Professional Documents
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SDO DDO Contextualized CPP
SDO DDO Contextualized CPP
CONTEXTUALIZED
CPP-BASED
GUIDELINES
IN SAFEGUARDING
SCHOOL CHILDREN
Draft
For Finalization
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Contents
RATIONALE......................................................................................................................................1
I. POLICY STATEMENT............................................................................................................1
II. SCOPE OF THE POLICY...................................................................................................1
III. GUIDING PRINCIPLES......................................................................................................2
IV. DEFINITION OF TERM.....................................................................................................2
V. DUTIES AND COMMITMENTS OF THE SCHOOL ADMINISTRATOR,
FACULTY, NON-TEACHING PERSONNEL AND OTHER CONCERNED PEOPLE.....7
The Division Offices shall have the following duties and responsibilities:. 7
The School Heads shall have the following duties and responsibilities:.8
Duties and Responsibilities of School Personnel.........................................................9
Duties and Responsibilities of Pupils, Students and Learners...............................9
Establishment of Child Protection Committee...........................................................10
VI. PREVENTIVE MEASURES TO ADDRESS CHILD ABUSE, EXPLOITATION,
VIOLENCE, DISCRIMINATION AND BULLYING AND OTHER ACTS OF ABUSE. .11
Capacity Building of School Officials, Personnel, Parents and Students........11
VII. PROTECTIVE AND REMEDIAL MEASURES TO ADDRESS CHILD ABUSE,
EXPLOITATION, VIOLENCE, DISCRIMINATION, BULLYING AND OTHER ACTS
OF ABUSE.......................................................................................................................................12
VIII. RULES AND PROCEDURES IN HANDLING CHILD ABUSE,
EXPLOITATION, VIOLENCE AND DISCRIMINATION CASES......................................13
School Discipline Rules of Procedure.............................................................................13
Disciplinary Actions...............................................................................................................18
Rules and Procedures in Handling Child Abuse, Exploitation, Violence and
Discrimination Cases.............................................................................................................19
Public Schools.......................................................................................................................20
Private Schools.........................................................................................................................22
Complaint against school personnel or official......................................................22
IX. REFERRAL AND ASSESSSMENT OF VICTIMS AND OFFENDERS AND
OTHER CHILDREN......................................................................................................................22
X. MISCELLANEOUS PROVISIONS..................................................................................23
XI. DUTIES THAT STUDENTS MUST DO TO PROMOTE A SAFE AND
PROTECTIVE ENVIRONMENT IN THE SCHOOL THROUGH THE OBSERVANCE
OF THIS CODE OF CONDUCT AND OTHER SCHOOL POLICIES..............................24
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XII. SANCTION AND PENALTIES FOR VIOLATION OF THE CHILD
PROTECTION POLICY................................................................................................................24
Implementation of the Policy............................................................................................24
Review of the Child Protection Policy............................................................................25
Division Child Protection Committee.............................................................................25
Division Learner Rights Protection Desk Members..................................................25
References......................................................................................................................................26
APPENDICES..................................................................................................................................27
Appendix A Flow Chart....................................................................................................................27
Appendix B Intake Sheet..................................................................................................................28
Appendix C Profiling and Initial Risk Assessment Tools for Children-at-Risk....................................30
Appendix D Children in Conflict with the Law (CICL) Intake Form...................................................36
Appendix E REFERRAL FOR SERVICE................................................................................................38
Appendix F RESTORATIVE JUSTICE AGREEMENT FORM...................................................................40
School-Based Report on Incidents of Bullying.................................................................................41
School-Based Report on Incidents of Child Abuse...........................................................................42
CONSOLIDATED REPORT ON CASES OF CHILDREN-AT-RISK (CAR)...................................................43
SCHOOL-BASED CHILD PROTECTION/ANTI-BULLYING POLICY IMPLEMENTATION CHECKLIST........45
DIVISION CONSOLIDATED REPORT ON INCIDENTS OF BULLYING....................................................48
DIVISION CONSOLIDATED REPORT ON INCIDENTS OF CHILD ABUSE...............................................50
Division Consolidated Reports on the Submission of School-Based Child Protection or.................52
Anti-Bullying Policies (As of July 2014)............................................................................................52
DIVISION CONSOLIDATED REPORT ON CHILD-FRIENDLY SCHOOLS BASED ON CHECKLIST..............54
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SDO DAVAO DE ORO CONTEXTUALIZED CPP-BASED
GUIDELINES IN SAFEGUARDING SCHOOL CHILDREN
RATIONALE
Protecting children’s rights and their best interests is the priority of the
Department of Education to safeguard the child from all forms of abuse, violence,
and exploitation that may be perpetuated by adults or persons in authority. Thus,
guidelines for safeguarding school children are crafted as an essential tool to help
ensure the protection and safety of the children at school. The stipulated manuals
and policy shall empower and educate children about their rights, personal safe,
and steps they can do if there are problems.
Overall, SDO Davao de Oro shall declare a zero-tolerance policy for any act
of child abuse, exploitation, violence, discrimination, bullying, and other forms of
abuse.
I. POLICY STATEMENT
SDO-Davao de Oro firmly believes that all children have the right to be
protected from physical neglect and abuse, including sexual victimization, and from
emotional neglect and all forms of abuse, and children have potential and that
every child matters. Children are a top priority as they have a unique honesty and
willingness to exchange knowledge and ideas that can meaningfully build trust and
make a sustainable difference in the future worldwide.
The SDO-Davao de Oro affirms the position that all children have the right
to be protected from all forms of abuse as set out in UNCRC and ensures that a
child-safe environment is maintained within the school.
1. School heads/Administrator
2. Teaching Staff
3. Non-teaching Personnel
3.1 Librarian
3.2 Guidance Counselor
3.3 School Clerk
4. Parents, Guardians or Custodians
5. School Visitors or Guests
6. PTA officials
7. Security Guards
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8. School Maintenance
Child- refers to the person below 18 years of age, or those over but unable to
take care or protect themselves from abuse, neglect, cruelty, exploitation or
discrimination because of physical or mental disability or condition (RA
7610). The term also includes students who may be above 18 years old bur
are in school.
"Children in School" - refers to bona fide pupils, students or learners who
are enrolled in the basic education system, whether regular, irregular,
transferee or repeater, including those who have been temporarily out of
school, who are in the school or learning centers premises or participating in
school-sanctioned activities.
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"Pupil, Student or Learner" - means a child who regularly attends classes
in any level of the basic education system, under the supervision and
tutelage of a teacher or facilitator.
"School Visitor or Guest" - refers to any person who visits the school and
has any official business with the school, and any person who does not have
any official business but is found within the premises of the school. This
may include those who are within the school premises for certain reasons,
e.g. student teachers, catechists, service providers, suppliers, bidders,
parents and guardians of other children.
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- Unreasonable deprivation of the child’s basic needs of survival;
- Failure to give medical treatment to an injured student resulting to
serious impairment of his or her growth and development, or in his/her
permanent incapacity or death ( Sec 3 [b], RA 7610)
There are two (2) main forms of child exploitation that are recognized:
2. Sexual violence refers to acts that are sexual in nature. It includes, but is
not limited to:
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sexually suggestive remarks, physically attacking the sexual parts
of the victim's body;
c. Taking of property;
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Such violence may be in the form of mauling, hitting, punching,
kicking, throwing things at the student, pinching, spanking, or
other similar acts;
1. Blows such as, but not limited to, beating, kicking, hitting, slapping, or
lashing, of any part of a child's body, with or without the use of an
instrument such as, but not limited to a cane, broom, stick, whip or belt;
2. Striking of a child's face or head, such being declared as a "no contact
zone";
3. Pulling hair, shaking, twisting joints, cutting or piercing skin, dragging,
pushing or throwing of a child;
4. Forcing a child to perform physically painful or damaging acts such as,
but not limited to, holding a weight or weights for an extended period and
kneeling on stones, salt, pebbles or other objects;
5. Deprivation of a child's physical needs as a form of punishment;
6. Deliberate exposure to fire, ice, water, smoke, sunlight, rain, pepper,
alcohol, or forcing the child to swallow substances, dangerous chemicals,
and other materials that can cause discomfort or threaten the child's
health, safety
and sense of security such as, but not limited to bleach or insecticides,
excrement or urine;
7. Tying up a child;
8. Confinement, imprisonment or depriving the liberty of a child;
9. Verbal abuse or assaults, including intimidation or threat of bodily harm,
swearing or cursing, ridiculing or denigrating the child;
10.Forcing a child to wear a sign, to undress or disrobe, or to put on
anything that will make a child look or feel foolish, which belittles or
humiliates the child in front of others;
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11.Permanent confiscation of personal property of pupils, students or
learners, except when such pieces of property pose a danger to the child
or to others; and
12.Other analogous acts.
The Division Offices shall have the following duties and responsibilities:
a. Conduct the information-dissemination activities and in-service training for
teachers on the protection of children in school from abuse, violence,
exploitation, discrimination, bullying or peer abuse and other related cases;
c. Organize and conduct the capacity building activities for members of the
Child Protection Committee and Guidance Counselors/Teachers; including,
but not limited to the identification of students who may be suffering from
significant harm based on any physical, emotional or behavioral signs;
e. Consolidate the reports on incidents and cases of all schools and submit a
Division Report (Annex "A") to the Regional Office;
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g. Exercise disciplinary jurisdiction, where appropriate, pursuant to the
Revised Rules of Procedure of the Department of Education in
Administrative Cases and other existing laws, rules and regulations;
The School Heads shall have the following duties and responsibilities:
a. Ensure the institution of effective child protection policies and
procedures, and monitor compliance thereof;
b. Ensure that the school adopts a child protection policy;
c. Ensure that all pupils, students or learners, school personnel, parents,
guardians or custodians, and visitors and guests are made aware of child
protection policy (Annex "C").
d. Organize and convene the Child Protection Committee for the school;
e. Conduct the capacity building activities for the members of the Child
Protection Committee and Guidance Counselors/Teachers;
f. Conduct disciplinary proceedings in cases of offenses committed by
pupils, students or learners;
g. Ensure that the participatory and other rights of children are respected
and upheld in all matters and procedures affecting their welfare;
h. Maintain a record of all proceedings related to bullying or peer abuse and
submit after each school year to the Division Office the report and a copy
of the intake form (Annexes "A" & "B", respectively);
i. Conduct the appropriate training and capability-building activities on
child protection measures and protocols;
j. Ensure that the school adopts a student Code of Conduct to be followed
by every pupil, student or learner while on school grounds, or when
traveling to and from school, or during a school-sponsored activity, and
during lunch period, whether on or off campus;
k. Adopt such conflict resolution mechanisms that respect the rights of
indigenous peoples, provided that they conform to this Department Order
and they uphold the rights of the child;
l. Coordinate with the appropriate offices and other agency or
instrumentality for appropriate assistance and intervention, as may be
required in the performance of its functions;
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m. Coordinate with the Department of Social Welfare and Development or,
the appropriate government agencies or non-governmental organizations
on a Child Protection Hotline for reporting abuse, violence, exploitation,
discrimination, bullying and other similar
acts and for counseling;
n. Ensure that all incidents of abuse, violence, exploitation, discrimination,
bullying and other similar acts are addressed in accordance with the
provisions of this Department Order.
a. Exercise special parental authority and responsibility over the child while
under their supervision, instruction and custody. Authority and
responsibility shall apply to all authorized activities whether inside or
outside the premises of the school, entity or institution.
Articles 220 and 233 of the Family Code of the Philippines, Presidential
Decree No. 603, and other related laws enumerated the following duties and
responsibilities of the abovementioned persons and personnel over the
children under their supervision, instruction and custody:
b. Keep them in their company and support, educate and instruct them by
right precept and good example;
c. Give them love and affection, advice and counsel, companionship and
understanding;
d. Enhance, protect, preserve and maintain their physical and mental health at
all times;
e. Furnish them with good and wholesome educational materials, supervise
their activities, recreation and association with others, protect them from
bad company and prevent them from acquiring habits detrimental to their
health, studies and morals;
f. Represent them in all matters affecting their interests;
g. Inculcate the value of respect and obedience;
h. Practice positive and non-violent discipline, as may be required under the
circumstances; provided, that in no case shall corporal punishment be
inflicted upon them;
i. Perform such other duties as are imposed by law upon them, as substitute
parents or guardians; and
j. School personnel shall also strictly comply with the school's child protection
policy.
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A. Comply with the school's regulations, as long as they are in harmony with
their best interests. Pupils, students and learners shall refrain from:
An allegation that any of these acts has been committed shall not be used to
curtail the child's basic rights, or interpreted to defeat the objectives of this
Department Order.
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(3) years. The template for the school child protection policy is attached
as Annex "C";
2. Initiate information dissemination programs and organize activities for
the protection of children from abuse, exploitation, violence,
discrimination and bullying or peer
abuse;
3. Develop and implement a school-based referral and monitoring system.
The template for the referral system is attached as Annex "D";
4. Establish a system for identifying students who may be suffering from
significant harm based on any physical, emotional or behavioral signs;
5. Identify, refer and, if appropriate, report to the appropriate offices cases
involving child abuse, exploitation, violence, discrimination and bullying;
6. Give assistance to parents or guardians, whenever necessary in securing
expert guidance counseling from the appropriate offices or institutions;
7. Coordinate closely with the Women and Child Protection Desks of the
Philippine National Police (PNP), the Local Social Welfare and
Development Office (LSWDO), other government agencies, and non-
governmental organizations (NGOs), as may be appropriate;
8. Monitor the implementation of positive measures and effective
procedures in providing the necessary support for the child and for those
who care for the child; and
9. Ensure that the children's right to be heard are respected and upheld in
all matters and procedures affecting their welfare.
They shall use training modules which include positive and non-violent
discipline in classroom management, anger and stress management and gender
sensitivity. They shall likewise employ means which enhance the skills and
pedagogy in integrating and teaching children's rights in the classroom.
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2. Capacity-building programs for school administrators, teachers and non-
academic personnel focused on children's rights, child development and
positive and nonviolent approaches in teaching and classroom management,
to enable them to incorporate positive discipline messages in parent-teacher
conferences and family counseling, and integrate messages on children's
rights and corporal punishment in classroom discussions;
3. Encouraging and supporting the formation and initiatives of support groups
among teaching and non-teaching staff, and parents and caregivers;
4. Implementing specific parenting orientation sessions with parents and
caregivers and other activities;
5. Implementing school activities or events that raise awareness on children's
rights, corporal punishment and positive discipline, fostering the active
involvement of and providing venues for bringing together parents, families
and children;
6. Encouraging and supporting student-led initiatives to raise awareness on
children's rights, corporal punishment and positive discipline; and
7. Setting up child-friendly mechanisms for obtaining children's views and
participation in the formulation, monitoring and assessment of school rules
and policies related to student discipline.
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appropriate, the case shall be dealt with in accordance with the provisions of
Republic Act 9344 and its Implementing Rules and Regulations.
c. Procedure - In all cases where the imposable penalty on the offending child
is suspension, exclusion or expulsion, the following minimum requirements
of due process shall be complied with:
The committee shall have the following specific duties and responsibilities.
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He/she shall secure records with confidentiality.
He/she shall serve as mediator between the offender and the
aggrieved party.
He/she shall serve as liaison between the school and the parents or
guardians.
He/she shall write letters to call the attention of parents or guardians
to invite for a conference.
Prepare the anecdotal report and safeguard confidentiality.
A.3 Referral
All cases beyond the control and expertise of School Discipline Committee
shall be referred to the following offices and furnish copy of referral form
attached with anecdotal report and other supporting documents for more
extensive supervision and control.
A.4 Jurisprudence.
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expected to refer the case to the School Discipline Committee. They shall call
the attention of parents or guardians for a short conference and prepare the
anecdotal report. When the parties involved are between and/or among
different year levels, the jurisdiction of school discipline officer shall be
based on the year level of the primary offender. The Child Protection
Committee (CPC) shall handle all sensitive cases and when the parties
involved are between or among students and teaching and/or non-teaching
staff.
A student who incurs absences of more than twenty percent (20%) of the
prescribed number of class or laboratory periods during the school year or
term should be given a failing grade and given no credits for the course or
subject. However, the learner will have a passing mark if he/she will comply
the necessary requirements as stated in the intervention plan instituted by
the School Administration/School Head. Provided further, the school head
may at his/her discretion may exempt a learner who exceeds the twenty
percent limit for reasons considered valid and acceptable to the school. Such
discretion shall not excuse the student concerned from responsibility in
keeping up with lesson assignments and taking examinations where
indicated. The discretionary authority is vested in the school head and may
not be availed of by a student nor granted by a faculty member without the
consent of the school head.
Habitual tardiness especially during the first period in the morning and in
the afternoon shall not be allowed. Teachers concerned shall call for the
parents of the student concerned or visit him/her at home.
A school uniform shall be prescribed for all learner “AS PER AGREEMENT”
by parents, teachers, and other stakeholders.
The uniform for male learners: polo/shirt with school logo; shorts or pants;
shoes with socks.
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The uniform for female learners: blouse/shirt with sports collar and school
logo; skirt length shall be knee level or below and shoes with socks.
All learners shall be required to wear the official school ID in the school
campus.
The acceptable haircut for male learners shall be at least one (1) inch above
the ear and three (3) inches above the collar line. And other hairstyle that
would show his ears and face.
Gross misconduct
Cheating, stealing, and selling stolen goods in school
Assaulting or making a threat to assault a teacher or any other school
authority or his agents or students
Rizzing (an ability to charm or woo a person) towards all or any school
personnel
Exhibitionism, immoral acts and other similar sexual acts but not
limited to kissing, necking, petting and fondling
Smoking/Vaping inside the school premises
Vandalism, writing on or destroying school property like chairs,
tables, windows, books, laboratory equipment and others
Gambling of any sort
Drinking and bringing intoxicants and liquor and entering to
school/class under the influence of any alcoholic beverages and
substance
Carrying and concealing deadly weapons
Extortion or asking money from others
Fighting and conspiring to cause injury to others
Using, possessing of paraphernalia, and selling of prohibited drugs
Use and possession of any improvise equipment’s for tattooing
Hazing in any form or manner whether inside or outside the school
premises
Membership and involvement of unauthorize groups or organization
but not limited to gangsterism
Instigating, leading or participating in concerned activities leading to
stoppage of classes
Preventing, threatening students or faculty members or school
authorities from discharging their duties or from attending classes or
entering school premises
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Forging or tampering with school records or transfer forms
Using, possessing, and sharing of pornographic materials
Unauthorized representation of person in authority
Bullying of any forms and cyber libel
Driving without license
Jumping over the fence
Video recording or taking pictures of school personnel or learners
without consent
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Not giving letter to parents
In the exercise of discretion given to the school head, all submitted reports
and recommendations by the various levels of officers (guidance
counselor/advocate, and school discipline committee) shall be considered
supportive and guidelines for proper basis of judgment, fair and just
decision.
Disciplinary Actions
Practice positive and non-violent discipline as may be required under the
circumstances, provided, that in no case shall corporal punishment be
inflicted upon them.
Think about all the possible reasons for the student’s behavior. Consider
the child’s stage of development and individuality. List as many reasons
as you can why a child would behave this way and then think about
which of those reasons might explain this child`s behavior in this
situation.
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Remember your long-term goals. Think about the characteristics that
you hope your students will develop. What kind of long-term impacts do
you hope to have on your students?
Provide warmth. Think about how you can ensure that the student feels
safe and respected as you solve this problem. What are some ways that
you could provide warmth or support?
Provide structure. Think of what the student needs to understand about
the situation and how you will engage him or her in finding solutions to
the problem. What are some ways that you could provide guidance and
information?
Respond with positive discipline. Once you have thought through the
problem, you can now respond in a positive way to resolve it. Involve the
student in thinking about and finding solutions to challenges and
difficulties.
Note:
Suspension from school shall not exceed three (3) days and may be
authorized by the school head without the approval of the Division
Superintendent. However, parents must be informed by the teacher or the
school head of any misconduct on the part of their children for which
disciplinary action is necessary. The respondent shall be liable for any actual
damages the aggrieved party incurred. Decision or resolution of the
committee shall be deemed final and executory without prejudice to the filing
of a separate action (civil or criminal). The filing of protest to the SDS shall
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stay the imposition of the penalty executed by the school head until
resolved.
1. Child abuse;
3. Child Exploitation ;
5. Corporal Punishment;
Public Schools
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complaint. Upon the filing of the formal complaint, the same shall be acted
upon pursuant to the preceding paragraphs.
If a prima facie case exists based on the Investigation Report and the
records, a Formal Charge shall be issued by the Disciplining Authority,
which may be the basis for the issuance of an Order of Preventive
Suspension or as an alternative, reassignment of the offending party, as
may be warranted. The respondent may be placed under preventive
suspension pending investigation, for a period of ninety (90) days, if the
injury or abuse committed against a child is so grave, as to render the child
unable to attend his or her classes. The respondent may also be preventively
suspended to preclude the possibility of influencing or intimidating
witnesses.
The respondent may file a Motion for Reconsideration with the Disciplining
Authority or may elevate the same to the Civil Service Commission by way of
an Appeal within fifteen (15) days from receipt thereof.
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than three (3) days from receipt of the notice, furnishing the
complainant a copy thereof, otherwise the Counter-Affidavit or
Comment shall be considered as not filed.
f. The Regional Directors shall periodically monitor and keep a record of all
reported child abuse cases, and submit a final consolidated regional report
to the Office of the Undersecretary for Legal and Legislative Affairs and the
Undersecretary for Regional Operations.
h. The Office of the Undersecretary for Legal and Legislative Affairs shall
compile the regional reports and submit an annual report to the Secretary.
On the other hand, the Magna Carta for Public School Teachers protects
the rights of teachers and no publicity shall be given to any disciplinary
action against a teacher during the pendency of his or her case.
Criminal and Civil Liability. Criminal and civil liability arising from
child abuse, discrimination, exploitation, and other acts of abuse are
separate and distinct, and shall not be a bar to the filing of an
administrative case under these guidelines.
Private Schools
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Complaint against school personnel or official. A complaint for child
abuse, violence, exploitation or discrimination in a private school shall be
filed with the School Head/Chief Executive Officer and shall be acted
upon pursuant to the school's rules of procedures on administrative cases.
The penalty shall be that which is provided by the rules of the school,
subject to the requirements of due process. The administrative case shall be
without prejudice to any civil or criminal case that may be filed.
The private school shall submit the report (Annex"A") to the Division Office
after each school year.
The School Head may also refer to the LSWDO other pupils, students or
learners who are victims of abuse at home, children at risk, children in
especially difficult circumstances, children with special needs or at risk,
children facing difficult situations, or those who are exhibiting signs of
aggressive behavior, with a view to obtaining professional assessment,
appropriate interventions and assistance from competent service providers.
X. MISCELLANEOUS PROVISIONS
Separability Clause
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Any part or provision of this Department Order which may be held invalid or
unconstitutional shall not affect the validity and effectivity of the other
provisions.
Repealing Clause
Mandatory Reporting
The CPC will not dismiss a child’s accusation of abuse without thorough and
appropriate investigation no matter who the alleged perpetrator is.
Reporting Procedures
Confidentiality
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Be sensitive with the feelings of others;
Use free time productively;
Maintain personal hygiene and grooming;
Cooperate and participate in class activities;
Respect the rights of other students
Be responsible enough to their actions and make good decisions.
Loving to their teachers, co-students and to the environments.
Mutual respect and cooperation.
Be reasonable and can accept failures
If a prima facie case exists based on the Investigation Report and the
Records, a formal charge shall be issued by the disciplining authority, which
may be the basis for the issuance of an order of preventive suspension or as
an alternative, reassignment of the offending party, as maybe warranted. The
respondent maybe placed under preventive suspension pending
investigation, for a period of ninety (90) days, if the injury or abuse
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committed against a child is so grave, as to render the child unable to attend
his or her classes. The respondent may also be preventively suspended to
preclude the possibility of influencing or intimidating witnesses.
The respondent may file a Motion for Reconsideration with the disciplining
authority or may elevate the same to the Civil Service Commission, by way of
an appeal within 15 days from the receipt thereof.
Members:
Members:
Guidance Counselor
Guidance Coordinator
Legal Assistant
Student Representative - SSLG President
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References
1. DECS Manual
2. DepEd Order No. 40 series 2012
3. United Nations Convention on the Rights of the Child
(UNCRC)
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APPENDICES
Enclosure A-1
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Appendix B Intake Sheet
Department of Education
INTAKE SHEET
I. INFORMATION:
A. VICTIM:
Name: _____________________________________________
Date of Birth: __________________________ Age: __________ Sex: ___________
Gr. /Yr. and Section: __________________ Adviser: ____________
Parents:
Mother: _______________________ Age: _______
Occupation: ____________________
Address: _______________________
Father: ________________________ Age: _______
Occupation: ____________________
Address and Contact Number:
__________________________________________________
___________________________________________________________________________
___________________________________________________________________________
B. COMPLAINANT:
Name: ____________________________________________________
Relationship to Victim: ___________________________________
Address and Contact Number:
_________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
C. RESPONDENT:
C-1. If respondent is a School Personnel
Name: _____________________________________________________
Date of Birth: ___________________________ Age: ________________ Sex:
________________
Designation/Position: __________________________________
Address and Contact Number:
__________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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C-2. If respondent is a Student
Name: ________________________________________________
Date of Birth: __________________________ Age: _____________ Sex: _____________
Gr. /Yr. and Section: ____________________ Adviser: ______________
Parents/Guardian:
Mother: ______________________________ Age: __________
Occupation: ______________________
Address and Contact Number: _____________________________________________
___________________________________________________________________________
___________________________________________________________________________
Father: ______________________________ Age: __________
Occupation: ___________________________
Address and Contact Number:____________________________________________
___________________________________________________________________________
___________________________________________________________________________
II. DETAILS OF THE CASE:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
III. ACTION TAKEN:
1.
2.
3.
