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Republic of the Philippines

DEPARTMENT OF EDUCATION REGION 3


Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P)

REGION-WIDE SCHOOL SAFETY ASSESSMENT

DIRECTION FOR DPOs:


Read each item/indicator CAREFULLY as the result of this assessment will be used as a basis in endorsing your school/s to Cen
Office for possible inclusion in face-to-face classes.
1. Fill out information on SCHOOL PROFILE accordingly and accurately.

2. Answer all PRE-ASSESSMENT INDICATORS with YES or NO only (except for mode of transportation).

3. Answer all ASSESSMENT INDICATORS with YES or NO only.

4. Supply what is asked for VACCINATION STATUS with FIGURES only (except for reasons for unvaccination).

5. Avoild leaving any column unfilled and altering any of the pre-set cells.
6. Prior to the cut off date, members of the Composite Team should have VALIDATED the responses in each
column. Submit an APPROVED and SIGNED copy of the sheet to pprd.ro3@deped.gov.ph on or before each cycle cut-off date.
Thank You and stay safe!
Republic of the Philippines
DEPARTMENT OF EDUCATION REGION 3
Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P)
REGION-WIDE SCHOOL SAFETY ASSESSMENT
SCHOOL PROFILE PRE-ASSESSMENT Q
For the past twenty-eight
(28) days, has the
barangay where your
school is located recorded
any confirmed COVID-19
case/s? *Kindly refer to
your respective barangay
for the data.
School ID School Name Name of School Head School Contact Number

Malinao Elementary
105310
School
Pagsangjan Elementary
159004
School LUCENA D. NANGAN 9359347650 NO

Part of 638 Pre-identified Schools (please prioritize in monitoring)

Vaidated:

___________________ ___________________ ___________________ ___________________ ___________________


JESSIE JONES P.
EROLD O. MONTEROLA (name) (name) (name)
CORPUZ
Health Officer DRMM Coordinator Engineer Planning Officer CID Representative

Recommending Approval: Approved:

___________________ ___________________ ___________________


(name) (name) (name)

SGOD Chief CID Chief Schools Division Superintendent


SDO: NUEVA ECIJA (Public Schools)
of San Fernando (P) Assessment Cycle: 1
Cycle Date: October 25 - November 5, 2021
PRE-ASSESSMENT QUESTIONS
Is the school accessible If YES, what specific mode Is the school accessible 1. The school has 2. The school has secured
through public of transportation through walking? secured support of LGUs written consent from
transportation? (Barangay, Municipality, parents/guardians who will
City, Province) through a participate in the limited
resolution or a letter of face-to-face classes.
support.

NO NO YES YES YES


3. The school has 4. The school has 1. The school has a. Number of teachers b. Teachers who
mobilized resources and conducted simulation implemented an who physically report physically report are 65
support from community activities among school Alternative Work meets the required years old and below
stakeholders to meet the personnel regarding Arrangement necessary to teacher: learner ratio
standards of the health protocols and routines to deliver quality basic
and safety protocols. replicate and discuss education in a safe
possible scenarios during learning environment to
the actual conduct of face- learners.
to-face classes.

YES YES YES YES YES


c. Teachers who d. Teachers who have e. Teachers who 2. The school has oriented 1. The school has
physically report to not service vehicles from and physically report are from teaching personnel and established mechanisms
have comorbidities, to area of residence and within the city/municipality non-teaching personnel on inside the classroom to
immunodeficiency, or any school where school/learning the Alternative Work ensure zero to minimal risk
health risk/conditions center is located Arrangement that will be of COVID-19 transmission
implemented during the of the learners.
limited face-to-face
classes.

YES YES YES YES YES


a. Number of seats to b. Seats to be c. Numbers of seats d. Presence of e. Availability of
be occupied must not occupied must be at least shall be equivalent to the markers and stickers on working electric fans
exceed from the required 1-2 meters apart number of learners present the floor to manage traffic
number of maximum system and physical
learners in the classroom distancing inside the
classroom

