Form C

OPLAN KALUSUGAN SA DEP ED

ACCOMPLISHMENT REPORT
REGION/DIVISION: Period Covered:
RO-I SCHOOLS DIVISION OF ILOCOS NORTE January – December 2019
Address: Brgy. 7-B Giron St. Laoag City
Telephone Number: Mobile Number:
Fax Number: Email Address:
Number of Schools in the Division: Elementary:
Secondary:
TOTAL:

A.SUMMARY OF SCHOOLS & BENEFICIARIES COVERED

Table 1. Number of Students and school personnel covered by Dep ED and Volunteers
Total Enrolment Actual Medically With Findings Given
Grade Level Examined Interventions
M F M F M F M F
Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
SPED
TOTAL
GRAND TOTAL:

Teachers
Non-Teaching p.
Non-plantilla p.

TOTAL

Table 2. Number of Schools Covered

Total Number of Schools
Elementary schools
High Schools
TOTAL:
B. ACCOMPLISHMENTS
1.a SCHOOL BASED FEEDING PROGRAM (SBFP) & NUTRITION SUPPORT
1.a.1. SBFP Coverage: Schools
Check which is applicable
SCHOOLS Number of Learners from Baseline NS FY20
No. of SS/S that Not covered
No.of SW/W are not SW/W TOTAL W/SBFP Covered by by SBFP or
Learners (K-6) Learners (K-6) (K-6) Partners Partners

1.a.2. SBFP Coverage: Learners

ACTUAL
Grade Level TARGET Severely Wasted Severely Stunted Stunted that are TOTAL
Wasted that are not SW/W not SW/W
Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
SPED
TOTAL

1.a.3. SBFP Funds

Schools Budget Allocation as Per Funds Utilized Percent Utilization
GAA (col3/28100%)

1.a.4. SBFP Nutritional Status – Before & After Feeding

Number of Beneficiaries After Feeding
Grade Number of
Level Beneficiaries %
fr. Table 1.a.2. Rehabilitated
Overweight
Severely Wasted Normal + TOTAL
Wasted Obese
Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
SPED
TOTAL
 1.a.5. SBFP with Gulayan sa Paaralan
% Contribution of GPP to SBFP expense (Check which is applicable per school)
Schools 0-4% 5-24% 25-49% >50%

Note: On the GPP record, all vegetables used for SBFP should be itemized with corresponding quantity and cost. The total cost of vegetables used divided by
(number of beneficiaries x 16.00 x 120 days) x100 = % contribution to the feeding program.

1.a.5. Gulayan sa Paaralan

SCHOOLS Amount of Financial Assistance Given

TOTAL

2. NATIONAL DRUG EDUCATION PROGRAM (NDEP)

# of Participants/Members
ACTIVITY SCHOOLS # OF Learners Coaches/advisers
Elementary Secondary Teachers/NTP Learners
Systematic Training for Effective
Parenting
Barkada Kontra Droga

Universal Preventive Curicula

Life Skills Training

Orientation on RA 9165

Tobacco Control

Red Cross Youth

Kabataan

Lakas Isip lng

Others:
 3. ADOLESCENT REPRODUCTIVE HEALTH (ARH
3.a. Teenage Pregnancy Data in Public Schools ( January – December 2019)
# of Learners: # of Learners: Quarter
Trimester of of CY Reported for 1st Impregnator:
st
# of Pregnancy at 1 clinic clinic Number
SCHOOLS Grade Pregnant consultation/referral) consultation/referral
Level Learners Undeter-
1st 2nd 3rd 1st 2nd 3rd 4th Minor Adult mined

TOTAL

3. b Status of Pregnant Learners

ACCESS TO EDUCATION: - No. of Learners ACCESS TO HEALTH SERVICES- No. of Learners
SCHOOLS No. In No. No. to Barangay No. with No. Lost to
School No. on ADM Dropped RHU/MHSO Private OB Follow up

3.c. ARH Activities

No. of
Activities SCHOOLS No. of Learners Participants/Members/
(Specify activities in your RO/SDO) Coaches/Advisers
Elementary High School Teachers/NTP Learners
Teen Center
HIV/AIDS training/ lectures
Mental Health Trainings/Lectures
Red Cross Youth
Others:

TOTAL

4. WASH IN SCHOOLS (WinS)

Three-Star Approach Rating (Check the school’s rating)
SCHOOLS 0 1 2 3 REMARKS

5. SCHOOL MENTAL HEALTH

5.a Licensed Mental Health Professionals
No. of Registered Number of Registered Number of Licensed
SCHOOLS Guidance Counselors Psychologists Psychometricians Other (Specify)
5.b Other Certified Mental Health Professionals
Number of Trained Personnel
Formal /Certificate of Training Other non-teaching
Health Personnel personnel Teaching

5.c Capacity Building Activities Conducted

Activity Conducted Participating Check if Elementary School or No. of Participants
(Specify title of Schools High School
activity) Elementary High School NTP Teachers Learners

TOTAL

5.d Cases of Mental Health

No. of Cases in Learners
Schools Interventions Remarks
M F TOTAL

TOTAL

No. of Cases in Personnel

Schools Interventions Remarks
M F TOTAL

TOTAL
6. MEDICAL-DENTAL-NURSING SERVICES (Use School Health Division Form 5 as basis for accomplishing this table)
6. a. Ten Most Common Signs & Symptoms (as reported by nurse)
% OF THOSE ASSESSED (Col.2/Total
SIGN/SYMPTOM NUMBER OF CASES Examined x 100%)

