Blank Badac Assessment

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BADAC ASSESSMENT & AUDIT FORM

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ATTESTATION
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BADAC ASSESSMENT & AUDIT FORM
ATTESTATION
Republic of the Philippines
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT
Regional Office No. IX
A.T.D.No.
Telephone Bldg., F.S.925
(062) Pajares
0258,Avenue, San0283,
(062) 925 Jose Telefax
District,No.
Pagadian City0252
(062) 925
Email: www.region9.dilg.gov.ph * dilg_region9@yahoo.com
BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM

for the Year 2019
Region: IX Municipality: LABANGAN
Province: ZAMBOANGA DEL SUR Barangay: Contact #
Instruction: Put a check ✓ on the box that corresponds to the given questions. FOR C/MLGOO / CD USE
INDICATORS YES NO MEANS OF VERIFICATION POINTS

1. Is BADAC composed of at least seven (7) members? Executive Order (Required) -4
BADAC Organizational Structure
Copies of IDs issued to BADAC members
Appointment papers
Others, please specify: ______________________
2. Did the BADAC organize a Committee on Operations? Executive Order (Required) -2

Appointment papers
3. Did the BADAC organize a Committee on Advocacy? Executive Order (Required) -2

Appointment papers
FOR C/MLGOO / CD USE

4. Did the BADAC organize a BADAC Auxiliary Team? Executive Order w/ attached list of updated -3
BAT members (Required)
IN COMPLIANCE WITH DILG-DDB JOINT MEMORANDUM CIRCULAR NO. 2018-01 Page 3/15 BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM
Copies of IDs issued to BAT members
Appointment papers
5. Did the BADAC organize House Clusters? Executive Order (Required) -3

Copies of IDs issued to House Cluster Leaders
Appointment papers
6. Did the BADAC designate Barangay Duty Officers (BDO)? Executive Order (Required) -2
Copies of IDs issued to Barangay Duty Officers
Appointment papers
7. Is there a desk or space in the barangay designated Actual photo of the desk (Required) -1
as Referral/BADAC Desk? Others, please specify: ______________________
8. Did the Punong Barangay attend training on Copy of Certificate of Participation (Required) -1
Strengthening BADACs, or other relevant trainings? Copy of attendance sheet w/ the title of the
activity, date/time, and venue
Attestation from the lead organizer
9. Did the Punong Barangay attend any training or planning Copy of Cert. of Participation (Required) -2
session on Community Support, Aftercare, and Reintegration Copy of attendance sheet w/ the title of the
Program (CSAR)? activity, date/time, and venue
In case the CADAC/MADACs were not able to organize any Attestation from the lead organizer
consultation or planning workshop on reintegration program, the Others, please specify: _______________
BADACs should check the corresponding box for “N/A” in page 2,
item number nine (9) of BADAC Self-Assessment and Audit Form.
With respect to this, the C/M LGOO or CD shall allocate the
corresponding one (1) point
FOR C/MLGOO / CD USE

10. Did the BADAC conduct at least one (1) training for the BADAC Activity Report with attendance sheets (Required) -2
BADAC House Cluster Leaders? Photo/video documentation
Copies of evaluation or feedback forms
Copy of signed liquidation report
Copy of Certificate of Participation awarded to
cluster leaders
11. Did the BADAC conduct at least one (1) training for the BADAC Activity Report with attendance sheets (Required) -2
BADAC Auxiliary Team (BAT)? Photo/video documentation
Copy of Certificate of Participation awarded to BAT
members
12. Did the Barangay Duty Officers attend at least one (1) Copies of Certificate of Participation (Required) -2
training on Community-Based Rehabilitation Program or Copy of attendance sheet with title of the activity,
other relevant trainings? date/time, and venue
Photo documentation
Attestation from lead organizer
13. Did the BADAC conduct at least one (1) consultative BADAC Activity Report with attendance sheets (Required) -1
meeting with stakeholders? Photo/video documentation
Minutes of the meeting/proceedings
14. Did the BADAC conduct regular monthly meetings? Copies of BADAC monthly meeting minutes with -5
Number of months in which meetings were conducted attendance sheets (Required)
10-12 months 4-5 Photo/video documentation
8-9 1-3 Minutes of the meeting/proceedings
6-7 0 Others, please specify: ______________________
INDICATORS YES NO MEANS OF VERIFICATION FOR C/MLGOO / CD USE

POINTS
15. Did the BADAC organize / co-organize at least two (2) BADAC Activity Report (Required) -4
community-based IEC campaign activities? Attendance sheets
Photo/video documentation
Copy of IEC materials used
Others, please specify: _______________________
16. Did the BADAC organize / co-organize at least one (1) BADAC Activity Report (Required) -4
school-based IEC campaign activity? Attendance sheets
Photo/video documentation
17. Did the SK or any youth organizations in the barangay Activity report by the youth organization (Required) -1.5
conduct at least one (1) drug awareness Attendance sheets
campaign activity? Photo/video documentation
18. Did any Civil Society Organizations (CSOs) conduct Activity report by the CSO (Required) -1.5
at least one (1) drug awareness campaign activity in Attendance sheets
the barangay? Photo/video documentation
19. Did the BADAC organize / co-organize any activities BADAC Activity Report (Required) -2
in observance of the International Day Against Drug Attendance sheets
Abuse and Illicit Trafficking (IDADAIT)? Photo/video documentation

