Form A. Inspection Checklist On Child Labor
Form A. Inspection Checklist On Child Labor
Form A. Inspection Checklist On Child Labor
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
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
BIR/SSS/Philhealth/Pag-ibig
Date:__________________________________ Recommendations/Comments: