Department of Education

Region NO. VIII

Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

CANTEEN EVALUATION CHECKLIST 2

Display of System
Nutritious Food Cleanliness of Trash Can
Name of School Area (Segregated)
5-10 Variety
Cooperative Arcabala
30 10 5 10 5
epartment of Education
Region NO. VIII
Ormoc City Division
RMOC CITY DISTRICT VI
Ormoc City

ALUATION CHECKLIST 2018

Building 40% Share Proper Attire

Structuring Feeding / TOTAL
Structure (Apron, hairnet)
Medicines

10 15 10 10 100

Evaluator:
 Department of Education
Region NO. VIII
Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

CLINIC EVALUATION CHECKLIST 2

STRUCTURING (40 pts)

Height Trash Can Basin

Name of School /
Medicine Medicine Treatment Weighing
Bed Soap /
Cabinet Area Scale Stand Towel

5 5 5 10 5 3 2 3

Evaluator:
 epartment of Education
Region NO. VIII
Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

UATION CHECKLIST 2018

FUNCTIONALITY & Recording (50 pts)

Record of BP CLEANLINESS TOTAL

Foot Daily Records Nutritional Health
Scaper Treatmen of Status Assessment
t Teacher
2 15 10 10 15 10 100
 Department of Education
Region NO. VIII
Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

PTA OFFICE EVALUATION CHECKLIST 20

PTA OFFICE (20 pts) ACCOMPLISHMENT (15 pts)
Organizational &Attendance
Project Project Project Minutes of
Name of School Solo Chart
TLS Shared Table P10,000 P5,000 - P1,000 - Meeting
(Concrete) up 9,000 4,000
20 15 10 5 15 10 5 10 10

Evaluator:
 partment of Education
Region NO. VIII
Ormoc City Division
RMOC CITY DISTRICT VI
Ormoc City

ALUATION CHECKLIST 2018

Officers Financial Mission/ Display Action Logbook TOTAL

(Folders) Statement Vision Board Plan

5 10 10 10 5 5 100
 Department of Education
Region NO. VIII
Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

HERBAL GARDEN EVALUATION CHECKLIST 201

Directory (Usage of Herbal Plants

With 10 Growing
Area
Name of School Herbal Plants
Plain GI Plywood
(20) (15)
20 50 20

Evaluator:
artment of Education
Region NO. VIII
rmoc City Division
MOC CITY DISTRICT VI
Ormoc City

VALUATION CHECKLIST 2018

Directory (Usage of Herbal Plants)

Cleanlines TOTAL
Tarpauilin
(10)
20 10 100
 Department of Education
Region NO. VIII
Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

ORCHIDARIUM EVALUATION CHECKLIST 201

Flowering & Properly

Area Cleanliness
Name of School Organized

30 20 10

Evaluator:
Department of Education
Region NO. VIII
Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

EVALUATION CHECKLIST 2018

Landscaping Fenced Total

20 20 100
 Department of Education
Region NO. VIII
Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

SBM - WinS EVALUATION CHECKLIS

3-Star Approach SBM-WinS
1 2 3 5 6
Access to Access to Sanitation Sanitation Hygiene Kit
Name of School Water for Water for (Latrine) (Wastes)
Drinking Handwashing

3 3 3 3 3

Evaluator:
 Department of Education
Region NO. VIII
Ormoc City Division
ORMOC CITY DISTRICT VI
Ormoc City

EVALUATION CHECKLIST 2018

3-Star Approach SBM-WinS
7 8 9 10
Deworming Information Advocacy Operation
Educational Points
Stakeholders
Communication Participation
(IEC)

3 3 3 3 3 3