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Self-Monitoring Compliance Form: Safety Requirements Compliant Yes No
Self-Monitoring Compliance Form: Safety Requirements Compliant Yes No
Indicate the compliance of your institution using the indicators below. Submit the form to the
City Disaster Risk Reduction Management Office at cdrrmoantipolocity1@gmail.com for
validation, subject to inspection by the Local Task Force against COVID-19.
Date: _______________________________________________________________________________
Name of Establishment: _______________________________________________________________
Owner: _____________________________________________________________________________
Location: ____________________________________________________________________________
Status of Business: With Permit Without Permit
*Adopted from Annex A, B, and C of TESDA Circular No. 096 s. 2021 issued 15 November 2021 entitled “Omnibus
Guidelines for TVET under the New Normal Arrangements.”