Republic of the Philippines

Department of Labor and Employment

Region IV-A CALABARZON

REPORT OF SAFETY ORGANIZATION

NAME OF ESTABLISHMENT: DR. CENERA DENTAL CLINIC

ADDRESS: BLK 19 LOT 30 OUR LADY OF CANDELARIA STREET, ROSARIO COMPLEX PHASE 1,
BARANGAY ROSARIO (FORMERLY BARANGAY SAN VICENTE), SAN PEDRO, LAGUNA, 4023

NATURE OF BUSINESS: HUMAN HEALTH & SOCIAL WORK ACTIVITIES - DENTAL SERVICES
PERSONS EMPLOYED INCLUDING MANAGEMENT
st
1 SHIFT : MALE FEMALE
nd
2 SHIFT : MALE FEMALE
rd
3 SHIFT : MALE FEMALE
REGULAR SHIFT: MALE _____________________ FEMALE _______1_____________
POLICY AND PROGRAM OF SAFETY AND HEALTH
POLICY: DR. CENERA DENTAL CLINIC IS A SAFE SPACE FOR HUMAN HEALTHCARE THAT TAKES
ACCOUNTABILITY, SUPPORTS ALL BENEFICIAL HEALTH & SAFETY PROGRAMS, AND PROMOTION OF
PRIORITIZING HEALTH AND SAFETY TO PREVENT WORKPLACE INJURIES THAT WILL RESULT IN
HEALTH AND FINANCIAL SUFFERING AND HARDSHIP.
PROGRAM: DR. CENERA DENTAL CLINIC IS DEVOTED IN THE PRACTICE OF EXPOSURE CONTROL FROM
BLOODBORNE PATHOGENS WHICH USE A FUNCTIONAL APPROACH, AN APPROACH THAT ANALYZES
AND STUDIES EVERY TREATMENT PROCEDURES IN DETAIL AND ITS POSSIBLE PROBLEMS THAT MIGHT
BE ENCOUNTERED, TO PROPERLY AND FULLY UNDERSTAND THE WORK AND GIVE PROTECTION TO
BOTH THE PATIENT AND THE PROFESSIONAL, WHO IS OATHED TO PRACTICE WITH CARE AND
COMPASSION TO BE OF GODLY SERVICE TO MANKIND.

COMPOSITION OF SAFETY COMMITTEE

TYPE: D
NAME POSITION
CHAIRMAN CHRISTIANE FAITH DE LEON CENERA OWNER

MEMBERS CHRISTIANE FAITH DE LEON CENERA OWNER

SECRETARY CHRISTIANE FAITH DE LEON CENERA OWNER

TECHNICAL INFORMATION
Brief description of process operation, number and kind of equipment:
Operation Name Kind of Equipment Quantity of Equipment Description of Operation Process
General Dental Operations Air Compressor, Dental Chair, 1 of each Oral Diagnosis of the patient
High Volume Suction, Dental Hand
Instruments
Oral Prophylaxis Ultrasonic Scaler, Air Compressor, 1 of each Scales and Cleans teeth of the patient
Dental Chair, High Volume to prevent gum disease
Suction, Dental Hand Instruments
Oral Surgery Air Compressor, High Volume 1 of each Extraction/ Surgical removal of
Suction, Dental Chair, Dental Hand decayed/infected tooth
Instruments, High Speed Handpiece
Restorative & Esthetic Dentistry Air Compressor, High Volume 1 of each Restores partially decayed tooth
Suction, Dental Chair, Dental Hand reshaping it to its esthetic value again
Instruments, High Speed
Handpiece, Low Speed Handpiece,
Light Curing Machine
Prosthodontics Air Compressor, High Volume 1 of each Fabrication of dentures or esthetic
Suction, Dental Chair, Dental Hand tooth replacements into missing ones
Instruments, High Speed
Handpiece, Low Speed Handpiece,
Light Curing Machine
Orthodontics Air Compressor, High Volume 1 of each Leveling and Alignment of
Suction, Dental Chair, Dental Hand malpositioned teeth to restore its
Instruments, High Speed proper function
Handpiece, Light Curing Machine
Sterilization Heat Dry Sterilizer 2 of each To sterilize instruments for hygiene

SUBMITTED BY:

CHRISTIANE FAITH DE LEON CENERA, DMD

General Manager/Employer
 GUIDE TO COMPOSITION OF SAFETY COMMITTEE

In Every place of employment, a safety committee shall be organized within sixty (60) days after this Standard takes
effect and for new establishments within one (1) month from the date the business starts operating, in both cases the
Safety Committee shall re-organize every January of the following year. In order to provide an opportunity for other
workers to become members and participate in safety program planning, a periodic change in membership is required.
For this purpose the term of office of the department head in the Committee shall be for one (1) year. The term of the
worker-members in Type A and Type B shall be two (2) years each in Type C, D, and E committee, shall be one (1) year.
The Chairman, physician or nurse and the secretary shall be permanent members of the committee.
In Joint Committee, the term of Office of the Chairman and the Members shall be one (1) year. Membership in
the Joint Committee shall be rotated among members of the safety committees in other establishments.

TYPE A – In every work place having a total of over four hundred (400) workers, the following Health and Safety
Committee shall be organized:
(1.) Safety Committee
Chairman - The Manager or his authorized representative who must be a top
Operating Official
Members - Two Department Heads
- Four Workers (must be union members, if organized)
- The Company Physician
Secretary - The Safety Man

TYPE B – In every work place having a total of over two hundred (200) to four hundred (400) workers, the following
shall be organized:
(1.) Safety Committee
Chairman - The Manager or his authorized representative who must be a top
Operating Official
Members - One Supervisor
- Three Workers (must be union members, if organized)
- The Company Physician or the Company Nurses
Secretary - The Safety Man

TYPE C – In every work place with less than one hundred (100) to two hundred (200) workers, the following shall
compose the Health and Safety Committee:
(1.) Safety Committee
Chairman - Manager or his authorized representative
Members - One Foreman
- Three Workers (must be union members, if organized)
- The Nurse
Secretary - The Part-time Safety Man

TYPE D – In every work place with less than one hundred (100) workers, the following shall compose the Health and
Safety Committee:
Chairman - Manager
Members - One Foreman
- Three Workers (must be union members, if organized)
Secretary - The Part-time Safety Man
- In this workplace, the line type as defined in 1048.02 may be
organized.

TYPE E – Joint Committee:

When two or more establishments are housed under one building, the Safety Committee organized in each
workplace shall organize themselves into a joint coordinating committee to plan and implement programs and
activities concerning all the establishments. This joint coordinating committee shall be composed of the
following:
Chairman - The Chairman of an establishment committee
Members - Two Supervisors from two different establishments
Secretary - Appointed by the Chairman (in high-rise, the secretary shall be
the building administrator.

Membership of Committees:
The Membership as provided is minimum requirements and nothing shall prohibit increases in the numbers as
may be found necessary.