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710.2.4P - Somali Meal Substitution Request Form

710.2.4P - Somali Meal Substitution Request Form

Adopted: November 2018
Revised

 

Download 710.2.4P - Somali Meal Substitution Request Form

 

Sida uu qabo Xeerka Degmada 710.2.4AR (Codsiga Beddelka Cunnada), degmadu waxay samayn doontaa beddelaad macquul ah oo cuntada dugsiga ah iyadoo loo eegayo kiis-kiis ardayda loo arko inay qabaan naafonimo xaddidaysa cuntadooda.

·        Waaliddiinta, dadka ardayda masuulka ka ah ama ardayda qaangaarka ah ee raba inay codsadaan beddelaad macquul ah oo cuntada dugsiga ku salaysan naafo waa inay u soo celiyaan foomkan oo dhamaystiran kalkaalisada dugsiga.

·        Foomkan waa inuu saxeexaa, ama uu taageeraa bayaan qoran oo saxeexan, takhtar shati haysta, kaaliyaha dhakhtarka, ama kalkaalisada hawl-sare ee ka diiwaan gashan, sida kalkaaliye caafimaad oo shahaado haysta.

Marka foomka la gudbiyo, Maamulaha Cuntada iyo Nafaqada ee dugsiga ayaa laga yaabaa inuu kula soo xiriiro si uu si faahfaahsan ugala hadlo codsiga. Macluumaadka aad ku dhiibto foomkan waxay ku xiran tahay qaybta “Ogaysiisyada” ee hoose.

Macluumaadka Ardayga

 

Magaca ardayga                                                                   Maalinta Dhalashda             

Kan Dambe/kan hore/harafka hore ee midka dhexe

Magaca Dugsiga/iskuulka/Barnaamijka laga qaybqaatay                                                                                                                                                                                                 

Magaca waalidka/Masuulka                                                                                                                                                                                                                                             

Lambarka Teleefoonka Guriga                 Lambarka Teleefoonka Shaqada                                                                                                                                                                          

Hoyga/Xaruunta Cuntada (Waa in uu buuxiyaa ama xaqiijiyaa takhtar shati haysta, kaaliyaha takhtar, ama kalkaaliye sare oo ka diiwaan gashan shaqada, sida kalkaaliye caafimaad oo shahaado haysta.)

 

·        Sheeg xasaasiyadda ama cuntada la iska ilaalinayo                                                                                                                                                                                            

 

·        Sharax kooban oo ku saabsan sida soo-gaadhista cuntadani u saamayso ardayga                                                                                                                                                                                                                                                                                           

·        Qor cuntooyinka gaarka ah ee la iska dhaafo oo la beddelo. Ku dheji xaashi leh tilmaamo dheeri ah haddii loo baahdo. (Degmada loogama baahna inay bixiso bedelka saxda ah ama wax ka bedelka la codsaday laakiin waxay kula shaqayn doontaa inaad bixiso wax ka bedel macquul ah oo si wax ku ool ah u daboolaya naafada ardayga.)

 

Cunnada la iska dhaafaayo

Cunnada la beddelayaayo

 

 

 

 

 

Nidaamka 710.2.4P

Bogga 2

 

Fadlan bixi macluumaad kasta oo dheeri ah oo aad rabto in dugsigu ogaado:

________________________________________________________________________________________________________________

 

Saxeexa Xirfadlaha Caafimaadka: Waxaan dhammaystiray ama xaqiijiyay macluumaadka hoyga cuntada ee sare.

 

Magaca (daabac) ______________________________ Ciwaan/Aqoonsiyada/Cadaymaha                                                   

 

Saxeexa                                                                        Rug caafimaad/cisbitaal                                          

 

Lambarka Teleefoonka ___________________________ Iimaylka ______________________________ Taariikhda _________

 

 

Saxeexa Ardayga Waalidka/Masuulka/Dadka Waaweyn

 

Saxeexa _________________________________________________________ Taariikhda ____________________

 

 

Oggolaanshaha Ikhtiyaarka: Waxaad u oggolaan kartaa shaqaalaha degmada ay khusayso inay foomkan u caddeeyaan xirfadlaha caafimaadka ee kor lagu sheegay adoo saxeexaya qaybta Oggolaanshaha Ikhtiyaarka ee soo socda:

 