POINTS
20. Did the BADAC organize / co-organize any activities in BADAC Activity Report (Required) -2
observance of the Drug Abuse Prevention and Control Attendance sheets
Week (DAPC)? Photo/video documentation
21. Did the BADAC submit an updated number of residents Copy of the Barangay Duty Officer's logbook, or -3
who surrendered through the Barangay Duty Officers and copy of the logbook/reports from mandated agencies
other mandated agencies? where the resident surrendered (Required)
22. Did the BADAC submit an updated number of residents Copy of referral letter from the barangay, received by -3
who were referred to higher ADACs and other law CADAC/MADAC, or other law enforcement
enforcement agencies for assessment? agencies (Required)
BDO's logbook showing the referral date
23. Did the BADAC submit an updated number and status of List of updated number and status of residents
residents who were assessed and enrolled in any enrolled in Wellness and Recovery Interventions
Wellness and Recovery Interventions? issued by CADAC/MADAC (Required)
Copies of Individual Treatment Card/Book
24. Did the BADAC submit an updated number of residents List of updated number of residents who completed -2
who have completed prescribed Wellness and Recovery their prescribed Wellness and Recovery Interventions
Inteventions? issued by CADAC/MADAC (Required)
Copies of Certificate of Completion
Copies of clearance certificate issued by authorized
service provider

POINTS
25. Did the BADAC submit an updated number of residents List of updated number of residents enrolled in CSAR -1
enrolled in CSAR or any equivalent reintegration program? program, or its equivalent, issued by
CADAC/MADAC (Required)
Copies of Individual Treatment Card/Book
26. Did the BADAC submit an updated number of residents List of updated number of residents who completed -1
who completed the CSAR or any equivalent reintegration the CSAR Program issued by CADAC/MADAC (Required)
program? Copies of Certificate of Completion, or copy of
Clearance Certificate issued by authorized service
provider
27. Did the BADAC submit the Summary of Consolidated Certificate of submission from CADAC/MADAC and -3.75
Information Report (CIR)? local PNP unit (Required)
Copy of received transmittal form
28. Did the BADAC submit an updated CIR to CADAC/MADAC Certificate of submission from CADAC/MADAC and -3.75
and local PNP unit? local PNP unit (Required)
Copy of received transmittal form
29. Did the BADAC submit its Barangay CSAR or any Copy of approved Barangay CSAR Plan, or equivalent, -1
equivalent reintegration plan as incorporated in their BADPA? received by CADAC/MADAC (Required)
30. Did the BADAC prepare its own BADAC Plan of Action Copy of approved BADPA or copy of approved -10
(BADPA) for FY 2019? BPOPS Plan with BADPA (Required)
31. Did the BADAC appropriate a substantial budget for its Copy of approved Barangay Annual Budget w/ -15
anti-illegal drug activities for FY 2017? budget allocation for BADAC (Required)
Total annual budget: _______________________

Allocation for BADAC: _______________________

POINTS
32. Did the BADAC submit its Annual BADAC Accomplishment Copy of Annual BADAC Accomplishment and Fund -7.5
and Fund Utilization Report to CADAC/MADAC and other Utilization Report (Required)
agencies? Others, please specify: _______________________
Audited by:
TOTAL POINTS
JEHANNE LORELEI A. RODRIGO
Municipal LGOO
Date signed: ________________

LEVEL OF FUNCTION
POINTS LEVEL OF FUNCTIONALITY

50 BELOW POOR
51-84 MODERATE
85-100 EXCELLENT
OR C/MLGOO / CD USE ONLY
REMARKS

REMARKS
REMARKS
REMARKS
REMARKS
REMARKS
REMARKS
TOTAL POINTS
EVEL OF FUNCTIONALITY
Republic of the Philippines
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT
Regional Office No. IX
A.T.D.No.
Telephone Bldg., F.S.
(062) Pajares
925 0258,Avenue, San0283,
(062) 925 Jose Telefax
District,No.
Pagadian City0252
(062) 925
Email: www.region9.dilg.gov.ph * dilg_region9@yahoo.com
BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM

for the Year 2019
CERTIFICATION OF TRUTH, ACCURACY AND COMPLETENESS

The undersigned certify under penalty of law, based on information and belief formed after reasonable inquiry, the
statements and information contained in this document are true, accurate, and complete.
Chair of Committee on Advocacy Chair of Committee on Operations

Date signed: _________________ Date signed: _________________
Punong Barangay / BADAC Chairperson

Date signed: _________________
Noted by:
JEHANNE LORELEI A. RODRIGO EDUARDO D. RELACION

Municipal LGOO Municipal Mayor
Date signed: ________________ Date signed: _______________

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This document was exported from Numbers. Each table was converted to an Excel worksheet.

Numbers Sheet Name Numbers Table Name

BADAC ASSESSMENT & AUDIT FORM

Excel Worksheet Name

BADAC ASSESSMENT & AUDIT FORM

BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM

INDICATORS YES NO MEANS OF VERIFICATION POINTS

2. Did the BADAC organize a Committee on Operations? Executive Order (Required) -2

3. Did the BADAC organize a Committee on Advocacy? Executive Order (Required) -2

FOR C/MLGOO / CD USE

5. Did the BADAC organize House Clusters? Executive Order (Required) -3

FOR C/MLGOO / CD USE

INDICATORS YES NO MEANS OF VERIFICATION FOR C/MLGOO / CD USE

INDICATORS YES NO MEANS OF VERIFICATION FOR C/MLGOO / CD USE

INDICATORS YES NO MEANS OF VERIFICATION FOR C/MLGOO / CD USE

Total annual budget: _______________________

INDICATORS YES NO MEANS OF VERIFICATION FOR C/MLGOO / CD USE

Date signed: ________________

POINTS LEVEL OF FUNCTIONALITY

OR C/MLGOO / CD USE ONLY

BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM

CERTIFICATION OF TRUTH, ACCURACY AND COMPLETENESS

Chair of Committee on Advocacy Chair of Committee on Operations

Punong Barangay / BADAC Chairperson

JEHANNE LORELEI A. RODRIGO EDUARDO D. RELACION

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