YES YES YES YES YES


f. Open windows and g. Installation of h. Availability of a i. Usage of high- 1. The school has set-up
doors at all times appropriate ventilation sterilization box where efficiency particulate air clear and easy-to-
equipment such as general outputs (e.g., quiz papers) (HEPA) filtration air understand signages,
and exhaust ventilation submitted by the learners purifiers to clean preferably in local
and CO2 monitoring will be placed for recirculated air for air- languages and Braille, and
devices disinfection conditioned spaces, mechanisms to strengthen
provided that the unit is observance of health
adequate for the size of protocols and protective
the room in which it is measures.
installed

YES NO YES N/A YES


a. Display of school b. Designation of c. Designation of d. Designated e. Hallway ground
map at the entrance point separate entrance and exit separate entrance and exit entrance and exit points in markings for walking
indicating the location of points in the school points in high traffic areas the classrooms direction guide
the classrooms (unidirectional markers,
installation of signages for
cueing and unidirectional
movement, sectioning, and
queueing)

YES YES NO NO YES


f. Designation of 1. The school has a. Availability of b. Availability of hand c. Availability of
areas for queue (e.g., established safe entrance temperature thermal sanitizer or alcohol surgical masks at school
restroom, library, and exit procedures for scanner or thermal gun in dispenser in school gates entrance reserved for
principal's office, etc.) teachers, students, non- entrance and/or exit gates symptomatic individuals
teaching personnel, and
school visitors.

YES YES YES YES YES


2. The school has a. Health declaration b. Health declaration c.Contact tracing tool for school-goers 3. The school has
established a contact sheet for school personnel sheet for students mobilized the School
tracing procedures/tools COVID-19 DRRM team
for school-goers. that will take charge in
ensuring effective
implementation of the
school’s health and safety
protocols that are in place
and are observed during
the preparation and
implementation of limited
face-to-face classes.

YES YES YES YES YES


MANAGING SCHOOL OPERATIONS
a. Designation of a 4. The school has set up a a. Availability of b. Availability of clean c. Schedule of
Safety Officer who shall proper sanitation and handwashing station with and safe toilet facilities supervised handwashing
serve as the focal person hygiene facility for school- clean and safe water and toothbrushing
for the health and safety goers. supply activities
protocols of the school

YES YES YES YES YES


d. Placement of e. Placement of trash f. Visuals signages on 5. The school has ensured a. Schedule of
handwashing facilities in a bins in strategic locations proper waste management regular sanitation and sanitation of frequently
strategic location (e.g., practices near trash bins disinfection of school touched surfaces (e.g.,
school entrance) facilities, furniture, and table, doorknobs, light
equipment. switches, etc.) every after
end of a school shift

YES YES YES YES YES


b. Schedule of c. Availability of 6. The school has ensured a. Disposal of all used PPEs in a b. Collection of the
disinfection of school sanitation and disinfecting a proper disposal system separate leak-proof yellow trash leak-proof yellow trash
facilities (e.g., chairs, desk, materials of infectious wastes, such bag/container with a cover properly labeled bag/container regularly or
blackboard, toilet facilities) as used tissues and as “USED PPE” twice a day (after end of
masks, in non-contact class and after working
receptacles. day) from
designated/specific area to
the general collection area
for treatment and disposal

YES YES YES YES YES


c. Availability of medical-grade face d. Treatment through e. Disposal of the 1. The school has a. Identification of
mask required for school personnel when disinfection or spraying of disinfected PPE with developed a platform of communication
collecting/handling the leak-proof yellow the collected wastes with a general waste to the final communication plan. for coordination purposes
trash bag/container chlorine solution (1:10) in disposal facility among the learners,
accordance with DOH parents/guardians, and
Department Memorandum teachers
No. 2020-0157 “Guidelines
on Cleaning and
Disinfection in Various
Settings as an Infection
Prevention and Control
Measure Against COVID-
19”

YES YES YES YES YES


b. Database of contact details including contact number c. Development of child-friendly 2. The school has
and address of parents/guardians of the learners are kept to Information, Education and Communication prepared an orientation
inform them in case their child shows flu-like symptoms while (IEC) materials on hygiene practices and session for learners,
in school premises respiratory etiquette including hand hygiene parents, guardians,
(hand disinfection thru handwashing and/or teaching and non-teaching
use of 70% isopropyl alcohol), respiratory personnel, external
hygiene and cough etiquette (coughing or stakeholders, and LGU of
sneezing into tissues or one’s elbow), the eligibility criteria for
protective measures (proper use of face participation, existing
shield and face mask, physical distancing), protocols, mechanisms,
among others, that are posted in common and procedures needed in
areas and are available in local languages the conduct of the limited
and braille. face-to-face classes.

