Republic of the Philippines

Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OFFICE - SCIENCE CITY OF MUÑOZ
Enclosure 1: CHECKLIST for Oplan Kalusugan sa DepEd Accomplishment Report Form

CHECKLIST FOR DEWORMING, IMMUNIZATION, HPV vaccine and WIFA SY 2021-2022

SCHOOL NAME: MUNOZ CENTRAL SCHOOL

GRADE LEVEL and SECTION:   GRADE 5- EHLEE          
No. Name Age Sex Address Deworming Measles- Tetanus- Human WIFA
(All grade Rubella Diphtheria Papillomav (Grade 7-12,
levels, ALS, (MR) (Td) irus ALS)
SPED)
 1 dose (July)
st
vaccine vaccine vaccine
 2 dose
nd (Grade 1 (Grade 1 and (Grade 4
(January) and 7) 7) female
students for
9 years old
and above
only)
1st
2nd
1st
2nd
1st
2nd
1st
2 nd
1 st
2 nd

dose dose dos dose dose dose dose dose dose dose
e
1 BAL-OT VIEN JEM A. 10 M LICAONG,SCOM NE

2 BARANGAN AL DENMARC V. 11 M POB. EAST,SCOM NE

3 DAMACIO REYMARK D. 10 M VILLA CUIZON, SCOM NE
4 ESTIADA RUSHAWN DAVE S. 10 M POB. EAST,SCOM NE
5 GABRIEL ROMEL JR. B. 11 M BACAL III, TALAVERA NE
6 GONZALES JUSTIN T. 10 M CATALANACAN SCOM NE
7 GUTIERREZ JHON MARK 10 M CATALANACAN SCOM NE

Loyal, Excellent, Accountable and Dedicated to Service

Address: Brgy. Rizal, Science City of Muñoz, 3119
Telephone No.: (044) 806 -2192; Email Address: munozscience.city@deped.gov.ph
DSCM-QMS-QMR-QSF-008 Rev.03 (01.31.20)
Certificate No. 50500731 QM15
 Republic of the Philippines
““L
L,oyal
“Loyal oyal,, E
Excellent
Excellent ,, A
Accountable
, Accountable
xcellent ccountable D
and and
and D
Dedicated to S
to Sto
edicated
edicated “L ”oyal”,
ervice
ervice
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OFFICE - SCIENCE CITY OF MUÑOZ
8 HOUK JAMES JR. O. 10 M POB. EAST, SCOM NE
9 ILETO REYMOND R. 10 M POB. EAST SCOM NE
10 LAURENTE JANCARL C. 10 M CATALANACAN SCOM NE
11 MANAOIS JHAN-ICE M. 12 M POB. SOUTH SCOM NE
12 PACAYO LAY ALVIN G. 10 M POB. WEST SCOM NE
13 PADILLA KENJIE E. 10 M POB. EAST SCOM NE
14
/

URMATAN JIMWEL C. 11 M BICAL SCOM NE

15 VALENTINO JOHN ASHLEY 11 M BACAL III TALAVERA NE
16 VIERNES JOSHUA M. 10 M BACAL III TALAVERA NE
17 BATO IRA MAE H. 10 F POB.EAST SCOM NE
18 BAUTISTA PINKY T. 11 F FRANZA SCOM NE
19 CANIZARES JELLIAN D. 12 F POB. SOUTH SCOM NE
20 CANLAS PRINCESS KHAYE ANNE A. 11 F CATALANACAN SCOM NE
21 DAGDAGAN KAYCEE D. 11 F BANTUG SCOM NE
22 DELA TORRE DANAH KATE G. 10 F POB. EAST SCOM NE
23 DOMINGO LEANNE JOY C. 11 F POB. EAST SCOM NE
24 GOMEZ MIKHAELLA C. 10 F CATALANACAN SCOM NE
25 JAVILLONAR REYNALYN E. 10 F MATINGKIS SCOM NE
26 ORTIZ RYLAI MAIDEN- 10 F BACAL III TALAVERA NE
27 RAMBAC SILVER JEAN D. 10 F POB. WEST SCOM NE
28 SANTIAGO CRISTAL JOYCE P. 11 F POB. EAST SCOM NE
29 SANTOS YSABELLA S. 11 F BANTUG SCOM NE
30 SOLIS AYA GRACE L. 11 F SAN ANDRES SCOM NE
31 VALENZUELA MHIRAIEH F. 10 F CATALANACAN SCOM NE

Loyal, Excellent, Accountable and Dedicated to Service

Address: Brgy. Rizal, Science City of Muñoz, 3119
Telephone No.: (044) 806 -2192; Email Address: munozscience.city@deped.gov.ph
DSCM-QMS-QMR-QSF-008 Rev.03 (01.31.20)
Certificate No. 50500731 QM15
 Republic of the Philippines
““L
L,oyal
“Loyal oyal,, E
Excellent
Excellent ,, A
Accountable
, Accountable
xcellent ccountable D
and and
and D
Dedicated to S
to Sto
edicated
edicated “L ”oyal”,
ervice
ervice
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OFFICE - SCIENCE CITY OF MUÑOZ

NOTE: This shall be accomplish by the class adviser and to be consolidated by Health and Nutrition Coordinator and shall serve as
the basis for Oplan Kalusugan Sa DepEd Accomplishment Report Form.

