Calauan Lamot 1 Badac Data Capture Forms 1-6-2018 03152019

BADAC DATA CAPTURE FORM 1
INDICATOR POSITION FIRST NAME LAST NAME SEX BIRTHDATE CIVIL STATUS ADDRESS
Chairperson / Punong PUROK 2, BRGY. LAMOT
Barangay NESTOR OCAMPO M 1/29/1963 M 1,CALAUAN, LAGUNA
Vice-Chairperson / Peace
& Order Committee Chair PUROK 3, BRGY. LAMOT
RODERICK DELA CRUZ M 3/22/1974 M 1,CALAUAN, LAGUNA
Members:
Chair of Women & Family PUROK 1, BRGY. LAMOT
Committee VALERIANA CORONADO F 8/16/1953 W 1,CALAUAN, LAGUNA
BADAC is SK Chairperson PUROK 1, BRGY. LAMOT

composed of GABRIEL JOHN CORONADO M 12/16/1997 S 1,CALAUAN, LAGUNA
seven (7) School Principal / PUROK 2, BRGY. LAMOT
members Representative ESTER BANAAG F M 1,CALAUAN, LAGUNA
PUROK 1, BRGY. LAMOT
Brgy Chief Tanod
ALFREDO BAUTISTA M 7/11/1953 M 1,CALAUAN, LAGUNA
NGO / CSO PUROK 2, BRGY. LAMOT
Representative ANTONIO VENTURA M M 1,CALAUAN, LAGUNA
Faith-based Org PUROK 1, BRGY. LAMOT
Representative FELICIDAD DINGLASAN F 4/30/1951 M 1,CALAUAN, LAGUNA
Adviser:
Local PNP Chief /
Representative PO1 RANDY TAGUINOD M
Chairperson / Peace & PUROK 3, BRGY. LAMOT
Order Committee Chair RODERICK DELA CRUZ M 3/22/1974 M 1,CALAUAN, LAGUNA
BADAC
Committee on Members:
Operations is PUROK 1, BRGY. LAMOT
organized Brgy Chief Tanod
BADAC Auxiliary Team Refer to BADAC Auxiliary Team Profile
Chairperson / Women & PUROK 1, BRGY. LAMOT

Family Committee Chair VALERIANA CORONADO F 8/16/1953 W 1,CALAUAN, LAGUNA
Members:
SK Chairperson PUROK 1, BRGY. LAMOT
BADAC GABRIEL JOHN CORONADO M 12/16/1997 S 1,CALAUAN, LAGUNA
Committee on
School Principal / PUROK 2, BRGY. LAMOT
Advocacy is
Representative ESTER BANAAG F M 1,CALAUAN, LAGUNA
organized
Committee on
Advocacy is
organized
NGO / CSO PUROK 2, BRGY. LAMOT
Representative ANTONIO VENTURA M M 1,CALAUAN, LAGUNA
Faith-based Org PUROK 1, BRGY. LAMOT
Representative FELICIDAD DINGLASAN F 4/30/1951 M 1,CALAUAN, LAGUNA
INDICATOR POSITION FIRST NAME LAST NAME SEX BIRTH DATE CIVIL STATUS ADDRESS
RONALD CARURUCAN M 8/8/1971 M 1,CALAUAN, LAGUNA