6. b Ten Most Common Diseases (as Diagnosed by Medical Doctors)

% OF THOSE ASSESSED (Col.2/Total
DIAGNOSIS NUMBER OF CASES Examined x 100%)

6. c Ten Most Common Dental Problems (as Diagnosed by Dentists)

% OF THOSE ASSESSED (Col.2/Total
DIAGNOSIS NUMBER OF CASES Examined x 100%)
 6.d Dental Service Accomplishment Report
No. of Number of Children
Classroom Given
Schools Enrolment Health Orally With Caries Underwent Fluoride Underwent Given Treated
Talks Given examined Defects Free Scaling Application Extraction Filling

TOTAL

NUMBER OF TEETH (TREAMEN DONE)

Extraction Filling Permanent Temporary
Schools Pit & ART
Permanen Temporar Fissure (Glass ZOE SyF D M F Sound d f
t y Sealant Ionomer) teeth

TOTAL

6. e School-Based Immunization Program

Number Immunized
Grade Sex Enrolment 1st Dose 2nd Dose Remarks
Level MR Td MR Td
M
Grade 1 F
M
Grade 7 F

Number Immunized
st
Grade Sex Enrolment 1 Dose 2nd Dose Remarks
Level HPV HPV (For 9 years old & above only)

Grade 4 F
 6.f Deworming Program

1ST DOSE 2ND DOSE

Grade Level SEX ENROLMENT Number Number
Dewormed % Enrolment Dewormed % Enrolment
M
Kinder F
M
Grade 1 F
M
Grade 2 F
M
Grade 3 F
M
Grade 4 F
M
Grade 5 F
M
Grade 6 F
M
Grade 7 F
M
Grade 8 F
M
Grade 9 F
M
Grade 10 F
M
Grade 11 F
M
Grade 12 F
M
SPED F
M
ALS F
M
TOTAL F
 6.g Weekly Folic Acid (WIFA) Supplementation Program

Enrolment of Number of Given IFA % Enrolment

Grade Level Female Learners
1st Dose 2nd Dose 1st Dose 2nd Dose
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
ALS
TOTAL

6.h Visual & Auditory Assessment

6.h.1. Vision Screening
GRADE NUMBER NUMBER NUMBER NUMBER
LEVEL SEX ENROLMENT ASSESSED PASSED FAILED REFERRED REMARKS
M
KINDER F
M
GRADE 1 F
M
GRADE 4 F
M
GRADE 7 F
M
GRADE 10 F
M
TOTAL F

6.h.2. Auditory Screening

GRADE NUMBER NUMBER NUMBER NUMBER
LEVEL SEX ENROLMENT ASSESSED PASSED FAILED REFERRED REMARKS
KINDER M
F
GRADE 1 M
F
GRADE 4 M
F
GRADE 7 M
F
GRADE 10 M
F
M
TOTAL F
 6.i Nutritional Status
6.i.1. BASELINE NURITIONAL STATUS
6.i.1.a Baseline for Elementary Learners
Grade Number SW/
Level Se Enrolment Assessed SU W/U NORMAL OW Ob SSt St NORMAL TOTAL
x
M
KINDER
F
M
1 F
M
2 F
M
3 F
M
4 F
M
5 F
M
6 F
M
SPED F

M
TOTAL F

6.i.1.b Baseline for Junior & Senior High School Learners

Grade Number SW/
Level Se Enrolment Assessed SU W/U NORMAL OW Ob SSt St NORMAL TOTAL
x
M
7 F
M
8 F
M
9 F
M
10 F
M
11 F
M
12 F

M
TOTAL F
 6.i.2. ENDLINE NURITIONAL STATUS
6.i.2.a Endline for Elementary Learners
Grade Number SW/
Level Se Enrolment Assessed SU W/U NORMAL OW Ob SSt St NORMAL TOTAL
x
M
KINDER
F
M
1 F
M
2 F
M
3 F
M
4 F
M
5 F
M
6 F
M
SPED F

M
TOTAL F

6.i.2.b Endline for Junior & Senior High School Learners

Grade Number SW/
Level Se Enrolment Assessed SU W/U NORMAL OW Ob SSt St NORMAL TOTAL
x
M
7 F
M
8 F
M
9 F
M
10 F
M
11 F
M
12 F
 M
TOTAL F

C. SUMMARY OF VOLUNTEER SERVICES

Table 3. Number of Partners Involved

Number of Schools Number of learners Number of School

Name of Organization/ Volunteers Served Personnel
Affiliation/Institution Examined Treated Examined Treated

D. DONATIONS/RESOURCES GENERATED (Add Additional sheets, if needed)

Type of Donations Quantity Estimated Cost

E. SIGNIFICANT EVENTS OF SBFP, NDEP, ARH, WINS & OTHER HEALTH & NUTRITION
PROGRAMS/ EXPERIENCES/ GOOD PRACTICES (Use separate sheets, if needed)
Outcome: What is/are its important
What happened? Who were involved? When? contribution to the OK sa DepEd
Program of the School?

G. SUGGESTIONS TO STRENGTHEN Ok sa Dep Ed Program

F. LESSONS LEARNED (include support needed from Central, Region & Division Office that can
increase the impact of Ok sa Dep Ed Program in the school
 H. PROPOSED PLAN OF ACTION FOR NEXT OK sa DEPED HEALTH SEVICES

I. PHOTOS (before, during and after)

Prepared by: Noted:

 OK sa DepED Focal Person School Head/Principal

Date:

Submit completed form to the SDO by 1st week of March