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Form A. Inspection Checklist On Child Labor

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Form A.

Inspection Checklist on Child Labor


Republic of the Philippines DEPARTMENT OF LABOR AND EMPLOYMENT Inspection Checklist on Child Labor INSTRUCTIONS: Accomplish this form in three (3) copies for each establishment inspected. The Regional Office submits to the Bureau of Working Conditions the original copy not later than every 12th day of the month after the covered period, keeps the second copy for the Regional Office file and the third copy for the Field Office. Original supporting documents in the Documents Attached portion, e.g. Child Personal and Work Profile Form, are to be attached to the Regional Offices file.

GENERAL INFORMATION Name of Establishment Address GEO Code Owner/Manager/President PSIC Code Kind of Business/Economic Activity/Principal Product Inspection Authority No. Enter premises permitted denied Access records permitted denied Interview employees permitted denied Age Group below 15 15 to below 18 18 & above Violation of Republic Act No. 9231 (Elimination of Worst Forms of Child Labor Act): death insanity serious physical injuries (a) Violation resulting in: (b) Child engaged or employed in:
prostitution obscene or lewd shows prohibited advertisement (employment of a child as a model in any advertisement directly or indirectly promoting alcoholic beverages, intoxicating drinks, tobacco and its by-products, gambling or any form of violence or pornography) slavery or similar practices, such as sale or trafficking of children, debt bondage, serfdom, forced labor, recruitment of children for armed conflict production/trafficking of dangerous drugs/volatile substances other illegal or illicit activities (please specify): exposure to a condition or practice that could be reasonably expected to cause death or serious physical harm before abatement under the enforcement procedures can be accomplished Work other than directly under sole responsibility of parents Work for public entertainment or information o No work permit o Children work more than 4 hours a day/twenty (20) hours a week o Children work between 8:00 p.m. to 6:00 a.m. the following day

Name/designation of person who refused entry Name/designation of person who refused access Name/designation of person who disallowed interview Employment Total No. of Aliens Employed Time & No. of Shifts

Female

Male

(c) Imminent danger: (d) Employment of children below 15 years old

(e) Work hours:

Children 15 to below 18 work more than 8 hours a day/40 hours a week Children 15 to below 18 work between 10:00 p.m. and 6:00 a.m. of the following day Children below 15 work more than 4 hours a day/20 hours a week Children below 15 work between 8:00 p.m. and 6:00 a.m. of the following day

(f) Others (please specify): DOCUMENTS ATTACHED


Child Personal & Work Profile Form(s) (No. ____) Birth certificate/s (No. ______) List of workers and hiring rates Employment contracts Daily time records/time sheet Payrolls or their equivalent Production records (if paid by results) Proof of remittance to Business permit/license/SEC registration Computation of separation pay/monetary benefit Accident reports Medical records Others (please specify):

Form A. Inspection Checklist on Child Labor

BIR/SSS/Philhealth/Pag-ibig

Inspection conducted by:

FOR REGIONAL OFFICE USE ONLY Evaluated by:

(Signature above printed name)

Date:__________________________________ Recommendations/Comments:

(Signature above printed name)

Date: _______________________________ Recommendations/Comments:

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