YES YES YES


a. Schedule of the b. Orientation 3. The school has a 4. The school has
orientation (at least one materials are made proactive COVID-19 local prepared a re-orientation
week prior to the conduct available for distribution to hotline/help desk or any session for school
of the face-to-face classes) teachers, learners, similar local mechanism stakeholders on measures
parents, BLGU, DRRM that connects and needed for the reopening
team members, and coordinates to the of the school in the event
persons-in-charge in hospitals, testing facilities, of resurgences and school
ensuring observance of and LGUs. lockdown.
protocols, mechanisms,
and procedures

YES YES YES YES


1. The school has followed a decision model and contingency a. Inclusion of decision b. In the event of
plan for reclosing and reopening the school in case of COVID- points for school lockdown school lockdown, all
19 resurgence in the community. dependent on the learners shall revert to
assessment and decision distance learning.
of the Local Task Force
against COVID-19 (LTF)
with the following
considerations:

When there is suspected,
probable, or confirmed
COVID-19 case to facilitate
disinfection and contact
tracing; ○ Change in
number of community
transmission and
quarantine risk
classification identified by
IATF; ○
YES YES
Violations/instances of YES
non-compliance of learners
or personnel with the
minimum public health
standards or PDITR for
review of protocols
c. Implementation of a 24-hour granular d. Consideration of the following for the reopening of classes 2. The school has a. Distance learning
lockdown period for disinfection following after a school lockdown: developed strategies for modalities during lockdown
identification/detection of suspect, probable, o Completed contact tracing o the continuity of learning in the decision model and
or confirmed COVID-19 confirmed case/s, Completed disinfection activities o while the school is closed contingency plan
only after which can it be opened for use to 14 days without confirmed cases in the school until the local authorities
occupants. have determined the safe
o School is in a barangay with low to no community resumption of face-to-face
transmission classes.
o Area where the school is located is classified as
minimal-risk

YES YES YES YES


b. Strategies for the 1. The school has a. 1:1 Face mask to b. 1:1 Face shield to c. 1:1 Toothbrush and
reopening of schools after secured sufficient supply of Person (daily) ratio Person ratio Toothpaste to Learner ratio
the lockdown in the personal protective (K-6 learners)
decision model and equipment (PPEs) for
contingency plan learners and school
personnel.

YES YES YES YES YES


d. 1:1 Bar of soap to e. Availability of f. Availability of PPEs 2. The school has secured a. 1:1 Replacement of
Learner ratio enough for 5x emergency health kits that for COVID-19 team adequate supply of face lost and damaged PPE to
of handwashing per day include PPEs and other members, health masks, face shields, Person ratio
(K-6 learners) needed supplies and personnel, and and/or other COVID-19
materials in the school maintenance, and security protective gears for
clinic guards learners.

YES YES YES YES YES


3. The school has ensured that the a. Sodium hypochlorite b. Ethanol in all c. Hydrogen peroxide 4. The school has
available sanitation and disinfection recommended ratio of surfaces at a in all surfaces at a secured sufficient supply of
materials are approved by the Philippine 0.1% (1000 ppm) by recommended ratio of 70- recommended ratio of sanitation and disinfection
Food and Drug Administration (FDA) such dissolving ½ tsp of chlorine 90%, or >0.5% materials for strategic
as: or 2 g to 2L of clean water school locations.
for regular disinfection, and
recommended ratio of
0.5% (5000 ppm) for body
fluids by dissolving 1 tbsp
of chlorine or 10 g to 2L of
clean water

YES YES YES YES YES


a. 1:1 bottle of hand- b. 1:1 bottle of hand- c. 1:1 bottle of hand- 5. The school has a. Availability of
sanitizers/alcohol-based sanitizers/alcohol-based sanitizers/alcohol-based ensured PPE medical mask and face
solutions/other solutions/other solutions/other requirements, shields for triage and
disinfectants to restroom disinfectants to classroom disinfectants to specifications, and screening of individuals in
entrance/exit point standards for different points of entry (for
types of COVID-19 personnel in school
management activities in entrances
accordance with DOH DM
2020-0176A.

