Republic of the Philippines DEPARTMENT OF EDUCATION Region Vi-Western Visayas DIVISION OF NEGROS OCCIDENTAL ‘B: Cottage Road, Bacolod City SF Tel No. (034) 4347138 & Fax No. (034) 4353960 ADVISORY March 30, 2020 Re “AUest of the Local Government Units (LGUs) to utilized Public Schools as Quarantine or \solations Areas for COVID- 19 Consistent with the di a Sirective from the Central Office through an Office Memorandum OM-OSEC 2020-002 ed March 26, 2020, requesting Local Government Unit (EGU) shall be guided by the following: 1. The LGU must state in its request the specific intended purpose or use for the school, and identify the particular facility in the schoo! that will be used as well as the duration oftheir use, subject to extension, ifnecessary; n The LGU must show that all other facilities have been duly assessed and were found to be ‘inadequate. Schools can be recommended only when no other facilities are available; The LGU must present an assessment by the municipal, city, or provincial health officer that the facility within the school is suitable for the specific intended purpose; 4. The LGU must present the planned management of the facility, which shall be under the supervision of the City/Municipal Health Officer, as stated in DOH Department Memorandum No. 2020-0123, and must conform to existing DOH standards and guidelines, including, but not limited to, patient management, safety standards within the facility and immediate community, ‘waste management/disposal, and other similar/related health requirements; and 5. The LGU request must include an undertaking: for the safekeeping of all property and valuables in the school premises during the operation of the facility; payment of utilities for the period; the ‘conduct of the general cleaning and fumigation, and repair and/or replacement of damaged school facilities as a result of the use of the school; and, payment of expenses related to the setting-up, operation and clearing of the areas used. ‘As such, the above mentioned requirements shall be accomplished by the requesting LGU and submitted to the Division Office for evaluation of Schools Division Superintendent and forwarded to Office of the Regional Director. If the request is approved by the Regional Director, the LGU shall be notified by the School Head and shall sign the Terms and Conditions with the School Inventory set by DepED. For guidance and information of all concerned, fetta MARSETTE D. SABBALUCA ‘Schools Division SuperintendentDate: April 3 2020 MA. GEMMA M. LED Regional Director meee D ae epED. Region iv- Western Visayas THRU: RU: eARSETIE D. SABBALUCA, CESO VI chools Division Superintendent Division of Negros Occidental Re: il Request to utilize Public Schools as Quarantine or Isolations Areas for COVID- 19 Dear Dir. Ledesma: In view of the current situation of the country involving this global pandemic scare of COVID-19, the undersigned respectfully seek your approval for us in Victorias City to utilize the Public Schools under our jurisdiction as quarantine or isolation area for COVID 19. Consistent with the directive from Department of Education, Department of Health and other government agencies involved with other relevant law and issuance on the matter, the undersigned specifically would like to utilize as a quarantine facility for the Persons Under Monitoring (PUMs) and Persons Under Investigation (PUls) of COVID-19 more particularly the use of Victorias Elementary Schoo! (VES) addressed at Yap Quifia Street, Bray. IV, Victorias City, Aleiandro Acufia Yap Quifia Memorial Elementary Schoo! (AAYQMES) addressed at Montinola Street, Bray. IV, Victorias City, and Victorias North Elementary School (VNES) addressed at Roxas Street. Bray. V, Victorias City which will be utilized from May 1, 2020 to May 21, 2020 subject to extension, ifnecessary, subject to approval of the Regional Director as recommended by the Schools Division Superintendent. The undersigned attests that all other facilities have been duly assessed and were found to be inadequate. Attached is an assessment