Community Action Plan Template: Purpose: Directions

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St. Paul College Foundation, Inc.

Bulacao Campus, Cebu City

College of Education
Final Examination
in
NSTP I

Name: Romero, Dianne . Program: Bscrim-1 Score: __________


Class Schedule: 08:00-11:00am Date: Dec. 16, 2020 Instructor: Mr. Rennil Bornia

Community Action Plan Template


Purpose: To create a “script” for your improvement effort and support implementation in the community.
Directions: Using this form as a template, develop a community action plan for each goal identified through the need’s assessment process.
Modify the form as needed to fit your unique context.

Goal: Dengue prevention and control the mosquitoes breeding.

Results/Accomplishments:

Action Steps Responsibilities Timeline Resources Potential Barriers Communications Plan


What Will Be Who Will Do It? By When? A. Resources Available A. What individuals or Who is involved?
Done? (Day/Month) B. Resources Needed (financial, organizations might resist? What methods?
human, political & other) B. How? How often?

Step 1: Resident of Jan. 1, 2020 A.Dustpan with broom, rag, A. keep yourself from the *Residents of sitoio
specific sitio Jan. 22, 2020 garbage bag, mop, and so on. tracts in time you need to *Clean twice a month.
Clean inside in And so on. clean based on the schedule, Prevention of some viruses
house Clean twice a B This is mandatory request don’t let your laziness not just dengue.
specifically in month. from Sitio leader all residents control you
the comfort must need to help and do the B. Be a responsible resident
room and wash Money collecting to buy the for you to live longer and for
the laundry. materials needed. you to live healthy
environment.
Step 2: A. A.
Sweep all the
garbages in B. B.
backyard or
just burn it, and
always keep on
mind to cover
all the water
container.

Step 3: Use A. A.
insect repellent
to kill those B. B.
killer
mosquitoes and
other pest that
might bother
you.

Evidence of Success (How will you know that you are making progress? What are your benchmarks?)
The specific sitio got involve with this action plan and they follow the protocols on how to eliminate the mosquitoes that cause common dengue virus.

Evaluation Process (How will you determine that your goal has been reached? What are your measures?)
The dengue case in the specific sitio has decreased according to the DOH.

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