BENITO DIALA M 3/21/1949 M 1,CALAUAN, LAGUNA
GOMER PLATERO M 11/21/1975 S 1,CALAUAN, LAGUNA
IGLECERIO CORONADO M 12/12/1947 W 1,CALAUAN, LAGUNA
SANTIAGO ALGUARAS M 7/25/1968 W 1,CALAUAN, LAGUNA
CARLOS DORADO M 11/4/1963 M 1,CALAUAN, LAGUNA
LARRY BAUTISTA M 6/21/1973 M 1,CALAUAN, LAGUNA
ROY MAGAPI M 9/23/1969 S 1,CALAUAN, LAGUNA
BADAC
Auxiliary Team PUROK 1, BRGY. LAMOT
(BAT) is FIDEL PLATERO M 8/21/1966 M 1,CALAUAN, LAGUNA
organized PUROK 1, BRGY. LAMOT
ALLAN RAMOS M 10/12/1975 M 1,CALAUAN, LAGUNA
MICHAEL RECIDE M 1/7/1977 M 1,CALAUAN, LAGUNA
EMMYLOU CARURUCAN F 04/31/1973 M 1,CALAUAN, LAGUNA
MYLYN EXCONDE F 12/4/1976 S 1,CALAUAN, LAGUNA
FREDIE CORONADO M 12/16/1978 M 1,CALAUAN, LAGUNA
DEMETRIO PRIMO M 11/18/1972 M 1,CALAUAN, LAGUNA
DEMETRIO CARTA M 11/10/1959 M 1,CALAUAN, LAGUNA
VICENTE SARMIENTO M 9/16/1960 M 1,CALAUAN, LAGUNA
RAMIR SOBREVILLA M 9/14/1957 M 1,CALAUAN, LAGUNA
Note: Use additional page if necessary. BAT shall be composed of one member per 80 residents; 25 members per 2,000 residents.
INDICATOR UNIT OF CLUSTER FIRST NAME LAST NAME SEX BIRTH DATE CIVIL STATUS ADDRESS
PUROK 1 LARRY BAUTISTA M 6/21/1973 M 1,CALAUAN, LAGUNA
ROY MAGAPI M 9/23/1969 S 1,CALAUAN, LAGUNA
BENITO DIALA M 3/21/1949 M 1,CALAUAN, LAGUNA
MYLYN EXCONDE F 12/4/1976 S 1,CALAUAN, LAGUNA
REYNALDO BAUTISTA M 3/17/1966 S 1,CALAUAN, LAGUNA
FIDEL PLATERO M 8/21/1966 M 1,CALAUAN, LAGUNA
MYLA HOMBROBUENO F 9/10/1967 M 1,CALAUAN, LAGUNA
EDMON SANDOVAL M 10/11/1984 M 1,CALAUAN, LAGUNA
BENJAMIN MEDALLA M 9/25/1963 M 1,CALAUAN, LAGUNA
GOMER PLATERO M 11/21/1975 S 1,CALAUAN, LAGUNA
MA. VICTORIA ALGUARAS F 4/30/1989 S 1,CALAUAN, LAGUNA
SANTIAGO ALGUARAS M 7/25/1968 W 1,CALAUAN, LAGUNA
PUROK 2 JULIUZ BRIZ M 11/11/1098 W 1,CALAUAN, LAGUNA
JOSELITO TOLENTINO M 12/28/1965 M 1,CALAUAN, LAGUNA
RAMIR SOBREVILLA M 9/14/1955 M 1,CALAUAN, LAGUNA
RONALD BARERRA M 11/1/1974 M 1,CALAUAN, LAGUNA
BADAC House SERAFIN BRIZ M 01/06/154 M 1,CALAUAN, LAGUNA
Clusters are
organized
BADAC House
Clusters are
organized PUROK 2, BRGY. LAMOT
DANILO LALONG ISIP M 6/29/1965 M 1,CALAUAN, LAGUNA
ROMEO DE CHAVEZ M 7/13/1967 M 1,CALAUAN, LAGUNA
WILFREDO MARASIGAN M 1/8/1967 M 1,CALAUAN, LAGUNA
JONARD BUNDALIAN M 6/1/1989 M 1,CALAUAN, LAGUNA
PUROK 3 MICHAEL RECIDE M 7/1/1977 S 1,CALAUAN, LAGUNA
GERALD ALEGADO M 10/10/1977 M 1,CALAUAN, LAGUNA
ERIC ALEGADO M 10/23/1970 M 1,CALAUAN, LAGUNA
JONATHAN FAJARDO M 10/20/1973 M 1,CALAUAN, LAGUNA
VICTOR ALVITE M 1/29/1983 S 1,CALAUAN, LAGUNA
RUEL ARROGANCIA M 10/14/1979 M 1,CALAUAN, LAGUNA
LOVIGILDA MEDALLA F 8/20/1962 M 1,CALAUAN, LAGUNA
CARLITO SUMERA M 9/6/1961 M 1,CALAUAN, LAGUNA
GIL AGUASON M 9/1/1951 M 1,CALAUAN, LAGUNA
IMELDA EMAAS F 10/25/1973 S 1,CALAUAN, LAGUNA
MYRNA SUAZO F 1/29/1955 W 1,CALAUAN, LAGUNA
RANDY SUIZO M 11/21/1982 M 1,CALAUAN, LAGUNA
RUBEN ESCASURA M 10/25/1986 M 1,CALAUAN, LAGUNA
Note: Use additional page if necessary. Examples of Unit of Cluster are by purok, by sitio, by block, by zone, by street, etc.
CONCURRENT
INDICATOR DESIGNATION (if FIRST NAME LAST NAME SEX BIRTH DATE CIVIL STATUS ADDRESS
applicable)
Barangay Duty
Officers are PUROK 3, BRGY. LAMOT
designated JENIFER CABANEROS F M 1,CALAUAN, LAGUNA
Officers are
designated
Note: Use additional page if necessary. Concurrent Designation refers to the primary appointment / item of the designated Brgy Duty Officer in the barangay, e.g. Barangay Health
Worker, VAWC Desk Officer, etc.
Page 1
CONTACT #
09983947999
09488999660
09462886038
09662734347
/09274105887
NONE
NONE
09488999660
NONE
09462886038
09662734347
/09274105887
NONE
Page 2
CONTACT #
09128726062
09485991246
09994471350
09306464375
09072663415
09076192968
09989180450
09071678752
09093185066
09097086590
09502354531
CONTACT #
09106929215
09106929215
09306900316
09071678752
09357347455
09465046818
09455705532
09065056760
09281524268
0948591246
09994471350
09994471350
09295146295
09483861047
09468843878
09465922028
09279144588
09475567808
0907776272
09460719304
09122937645
09179734291
09999909112
09108338528
09124504097
09480725864
09066863413
09075242320
09508511525
09196742268
09758030892
09068389370
0948189673
CONTACT #
NONE
. Barangay Health
Page 3
DURATION SPEAKER /
INDICATOR ACTIVITY TITLE VENUE LEAD ORGANIZER
DATE (MM/DD/YYYY) TIME FACILITATOR
Trainings Attended
by Punong NONE
Barangay on
Strengthening
BADACs
Note: Use additional page if necessary.

