SBFP Form 1

Department of Education
Region III

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

Division/Province: ____________ OLONGAPO/ZAMBALES Name of Principal : ____________ AMALIA M. ABAYAN

City/ Municipality/Barangay : ____ NEW CABALAN, OLONGAPO CITY Name of Feeding Focal Person : _________________________
Name of School / School District : _________________________ Sponsor of Feeding: _________________________________
School ID: ______________________

Date of Beneficiary
BMI for
Date of Birth Weighing / Age in 4Ps ID of SBFP in
Weight Height 6 y.o. Nutritional Status
No. Name Sex (MM/DD/YYY Measuring Years / Ethnicity Disability Name of Parents Previous
Y) (MM/DD/YYY Months (Kg) (cm) and (NS) Number Years (yes
above
Y) or no)

K - 1 Franco, Mickaela F 6/12/2014

2 Madriaga, Cinderella S. F 7/17/2013

3 Espada,Jhanella Mae F 9/24/2013

4 Princess Athena Joy F 7/13/2014

5 Estropigan, Sherie Ann, B. F 4/6/2014

6 Lizada, Samantha, Pulgado F 6/28/2014

7 Solano, Marjorie, Besa F 3/8/2014

8 Paat, Princess Rhei Anne D. F 2/23/2013

9 Alegado, Joshua, Jardin M 5/18/2014

10 De Silva, Carlo, Borja M 10/26/2013

11 Lipumano, John Matthew N. M 1/2/2014

12 Delos Santos, Jael Nikkie, Mansueto F 8/13/2014

13 Mamalias, Rhian, Espinosa F 4/25/2014

14 Lozano, Irish L. F 2/7/2014

15 Mansueto, Joewell Glory Anne A. F 5/14/2014

16 Lumangtad, Adrian V. M 1/7/2014

17 Condes, Rhayne Albhrenz D. F 1/29/2014

18 Vallejera, Graceelyn A. F 8/18/2014

19 Asuar, Lian Mhar M 5/2/2014

 20 Edquila, Princess Ashley F 7/9/2014

21 Caparas, Eian Jorge M. M 10/21/2013

22 Aringo, Sheila Marie F 8/18/2014

23 Fabro, John Angelo M. M 1/4/2007

24 Castillo, Aprilyn Carpio F 4/13/2013

25 Japona Evangieline F 12/23/2012

26 Orale, Sophia Louise Abujen F 3/30/2014

27 Juliano, Rica Carpio F 11/16/2013

28 Mardo, Jenelle Ashley F 7/31/2014

29 Pedong, Clarisse P. F 2/27/2014

30 Mendoza, Angel May. Bernaldo F 5/29/2013

31 Ambulario, John Gabriel M 5/22/2014

32 Bruan, Princess Nicole Sola F 11/1/2013

Gr. 1 - 33METALICOP, HAYDE M 9/24/2010

34 PADILLA, PRINCESS GERALYN C. F 1/25/2013

35 DEL PILAR, JHADE CHLOE T. F 8/18/2013

36 Arao, Vincent Jay A. M 7/8/2012

37 Turdos, Rodelio Jr. M 9/6/2012

38 GONTINAS, PATRICK M 7/25/2013

39 ONATE, JAN DANIEL M 1/19/2013

40 LOMEHOC, QUINCEE F 9/10/2013

41 POSTRADO, DWAYNE M 10/23/2012

42 TEMPLADO, GREGGY M 10/28/2013

43 MONTEJO, CHRISTINA F 8/8/2013

44 CLEMENTE, JULIE F 11/18/2012

45 NALLAS, ASHLEY F 11/12/2012

46 WRIGHT, MILES F 4/6/2013

47 Catlee, Alvin G. M 10/14/2013

48 Maravilla, Gino B. M 12/19/2012

49 Bello, Jocelyn T. F 9/25/2012

50 DASSUN, DAVID V. M 3/12/2010

51 BARNACHEA, NICOLE ANDREA F 9/21/2012

52 AQUINO, KAREN JOY F 10/17/2013

53 LORENZANA, KOBE ADRIAN E. M 12/15/2011

 54 CRUZ, JEREMY RYAN D. M 10/19/2012

55 BUTON, ELLAROSE C. F 9/17/2013

