Republic of the Philippines

Department of Education
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL SUR
ZDS_SGOD_SMME_2020_01

SITE INSPECTION REPORT

Name of School: UPPER DIMOROK ELEMENTARY SCHOOL Date: August 26, 2020
School Address: UPPER DIMOROK, MOLAVE, ZAMBOANGA DEL SUR
School Head: ALEX A. GARCES District: MOLAVE WEST

Date of Inspection: August 25, 2020

Instruction: Please check (/) in each item which are available/observable/evident.

A. Site Description:
Rock Firm clay over soft clay
Chalk Peat
Gravel and Sand Filled grounds
 Sloping Others, specify:

B. School Land Area (sq.m.):

C. Adequacy for school purposes:

 School Improvement Plan Inventory of Modules
 Learning Continuity Plan  Learners Enrollment and Survey Form
 Master Class Program  School Form 1
 Teaching Loads Clustering of Learners (if applicable)
 Most Essential Learning Competencies

D. Building Description (specify the number):

4 Concrete 2 Semi-Concrete Temporary

E. Facilities:
 Administration Office  Orientation Area
Library  Distribution Area
Guidance Room  ICT Room
 Triage/Holding Area Disinfection Area

F. Health Facilities:
Clinic Toilets (with available soap and water)
 Drinking Station Gender segregated
Canteen  7 Non-gender segregated
 Handwashing station  Trash bins (Four types with label)
 Material recovery facility

G. Clinic:
 First aid kit (gauze, gloves, wound disinfectant)
Protective Personal Equipment (Cover all, gloves, surgical mask, face shield, bonnet/head cap)

Address: Provincial Government Center, Dao, Pagadian City

Telephone No.: (062) 214 – 1991
E-mail Address: depedzambosur@gmail.com
Website: www.depedzambosur.info
 Republic of the Philippines
Department of Education
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL SUR

 Health essentials
Examination table
Medicine cabinet (internal/external medicines)
H. Availability of Health Essentials
 Alcohol/Sanitizer Medicine, please specify:
 Soap
 Disinfectant
 Infrared Thermometer
Surgical face mask
 Tissue paper

I. Equipment:
 Overhead Projector*  Printer
PAS (Public Address System)  Television*
Photocopier Others, please specify:

J. Physical Structures
Early warning device is available and functional (buzzer, megaphone, bells)
Disinfection area has available foot bath, alcohol-based sanitizer, thermal gun
 Signages in the entrance and exit and other IEC materials
Fire Extinguishers in every building/area
 Orientation Area are well-arranged
 Holding and Orientation area are well-ventilated and well-lighted
 Barriers are installed in the Distribution area
 There is a separate area for exit.

K. School Grounds:
 School grounds are well-kept and properly maintained.
 School grounds are free from hazards.
 School grounds are properly landscaped.
 Practices proper garbage disposal.
 With appropriate sewage system

I hereby certify that the above observations are true and correct.

JOURLY C. RANQUE ALEX A. GARCES

Signature Over Printed Name Signature Over Printed Name

________________________________________ _______________________________________
Signature Over Printed Name Signature Over Printed Name

Address: Provincial Government Center, Dao, Pagadian City

Telephone No.: (062) 214 – 1991
E-mail Address: depedzambosur@gmail.com
Website: www.depedzambosur.info
 Republic of the Philippines
Department of Education
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL SUR

Noted:

MANUEL S. LAYUG
Public Schools District Supervisor

Address: Provincial Government Center, Dao, Pagadian City

Telephone No.: (062) 214 – 1991
E-mail Address: depedzambosur@gmail.com
Website: www.depedzambosur.info