by the municipal, city, or provincial health officer that the facility within the school is suitable for the specific intended purpose. (Attach assessment report duly signed by the Local Health Officer) We have crafted a management plan of the facility, which shall be under the supervision of the City/Municipal Health Officer, as stated in DOH DepartmentMemorandum No. 2020-0123, and must conform to existing DOH standards and guidelines, including, but not limited to, patient management, safety ‘standards within the facility and immediate community, waste management/disposal, and other similar/related health requirements. (Attach management plan)Lastly, the "ane undersigned ass but not limited to: res your Office with utmost caré and diligence including 1 Safekeepi Ping of . s ‘ Cheon she ae and valuables in the school premises during the 2. Payment of utilities for the period; 3. The conduct of the general cleaning and fumigation, and repair and/or feplacement of damaged school facilities as a result of the use of the school; and 4. Payment of expenses related to the setting-up, operation and clearing of the areas used. We understand that after the approval of this request, the undersigned will sign and conform to the Terms and Conditions together with the ‘School inventory set by the DepEd “Thank you. Very truly yours, Attached: As statedRenuhli Nae eens Sh CITY HEALTH OFFICE the sweet green cty April 4, 2020 HON. FRANCIS FREDERICK P. PALANCA layor - Local Government of Victorias ity Hall, Brgy. IV Pob, ty, Negros Occidental Victorias Cit Dear Sir: In liew of the present circumstances, I would like to request before the corresponding Department of Education office the following DepEd schools, including its facilities, which may be used by the Local Government of Victorias City as temporary quarantine or isolation facility, in relation to the COVID-19 public health situation, for a period of Twenty-one (21) days: 1. Victorias North Elementary School - Brgy. V, Victorias City, Negros Occidental 2. Alejandro Acuita Yap Quinta Memorial Elementary School -Brgy. IV, Victorias City, Negros Occidental 3, Vidtriag ementary School - 2gy- Vietorine City, Megrovs Cecidental ‘These educational facilities have been assessed and evaluated by the City Health Office and have been found to possess the appropriate spaces, structures, comfort rooms, and handwashing facilities which will be used by persons which will be isolated/confined in the said locations. Moreover, the LGU of Victorias, through the City Health Office, shall supervise the aforementioned facilities in order to make sure that they are in conformity to existing DOH standards and guidelines, including, but not limited to, patient management, safety standards within the facility and immediate community, waste management/ disposal, and other similar/health requirements. May you find this recommendation adequate in response to the need of a quarantiny facility in view of the COVID-19 situation. Thank you for your approval. Yours truly, RY. Garlitos ‘ity Health Officer, LGU- VictoriasREPUBLIC OF THE PHILIPPINE: PROVINCE OF NEGROS OCCIDENTAL CITY OF VIGTORIAS covip- ‘OVID-19 QUARANTINE FACILITY MANAGEMENT PLAN COVERAGE This m (ClUs) thavcment Plan will be applicable to quarantine areas/community isolation units Education (ull be established by the LGUs in the faciity/ies under the Department of (DepEd). The quarantine Under areas/CIUs shall accommodate Persons Un Mo aS) (PUMSs), Persons Under Investigation (PUIs), and confirmed cases of COVID- Id symptoms, whose home environment cannot support isolation (e.g. crowded living conditions), ROLE OF THE DEPARTMENT OF EDUCATION 1. DepEd and its Regional Offices shall manage this engagement particularly on providing guidelines and policy support, monitoring and evaluation of this activity 2. DepEd shall also provide technical advice in the identification, establishment, and maintenance of quarantine centers/ClUs in the school's facility. ROLE OF LGU 4, LGUs, with the assistance of their health personnel and experts, must identify SUCs in their areas that can be converted into a quarantine center/CIU. Temporary structures may also be built in accordance with the requirements. 