YES YES YES NO YES


b. Availability of c. Availability of d. Availability of full 1. The school has a. Conduct of hand
medical mask, goggles or respirator (N95 or FFP2), PPE for assisting in developed strategies to hygiene and temperature
face shield, gloves, gown goggles or face shield, transporting passengers to prevent COVID-19. checks using a thermal
for caring for a suspected gloves, gown for caring for a healthcare facility scanner prior to entering
case of COVID-19 with no suspected/confirmed the school
aerosol-generating cases of COVID-19 with no
procedure (for personnel in aerosol-generating
school clinics) procedure for personnel in
school clinics)

YES NO YES YES YES


b. Prioritization of non- c. Conduct of daily d. Conduct of e. Availability of surgical face masks and school clinic for
face-to-face rapid health checks in the necessary disinfection further assessment of anyone who will show symptoms of
communications and classroom activities especially in the COVID-19
coordination through areas of the school
available platforms and frequented by personnel or
discouragement of learners that tested
entrance of school visitors positive
and other external
stakeholders

YES YES YES YES


f. g. Designation of h. Designation of i. Designation of clinic j. Orientation to the
Establishment/setting- private screening area at separate space where sick teachers(s) in absence of clinic teacher by the school
up/refurbishment of a the entrance where school- school-goers who have school health personnel, health personnel at the
school clinic to provide goers who show symptoms been managed in the clinic who shall provide basic SDO for proper guidance
basic health services to all upon screening can be can temporarily stay, health services and on how to effectively run
school-goers, such as: further examined, or awaiting referral to the facilitate referral in the school clinic
referred appropriate health facility, coordination with the
o Health assessment without creating stigma school health personnel at
and physical examination, SDO, in absence of
as needed school-based health
personnel
o Appropriate
intervention, first aid, or
treatment o
Proper management of
symptoms, including rest
at home

o
YES
Referral and follow-up of YES YES YES YES
learners, teachers, and
personnel to appropriate
facilities
k. Reiteration of l. Record of students’ 2. The school has a. Cooperation with
protocols for learners, health status and identified strategies to the local health authorities
teachers, and personnel development, including detect COVID-19. in the tracing and
who manifest COVID-19 immunization checks to quarantine of close
symptoms to not physically prevent outbreak-prone contacts of confirmed
report to school and seek vaccine-preventable cases of COVID-19
medical advice virtually if disease (e.g., measles consistent with DOH
possible guidelines

YES YES YES YES


b. Presence of the School DRRM Team who shall c. Close coordination d. Development of a e. Provision of health
ensure that contact tracing activities, as required by with Epidemiology reporting system requiring form to parents/guardians
the local health authorities, are initiated, and Surveillance Unit (ESU) parents to report to the at the beginning of each
completed among the possible close contacts among officers per setting school if their children are school term confirming
DepEd personnel and learners o experiencing flu-like their child and/or family
DOH Regional ESU of system, recommendation members do not have
reporting school of testing to be done COVID-19 before being
o LGU City immediately with support permitted to go to school to
ESU/Provincial and guidance from the be submitted 24 to 72
ESU/Municipal ESU of LGUs hours prior to the start of
reporting school school opening

o DOH
Regional ESU of identified
case (place of residence)

o
LGU City ESU/Provincial
ESU/Municipal ESU of
YES YES
identified case (place of YES YES
residence)
3. The school has a. Designation of b. Availability of c. Notification of family d. Immediate isolation
developed strategies to rooms for isolation of transport vehicles from member/guardians of the and referral of the
isolate and treat COVID- students and personnel school to Temporary learner, or family member personnel/s or learner/s
19. with fever and flu-like Treatment and Monitoring of school personnel who who show COVID-19
symptoms near the Facility (TTMF) show flu-like symptoms symptoms based on the
entrances severity for proper
management and
appropriate testing

YES YES NO YES YES


WELL_BEING AND P
e. Provision of f. Referral/full g. Strict observance of h. Report of the close i. Strict compliance of
necessary emergency care disclosure of the case to advice from health follow-up of the learners and personnel
to the personnel or learner the identified health authorities including attending/assigned school who have tested positive
following precautionary authority (e.g., barangay possibility of home health personnel or for COVID-19 to not return
measures, by the health health station, rural health quarantine or isolation in a designated clinic teacher to school without clearance
personnel or designated unit) for further evaluation quarantine facility or with the condition of the from medical authorities
clinic teacher or referral to a hospital if confinement identified
needed learner/personnel to the
SDO School health and
Nutrition Unit/Section, as
required by existing
reporting mechanisms

