Attachment 2

Document Code:
Quality Form
Revision:
OK sa DepEd - School-Based Feeding Program (SBFP)
Program Terminal Report Form Effectivity date: 01-1-2021

(SBFP PTR - Form C) BLSS-School Health Division

Region/Division: Period Covered:

Office Address:
Office Telephone Number: Mobile Number:
Fax Number: Email Address:
Number of Schools in the Region: Elementary Enrolment:
Secondary Enrolment:
TOTAL:
A. ACCOMPLISHMENTS

1. SBFP Coverage: Total Beneficiaries for Nutritious Food Products

Pupils-at-Risk-
Severely Indigenous Indigent
SDOs All Kinder Wasted Stunted of-Dropping- TOTAL
Wasted Peoples Learners
Out (PARDOs)
0
0
0
0
0
0
0
0
0
TOTAL 0 0 0 0 0 0 0 0

2. SBFP Coverage: Total Beneficiaries for Milk sourced from NDA/PCC

Severely Pupils-at-Risk- Indigenous Indigent
SDOs All Kinder Wasted Stunted of-Dropping- TOTAL
Wasted Peoples Learners
Out (PARDOs)
0
0
0
0
0
0
0
0
0
TOTAL 0 0 0 0 0 0 0 0

3. SBFP Coverage: Total Beneficiaries for Milk sourced from Commercial Sources
Severely Pupils-at-Risk- Indigenous Indigent
SDOs All Kinder Wasted Stunted of-Dropping- TOTAL
Wasted Peoples Learners
Out (PARDOs)
0
0
0
0
0
0
0
0
0

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Attachment 2
TOTAL 0 0 0 0 0 0 0 0

4. SBFP Coverage: Total Beneficiaries for Milk Donated by Partners

Pupils-at-Risk-
SDOs All Kinder Severely Wasted Stunted of-Dropping- Indigenous Indigent TOTAL
Wasted Out (PARDOs) Peoples Learners
0
0
0
0
0
0
0
0
0
TOTAL 0 0 0 0 0 0 0 0

5. SBFP Coverage: Grand Total Beneficiaries for Milk (All sources)

Severely Pupils-at-Risk- Indigenous Indigent
SDOs All Kinder Wasted Wasted Stunted of-Dropping- Peoples Learners TOTAL
Out (PARDOs)
0
0
0
0
0
0
0
0
0
TOTAL 0 0 0 0 0 0 0 0

6. Type of Food Commodities Distributed to Learners (Check applicable items)

a. Nutritious Food Products
Enutribun
Fortified/Enriched Bread
Fruits
Rootcrops
Vegetables
Nutripacks

b. Milk
Fresh Milk
Sterilized Milk
Commercial Milk
Provided by Partner

7. SBFP Funds (for those with downloaded funds)

Amount Received from CO Funds Utilized Percent Utilization
(col 3/2*100%)

NFP
Milk
PSF
Additional Funds
Total:

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Attachment 2
B. DONATIONS/ RESOURCES GENERATED
(Add Additional Sheets, if needed)

Partner & Type of Donations/Services Provided Quantity (if applicable) Estimated Cost (if applicable)

C. SIGNIFICANT EVENTS OF SBFP, AND OTHER HEALTH AND NUTRITION PROGRAMS/

EXPERIENCES/ GOOD PRACTICES
(Add Additional Sheets, if needed)
What happened? Who were involved? When Outcome: What is/are its important contribution to the
School-Based Feeding Program of the school?

D. LESSONS LEARNED G. SUGGESTIONS TO STRENGTHEN SBFP (Include support

needed from Central, Region, and Division Office that can increase the impact of OK
sa DepEd Program in the schools)

E. PROPOSED PLAN OF ACTION AND RECOMMENDATIONS

F. PHOTOS (Before, During and After)

Prepared by: Noted:

SBFP Coordinator Schools Division Superintendent

Date:

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Attachment 2
Document Code:
Quality Form
Revision:
OK sa DepEd - School-Based Feeding Program (SBFP)
Program Terminal Report Form Effectivity date: 01-1-2021

(SBFP PTR - Form B) BLSS-School Health Division

Region/Division: Period Covered:

Office Address:
Office Telephone Number: Mobile Number:
Fax Number: Email Address:
Number of Schools in the Schools Division: Elementary Enrolment:
Secondary Enrolment:
TOTAL:
A. ACCOMPLISHMENTS