56 ECLARINO, ALTHEA KATE G. F 2/22/2013

57 MACKAY, MICHAELA MAIKA C. F 9/22/2012

Gr. 2 - 58Malubag, Cheska Janine A. F 7/31/2011

59 Celino, Dastain Kyle D. M 5/29/2012

60 Casas, John Nathan M 4/24/2011

61 Faustino, Carlo Angelo Y. M 5/8/2012

62 Prado, Jonas Flores M 4/6/2012

63 Vinegas, Carvin Jayl M 7/1/2012

64 Soriano, Ezeleo Raijin C. M 12/30/2012

65 Caturan , John Dave M 12/8/2011

66 Dacuyan, John Paul C. M 6/23/2012

67 Espinosa, Novilyn F 11/1/2011

68 Manio, Nellania Heart A. F 2/2/2012

69 Fabro, Ronalyn M. F 6/14/2008

70 Reyes, Zhian Carl Payumo M 3/13/2012

71 Sumile, Vince Rovin M 6/1/2010

72 Santos, Jairalyn Mae Tumanlao F 11/20/2010

73 Cabiles, Arvin B. M 7/31/2012

74 Feria, John Lawrence H. M 11/19/2011

75 Lipumano, Cloe Pearl N. F 2/17/2012

76 Madera, King M 3/28/2008

77 Muñoz, John Carl Isip M 10/13/2011

Gr. 3 - 78Liscano, Steven Arron M. M 4/11/2009

79 Aligue, Ruby Q. F 4/10/2011

80 Romero, Jeana Rose R. F 2/3/2010

81 Cruz, John Lloyd D. M 12/14/2010

82 Salazar, Kylie O. F 1/1/2011

83 Javelona Kenan C. M 12/12/2010

84 Siguenza, Prince Lee Jae G. M 6/20/2011

85 Yaon, King Meldhenz C. M 11/6/2010

86 Eroza, Rhealyn L. F 3/21/2011

87 Atanacio, Ricky Boy P. M 7/7/2007

 88 De Vera, Jhonaz P. M 1/11/2011

89 Dimandiman, John Paul G. M 8/3/2011

90 Otico, Lance Yuri M 9/9/2010

91 Padilla, Rustom M 4/24/2009

92 Manglicmot Ji-Anne Cristy A. F 3/8/2008

93 Gomez, Ayesha Jade B. F 1/11/2011

94 Cambic, Rommel A. M 4/5/2011

95 Roque, Reynaldo III R. M 2/8/2011

96 Aquino, Cheska Jean C. F 5/20/2011

97 Mostue, Alessa Khay E. F 11/9/2010

98 Ocampo, Crislyn J. F 7/19/2009

99 Bruan, Jho Airenz S. M 6/12/2011

100 Guevarra, Kyla Alyanna F 2/20/2010

101 Pasag, Janna F. F 8/27/2011

Gr. 4 - 102Feria, John Ruzty M 8/16/2010

103 Bautista, Carol F 9/20/2010

104 SIMBRA, ARBIE JAY SALUT M 5/30/2009

105 Madriaga, Angelo B. M 10/17/2009

106 Magno, Sofia Arceli N. F 1/12/2010

107 Bactad, Rolando Jr. Mojica M 1/13/2010

108 Bravo, Allan Isaac Ednalan M 1/27/2009

109 Dacuyan, Jodilyn Buban F 1/4/2010

110 Castillo, Laurence Veniel Mhar M 1/5/2008

111 Dasun, Domenic M 4/10/2006

112 Manglicmot, John Alexis M 2/25/2007

113 Rena, Sam M 6/18/2010

114 Sabeniano, Ronald Jr. M 7/30/2008

115 Serafin, Sunny M 8/1/2009

116 MUSA, JADEN ESTINOR M 7/25/2010

117 ONNAGAN, ARVIN JAY CINCO M 11/3/2007

118 AMPOSTA, NADINE GWEN DIMACA F 12/16/2009

119 BUSLON, MICHAELA ALTHEA ACA F 7/7/2010

Gr. 5 - 120
Olivario, Kenji Dominguez M 7/29/2004

121 Mapa, Sariah Joeanne Perez F 2/16/2009

 122 Pulgado, Kilboy M 5/7/2009

123 Corrales, Athea F 10/23/2008

124 Cunanan, Micca F 6/8/2009

125 Catlee, Acie Gaspar M 2/22/2009

126 Derain, Reygie Yutuc M 2/11/2008

127 Perez, Cypress M 11/10/2006

128 Yutuc, Gabriel M 1/28/2008

129 Cariño, Asheley Nicole F 3/22/2009

130 Doinog, Claire Arceo F 1/22/2009