IV. RECOMMENDATIONS:
1.
2.
3.
Prepared By:
_____________________________
Name over Printed Name
_____________________________
Designation
_____________________________
Date
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Appendix C Profiling and Initial Risk Assessment Tools for Children-at-Risk
PART I:
This form will help the guidance teacher or guidance counselor quickly note down
risk factors that make the child vulnerable to coming into conflict with the law. A
check mark on those items in red/bold font require immediate referral of the child
to the LSWDO, DSWD or licensed child-caring agencies and NGOs for further
assessment and treatment or intervention planning.
A mark on the other items or factors, other than those in red, require further
investigation or data gathering on the part of the school CPC before referral is made
to the LSWDO or DSWD.
Initial assessment made using this form will not substitute for the professional
assessment and judgment of a licensed counselor, licensed child psychologist and
licensed social worker.
Name:
____________________________________________________________________________
Age: ________________ Date of Birth:
________________________
Sex: ________________
Address:
__________________________________________________________________________
In School? ____ Yes; Grade/Year Level: ____________
____ No; Highest grade/year level finished: _________________
Caregivers: ____ Father only ____ Mother only ____ Father and Mother
____ Others(indicate relationship to child):
_________________________________
Caregiver’s source of income/employment and monthly income:
_____________________________
No. of Siblings: _________ No. of Siblings below 18 yrs. Old: _______________
Ordinal Position: ___________
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II. Individual factors:
Types of offenses committed (Mark with X and indicate how many times reported
for every type of offense committed)
_______________ Theft
_______________ Robbery
_______________ Physical injuries
_______________ Sexual harassment
_______________ Rape
_______________ Homicide
_______________ Murder
_______________ Drug-related offense
_______________ Other offenses punished under penal laws (please indicate)
Family/community factors:
_____ Child is a victim of abuse, identity ________________ (sexual, physical,
emotional, verbal)
_____ Child is a victim of neglect
_____ Child has no parents or no adult guardian in the household
_____ History of parental criminal behavior
_____ History of sibling’s criminal behavior
_____ Witness to family/domestic violence
_____ Parent substance abuse
_____ Homeless
_____ Abandoned
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_____ Witness to community violence
_____ Presence of support system (family, community, church, school)
School behavior
_____ Child is behaving well in school
_____ Child is a victim of bullying in school
_____ Child has been observed to have moderate behavior problems in school
_____ Child had severe problems with behavior in school. Child has been reported
for bullying in school.
Seriousness
_____ Youth has engaged only in status violations or violations of local ordinances
_____ Youth has engaged in criminal behavior
_____ Youth has engaged in criminal behavior that places other citizens at risk of
significant physical harm
Peer Influences
_____ Youth’s primary peer social network does not engage in delinquent behavior
_____ Youth predominantly has peers who engage in delinquent behavior
_____ Youth’s primary peer social network are known to engage in criminal behavior
_________________________________
Indicators were based on the Juvenile Justice Module of the Child and Adolescent Needs and
Strengths Manual. Preda Foundation (1999)
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Enclosure A-2
PART II:
The table below further provides a non-exhaustive list of examples of
evidence which would suggest that a student has met the threshold for an
immediate referral to the proper authorities (LSWDO, Licensed SW of accredited
and duly-licensed child caring agency, or to the DSWD CIU) or whether there is still
a need for further investigation or data gathering on the allegations before referrals
are made.
Initial assessment made using this form will not substitute for the
professional assessment and judgment of a licensed counselor, licensed
child psychologist and licensed social worker.
The child has been traumatized, injured Allegation concerning verbal threats
or neglected as a result of domestic
violence
Allegations of emotional abuse including
Repeated allegations involving serious that caused by minor domestic violence
verbal threats and/or emotional abuse
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Allegations/reasonable suspicions of Allegations of periodic neglect including
serious neglect insufficient supervision; poor hygiene; clothing
or nutrition; failure to seek/attend treatments
or appointments; young carers undertaking
intimate personal care.
Direct allegation of sexual abuse made by Suspicions of sexual abuse (e.g. medical
child or abuser’s confession to such concerns, sexualized behavior, or referral
abuse by concerned relative, neighbor and
Any allegation suggesting connections caregiver)
between sexually abused children in
different families or more than one
abuser.
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Pregnancy in a child
____________________________________ _________________________
Name and Signature Designation
Noted By:
____________________________________ _________________________
Name and Signature Designation
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Enclosure A-3
Appendix D Children in Conflict with the Law (CICL) Intake Form
I. Identifying Information
Name: _____________________________________________________________
Nickname: __________________
Age: ___________ Sex: _________________
Date of Birth: _____________________
Place of Birth: _____________________
Address: ____________________________________________________________
Grade/Year Level & Section: ____________________________________________
Class Adviser: ________________________________________________________
Parents/Guardian Information:
Parents/Guardian: ____________________________________________________
Address: ____________________________________________________________
Contact No’s: ________________________________________________________
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III. Actions Taken, if any
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
IV. Disposition:
Released to:
Parents
Guardian
Relative/s Name: ___________________________ Contact No: __________________
____________________________________
Name and Signature of Receiving Copy
Address: ________________________________________________
Prepared by:
________________________________ _________________________
Name and Signature Designation
Noted by:
________________________________ _________________________
Name and Signature Designation
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Enclosure A-4
Appendix E REFERRAL FOR SERVICE
To: _______________________________________________________________________________
Address: __________________________________________________________________________
Please refer to attached report/ intake form /case summary for more information.