1. SBFP Coverage: Total Beneficiaries for Nutritious Food Products

Pupils-at-Risk-
Severely Indigenous Indigent
Grade Level All Kinder Wasted Stunted of-Dropping- TOTAL
Wasted Peoples Learners
Out (PARDOs)
Kinder 0
Grade 1 0
Grade 2 0
Grade 3 0
Grade 4 0
Grade 5 0
Grade 6 0
SPED 0
Multigrade 0
TOTAL 0 0 0 0 0 0 0 0

2. SBFP Coverage: Total Beneficiaries for Milk sourced from NDA/PCC

Severely Pupils-at-Risk- Indigenous Indigent
Grade Level All Kinder Wasted Stunted of-Dropping- TOTAL
Wasted Peoples Learners
Out (PARDOs)
Kinder 0
Grade 1 0
Grade 2 0
Grade 3 0
Grade 4 0
Grade 5 0
Grade 6 0
SPED 0
Multigrade 0
TOTAL 0 0 0 0 0 0 0 0

3. SBFP Coverage: Total Beneficiaries for Milk sourced from Commercial Sources
Severely Pupils-at-Risk- Indigenous Indigent
Grade Level All Kinder Wasted Stunted of-Dropping- TOTAL
Wasted Peoples Learners
Out (PARDOs)
Kinder 0
Grade 1 0
Grade 2 0
Grade 3 0
Grade 4 0
Grade 5 0
Grade 6 0
SPED 0
Multigrade 0

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Attachment 2
TOTAL 0 0 0 0 0 0 0 0

4. SBFP Coverage: Total Beneficiaries for Milk Donated by Partners

Pupils-at-Risk-
Grade Level All Kinder Severely Wasted Stunted of-Dropping- Indigenous Indigent TOTAL
Wasted Out (PARDOs) Peoples Learners
Kinder 0
Grade 1 0
Grade 2 0
Grade 3 0
Grade 4 0
Grade 5 0
Grade 6 0
SPED 0
Multigrade 0
TOTAL 0 0 0 0 0 0 0 0

5. SBFP Coverage: Grand Total Beneficiaries for Milk (All sources)

Severely Pupils-at-Risk- Indigenous Indigent
Grade Level All Kinder Wasted Wasted Stunted of-Dropping- Peoples Learners TOTAL
Out (PARDOs)
Kinder 0
Grade 1 0
Grade 2 0
Grade 3 0
Grade 4 0
Grade 5 0
Grade 6 0
SPED 0
Multigrade 0
TOTAL 0 0 0 0 0 0 0 0

6. Type of Food Commodities Distributed to Learners (Check applicable items)

a. Nutritious Food Products
Enutribun
Fortified/Enriched Bread
Fruits
Rootcrops
Vegetables
Nutripacks

b. Milk
Fresh Milk
Sterilized Milk
Commercial Milk
Provided by Partner

7. SBFP Funds (for those with downloaded funds)

Tranches Amount Received from RO Funds Utilized Percent Utilization
(col 3/2*100%)

Total:

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Attachment 2
B. DONATIONS/ RESOURCES GENERATED
(Add Additional Sheets, if needed)

Partner & Type of Donations/Services Provided Quantity (if applicable) Estimated Cost (if applicable)

C. SIGNIFICANT EVENTS OF SBFP, AND OTHER HEALTH AND NUTRITION PROGRAMS/

EXPERIENCES/ GOOD PRACTICES
(Add Additional Sheets, if needed)
What happened? Who were involved? When Outcome: What is/are its important contribution to the
School-Based Feeding Program of the school?

D. LESSONS LEARNED G. SUGGESTIONS TO STRENGTHEN SBFP (Include support

needed from Central, Region, and Division Office that can increase the impact of OK
sa DepEd Program in the schools)

E. PROPOSED PLAN OF ACTION AND RECOMMENDATIONS

F. PHOTOS (Before, During and After)

Prepared by: Noted:

SBFP Coordinator Schools Division Superintendent

Date:

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Attachment 2
Document Code:
Quality Form
Revision:
OK sa DepEd - School-Based Feeding Program (SBFP)
Program Terminal Report Form Effectivity date: 11-19-2021
(SBFP PTR - Form A) BLSS-School Health Division

Region/Division: Misamis Oreintal Period Covered: 120 days

School Name & ID: Binitinan Elementary School
School Address: Binitinan,Balingasag, Misamis Oriental
School Telephone Number: Mobile Number: 9658823271
Fax Number: Email Address: elsa.loquias@deped.gov.ph
Total Enrolment: 604 Total No. of T & NTP: 23 Teachers & 3 NTP

