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S :hedul' -A <br /> <br />TITLE !I!-C CONGREGATE/HOME DELI~EI~ED NUTRITION <br /> MENU SUBSTITUTION <br /> <br />County <br /> <br />Date of' Substitution <br /> <br />Substitution Made At Followinq Sites: <br /> <br />~EAT OR ALTERNATE <br /> 3 OZ COOKED PORTION <br /> <br />VEGETABLES & FRUITS <br /> 2-1/2 CUP SERVINGS <br /> <br />BREAD OR ALTERNATE <br /> 1 SERVING <br /> <br />BUTTER OR MARGARINE <br /> 1.TEASPOON <br /> <br />DESSERT <br /> 1/2 cup <br /> <br />A~PROVED <br /> MENU <br /> <br />SUBSTITUTED <br /> <br />MILK <br /> 1/2 PINT <br /> <br />BEVERAGE (OPTIONAL) <br /> <br />Signature of Person Completinq Form <br /> <br />Signature of Nutrition Program Director <br /> <br />Date <br />Date <br /> <br />REGISTERED DIETITIAN'APPROVAL: . <br /> <br />I CERTIFY THAT THE ABOV~ SUBSTITUTION ~EETS 1/3 RDA AND THE'M~AL PATTERN AS <br />SET BY THE. NCDOA SERVICE STANDARDS. YES, MEETS STANDARDS NO, DOES NOT <br />MEET STANDARDS -' <br /> <br />NAME OF REGISTERED DIETITIAN <br /> <br />DATE <br /> <br />SIGNATURE OF REGiSTEkhD DIETITIAN <br /> <br />RD$ <br /> <br /> <br />