Department of Social Welfare and Development PANTAWID PAMILYANG PILIPINO PROGRAM

Field Office VIII

LOGSHEET
CV FORM 2 (EDU) SEP-OCT 2012 Province: Municipality: # of School Code Forms (Based CVF2) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 527553 530869 530390 529565 523720 523721 530414 530508 527811 530611 530612 527512 TACLOBAN CITY Check if Encoded Name of School
(Based CVF2)

Name of Principal/ Head Teacher/ TIC/ Daycare Worker MARITES J. RONDA MARIBEL D. AMARILLA MARIBEL D. AMARILLA JENNILYN V. ASPIRAS JENNILYN V. ASPIRAS ELIZABETH GULRAJANI LESLIE A. BOCTOT BELLA C. MENDIOLA MARLYN T. MACARAYON FLORA B. BACULO MATILDE B. VILLAJOS MA. VANELYN LORENZO

Number of Non-Compliance Beneficiaries (Based CV F2) Sept Oct

Compliance Sept Oct

Less than 85% Sept Oct

Not Dropout Enrolled

DEWORMING Y N

PATERNO DCC BRGY 36 DCC BRGY 37 DCC BRGY 39 DCC BRGY 42-A DCC BRGY 43-A DCC BRGY 52 DCC BRGY 56 DCC PAMPANGO DCC BRGY 66-A DCC RAWIS DCC SAN ROQUE DCC

3 7 10 5 3 1 4 1 12 1 9 21

0 6 0 5 3 1 0 0 2 0 1 6

0 6 3 5 3 1 0 0 1 0 1 2

3 1 10 0 0 0 4 1 10 1 8 15

3 1 7 0 0 0 4 1 11 1 8 19

0 0 0 0 0 0
0 0

0 0 3 0 0 0
0 0

2 0 1 6

1 0 1 2

0 0 0 0 0 0 0 0 0 0 0 0

0 6 0 5 3 1 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0

TOTAL
Prepared by:

77
Reviewed by:

24

22

53

55

0
Noted by:

15

CASTROVERDE, KRIZEL MARY B.

Social Welfare Assistant Checked by: PDO-CVS SWO III

RODEL P. EBINA
Municipal Link

____________________
Date Submitted

Encoded

VERIFICATION

ENCODING Encoders Name Date Encoded

Department of Social Welfare and Development PANTAWID PAMILYANG PILIPINO PROGRAM

Field Office VIII

LOGSHEET
CV FORM 2 (EDU) SEP-OCT 2012 Province: Municipality: # of School Code Forms (Based CVF2) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 521910 525139 530543 530930 518387 518436 518451 518451 525157 539884 518385 518385 518424 518450 530427 518424 TACLOBAN Check if Encoded Name of School
(Based CVF2)

Name of Principal/ Head Teacher/ TIC/ Daycare Worker Valeria B. Gabriel, Ed. D Delia A. Espedilla Godofredo B. Roca Sr. Monette Felices, OSF David C. Alcober Noemi B. Lauzon Josefina G. Tanpiengco Josefina G. Tanpiengco Lita V. Jongco Lita V. Jongco Amalia P. Pepinas Amalia P. Pepinas Imelda M. Gayas Irene B. Go Irene B. Go Acela C. Refuerzo

Non-Compliance Sept Oct

Compliance Sept Oct

Less than 85% Sept Oct

(Based CV F2)

DEWORMING Not Dropout Enrolled Y N

Cirilo Roy Montejo NHS Cirilo Roy Montejo Night HS JE Mondejar CC Liceo del Verbo Divino Rizal CS Panalaron CS Anibong ES Anibong ES Scandinavian ES Scandinavian ES San Roque ES San Roque ES San Fernando CS City CS City Central School Kapangi-an CS

124 5 4 96 87 507 4 121 1 71 2

17 1 0 0 0 1 0 1 0 3 2

17 1 0 0 0 1 0 0 0 3 2

107 4 4 96 87 506 4 120 1 68 0

107 4 4 96 87 506 4 121 1 68 0

0 1 0 0 0
0 0

0 1 0 0 0
0 0

0 0 0 0 0 0 0 0 0 1 0

17 0 0 0 0 1 0 0 0 1 2

1 0 1 0

0 0 1 0

0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0

TOTAL
Prepared by:

1022
Reviewed by:

25

24

997

998

1
Noted by:

21

CASTROVERDE, KRIZEL MARY B.

