Republic of the Philippines

Department of Education
Region X – Northern Mindanao
DIVISION OF LANAO DEL NORTE
Gov. A. Quibranza Prov’I Gov’t Compound
Pigcarangan, Tubod, Lanao del Norte
(063) 227 – 6633 (063) 341 – 5109
[email protected]

UNIFIED MONITORING AND EVALUATION TOOL

DIVISION PROGRAMS, PROJECTS & ACTIVITIES (PPAs) IMPLEMENTATION
(http://deped.in/unifiedmonitoring)

Instruction: Fill-up the spaces provided correctly and completely. This form shall be accomplished by the
School Head or any authorized representative from the School.

A. SCHOOL PROFILE
Date Monitored: ____________________ School Year: _______________
Name of School: __________________________________________ School ID Number: ____________
District: _______________________________________ Division: Lanao del Norte Division
Complete School Address: ______________________________________________________________
Name of School Head: _______________________________________ Contact No.: _______________
Teaching Personnel: Male: _________Female: ________ Total: __________
Non-teaching Personnel: Male: ______Female:________ Total: __________
Total Enrolment: Male: ____________ Female: ________Total: ___________
With Functional Biometric: Yes:_____ No:_____ Updated Logbook of Teachers: Yes:____ No:___
If No, why?_____________________________

SCHOOL HEALTH SECTION

B. WinS (WaSH in School) PROGRAM
1. Is WinS Program implemented in the school? Yes No
2. Is WinS being advocated in the GPTCA assembly? Yes No
3. Are there organized structures (eg. TWGs, student clubs) to promote WinS? Yes No
WATER
4. Does the school provide safe drinking water?
All the time
Yes, but supply is not regular
No drinking water in school
5. Is the drinking water provided by the school for free? Yes No
6. Does the school coordinate with LGU or water district to test the quality of water? Yes No
7. How many times was the quality of water tested in current calendar year? _____________

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SANITATION
8. How many toilet seats are available for children / students in the school?
Do not include toilet seat for teachers.

Male Female Shared/Communal Total Ratio

Functional
Not functional
9. Does the school have genderized CR in the classroom? Yes No
If Yes, how many classrooms with genderized CR?__________ If No, Why?__________
10. Is waste segregation being practiced in school? Yes No
11. Does the school have policies / sanctions which promote the practice
of waste segregation? Yes No
12. Does the school have a compost pit for biodegradable waste? Yes No
13. Does the school have a materials recovery facility (MRF)? Yes No

HYGIENE
14. Do you have handwashing and toothbrushing chart per classroom? Yes No
If Yes, how many learners are involved and when it was conducted?
_____________________________________________________If No, why? _____________________
15. What are the sources of funds for WinS Supplies? Please check all that apply.
School Private LGU Children bring
MOOE donations PTA Funds their own
Soap
Toothbrush
Toothpaste
Cleaning materials/supplies for toilets
Repair and maintenance
16. Where can learners avail of sanitary pads?
S School Canteen S Guidance Office S Others
S School Clinic S Class Adviser/Teacher
17. Is there information on proper disposal of sanitary napkins in the girls’ toilet? Yes No
Yes No
18. Is there a designated rest space/changing room for girls with menstrual Yes No
discomfort?
C. SCHOOL CANTEEN

19. Does the school have canteen? Yes No

20. Does the school canteen have sanitary permit? Yes No
21. Do food handlers practice the following food safety measures?
S Wearing of hairnet, gloves, masks and apron S Handwashing
Segregation of dry and wet food materials
22. Have all food handlers been oriented on food safety measures? All Some None
23. Do all food handlers in the school have health certificates? All Some None
24. Is there approved School Canteen Financial Report posted
in the Bulletin Board/Transparency Board? Yes No

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25. Are the foods displayed in the canteen nutritious and properly covered? Yes No

D. DEWORMING
26. Is deworming done semi-annually? Yes No
27. What is the total number of students dewormed? Male: _____ Female: ______ Total:_____

E. SCHOOL-BASED FEEDING PROGRAM (SBFP)

28. How many SBFP Beneficiaries? ______
29. Is there tarpaulin posted in the transparency board reflected the Budget &
Number of Beneficiaries of SBFP? Yes No
30. Are the tables and chairs in the feeding center properly arranged? Yes No
31. Does the feeding center in the school clean and orderly? Yes No
32. Is there available menu prepared for the whole week? Pls. see attach menu. Yes No
33. Is there feeding schedule posted in the feeding center? Yes No
F. DUGONG GURO DUGONG BAYANI
34. Number of Blood Donors:_______________ 69. Percentage of Blood Donors: ____________