131 Juliano, Novilyn F 11/29/2008

132 Ocomen, Jonnel Cortez M 2/2/2009

133 Paguio, Mariane Reyel F 10/19/2009

134 Torres, Trixia Mae Eniego F 2/26/2009

135 Gontiñas, Marlon JR. Galarosa M 4/18/2009

136 Vengaso, MJ Cordial M 12/22/2006

137 Gorospe, Rhianne Mae Mackay F 5/30/2009

138 Nillasca, Patricia Jhoy Sabarillo F 9/7/2009

139 Claor, Bea F 6/7/2008

Gr. 6 - 140
Caber, Michael Mendiola M 5/14/2003

141 Madriaga, Franky Sigua M 12/22/2006

142 Tolentino, Ron Allen M 6/25/2008

143 ARCAMO, AIKHON F 8/8/2008

144 POSTRADO, ALTHEA LYN JASARE F 6/11/2006

145 BOTALON, JIM RHEXEL T. M 12/20/2007

146 FLORENDO, BENJAMIN JAMES R. M 3/7/2008

147 HIPOLITO, ALJON F. M 5/14/2008

148 MAGALLANO, RHAINE FRANCIS B. M 12/7/2007

149 Florita Jr., Jorge Padilla M 4/13/2008

150 Cervantes, Lian Basilio F 9/24/2007

151 Del Rosario, Anicka Kim Gallego F 7/1/2008

152 ESPANO,JERICHO P. M 3/24/2007

153 HINGADA,CHRISTOPHER M 12/15/2007

154 MONTEJO, DAVE C. M 1/24/2008

155 OBRENO, MARK YURI S. M 12/21/2007

156 Panes, Lyle Honny Valinte F 1/29/2008

157 SALES, STEVEN NUHJ C. M 1/2/2008

158 AQUINO, JOHN CARLO RODAVIA M 8/8/2008

159 CALIXTRO, JASTINE JAY DIODE M 12/31/2005

160 DIMAPORO, MAIRAH FERNANDEZ F 11/6/2007

161 MANALO, ALYNNA VARGAS F 3/3/2008

162 MINIMO, DJHOANA BABIANO F 3/26/2008

163 VILLAMOR, ALEXA JAMILLA SIGUA F 9/3/2008

Prepared by: Noted :

____ MONA LIM AMALIA M. ABAYAN

Feeding Focal Person School Principal / Officer-in-Charge

Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
SBFP Form 2
Department of Education
Region III

SCHOOL-BASED FEEDING PROGRAM (SBFP)

Division/Province: ______________________________________
School District/City/ Municipality : ____________________________

Name of District
Name of Schools BEIS ID No. School Address Name of Barangay Supervisors/ Contact Number
School Principal or OICs

Prepared by: Noted by:

SBFP DepED Focal Unit Chief

Note: This form shall be prepared by the DO, for final consolidation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
Department of Education
Region III

ASED FEEDING PROGRAM (SBFP)

Total
Beneficiaries

Unit Chief
SBFP Form 3
Department of Education
Region ___

SCHOOL-BASED FEEDING PROGRAM (SBFP)

Division/Province: ______________________________________ School ID: ______________________
City/ Municipality/Barangay : ____________________________
Name of School / School District : _________________________
Nutritional Status at Start of Feeding Ethnicity 4 Ps Beneficiaries
Number of Undernourished School
Children by Grade Level No. of No. of No. of Pupils who
Severely No. of Total Dewormed No. of Ethnic No. of 4Ps are beneficiaries in
Wasted Wasted Beneficiaries Beneficiaries Beneficiaries Beneficiaries previous years
1. Kinder
2. Grade I
3. Grade II
4. Grade III
5. Grade IV
6. Grade V
7. Grade VI
Total

