Administrative Review Summary Report
Date: 11-19-21
Date: 05-02-25
Name of Agency: Youth Services of Tulsa
Date of off-site review: 02-04-25
Reviewer: Matthew Smith Date of on-site review: 03-18-25
Fiscal Action: No
Persons interviewed: Kolby Brown and Date of exit conference: 05-01-25
Jessica Whinery
Programs Operated by the School Food Authority (SFA): This SFA operates the National School Lunch Program, the School Breakfast Program, and the After School Snack Program.
The following areas were corrected prior to the On-Site Portion of this Administrative Review (AR):
· Buy American Provision: During the menu week assessment of the breakfast and lunch menus for the week of 01/19/25 – 01/25/25 it was discovered that Youth Services of Tulsa (YST) had used non-domestic food products with some of the menus [in violation of federal regulations 7 CFR Part 210.21 (d) and 7 CFR Part 220.16 (d)]. Prior to the completion of the on-site visit, YST took corrective actions replacing the non-domestic food products with domestically produced food products.
· Meal Patterns: During the menu week assessed as part of this AR, insufficient serving sizes for some of the lunch menus served during the week [in violation of federal regulation 7 CFR Part 210.10 (c)]. Prior to the completion of the on-site portion of this AR, YST took corrective action bringing the insufficient serving sizes into compliance with the meal patterns for grades 9 – 12. OKDHS School Nutrition Programs (SNP) is exercising its discretion to not apply fiscal action for the insufficient serving sizes as permitted by federal regulation [7 CFR Part 210.18 (g) (2)].
· Non-Creditable Items were Served as Part of Reimbursable Meals: During the menu week of breakfast and lunch menus assessed, as well as on the day of review (03/18/25) non-creditable food items were served as part of the menus [in violation of federal regulation of Appendix C of 7 CFR Part 210 and Appendix C of 7 CFR Part 220]. Prior to the completion of the on-site portion of this AR, YST took corrective action replacing the non-creditable items with creditable items.
· Whole Grain Rich – Percentage of Weekly Serving Under 80%: During the assessment of breakfast and lunch menus for the week of 01/19/25 through 01/25/25 it was discovered the percentage of the bread/grain component weekly serving for the breakfast (grains & meats/meats alternates) and lunch menus were under 80% [in violation of federal regulations 7 CFR Part 210.10 (c) (2) (iii) (A) and 7 CFR Part 220.8 (c) (2) (iii) (A)]. Prior to the completion of the on-site portion of this AR, YST took corrective actions bringing both the breakfast and lunch percentage of the weekly servings into compliance with the meal patterns for breakfast and lunch for grades 9-12.
No further action is required for the above.
Findings and Recommendations Identified During the Off-Site Portion of the Review Conducted February 4, 2025:
Afterschool Snack Program – Self Monitoring: During the off-site portion of this Administrative Review (AR) it was discovered Youth Services of Tulsa (YST) had not conducted the first self-monitoring review within the first four weeks of school starting [as required by federal regulation 7 CFR Part 210.9 (c) (7)]. The first self-monitoring inspection was conducted by YST on 01/23/25.
To demonstrate compliance with self-monitoring requirements:
· Provide YST plan for corrective action to demonstrate understanding and compliance.
Local Wellness Policy: The most recent local wellness policy and the triennial wellness assessment report (documentation of the most recent assessment) had different local wellness committee members in the two documents. Federal regulations [7 CFR 210.31 (c) (5) and 7 CFR Part 210.31 (d) (1)] as part of documenting community involvement requires the listing of the local wellness committee in both documents and they must be the same.
Also, during the most recent assessment and update to the local wellness policy it was not compared to the model wellness policy. Federal regulation [7 CFR Part 210.31 (e) (2) (ii)] requires local wellness policies to be compared to the model wellness policy.
To demonstrate compliance with local wellness policy requirements:
- Update the local wellness policy to contain the committee listed on the most recent triennial wellness assessment report.
- Provide a copy of the updated local wellness policy along with YST’s plan for corrective action to demonstrate understanding and compliance with local wellness policy requirements.
Findings and Recommendations Identified During the On-Site Portion of the Review Conducted March 18, 2025:
Production Records: During the menu week assed the production records did not fully document how some of menus served during the week “…contributed to the required meal components and food quantities…” as required by federal regulations [7 CFR Part 210.10 (a) (3) and 7 CFR Part 220.8 (a) (3)].
To demonstrate compliance with production requirements:
· Provide a copy of one complete breakfast production record.
· Provide a copy of one complete lunch production record.
· Provide the above documents along with YST’s plan for corrective action to demonstrate understanding and compliance.
Health Inspections: YST did not receive two health inspections for the local health department during school year 2023 – 2024 as required by federal regulation [7 CFR Part 210.13 (b)]. During school year 2023 – 2024, YST contacted the local health department to request a second inspection. The local health department denied the request. YST failed to retain documentation of this request as required by federal regulation [7 CFR Part 210.13 (b)] and the USDA FNS Administrative Review Manual.
To demonstrate compliance with health inspection requirements:
· Begin to retain documentation of annual contact to request a second inspection. Retain this documentation for three school years plus the current school year.
· Provided YST’s plan for corrective action demonstrating compliance and understanding.
Reviewer’s Comments: Overall, the staff working in YST’s school food services program are doing a good job. I would like to commend them for a job well done during this review. Keep up the good work!
Procurement Review Summary Report
Date: 05-02-25
Name of Agency: Youth Services of Tulsa
Date of AR off-site review: 02-04-25
Reviewer: Matthew Smith Date of AR on-site review: 03-18-25
Persons interviewed: Kolby Brown and Date of exit conference: 05-01-25
Jessica Whinery
Programs Operated by the School Food Authority (SFA): This SFA operates the National School Lunch Program, the School Breakfast Program, and the After School Snack Program.
The following areas were corrected during the Procurement Review (PR):
· Procurement Plan: At the time of the PR commenced, Youth Services of Tulsa’s (YST) procurement plan did not address the use of the micro-purchase method of procurement. Federal regulation [2 CFR Part 200.318 (a) requires procurement plans to address the procurement practices used by SFAs. Prior to the completion of the PR, YST took corrective action by adopting an amendment to their procurement plan addressing the use of the micro-purchase method of procurement.
No further action is required for the above.
Findings for the Procurement Review (PR)
There were no additional findings for the Procurement Review.