Social Welfare Assistant Checked by: PDO-CVS SWO III

RODEL P. EBINA
City Link

____________________
Date Submitted

Encoded

Number of Beneficiaries

VERIFICATION

ENCODING Encoders Name Date Encoded

Department of Social Welfare and Development PANTAWID PAMILYANG PILIPINO PROGRAM

Field Office VIII

LOGSHEET
CV FORM 3 (HEALTH) SEP-OCT 2012 Province: Municipality: # of Forms 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 TACLOBAN CITY Check if Encoded HC Code Name of RHU / BHS
(Based CVF3) CVF3) (Based

Name of Doctor / Nurse Beneficiaries / Midwife/Doctor (Based CVF3) AGNES T. PEREGRINO ALILY P. ROMO GINA A. BACUNATA CATALINA A. ODITA CATALINA A. ODITA 227 90 91 183 2

0<2 yo 2-5 yo 0 0 0 0 0 227 90 91 183 2

Preg

REMARKS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Compliance
Sept Oct For 2 mos.

No R-HC Preg-NA Miscarriage Delivered

Sept

Oct

For 2 mos.

502872 504007 502869 502873 502873

SEAWALL BHS TACLOBAN CHO MAGALLANES BHS SERINE QUARRY DBHS SERINE QUARRY DBHS

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

2 0 0 0 0

0 0 0 0 0

0 0 0 0 0

225 90 91 183 2

TOTAL
No R-HC (No Record in Health) Prepared by:

593

593

591

Reviewed by:

Noted by:

CASTROVERDE, KRIZEL MARY B.

Social Welfare Assistant Checked by: PDO-CVS SWO III

RODEL P. EBINA
City Link

____________________
Date Submitted

Encoded

Number of

Based on CV F3

VERIFICATION Non-Compliance

ENCODING Encoders Name Date Encoded

Department of Social Welfare and Development PANTAWID PAMILYANG PILIPINO PROGRAM

Field Office VIII

LOGSHEET
CV FORM 4 (FDS) SEP-OCT 2012 Province: Municipality: # of Barangay Code (Based CVF4) Forms 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 lLEYTE ALANGALANG Check if Encoded Name of BRGY.
(Based CVF4)

(FDS) Date Accomplished

CVF4)

Sept

Oct

Sept

Oct

TOTAL
Prepared by: Reviewed by:

0
Noted by:

Municipal Link

PDO-CVS

SWO III

____________________
Date Submitted

Encoded

Number of Beneficiaries (Based

No. of Beneficiaries Compliance Non-Compliance

ENCODING Encoders Name Date Encoded

Department of Social Welfare and Development Pantawid Pamilyang Pilipino Program Reasons for Non-Compliance in Education Condition SEP-OCT 2012 Province: Municipality of CATEGORY OF REASON:
1. SICKNESS/SICKLY 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO DAY CARE WORKER/TEACHER/MIDWIFE 8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. NO SCHOOL ALLOWANCE
CV Remarks (put number 1) Less than 85% attendance

TACLOBAN

15. CHILD LABOR 16. MISPELLED NAMES 17. FAMILY MATTERS 18. NOT SUBMITTED CV FORMS 19. OTHERS

No.

Barangay

HH no.