J. NATIONAL DRUG EDUCATION PROGRAM (NDEP)

35. For Elementary: Is there NDEP Corner inside the Classroom? Yes No
36. For Secondary: Is there Barkada Kontra Droga Center in the school campus? Yes No
37. Is there BKD Plan prepared by the School BKD Coordinator? Yes No

H. GULAYAN SA PAARALAN

38. Is there functional garden in School? Yes No

In plots?_______ in containers?__________
Established Garden _________Sustained ____________
39. Are there Garden Tools available in the school? Yes No
40. Is there functional Seed Bank? Yes No
41. Is there functional Nursery? Yes No

I. ANTI-SMOKING PROGRAM

42. Is there “No Smoking” signage’s available in the canteen, School Principal’s Office,
Stage, CR and School Entrance? Yes No

43. Is there organized structure such as Technical Working Group in the school
that composed of Principal as Chairperson, PTA President, Brgy. Captain, Yes No
SPG/SSG teachers as members?
44. Does the school have compilation of Memorandum on Anti-smoking program,
Copy of R.A. 9211 and E.O. No. 26 at the Principal’s Office/SBM Room? Yes No

45. Does the school have compilation of Monthly Narrative Report on

Anti-smoking in the Principal’s Office/SBM Room? Yes No

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J. MENTAL HEALTH PROGRAM
46. Is there Technical Working Group created in the school for the
Mental Health Program that composed of Principal as Chairperson,
Guidance Counselor as Co-Chairperson, SSG Officers (Secondary)/
SPG (Elementary), all teachers as members? Yes No

47. Is there PINK Room available in the school to be utilized for counselling? Yes No

48. Is there HELP LINE in case for referral of patient posted in the Yes No
guidance counselor’s office?

K. DENGUE FEVER/DENGUE HEMORRHAGIC FEVER

49. How many number of cases of dengue since the Opening of Classes? _______________
50. What are the precautionary measures done in the school? _____________________
51. Are you aware of the 4 “S-strategy”? _________________
52. Does the school practice the 4 “S” campaign? _____And How? ___________________

L. FORM 86 – ANNUAL PHYSICAL EXAMINATION

53. Number of Non-Compliant Personnel: __________________
54. Number of Personnel with Hypertension? _______
with follow up check up? Yes ___ No____
with maintenance? Yes ____ No ____ if yes, name of medicine
55. Number of Personnel with PTB. ___________
Under Medication: ____________ Relapse __________ Cured________
56. Number of Personnel with DIABETES? ______with medication Yes No

M. ADOLESCENT REPRODUCTIVE HEALTH (ARH) SECONDARY

57. Please complete the table below:
WEEKLY IRON FOLIC ACID (WIFA)
GRADE LEVEL MALE FEMALE TOTAL
GRADE 7
GRADE 8
GRADE 9
GRADE 10
GRADE 11
GRADE 12
58. Do you have Pregnant Leaners? Yes No
If yes, how many pregnant learners? ______________
59. Are the pregnant learners undergo Pre-natal check-up? Yes No
If yes, where the pre-natal conducted? Public___ Private____ pls. specify_____________
and when was the last schedule? ________
60. Does the school conduct ARH symposium/lecture? Yes No
If yes, how many participants? ________when? ______ where?______
If No? why? _________________
61. Is there HIV/AIDS drive conducted in school?
If yes, please write the details______________________________________________________
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 If No? why? ___________________________

N. CANCER AWARENESS

62. Is there Teacher/School Head diagnosed CANCER in your School?

If yes, please specify the details
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
63. Does the school conduct Cancer Symposium/Lecture to all teaching and non-teaching
school personnel? Yes No
If yes, how many participants? ________when? ______ where?______
If No? why? _________________

PLANNING AND RESEARCH SECTION

64. Is there approved School Improvement Plan (SIP) in School? Yes No
If No, why? ________________

65. Is there annual Monitoring Report conducted by School Monitoring Team? Yes No
If No, why?__________________

66. ENROLLMENT
Date conducted: ________________

ENROLLMENT Enrollment (Based on

LEVEL No. of (Formal Class) actual head count) Enrollment for ALS
Sections Male Female Total Male Female Total LEVEL Male Female Total
Kindergarten BLC
Grade 1
Grade 2
Grade 3 A&E
Grade 4 ELEM.
Grade 5
Grade 6
Grade 7
Grade 8 A&E
Grade 9 SEC.
Grade 10
Grade 11
Grade 12 SHS
TOTAL
67. SPED PROGRAM
How many SPED Learners?

