Form FNS-663 FOOD DISTRIBUTION COMMODITY ACCEPTABILITY PROGRESS (CAP)

Food Distribution Programs

FNS-663

Business

OMB: 0584-0293

Document [pdf]
Download: pdf | pdf
FORM 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 Typeapplication/pdf
File TitleJetForm:FNS- 663.IFD
Authorlhibbitts
File Modified2009-10-29
File Created2007-06-18

© 2024 OMB.report | Privacy Policy