Name

Name of School
(Based CVF2)

Dropped

Not Enrolled

Category of Reasons Non- Compliance

Sept 1 2 3 4 5 6 7 8 9 10 11 83747

Oct

Action Taken/FINDINGS C/ML

TOTAL
Prepared by: KRIZEL MARY B. CASTROVERDE Social Welfare Assistant RODEL P. EBINA City Link Reviewed by:

0
Noted by:

PDO CVS _____________________ Date Submitted

SWO III

Department of Social Welfare and Development Pantawid Pamilyang Pilipino Program Reasons for Non-Compliance in Health Conditions SEP-OCT 2012 Province of Municipality of CATEGORY OF REASON:
1. FINANCIAL PROBLEM 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO MIDWIFE 8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. MISPELLED NAMES 15. FAMILY MATTERS 16. NOT SUBMITTED CV FORMS 17. OTHERS

lLEYTE TACLOBAN CITY (Capital)

CV Remarks (Put number 1) No. Barangay HH no. Name Name of Health Center
(Based CVF3)

Remarks No RHC Preg NA Miscarriage

Non-Compliance For 2 Sept Oct Months

Category of Reasons Non- Compliance

2

Action Taken / FINDINGS (C/ML)

1 2 3 4 5 6 7 8 9

37 83747060 LIM, JEROS T. 37 83747060 LIM, RHEA MAE T.

SEAWALL BHS SEAWALL BHS

1 1

TOTAL
Prepared by: CASTROVERDE, KRIZEL MARY B. Social Welfare Assistant RODEL P. EBINA City Link Reviewed by:

2
Noted by:

PDO CVS 10/31/2012 Date Submitted

SWO III

Third Template

Department of Social Welfare and Development Pantawid Pamilyang Pilipino Program Reasons for Non-Compliance in Family Development Sessions Condition SEP-OCT 2012 Province Of Municipality of CATEGORY OF REASON:
1. SICKNESS/SICKLY 2. AT WORK 3. DECEASED 4. DISABLED 5. NOT INFORM ABOUT FDS SCHEDULE 6. VENUE IS NOT ACCESSIBLE / BAD WEATHER 7. NOT INTERESTED 8. MULTIPLE ENTRY 9. MG WAS TOO OLD 10. GRANTEE WAS TOO YOUNG 11. TRANSFERRED RESIDENCE 12. FAMILY MATTERS 13. POSTPARTUM DEPRESSION 14. NO 0-14 y/o CHILD/CHILDREN 15. INCLUSION ERROR/ FOR DELSTING / WAIVED 16. OTHERS

lLEYTE ALANGALANG

No. 1 2 3 4 5 6 7 8

Barangay

HH no.

Name of Beneficiary

Non Compliance (Put number 1) Sept Oct

Category of Reason

Action Taken/Findings

TOTAL Prepared by:

0
Noted by:

Municipal Link __________________ Date Submitted

SWO III

Department of Social Welfare and Development Pantawid Pamilyang Pilipino Program Reasons for Non-Compliance in Deworming Condition SEP-OCT 2012 Province of Municipality of lLEYTE ALANGALANG

CATEGORY OF REASON:
1. SICKNESS/SICKLY 2. ABSENT DURING DEWORMING 3. DECEASED 4. DISABLED 5. BENEFICIARY HESISTATED TO TAKE DEWORMING PILL 6. PARENT HESITATED TO LET HIS/HER PUPIL TO TAKE DEWORMING PILL 7. NO SCHOOL NURSE 8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. WRONG ENTRY OF FACILITY 15. MISPELLED NAME 16. NOT SUBMITTED CV FORMS 17. OTHERS

No. 1 2 3 4 5 6 7

Barangay

HH no.

Name

Name of School
(Based CVF2)

Category of Reason

Action Taken / Findings

Prepared by:

Reviewed by:

Noted by:

Municipal Link

PDO CVS _____________________ Date Submitted

SWO III

Social Welfare Assistant

Department of Social Welfare and Development Pantawid Pamilyang Pilipino Program

Province of Municipality of

lLEYTE ALANGALANG

__________ Period 2012 Compliance Verification System Issues and Concerns

ISSUES and CONCERNS ACTIONS TAKEN

RECOMMENDATIONS

Distribution of CV Forms from SWAs to Schools and Health Centers

Accomplishments of CV Forms

Collection of CV Forms

OTHER CONCERNS

Prepared by: _____________________ Municipal Link _____________________ Social Welfare Assistant

Reviewed by: _____________________ PDO CVS _____________________ Date Submitted

__ Period 2012 Compliance Verification System Issues and Concerns

REMARKS

ls and Health Centers

Noted by: __________________________ SWO III

EMAIL ADDRESS: FILENAME: example SUBJECT:

