Form 03 SWHM Checklist (Controlled)

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Republic of the Philippines

Department of Education
Region IX – Zamboanga Peninsula
SCHOOLS DIVISION OF DIPOLOG CITY
SCHOOL WATCHING AND HAZARD MAPPING CHECKLIST
(DepEd Order No. 23, series of 2015)

Date Conducted: ______________________


School Profile
Region
Division
Name of School
School ID
School Address

Learner engagement is an important factor in mainstreaming DRRM. The ability to identify hazards
at the school environment will allow students to understand possible threats to their safety. Because of this,
schools should annually conduct student-led school watching as well as update the school hazard map.
Providing learners with information on DRRM during classroom instructions may be complemented
with practical steps in applying their knowledge. The checklist below can be used by the school in guiding
learners to identify safe and unsafe areas within the facility’s perimeter.

No. of No. of
No. Description/Specifications Yes No Rooms Buildings Remarks
1. Broken Windows
2. Slippery Pathways
3. Blocked Corridors
4. Heavy objects mounted on
cabinets/shelves
5. Flooded area
6. Busted plugs/light bulbs/electrical
facilities
7. Exposed electrical wires
8. Protruding nails from chairs and
tables
9. Broken doorknobs
10. Warning signs for slippery
pathways/corridors
11. Plants mounted on building railings
12. Flooding
13. Exposed chemicals and liquids
14. Lack/absence of storage for
equipment
15. Unlabeled chemicals
16. Dripping ceilings
17. Open pit
18. Stagnant water
19. Unpruned trees/bushes/shrubs
20. Open/Clogged canals

Form 03, SGOD-DRRM-01, Rev. 0, Effective 04/18/2022


No. of No. of
No. Description/Specifications Yes No Rooms Buildings Remarks
21. No ramps for elevated school
buildings or other facilities
22. Swing-in doors
23. Broken/dilapidated ceiling
24. Open/incomplete perimeter fence
25. Presence of stray animals inside the
school campus
26. Presence of electrical
post/transformer near or within the
school perimeter
27. No system of learner release to
parents during emergencies
28. No posted emergency hotlines around
the school
29. Garbage Area (Segregation of
Biodegradable and Non-
Biodegradable)
30. Detached or peeled off GI sheet
31. Broken toilet bowl and/or sinks
32. Broken chairs/desks/tables
33. Blocked/no emergency exits
34. Unmounted cabinets/shelves
35. Medical kits in every classroom
36. Bells/alarms
37. Condemnable building (i.e. very old
structure, collapsing building and/or
38. Enumerate other items as applicable
(additional sheets may be added):

Note: School & Community Hazard Map shall be attached to this form

Other remarks on premises/structures/facilities:

Prepared by: Checked and Noted by:

(Name and Signature) (Name and Signature)

SDRRM Coordinator School Head/Principal

Form 03, SGOD-DRRM-01, Rev. 0, Effective 04/18/2022

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