Republic of the Philippines

City Social Welfare and Development Office

City of Santa Rosa
Province of Laguna

FORM NO. CSRL-CSWD-DCC-FO2 Rev. (01)

MONITORING REPORT
Child Development Center: _______________________________________________ Date: _______________
Child Development Teacher/Worker: _______________________________________ Time: _______________
Session Time: ________________________________________________ __________Time Visited: _________
Total No. of Children: _________________________ No. of Children Attended: ________________

No. Administrative Records Complete Incomplete None Remarks

Child Development Teacher’s / Workers’
Personal Records:
FO2-1 Resume
FO2-2 Personal Data Sheet
FO2-3 ECCD Service Provider
FO2-4 Transcript of Records
FO2-5 Diploma
FO2-6 Certificate of Eligibility
FO2-7 Birth Certificate
FO2-8 NBI / Barangay Clearance
FO2-9 Certificate of Trainings/Seminars
FO2-10 Appointment Cert. (City Government)
FO2-11 Appointment Cert. (Barangay)
FO2-12 On the Job Training
FO2-13 Duties and Responsibilities
FO2-14 Certificate of First Aide Administration
And Treatment
FO2-15 Medical Certificate
FO2-16 X-ray
FO2-17 Barangay Resolution of CDC Building
FO2-18 Memorandum of Agreement - CSWDO
FO2-19 Memorandum of Agreement - Barangay
FO2-20 Memorandum of Agreement – Teacher/
Worker’s Aide
FO2-21 Memorandum of Agreement –
CDT/CDW and Parents
FO2-22 Legal Bases
FO2-23 Child Protection Policy
FO2-24 List of Child Development Teachers’/
Workers’ Federation Officers
FO2-25 List of Parents’ Committee Officers /
Group of Officers
FO2-26 By-Laws
FO2-27 Annual Activity Action Plan:
- Laguna Child Development Workers’
Federation Action Plan
-Annual Activity Action Plan – CSWDO
-Annual Activity Action Plan –
Association
-Annual Activity Action Plan –
Parents’ Committee Officers / Group of
Officers
-Annual Activity Action Plan - CDC
 No. Administrative Records Complete Incomplete None Remarks
FO2-28 Daily Schedule of Planned Activities

FO2-29 Accomplishment Report

FO2-30 Curriculum Plan ( LRP )
FO2-31 Daily Activity Plan
FO2-32 Weekly Activity Plan
FO2-33 Activity Web
FO2-34 In-coming Communication
Out-going Communication
FO2-36 Registration List
FO2-37 Master List with Contact Numbers
FO2-38 Attendance of Children
FO2-39 Resource Generated Report
FO2-40 User’s Fee
FO2-41 Annual Development Planning
FO2-42 Three Years Improvement Plan
FO2-43 Announcement
FO2-44
FO2-45 User’s Fee
FO2-46 Annual Development Plan
FO2-47 Three years Improvement Plan
FO2-48 Annual Budget intended for children
from the Barangay
FO2-49 Annual Budget from CSWDO
FO2-50 Inventory
FO2-51 Financial Report
FO2-52 Minutes – Laguna Child Development
Workers’ Federation
FO2-53 Minutes – Child Development Workers’
Regular Meeting with CSWDO
FO2-54 Minutes – Child Development Workers’
Monthly Meeting
FO2-55 Minutes – Child Development Workers’
Election of Officers
FO2-56 Minutes – Parents’ Election of Officers
FO2-57 Minutes – Parents Monthly Meeting
With Attendance
FO2-58 BCPC – Minutes of the Meeting and
Attendance
Technical Records
FO2-59 Child’s Portfolio:
FO2-60 Child’s Profile
-Kasunduan ng Magulang at ng
DCW/DCC
-Child’s Information Sheet
-Registration Form
-Impormasyon ng Magulang
-Intake Form
-Pahintulot / Consent
-Parent’s Feedback
-Initial and Annual Health Records
-Dental Health Record
- Physical Health Inventory
FO2-61 ECCD Checklist
FO2-62 Mapping Tools
-Form 1A - Father’s Profile
-Form 1B - Mother’s Profile
-Form 1C - Family Profile
-Form 2 - Children’s Profile
 No. Technical Records Complete Incomplete None Remarks
Form 3 - Community Profile
Form 4 - Consolidated Family Profile
Form 5 - Consolidated Children’s
Profile
Form 6 - Child Development Worker
Profile
Form 7 - Child Development Center
Profile
Form 8 - Consolidated Child
Development Worker Profile
Form 9 – Consolidated Child
Development Center Profile
FO2-63 ECCD Information Sheet (IS)
FO2-64 Birth certificate
FO2-65 Immunization Record
FO2-66 Nutritional Status
FO2-67-A Eccd Card – Growth & Development
FO2-67-B Eccd Card – Health Status
FO2-68 Child’s Growth System (CGS)
FO2-69 Clinical Referral
FO2-70 Emergency Treatment Record
FO2-71 First Child’s Work
FO2-72 Observation /Journal
FO2-73 Assessment Report
FO2-74 Parent’s Conference
FO2-75 Report on Resource Speaker
FO2-76 Family Support Program
FO2-77 PABASA sa Nutrisyon/Mother Class
FO2-78 Documentation of Monthly Actvities
FO2-79 Clippings on Supplementary Feeding
Program
FO2-80 Menu Plan
FO2-81 Weekly Menu Plan
FO2-82 Operation Timbang
FO2-83 List of Children with Allergies
FO2-84 Master List of Beneficiaries
FO2-85 SFP-Different Committee ( Parents)
FO2-86 Daily Toothbrushing Progress Program
FO2-87 Certification of Water Potability
FO2-88 Barangay Certification that the CDC
Is Free from Hazards
FO2-89 Administered Vitamins and Prescribed
Medicine
FO2-90 Minutes/Documentation – Peer Group
Support and Exchange
FO2-91 Visitors Logbook
FO2-92 ECCD Facility Profile
A. Different Corners:
Organizational Chart
Bulletin Board
Spiritual Corner
Arts and Crafts Corner and Exhibit
Personality Corner for Health Kit
No. Child Development Center Complete Incomplete None Remarks
Wash Area
Nap Area
Library Corner
Big Books ( Story Books)
Discovery Corner
Visual Materials
Musical Corner
Play Area or Toys for Table Games
( Blocks, Shapes, etc.)
Carpentry Tools
Garden Tools
B. Physical Environment and Safety:
Fire Extinguisher/ Bags of Sand or pail
and water)
Signage of Fire Exit
Signage of No Smoking
First Aid Kit – Jump Kit and Fixed
Medicine Cabinet
Hanging Cabinets for Sharp and
Hazardous Objects
Toilet for Boys and Girls
Clean CR and Floors not Slippery
Cleaning Materials
Kitchen Area
Well-lighted and Well-ventilated
Screened doors and windows or air-
conditioned
Door Knobs within the reach of children
Cabinet with lock
Cubby Holes
Play Ground Devices

MONITORING VISIT

Findings / Areas for Recommendation / Agreement Time Frame

Improvement
 MONITORING VISIT

Findings / Areas for Recommendation / Agreement Time Frame

Improvement

A. Observation:

Prepared by: Conforme:

ROSALIA G. LAYTO NEMA B. MARTINEZ

CDT/CDW’s Coordinator CDT/CDW