A.

ADULTS

-M: 18

-F: 23

CHILDREN

-M: 10

-F: 9

B.

SINGLE: 3

MARRIED: 6

C.

College Undergraduate: 2

College Graduate: 10

D.

Farmer: 3

Housewife: 2

Driver: 1

OFW: 1

OTHERS: 6

E.

Roman Catholic: 9

OTHERS: 3

F.

Nuclear: 8

Extended: 2
 Single: 2

G.

a. Decision Making

- P: 1

-M: 2

-E: 9

b. Child Discipline

-P: 2

-M: 5

-E: 5

c. Healthcare Decision

-P: 1

-M: 9

-E: 2

d. Financial management

-P: 4

-M: 8

-E: 0

H.

hypertension: 5

headache: 3

colds: 1

others: 1
Diagnosed

Yes: 6

No: 0

I.

Pregnant: 0

J.

6-10: 2

11-15: 2

Above 15 yrs: 6

Materials used:

Concrete: 8

Mixed: 4

Number Floors

One: 4

Two: 8

Lightning Facility

Electric: 12

General state of pair

Roof: 4

Floor: 1

Wall: 3

Ladder: 3

Window: 1
 Foundation: 1

Roof Braces: 1

Room: 2

Sink: 1

Kitchen: 1

Toilet: 1

Others: 0

K.

Hangouts

Court: 2

Yards: 7

House: 12

Other: 1

L.

Animals

Dog: 8

Cats: 5

Pig: 3

Chicken: 7

Duck: 3

Goat: 2

Carabao: 1

OTHERS: 4 (fish)

M. Water Drinking

Source

Others: TOTAL: 12
(Mineral 6)

(Purified: 5)

(Distilled: 1)

Ownership:

Owned: 12

Shared: 0

Storage:

Refrigerated: 11

N. Refrigerated: 6

Covered: 3

N. Covered: 0

Water General Usage

Faucet: 12

Deep well: 1

Pump well: 5

Storage:

Drum: 3

Jugs: 2

Bottles: 5

Pail: 11

Jar: 1

Usage

Bathing: 12

Cooking: 11

Laundry: 12
N. Food

Cooking Facility

Firewood: 7

Gas stove: 12

Charcoal: 2

Electric Stove: 4

Others: 2

Storage:

Refrigerated: 12

N. Refrigerated: 1

Covered: 6

N. Covered: 1

Usual # of meals per day:

5: 2

4: 0

3: 10

Usual Composition

Vegetable: 10

Fish: 10

Chicken: 11

Meat: 12

Fruits: 10

Rice’s: 12

Pork: 10
O. Exercise

Yes: 12

No: 0

Types:

Jog: 2

Walking: 9

Work: 6

Biking: 3

Stretching: 7

Others: 4

P. Vices

Smoking: 0

Drinking: 2

Q.

Chatting: 3

Listening to radio: 2

Sports: 3

Sleeping: 4

Walking: 3

Watching: 10

Playing Cards: 2

Others: 5

R.

Toilet

Owned: 12

Shared: 0
Type

Flush: 8

Pail System: 6

2-3M: 6

4-5M: 2

6-7M: 1

S.

Garbage

Trashcan: 11

Plastic: 5

Sack: 6

Box: 1

Pail: 2

Hole: 1

Method:

Burning: 7

Composting: 8

Open Dumping: 1

Others (Garbage Collection): 1

Waste Segregation

Yes: 11
T. Drainage System

Type of Drainage:

Open: 7

Close: 5

Household drainage:

Open: 1

Close: 8

U. Transportation

Jeepney: 0

Truck: 0

Motorcycle: 10

Tractor: 0

Tricycle: 4

Van: 5

Others, specify: 6

V. Income

*Who earns?

Mother: 2

Father: 2

Both Parents: 8

Children: 1

Source

Farming: 8

Employment: 8

Self-Employment: 3

Pension: 0

Others: 2
Monthly Income:

5001 above- 11

Expenditure

Clothing: 8

Education: 11

Food: 11

Farm: 8

Housing: 5

Medicine: 11

OTHERS: 3

Products

Rice: 7

Corn: 1

Vegetable: 0

Poultry: 5

Others: 2

Land Ownership:

Tenant: 0

Owned: 12

Protective Services:

Police: 1

Army: 0

Tanod: 12

Security Facilities:

Streetlights: 12

Road humps: 1

CCTV: 1

OTHERS: 2
Social Facilities:

Courts: 12

Waiting Shed: 11

Others: 2

Botika: 8

Health Center: 9

Others: 7

Health Care:

Nurse: 12

Doctors: 11

Midwives: 9

Reasons:

Health Ed: 2

Check-up: 11

Medicine: 11

Feeding Program: 0

Others (confinement): 2

Level of Satisfactory

Very Satisfied: 4

Satisfied: 8

Frequency:

Once: 1

As needed: