CHICKEN DRUMSTICKS 40# CTN
140
TURKEY SAUSAGE LINKS-SOC 40# CTN
117
CHICKEN LEG QTRS 40# CTN
141
TURKEY SAUSAGE PATTIES-SOC 36# CTN
118
CHICKEN NUGGETS CK-SOC 30# CTN
142
TURKEY WHOLE FRZ 30 , 60 # CTN
119
CHICKEN PATTIES CK-SOC 30# CTN
143
120
CHICKEN THIGHS 4/10# CTN
144
121
HAM COOKED BONELESS 40# CTN
122
MEAT CND LUNCHEON 24, 30 OZ CANS
123
PORK CANNED W/NJ 29 OZ CAN
201
BEANS BABY LIMA 6/#10 CAN
124
PORK BULK COARSE GROUND 60# CTN
202
BEANS BABY LIMA 2, 25, 100# BAGS
MEAT ALTERNATES
PAGE 2 OF 9
PART II - PRODUCT ACCEPTANCE
MEAT
TOP 10 ITEM
PRODUC
TS ("x") NO.
203 BEANS BLACKEYE 6/#10 CAN
230
204 BEANS BLACKEYE 2, 25, 100# BAGS
231 CHEESE MOZZ LITE 5.2, 6, 7.5, 20# LVS
205 BEANS BLACK TURTLE 6/10 CAN
232
CHEESE MOZZ SHRED LITE 15#, 45#
206 BEANS BLACK TURTLE 2, 25# BAGS
233
CHEESE MOZZ UNFRZ 5.2, 6, 7.5, 20# LVS
207 BEANS GARBANZO 6/#10 CAN
234
CHEESE PROCESS 6/5# LVS
208 BEANS GARBANZO 2, 25, 100# BAGS
235
CHEESE PROCESS SLICED 6/5# LV S
209 BEANS GRT NORTH 6 /#10 CAN
236
EGG MIX 48/6 OZ PKG. 4/10# BAG
210 BEANS GRT NORTH 2, 25 # BAGS
237
EGGS FROZEN WHOLE 6/5# CTN
211 BEANS LENTILS 2# BAGS
238
PEANUT BUTTER CHUNKY 6/#10 CAN
212 BEANS PINK 6/#10 CAN
239
PEANUT BUTTER SMITH 24/2#,6/#10 CANS
213 BEANS PINK 2, 25, 100# BAGS
240
PEANUT GRANULES 6/#10 CAN
214 BEANS PINTO 6/10# CAN
241
PEANUTS ROASTED 24/12 OZ CAN
215 BEANS PINTO 2, 25, 100# BAGS
242
WALNUT PIECES 30# CTN
216 BEANS NAVY PEA 2, 25, 100# BAGS
243
217 BEANS RED KID 6/10# CAN
244
218 BEANS RED KID 2, 25, 100# BAGS
245
ITEM
NO.
MEAT
TOP 10
PRODUC
TS ("x")
CHEESE MOZZ FRZ 5.2, 6, 7/5, 203 LVS
219 BEANS RED KID LT 2, 25, 100# BAGS
FRUITS
220 BEANS REFRIED 6/#10, #300 CANS
221 BEANS SMALL RED 6/#10 CAN
301
APPLE JUICE 12/ 46 OZ CAN
222
BEANS SMALL RED 2, 25, 100# BAGS
302
APPLE SLICES 6/#10 CAN
223
BEANS SMALL WHITE 2, 25# BAGS
303
APPLESAUCE 6/#10, #303 CANS
224
BEANS SPLIT PEAS 2, 25# BAGS
304
APPLES FRESH 40 #
225
BEANS VEGETARIAN 6/#10, #300 CANS
305
APRICOTS 6/#10, 303 CANS
226
CHEESE CHEDDAR BARREL 500#
306
BLUEBERRIES FRZ 10#, 30# CTN
227
CHEESE CHEDDAR REGULAR 40# CTN
307
CHERRIES FRZ 30# CTN
228
CHEESE CHEDDAR REDUCE-FAT 40# CTN
308
CHERRIES IQF 40 # CTN
229
CHEESE CUT CHEDDAR 4/10# LVS
309
CHERRIES RED 10 WATER PCK 6/# 10 CAN
PAGE 3 OF 9
PART II - PRODUCT ACCEPTANCE
ITEM
NO.
FRUIT - CONT'D
TOP 10 ITEM
PRODUC
NO.
