Home / ca breeze license verification / Worksheet to Determine Verification Sample Size

Worksheet to Determine Verification Sample Size - ca breeze license verification



California Department of Education School Nutrition Programs
Nutrition Services Division August 2016

This form is used as ATTACHMENT D during an ADMINISTRATIVE REVIEW, but may also be used by the district to determine the number of applications to be verified on an annual basis.

WORKSHEET TO DETERMINE VERIFICATION SAMPLE SIZE

Verification is to be completed as a district-wide activity by November 15th each year. Households can provide documentation of income for any point in time between the month prior to the application and the time the household is required to provide income documentation.
|Sponsor Name: |CNIPS ID: |
|Verifying Official: |Program Year: |
|Date Households Were Notified of Selection: |Date Verification Completed: |
|Determine Sample Size Using the Standard or Alternate Sample Size Options |
|“(” the box below next to |Enter the total number of |X |Multiply total applications by|= |Minimum number of applications |Enter the actual number of applications|
|the method used to verify |approved Free and | |this Percentage | |to be verified |selected |
|applications. |Reduced-Price applications* | | | |(rounded up to next whole | |
| |on file | | | |number; e.g., 3.1 = 4.0 | |
| |October 1 | | | |applications) | |
|1. STANDARD SAMPLE SIZE METHOD – This method must be used if district is not eligible for an Alternate Sample Size Option. |
|Standard Sampling Size Method: Calculate three percent of the total approved Free/Reduced-Price (F/RP) applications on file October 1 to determine your sample size. Select |
|Error-Prone applications (where household income falls within $100 below the monthly or $1,200 below the annual F/RP income limits) to complete your sample size. If there |
|are not enough Error-Prone applications to fulfill the three percent sample size, sponsors must randomly select other approved income and categorical applications to |
|fulfill the required sample size. Round all decimals up to the next whole number. Additional applications may be selected only “for cause.” Applications chosen for cause |
|are not part of your sample size. |
|( STANDARD | |X |.03 = |= | | |
|Sample Size |Total Applications* | |(three percent) | |(OR 3,000 applications, |Selected from |
| | | | | |whichever is less) |Error-Prone applications |
| |
|ALTERNATE SAMPLE SIZE OPTIONS - A sponsor may use one of two alternate sample sizes listed below instead of the Standard Sample Size Method. However, to use the |
|ALTERNATE-RANDOM METHOD (ONE) or ALTERNATE-FOCUSED METHOD (TWO), the sponsor/district must meet one of the following conditions: |
| |
|The district has a lowered non-response rate. |
|The district has 20,000 or fewer students approved for F/RP meals on October 1, and the “non-response rate” as of November 15 of the preceding school year is less than 20 |
|percent. The “non-response rate” is the percentage of approved household applications selected for verification for which the sponsor did not obtain verification |
|information by November 15; or |
| |
|The district has an improved non-response rate. |
|The district has more than 20,000 students approved F/RP meals on October 1, and can verify that the “non-response rate” for the preceding school year as of November 15 is |
|at least 10 percent below the “non-response rate” for the second preceding year. |
| |
|If the above alternate Sample Size criteria is met, choose one of the following: |
|ALTERNATE-RANDOM SAMPLING METHOD – Randomly select three percent of total F/RP applications on file October 1; each application must have the same chance of being selected.|
|Round decimals up to the next whole number. |
|( Alternate Method One | |X |.03 = |= | | |
|RANDOM |Total Applications* | |(three percent) | |(OR 3,000 applications, |Selected at Random |
| | | | | |whichever is less) |from all applications |
|ALTERNATE-FOCUSED SAMPLING METHOD (Two-Step Process) – Select one percent of the total F/RP approved applications on file October 1 from Error-Prone applications, plus |
|select 0.5 percent from applications approved based on categorical eligibility that used a CalFresh, CalWORKs, or Food Distribution Program on Indian Reservations (FDPIR) |
|case number. Use a method that is equitable and ensures that the same household is not selected each year. Round decimals up to the next whole number. |
|( Alternate Method Two |Step 1 |X | |= | | | | |
|FOCUSED | | | | | | | |Total applications |
| |Total Applications* | |.01 = | |(OR 1,000 applications, |Selected from Error-Prone |= |selected |
| | | |(one percent) | |whichever is less) |applications | | |
| | | | | | | | | |
| | | | | | |+ | | |
| | | | | | | | | |
| | | | | | | | | |
| | | | | | |Selected from applications | | |
| | | | | | |approved with CalWORKS, CalFresh, or| | |
| | | | | | |FDPIR case number. | | |
| |Step 2 |X | |= | | | | |
| | | | | | | | | |
| |CalWORKs/CalFresh/FDPIR | |.005 = | | | | | |
| |categorically eligible | |(one-half of one | |(OR 500 applications, | | | |
| |applications | |percent) | |whichever is less) | | | |


* Note: Total Applications refers to actual approved application documents/pieces of paper (whether for a household or an individual student) on file October 1. Districts that implement Direct Certification must only complete Verification activities based on applications received and certified and must not include directly certified students in their calculations. Verification is not required of students who are directly certified.

How to comply with the verification request?