<NAME OF SCHOOL>

<SCHOOL ID>

Contingency Plan for

<HAZARD>
As of <DATE>
 CHAPTER I. BACKGROUND

A. Introduction

<Sample introduction>
Municipality X is one of the 17 municipalities that comprise Province Y. It has a
land area of 6,731 hectares comprising 3.63% of the land area of the province. It is
approximately 76 road kilometers from Municipality Z, the capital town of Province
Y, 237 road kilometers from City V, 12 hours sea travel and 45 minutes air travel
from Metropolis and other prime cities in the country.

Classified as 1st class and basically a tourism municipality, Municipality X is where

the world-famous Island Bae is located. It became a municipality on December X,
19XX by virtue of Republic Act XXXX. It comprises 14 barangays, 3 of which are
located in Island Bae.

Of the 14 barangays of the municipality, the three (3) most populated barangays
are: Barangay A with a population of 12,526 followed by Barangay B with 11,076
people and Barangay C with 6,593 people.

The projected population of Municipality X for 20XX is at 60,000 with 15,000

households. Its population density is 720 persons/square kilometer on average.
Island Bae has a higher density of 2,836 persons/square kilometer. Municipality X
has a diverse culture, religion and dialect brought about by its popular tourism
industry patronized by varied provinces and foreign countries. The population
growth rate of Municipality X is at 6.45% per annum, the highest in the region.
Indigenous people are the Local Ati.
B. Hazard Analysis

CP Form 1: Hazard Analysis

PROBABILITY IMPACT
HAZARD AVERAGE RANK
RATE REMARKS RATE REMARKS

<Describe the results of the accomplished form.>

C. Hazard to Plan for: <Insert hazard that ranked as number one in CP Form 1>

CP Form 2: Anatomy of the Hazard

HAZARD
EXISTING MITIGATING
ROOT CAUSES EARLY WARNING SIGNS TRIGERRING FACTORS
MEASURES
 D. Scenario

CP Form 3A: Scenario Generation for Natural Hazard

PARTICULARS BAD WORSE WORST

General Description of Event
LEARNERS
No. of Affected Learners
(Male, Female, IP, Muslim, PWD)
No. of Dead Learners
(Male, Female, IP, Muslim, PWD)
No. of Injured Learners
(Male, Female, IP, Muslim, PWD)
No. of Missing Learners
(Male, Female, IP, Muslim, PWD)
PERSONNEL
No. of Affected Teaching Personnel
(Male, Female)
No. of Dead Teaching Personnel
(Male, Female)
No. of Injured Teaching Personnel
(Male, Female)
No. of Missing Teaching Personnel
(Male, Female)
No. of Affected Non-Teaching
Personnel (Male, Female)
No. of Dead Non-Teaching Personnel
(Male, Female)
No. of Injured Non-Teaching Personnel
(Male, Female)
No. of Missing Non-Teaching Personnel
(Male, Female)
EFFECTS
Infrastructure
 Totally damaged CLs
 Partially damaged CLs
 Damaged WASH facilities
 Damaged other infrastructures
and ancillary facilities
(e.g., laboratories, clinic, library)
Non-infrastructure
 Damaged furniture and fixtures
 Damaged learning resources
and self-learning modules
 Damaged Information and
Communication Technology
(ICT) equipment
 Damaged laboratory equipment
 Damaged medical and dental
equipment and supplies
 Damaged technical-vocational
supplies and equipment
Communication
Power/Electricity
Transportation
Response Capabilities
Others
 <Describe the results of the accomplished form.>

CP Form 3B: Scenario Generation for Human-Induced Hazard

PARTICULARS BAD WORSE WORST

General Description of Event
LEARNERS
No. of Affected Learners
(Male, Female, IP, Muslim, PWD)
No. of Dead Learners
(Male, Female, IP, Muslim, PWD)
No. of Injured Learners
(Male, Female, IP, Muslim, PWD)
No. of Missing Learners
(Male, Female, IP, Muslim, PWD)
PERSONNEL
No. of Affected Teaching Personnel
(Male, Female)
No. of Dead Teaching Personnel
(Male, Female)
No. of Injured Teaching Personnel
(Male, Female)
No. of Missing Teaching Personnel
(Male, Female)
No. of Affected Non-Teaching
Personnel (Male, Female)
No. of Dead Non-Teaching Personnel
(Male, Female)
No. of Injured Non-Teaching Personnel
(Male, Female)
No. of Missing Non-Teaching Personnel
(Male, Female)
EFFECTS
Infrastructure
 Totally damaged CLs
 Partially damaged CLs
 Damaged WASH facilities
 Damaged other infrastructures
and ancillary facilities
(e.g., laboratories, clinic, library)
Non-infrastructure
 Damaged furniture and fixtures
 Damaged learning resources
and self-learning modules
 Damaged Information and
Communication Technology
(ICT) equipment
 Damaged laboratory equipment
 Damaged medical and dental
equipment and supplies
 Damaged technical-vocational
supplies and equipment
Communication
Power/Electricity
Transportation
Environment
Response Capabilities
Government Trust
Others
<Describe the results of the accomplished form.>

