Professional Documents
Culture Documents
1st Quarter 2022 CBDRP-Reporting-Forms - Ifugao
1st Quarter 2022 CBDRP-Reporting-Forms - Ifugao
Please faithfully follow the following guidelines in filling-out the CBDRP Reporting Form 1
A. LGU
1. In Column C, kindly indicate your City/Municipality as the first entry, followed by your respective barangays.
2. Kindly indicate in Column D "1" if there is existing DOH-certified CBDRP and "0" if there is none.
3. If there are no surrenderers or if the LGU is drug-free or drug-cleared, please indicate "1" if there is a CBDRP Plan ready should the need arise, and "0" if there is non
Note: Please know that there is a separate CBDRP for City/Municipal and for Barangays. As per the JMC, all cities/municipalities should have
CBDRPs, while for barangays, it is optional, considering the need thereof and the capacity of the barangay. All CBDRPs should be certified by the
DOH as per DDB BR 4 2020 before implementation.
B. Participants
1. In Column F, kindly indicate the total no. of surrenderers for the quarter being covered
2. In Column G, kindly indicate the total no. of CBDRP participants that are new to the program
3. In Column H, kindly indicate the total no. of CBDRP participants that were once admitted to the program but stopped, then presented themselves again to continue
4. In Column I, kindly indicate the total no. of CBDRP participants who completed the program during the quarter being covered
C. Referral
1. In Column K, kindly indicate the total no. of clients with Low Risk and were referred to General Intervention
2. In Column L, kindly indicate the total no. of clients with Moderate Risk/MILD SUD and were referred to CBDRP
3. In Column M, kindly indicate the total no. of clients with Moderate SUD and were referred to out-patient facility/program
4. In Column N, kindly indicate the total no. of clients with Severe SUD and were referred to in-patient facility/program
4. In Column O, kindly indicate the total no. of clients with risk and co-occuring psychiatric/medical comorbidity and were referred to mental health facilty/medical pro
Note: The total number in column L should be the same with the sum of the total number in column G and H.
Note: The total number in column F should be the same with the sum of the total number in column K, L, M, N, and O.
D. CBDRP Interventions
1. In Columns Q-AA, kindly indicate "1" if the intervention is being implemented and "0" if there is no available intervention in the LGU
Note: Please do not encode the total no. of participants in each intervention, just kindly encode "1" if the intervention is available and "0" if not.
eed arise, and "0" if there is none.
Pa
With DOH
CITY/MUNICIPALITYMUNICIPALITY/BARANGAY certified