Prepared by: Noted by:

______________________________________ _________________________________
SBFP DepEd Focal Unit Chief

Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepE
 Department of Education
Region ___

OL-BASED FEEDING PROGRAM (SBFP)

______________________

Ethnicity 4 Ps Beneficiaries

Remarks

O, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
FOR THE MONTH OF ______________________ , SY 2019-2020
Region ____________________________
Division ___________________________ School: ___________________________
District ___________________________ Grade: __________ Section __________

PRE FEEDING ACTUAL FEEDING

Beneficiary
4Ps Nutritional Status Deworming
of Previous
NAME OF PUPIL Beneficiary (y
SBFP Birth
or n) Age Sex Ht Wt Date (√ ) or Date
(y or n) Date NS
cm kg Taken (X) Taken 1 2 3 4 5 6 7 8 9 10 11 12 13 14
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:
Prepared by:
LEGEND
____________________________ A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wastedSU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght

O - Obese

Note: This form shall be prepared by the school to be consolidated using SBFP Form 5
SED FEEDING PROGRAM
___________________ , SY 2019-2020

School: ________________________________
Grade: __________ Section ________________

ACTUAL FEEDING

15 16 17 18 19 20
LEGEND

D. Actual Feeding

( √ ) - Present, served
( A ) - Absent, not served
(√√ ) - Present, served twice
 SBFP Form 4

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF ______________________ , SY 2019-2020
Region ____________________________
Division ___________________________ School: _____________________________________
District ___________________________ 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
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:

D. Actual Feeding

( √ ) - Present, served
( A ) - Absent, not served
(√√ ) - Present, served twice
ED FEEDING PROGRAM
___________________ , SY 2019-2020

ACTUAL FEEDING

54 55 56 57 58 59 60
 SBFP Form 4

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF ______________________ , SY 2019-2020
Region ____________________________
Division ___________________________ School: _____________________________________
District ___________________________ 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
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:

D. Actual Feeding

( √ ) - Present, served
( A ) - Absent, not served
(√√ ) - Present, served twice
ED FEEDING PROGRAM
___________________ , SY 2019-2020

ACTUAL FEEDING

94 95 96 97 98 99 100
 SBFP Form 4

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF ______________________ , SY 2019-2020
Region ____________________________
Division ___________________________ School: _____________________________________
District ___________________________ Grade: __________ Section _____________________

ACTUAL FEEDING POST FEEDING

Nutritional Status
NAME OF PUPIL
Ht Wt Date
101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 cm kg Taken NS
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:

D. Actual Feeding

( √ ) - Present, served
( A ) - Absent, not served
(√√ ) - Present, served twice
 ATTENDANCE
Days Feeding
Percentage
Present Days
(A) (B) (A/B)*100
AVERAGE:
SBFP Form 5

SCHOOL-BASED FEEDING PROGRAM

CONSOLIDATED NUTRITIONAL STATUS AND ATTENDANCE REPORT

Region: _______
Division/District: ________________________
School: ________________________________
BEIS ID No.: ___________________________
NUTRITIONAL STATUS
No. of Pupils
GRADES AND SECTIONS BEFORE AFTER
Dewormed
SW/SU W/U N Ow Ob Total SW/SU W/U N Ow O Total
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL AVERAGE:
Legend:
For 6-19 y.o For below 6 y.o
 SW - Severely Wasted SU - Severely Underweight
W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overweight Ow - Overweight
O - Obese

Prepared by: Noted by:

_____________________________ ___________________________
Classroom Adviser / School Nurse School Head

Note: This form shall be prepared by the school using the data from SBFP Form 4.
OOL-BASED FEEDING PROGRAM

RITIONAL STATUS AND ATTENDANCE REPORT

PERCENTAGE
ATTENDANCE
 School-Based Feeding Program Accom
School Physical and Financial R
Region _____________
As of ________________

Name of School: __________________________

BEIS ID No.: _____________________________

Actual Served
Province School District Target based from WFP (3)
(4)
(1) (2)
No. of SBFP Beneficiairies No. of SBFP Beneficiairies
(3.1) (4.1)

