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QA FORM 7
Republic of the Philippines
Department of Education
MIMAROPA Region
Meralco Ave. cor. St. Paul Road
Pasig City

REVISED PROCESSING SHEET

APPLICATION FOR ESTABLISHMENT OF PUBLIC ELEMENTARY/SECONDARY SCHOOL

Name of School (Current) : ____________________________________

Proposed Name of School : ____________________________________

Address of School : ____________________________________

Courses Offered : Kindergarten Elem. JHS
School Year : ____________________________________
Date Received : ____________________________________
Date Evaluated : ____________________________________
Date Released : ___________________________________ _
Contact Person : ____________________________________
Contact Numbers : ____________________________________
Email Address : ____________________________________

Particulars Quality Description Remarks

DO RO
Document Presentation  Submitted 2 sets of documents
(original and photocopies of the original documents)
 Submitted to RO within 1st week of
July of the current year
 Page finder descriptor tabs corresponding to the
numbers in the checklist were affixed accordingly
to each document
 Colored expanding folder per division
was utilized.
Calapan – Pink Occi.Mdo. - Red
Palawan – Yellow Or. Mdo - Orange
Marinduque – Green PPC - Blue
Romblon – Purple
Long Expanding folders and papers (8.5”x13”)
were used
All documents were listed in a Table of Contents
LIST OF DOCUMENTARY REQUIREMENTS AND ITS DESCRIPTION
1.Revised Evaluation Duly accomplished and signed by the Division
Sheet Review and Evaluation Committee
No information was left out by the processor
2.Letter Request Addressed to the Schools Division Superintendent
(SDS) either from PTA or Barangay Council
Stated reasons for the urgent need to establish
school in the area to be served
Duly signed by the requesting officer,
designation/position and date of request
3.Feasibility Study Contained the following:
 Justification on the need for the establishment
of school
 Proposed Organizational Structure
 School Environment (Environmental
scanning/situational analysis) stating the
specified location/classification (Urban or
Rural), topography/geographical condition of
the site (Mountainous, Coastal, Plain),
catchment area as well as the mode of
transportation in going from home to school and

Revised 9.18.18
Quality Assurance Division Tel No. (02) 637-4184/Telefax (02) 637-3093 Email Address: qad.depedro4b@gmail.com
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QA FORM 7
vice versa
 School map showing the location of the building
duly signed by the Division Engineer.
Proposed Budget/Budgetary Requirements
covering the 5-year proposed schools’ crucial
resources
Proposed School Development Plan duly
signed by the Division Engineer
Duly signed by the School Head and Punong
Barangay and countersigned by the SMME
3. Division Inspection Template was completely filled out
Report COMPLIANT
PARTICULARS TO
STANDARD
YES NO
1.School Building/Classroom
2.No. of available classrooms, if
any
3. Size of school site in square
meters
Classrooms are built to be in accordance with the
existing DepEd standards, 7mx9m regardless of
class size
Included the following:
Duly signed school site development plan
Duly signed building plan indicating the number
and technical specifications of the classrooms to
be built
Building design duly approved by the DepEd
Education Facilities Division, Administrative
Services
School building permit issued by the
Municipal/City Engineer
Duly signed Bureau of Fire 9BFP) Certificate
Duly signed inspection report from In-Charge of
Education Facilities Section/SMME In-Charge of
Inspection, in case classroom are already
constructed
4. Sangguning Contained statement of support of the
Bayan/Panglungsod Sangguniang Bayan/Panglungsod to the
Resolution establishment of school
Indicated the complete and correct name of the
school
Duly signed by the
SanggunianBayan/Panglungsod members,
secretary and Vice Mayor and approved by the
Mayor
5.List of Prospective Contained the following:
Enrolees Name segregated by sex
Age
Address
School currently enrolled
Attained the minimum number of enrolees (at
least 100 pupils/students composed of one or
more grade levels)
Signed justification by the SDS if aforementioned
criterion was not met
6.GASTPE Stated the non-participation of the school to
Certification GASTPE Program of DepEd or that GASTPE
(For Secondary schools participating high school has reached its allocation
only) or number of available slots
Duly signed by the SDS