TS ("x")
FRUIT - CONT'D
310
FRUIT COCKTAIL #303 CAN
337
PRUNES PITTED 1# PKG
311
GRAPE JUICE 12/46 OZ CAN
338
RAISINS 24-48/1# PKG 30# CTN
312
GRAPEFRUIT JUICE 12/46 OZ CAN
339
STRAWBERRIES EQF FRZ 30# CTN
313
MIXED FRUIT 6/#10 CAN
340
STRAWBERRIES SLICED FRZ 30# CTN
314
ORANGE JUICE 12/46 OZ CAN
341
315
ORANGES FRESH 34, 39# CTN
342
316
PEACH CUPS FRZ 4 OZ CUP
317
PEACHES CLING CND 6/#10, #2.5, #303 CNS
318
PEACHES CLING DICED 6/#10 CAN
401
ASPARAGUS CND 24#300 CAN
319
PEACHES CLING SLICES 6/#10 CAN
402
ASPARAGUS FRZ 6/5# PKG
320
PEACHES FREE DICED 6/#10 CAN
403
BEANS GRN CND 6/#10,#300,#303 CANS
321
PEACHES FREE QTRS 6/#10 CAN
404
BEANS GREEN FRZ 30# CAN
322
PEACHES FREE SLICES 6/#10 CAN
405
CARROT STICKS FRESH 6/5# PKG
323
PEACHES FRZ SLICES 20# CTN
406
CARROTS CND #300, #303 CAN
324
PEARS CND 6/#10, #2.5, #303 CANS
407
CARROTS PRE-CUT FRH 6/5# PKG
325
PEARS CND DICED 6/#10 CAN
408 CORN FRESH YELLOW 48/5INCH EARS
326
PEARS CND HALVES 6/#10 CAN
409
CORN FRZ 30# CTN
327
PEARS CND QTRS 6/#10 CAN
410
CORN WHL KERNEL LIQ 6/#10,#300 CANS
328
PEARS CND SLICES 6/#10 CAN
411
CORN WHL KERNELVAC 6/#10 CAN
329
PEARS FRESH #45 CTN
412
CORN CRM CND 6/#10,#300,#303 CANS
330
PINEAPPLE JUICE 12/46 OZ
413
PEAS 6/#10, #300, #303 CANS
331
PINEAPPLE CND 24/#2, 6/#10 CANS
414
PEAS FRZ 30# CTN
332
PINEAPPLE CHUNKS 6/#10 CAN
415
POTATO FLAKES DHY 1#, 6/5# PKG
333
PINEAPPLE TIDBITS 6/#10 CAN
416
POTATO WEDGES 6/5# CTN
334
PLUMS 6/#10, #303 CANS
417
POTATOES FRESH 50# CTN
335
PLUMS PITTED 6/#10 CAN
418
POTATOES OVEN FRY 6/5# CTN
336
PRUNES 1# PKG
419
POTATOES ROUND 6/5# BAG
TOP 10
PRODUC
TS ("x")
VEGETABLES
PAGE 4 OF 9
PART II - PRODUCT ACCEPTANCE
ITEM
NO.
VEGETABLES - CONT'D
TOP 10 ITEM
PRODUC
NO.
TS ("x")
TOP 10
PRODUC
TS ("x")
GRAINS/BREADS - CONT'D
420
POTATOES WHOLE #300, #303 CANS
512
FLOUR WHOLE WHEAT 10, 50# BAGS
421
PUMPKIN CND #300, #303 CANS
513
FORMULA INF LIQ 12-24/13 FL OZ CANS
422
SPAGHETTI SAUCE MEATLESS 6/#10 CAN
514
FORMULA INF POWDER 6-12/1# PKG
423
SPINACH #300, #303 CANS
515
FORMULA INF SOY 12-24/13 FL OZ CANS
424
SWT POTATOES 6/#10,#300,#303 CANS
516
FORMULA INF SOY DRY 6/14 OZ CAN
425
TOMATO JUICE 12/46 OZ CAN
517
FORMULA INF SOY POWDER 6/#1,12/1# CAN
426
TOMATO PASTE 6/10#, 55 GAL
518
GRITS CORN 5, 10, 50# BAGS
427
TOMATO SAUCE 6/10#,#300,#303 CANS
519
MACARONI 24/1#, 20# PKGS
428
TOMATOES 6/#10,#300,#303 CANS
520
MACARONI AND CHEESE 12/26 OZ PKG
429
TOMATOES DICED 6/#10 CAN
521
MACARONI ROTINI 20# CTN
430
TOMATOES FRESH 25# CTN
522
OATS ROLLED 50# BAG
431
523
RICE BROWN 25, 50# BAGS
432
524
RICE MILLED 2, 25, 50, 100# BAGS
433
525
RICE MILLED LNG GRN 50# PKG
526
SPAGHETTI 24/1#, 12/3#, 20# PKG
GRAINS/BREADS
527
501
CEREAL CORN 16, 17.5 OZ PKG
528
502
CEREAL OATS 15, 16 OZ PKG
529
503
CEREAL RICE 12, 17.5 OZ PKG
530
504
CEREAL WHEAT 16 OZ PKG
505
CEREA L INFA NT RICE 8 OZ PKG
506
CORNMEAL DEGERMED 5, 10# BAG
601
BUTTER 36/1#
507
FARINA 14 OZ PKG
602
BUTTER LITE 18/1#, 36/1# QTRS
508
FLOUR ALL PURPOSE 5, 10, 50# BAGS
603
BUTTER PATTIES 6/5#
509
FLOUR/BAKERY MIX 5# BAG
604
BUTTER OIL 55 GAL DRUM
510
FLOUR BREAD 5, 10, 50, 100# BAGS
605
HONEY 6/5# CAN 24 FL OZ BOTTLE
511
FLOUR MASA YELLOW 50# BAG
606
MILK EVAP 12-48/12 FL OZ CAN
OTHER
PAGE 5 of 9
PART II - PRODUCT ACCEPTANCE
ITEM
NO.
