[Code of Federal Regulations] [Title 45, Volume 4] [Revised as of October 1, 2007] From the U.S. Government Printing Office via GPO Access [CITE: 45CFR1304.23] [Page 127-129] TITLE 45--PUBLIC WELFARE CHAPTER XIII--OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 1304_PROGRAM PERFORMANCE STANDARDS FOR THE OPERATION OF HEAD START Subpart B_Early Childhood Development and Health Services Sec. 1304.23 Child nutrition. (a) Identification of nutritional needs. Staff and families must work together to identify each child's nutritional needs, taking into account staff and family discussions concerning: (1) Any relevant nutrition-related assessment data (height, weight, hemoglobin/hematocrit) obtained under 45 CFR 1304.20(a); (2) Information about family eating patterns, including cultural preferences, special dietary requirements for each child with nutrition- related health problems, and the feeding requirements of infants and toddlers and each child with disabilities (see 45 CFR 1308.20); (3) For infants and toddlers, current feeding schedules and amounts and types of food provided, including whether breast milk or formula and baby food is used; meal patterns; new foods introduced; food intolerances and preferences; voiding patterns; and observations related to developmental changes in feeding and nutrition. This information must be shared with parents and updated regularly; and (4) Information about major community nutritional issues, as identified through the Community Assessment or by the Health Services Advisory Committee or the local health department. (b) Nutritional services. (1) Grantee and delegate agencies must design and implement a nutrition program that meets the nutritional needs and feeding requirements of each child, including those with special dietary needs and children with disabilities. Also, the nutrition program must serve a variety of foods which consider cultural and ethnic preferences and which broaden the child's food experience. (i) All Early Head Start and Head Start grantee and delegate agencies must use funds from USDA Food and Consumer Services Child Nutrition [[Page 128]] Programs as the primary source of payment for meal services. Early Head Start and Head Start funds may be used to cover those allowable costs not covered by the USDA. (ii) Each child in a part-day center-based setting must receive meals and snacks that provide at least \1/3\ of the child's daily nutritional needs. Each child in a center-based full-day program must receive meals and snacks that provide \1/2\ to \2/3\ of the child's daily nutritional needs, depending upon the length of the program day. (iii) All children in morning center-based settings who have not received breakfast at the time they arrive at the Early Head Start or Head Start program must be served a nourishing breakfast. (iv) Each infant and toddler in center-based settings must receive food appropriate to his or her nutritional needs, developmental readiness, and feeding skills, as recommended in the USDA meal pattern or nutrient standard menu planning requirements outlined in 7 CFR parts 210, 220, and 226. (v) For 3- to 5-year-olds in center-based settings, the quantities and kinds of food served must conform to recommended serving sizes and minimum standards for meal patterns recommended in the USDA meal pattern or nutrient standard menu planning requirements outlined in 7 CFR parts 210, 220, and 226. (vi) For 3- to 5-year-olds in center-based settings or other Head Start group experiences, foods served must be high in nutrients and low in fat, sugar, and salt. (vii) Meal and snack periods in center-based settings must be appropriately scheduled and adjusted, where necessary, to ensure that individual needs are met. Infants and young toddlers who need it must be fed ``on demand'' to the extent possible or at appropriate intervals. (2) Grantee and delegate agencies operating home-based program options must provide appropriate snacks and meals to each child during group socialization activities (see 45 CFR 1306.33 for information regarding home-based group socialization). (3) Staff must promote effective dental hygiene among children in conjunction with meals. (4) Parents and appropriate community agencies must be involved in planning, implementing, and evaluating the agencies' nutritional services. (c) Meal service. Grantee and delegate agencies must ensure that nutritional services in center-based settings contribute to the development and socialization of enrolled children by providing that: (1) A variety of food is served which broadens each child's food experiences; (2) Food is not used as punishment or reward, and that each child is encouraged, but not forced, to eat or taste his or her food; (3) Sufficient time is allowed for each child to eat; (4) All toddlers and preschool children and assigned classroom staff, including volunteers, eat together family style and share the same menu to the extent possible; (5) Infants are held while being fed and are not laid down to sleep with a bottle; (6) Medically-based diets or other dietary requirements are accommodated; and (7) As developmentally appropriate, opportunity is provided for the involvement of children in food-related activities. (d) Family assistance with nutrition. Parent education activities must include opportunities to assist individual families with food preparation and nutritional skills. (e) Food safety and sanitation. (1) Grantee and delegate agencies must post evidence of compliance with all applicable Federal, State, Tribal, and local food safety and sanitation laws, including those related to the storage, preparation and service of food and the health of food handlers. In addition, agencies must contract only with food service vendors that are licensed in accordance with State, Tribal or local laws. (2) For programs serving infants and toddlers, facilities must be available [[Page 129]] for the proper storage and handling of breast milk and formula. (The information collection requirements are approved by the Office of Management and Budget (OMB) under OMB Control Number 0970-0148 for paragraph (a).) [61 FR 57210, Nov. 5, 1996, as amended at 63 FR 2313, Jan. 15, 1998]