SBFP Form 1 (2023)

Department of Education
Region VIII

Master List Beneficiaries for School-Based Feeding Program (SBFP) (SY_2023-2024)

Schools Division Office: BISLIG CITY Name of Principal :

City/ Municipality/Barangay : Name of Feeding Focal Person :
Name of School / School District :
School ID Number:

Nutritional Parent's
BMI for Beneficiary of
Grade/ Date of Weighing / Age in Weight Height 6 y.o. Status (NS) Dewormed? consent for Participation
SBFP in
Date of Birth
No. Name Sex Measuring Years / milk? in 4Ps
Section (MM/DD/YYYY)
(MM/DD/YYYY) Months (Kg) (cm) and
(yes or no) (yes or (yes or no)
Previous Years
above (yes or no)
no)
BMI-A HFA
1
2
3

Prepared by: Approved by:

School Head
Feeding Focal Person

Note: This form shall be prepared by the school before the start of feeding to be compiled by the SDO.
SBFP Form 2 (2023)
Department of Education
Region ___

SCHOOL-BASED FEEDING PROGRAM (SBFP) SUMMARY OF BENEFICIARIES & START OF FEEDING (SY 2023-2024)
Schools Division Office: BISLIG CITY
City/ Municipality/Barangay :
Name of School / School District :
School ID Number:
Date of Start of Feeding: __________________________
Last Mile School: ___Y ___N
Nutritional Status at Start/End of Feeding No. of Secondary Targets No. of 4 Ps No. of 4 Ps No. of Date
Learners Beneficiari Pupils who Feeding
Number of Severely Wasted Normal Overweight Severely Stunted Normal Tall No. of Pupils- No. of No. of No. of Dewormed es are
Undernourished School Wasted + Stunted at-risk-of- Stunted/ Indigent Indigenous beneficiarie Started/E
Children by Grade Obese dropping-out Severely Learners Peoples (IPs) s in nded
Level (PARDOs) Stunted previous
years
(Repeaters)

1. Kinder

2. Grade I

3. Grade II

4. Grade III

5. Grade IV

6. Grade V

7. Grade VI
Total

Prepared by: Approved by:

SBFP DepEd Focal School Head
Note: This form shall be prepared by the school before the start of feeding and after feeding, to be compiled by the SDO, and for final compilation by the RO, for submission to
DepEd BLSS-SHD
 SBFP Form 3 (2023)
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF ______________________ , SY _____________

Region: VIII
SDO: SOUTHERN LEYTE School: _____________________________________
District: ___________________________ School ID Number: _________________________
Grade: __________ Section _____________________
NAME OF PUPIL ACTUAL FEEDING

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
TOTAL:
Prepared by:
__________________________
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SBFP Form 3 (2023)

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF ______________________ , SY _____________

Region: ____________________________
SDO: ___________________________ School: _____________________________________
District: ___________________________ School ID Number: _________________________
Grade: __________ Section _____________________

ACTUAL FEEDING

NAME OF PUPIL

21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL:

page 2
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice

page 2
 SBFP Form 3 (2023)

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF ______________________ , SY _____________

Region: ____________________________
SDO: ___________________________ School: _____________________________________
District: ___________________________ School ID Number: _________________________
Grade: __________ Section _____________________

ACTUAL FEEDING

NAME OF PUPIL

61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL:

page 3
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice

page 3
 SBFP Form 3 (2023)

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF ______________________ , SY _____________

Region: ____________________________
SDO: ___________________________ School: _____________________________________
District: ___________________________ School ID Number: _________________________
Grade: __________ Section _____________________

ACTUAL FEEDING
ATTENDANCE
NAME OF PUPIL No. of No. of
Days Feeding Percentage
Present Days
101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 (A) (B) (A/B)*100
1
2
3
4
5
6
7
8
9
10
11
12
13
TOTAL: AVERAGE:

D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice

page 4
SBFP Form 6 (2021)

SBFP Form 6 (2023)

DEPARTMENT OF EDUCATION
Region ___

REGION/DIVISION/DISTRICT: ______________________________________________________________________________
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________

SCHOOL-BASED FEEDING PROGRAM

NFP DELIVERIES (SY________)

Grade Level Number of Beneficiaries Date No. of Packs Received No. of Packs for Remarks
Delivered Replacement/
New Replacement Total (New + Rejected
Replacement)

Kinder

Grade 1

Grade 2
Grade 3

Grade 4
Grade 5

Grade 6

TOTAL:

Prepared by:

APPROVED BY:

School Feeding Coordinator School Head