CBDRP? Total no. of
surrenderer
BANA BANAUE 0 0
1 BANA AMGANAD 0 0
2 BANA ANABA 0 0
3 BANA BANGAAN 0 0
4 BANA BATAD 0 0
5 BANA BOCOS 0 0
6 BANA BANAO 0 0
7 BANA CAMBULO 0 0
8 BANA DUCLIGAN 0 0
9 BANA GOHANG 0 0
10 BANA KINAKIN 0 0
11 BANA POBLACION 0 0
12 BANA POITAN 0 0
13 BANA SAN FERNANDO 0 0
14 BANA BALAWIS 0 0
15 BANA UHAJ 0 0
16 BANA TAM-AN 0 0
17 BANA VIEW POINT 0 0
18 BANA PULA 0 0
HUNGHUNGDUAN 0 0
1 HUNGABATAN 0 0
2 HUNGBANGBANG 0 0
3 HUNGMAGGOK 0 0
4 HUNGPOBLACION 0 0
5 HUNGBOKIAWAN 0 0
6 HUNGHAPAO 0 0
7 HUNGLUBO-ONG 0 0
8 HUNGNUNGULUNAN 0 0
9 HUNGBA-ANG 0 0
KIANGKIANGAN 0 0
1 KIANGAMBABAG 0 0
2 KIANGBAGUINGE 0 0
3 KIANGBOKIAWAN 0 0
4 KIANGDALLIGAN 0 0
5 KIANGDUIT 0 0
6 KIANGHUCAB 0 0
7 KIANGJULONGAN 0 0
8 KIANGLINGAY 0 0
9 KIANGMUNGAYANG 0 0
10 KIANGNAGACADAN 0 0
11 KIANGPINDONGAN 0 0
12 KIANGPOBLACION 0 0
13 KIANGTUPLAC 0 0
14 KIANGBOLOG 0 0
LAGAWE
LAGAWE (Capital) 1 7
1 LAGAWE
ABINUAN 0 0
2 LAGAWE
BANGA 0 0
3 LAGAWE
BOLIWONG 0 0
4 LAGAWE
BURNAY 0 1
5 LAGAWE
BUYABUYAN 0 0
6 LAGAWE
CABA 0 0
7 LAGAWE
CUDOG 1 1
8 LAGAWE
DULAO 0 0
9 LAGAWE
JUCBONG 0 0
10 LAGAWE
LUTA 0 0
11 LAGAWE
MONTABIONG 0 0
12 LAGAWE
OLILICON 0 0
13 LAGAWE
POBLACION SOUTH 0 0
14 LAGAWE
PONGHAL 0 0
15 LAGAWE
PULLAAN 0 0
16 LAGAWE
TUNGNGOD 0 0
17 LAGAWE
TUPAYA 0 0
18 LAGAWE
POBLACION EAST 0 1
19 LAGAWE
POBLACION NORTH 0 1
20 LAGAWE
POBLACION WEST 0 1
LAMUTLAMUT 0 0
1 LAMUTAMBASA 0 0
2 LAMUTHAPID 0 0
3 LAMUTLAWIG 0 0
4 LAMUTLUCBAN 0 0
5 LAMUTMABATOBATO (LAMUT) 0 0
6 LAMUTMAGULON 0 0
7 LAMUTNAYON 0 0
8 LAMUTPANOPDOPAN 0 0
9 LAMUTPAYAWAN 0 0
10 LAMUTPIEZA 0 0
11 LAMUTPOBLACION EAST 0 0
12 LAMUTPUGOL (IFUGAO RESERVATION) 0 0
13 LAMUTSALAMAGUE 0 0
14 LAMUTBIMPAL 0 0
15 LAMUTHOLLOWON 0 0
16 LAMUTPOBLACION WEST 0 0
17 LAMUTSANAFE 0 0
18 LAMUTUMILAG 0 0
MAYOMAYOYAO 0 0
1 MAYOADUYONGAN 0 0
2 MAYOALIMIT 0 0
3 MAYOAYANGAN 0 0
4 MAYOBALANGBANG 0 0
5 MAYOBANAO 0 0
6 MAYOBANHAL 0 0
7 MAYOBONGAN 0 0
8 MAYOBUNINAN 0 0
9 MAYOCHAYA 0 0
10 MAYOCHUMANG 0 0
11 MAYOGUINIHON 0 0
12 MAYOINWALOY 0 0
13 MAYOLANGAYAN 0 0
14 MAYOLIWO 0 0
15 MAYOMAGA 0 0
16 MAYOMAGULON 0 0
17 MAYOMAPAWOY 0 0
18 MAYOMAYOYAO PROPER 0 0
19 MAYOMONGOL 0 0
20 MAYONALBU 0 0
21 MAYONATTUM 0 0
22 MAYOPALAAD 0 0
23 MAYOPOBLACION 0 0
24 MAYOTALBOC 0 0
25 MAYOTULAED 0 0
26 MAYOBATO-ALATBANG 0 0
27 MAYOEPENG 0 0
AGUINAGUINALDO 0 0
1 AGUINAWAYAN 0 0
2 AGUINBUNHIAN 0 0
3 AGUINBUTAC 0 0
4 AGUINCHALALO 0 0
5 AGUINDAMAG 0 0
6 AGUINGALONOGON 0 0
7 AGUINHALAG 0 0
8 AGUINITAB 0 0
9 AGUINJACMAL 0 0
10 AGUINMAJLONG 0 0
11 AGUINMONGAYANG 0 0
12 AGUINPOSNAAN 0 0
13 AGUINTA-ANG 0 0
14 AGUINTALITE 0 0
15 AGUINUBAO 0 0
16 AGUINBUWAG 0 0
HINGYHINGYON 0 0
1 HINGYANAO 0 0
2 HINGYBANGTINON 0 0
3 HINGYBITU 0 0
4 HINGYCABABUYAN 0 0
5 HINGYMOMPOLIA 0 0
6 HINGYNAMULDITAN 0 0