[email protected] CVS_MUNICIPALITY_PERIOD CVS_TACLOBAN_SEPT-OCT2012 CVS_TACLOBAN_SEPT-OCT2012

Pantawid Pamilyang Pilipino Program SUMMARY OF NON COMPLIANCE SEP-OCT 2012 Province of Municipality of EDUCATION - COMPLIANCE VERIFICATION FORM 2 lLEYTE ALANGALANG

CATEGORY OF NON COMPLIANCE SUMMARY

1. SICKNESS/SICKLY 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO DAY CARE WORKER/TEACHER/MIDWIFE

LESS THAN 85% ATTENDANCE MONTH OF SEPTEMBER 0 8. NO GUARDIAN 0 0 9. TRANSFERRED RESIDENCE 0 0 10. MULTIPLE ENTRY 0 0 11. ARMED CONFLICT 0 0 12. NO PERMANENT ADDRESS 0 0 13. OVER AGE 0 0 14. NO SCHOOL ALLOWANCE 0 LESS THAN 85% ATTENDANCE MONTH OF OCTOBER 0 8. NO GUARDIAN 0 0 9. TRANSFERRED RESIDENCE 0 0 10. MULTIPLE ENTRY 0 0 11. ARMED CONFLICT 0 0 12. NO PERMANENT ADDRESS 0 0 13. OVER AGE 0 0 14. NO SCHOOL ALLOWANCE 0
NOT ENROLLED

15. CHILD LABOR 16. MISPELLED NAMES 17. FAMILY MATTERS 18. NOT SUBMITTED CV FORMS 19. OTHERS

0 0 0 0 0

1. SICKNESS/SICKLY 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO DAY CARE WORKER/TEACHER/MIDWIFE

15. CHILD LABOR 16. MISPELLED NAMES 17. FAMILY MATTERS 18. NOT SUBMITTED CV FORMS 19. OTHERS

0 0 0 0 0

1. SICKNESS/SICKLY 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY

0 0 0 0 0

8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS

0 0 0 0 0

15. CHILD LABOR 16. MISPELLED NAMES 17. FAMILY MATTERS 18. NOT SUBMITTED CV FORMS 19. OTHERS

0 0 0 0 0

6. NOT ACCESSIBLE / BAD WEATHER 7. NO DAY CARE WORKER/TEACHER/MIDWIFE

0 0

13. OVER AGE 14. NO SCHOOL ALLOWANCE DROP OUT

0 0

1. SICKNESS/SICKLY 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO DAY CARE WORKER/TEACHER/MIDWIFE

0 0 0 0 0 0 0

8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. NO SCHOOL ALLOWANCE

0 0 0 0 0 0 0

15. CHILD LABOR 16. MISPELLED NAMES 17. FAMILY MATTERS 18. NOT SUBMITTED CV FORMS 19. OTHERS

0 0 0 0 0

HEALTH - COMPLIANCE VERIFICATION FORM 3

CATEGORY OF NON COMPLIANCE SUMMARY NON COMPLIANCE MONTH OF SEPTEMBER
1. FINANCIAL PROBLEM 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO MIDWIFE