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Feedback is requested. Please send to:
Referred by:
____________________________________ ______________________________
Signature over Printed Name Designation
____________________________________
Date Accomplished
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Enclosure A-5
Appendix F RESTORATIVE JUSTICE AGREEMENT FORM
For the best interest of (name of offender) and the school/community, the following shall be
undertaken:
__________________________________________________________________________________________
__________________________________________________________________________
For the social worker or Local Social Welfare and Development Officer (LSWDO):
__________________________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________________
Prepared by:
_____________________________________
Guidance Counselor/RJP Secretary
Conformed:
Noted by:
________________________________
Principal/RJP Chairperson
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Enclosure A-6
Note: Bullying is perpetrated by a student against another student which may be:
Physical-unwanted physical contact (punching, shoving, pushing, kicking, slapping, tickling, headlocks, etc.)
Social-refers to any deliberate, repetitive and aggressive social behavior intended to hurt or belittle an individual (name-calling, cursing, labelling, etc.)
Gender-based – refers to any act that humiliates or excludes a person on the basis of perceived or actual sexual orientation and gender identity.
Cyber Bullying – any bullying done through the use of technology or any electronic means (texting, email, chatting, online games, etc.)
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Enclosure A-7
School-Based Report on Incidents of Child Abuse
School Year: _____________
TOTAL
Note:
Child Abuse refers to the maltreatment of a child, whether habitual or not, which includes any of the following:
Physical-refers to acts that inflict bodily harm and which subjects children to perform tasks which are hazardous to their physical well-being;
Sexual-refers to acts that are sexual in nature such as rape, sexual harassment, sexually demeaning remarks, forcing children to watch obscene publications or
shows, etc.; and
Psychological – refers to acts or omissions causing or likely to cause mental or emotional suffering to the child which include intimidation, harassment, stalking,
public ridicule, threat of deduction from grade or merit as a form of punishment, and repeated verbal abuse.
- Relationship to the victim refers to relatives (father, mother, cousin, etc.) or school personnel (teachers and non-teaching staff)
- No amicable settlement for any acts of child abuse
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Enclosure A-8
School/Division/Region: _________________________________
Period Covered: _________________________________
I. CHILDREN-AT-RISK (CAR)
No. of Students
Classification Action Taken Remarks
Male Female
1. Victim of Abuse (sexual, physical,
psychological, mental, economic,
and other mean)
2. Victim of Neglect
3. Coming from a dysfunctional
family or without parent or guardian
4. Being member of a gang
5. Living in a community with a
higher level of criminality
6. Living in a situation of armed
conflict
7. Committed a status Offense
under Section 57 of RA 9344, as
amended
8. Prostituted Children
9. Mendicant under PD 1563
10. Solvent/Rugby User
11. Others
II. Description of action taken by the school or division to alleviate the risk factors of the CAR:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
________________________ ____________________________________
Designation Principal/Superintendent/Regional Director
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Enclosure A-9
School/Division/Region: __________________________________
Period Covered: ________________________________________
B. Description of any intervention program or diversion program that the school or division initiated or adapted which facilitated the reintegration of the
CICL in the school and community
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________ _______________________________________
Designation Principal/Superintendent/Regional Director
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Enclosure A-10
Instruction: This checklist is designed to monitor and evaluate the compliance of the school in the
implementation of DepEd Order No. 40, s. 2012 and DepEd Order No. 55, s. 2013
Findings will be based simply on the presence or absence of the requirement as stated in each item
and shall be the basis for a plan of action by the school and the Schools Division Office.
P A
1. The school has a written school-based child protection and/or anti-bullying
policies
2. There is a code of conduct incorporated in the school-based child protection
or anti-bullying policy for the following:
a) b) Students
c) d) School Administrators
e) f) Non-Teaching Personnel (guards, maintenance, etc.)
g) h) Teachers
i) j) Visitors (Parents, Alumni, etc.)
k) l) Off-Campus activities such as field trips, camping’s, etc.
3. The code of conduct has specific provisions to address potential risks to
students such as:
a) b) Disregarding abusive situation or behavior against
children;
c) d) Employing children as house helper or asking students to
care for teacher’s children while in school;
e) f) Relating with children in private for personal matters like
student-teacher as “text mates” or Facebook friends;
g) h) Going out with students after school such as watching
movies;
i) j) Using green jokes or jokes with double meaning in the
class; and
k) l) Cultural beliefs (marrying children because it is acceptable
based on one’s culture/religion, amicable settlement on
child abuse cases)
4. Promotion or information dissemination of the school-based child protection
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and/or anti-bullying policies is done during school opening for:
a) b) Students
c) d) Teachers
e) f) Non-Teaching Personnel
g) h) Parents
5. There are written procedures to guide in conducting disciplinary proceedings
in cases of offenses committed by pupils, students, or learners.
6. The School has adopted a conflict resolution mechanism that respects the
rights of indigenous peoples, provided that they conform to child’s rights and
the Department issuances on child protection.
7. There is an established system for identifying students who may be suffering
from significant harm based on physical, emotional, or behavioral signs.
8. Has developed and implemented a school-based referral and monitoring
system to address child abuse and bullying cases.
