Republic of the Philippines

Department of Education
Region V
SCHOOLS DIVISION OFFICE OF CAMARINES SUR

COMPLIANCE CHECKLIST FOR COVID-19 PREVENTION AND MITIGATION IS SCHOOLS

(per DepEd Order 14, s.2020)
District: ________________________________________________ Date of Visit: _______________________
Name of School: ___________________________________________________________________________
Compliance
I. SCHOOL HEALTH AND SAFETY PROTOCOLS
YES NO Remarks
A. School Sanitation a d Hygiene Practices
1. Temperature checks at entrances
2. Foot bath in all entrances
3. Use of facemask is required (with nose and mouth covered)
4. Use of face shield is required
5. Face masks are available for those who may need them
6. Contact tracing and Health Declaration Forms are recorded
7. Common areas are with markers for physical distancing (at least 1
meter apart)
8. Information, education and communication (IEC) materials on Health
and safety against COVID-19 are displayed (including coughing and
sneezing, no smoking/vaping)
9. Toilets are with adequate water and soap.
10. There are hand washing stations.
11. The School implements the WINS Program/ is complaint to DepEd
Order No. 10, s. 2016
12. Hand sanitizers/alcohol-based solutions/other disinfectants in eating
areas are available
13. The school canteen offers nutritious food / is compliant to DepEd
Order No. 13 s. 2017
14. The School Clinic or clinic corners are functional and manned by
medical personnel, or a clinic teacher
15. There are trash bins for tissue and face masks disposal
16. There is a Materials Recovery Facility (MRF) for waste segregation
17. There is a mechanism for disinfection of frequently touched surfaces
(twice a day)
18. There is a mechanism for disinfection of the campus, building and
classrooms (once a week)
B. Classroom Preparedness
1. Properly ventilated
2. Layout ensures physical distancing
3. Hand sanitizing / hand washing facilities are available
4. There are trash bins for disposal of used tissues and disposable
masks
C. Personnel preparedness
1. There is a COVID-19 Task Force established to manage response to
the Pandemic
2. There is a contingency Response Plan for COVID-19
3. School Personnel are aware of the Preventive Alert Systems is
Schools (PASS)
4. The School Clinic Personnel has an Orientation on how to manage the
Clinic

Address: Freedom Sports Complex, San Jose, Pili, Camarines Sur

Email: deped.camsur@deped.gov.ph
Website: www.depedcamsur.com
Telephone No: (telefax) 8713340
Website: www.depedcamsur.com
Telephone No: (telefax) 8713340
 Republic of the Philippines
Department of Education
Region V
SCHOOLS DIVISION OFFICE OF CAMARINES SUR

D. Other Components of Preparedness

1. Health and safety protocols in school activities and events are
included in the School Contingency Plan for COVID-19
2. Plans for Psychological and other forms of Support are included in the
Contingency Plan for COVID-19

II. SUPPORT MECHANISM

1. Is there a functional Guidance Office with a Guidance Counselors /
Guidance Teacher?
2. What activities have been done to ensure Physical and Mental Resilience?
School Personnel Students/Pupils Parents and Other Stakeholders

Notes/ Comments/ Suggestions

Areas Suggestions
School Health and Safety Protocols

Classroom Preparedness

Support Mechanisms

References:
DepEd Order No. 2, s.2020, DepEd Order No. 34, s.2003, DepEd Order No. 10, s.2019, DepEd Order No. 13,
s.2017

Monitored by: Noted by:

Name: _____________________________________ Name: _____________________________________

Position: ___________________________________ Position: ___________________________________

Signature: __________________________________ Signature: __________________________________

Date: ______________________________________ Date: ______________________________________

Address: Freedom Sports Complex, San Jose, Pili, Camarines Sur

Email: deped.camsur@deped.gov.ph
Website: www.depedcamsur.com
Telephone No: (telefax) 8713340
Website: www.depedcamsur.com
Telephone No: (telefax) 8713340