2. Once identified, the LGU shall enter a Memorandum of Agreement with the concerned SUC. 3, Through the LGUs, all quarantine areas/CIUs shall provide the following services a. Food . Sanitation (facilities such as toilets and bathrooms) c. Infection contro! d. Health monitoring and prompt referral e. Symptomatic treatment f Discharge instructions including home care and follow-up g, Psychosocial wellness and support (includes visits of relatives) h. Laundry i, Waste management and vector control j. Security k. Other services as appropriate 4. The Local Government Units (LGUs) shall ensure that the following requiremer met for setting up quarantine centers/ClUs: a. Space - A quarantine center/CIU can be a permanent or temporary si SUCs such as school gymnasia, classrooms, huge offices or training with utilities and basic amenities. truc b. Human resources from the LGU\ ClU manager "I. Sanitation of i ation officer is Physician (Via telecon 'V. Other: healthca ae \. Support staff (secant emia curity and ouif®. and barangay health workers) intenance personnel) HUMAN RESOURCE FUNCTION ie Human Resource clu. Function janager ay. * Maintains order and ensures upkeep and security of the CIU * Oversees provision of supplies/iogistics: + Prepares daiy summary of PUls and PUMs admitted tothe CU ‘* Oversees and coordinate the human resources for the CIU * Coordinates with Barangay Officials Sani ea ‘tation Officer '* Oversees the infectious waste management of the CIU + Ensures proper food handing protocols in meal preparation Health Care Workers. aCe ‘Performs daily rounds and assessment ‘* Performs daily assessments of patients in CIU care on © Presence of symptoms in patient and family members, (1 per 12 patients) © Compliance to quarantine guidelines Physician © Approves admission, referral, and discharge of patients (via teleconsutt) © 24/7 on call ‘Support Staff ‘Ensures security of the CIU and monitors the entrances and exits Secunty (2) Maintenance (1) 5. LGUs, in coordination with the DepEd, shall ensure that their facilities are in compliance with the requirements set by DOH. 6 Infection control shall be a priority in the quarantine centers/ClUs. To ensure adequate control, the following shall be observed: a Cleaning and disinfection of quarantine units/CIU rooms shall be the responsibility of the admitted patients. b. Handling of laundry shall be in accordance with DOH guidelines on Management of PUls and PUMs c. Waste management shall be in accordance with DOH guidelines on Management of PUIs and PUMs. 7. The LGU shall coordinate and monitor the activities of the DepEd. It shall also regularly update the involved school, particularly on breaches in protocols or other problems. 8 The LGU shall also regularly update the concerned DOH Center for Health Development (DOH-CHD), ROLE OF THE SCHOOL 4. The school principal or his/her identified representative shall engage tl LGU 2. Schools and LGUs shall ensure that their facilities are in co requirements set by DOH3. Once compliant with the reo a eee "Pe School shall enter 2 Memorandum of The school May augment the Jogi Gan employees. Appropriate Seats: Particularly adcitional workforce : = a through thei deployment, trainings must be given to CAGE MGIaS nor ig 5. The Schoo! pri Principal or his/her identi : CHED Regional om 'dentified representative shall regularly update the other Problems. gard ling their status especially for breaches in protocols and The Manage eee fated Plan of the facility shall be under the supervision of the City Health existing a sae ie Department Memorandum No. 2020-0123, and conforras ‘0 rds and guidelines, includin; . but not limited to, patient management, safety standard 2 including, pai within the facility and immediate community, waste management and disposal, and other Similar/related health-related requirements. ‘This Management Pian shall operate for the duration of