PSYCHOLOGICAL FIRST AID (PFA) MONITORING TEMPLATE

Instructions:
The consolidated monitoring template should be submitted on or before APRIL 8, 2022, along with other pertinent documents and photos indicated in the guidelines to drrmo+mhpss@dep
specialized MHPSS, please refer to DM-OUCI-2021-055. To those who will send updated reports, please do not overwrite previously submitted data. Simply add the new information in a n
DRRMS immediately (drrmo@deped.gov.ph; tel no. 02 636-4997).

Legend:
- IP - Indigenous Peoples or Learners enrolled under the IP Education Program
- LWD - Learners with Disabilities or Learners enrolled under the SPED Program
- Muslim Learners - Learners enrolled under the Madrasah Program
- PFA - Psychological First Aid
- Specialized MHPSS - Mental Health and Psychosocial Support Beyond PFA; for guidance, please refer to DM-OUCI-2021-055

School information MHPSS Basic Information

Were Basic Needs

Is access to Date of PFA No. of mobilized
provided? (i.e.,
Region Division School ID School Name family/community Provision PFA Providers in
food, clothing,
support available? (MM/DD/YYYY) this date
shelter)
ANAPOG
BAGTIK
VII CEBU PROVINCE 500220 INTEGRATED
ELEMENTARY
BATAD
VII CEBU PROVINCE 119671 SCHOOL
SCHOOL
INTEGRATED
BUSOGON
VII CEBU PROVINCE 500486 SCHOOL
INTEGRATED
CALAMBUA
VII CEBU PROVINCE 500221 SCHOOL
INTEGRATED
KANAGAHAN
VII CEBU PROVINCE 500666 SCHOOL
ELEMENTARY
KINAWAHAN
VII CEBU PROVINCE 119675 SCHOOL
INTEGRATED
LAMBUSAN
VII CEBU PROVINCE 500920 SCHOOL
ELEMENTARY
LAMBUSAN
VII CEBU PROVINCE 119677 SCHOOL
NATIONAL HIGH
LIBAONG
VII CEBU PROVINCE 303030 SCHOOL
ELEMENTARY
LIBAONG
VII CEBU PROVINCE 119678 SCHOOL
NATIONAL HIGH
LUYANG
VII CEBU PROVINCE 303041 SCHOOL
ELEMENTARY
LUYANG
VII CEBU PROVINCE 119679 SCHOOL
NATIONAL HIGH
VII CEBU PROVINCE 303046 SCHOOL
 SAB-A
ELEMENTARY
SAN MIGUEL
VII CEBU PROVINCE 119680 SCHOOL
ELEMENTARY
SAN MIGUEL
VII CEBU PROVINCE 119681 SCHOOL
NATIONAL
TACUPHIGH
VII CEBU PROVINCE 303086 SCHOOL
ELEMENTARY NO NO NA 0
TAMBONGON
VII CEBU PROVINCE 119682 SCHOOL
INTEGRATED
TOONG
VII CEBU PROVINCE 500665 SCHOOL
ELEMENTARY
VICTORIA
VII CEBU PROVINCE 119684 SCHOOL
ELEMENTARY
VII CEBU PROVINCE 119685 SCHOOL
Prepared By

[Name and Signature]

Division School Health and Nutrition Personnel
n the guidelines to drrmo+mhpss@deped.gov.ph with subject "[TY Odette PFA] Region Division_Date of Submission". Please include SIGNED and EDITABLE/EXCEL version of the template. For
. Simply add the new information in a new row. If there are cells that are not applicable, kindly indicate "N/A". If there are concerns regarding the fund support for PFA, kindly contact DepEd

PFA Provision for Learners

Number of Learners provided with Number of Learners provided
Number of IP* Learners Provided Number of IP Learners linked for
School Level of PFA (Excluding IP, Muslim and linked for specialized MHPSS
with PFA specialized MHPSS
Learners LWD) (Excluding IP, Muslim and LWD)
Female Male Female Male Female Male Female Male

0 0 0 0 0 0 0 0
HIGH SCHOOL 0 0 0 0 0 0 0 0
Noted By Approved By

[Name and Signature] [Name and Signature]

Division DRRM Coordinator Schools Division Superintendent
L version of the template. For
kindly contact DepEd

Data on PFA Provision

ion for Learners

Number of Muslim Learners Number of Muslim Learners linked Number of LWDs** provided with Number of LWDs linked for Number of Teaching Personnel
provided with PFA for specialized MHPSS PFA specialized MHPSS provided with PFA

Female Male Female Male Female Male Female Male Female

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
me and Signature]
ols Division Superintendent

mber of Teaching Personnel
provided with PFA
Male
PFA Provision for Personnel
Number of Non-Teaching
Number of Teaching Personnel Number of Non-Teaching
Personnel linked for specialized Where were learners/personnel linked?
linked for specialized MHPSS Personnel provided with PFA
MHPSS
Female Male Female Male Female Male

0 0 0 0 0 0 0
0 0 0 0 0 0 0 NONE
 Source of Fund for PFA Provision

If from DRRMS,
Source of Fund If from DRRMS, With photo
Date amount was Amount liquidated with certificate of If with Partner,
(e.g., DRRMS, RO, Liquidated as of documentation Remarks
released (MM-DD) (PHP) liquidation name of Partner
Partner) (MM-DD) (YES/NO)
(YES/NO)
0 0 0 NA NA NA NA
ANNEX A. PSYCHOLOGICAL FIRST AID (PFA) MONITORING TEMPLATE
Instructions:
The consolidated monitoring template should be submitted every Monday by DRRM Coordinators, along with other pertinent documents and photos indicated in the guidelines to drrmo+m
submissions, please do not overwrite previously submitted data. Simply add the new information on a new row. If there are cells not applicable, kindly indicate "N/A". Submitted reports sha
(drrmo@deped.gov.ph; tel no. 02 636-4997).