DURATION SPEAKER /
Trainings /
Planning Session NONE
Attended by
Punong Barangay
on CSAR

NO. OF
DURATION SPEAKER /
INDICATOR ACTIVITY TITLE VENUE PARTICIPANTS
DATE (MM/DD/YYYY) TIME FACILITATOR MALE FEMALE
Trainings
Conducted by
NONE
BADAC for House
Cluster Leaders

NO. OF
DURATION SPEAKER /
INDICATOR ACTIVITY TITLE VENUE PARTICIPANTS
DATE (MM/DD/YYYY) TIME FACILITATOR MALE FEMALE
Trainings
Conducted by
NONE
BADAC for BADAC
Auxiliary Team

DURATION SPEAKER /
Trainings Attended NONE

by Barangay Duty
Officers
DURATION
INDICATOR ACTIVITY TITLE VENUE
DATE (MM/DD/YYYY) TIME
BADAC CONSULTATIVE MEETING
Conduct of 2/19/2018 9AM-11AM DAYCARE CENTER, BRGY. LAMOT 1
WITH STAKEHOLDERS
BADAC
Consultative
Meetings

DURATION
Every 3rd saturday of the Brgy. Hall, Brgy. Lamot 1, Calauan,

Monthly Meeting 9:00Am
Conduct of Month Laguna
BADAC Monthly
Meetings

DURATION
Organization/Co-
organization of HOUSE TO HOUSE IEC CAMPAIGN 8/13/2018
Community-based DAYCARE CENTER,BRGY. LAMOT 1
IEC Campaign
Activities

