Form 10.2.

MENU CHECK SHEET

Is the menu nutritionally adequate? YES NO

1. Includes at least one serving of a good vitamin C source daily?  

List the daily vitamin C sources on the next page.

2. Includes at least one serving of a dark-green or deep-yellow

vegetable or fruit every other day?  
List the vitamin A sources on the next page.

3. Includes at least four or more servings of fruits/vegetables daily?  

4. Includes at least two cups of milk daily?  

5. Includes daily, at least four to six ounces, cooked weight, of meat,

fish, poultry or substitute?  
Includes _____ eggs per week

6. Includes at least four or more servings of whole-grain, enriched, or

restored bread daily?  
Other factors:
7. Are the foods in season, available and within the budget?  

8. Can foods be prepared with available equipment and personnel?  

9. Is there a repetition of food items within the week?  

10. Is there variety in the food items served during the week?  

11. Do flavors complement each other?  

12. Do the foods offer contrasts in:

color? 


texture?  

temperature?  

size, shape or form?  

lightness and heaviness?  

preparation methods?  

13. Are suitable garnishes and accompaniments used for interest?  

14. Will foods appeal to the patients/residents/clients?  

15. Will meal look appealing when served?  
 SOURCES

Submit both pages of this check sheet with your meal plans.