607
608
OTHERS - CONT'D
TOP 10 ITEM
PRODUC
NO.
TS ("x")
OTHERS - CONT'D
TOP 10
PRODUC
TS ("x")
MILK NFD INSTANT 24-6/4# CTN
OIL VEG 6/1 GAL CAN 8/48OZ BLK
609
SALAD DRESSING REDUC-CAL 4/1 GAL BTL
610
SALAD DRESSING REG 4/1 GAL BTL
611
SALSA CND 6/#10 CANS
612
SHORTENING VEG 12/3# CAN - 50# CUBE
613
SHORTENING LIQ 6/1 GAL BTL
614
SYRUP CORN 12/24 OZ PLASTIC BTL
615
616
617
618
619
620
PAGE 6 of 9
PART II - PRODUCT ACCEPTANCE (CONT'D)
7. LEAST ACCEPTABLE PRODUCTS. Please provide comments on the quality, popularity, packaging or usability for up to TEN of
the products which were NOT well received by at least 25 percent of respondent RAs or HHs. (NOTE: Where applicable, please use
the "Comment Codes" listed in Column B. You may also provide any additional comments in column C. Also, if your RAs/HHs are
generally satisfied with the commodities received during this reporting period, you may skip this item.)
A
B
C
D
ADDITIONAL COMMENTS ON
POPULARITY, QUALITY, PACKAGING
AND
SPECIFICATION CHANGES, ETC.
NUMBER OF
RESPONDENTS
MAKING
COMMENTS
COMMENT CODES
(Multiple Codes May be Used)
COMMODITY/CODE
1. Do not want; Not usable
2. Children do not like
3. Poor apperance
4. Taste/flavor/texture not
acceptable
5. Pack size too large
6. Pack size to small
7. Packaging problems
8. To much fat/grease
9. Too salty
10. Too tough
11. Strong aroma/small or sticky
when cooked
12. Turns brown/mushy or
sticky when cooked
13. Prefer canned
14. Prefer frozen
15. Too labor intensive
16. Does not melt or shred well
17. Other (explain in column C)
PAGE 7 of 9
PART II - GENERAL
8. NEW PRODUCTS - (OPTIONAL). List up to FIVE products NOT currently offered by USDA which your RAs/HHs would be
interested in receiving especially those that might help them meet the FEDERAL DIETARY GUIDELINES. Please list and rank the
items in 1-2-3 priority order with "1" representing the product "MOST" preferred by program participants. (NOTE: The DA/ITO should
review the current FNS Commodity File Listing before completing the following to make sure, for example, a particular product or
pack size is not ALREADY being offered by USDA.)
PLANNED USAGE
OF REQUESTED NEW PRODUCT
COMMODITY/CODE
PREFERRED FORM / PACK SIZE
1 - ENTREE ITEM
5 - STEWS
2 - SANDWICHES
6 - CASSEROLES
3 - SOUPS
7 - CONDIMENTS
4 - SALADS
8 - OTHER (Lists)
NUMBER OF
RESPONDENTS
REQUESTING THIS
PRODUCT
9. REMARKS AND GENERAL RECOMMENDATIONS - (OPTIONAL)
10. SIGNATURE OF STATE OFFICIAL
11. FULL TITLE OF STATE OFFICIAL
12. DATE SIGNED
PAGE 8 of 9
INSTRUCTIONS
REPORT SUBMISSION REQUIREMENTS
PART II - PRODUCT ACCEPTANCE INFORMATION
By April 30 of each, each Distributing Agency (DA) and
Indian Tribal Organization (ITO) must submit this report
(Form FNS-663) to the appropriate Food and Nutrition
Service (FNS) Regional Office, for EACH of the following
programs.
