DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT

Field Office 02
LGU ______________________________
MASTERLIST OF DAY CARE CHILDREN
SY 2020-2021
Name of Child Development Center: __________________
Time of Feeding: ______________________________ Location (Barangay/Municipality): ______________________
AM or PM SESSION: _______________________ District : ______________________
NAME Date Of Birth NUTRITIONAL STATUS
Actual Date of Pantawid Member IP Child Child of
Weighing / weight heigt Age in Weight Weight for Height for (pls specify PWD (pls. (pls. put Solo Parent
No. Address Name of Mother Sex RCCT/4p's or MCCT put check (pls put
First Name Middle Name Last Name month day year Measuring (kg) (cm) months for Age Height Age Status and indicate mark)
check
check
(mm/dd/yyyy) Status (Wasting) (Stunting) reference number) mark)
mark)

10

11

12

13

14

15

***Total Number of Undernourished Children

Prepared By:
____________________________
CDW
 DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
Supplementary Feeding Program FO2
10th Cycle Consolidated Nutritional Status SY 2020-2021
Municipality: Please Check: Baseline/Upon Entry (Before Feeding) Report Endline (After Feeding) Report
________________________
UNDERWEIGHT WASTING STUNTING
(Weight-for-Age) (Weight-for-Height) (Height-for-Age)
No. Name of Child Development No. of
Centers Beneficiries Severely Severely Severely
Normal Underweight Underweight Overweight TOTAL Normal Wasted Wasted Overweight Obese TOTAL Normal Stunted Stunted Tall TOTAL
(N) (UW) (OW) (N) (W) (OW) (O) (N) (S) (T)
(SUW) (SW) (SS)

10

11

12

13

14

15

16

17

18

19

20

TOTAL
Prepared by:
____________________________
C/MSWDO/ SFP Focal Person