Franciscan College of the Immaculate Conception, Baybay City, Leyte, Incorporated

Baybay City, Leyte

Graduate School Department

SURVEY ON THE APPLICATION AND ENFORCEMENT OF CHILD

PROTECTION POLICY (SY 2016-2019)

Name of School: _______________________________________________________________________

Name of School Head/Principal: __________________________________________________________
Presence of Child Protection Council/Committee: ____________________________________________
Presence of Child Protection Policy: _______________________________________________________

I. Number of Bullying Cases __________

Offended Party Male _______ Female _______
Offender Male _______ Female _______
Specific Acts of Bullying (list as many as there are complaints)
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Action Taken:
________________________________________________________________________
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II. Child Abuse Cases ____________
Offended Party Male _______ Female _______
Offender Male _______ Female _______
Specific Acts of Child Abuse (list as many as there are complaints filed)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Action Taken:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

III. Sexual Harassment Cases _________________________

Offended Party Male _______ Female _______

Offender Male _______ Female _______
Action Taken:
________________________________________________________________________
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________________________________________________________________________
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Signature over Printed Name