Child and Adult Care Food Program (CACFP)
6. " TOP 10" MOST HIGHLY ACCEPTABLE PRODUCTS BY FOOD GROUP, in accordance with the instructions
given in item 6 of this form. FOR EACH FOOD GROUP,
you may select or "X" up to TEN commodities receiving
the "HIGHEST" evaluation scores by your RAs/HHs.
However, the DA or ITO may select fewer than 10 items if
appropriate,. For example, based on a survey of 100
respondents, the results were as follows:
Commoditiy Supplemental Food Program (CSFP)
Food Distribution Program on Indian Reservations
(FDPIR)
National School Lunch Program (NSLP)
Nutrition Services Incentive Program (NSIP)
NOTE: This report must be completed at DA/ITO level in
coordination with eligible RAs/HHs participating in each of
the food distribution programs listed above.
PART I - DA/ITO INFORMATION
ITEM
1.
STATE NAME, Self-explanatoroy.
2.
DA/ITO 3-DIGIT CODE, Enter the 3-digit State DA code
or the first 3-digits of the ITO code assigned by FNS and
used on the FNS-52 or FNS-53 Food Order reports
when placing food order requests with the appropriate
FNS Regional Office.
3.
4.
REPORT MONTH/YEAR, Enter the applicable calendar
year next to the pre-printed report month for which the
data are being submitted.
PROGRAM IDENTIFICATION, Place an "X" in the
appropriate block next to the program for which this
report is being submitted (i.e., CACFP, CSFP, FDPIR,
NSLP or NSIP.
NOTE: Only ONE Program can be checked per report.
5A. NUMBER OF ELIGIBLE RAs/HHs, Enter the number of
eligible RAs/HHs within the State DA's/ITO's jurisdiction
which are authorized to participate in the Program
checked under item 4 (Program identification).
5B. NUMBER OF RAs/HHs SURVEYED, Enter the number
of eligible RAs or HHs which the DA/ITO surveyed before completing this report.
5C. NUMBER OF RESPONDENT RAs/HHs, Enter the number,
of eligible RAs/HHs which provided responses to the DA's/
ITO' s survey request and were used to complete this report.
NOTE: For each program, the DA's/ITO's response must
represent at least 10 percent of the total number of eligible
RAs/HHs in the State/ITO, or 100 RAs/HHs, whichever is
less.
Commodity
Number of RAs/HHs
Listing This Product
On Their Top 10 Meat List
NUMBER 1
NUMBER 2
NUMBER 3
NUMBER 4
NUMBER 5
NUMBER 6
NUMBER 7
ALL OTHER MEATS
96
94
90
89
86
85
70
(less than 50 each)
In this example, the DA/ITO had only 7 commodities which
were the most frequently identified items listed by the 100
RAs/HHs responding to the DA's/ITO's survey request.
Therefore, the DA/ITO should only "X" the top 7
commodities for the Meat Food Group. No additional
commodities would have to be selected for this Food
Group since no other products were mentioned as
frequently as the 7 items shown in this example.
7. LEAST ACCEPTABLE PRODUCTS. See instructions
provided in item 7 of this form. You may skip this item if
your RAs/HHs are generally satisfied with the
commodities received during this reporting period.
PART III - GENERAL INFORMATION
8. NEW PRODUCTS - (OPTIONAL). See instructions in item
8 of this form.
NOTE: The DA or ITO should carefully review all requests
for new products BEFORE entering them on this report to
be sure that the products or pack sizes being requested are
not ALREADY being offered by USDA including: reducedfat Cheddar Cheese, reduced-fat potatoes wedges, Low Fat Turkey Ham, which is 95 percent fat-free, smaller and
larger pack size for various products, etc.
9 . REMARKS & GENERAL RECOMMENDATIONS - (Optional),
Enter remarks, if any, and the most frequently made
recommendations for improving the USDA commodity program.
10. SIGNATURE OF STATE OFFICIAL. The approving State
Official signs the form here to certify that the information
provided is representative of the information provided by
the RAs/HHs.
11. FULL TITLE OF STATE OFFICIAL. Enter the approving
official's full title including the name of his/her DA.
12. DATE SIGNED. Self-explanatory.
PAGE 9 of 9
File Type | application/pdf |
File Title | JetForm:FNS- 663.IFD |
Author | lhibbitts |
File Modified | 2009-10-29 |
File Created | 2007-06-18 |