DURATION
Organization/Co-
organization of IEC CAMPAIGN STUDENTS 10/14/2018 9AM-10AM DAYCARE CENTER,BRGY. LAMOT 1
School-based IEC
Campaign
Activities
Organization/Co-
organization of
School-based IEC
Campaign
Activities
DURATION
Conduct of Youth-
led IEC Campaign DRUG AWARENESS CAMPAIGN OCT. 2018 SENIOR CITIZENS OFFICE,BRGY.
Activities LAMOT 1

DURATION
Conduct of CSO- NONE

led IEC Campaign
Activities

DURATION
Organization/Co-
organization of NONE
Activities in
Observance of the
IDADAIT

DURATION
Organization/Co-
organization of NONE
Activities in
Observance of the
DAPC Week

Page 4
NO. OF PARTICIPANTS
PRESIDING OFFICER
MALE FEMALE
MAAM CONDE
NO. OF PARTICIPANTS
PRESIDING OFFICER
MALE FEMALE
Brgy. Chairman-Nestor M. Ocampo 24 3
NO. OF PARTICIPANTS
TARGET AUDIENCE
MALE FEMALE
CONSTITUENTS OF BRGY.LAMOT 1
NO. OF PARTICIPANTS
TARGET AUDIENCE
MALE FEMALE
DAYCARE STUDENTS & PARENTS

Page 5
NO. OF PARTICIPANTS
TARGET AUDIENCE
MALE FEMALE
KABATAAN
NO. OF PARTICIPANTS
TARGET AUDIENCE
MALE FEMALE
NO. OF PARTICIPANTS
TARGET AUDIENCE
MALE FEMALE
NO. OF PARTICIPANTS
TARGET AUDIENCE
MALE FEMALE
Page 6
UNIFIED BARANGAY REPORT ON REFERRAL ACTION (UBRRA)
Data provided herein are those recorded within the months of: January to June ( ) July to December ( ) Year (YYYY) 2018
NO. OF SURRENDERERS NO. OF REFERRED SURRENDERERS

INDICATOR INDICATOR
MALE FEMALE MALE FEMALE
TOTAL TOTAL
BELOW 18 ABOVE 18 BELOW 18 ABOVE 18 BELOW 18 ABOVE 18 BELOW 18 ABOVE 18
Submission of Updated
Submission of Updated Number
Number of Residents who 25 25
of Referred Surrenderers
Surrenderred
NO. OF SURRENDERERS ENROLLED IN WELLNESS &

STATUS / STATUS AND NO. OF ASSESSED SURRENDERERS WELLNESS & RECOVERY INTERVENTIONS
INDICATOR LEVEL OF INDICATOR RECOVERY
RISK MALE FEMALE INTERVENTIONS MALE FEMALE
TOTAL TOTAL
General
Low 25 25
Interventions
Community-based
Mild Submission of Treatment &
Submission of Rehab
Updated
Updated Number
Number of
of Assessed Health Facility-
Enrolled
Surrenderers based Outpatient
Moderate Surrenderers
Treatment &
Rehab
Inpatient
Severe Treatment &
Rehab
NO. OF SURRENDERERS WHO COMPLETED WELLNESS &

RECOVERY INTERVENTIONS The purpose of this form is to determine the number of surrenderers per semester (January-June,
INDICATOR
MALE FEMALE July-December), and monitor the number of who, among those surrenderers, have been referred,
TOTAL assessed, and who have completed any Wellness and Recovery Program interventions within the
BELOW 18 ABOVE 18 BELOW 18 ABOVE 18
6-month time frame. Counting shall restart at the onset of the new semester; meaning, the data on
those who surrendered in the previous semester shall no longer be accounted in the next,
Number of Surrenderers Who
18 18 regardless of whether they have been referred or assessed in the following semester.
Completed Wellness &
Recovery Interventions
6-month time frame. Counting shall restart at the onset of the new semester; meaning, the data on
those who surrendered in the previous semester shall no longer be accounted in the next,
Number of Surrenderers Who
18 18 regardless of whether they have been referred or assessed in the following semester.
Completed Wellness &
Recovery Interventions
Page 7
COMMUNITY SUPPORT, AFTERCARE AND REINTEGRATION (CSAR)
Data provided herein are those recorded within the months of: January to June ( ) July to December ( ) Year (YYYY) 2018
NO. OF CSAR ENROLLEES NO. OF CSAR GRADUATES

