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    Department of Education: Republic of The Philippines

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    lawrence
    This document contains forms and schedules from Northville VI Elementary School in Bulacan, Philippines related to the implementation of in-person classes amid the COVID-19 pandemic. It includes a parental consent form for students' return to school, a contact tracing log, a student information form, a learner health record, and schedules for the school's disinfection. The principal, Josie Gratil, approved the disinfection schedule prepared by the school's disaster risk reduction management focal person.

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    Department of Education: Republic of The Philippines

    Uploaded by

    lawrence
    110 views8 pages
    This document contains forms and schedules from Northville VI Elementary School in Bulacan, Philippines related to the implementation of in-person classes amid the COVID-19 pandemic. It includes a parental consent form for students' return to school, a contact tracing log, a student information form, a learner health record, and schedules for the school's disinfection. The principal, Josie Gratil, approved the disinfection schedule prepared by the school's disaster risk reduction management focal person.

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    This document contains forms and schedules from Northville VI Elementary School in Bulacan, Philippines related to the implementation of in-person classes amid the COVID-19 pandemic. It includes a parental consent form for students' return to school, a contact tracing log, a student information form, a learner health record, and schedules for the school's disinfection. The principal, Josie Gratil, approved the disinfection schedule prepared by the school's disaster risk reduction management focal person.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    110 views8 pages

    Department of Education: Republic of The Philippines

    Uploaded by

    lawrence
    This document contains forms and schedules from Northville VI Elementary School in Bulacan, Philippines related to the implementation of in-person classes amid the COVID-19 pandemic. It includes a parental consent form for students' return to school, a contact tracing log, a student information form, a learner health record, and schedules for the school's disinfection. The principal, Josie Gratil, approved the disinfection schedule prepared by the school's disaster risk reduction management focal person.

    Copyright:

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    of 8

    Republic of the Philippines

    Department of Education
    REGION III – CENTRAL LUZON
    SCHOOLS DIVISION OF BULACAN
    NORTHVILLE VI ELEMENTARY SCHOOL
    SANTOL, BALAGTAS, BULACAN

    ___________________
    Petsa

    SA KINAUUKULAN:

    Ako si ______________________________________________, magulang / legal na tagapag-alaga ni


    ( Pangalan ng Magulang / Guardian )

    ___________________________________, Baitang ______________________, Pangkat ______________________


    ( Pangalan ng Bata )

    sa ilalim ng pamamatnubay ni _____________________________________________ ay kusang loob na lumalagda


    ( Pangalan ng Guro )

    sa kasunduang ito sa muling pagbabalik sa paaralan para sa Implementation of Expanded Phase of Face to Face

    Classes ayon sa DepEd Memorandum no. 085 s. 2021.

    Lagyan ng tsek ( / ) ang box

    Pumapayag na mulng papasukin sa paaralan ang aking anak


    ( Expanded Phase of Face to Face Classes )

    Hindi ako pumapayag na muling papasukin sa paaralan

    _____________________________________
    Lagda ng Magulang / Contact Number
    ( Signature over Printed Name)

    Northville VI Elementary School


    Address: Santol, Balagtas, Bulacan
    Contact No.: 0943-484-9428
    Email: 158524@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION III – CENTRAL LUZON
    SCHOOLS DIVISION OF BULACAN
    NORTHVILLE VI ELEMENTARY SCHOOL
    SANTOL, BALAGTAS, BULACAN
    Northville VI Elementary School

    _______________________
    Control Number

    CONTACT TRACING LOG

    DATE NAME ADDRESS CONTACT NO. TEMP. SIGNATURE

    Northville VI Elementary School


    Address: Santol, Balagtas, Bulacan
    Contact No.: 0943-484-9428
    Email: 158524@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION III – CENTRAL LUZON
    SCHOOLS DIVISION OF BULACAN
    NORTHVILLE VI ELEMENTARY SCHOOL
    SANTOL, BALAGTAS, BULACAN

    Northville VI Elementary School


    Address: Santol, Balagtas, Bulacan
    Contact No.: 0943-484-9428
    Email: 158524@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION III – CENTRAL LUZON
    SCHOOLS DIVISION OF BULACAN
    NORTHVILLE VI ELEMENTARY SCHOOL
    SANTOL, BALAGTAS, BULACAN

    Elementary Pupils
    NAME : _____________________________________________________________________ SCHOOL ______________________________________________
    Last First Middle
    Date of Birth ______________________________________ Region ______________________ Division ________________________________________
    Month Day Year
    Birthplace: __________________________________________ Parent/ Guardian _______________________________________________________________
    Address __________________________________________________________________________ Telephone Number ________________________________

    Northville VI Elementary School


    Address: Santol, Balagtas, Bulacan
    Contact No.: 0943-484-9428
    Email: 158524@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION III – CENTRAL LUZON
    SCHOOLS DIVISION OF BULACAN
    NORTHVILLE VI ELEMENTARY SCHOOL
    SANTOL, BALAGTAS, BULACAN

    LEARNER’S HEALTH COMMORBIDITY RECORD

    WITH PARENT/
    TYPE OF
    NO NAME OF LEARNER AGE LEVEL COMMORBIDITY/ GUARDIAN
    COMMORBIDIT
    WITHOUT SIGNATURE
    Y
    COMMORBIDITY

    Northville VI Elementary School


    Address: Santol, Balagtas, Bulacan
    Contact No.: 0943-484-9428
    Email: 158524@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION III – CENTRAL LUZON
    SCHOOLS DIVISION OF BULACAN
    NORTHVILLE VI ELEMENTARY SCHOOL
    SANTOL, BALAGTAS, BULACAN

    Prepared : Noted :

    _______________________________________ JOSIE D. GRATIL


    ADVISER PRINCIPAL II

    SCHEDULE OF SCHOOL’S DISINFECTION


    S.Y. 2021-2022

    DAY TIME PERSON’S INVOLVE


    GRADE LEVEL ACTIVITY
    KINDER Fogging Monday-Friday 11:00-11:10 am LGU’s ,DRRM safety Team

    GRADE I Fogging Monday-Friday 1:00-1:10 pm LGU’s ,DRRM safety Team

    GEADE II Fogging Monday-Friday 1:10-1:20 pm LGU’s ,DRRM safety Team

    GRADE III Fogging Monday-Friday 1:20- 1:30 pm LGU’s ,DRRM safety Team

    GRADE IV Fogging Monday-Friday 11:30-11:40 am LGU’s ,DRRM safety Team

    GRADE V-VI Fogging Monday-Friday 2:00-2:15 pm LGU’s ,DRRM safety Team

    SCHOOL VICINITY Fogging Tuesday and Friday 5:00-5:30 pm LGU’s ,DRRM safety Team

    Note : Disinfection of all rooms will be done immediately after class hour

    Northville VI Elementary School


    Address: Santol, Balagtas, Bulacan
    Contact No.: 0943-484-9428
    Email: 158524@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION III – CENTRAL LUZON
    SCHOOLS DIVISION OF BULACAN
    NORTHVILLE VI ELEMENTARY SCHOOL
    SANTOL, BALAGTAS, BULACAN

    Prepared by: Approved by :

    CHRISTIAN CATHERINE L. GONZALO JOSIE D. GRATIL


    SDRRM Focal Person Principal II

    Northville VI Elementary School


    Address: Santol, Balagtas, Bulacan
    Contact No.: 0943-484-9428
    Email: 158524@deped.gov.ph

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