7 HINGYO-ONG 0 0
8 HINGYPIWONG 0 0
9 HINGYPOBLACION (HINGYON) 0 0
10 HINGYUBUAG 0 0
11 HINGYUMALBONG 0 0
12 HINGYNORTHERN CABABUYAN 0 0
TINOCTINOC 0 0
1 TINOCAHIN 0 0
2 TINOCAP-APID 0 0
3 TINOCBINABLAYAN 0 0
4 TINOCDANGGO 0 0
5 TINOCEHEB 0 0
6 TINOCGUMHANG 0 0
7 TINOCIMPUGONG 0 0
8 TINOCLUHONG 0 0
9 TINOCTINOC 0 0
10 TINOCTUKUCAN 0 0
11 TINOCTULLUDAN 0 0
12 TINOCWANGWANG 0 0
ASIPUASIPULO 0 0
1 ASIPUAMDUNTOG 0 0
2 ASIPUANTIPOLO 0 0
3 ASIPUCAMANDAG 0 0
4 ASIPUCAWAYAN 0 0
5 ASIPUHALIAP 0 0
6 ASIPUNAMAL 0 0
7 ASIPUNUNGAWA 0 0
8 ASIPUPANUBTUBAN 0 0
9 ASIPUPULA 0 0
10 ASIPULIWON 0 0
Total 2 12
Participants Referral
Total no. of
Total no. of Total no. of Total no. of
Total no. of clients
readmitted Total no. of clients clients
new CBDRP referred to
CBDRP graduates referred to referred to in-
participants General
participants CBDRP patient facility
Interventions
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0 0 30 0 0 0
act Person on GS: RTA ADAC Jean C. Kimbes 0948-951-1518 / Statistician I Allan F. Ocal, 0966-140-3340 (Viber/Globe)
COMMUNITY-BASED DRUG REHABILITATION PROGRAM QUARTERLY REPORT
Province of Ifugao
Region CAR
1st Quarter 2022
Community-ba
eferral
Community-based Treatment
Community-based Support Service
Services
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12 0 7 8 1 14
Viber/Globe)
RLY REPORT
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7 3 8 7 4
Reintegration Services
Preventive Drug
Community Education,
service, Civic community-
and reconciliation
Environment sessions or
Awareness community
programs information
sessions
REMARKS
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total surrenderer 7 only 2 graduated from the
1 1 outpatient facility for the 1st quarter
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1 0
13 4
Accomplished By:
A. LGU
1. In Column C, kindly indicate your Province as the first entry, followed by your respective C/Ms.
2. Kindly indicate in Column D the total no. of brgy in each C/M
3. Kindly indicate in Column E the total no. of brgy in each C/M which have DOH Certified CBDRP
4. Kindly indicate in Column F "1" if there is existing DOH-certified CBDRP in the province/city/municipality and "0" if there is none.
5. If there are no surrenderers or if the LGU is drug-free or drug-cleared, please indicate "1" if there is a CBDRP Plan ready should the need arise, and "0" if there is non
Note: Please know that there is a separate CBDRP for City/Municipal and for Provinces. As per the JMC, all cities/municipalities should have
CBDRPs, while for provinces, it is optional, considering the need thereof and the capacity of the barangay. All CBDRPs should be certified by the
DOH as per DDB BR 4 2020 before implementation.