one hundred and twenty (120) days, and shall apply to the twenty (20) rooms from the schools listed herein as temporary quarantine or isolation facility, with reference to the Terms and Conditions agreed upon by the LGU and the Department of Education,TERMS AND CONDITIONS FOR THE USE OF DEPED SCHOOL AS QUARANTINE FACILITY BY THE LOCAL GOVERNMENT UNIT The Local Government Unit of the City/Municipality of VICTORIAS, with office address at BARANGAY IV, VICTORIAS CITY, NEGROS OCCIDENTAL, and represented by FRANCIS FREDERICK P, PALANCA, Mayor, hereinafter referred to as the “LGU”, has requested from the DepEd-Regional Office Vi-Western Visayas, as MA. GEMMA M, LEDESMA, Regional Director, hereinafter referred to the_use of ALEJANDRO ACUNA YAP QUINA MEMORIAL YY SCHOOL, with address at BARANGAY IV, VICTORIAS CITY, NE OCCIDENTAL and School Head, NOE BALDOMER, as a TEMPORARY QUARANTINE/ISOLATION FACILITY relative_to the COVID-19 public health emergency. represented b as the “RO’ The request is made under the following premises: The President issued Proclamation No, 922 dated March 8, 2020, “Declaring a State of Public Health Emergency Throughout the Philippines”, in view of the COVID- 19 outbreak; Section 2 of Proclamation No. 922, s. 2020, states that “(a)ll government agencies and LGUs are hereby enjoined to render full assistance and cooperation and mobilize the necessary resources to undertake critical, urgent, and appropriate response and measures ina timely manner to curtail and eliminate the Covid-19 threat”; ‘The LGU needs a facility for a TEMPORARY QUARANTINE/ISOLATION FACILITY relative to its response to the COVID-19 public health emergency and it has no other available place or structure for use, thus it submitted a request to the RO for the use of the of ALE[ANDRO ACUNA YAP QUINA MEMORIAL ELEMENTARY SCHOOL, hereinafter referred to as the “School”, as TEMPORARY QUARANTINE/ISOLATION FACILITY of the LGU, subject to OFFICE MEMORANDUM OM-OSEC-2020-002; ‘The RO, acting on the recommendation of the Schools Division Office, approved the request, in adherence to applicable laws, rules and guidelines, upon a clear showing by the LGU of the need to use the School as TEMPO! QUARANTINE/ISOLATION FACILITY due to absence of other available facility, and pursuant to an assessment by the Regional Director of the Department of Interior and Local Government/Head of the Regional Task Force COVID-19 that the use o school is compliant with the national directives on COVID-19 and a certification proper local official that the use of the school is suitable for the specific int purpose, in accordance with applicable rules and guidelines. ‘The approval of the RO was conditioned upon the presentation management of the facility and undertaking of the LGU for the s property and valuables in the school premises during the opera payment of all expenses including, utilities in relation to the useTEMPORARY _QUARANTINE/ISOLATION FACILITY, conduct of the general cleaning and fumigation, repair and/or replacement of damaged or lost school facilities as a result of, and incidental to, the use of the School by the LGU. Foregoing, premises considered, the LGU commits and binds itself to the following terms and conditions set by the DepEd in its use of the School as TEMPORARY QUARANTINE/ISOLATION FACILITY. 1. SCOPE This Terms and Conditions (TAC) pertains to the use of ALE) |ANDRO- ACUNA_YAP_QUINA MEMORIAL ELEMENTARY SCHOOL as TEMPORARY QUARANTINE/ISOLATION FACILITY of the LGU in relation to the COVID-19 outbreak during the period of Public Health Emergency under Proclamation No. 922, s. 2020. The School may only be used by the LGU for this purpose if classes are not being conducted therein. IL. ROLES AND RESPONSIBILITIES A. The LGU shall: 1. Prepare the areas of the School approved by the RO to be used as TEMPORARY QUARANTINE/ISOLATION FACILITY and not require students/pupils and DepEd personnel to be engaged in the preparation of the School for this purpose. The LGU shall vacate the designated areas and remove education equipment and resources therefrom, as may be necessary, under the supervision and guidance of the School. 