Revised 9.18.18
Quality Assurance Division Tel No. (02) 637-4184/Telefax (02) 637-3093 Email Address: qad.depedro4b@gmail.com
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QA FORM 7
Duly signed justification by the SDS if
aforementioned criterion was not met
7.Municipal Stated that the proposed school to be established
Certification is not within the 2 km radius (for rural areas) and
1 km radius (for urban areas) from any existing
public school
Duly signed by the Municipal Engineer
Included map preferably drawn to scale, showing
the distance of the existing schools within the
catchment area of the proposed school duly
certified by the Municipal Engineer
Duly signed justification by the SDS if waived the
aforementioned criterion
8.School Site Complied lot size requirement of at least 5,000
Document square meters or one half (1/2) hectare for rural
areas; 2,500 square meters for highly urbanized
cities
Conformed to any one of the following
requirements:
Deed of Donation
 Duly signed by the donor and done (SDS)
and witnesses
 Duly accepted by the SDS as the done
 Notarized
Deed of Sale or Contract of Usufruct
 Duly signed by both contracting parties
 Land Title
 If tax declaration, attached certificate of no
pending land registration application from
the Registry of Deeds (ROD) or from the
Regional Trial Court (RTC)
 Type of land indicated in the Tax
Declaration like Timberland must be
converted into a school site and
Ancestral land in consultation with
the NCIP
 If public elementary to public secondary,
contracting parties are the school heads to be
confirmed by the SDS. Letter request to the
CO through the RO for the Deed of
confirmation to be signed by the SDS
Duly signed justification by the SDS if
aforementioned criterion was not met
9.Mines and Stated the following:
Geosciences Bureau The school site is not a high-risk area (natural or
(MGB) and Regional man-made)
Office Department of The land type is in good elevation to avoid
Environment and flooding and soil erosion, with good drainage
Natural resources system and safe/potable water supply
(RO-DENR) School site is declared as safe or not a high-risk
Certificates area
Duly signed by the MGB Provincial Head
Duly signed by the RO-DENR
10.Memorandum of Duly signed by and between the SDS as DepEd
Agreement (MOA) Representative and the Mayor or Provincial
Governor of LGU
Stated that the LGU or DepEd Office provides
funds for the following:
Construction of new school building(s)
Procurement of educational facilities, furniture
and instructional materials
Operation and maintenance for at least five (5)

Revised 9.18.18
Quality Assurance Division Tel No. (02) 637-4184/Telefax (02) 637-3093 Email Address: qad.depedro4b@gmail.com
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QA FORM 7
years until such time when funds for the
purpose re incorporated in the national budget
Salaries of teaching and non-teaching
personnel, preferably at par with the national
salary rates
Supported by the duly signed and approved
Sangguniang Bayan/Panlalawigan/Panglungsod
Resolution for the purpose
Duly signed certification that the Schools Division
Office has sufficient fund to cover resulting
expenses
Duly signed list of teaching and non-teaching
personnel to be borrowed from the existing nearby
school/s, duly identified by the respective item
numbers per PSIPOP and name of school, if any
Notarized

Evaluated by the Division and Evaluation Committee (DREC):

SMME Div. Admin. Officer Div. Planning

Officer

___________________ ____________________ ___________________

Division Accountant In-Charge of Education Facilities SGOD Chief

Validated by the Regional Inspectorate Team (RIT):

____________________ _______________________ ___________________

ENGR. DIEGO BUSTAMANTE WENDELL I. FORMALEJO, PhD. MELBERT S. BROQUEZA, PhD.
In-Charge, Education Facilities EPS, CLMD EPS, QAD

_______________________ ________________________ ____ __________________

RITCHIE G. DIOLA, PhD. ARDEE DC RAMILO ATTY. RENEE R. MORENO-PEREZ
EPS, QAD CAO, Finance Atty. IV, Legal Unit

__________________________
GLORIA M. CRUZ
Chief, QAD

__________________________
RUTH L. FUENTES, CESO V
OIC, Office of the Assistant Regional Director

Revised 9.18.18
Quality Assurance Division Tel No. (02) 637-4184/Telefax (02) 637-3093 Email Address: qad.depedro4b@gmail.com