B. Participants
1. In Column H, kindly indicate the total no. of surrenderers for the quarter being covered
2. In Column I, kindly indicate the total no. of CBDRP participants that are new to the program
3. In Column J, kindly indicate the total no. of CBDRP participants that were once admitted to the program but stopped, then presented themselves again to continue
4. In Column K, kindly indicate the total no. of CBDRP participants who completed the program during the quarter being covered
Note: The total number in Columns H-K should reflect the total no. of surrenderers/participants from the City/Municipal and its Barangays from
CBDRP RF 1. For example, if there are 3 surrenderers from City 1, and 15 surrenderers from City 1's barangays, then the total no. of surrenderers
is 18 for City 1.
C. Referral
1. In Column M, kindly indicate the total no. of clients with Low Risk and were referred to General Intervention
2. In Column N, kindly indicate the total no. of clients with Moderate Risk/MILD SUD and were referred to CBDRP
3. In Column O, kindly indicate the total no. of clients with Moderate SUD and were referred to out-patient facility/program
4. In Column P, kindly indicate the total no. of clients with Severe SUD and were referred to in-patient facility/program
5. In Column Q, kindly indicate the total no. of clients with risk and co-occuring psychiatric/medical comorbidity and were referred to mental health facilty/medical pro
Note: The total number in column N should be the same with the sum of the total number in column I and J.
Note: The total number in column H should be the same with the sum of the total number in column M, N, O, P, and Q.
Column H = Column M + Column N + Column O
Total no. of Surrenderees (GI Participants) (CBDRP Participants) (Out-patient clients)
Note: The total number in Columns M-Q should reflect the total no. of clients from the City/Municipal and its Barangays from CBDRP RF 1. For
example, if there are 3 CBDRP clients in City 1, and 12 CBDRP clients from City 1's barangays, then the total no. of CBDRP clients is 15 for City 1.
D. CBDRP Interventions
1. In Columns S-AC, kindly indicate "1" if the intervention is being implemented and "0" if there is no available intervention in the LGU
Note: Please do not encode the total no. of participants in each intervention, just kindly encode "1" if the intervention is available and "0" if not.
Legend
= do not fill-out
ed arise, and "0" if there is none.
A. LGU
1. In Column C, kindly indicate the Provinces, HUCs and ICCs under your region
2. Kindly indicate in Column D the total no. of brgy
2. Kindly indicate in Column E the total no. of brgy which have DOH Certified CBDRP
2. Kindly indicate in Column F the total no. of city/municipality
2. Kindly indicate in Column G the total no. of C/M which have DOH Certified CBDRP
2. Kindly indicate in Column H "1" if there is existing DOH-certified CBDRP in the province and "0" if there is none.
3. If there are no surrenderers or if the LGU is drug-free or drug-cleared, please indicate "1" if there is a CBDRP Plan ready should the need arise, and "0" if there is non
Note: Please know that there is a separate CBDRP for City/Municipal and for Provinces. As per the JMC, all cities/municipalities should have
CBDRPs, while for provinces, it is optional, considering the need thereof and the capacity of the barangay. All CBDRPs should be certified by the
DOH as per DDB BR 4 2020 before implementation.
B. Participants
1. In Column J, kindly indicate the total no. of surrenderers for the quarter being covered
2. In Column K, kindly indicate the total no. of CBDRP participants that are new to the program
3. In Column L, kindly indicate the total no. of CBDRP participants that were once admitted to the program but stopped, then presented themselves again to continue
4. In Column M, kindly indicate the total no. of CBDRP participants who completed the program during the quarter being covered
te: The total number in Columns J-M should reflect the total no. of surrenderers/participants from the Barangay up to the Provincial level.