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 Please specify:
_________________________________________________________________________________________
_________________________________________________________________________________________
68. ALIVE PROGRAM
How many ALIVE Learners?________
Please specify: _______________________________________________________________
___________________________________________________________________________
69. IPED PROGRAM
How many IPED Learners?________
Please specify:_______________________________________________________________
___________________________________________________________________________
70. OPEN HIGH SCHOOL PROGRAM
How many Open High School Learners?________
Please specify: _______________________________________________________________
___________________________________________________________________________
71. DROP-OUT

MONTHLY DROP-OUT
GRADELEVEL JUNE JULY AUGUST SEPTEMBER OCTOBER
Male Female Male Female Male Female Male Female Male Female
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
TOTAL

MONTHLY DROP-OUT
GRADE LEVEL NOVEMBER DECEMBER JANUARY FEBRUARY MARCH
Male Female Male Female Male Female Male Female Male Female
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8

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 Grade 9
Grade 10
Grade 11
Grade 12
TOTAL

72. LARDO (Learners at Risk of Dropping Out)

MONTHLY LARDO
GRADELEVEL JUNE JULY AUGUST SEPTEMBER OCTOBER
Male Female Male Female Male Female Male Female Male Female
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
TOTAL

MONTHLY LARDO
GRADE LEVEL NOVEMBER DECEMBER JANUARY FEBRUARY MARCH
Male Female Male Female Male Female Male Female Male Female
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
TOTAL

Please enumerate the causes of drop-out and intervention given.

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 _________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
73. MULTIGRADE

Status Number of
Grade Combination Teachers
Mixed (MG &
Pure MG

Mono)

Others
K& K,1& 1& 2& 3& 4& 5& 1,2& 4,5& Pure Comb Mon
(Please
1 2 2 3 4 5 6 3 6 specify) MG i o

EARLY REGISTRATION
74. Does the school have tarpaulin on Early Registration posted in the visible area? Yes No
75. Does the school upload the data on early registration in the LIS
Early Registration Facility? Yes No
76. Please supply the needed data below:

EARLY REGISTRATION REPORT SY 2020-2021

Total Enrolment
LEVEL Male Female TOTAL
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
TOTAL
Issues and concerns on Early Registration

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 Issues/Concerns Solution Employed Remarks

Remarks: Please enumerate remarkable initiatives done by the schools to invite more enrollees.
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

MONITORING AND EVALUATION SECTION

74. Is there electronic School Report Card in the School? Yes No

75. Does the school have compilation of QATAME reports of the trainings
conducted in School? Yes No
76. Does the school have compilation of Quarterly SMEA reports? Yes No
77. Does the school have compilation of Monitoring & Evaluation Tools? Yes No
78. Does the school have functional School Based Management (SBM) Yes No
room/corner in the school?

Please fill up the needed data below:

RESULTS
LEVE
DOD (40%) L OF
PRAC
SBM DATE
Leadershi Curriculu Accountabil Manag TOT TICE
PI
VALIDATI CONDUCTED CONDUCT (60 p& m and ity & ement AL

ON BY ED %) Governan Instructi Continuous of

ce (30%) on (30%) Improveme Resour
nt (25%) ces
(15%)
SCHOOL STAKEHOLDE
LEVEL RS
SCHOOL SCHOOL
LEVEL COORDINATI
NG TEAM
DIVISION DIVISION
LEVEL COORDINATI
NG TEAM
REGIONA REGIONAL
L LEVEL COORDINATI
NG TEAM
NATIONA NATIONAL
L LEVEL COORDINATI
NG TEAM
OBSERVATIONS AND RESPONSES TEMPLATE:

Write below actual responses and observations on areas for improvement and highlights during the conduct
of DOD.
SBM Principle:__________

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 DATE SITUATION/OBSERVATION DOCUMENT/PERSON INTERVIEWED

Evaluated by:_________________

HUMAN RESOURCE DEVELOPMENT (HRD) SECTION

79. Is there list of Approved Trainings Conducted in the School? Yes No
80. Does the school have printed copy of ESAT? Yes No
81. Does the school have compilation of Individual Training Record of
teachers and School Head and Training Effectiveness Evaluation? Yes No
82. Is there approved schedule for Learning Action Cell (LAC) Session? Yes No
83. Does the school have compilation of approved IPCRF and OPCRF? Yes No
84. Does the school have RPMS-PPST Manual? Yes No
85. Does the school have PPST Resource Package? Yes No
86. Does the school have a hard copy of consolidated RPMS Data Collection) Yes No