9. There is an existing record of all proceedings related to bullying and child
abuse cases using the Intake Sheet (Annex B of DO 40, s. 2012 or Appendix B
of DO 18, s. 2015) as appropriate.
10. Records related to complex cases of child abuse and bullying using the Intake
Sheets (Annex A of DO 40, s. 2012 or Appendix B of DO 18, s. 2015) are well-
kept and separate from simple cases.
11. The school has submitted its consolidated reports on bullying and child abuse
cases to the Division Office a week after the opening of each school year.
12. Has mapped out available resources in their community for possible linkages
or networking for cases needing referrals, etc.
13. Has an active coordination with WPCD, DSWD, and other government and
Non-Government Organizations (NGO).
14. Has a clear policy on the use of positive and non-violent discipline for
children.
15. There is an organized Child Protection Committee (CPC) in the school.
16. There is an annual capacity building activities for the members of the CPC:
a) b) Guidance Counselor/Designated Guidance Teacher
c) d) Representative of the Students
e) f) Representative of the Parents
g) h) Representative of the Barangay
i) j) Representative of the Teachers
17. The CPC is meeting regularly to discuss appropriate interventions and/or
responses to school problems on bullying and child abuse cases and other
concerns.
18. The school with its CPC has initiated information dissemination programs and
organized activities for the protection of children from abuse, exploitation,
violence, harm, and bullying.
19. There is a strong student participation in the promotion of child protection
and anti-bullying policies of the school.
20. There is a feedback mechanism in the school to monitor the implementation
of the Child Protection and/or Anti-Bullying policies.
Respectfully Submitted:
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_________________________________________________
Signature above Printed Name of School Head
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Enclosure B-1
Division: __________________
Total Number of Public Schools: ________ Total Number of Private Schools: ________
Elementary: ________ Elementary: _________
Secondary: _________ Secondary: __________
Total: ________ Total: ________
Sub-Total
(Public Elementary):
B. Secondary
1.
2.
Sub-Total
(Public Secondary)
II. Private
A. Kindergarten
1.
2.
Sub-Total
(Private Kindergarten)
B. Elementary
1.
2.
Sub-Total
(Private Elementary)
C. Secondary
1.
2.
Sub-Total
(Private Secondary)
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Total:
Note: Bullying is perpetrated by a student against another student, which may be:
Physical-unwanted physical contact (punching, shoving, pushing, kicking, slapping, tickling, headlocks, etc.)
Social-refers to any deliberate, repetitive and aggressive Social behavior intended to hurt or belittle an
individual (name-calling, cursing, labelling, etc.)
Gender-Based – refers to any act that humiliates or excludes a person on the basis of perceived or actual
sexual orientation and gender identity.
Cyber Bullying-any bullying done through the use of technology or any electronic means (texting, email,
chatting, online games, etc.).
____________________________ _______________________________
Name and Designation Name and Designation
____________________________ _______________________________
Date Date
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Enclosure B-2
Division: __________________
Total Number of Public Schools: ________ Total Number of Private Schools: ________
Elementary: ________ Elementary: _________
Secondary: _________ Secondary: __________
Total: ________ Total: ________
Sub-Total
(Public Elementary)
B. Secondary
1.
2.
Sub-Total
(Public Secondary)
II. Private
A. Kindergarten
1.
2.
Sub-Total
(Private Kindergarten)
B. Elementary
1.
2.
Sub-Total
(Private Elementary)
C. Secondary
1.
2.
Sub-Total
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(Private Secondary)
Total:
Note:
Child Abuse refers to the maltreatment of a child, whether habitual or not, which includes any of the following:
Physical-refers to acts that inflict bodily harm and which subjects children to perform tasks which are
hazardous to their physical well-being;
Sexual-refers to acts that are sexual in nature such as rape, sexual harassment, sexually demeaning remarks,
forcing children to watch obscene publications or shows, etc.; and
Psychological – refers to acts or omissions causing or likely to cause mental or emotional suffering to the
child which include intimidation, harassment, stalking, public ridicule, threat of deduction from grade or
merit as a form of punishment, and repeated verbal abuse.
- Relationship to the victim refers to relatives (father, mother, cousin, etc.) or school personnel (teachers and
non-teaching staff)
- No amicable settlement for any acts of child abuse
_________________________________ ___________________________________
Name and Designation Name and Designation
_________________________________ ___________________________________
Date Date
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Enclosure B-3
Division: __________________
Total Number of Public Schools: ________ Total Number of Private Schools: ________
Elementary: ________ Elementary: _________
Secondary: _________ Secondary: __________
Total: ________ Total: ________
Policy Submitted
School-Based
School-Based
Child Protection Anti-
Name of School School I.D. Child Protection
Policy without bullying
Policy with Anti-
Anti-bullying Policy Only
Bullying Policy
Policy
I. Public
A. Public
1.
Instruction:
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1. * Put a check (√) on the kink pf policy the school has submitted. Choose one.
2. Get the total no. of policy submitted per category. (Ex. Total No. of School Base-Based Protection with Anti-
Bullying Policy submitted by Public Elem.)
Prepared by:
______________________________
Designation
______________________________
Date
_______________________________
Designation
_______________________________
Date
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Enclosure B-4
Division: _____________________
School Year: ____________________
Date of Submission: _______________________
Submitted by:
________________________________
Signature over Printed Name
________________________________
Designation
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