MONITORING OF SCHOOL WINS (WASH)

IMPLEMENTATION
SY 2017
A. School Profile
Date of Survey: (yyyy-mm-dd)  

School Year  

School Name

School ID

Level  

School District  

Division

School Address

Name of the School Head  

Contact Number  

Total Enrolment Male Female Total  Remarks (If any)

Shift 1 ( AM)      

Shift 2 ( PM)      

Shift 3 ( If ever there is third shift)      

B. Water Access
DIRECTION: To account your evaluation , kindly check the appropriate box and answer directly some questions

1. Does the school provide safe drinking water? All the Yes, but No  
time supply is drinking
 
not water in
regular school

2. Is the drinking water provided by the school for free? Yes No    

3. What mechanism are used to ensure learners have safe drinking water?
 A Teachers ask the learners to bring their own drinking water to Yes No    
school

 B Safe water in refillable containers are provided in designated Yes No    

areas within the school

 C Water from an accessible water source is boiled Yes No    

 D Water from an accessible water source is filtered Yes No    

 E Others          

4. In the previous week, how often is water for daily handwashing Available Available Available  
and cleaning of toilets available in the school regardless of only on daily but daily for
source? (This includes water delivered to the school or collected certain only in 24 hours
from rain) days of certain
the week hours

5. Does the school coordinate with the LGU or water district to Yes No    
test the quality of drinking water?

6. How many times was the quality of drinking water tested in the 1 2 3 Other please
specify
previous school year?

C. Sanitation
7. How many toilet seats are available for Male Female Shared/ Total Pupil
children in the school? Do not include toilet Communal Toilet
seats for teachers. Ratio

  Functional

  Not Functional

8. Are toilets secure, private and have door with lock? Yes No    

  Do toilets have lighting? Yes No    

  Do toilets have adequate ventilation? Yes No    

9. Do toilets for girls have wrapping materials for used sanitary Yes No    
pads?

10. How many toilets for girls have a washing  

facility inside the toilet?

11. Are detached toilets for girls within view of school building and Yes No    
people?

12. Are there toilet/s designed for persons with limited mobility? Yes No    
(These toilets must have a ramp, railing and adequate space
for a wheelchair)

13. How often are the sanitation facilities cleaned? Daily At least A least Less than
twice a once a once a
 
week week week

14. Does the school burn its waste? Yes No    

15. Are segregated trash bins with cover available in the following areas?

  Classrooms  Yes No     

  Toilets  Yes No     

  Canteens  Yes No     

  Offices  Yes No     

  Clinics  Yes No     

  Play areas  Yes No     

  Gardens  Yes No     

  Hallways  Yes No     

  Gyms/Stage  Yes No     

16. Is waste segregation being practiced in the school Yes No    

17. Does the school have policies/sanctions which promote the Yes No    
practice of waste segregation
18. How regular is garbage being collected from the school? Daily 2-3 times Once a No
a week Week collection

19. Does the school have a compost pit for biodegradable waste?  Yes No     

20. Does the school have a refuse pit for non-biodegradable  Yes No     
waste?

21. Does the school have a materials recovery facility (MRF)?  Yes No     

22. Do all toilets in the school have functional septic tank/s? All Some None  

23. Does the school have a functional drainage from the kitchen  Yes No     
and wash areas to ensure that there is no stagnant water?

24. In the past year, did the school experience any floods?  Yes No     

25. Does the school adopt the following mechanisms to address stagnant water?

  Pumping out of water  Yes No     

  Filling of stagnant water  Yes No     

  Soak pit  Yes No     

  Treatment of stagnant water to prevent breeding of  Yes No     

mosquitoes

26. Does the school have a canteen?  Yes No     

27. Does the school canteen have a sanitary permit?  Yes No     

28. Do food handlers practice the following food safety measures?  Yes No     

  Wearing of hairnet, gloves, masks and apron  Yes No     

  Handwashing  Yes No     

  Segregation of dry and wet food materials  Yes No     

29. Have all food handlers been oriented on food safety measures?  All Some   None   

30. Do all food handlers in the school have health certificates?  All Some   None  
D. Hygiene
31. How many times in a week is group
handwashing with soap conducted for all
children in the school? (only for
elementary)

32. What is the extent of student participation in supervising group  Yes No     
handwashing? (only for elementary)

  Students are participants supervised by teachers  Yes No     

  Students assist teachers in supervising handwashing activities  Yes No     

  Students are assigned to lead handwashing activities  Yes No     

33. How many group handwashing facilities  

are available in the school?

