Public Shool Qa Form 8

(PUBLIC SCHOOL) Page 1 of 5
QA FORM 8
Republic of the Philippines
Department of Education
MIMAROPA Region
Meralco Ave. cor. St. Paul Road
Pasig City
REVISED PROCESSING SHEET

APPLICATION FOR SEPARATION OF SCHOOL ANNEX
Name of School
to be separate (current) : ____________________________________
Mother School : ____________________________________
School ID (Mother Sch.) : ____________________________________
(Annex Sch.) : ____________________________________
Proposed Name
of school (to be separated) : ____________________________________
Address of School : ____________________________________
Courses Offered : Kindergarten Elem. JHS
School Year : ____________________________________
Date Received : ____________________________________
Date Evaluated : ____________________________________
Date Released : ____________________________________
Contact Person : ____________________________________
Contact Numbers : ____________________________________
Email Address : ____________________________________
Particulars Quality Description Remarks

DO RO
Document Presentation  Submitted 2 sets of documents
(original and photocopies of the original documents)
 Submitted to RO within 1st week of
July of the current year
 Page finder descriptor tabs
Corresponding to the numbers in the checklist
were affixed accordingly to each document
 Colored expanding folder per division
was utilized.
Calapan – Pink Occi.Mdo. – Red
Palawan – Yellow Or. Mdo – Orange
Marinduque – Green PPC – Blue
Romblon – Purple
Long Expanding folders and papers (8.5”x13”)
were used
All documents were listed in a Table of Contents
LIST OF DOCUMENTARY REQUIREMENTS AND ITS DESCRIPTION
1.Revised Evaluation Duly accomplished and signed by the Division
Sheet Review and Evaluation Committee
No information was left out by the processor
2.Letter Request Addressed to the Schools Division Superintendent
(SDS) by the school head of the mother school
and/or PTA or Barangay Council
Stated reasons for the separation of the school
annex
Duly signed by the requesting officer,
designation/position and date of request
3. DepEd School ID Composed of six (6) digit number
Listed in the EBEIS (school annex)
4. Approval on its Stated DepEd approval on its operation as annex
Operation as Annex school
 Duly signed by DepEd Regional Director
5. Sangguning Contained statement of support to the separation
Revised 9.18.18
Quality Assurance Division Tel No. (02) 637-4184/Telefax (02) 637-3093 Email Address: [email protected]
QA FORM 8
Bayan/Panglungsod of the school annex
Resolution Indicated the complete and correct name of the
school
Duly signed by the SanggunianBayan
/Panglungsod members, secretary and Mayor
and approved by the Mayor
6.Feasibility Study Contained the following:
Justification on the need to separate the school
annex
Proposed Organizational Structure
No. of Positions
Position Title Nationally- Locally- Total
Paid Paid
School Principal
Master Teacher
Teacher I/II/III
Administrative Asst
Others
TOTAL
School Environment (Environmental

scanning/situational analysis) stating the
specified location/classification (Urban or Rural),
topography/geographical condition of the site
(Mountainous, Coastal, Plain), catchment area
as well as the mode of transportation in going
from home to school and vice versa
Travel Time
Mode Frequency* (in
minutes/hours
)
1.Land Transportation
a. Tricycle
b. Jeepney
c. Bus
d. Motorcycle
e. Jabal-jabal
f. Others
2. Banca Ride
3. Animal Ride
4. Hiking
*whether once a day, twice, every hour, etc.
Proposed School Development Plan duly signed

by the Division Engineer
Proposed Budget/Budgetary Requirements
covering the 5-year proposed schools’ crucial
resources
Particulars Amount
1.Staffing
2.Furniture and
Fixtures
3.School Building/classroom
4.Others
TOTAL
Duly signed by the School Head and Punong

