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Grievance Redress System (GRS) Intake Form

This document contains an intake form for grievances related to the KC-NCDDP (Kapit-Bisig Laban sa Kahirapan - Comprehensive and Integrated Delivery of Social Services) program. The form collects information about the grievance such as the date, location, and how it was filed. It also collects details about the complainant and the nature of the issue, which can include queries, compliance issues, or violations of law. Finally, it requests the complainant's feedback on how the grievance was resolved and lists common categories of concerns.

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Ian Laping
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2K views3 pages

Grievance Redress System (GRS) Intake Form

This document contains an intake form for grievances related to the KC-NCDDP (Kapit-Bisig Laban sa Kahirapan - Comprehensive and Integrated Delivery of Social Services) program. The form collects information about the grievance such as the date, location, and how it was filed. It also collects details about the complainant and the nature of the issue, which can include queries, compliance issues, or violations of law. Finally, it requests the complainant's feedback on how the grievance was resolved and lists common categories of concerns.

Uploaded by

Ian Laping
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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CDD A-12: Form

GRIEVANCE REDRESS SYSTEM (GRS) INTAKE FORM

Date Received : Date Resolved:

GRS Form : PINCOs Filed Grievance

Intake Level : Central Region Municipal


Grievance Location : Region : Province: Municipality: _ Barangay:

Mode of Filing :

Mail/Letter Walk-in/verbal narration Phone/Fax BA Reports (specify) _

E-mail Text Message Suggestion Box Media Others (specify)

I. Complainant/Sender’s Information
Name (optional) : IP Group:_

Sex : Male Female Unknown Group/Organization/Institution (specify):

Designation/Position

MLGU Official/Staff BLGU Official/Staff DSWD/KC-NCDDP Personnel Volunteer Ordinary Resident

Contractor Service provider/Supplier Other Participating Agencies (specify):


Others(specify)

Contact Information (Address/Tel/Fax/Cel./Email):

II. Details of the Issue/Concern


Nature of Issue/Concern:

Type A: Queries, Comments and Suggestions (non-contentious)

Type B: Compliance with project processes, MOA and other KC-NCDDP implementation arrangements (non-performance of obligations)

Type C: Conformance with KC-NCDDP/government procurement and finance guidelines (violation of law)

Subject of Complaint:

MLGU Official/Staff BLGU Official/Staff DSWD/KC-NCDDP Personnel Volunteer Ordinary Resident Contractor
Service provider/Supplier Other Participating Agencies (specify): Others(specify)

Category of Concerns

Administrative CEAC Schedule/Timeline Community Participation Delivery of LCC Delivery of Materials

Financial Mgmt Gender Concerns Graft and Corruption KC-NCDDP Process/Design/Guidelines

LGU Participation O&M/Sustainability Positive Comments Procurement

Quality and Operations of SP RFR Processing Salary and allowances Social and Envt’l Safeguards

SP Imple. TA/support, information dissem. and capability building Other concerns specify)

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.Details of Concern (if PINCOs, indicate if Community and/or Operation and Management Concern):

Details/Narrative Summary Actions Taken/Resolution of the FOR PINCOs ONLY


(Use additional sheet if table is not enough.) Issue Recommendations
(Action needed from RPMO/NPMO/Other
agencies)

III. Complainant’s Feedback on Resolution of Grievance


No comment Not Satisfied Satisfied Very Satisfied

Name of Intake Office

Designation

List of Categories

Concerns Cases/Examples
Administrative
(includes HR concerns - (recruitment, hiring,
staffing, behavior of staff)
CEAC Schedule/Timeline

Community participation (functionality of


committees, volunteers’ responsibility, etc.)

Delivery of LCC
Delivery of materials

Financial Management

Gender concerns

Graft and corruption

KC-NCDDP Process/design/guidelines

LGU Participation
O&M/Sustainability
(includes financial management issues, functionality
of SPs and ODM)
Positive Comments

Procurement

Quality and operation of SPs

RFR Processing
Salary and allowances

Social and environmental safeguards

Subproject implementation

TA/support, information dissemination and


capability building

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