San Pedro, Dapitan CitY

09985464820
125958@deped.gov.ph
Republic of the Philippines
Department of Education
REGION IX – DIVISION OF DAPITAN CITY

Incident Report No. ____

INCIDENT REPORT FORM

RO/SDO: Region IX / Schools Division Office of Dapitan City

School: San Pedro Integrated School

TYPE OF INCIDENT

DATE OF INCIDENT

TIME OF INCIDENT

PLACE/EXACT
LOCATION OF
INCIDENT

PERSONS INVOLVED
AND THEIR SPECIFIC
PARTICIPATION

DESCRIPTION/DETAILS
OF THE INCIDENT

ACTIONS TAKEN

THE DEPED VISION THE DEPED MISSION OUR CORE VALUES

We dream of Filipinos who passionately love their country
and whose values and competencies enable them to realize
their full potential and contribute meaningfully to building the
nation.
As a learner-centered public institution, the Department of
Education continuously improves itself to better serve its
stakeholders.
To protect and promote the right of every Filipino Maka-Diyos
to quality, equitable, culture-based, and complete Maka-tao
basic education where: Makakalikasan
Makabansa
Students learn in a child-friendly, gender-
sensitive, safe, and motivating
environment.Teachers facilitate learning and
constantly nurture every learner.Administrators
and staff, as stewards of the institution, ensure
an enabling and supportive environment for
effective learning to happen.
 San Pedro, Dapitan CitY
09985464820
125958@deped.gov.ph
Republic of the Philippines
Department of Education
REGION IX – DIVISION OF DAPITAN CITY

FOLLOWUP
RECOMMENDATIONS

PREPARED BY

DATE PREPARED

RECEIVED AND
REVIEWED BY
CHEENEE C. TUBALLA
Guidance Advocate
NOTED BY

PACITA E. BALLADARES, HT-V

School Principal

THE DEPED VISION THE DEPED MISSION OUR CORE VALUES

We dream of Filipinos who passionately love their country
and whose values and competencies enable them to realize
their full potential and contribute meaningfully to building the
nation.
As a learner-centered public institution, the Department of
Education continuously improves itself to better serve its
stakeholders.
To protect and promote the right of every Filipino Maka-Diyos
to quality, equitable, culture-based, and complete Maka-tao
basic education where: Makakalikasan
Makabansa
Students learn in a child-friendly, gender-
sensitive, safe, and motivating
environment.Teachers facilitate learning and
constantly nurture every learner.Administrators
and staff, as stewards of the institution, ensure
an enabling and supportive environment for
effective learning to happen.