YES YES YES YES YES


WELL_BEING AND PROTECTION
j. Monitoring and k. Coordination of SH l. Coordination of SH with the SDO in m. Strict observance of 4. The school has
provision of necessary to all cases with DepEd ensuring continuity of teaching and learning provision of Section IV.A developed strategies in
support of the School school health personnel in line with the school’s contingency plan (Screening of Returning providing psychosocial
Head (SH) to all cases and local health authorities Personnel and Learners support to the learners,
(close contacts, suspect, and Testing Protocol) of teachers, and personnel.
probable, confirmed) the Specific Measures for
COVID-19 Prevention and
Mitigation in Schools
(Enclosure No. 2 to DepEd
Order No. 014, s. 2020)
before the participation of
COVID-19 infected
learners or personnel in
the face-to-face classes

YES YES YES YES YES


a. Allotment of time b. Designation of trained teachers who c. Setting up of an d. Availability of a hotline/online platform
and preparation of will facilitate activities fostering Mental operational Guidance in the SDOs to provide counseling services
modules on Mental Health Health such as mental health topics, nature Office that is staffed by a to learners, teachers, and personnel who
to be facilitated by their of COVID-19, and preventive measures registered guidance require counseling services, in absence of an
respective classroom (WASH, physical distancing, etc.) counselor (RGC) or a RGC
advisers or designated designated guidance
teachers associate (not an RGC but
is trained on MHPSS and
is capable of effective
referral) every school day,
to provide basic mental
health services to learners,
teachers, and personnel
who may need such
services

YES YES YES YES


e. Provision of f. Establishment and g. Engagement of parents, guardians, or h. Coordination of i. Strict adherence to
specialized psychosocial contextualization of the any care providers of learners on taking care mechanisms to ensure that Republic Act No.10173 or
support to learners, inter-sectoral referral of mental health and creating a positive the mental health and the the Data Privacy Act of
teachers and personnel pathways to ensure that environment basic needs of learners 2012 in the provision of
who are confirmed to be psychosocial needs of both and personnel with pre- mental health services and
positive, under isolation/ the personnel and the existing mental health referral
quarantine, and learners are provided conditions and special
categorized as suspect needs including neurologic
and probable, through the and substance abuse
Guidance Office using the disorders such as
DRRMS MHPSS materials medications and other key
as reference services are provided

YES YES YES YES YES


j. Promotion of k. Mobilization of 5. The school has a. Communication plan b. Communication plan
“school-life balance” trained Psychological First established a clear which includes which includes a referral
through proper scheduling Aid (PFA) providers of the procedure of referral coordination system with system for COVID-19
of schoolwork that will schools to provide system for COVID-19 LGU for school personnel confirmed and suspected
allow learners to enjoy necessary mental health confirmed and suspected and learners who show flu- personnel and learners
quality time at home and psychosocial support personnel and learners. like symptoms
to concerned personnel or
learners

YES YES YES YES YES


c. Flow chart of the 6. The school has a. Communication plan b. Communication plan c. Flow chart of the
referral system established a clear contact which includes which includes notification contact tracing and
tracing and quarantine coordination system with of quarantine system
system for close contacts local health authorities in family/parent(s)/guardian(s
of COVID-19 confirmed contact tracing and ) of the concerned
positive cases. quarantine of close learner/s
contacts of confirmed
COVID-19 positive cases

YES YES YES YES YES


d. Contingency plan 1. The school has a.indigent children b.out-of-school youth c. physically and
for school lockdown identified learners who are mentally handicapped
most vulnerable and
disadvantaged in terms of
access to learning as
indicated in the eligibility of
learners, such as inclusion
of:

YES YES NO NO
d. distressed e.low resourced students f. abandoned and g.street children h.children of former rebels
individuals and families, neglected children
including internally
displaced persons (IDPs)

