R epublic of the P hilippines

D epartment of Education
REGION IV-A CALABARZON
REGION IV-A CALABARZON
Division of Batangas
District of Calatagan
PEDRO PALACIO SR. MEMORIAL ELEMENTARY SCHOOL

GULOD ELEMENTARY SCHOOL

DAILY SCHOOL INSPECTION OF PERSONNEL

DAILY HEALTH DECLARATION SUMMARY REPORT

December 13, 2021

PPEs Health Declaration

Name Position Face Face Coug
Temp Colds Exposure Others
Mask Shield h

1. ELISA B. ELPOSAR TIC ✅ ✅ 36.5ºC ❌ ❌ ❌

2. ASUNCION D. LIMOICO TIII ✅ ✅ 36.4ºC ❌ ❌ ❌

3. LAURA D. BARAL TIII ✅ ✅ 36.4ºC ❌ ❌ ❌

4. CLARITA E. ERNA TIII ✅ ✅ 36.6ºC ❌ ❌ ❌

5. SONIA A. DINO TII ✅ ✅ 36.6ºC ❌ ❌ ❌

6. CATHERINE A. DESTREZA TIII ✅ ✅ 35.6ºC ❌ ❌ ❌

7. NONETTE A. ACBANG TII ✅ ✅ 36.6ºC ❌ ❌ ❌

8. ELEONOR E. BASIT TI ✅ ✅ 36.6ºC ❌ ❌ ❌

9. JOYCEPHINE MARIE D.
TI ✅ ✅ 36.5ºC ❌ ❌ ❌
RODRIGUEZ

Inspected by: Approved by:

CATHERINE A. DESTREZA ELISA B. ELPOSAR

 R epublic of the P hilippines
D epartment of Education
REGION IV-A CALABARZON
REGION IV-A CALABARZON
Division of Batangas
District of Calatagan
PEDRO PALACIO SR. MEMORIAL ELEMENTARY SCHOOL

GULOD ELEMENTARY SCHOOL