Legend:
- IP - Indigenous Peoples, or Learners enrolled under the IP Education Program
- LWD - Learners with Disabilities, or Learners enrolled under the SPED Program
- Muslim Learners - Learners enrolled under the Madrasah Program
- PFA - Psychological First Aid
- Specialized MHPSS - Mental Health and Psychosocial Support Beyond PFA; for guidance, please refer to DM-OUCI-2021-055

In the sample below, two PFA sessions were conducted for Barake Elementary School on different dates. On January 3, 2022, 10 female and 15 male learners (excluding IP, Muslim, LWD
teaching personnel linked for specialized MHPSS, he was linked to a local psychologist. The conduct of PFA for January 3 was supported by funds from DRRMS. In the following week, on
learners (excluding IP, Muslim, LWD). This is in addition to the previous 10 female and 15 male learners provided with PFA last January 3, 2022. Another 3 female and 2 male LWDs were
health clinic, and a psychologist from their partner NGO. For the PFA Provision on January 6, fund support was provided by a partner organization, Save the Children.

School information MHPSS Basic Information

Were Basic Needs

Is access to Date of PFA No. of mobized
provided? (i.e.,
Region Division School ID School Name family/community Provision PFA Providers in
food, clothing,
support available? (MM/DD/YYYY) this date
shelter)

IV-B Palawan 110717 Barake Elementary School Yes No 01/03/2022 10

IV-B Palawan 110717 Barake Elementary School Yes Yes 01/06/2022 15
Prepared By

[Name and Signature]

Division School Health and Nutrition Personnel
 in the guidelines to drrmo+mhpss@deped.gov.ph with subject "[TY Odette PFA] Region Division_Date of Submission". For specialized MHPSS, please refer to DM-OUCI-2021-055. For weekly
e "N/A". Submitted reports shall be included in the daily Situation Report of DRRMS. If there are concerns regarding the fund support for PFA, kindly contact DepEd DRRMS immediately

rs (excluding IP, Muslim, LWD) were provided with PFA. On top of that, 2 female and 1 male learners with disabilities were also provided with PFA. 3 female and 1 male teaching personnel were provid
MS. In the following week, on January 6, 2022, PFA providers continued to serve learners and personnel from the same school. During that day, there were 15 PFA providers mobilized, enough to sup
male and 2 male LWDs were served on that day as well, unique from the previous 2 female and 1 male learner served the week before. For the LWD and teaching personnel linked for specialized, they
Children.

PFA Provision for Learners

Number of Learners provided with Number of Learners provided
Number of IP* Learners Provided Number of IP Learners linked for
School Level of PFA (Excluding IP, Muslim and linked for specialized MHPSS
with PFA specialized MHPSS
Learners LWD) (Excluding IP, Muslim and LWD)
Female Male Female Male Female Male Female Male
ES 10 15 0 1 0 0 0 0
ES 12 8 1 0 0 0 0 0
Noted By Approved By

[Name and Signature] [Name and Signature]

Division DRRM Coordinator Schools Division Superintendent
OUCI-2021-055. For weekly
RRMS immediately

ale teaching personnel were provided with PFA. For the 1 male
roviders mobilized, enough to support 12 female and 8 male
ersonnel linked for specialized, they were linked to a local mental

Data on PFA Provision

ion for Learners

Number of Muslim Learners Number of Muslim Learners linked Number of LWDs** provided with Number of LWDs linked for Number of Teaching Personnel
provided with PFA for specialized MHPSS PFA specialized MHPSS provided with PFA

Female Male Female Male Female Male Female Male Female

0 0 0 0 2 1 0 0 3
0 0 0 0 3 2 1 1 2
me and Signature]
ols Division Superintendent
 PFA Provision for Personnel
Number of Non-Teaching
mber of Teaching Personnel Number of Teaching Personnel Number of Non-Teaching
Personnel linked for specialized Where were learners/personnel linked?
provided with PFA linked for specialized MHPSS Personnel provided with PFA
MHPSS
Male Female Male Female Male Female Male
1 0 1 0 0 0 0 Local Psychologist
Local Mental Health Clinic,
1 0 0 0 0 0 0
Psychologist from NGO Partner
 Source of Fund for PFA Provision

If from DRRMS,
Source of Fund Date amount was If from DRRMS, With photo
Amount liquidated with certificate of If with Partner,
(e.g., DRRMS, RO, released Liquidated as of documentation Remarks
(PHP) liquidation name of Partner
Partner) (MM/DD/YYYY) (MM-DD) (YES/NO)
(YES/NO)

DRRMS 01/01/2022 10,000 01/02/2022 Yes N/A Yes

Partner 01/04/2022 10,000 N/A N/A Save the Children Yes