INDICATOR INDICATOR
MALE FEMALE MALE FEMALE
TOTAL TOTAL
Submission of
Submission of Updated Updated Number of
Number of Residents Residents Who
0 0 0 0
Enrolled in CSAR Program, Completed the
or its equivalent CSAR Program, or
its equivalent
The purpose of this form is to determine the number of residents enrolled in CSAR Program, or its equivalent, per semester (January-June, July-December), and monitor the number of
who, among those enrolled, have completed the CSAR program within the 6-month time frame. Counting shall restart at the onset of the new semester; meaning, the data on those
enrolled in the previous semester shall no longer be accounted in the next, regardless of whether they have been referred or assessed in the following semester.
Page 8
SUMMARY OF CONSOLIDATED INFORMATION REPORT
as per Section 8 of DDB Board Regulation No. 3, s. 2017
Year (YYYY): 2018
Data provided herein are those recorded within the months of: January to March ( ) April to June ( ) July to September ( ) October to December ( )
DRUG SUPPLY DRUG TRANSIT / CLANDESTINE

DRUG PUSHER DRUG USER / DEPENDENT
INDICATOR AVAILABILITY TRANSHIPMENT ACTIVITY LABORATORY
PRESENT / ABSENT TOTAL PRESENT / ABSENT TOTAL PRESENT/ABSENT PRESENT/ABSENT PRESENT/ABSENT
0 0 0 0 0 0 0
Submission of
Updated Summary of CLANDESTINE CHEMICAL MARIJUANA CULTIVATION DRUG DEN, DIVE OR DRUG PROTECTOR /
CLANDESTINE DRUG WAREHOUSE
Consodated WAREHOUSE SITE / PLANTATION RESORT CODDLER & FINANCIER
Information Report
(CIR)
PRESENT/ABSENT PRESENT/ABSENT PRESENT/ABSENT PRESENT/ABSENT PRESENT/ABSENT
0 0 0 0 0

Calauan Lamot 1 Badac Data Capture Forms 1-6-2018 03152019

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Calauan Lamot 1 Badac Data Capture Forms 1-6-2018 03152019

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BADAC DATA CAPTURE FORM 1

BADAC is SK Chairperson PUROK 1, BRGY. LAMOT

Chairperson / Women & PUROK 1, BRGY. LAMOT

BADAC DATA CAPTURE FORM 1

PUROK 1, BRGY. LAMOT

Note: Use additional page if necessary.

Note: Use additional page if necessary.

Note: Use additional page if necessary.

Note: Use additional page if necessary.

Trainings Attended NONE

Note: Use additional page if necessary.

Every 3rd saturday of the Brgy. Hall, Brgy. Lamot 1, Calauan,

Note: Use additional page if necessary.

Note: Use additional page if necessary.

Note: Use additional page if necessary.

BADAC DATA CAPTURE FORM 3

Note: Use additional page if necessary.

Conduct of CSO- NONE

Note: Use additional page if necessary.

Note: Use additional page if necessary.

Note: Use additional page if necessary.

Brgy. Chairman-Nestor M. Ocampo 24 3

DAYCARE STUDENTS & PARENTS

NO. OF SURRENDERERS NO. OF REFERRED SURRENDERERS

NO. OF SURRENDERERS ENROLLED IN WELLNESS &

NO. OF SURRENDERERS WHO COMPLETED WELLNESS &

NO. OF CSAR ENROLLEES NO. OF CSAR GRADUATES

DRUG SUPPLY DRUG TRANSIT / CLANDESTINE

PRESENT / ABSENT TOTAL PRESENT / ABSENT TOTAL PRESENT/ABSENT PRESENT/ABSENT PRESENT/ABSENT

PRESENT/ABSENT PRESENT/ABSENT PRESENT/ABSENT PRESENT/ABSENT PRESENT/ABSENT

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