NO YES NO NO NO
i. children living in j. children with k. children from 2. The school has a. Inclusion of learners
conflict-affected areas and disabilities and SPED Geographically Isolated identified learners who are who need assistive
vulnerable communities students and Disadvantaged Areas most vulnerable and devices that do not require
(CVAS) disadvantaged in terms of them to remove their face
access to learning as masks
indicated in the eligibility of
learners, such as inclusion
of:

NO NO YES NO
b. Coordination with c. Ensured that 3. The school has developed learning 4. The school has ensured participation
partner agencies in the parent/guardian of learners strategies to cater the needs of the in school-based services which includes but
provision of assistive are informed that his/her disadvantaged learners such as modules in is not limited to feeding and nutrition
devices such as child has their own braille, mother-tongue languages, and usage programs, immunizations, Mental Health and
wheelchairs, cane, assistive device during of Filipino Sign Language. Psychosocial Support (MHPSS), prevention
walkers, and others face-to-face classes of Violence against Children (VAC) (i.e.,
bullying from social stigma) and other health
services.

NO NO YES YES
5. The school has established close 6. The school has a. Routine b. Facilitation of the completion of
coordination with the Department of Social coordinated with their implementation of SBI routine immunizations through regular
Welfare and Development (DSWD) Case respective local together with school health immunization mechanisms available through
Managers of those learners who are government units with the services among target the National Immunization Program (NIP)
marginalized; Other partner agencies and implementation of routine learners
organizations such as National Council on school-based
Disability Affairs (NCDA). immunization (SBI) and
other school health-related
services such as but not
limited to deworming and
weekly iron-folate acid
supplementation (WIFA).

YES YES YES YES


c. Routine d. Referral of learners who have not e. Participation in intensive health 1. The school has
immunization card checks completed their routine infant vaccines to the promotion campaign activities/supportive- developed a plan in
through the school nurse nearest LGU/private pediatrician for catch-up policies that shall be instituted by schools in coordinating with the
or the designated clinic vaccination collaboration with their local health offices to Barangay Local
teachers to ensure that maintain optimal health-seeking behaviors of Government Unit (BLGU)
children entering schools learners and other community members or the Barangay Health
have completed their Emergency Response
routine immunization (i.e., Team (BHERT) in
3 doses of Polio and DPT- ensuring that protocols are
HepB-Hib vaccines, and observed properly.
two doses of Measles-
containing vaccines) in the
community

YES YES YES YES


HOME-SCHOOL COORDINATION
a. Operationalization 2. The school has a.Safe drop-off and pick-up procedures b. Safety precautions c. Safety precautions
of the Preventative Alert developed a strategy in and preventive measures and preventive measure
System in Schools (PASS) orienting parents on health while commuting [e.g., upon entering the school
for COVID-19 (per DepEd protocols and safety wearing of proper face premises
Memorandum No. 15, s. measures. masks and face shields,
2020) refrain from talking and
eating while in public
transportation, ensure
adequate ventilation,
frequent and proper
disinfection, appropriate
physical distancing]

YES YES YES YES YES


3. The school has Number of Fully Number of Fully Number of Vaccinated (1st Number of Vaccinated (1st
identified a designated Vaccinated Male Teaching Vaccinated Female Dose Only) Male Teaching Dose Only) Female
waiting area with proper Personnel Teaching Personnel Personnel Teaching Personnel
ventilation for
parents/guardians.

YES 2 4 0 0
VACCINATION STATUS
Total Number of Fully Total Number of Male and % of Fully Vaccinated Number of Unvaccinated Reasons for Unvaccination
Vaccinated Male and Female Teaching Teaching Personnel Male and Female
Female Teaching Personnel Teaching Personnel
Personnel

6 6 100% 0
VACCINATION STATUS
Number of Fully Number of Fully Number of Vaccinated (1st Number of Vaccinated (1st Total Number of Fully
Vaccinated Male Non- Vaccinated Female Non- Dose Only) Male Non- Dose Only) Female Non- Vaccinated Male and
Teaching Personnel Teaching Personnel Teaching Personnel Teaching Personnel Female Non-Teaching
Personnel

0 0 0 0 0
Total Number of Male and % of Fully Vaccinated Non- Number of Unvaccinated Reasons for Unvaccination
Female Non-Teaching Teaching Personnel Male and Female Non-
Personnel Teacing Personnel

2 0% 2 culture and beliefs

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