SOCIAL MOBILIZATION AND NETWORKING SECTION

87. Does the school have list of FPTA Officials/Classroom PTA officials and SGC Officers
with their duties and functions? Yes No

88. Is there PTA contribution collected from the students? Yes No

If yes, how much?__________ (monthly/annually), who collected?________
and what is the purpose in collecting PTA Funds?_____________ Yes No
89. Does the school have Transparency Board based on the prescribed format
indicated in Annex A of Division Memorandum No. 185 s. 2019 re: Upscaling of
Transparency Board? Yes No
If yes, Is it updated? Please check the updated report listed below:
Monthly MOOE Liquidation Report PTA Financial Report (Quarterly)
Canteen SORD (Statement of Receipts and Disbursement)
School Based Feeding Program (SBFP) Liquidation
Gulayan Funds Funds for Internet Connectivity
Donations Received Other Funds: (Pls. specify) _________

90. Does the school have compilation of MOA/MOU/DOD/DOA? Yes No

91. Does the school have list of stakeholders/partners with their contributions? Yes No
92. Does the school have annual Brigada Eskwela Accomplishment Report? Yes No
93. Is there Evacuation Plan (Flood &Earthquake/Fire)? Yes No
94. Is there Medicine Kit? Yes No
95. Is there Fire Extinguisher? Yes No
96. Are there Visible Emergency Hotlines (Police, AFP, MDRRMO, RHU & LGU)? Yes No
97. Does the school have DRRM Equipment? Yes No
98. Does the school have updated DDRM Team and Student-Led/ School Yes No
Watching Team? Yes No
99. In the past year, did the school experience any floods or calamities? Yes No

100. What are the resources needed in your school? Please enumerate below:
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 ____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
101. What are the status of the DRRM Equipment given from the Division Office? Please specify:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
102. Does the school have an account in DepED Partnership Database System (DPDS)? Yes No
If yes, please indicate the data of the following to be generated from the system:
Number of Partners:_________________ and Total amount generated:____________

SPECIAL PROGRAMS AND PROJECTS SECTION

103. Does the school have Child Protection Policy? Yes No
104. Does the school have list of SPG/SSG with the corresponding duties and functions? Yes No
105. Are there cases of Bullying happening in the school? Yes No
If yes, please spicify: ___________________
106. Does gang or fraternity exist in the school? Yes No
If yes, please spicify:______________ Interventions given__________________
107. Does the school have Annual Career Guidance Program of Activities? Yes No
108. Does the school have Annual Youth Formation Program? Yes No
If yes, please check:
Sports Values Formation Scouting Other activities __________

Please specify MOVs (Means of Verifications) to support Youth Formation Program

_______________________________________________________________________
_______________________________________________________________________

For Sports, please specify the sports being specialized in the school?
_______________________________________________________________________
_______________________________________________________________________
109. Does the school have proponent for IGP?
If yes, how many teachers? _______________ Yes No

PHYSICAL FACILITIES SECTION

110. How many years does the School Operate? ________
111. When did it start? _____When was it founded? ______________
112. Please check the proof of site ownership of the school.
Titled under DepED Tax Declaration under LGU
Titled under LGU Deed of Sale
Title under Private Presidential Proclamation
Contract of Usufruct For Acquisition
Deed of Donation No Information
Tax Declaration under DepED
113. Does the school have updated Approved Site Development Plan? Yes No
114. Does the School have complete perimeter fence? Yes No
If No, provide the measurement needed for perimeter fence __________
115.Are there sufficient number of classrooms available? Yes No
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 If No, how many classrooms needed? ___________
116. Are there sufficient chalkboards/whiteboards in all classrooms? Yes No
If No, how many classrooms have no chalkboards/whiteboards?_____

117. Are there sufficient number of chairs available for the learners?
If No, how many chairs are needed? _______________ Yes No

118. Are there sufficient, well-located and readily accessible electrical outlets
and switches in all rooms? Yes No
If No, how many classrooms need electrical wiring installation? _____

Observations/Findings: ____________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

Recommendations: _______________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

Checked & Evaluated by:

Printed Name & Signature: ________________________________ Position:________Date: ______

Certified True & Correct by:

Printed Name & Signature: _________________________________ Position:________Date: _____
School Head

ivytjumawan
PPAs M&E Unified Tool updated on February 7, 2020

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