34. What is the total number of water outlets  

in all the group handwashing facilities?
 

35. Is there a regular supply of soap for handwashing?  Yes No     

36. Are handwashing facilities with soap available in the following  Yes No     
areas?

  Classrooms  Yes No     

  Toilets  Yes No     

  Canteen/Eating Areas  Yes No     

  Play areas  Yes No     

  Clinics  Yes No     

  Laboratories  Yes No     

  Agricultural areas (eg. Gulayan, livestock area)  Yes No     

37. Do children perform individual handwashing the following times?

  Before meals  Yes No     

  After using the toilet  Yes No     

  After cleaning activities  Yes No     

  After playing in the playground  Yes No     

  After handling soil and animals  Yes No     

38. How many times in a week is group  

toothbrushing with flouride conducted for
 
all children in the school?
 

39. What is the extent of student participation in supervising group tooth brushing

  Students are participants supervised by teachers  Yes No     

  Students assist teachers in supervising tooth brushing activities  Yes No     

  Students are assigned to lead tooth brushing activities  Yes No     

40. Is there a regular supply of toothbrush and toothpaste for  Yes No     
tooth brushing?

41. Are the repair and maintenance requirements for WASH facilities reflected in the following:

  School improvement plan (SIP)  Yes No     

  Annual improvement plan (AIP)  Yes No     

42. What are the sources of funds for WinS School Private PTA LGU Funds Children
Supplies? Please check all that apply. MOOE donations bring their
own

  Soap          

  Toothbrush          

  Toothpaste          

  Cleaning materials/supplies for toilets          

  Repair and maintenance          

43. Where can learners avail of sanitary pads? ( Kindly check your answer)

  School Canteen  

  School Clinic  

  Guidance Office  
  Class Adviser/Teacher  

  Others  

44. Is there information on proper disposal of sanitary napkins in  Yes No     

the girls toilet?

45. Are there DepEd Approved Instructional materials on  Yes No     

Menstrual Health for Teachers?

46. Are there DepEd Approved Information, Education and  Yes No     
Communications (IEC) materials on Menstrual Health for
Students?

47. Is there a designated rest space/changing    Yes No     

room for girls with menstrual discomfort?

E. Deworming
48. Is deworming done semi-annually?    Yes No     

49. What is the total number of students  

dewormed?
 

F. Health Education
50. Which areas in the school have IEC Hygien Menstrual Sanitation Food safety
materials for WinS? ( Check your answer) e Health

  Bulletin board        

  Classrooms        

  Toilets        

  Handwashing facilities        

  Canteen/Eating areas        

51. Are there organized structures (eg. TWGs, student clubs) to  Yes No   
promote WinS?

52. Is WinS a part of INSET?  Yes No   

53. Are learning materials available for teaching WinS?  Yes No   

54. Is WinS being advocated in the GPTCA assembly?  Yes No   

55. Are there planned and organized activities for advocating WinS  Yes No   
to parents/stakeholders?
56. Is WinS part of the co/extra-curricular program for students?  Yes No   

 Evaluated: Noted:

____________________________________ __________________________________
Signature Overprinted Name School Head

____________________________________
School where the Evaluator teaches

Date and Time Evaluated:

____________________________________

Reminders:
As evaluator, it is ’expected that you__________
1. Report evidently, analyzing all the data through (Focused Group Discussion), D-O-D
(Documents Analysis-Observation-Discussion) and MOVs (Mode of Verifications)

2. Documents your monitoring by taking pictures;

3. Strictly follow “No Showing of proof No rate”;
4. Count all the evidences by your eyes;
5. That you visit all the prescribed area/corner stated on the monitoring tool;
6. Rate only tangible and visibly evidences; and
7. Report to the Division Office (SGOD) right after the evaluation for encoding the
result.