A. ACCOMPLISHMENTS

1. SBFP Coverage: Primary Beneficiaries for Nutritious Food Products

Grade Level Severely Wasted Wasted TOTAL

Kinder 68 0 0 68
Grade 1 9 0 0 9
Grade 2 9 0 0 9
Grade 3 9 0 0 9
Grade 4 17 0 0 17
Grade 5 4 0 0 4
Grade 6 3 0 0 3
SPED 0 0 0 0
Multigrade 0 0 0 0
TOTAL 119 0 0 119

2. SBFP Coverage: Secondary Beneficiaries for Nutritious Food Products

Pupils-at-Risk-of-
Grade Level Stunted Dropping-Out Indigenous Peoples Indigent Learners TOTAL
(PARDOs)
Kinder 0 0 0 0 0
Grade 1 0 0 0 0 0
Grade 2 0 0 0 0 0
Grade 3 0 0 0 0 0
Grade 4 0 0 0 0 0
Grade 5 0 0 0 0 0
Grade 6 0 0 0 0 0
SPED 0 0 0 0 0
Multigrade 0 0 0 0 0
TOTAL 0 0 0 0 0

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Attachment 2

3. SBFP Coverage: Primary Beneficiaries for Milk

Grade Level Severely Wasted Wasted TOTAL

Kinder 68 68
Grade 1 9 9
Grade 2 9 9
Grade 3 9 9
Grade 4 17 17
Grade 5 4 4
Grade 6 3 3
SPED 0 0
Multigrade 0 0
TOTAL 119 119

4. SBFP Coverage: Secondary Beneficiaries for Milk

Pupils-at-Risk-of-
Grade Level Stunted Dropping-Out Indigenous Peoples Indigent Learners TOTAL
(PARDOs)
Kinder 68
Grade 1 9
Grade 2 9
Grade 3 9
Grade 4 17
Grade 5 4
Grade 6 3
SPED 0
Multigrade 0
TOTAL 119

5. Type of Food Commodities Distributed to Learners (Check applicable items)

a. Nutritious Food Products
Enutribun /
Fortified/Enriched Bread /
Fruits
Rootcrops
Vegetables
Nutripacks /

b. Milk
Fresh Milk /
Sterilized Milk
Commercial Milk
Provided by Partner

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Attachment 2
6. SBFP Funds (for those with downloaded funds)

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Attachment 2
Tranches Amount Received from SDO Funds Utilized Percent Utilization (col 3/2*100%)

N/A

Total:

B. DONATIONS/ RESOURCES GENERATED

(Add Additional Sheets, if needed)

Partner & Type of Donations/Services Provided Quantity (if applicable) Estimated Cost (if applicable)

N/A

C. SIGNIFICANT EVENTS OF SBFP, AND OTHER HEALTH AND NUTRITION PROGRAMS/

EXPERIENCES/ GOOD PRACTICES
(Add Additional Sheets, if needed)
What happened? Who were involved? When Outcome: What is/are its important contribution to the School-Based Feeding Program of the
school?
Pupils, Parents & Teachers, Feeding
Distribution of nutribun,milkybun and freshmilk Focal Person, School Property Nov.18,2021 - FMakes the pupils healthy in mind and body
Custodian, District Nurse
Before, some learners do not like milk, but now Helps the pupils gain weight and can add nutrients to become more energetic.
Learners, Parents
they already loved it.
Imposed proper health protocols during the
It reduces
The pupils
important at risk of malnutrition
contribution that milk feeding gives to the learners is the chance of drinking milk
distributions.
everyday that most of them cannot drink because of financial difficulty.

D. LESSONS LEARNED G. SUGGESTIONS TO STRENGTHEN SBFP

Just continue the milk,nutribun,milkybun feeding program for the betterment of learners in the midst of pandemic.
I learned that SBFP milk feeding is a big help in the benefeciaries especially those
families who have been greatly affected by the pandemic.

E. PROPOSED PLAN OF ACTION AND RECOMMENDATIONS

NONE

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Attachment 2
F. PHOTOS (Before, During and After)

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Attachment 2

Prepared by: Noted:

MA.LEOFEL G. GALLARDO ELSA E. LOQUIAS

SBFP Coordinator PRINCIPAL I
Date: 03/21/2022

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