Annex 2.

1: Contingency Plan Template for School Version: 2

Date: 27 August 2019
TEMPLATE 3: HISTORICAL DATA ON DISASTERS

School Name:___________________
School ID:______________________

EFFECTS ON:
AFFECTED POPULATION
INFRASTRUCTURE NON-INFRASTRUCTURE
Incident Name
Date of No. of Non- No. of Damaged Estimated Total
Type of Incident No. of Instructional No. of Damaged No. of Damaged Other effects/damages
Occurence Instructional No. WASH Facilities DepEd Cost of Damage
No. of Learners No. of Personnel Classrooms School Learning
Classrooms Computerization
Furniture Resources
Project (DCP)
Minor Major Totally Minor Major Totally Minor Major Totally

Remarks: Data is based on historical RADaR reports and other official documents

Prepared by: Noted by:

School Head

Instructions:
This template should be accomplished by the SDRRM Team and School Head.
Incident Name - specific name of the hazard or disaster (e.g. TY Ompong, TD Ineng, Magnitude 6.5 Earthquake in San Julian, Eastern Samar).
Type of Incident - choose among the following: Tropical Cyclone, Armed Conflict, Fire, Landslides, Earthquake, Volcano Eruption, Others (please specify).
Date of Occurrence - specific date when the incident happen.
Affected Population - based on the existing or historical record of the school visa via the date of occurrence of the incident.
Infrastructure ad Non Infrastructure - quantity of damage per incident.
Instructional classrooms - includes all academic rooms used by the learners.
Non-instructional classrooms - includes all non-academic rooms like Canteen, Library, Faculty Room, etc.
DCP - it should be per computer set (if possible).
Estimated Total Cost of Damage - based on the existing and historical record of the school.