CHECKLIST ON THE PREPARATIONS FOR LIMITED FACE TO FACE CLASSES

Name of School: _________________________________

Name of school Head: _____________________________
Number of Participating Learners: _______________
Number of Participating Teachers: _______________
Number of Classroom to be used: _______________

Activities Evident/ Not Evident/ Responsible Name and

Accomplished Not People Signature
Accomplished
Physical Structures, health equipments, and Classroom preparations
Functional WASH Facilities School Health
Coordinator
Visible Floor Markings (Pathways and School Traffic
classrooms) Management
Arranged classroom based on the School Traffic
prescribed layout Management
Isolation room (near the entrance) School Traffic
Management
Entrance and exit signages School Traffic
Management
Health Advocacy signages School Health
Coordinator
Waiting area for School Traffic
parents/guardians/fetchers Management
Thermal Scanner with alcohol School Health
dispenser in the entrance gate. Coordinator
Carbon Dioxide Meter School Health
Coordinator
Working Electric fans School Health
Coordinator
Sterilization box with UV light School Health
Coordinator
Personal Protective Equipment (PPEs) School Health
Coordinator
Alcohol dispenser in the classroom School Health
Coordinator
Yellow Garbage Bag School Health
Coordinator
Database of Participating Learners School Registrar
 Database of Participating School School Registrar
Personnel
Contingency Plan DRRM
Coordinator
Waste Management Plan DRRM
Coordinator

Curriculum and Instruction

Class schedule School Head
Alternative Working Arrangement School Head
(AWA)
Weekly Home Learning Plan (WHLP) School Head
Textbooks are distributed LR Coordinator
Modules for Psychosocial Support School Health
Coordinator

Community Involvement
Contact Tracing system School Health
Coordinator
Referral System School Health
Coordinator
Brgy Resolution Supporting the School Head
reopening of classes
Coordination with Barangay Health School Health
Emergency Response Coordinator

Activities before F2F classes

Conducted orientations to: School Health
Teachers Coordinator
Parents
Learners
Signed Parental Consent Advisers
Conducted Simulation of Classes School Health
Coordinator

Monitored By:

___________________________
Public Schools District Supervisor

__________________________
Date