Loyal, Excellent, Accountable and Dedicated to Service

Address: Brgy. Rizal, Science City of Muñoz, 3119
Telephone No.: (044) 806 -2192; Email Address: munozscience.city@deped.gov.ph
DSCM-QMS-QMR-QSF-008 Rev.03 (01.31.20)
Certificate No. 50500731 QM15
 Republic of the Philippines
““L
L,oyal
“Loyal oyal,, E
Excellent
Excellent ,, A
Accountable
, Accountable
xcellent ccountable D
and and
and D
Dedicated to S
to Sto
edicated
edicated “L ”oyal”,
ervice
ervice
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OFFICE - SCIENCE CITY OF MUÑOZ
Enclosure No. 2 MASTERLIST OF LEARNERS SY 2020-2021 to be submitted to City Health Office
MASTERLIST OF LEARNERS SY 2021-2022
SCHOOL NAME: MUNOZ CENTRAL SCHOOL
GRADE LEVEL: GRADE 5 - EHLEE
No. Name Age Sex Permanent Address Contact Number
1 BAL-OT VIEN JEM A. 10 M LICAONG SCOM NE 09054795167
2 BARANGAN AL DENMARC V. 11 M POB. EAST SCOM NE 09161974595
3 DAMACIO REYMARK D. 10 M VILLA CUIZON SCOM NE 09655220012
4 ESTIADA RUSHAWN DAVE S. 10 M POB. EAST SCOM NE 09363336408
5 GABRIEL ROMEL JR. B. 11 M
6 GONZALES JUSTIN T. 10 M BANTUG SCOM NE 09387893865
7 GUTIERREZ JHON MARK - 10 M POB. NORTH SCOM NE 09497005275
8 HOUK JAMES JR. O. 10 M POB. WEST SCOM NE 09975794501
9 ILETO REYMOND R. 10 M BANTUG WEST SCOM NE 09659722727
10 LAURENTE JAN CARL C. 10 M MARAGOL SCOM NE 09269361520
11 MANAOIS JHAN-ICE M. 12 M BANTUG SCOM NE 09516600179
12 PACAYO LAY ALVIN G. 10 M POB.SOUTH SCOM NE 09351815984
13 PADILLA KENJIE E. 10 M BICAL SCOM NE 09
14 URMATAN JIMWEL C. 11 M BICAL SCOM NE
15 VALENTINO JOHN ASHLEY 11 M POB.EAST SCMO NE 09605790029
16 VIERNES JOSHUA M. 10 M BACAL III TALAVERA NE 09
17 BATO IRA MAE H. 10 F BAKAL III TALAVERA NE 09757082319
18 BAUTISTA PINKY T. 11 F BAKAL III TALAVERA NE 09561001395
19 CANIZARES JELLIAN D. 12 F POB. WEST SCOM NE 09752214463
20 CANLAS PRINCESS KHAYE ANNE A. 11 F BANTUG SCOM NE 09979354229

Loyal, Excellent, Accountable and Dedicated to Service

Address: Brgy. Rizal, Science City of Muñoz, 3119
Telephone No.: (044) 806 -2192; Email Address: munozscience.city@deped.gov.ph
DSCM-QMS-QMR-QSF-008 Rev.03 (01.31.20)
Certificate No. 50500731 QM15
 Republic of the Philippines
““L
L,oyal
“Loyal oyal,, E
Excellent
Excellent ,, A
Accountable
, Accountable
xcellent ccountable D
and and
and D
Dedicated to S
to Sto
edicated
edicated “L ”oyal”,
ervice
ervice
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OFFICE - SCIENCE CITY OF MUÑOZ
21 DAGDAGAN KAYCEE D. 11 F BANTUG SCOM NE 09973495559
22 DELA TORRE DANAH KATE G. 10 F P0B.SOUTH SCOM NE 09216631608
23 DOMINGO LEANNE JOY C. 11 F POB. WEST SCOM NE 09
24 GOMEZ MIKHAELLA C. 10 F POB. SOUTH SCOM NE 09269017800
25 JAVILLONAR REYNALYN E. 10 F FRANZA SCOM NE 09152588770
26 ORTIZ RYLAI MAIDEN 10 F POB. SOUTH SCOM NE 09557380879
27 RAMBAC SILVER JEAN D. 10 F BAKAL III TALAVERA NE 09166330562
28 SANTIAGO CRISTAL JOYCE P. 11 F POB. WEST SCOM NE 09102078439
29 SANTOS YSABELLA S. 11 F BANTUG SCOM NE
30 SOLIS AYA GRACE L. 11 F SAN ANDRES SCOM NE
31 VALENZUELA MHIRAIEH F. 10 F CATALANACAN SCOM NE 09169489632
32 F
33 F
34 F
35 F
36 F
37 F
38 F
39
44141
F

EHLEE S. TUBALINAL         _EMILY I. FERNANDEZ, PH.D.__

CLASS ADVISER PRINCIPAL IV
Note: This shall be consolidated per grade level.

Loyal, Excellent, Accountable and Dedicated to Service

Address: Brgy. Rizal, Science City of Muñoz, 3119
Telephone No.: (044) 806 -2192; Email Address: munozscience.city@deped.gov.ph
DSCM-QMS-QMR-QSF-008 Rev.03 (01.31.20)
Certificate No. 50500731 QM15