Iyadoo la raacayo xeerarka Caymiska Caafimaadka Qaadista iyo La Xisaabtanka Caymiska (HIPPA) ee 1996 iyo Xeerka Xuquuqda Waxbarashada Qoyska iyo Qarniga, waxaan halkan ku fasaxayaa xirfadlaha caafimaadka ee kor lagu aqoonsan yahay inuu sii daayo macluumaadka caafimaadka ee dhowrsan sida loogu baahan yahay ujeedada gaarka ah siinta macluumaadka cunto ee khaaska ah shaqaalaha Degmada 196 ee leh baahi sharci ah inay ogaadaan macluumaadkan oo kale waxaanan ogolaaday inaan u ogolaado xirfadlaha caafimaadka iyo Degmada 196 inay isweydaarsadaan macluumaadka la xidhiidha baahiyaha cunto ee khaaska ah ee ardaygayga, taas oo-waxaan qirayaa-ay ku jiri karto macluumaadka loo arko xogta waxbarashada gaarka ah. on ardaygayga. Waxaan fahamsanahay in oggolaanshaha wadaagista macluumaadkaas laga yaabo inay ka caawiso shaqaalaha Degmada 196 inay qiimeeyaan oo ay dejiyaan baahiyaha cuntada ee ardayga, laakiin iguma qasbana inaan saxeexo oggolaanshahan. Waxaan fahamsanahay in diidmada saxiixa oggolaanshahan aysan saameyn ku yeelaneynin awoodda aan u leeyahay in aan codsado beddelaad cunto oo macquul ah iyo in degmadu ay weli tixgelin doonto codsigayga. Waxaan fahamsanahay in oggolaanshaha macluumaadkan la burin karo wakhti kasta marka laga reebo marka xogta mar hore la sii daayay.

 

Saxeexa waalidka/masuulka/Ardayga qaangaarka ah _______________________________Taariikhda______________

 

 

 

Ogeysiisyada: Macluumaadka lagu bixiyo foomkan waxaa loo isticmaali doonaa in lagu go'aamiyo haddii u ardaygaagu u qalmo beddelka macquulka ah ee cuntooyinka ku salaysan naafanimada. Marka laga reebo sida kale ee uu sharcigu u ogolyahay ama uu u baahan yahay amar maxkamadeed ama amar maxkamadeed, macluumaadka lagu soo gudbiyay foomkan waxa kaliya oo lala wadaagi doonaa shaqaalaha Degmada 196 ee leh baahi sharci ah oo ah inay ogaadaan macluumaadkaas (sida kalkaalisada dugsiga iyo shaqaalaha Cuntada iyo Nafaqada ee ku lug leh qiimaynta iyo buuxinta codsiyada beddelka cuntada). Qasab kuguma aha inaad bixiso macluumaadka foomkan, laakiin haddii aanad sidaa yeelin, degmada dugsigu waxa laga yaabaa inay kari weydo inay ubadkaaga siiso beddel cunto oo macquul ah.

Nidaamka 710.2.4P

Bogga 3

 

Iyadoo la raacayo sharciga xuquuqda madaniga ah ee federaalka iyo Waaxda Beeraha ee Maraykanka (USDA) qawaaniinta iyo siyaasadaha xuquuqda madaniga ah, degmada dugsigu waxa ka mamnuuc ah takoorka ku salaysan isir, midab, asal qaran, diin, lab iyo dheddig, aqoonsiga jinsiga (ay ku jirto muujinta jinsiga) , nooca galmoodka, naafanimada, da'da, xaalada guurka, qoyska/xaaladda waalid, dakhliga laga helo barnaamijka kaalmada dadweynaha, aaminsanaanta siyaasadeed, ama aargoosiga ama aargoosiga hawlihii hore ee xuquuqda madaniga ah, barnaamij kasta ama hawl kasta oo ay qabato ama ay maalgeliso USDA (ma aha dhammaan saldhigyadu waxay khuseeyaan dhammaan barnaamijyada). Macluumaad dheeri ah, oo ay ku jiraan faahfaahinta ku saabsan habab kale oo lagu helo macluumaadka barnaamijka, fadlan booqo: http://www.district196.org/about/departments/food-and-nutrition-services/

                                                                                                                                           

Tixraacyada: - Xeerka Maamulka 710.2.4AR, Codsiyada beddelka cuntada