2. Use only the specified School area and facilities approved by the RO to be used as TEMPORARY QUARANTINE/ISOLATION FACILITY 3. Take charge of the management and maintenance of the School used as TEMPORARY QUARANTINE/ISOLATION FACILITY. 4. Cordon off the identified TEMPORARY QUARANTINE/ISOLATION FACILITY to be used by the LGU from the rest of the School premises or facilities. 5, Provide measures to ensure the safety and security of the School. 6. Provide all resources and equipment required for the use of the School as TEMPORARY QUARANTINE/ISOLATION FACILITY. 7. Ensure that water supply will be sufficient and there will be no cooking, School during its use as TEMPORARY QUARANTINE/ISOLATION FACILITY,8. Ensure compliance with the sanitation and health standards applicable to the School before, during and after its use by the LGU as TEMPORARY QUARANTINE/ISOLATION FACILITY, including disinfecting the premises used and ensuring the use of required protective equipment. 9. Facilitate and provide for the general cleaning, maintenance and upkeep of School premises, structures, facilities, equipment, and resources, and repair and replace them if damaged, destroyed or lost as a result of their use by the LGU as TEMPORARY QUARANTINE/ISOLATION FACILITY. Such repair and replacement shall be completed prior to the return of the use of the School to the School Head. 10. Clean up and fumigate the School within a maximum period of one week after its use by the LGU as a TEMPORARY QUARANTINE/ISOLATION FACILITY during the public health emergency. The proper health authorities shall certify whether the School is fit for education use subsequent to the fumigation, in accordance with pertinent guidelines of the Department of Health (DOH) and other applicable rules and issuances 11. Pay for utilities during its use of the School as TEMPORARY QUARANTINE/ISOLATION FACILITY, and until it has returned the use of the School to its School Head for education use and the School Head has accepted the same. 12, Ensure that the School and facilities be restored to their original or better state, compared to their condition upon commencement of their use as TEMPORARY QUARANTINE/ISOLATION FACILITY by the LGU. 13. Prior to return by the LGU of the use of the School to the School Head, secure clearance from the School with respect to the LGU’s compliance with the TAC. 8. The School shall: ne Make available the spaces, structures, comfort rooms, and other facilities as approved by the Regional Office, as attached herein (See Annex A).. School areas beyond those approved by the RO shall be off-limits to the LGU and users of the quarantine or isolation facility. 2 In preparation for the use of the School as TEMPORARY QUARANTINE/ISOLATION FACILITY, ensure proper storage and safekeeping of all learning and education equipment, resources, materials and school records. The School shall provide supervision and guidance to the LGU in the vacating, as may be necessary, of designated School spaces/structures and removal of education equipment and resources therefrom by the LGU, provided that all DepEd personnel involved in’ the preparation of the school premises shall strictly observe all existing health precautions and social distancing protocols of the DOH and the World Healt Organization (WHO). 3 3 Prepare and implement work protocols that would not require De Personnel to report to the School for the performance of regular functions during Period the School is used as TEMPORARY QUARANTINE/ISOLATIO! 4 Inform the LGU of any damage, destruction, or loss of and resources due to, or incidental to, the use of the School, if srepair, maintenance, and/or replacement by the LGU after use of the School as TEMPORARY QUARANTINE/ISO! ION FACILITY. 