4Ps Non. 4Ps Total 4Ps Non. 4Ps Total

Beneficiaries Beneficiaries (3.1.3) Beneficiaries Beneficiaries (4.1.3)
(3.1.1) (3.1.2) (4.1.1) (4.1.2)

Prepared by: APPROVED:

Feeding Teacher School Head

% (6.1.3 = Utilization (6.1.2) ÷ Amount Received from DO (6.1.1) X 100%

Balance (6.1.4) = Amount Received fr DO (6.1.1) less Utilization (6.1.2)
eding Program Accomplishment
sical and Financial Report
on _____________
________________

Served
Other Financial (6) Remarks
4)
No. of Services Cash Utilization (7)
Feeding Provided (6.1)
Days (4.2.) (Pls. Specify)
(5)
Amount Utilization % Utilization Balance
Receive (6.1.2) (6.1.3) (6.1.4)
d fr DO
(6.1.1)

APPROVED:

School Head
 WORK AND FINANCIAL PLAN
SCHOOL-BASED FEEDING PROGRAM (SBFP)
SY 2019-2020
Region: III
Division: Olongapo City
District: _____________________
Name of School: _____________________
BEIS School ID: _____________________

Objectives: To rehabilitate at least 85% of the beneficiaries to normal nutritional status

Ensure 85-100% attendance among target beneficiaries
To improve the children's health and nutrition, values and behavior
Perform Target Beneficiaries SY RESPO SOU
Financial Requirements for SY 2019-2020 NSI- RCE
ance 2019-2020
Grad 3rd - 1st
TOTA
Cost REMA
PROGRAM/ACTIVITY/PROJECT
Indicator Kind e 1 to 4th L CY 2019 BILITY OF
RKS
/Unit of er Grad Qtr. of Qtr. TARG Assumpti AUGUS TOTAL CENTE FUN
2017 on SEPT. OCT. NOV. DEC.
Measure e 6 2016
ET T 26 36 40 10 120 R D
8 days
days days days days days
GAS/STO/Project
1. Procurement of
no. of Number
Food Commodities
BFP of
for School-Based benefici beneficia BAC
Feeding Beneficiaries aries ries 26days
fed XP16.00
(See attached lists of commodities beneficiaries
w/ estimated amount &
Cycle Menu}
Kinder 16 ###
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Total No. of Beneficiaires
 Iron Supplements for no. of
School-Based Feeding BFP BAC
Beneficiaries benefici
aries beneficiaries Number
of
benefici
aries X
P1 X
Kinder 16 320
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Total No. of Beneficiaires Sub-
Number
Essential Health Care
no. of Total
of
Package for School- BFP beneficia BAC
Based Feeding benefici ries X
Beneficiaries aries P25.00
(See attached lists of commodities beneficiaries
Kinder 16 400
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6

Total No. of Beneficiaires GRAND TOTAL

II. Operational Expenses Number
of
beneficia
ries
XP2.00X

Maintenance and
Operating
1. SuppliesExpenses
& materials
related to feeding
program
(Gasul,kerosene, fuel,
charcoal, water, etc.)

2. Management Program
Operation
(minimal transportation
expenses, xerox, and
other priority related
expenses)

Sub-
Total

ESTIMATED COST GRAND TOTAL

Prepared by: Noted By: Approved by:

Michelle Ann BERNADETTE F.

ROMINA D. RESULTAN, RN ELEONOR C. CAYABYAB,Ed.D.ISIDRO IMINGAN Sarte TAMAYO, CESO VI
SBFP Focal Person OIC-Chief, SGOD Budget Officer Accountant III Schools Division Superintendent
 DEPARTMENT OF EDUCATION
CY _______ PROJECT PROCUREMENT MANAGEMENT PLAN

(Name of Office)
ESTIMATED BUDGET and MODE OF PROCUREMENT
PROC SOURCE
NO. PROJECT ACTIVITIES Negotiated Proc
DATE OF FUND Competitive Bidding Shopping Direct Contracting
(Small Value)
ENT
Negotiated Proc (A
to A)