Quality Form Oplan Kalusugan Sa Deped Accomplishment Report Form
Quality Form Oplan Kalusugan Sa Deped Accomplishment Report Form
Quality Form Oplan Kalusugan Sa Deped Accomplishment Report Form
Quality Form
Revision:
Teachers
Non-Teaching
Personnel
Non-plantilla
personnel
TOTAL:
Elementary
Secondary
Integrated School
TOTAL
B. ACCOMPLISHMENTS
1.a SCHOOL BASED FEEDING PROGRAM (SBFP) & NUTRITION-SUPPORT
1.a.1. SBFP Coverage:
Check which is applicable
FY 20___
With SBFP Covered by Not covered by
(K-6) Partners SBFP or Partners
Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
SPED
TOTAL
Total:
Note: On the GPP record, all vegetables used for SBFP should be itemized with corresponding quantity and cost. The Total cost of vegetables used
divided by (number of beneficiaries X 16.00 X 120 days) X 100 = % contribution to the feeding program
No. of learners:
No. of Trimester of Pregnancy No. of learners: Quarter of CY Impregnator:
Grade Level pregnant at first clinic Reported for first clinic Number
learners consultation/ referral consultation/ referral
0 1 2 3
TOTAL
6. MEDICAL-DENTAL-NURSING SERVICES
(Use School Health Division Form 5 as basis for accomplishing this table)
6.a. Ten Most Common Signs and Symptoms (as reported by nurse)
Sign/Symptom Number of Cases % of those assessed (Col 2/ Total Examined x 100%)
6.b. Ten Most Common Diseases (as Diagnosed by Medical Doctors)
Diagnosis Number of Cases % of those assessed (Col 2/ Total Examined x 100%)
Total:
Total:
No. Immunized
Grade Level Sex Enrollment 1st Dose 2nd Dose REMARKS
HPV HPV
( For 9 yers old & above
Grade 4 F
only)
Grade Level Sex Enrolment No. Assessed No. Passed No. Failed No. Referred Remarks
Kinder M
F
Grade 1 M
F
Grade 4 M
F
Grade 7 M
F
Grade 10 M
F
TOTAL M
F
6.h.2. Auditory Screening
Grade Sex Enrolment No. Assessed No. Passed No. Failed No. Referred Remarks
Kinder M
F
Grade 1 M
F
Grade 4 M
F
Grade 7 M
F
Grade 10 M
F
TOTAL M
F
E SIGNIFICANT EVENTS OF SBFP, NDEP, ARH, WINS, SMH, AND OTHER HEALTH AND NUTRITION PROGRAMS/
EXPERIENCES/ GOOD PRACTICES
(Add Additional Sheets, if needed)
What happened? Who were involved? When Outcome: What is/are its important contribution to the OK
sa DepEd Program of the school?
Given Interventions
F
TOTAL
TOTAL
TOTAL
Utilization
ol 3/2*100%)
%
Rehabilitated
al cost of vegetables used
Learners
Impregnator:
Number
Adult Undetermined
SERVICES - No. of Learners
pants/ Members/
s/ Advisers
Learners
REMARKS
Other (Specify)
Teaching personnel
Participants
Learners
Remarks
Remarks
Treated
TEMPORARY
f
REMARKS
REMARKS
se
% Enrolment
ment
2nd Dose
Remarks
Remarks
N T
N T
N T
N T
No. of School Personnel
Treated
mated Cost
PROGRAMS/
OK SA DEPED
al, Region, and Division Office
endent