5. Have the authority to monitor and access the School, subject to strict ‘observance of safety and health requirements applicable during the public health emergency. ce The LGU and the School i The School shall make a School Inventory and record the condition of school premises, structures, facilities, equipment and resources immediately prior to use, and after the use and fumigation of the School by the LGU. The Inventory prior to use shalll be signed by both the School Head and Mayor and shall form an integral part of this TAC (See Annex A). 2 Any and all expenses relative to the preparation and operation of the School as TEMPORARY QUARANTINE/ISOLATION FACILITY as well as the clearing, fumigation and restoration of the School to its educational use shall be shouldered by the LGU. 3 ‘The School and LGU shall each designate focal person/s who shall be responsible for coordination between the Parties to ensure compliance with this TAC. 4, ‘The LGU shall ensure that only the areas approved by the Regional Office will be used as TEMPORARY QUARANTINE/ISOLATION FACILITY. 5. The LGU shall also ensure that access to the school premises shall be limited only to the persons under quarantine/isolation/monitoring and healthcare professionals. ul. GENERAL PROVISIONS ao ihe; LGU shall use the School as TEMPORARY QUARANTINE/ISOLATION FACILITY only upon its showing to the RO that there is no other available space or structure which can be used for that purpose. The use of the School as TEMPORARY QUARANTINE/ISOLATION FACILITY is a continuing requirement, Should a place or structure which can be used for this purpose become available, the LGU shall terminate its use of the School as TEMPORARY QUARANTINE/ISOLATION FACILITY. 2. This TAC shall take effect upon its execution, and shall be in full force and effect for a period of .2/ days during the period of Public Health Emergency Proclamation No. 922, s. 2020, unless mutually extended by the LGU and the writing, or sooner terminated by either the LGU or the RO upon fifteen-day notice for valid reasons, :Notwithstanding the lifting of the said Public Health Emergency, the responsibilities and obligations of the LGU under this TAC shall subsist until fully complied with. 3. When warranted by compelling circumstances, the RO may amend, modify or supplement this TAC for valid reasons, upon prior written notice to the LGU. 4. The LGU represents and warrants that it has the requisite power and authority to make, deliver, and comply with the provisions of this TAC, and has taken all the necessary actions to duly and validly authorize the execution, delivery and performance of this TAC. 5. Should there be any conflict between the provisions of this TAC and other Agreements between the LGU and the DepEd through the Regional Office, Schools Division Office or the School, this TAC shall prevail. LOCAL GOVERN! DEPARTMENT OF EDUCATION REGIONAL OFFICE VI FRANCIS FRERERICK P. PALANCA Mayet, Gfty of Victorias MA. GEMMA M. LEDESMA Regional DirectorACKNOWLEDGMENT REPUBLIC OF THE PHILIPPINES) CITY OF VICTORIAS )ss. 3,0 APR 2020 Before me, a notary public for and in the City of Victorias this personally appeared the following: Name Competent Evidence of _ | Date/Place Issued Identity FRANCIS FREDERICK P. PALANCA. TIN 176-015-046 known to me to be the same persons who executed the foregoing documents on Terms and Conditions for the Use of DepEd School by the Local Government Unit as TEMPORARY QUARANTINE/ISOLATION _FACILITY with School Inventory consisting of (__) pages, including the Annex A-School Inventory and the page on which this Acknowledgment is written, and they acknowledged to me that the same are their free and voluntary act and deed. WITNESS MY HAND AND SEAL, on the date and in the place first above written. Doc. No. 4; Page No._l_; Book No. “IK _; Series of 2020.ANNEX A, INVENTORY OF FACILITIES OF : (NAME OF SCHOOL) FOR USE AS TEMPORARY QUARANTINE OR ISOLATION FACILITY Designated Facilities for Use as Temporary Quarantine or Isolation Facility: 1, E.g, Gymnasium 2 uRGomie a 3. Room 4 ——————__—_____ Facility (Gymnasium, | Item (Furniture and — | Quantity Condition Room, etc.) Fixture, Equipment, oe oto) LGU/LSB BLDG 10 _(5 Rooms) ati Room 1 Cabinet 1 Good | EES Wall Fan 4 Good Room2 | Cabinet 1 Good is Swaine 4 