Barangay and countersigned by the SMME
7. Inventory of Crucial Listed crucial resources to be transferred to the
Resources proposed school to be separated
Duly signed by the mother school’s Property
Revised 9.18.18
QA FORM 8
Custodian
8. Memorandum of Duly signed by and between the School Head of
Agreement (MOA) the mother school and Officer In-Charge
(OIC)/Teacher In-Charge (TIC) of the school
annex
Indicated among others, the transfer of crucial
resources to the proposed regular school, to wit:
1. Teaching and non-teaching items, pursuant to the
existing DepEd-DBM staffing standards for
standards;
2. Funds for Personal Services based on the actual
salaries of the school personnel (both teaching and
nonteaching) to be transferred;
3. Funds for maintenance and Other Operating
Expenses (MOOE);
4. Facilities, furniture, equipment and textbooks in all
subject areas; and
5. Other funding requirements until such time that the
school’s funding requirements in integrated in the
General Appropriations Act (GAA)
Notarized
Justification from the School Head or SDS in case
the required MOA cannot be met
9. Personal Services Contained the following information:
Itemization and Position Titles No. of Positions Funding
Plantilla of Requirements
Personnel E.g. Principal 1
(PSIPOP) Teacher 1
Others
Total
 Updated and certified as true copy of the original

by the School Head
5.List of Prospective Contained the following:
Enrolees Name segregated by sex
Age
Address
School currently enrolled
Attained the minimum number of enrolees from
Kinder to 6 or Grades 7 to 10 for the current
school year with at least 400 pupils/students
Grade Level No. of Enrolees
1
2
3
4
5
6
7
8
9
10
TOTAL
Signed justification by the SDS if aforementioned

criterion was not met
10.School Site Complied lot size requirement of at least 5,000
Document square meters or one half (1/2) hectare for rural
areas; 2,500 square meters for highly urbanized
cities
Conformed to any one of the following
requirements:
Revised 9.18.18
QA FORM 8
Deed of Donation
 Duly signed by the donor and done (SDS) and
witnesses
 Duly accepted by the SDS as the done
 Notarized
Deed of Sale or Contract of Usufruct
 Duly signed by both contracting parties
 Land Title
 If tax declaration, attached certificate of no
pending land registration application from the
Registry of Deeds (ROD) or from the Regional
Trial Court (RTC)
 Type of land indicated in the Tax
Declaration like Timberland must be
converted into a school site and
Ancestral land in consultation with the
NCIP
 If public elementary to public secondary,
contracting parties are the school heads to be
confirmed by the SDS. Letter request to the CO
through the RO for the Deed of confirmation to
be signed by the SDS
Duly signed justification by the SDS if
aforementioned criterion was not met
Evaluated by the Division and Evaluation Committee (DREC):
SMME Div. Admin. Officer Div. Planning

Officer
___________________ ____________________ ___________________

Division Accountant In-Charge of Education Facilities SGOD Chief
Validated by the Regional Inspectorate Team (RIT):
____________________ _______________________ ___________________

ENGR. DIEGO BUSTAMANTE WENDELL I. FORMALEJO, PhD. MELBERT S. BROQUEZA, PhD.
In-Charge, Education Facilities EPS, CLMD EPS, QAD
_______________________ ________________________ ____ __________________

RITCHIE G. DIOLA, PhD. ARDEE DC RAMILO ATTY. RENEE R. MORENO-PEREZ
EPS, QAD CAO, Finance Atty. IV, Legal Unit
__________________________
GLORIA M. CRUZ
Chief, QAD
Revised 9.18.18
QA FORM 8
__________________________
RUTH L. FUENTES, CESO V
OIC, Office of the Assistant Regional Director
Revised 9.18.18

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(PUBLIC SCHOOL) Page 1 of 5

REVISED PROCESSING SHEET

Particulars Quality Description Remarks

School Environment (Environmental

Proposed School Development Plan duly signed

Duly signed by the School Head and Punong

 Updated and certified as true copy of the original

Signed justification by the SDS if aforementioned

Evaluated by the Division and Evaluation Committee (DREC):

SMME Div. Admin. Officer Div. Planning

_ _

Validated by the Regional Inspectorate Team (RIT):

________ _ _________

_____

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