CP Form 4A.1: Affected Learners

DISPLACED LEARNERS
NO. OF NO. OF
NO. OF
LEARNERS LEARNERS
AREA/LOCATION AFFECTED
INSIDE OUTSIDE REASONS FOR DISPLACEMENT
LEARNERS
EVACUATION EVACUATION
CENTERS CENTERS

TOTAL

<Describe the results of the accomplished form.>

 CP Form 4A.2: Affected Personnel

DISPLACED TEACHING PERSONNEL DISPLACED NON-TEACHING PERSONNEL

NO. OF NO. OF NO. OF NO. OF NO. OF NON- NO. OF NON-
AFFECTED TEACHING TEACHING AFFECTED TEACHING TEACHING
AREA/LOCATION PERSONNEL PERSONNEL REASONS FOR PERSONNEL PERSONNEL REASONS FOR
TEACHING TEACHING
PERSONNEL
INSIDE OUTSIDE DISPLACEMENT PERSONNEL
INSIDE OUTSIDE DISPLACEMENT
EVACUATION EVACUATION EVACUATION EVACUATION
CENTERS CENTERS CENTERS CENTERS

TOTAL

<Describe the results of the accomplished form.>

 CP Form 4B.1: Breakdown of Affected Learners

No. OF
BREAKDOWN
LEARNERS
AREA/ AFFECTED IP MUSLIM ALS
LEARNERS K – G3 G4 – G7 G8 – G10 G11 – G12 WITH OTHERS
LOCATION LEARNERS
DISABILITY
LEARNERS LEARNERS

M F M F M F M F M F M F M F M F M F

<Describe the results of the accomplished form.>

 CP Form 4B.1: Breakdown of Affected Learners

No. OF AFFECTED No. OF AFFECTED

AREA/ TEACHING NON-TEACHING
PERSONNEL PERSONNEL OTHERS
LOCATION
M F M F

<Describe the results of the accomplished form.>

 CHAPTER II. GOALS AND OBJECTIVES

A. Goal

<Sample goal statement>

The goal of the contingency plan is to provide effective, efficient, timely and
well-coordinated response mechanisms in the event of the occurrence of a
typhoon in Municipality X. Such mechanisms shall help to protect lives,
properties, and the environment, and restore the immediate needs of the
affected communities.

B. General Objective(s)

<Sample objectives>
The general objectives of the contingency plan are as follows:
1) To ensure the protection of lives and properties in the event of typhoon in
Municipality X;
2) To determine the immediate needs and the resources that will meet the
needs in the event of typhoon; and
3) To establish coordination and linkages between and among the
stakeholders of Municipality X in the event of the typhoon.
 CHAPTER III. RESPONSE ARRANGEMENTS

A. Response Clusters

Response Activities

CP Form 6: Response Activities

TIMEFRAME RESPONSIBLE
RESPONSE ACTIVITIES
(after the trigger) TEAM/COMMITTEE
within 24 hours
within 48 to 72 hours
after 72 hours and onwards

Note: Refer to DepEd Order No. 33 s. 2021, Enclosure 2.

<Describe the results of the accomplished form.>

 Response Inventory

CP Form 7: Resource Inventory

TEAM/COMMITTEE RESOURCES QUANTITY REMARKS

<Describe the results of the accomplished form.>

 Response Projection

GAPS ACTIVITIES/SOURCES COST SOURCE OF

RESOURCES NEED HAVE
(NEED-HAVE) TO FILL THE GAPS ESTIMATES FUNDS

<Describe the results of the accomplished form.>

Response Gap Summary
B. Emergency Operations Center

CP Form 10: Emergency Operations Center

LOCATION
CONTACT INFORMATION
Primary Alternate
Landline: Satellite Phone:

Mobile: Radio Frequency:

Email Address: Others:

Social Media:

Others:

EOC MANAGEMENT TEAM

Names and Contact
Designation
Agency/Office/Organization Information
EOC Manager

Operations Coordinator

Planning Coordinator

Logistics Coordinator

Finance/Admin
Coordinator

Others
Others
Others
 CHAPTER IV. ACTIVATION, DEACTIVATION, AND NON-ACTIVATION

Activation
<Use flow chart to describe CP activation and deactivation>

Deactivation
<Use flow chart to describe CP activation and deactivation>

Non-Activation
<Indicate if the CP will be maintained as a continuing plan or will be integrated in
the overall DRRM plan when not used.>
 ANNEXES

Working Group

Purpose:

<Sample purpose statement>

The Working Group will be responsible for the refinement, finalization, testing,
evaluation, packaging, updating and improvement of the CP.

Duties and Responsibilities:

<Sample duties and responsibilities>

1. Facilitate the refinement and finalization of the CP to include testing,
evaluation, packaging, updating and improvement;
2. Develop work plan for the completion and updating of the CP;
3. Organize consultation meetings with the planners and relevant
technical experts regarding the development of the CP; and
4. Facilitate the presentation and endorsement of the CP to the
authorities for comments and approval.

Members:
Head :
Facilitator :
Secretariat :
Cluster Representatives :