Good Cabinet 1 Good Wall Fan 4 Good Room 4 Cabinet 1 Good BER [Ez _| Wall Fan A Good a Room 5 Cabinet 1 Good [ Wall Fan 4 Good Other Remarks on Premises/Structures/Facilities Prepared byy ANNEX A. INVENTORY OF FACILITIES OF (NAME OF SCHOOL) FOR USE AS TEMPORARY QUARANTINE OR ISOLATION FACILITY Designated Facilities for Use as Temporary Quarantine or Isolation Facility: 1. Eg. Gymnasium 2. Room 3. Room 4. Facility (Gymnasium, | Item (Furniture and | Quantity Condition Room, etc.) Fixture, Equipment, i) LGU/LSB BLDG 13 | (6 Rooms) _ s Room 1 Arm Chairs 39 Good a ‘Teachers Table 1 Good real Electric Fan 2 Good | Room 2 Cabinet/Shelf sna Good TV Set it Good i 2 Electric Fan 4 Good Desk a 24 Good Ss [ Teacher Tables 2 Good a Table 1 Good Room 3 ___| Cabinet/Shelf 5 Good TV Set 1 Gocdeaas Electric Fan 3 Good —_| Desk 24 Good [ ‘Teacher Tables 2 Good Other Remarks on Premises/Structures/Facilities Prepared byANNEX A INVENTORY OF FACILITIES OF (NAME OF SCHOOL) FOR USE AS TEMPORARY QUARANTINE OR ISOLATION FACILITY Designated Facilities for Use as Temporary Quarantine or Isolation Facility: 1. Eg. Gymnasium 2. Room 3. Room 4 Facility (Gymnasium, | Item (Furniture and | Quantity Condition Room, etc.) Fixture, Equipment, etc) | BLDG 13 LGU/LSB | (© Rooms) |Room4 Desk Teacher Tables Electric Fans Cabinet/Shelf TV Set Electric Fan Desk Cabinet/shelf (eat Teacher Tables [Room 6 Cabinet/Shelf TV Set [ee Electric Fan | Desk ‘Teacher Tables iS Good Good Good Good & sipl-/-ls|selg|s/-[sla|ely Other Remarks on Premises/Structures/Facilities Prepared by:INVENTORY OF FACILITIES OF (NAME OF SCHOOL) FOR USE AS TEMPORARY QUARANTINE OR ISOLATION FACILITY Designated Facilities for Use as Temporary Quarantine or Isolation Facility: 1. Eg. Gymnasium 2. Room _ 3. Room 4 Facility (Gymnasium, | Item (Furniture and | Quantity Condition Room, etc.) Fixture, Equipment, Ko eo) Bldg 1 BLSB Type 1 | Cabinet/Shelf 4 Good (7 Rooms) _ Room 1 Tables 2 Good Arm Chairs 46 Good i ‘Teachers Table 2 Good Bi) IE TV Sets 1 Good | Eee BESS Electric Fan 3 Good Room 2 Cabinet/Shelf, 6 Good | Table 1 Good ____| Arm Chairs 38 Good Teachers Table 2 Good Electric Fan 2 Good | Other Remarks on Premises/Structures/Facilities Prepared by 4 Conforme:INVENTORY OF FACILITIES OF : (NAME OF SCHOOL) ‘OR USE AS TEMPORARY QUARANTINE OR ISOLATION FACILITY. Designated Facilities for Use as Temporary Quarantine or Isolation Facility: 1. E.g, Gymnasium 2. Room 3. Room 4. ee Facility (Gymnasium, | Item (Furniture and — | Quantity Condition Room, ete.) Fixture, Equipment, hea _| ete) _ " sah Bien |e aie ee | Bldg 1 BLSB Type 1__| Cabinet/Shelf_ fi 2 Good Room 3 Tables 2 Good ‘Arm Chairs 45 Good Teachers Table 2 ‘ Good | Walll Clock 3 Good Electric Fan 6 Good |Room4 _[ TV Set 1 Good - Table 2 Good ‘Arm Chairs 38 Good ‘Teachers Table 2 Good a Electric Fan. 2 Good Other Remarks on Premises/Structures/Fé Prepared by: Conforme:INVENTORY OF FACILITIES OF FOR (NAME OF SCHOOL) USE AS TEMPORARY QUARANTINE OR ISOLATION FACILITY Designated Facilities for Use as Temporary Quarantine or Isolation Facility 1. Eg, Gynmasium 2. Room 3. Room gainer | Facility (Gymnasium, | Item (Furniture and _ | Quantity Condition Room, etc.) Fixture, Equipment, Bldg 1 BLSB Type 1 4 Good | Room 5 B) a Good Arm Chairs: 46 Good Teachers Table 2 ai Good _| TV Sets 1 Good Electric Fan 3 Good Room 6 Cabinet/Shelf 2 Good Tables 4 Good a Arm Chairs 4 Good p Teachers Table 2 Good Electric Fan 5 Good TV Set i Good Other Remarks on Premises/Structures/Facilities Prepared by: pa 2/4 (22 Conforme:INVENTORY OF FACILITIES OF (NAME OF SCHOOL) FOR USE AS TEMPORARY QUARANTINE OR ISOLATION FACILITY Designated Facilities for Use as Temporary Quarantine or Isolation Facility: 1. E.g. Gymnasium 2. Room 3. Room a 4 Facility Gymnasium, | Item (Furniture and | Quantity ‘Condition Room, ete.) Fixture, Equipment, ke pores Oty) E | Bldg 1 BLSB Type |_| Cabinet/Shelf 4 Good Room 7 oo Tables 2) Good z Arm Chairs. Bo) Good Teachers Table 2 Good Electric Fan Bl Good Other Remarks on Premises/Structures/Facilities Conforme: HON.FRANCIS Signat