0 0 0 0 0 0 0

8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. MISPELLED NAMES

0 0 0 0 0 0 0

15. FAMILY MATTERS

16. NOT SUBMITTED CV FORMS 17. OTHERS

0 0 0

NON COMPLIANCE MONTH OF OCTOBER 1. FINANCIAL PROBLEM 2. NOT INTERESTED 3. DECEASED 4. DISABLED

0 0 0 0

8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT

0 0 0 0

15. FAMILY MATTERS

16. NOT SUBMITTED CV FORMS 17. OTHERS

0 0 0

5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO MIDWIFE

0 0 0

12. NO PERMANENT ADDRESS 13. OVER AGE 14. MISPELLED NAMES

0 0 0

NON COMPLIANCE FOR 2 MONTHS 1. FINANCIAL PROBLEM 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO MIDWIFE

0 0 0 0 0 0 0

8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. MISPELLED NAMES NO RECORDS IN HEALTH CENTER

0 0 0 0 0 0 0

15. FAMILY MATTERS

16. NOT SUBMITTED CV FORMS 17. OTHERS

0 0 0

1. FINANCIAL PROBLEM 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO MIDWIFE

0 0 0 0 0 0 0

8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. MISPELLED NAMES PREGNANCY NOT APPLICABLE

0 0 0 0 0 0 0

15. FAMILY MATTERS

16. NOT SUBMITTED CV FORMS 17. OTHERS

0 0 0

1. FINANCIAL PROBLEM 2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO MIDWIFE

0 0 0 0 0 0 0

8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. MISPELLED NAMES MISCARRIAGE

0 0 0 0 0 0 0

15. FAMILY MATTERS

16. NOT SUBMITTED CV FORMS 17. OTHERS

0 0 0

1. FINANCIAL PROBLEM

8. NO GUARDIAN

15. FAMILY MATTERS

2. NOT INTERESTED 3. DECEASED 4. DISABLED 5. WRONG ENTRY OF FACILITY 6. NOT ACCESSIBLE / BAD WEATHER 7. NO MIDWIFE

0 0 0 0 0 0

9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. MISPELLED NAMES

0 0 0 0 0 0

16. NOT SUBMITTED CV FORMS 17. OTHERS

0 0

FAMILY DEVELOPMENT SESSION - COMPLIANCE VERIFICATION FORM 4 CATEGORY OF NON COMPLIANCE SUMMARY
NON COMPLIANCE MONTH OF SEPTEMBER
1. SICKNESS/SICKLY 2. AT WORK 3. DECEASED 4. DISABLED 5. NOT INFORM ABOUT FDS SCHEDULE 6. VENUE IS NOT ACCESSIBLE / BAD WEATHER 7. NOT INTERESTED

0 0 0 0 0 0 0

8. MULTIPLE ENTRY 9. MG WAS TOO OLD 10. GRANTEE WAS TOO YOUNG 11. TRANSFERRED RESIDENCE 12. FAMILY MATTERS 13. POSTPARTUM DEPRESSION 14. NO 0-14 y/o CHILD/CHILDREN

0 0 0 0 0 0 0

15. INCLUSION ERROR/ FOR DELSTING / WAIVED

16. OTHERS

0 0

NON COMPLIANCE MONTH OF OCTOBER

1. SICKNESS/SICKLY 2. AT WORK 3. DECEASED 4. DISABLED 5. NOT INFORM ABOUT FDS SCHEDULE 6. VENUE IS NOT ACCESSIBLE / BAD WEATHER 7. NOT INTERESTED

0 0 0 0 0 0 0

8. MULTIPLE ENTRY 9. MG WAS TOO OLD 10. GRANTEE WAS TOO YOUNG 11. TRANSFERRED RESIDENCE 12. FAMILY MATTERS 13. POSTPARTUM DEPRESSION 14. NO 0-14 y/o CHILD/CHILDREN

0 0 0 0 0 0 0

15. INCLUSION ERROR/ FOR DELSTING / WAIVED

16. OTHERS

0 0

DEWORMING - COMPLIANCE VERIFICATION FORM 2 CATEGORY OF NON COMPLIANCE SUMMARY

NON COMPLIANCE FOR 2 MONTHS

1. SICKNESS/SICKLY 2. ABSENT DURING DEWORMING 3. DECEASED 4. DISABLED 5. BENEFICIARY HESISTATED TO TAKE DEWORMING PILL 6. PARENT HESITATED TO LET HIS/HER PUPIL TO TAKE DEWORMING PILL 7. NO SCHOOL NURSE

0 0 0 0 0 0 0

8. NO GUARDIAN 9. TRANSFERRED RESIDENCE 10. MULTIPLE ENTRY 11. ARMED CONFLICT 12. NO PERMANENT ADDRESS 13. OVER AGE 14. WRONG ENTRY OF FACILITY

0 0 0 0 0 0 0

15. CHILD LABOR 16. MISPELLED NAMES 17. FAMILY MATTERS 18. NOT SUBMITTED CV FORMS 19. OTHERS

0 0 0 0 0