C. Referral
1. In Column O, kindly indicate the total no. of clients with Low Risk and were referred to General Intervention
2. In Column P, kindly indicate the total no. of clients with Moderate Risk/MILD SUD and were referred to CBDRP
3. In Column Q, kindly indicate the total no. of clients with Moderate SUD and were referred to out-patient facility/program
4. In Column R, kindly indicate the total no. of clients with Severe SUD and were referred to in-patient facility/program
4. In Column S, kindly indicate the total no. of clients with risk and co-occuring psychiatric/medical comorbidity and were referred to mental health facilty/medical pro
Note: The total number in column N should be the same with the sum of the total number in column I and J.
Note: The total number in column H should be the same with the sum of the total number in column O, P, Q, R and S.
Column J = Column O + Column P + Column Q
Total no. of Surrenderees (GI Participants) (CBDRP Participants) (Out-patient clients)
Note: The total number in Columns J-M should reflect the total no. of clients from the Barangay up to the Provincial level.
D. CBDRP Interventions
1. In Columns U-AE, kindly indicate "1" if the intervention is being implemented and "0" if there is no available intervention in the LGU
Note: Please do not encode the total no. of participants in each intervention, just kindly encode "1" if the intervention is available and "0" if not.
ed arise, and "0" if there is none.
No.
1 Province of Ifugao
2 AGUINALDO 16 0
3 ALFONSO LISTA (POTIA) 20 0
4 ASIPULO 10 0
5 BANAUE 18 0
6 HINGYON 12 0
7 HUNGDUAN 9 0
8 KIANGAN 14 0
9 LAGAWE (Capital) 20 1
10 LAMUT 18 0
11 MAYOYAO 27 0
12 TINOC 12 0
Total 176 1
Participants
With DOH
Total no. of
certified Total no. of
Total no. of clients
CBDRP? Total no. of readmitted Total no. of
new CBDRP referred to
surrenderer CBDRP graduates
participants General
participants
Interventions
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1 12 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 30 0
1 12 0 0 30 0
Contact Person on GS: RTA ADAC Jean C. Kimbes 0948-951-1518 / Statistician I Allan F. Ocal, 0966-140-3340 (Viber/Globe)
COMMUNITY-BASED DRUG REHABILITATION PROGRAM QUARTERLY REPORT
Province of Ifugao
Region CAR
1st Quarter 2022
Referral
Community-based Treatment
Services
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 12 0 1 1
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 12 0 1 1
66-140-3340 (Viber/Globe)
LY REPORT
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 1 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 1 1 1
gram Interventions
terventions Reintegration Services
Preventive Drug
Community Education,
Family
Relapse service, Civic community-
relationship
management and and reconciliation
restoration
early recovery Environment sessions or
sessions and
skills Awareness community
counselling
programs information
sessions
0 0 0 0
0 0 0 0
0 0 1 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1 1
0 0 0 0
1 1 1 1
0 0 0 0
0 0 0 0
0 0 0 0
1 1 3 3
REMARKS
Participants
11 1 0 12 0
11 1 0 12 0
Contact Person on GS: RTA ADAC Jean C. Kimbes 0948-951-1518 / Statistician I Allan F. Ocal, 0966-140-3340 (Viber/Globe)
COMMUNITY-BASED DRUG REHABILITATION PROGRAM QUARTER
Province of Ifugao
Region CAR
1st Quarter 2022
Participants Referral
0 30 0 0 0 12
0 30 0 0 0 12
Community-based Drug Re
Community-based Treatment
Community-based Support Services
Services
Total no. of
Medication- Health Services Spirituality Individual, Psychoeduca
clients
assisted and Wellness and moral Group and tion/
referred to
Treatment, Promotion recovery Family psychosocial
mental health
Detoxification Programs programs Counselling support
facility
0 0 0 0 0 0
0 0 0 0 0 0
ty-based Drug Rehabilitation Program Interventions
Aftercare Interventions Reintegration Services
0 0 0 0 0
0 0 0 0 0
gration Services
Preventive Drug
Education,
community-
reconciliation
sessions or
community
information
sessions
REMARKS
0
0