ANNEX 1B Child Mapping Tool

Before you go around your community to conduct your early registration activities, coordinate with the District or Division office and your barangay. If there are other schools in your barangay, coordinate with them as well.
Distribute this child mapping tool to your team of teachers and volunteers. They should fill this up as they move from house to house in the barangay. This will help you get important basic information on the status of 4-17 year old children in your community which you can use in school planning. You only need to
cover your barangay unless majority of your students come from nearby communities, in which case, you need to conduct child mapping in those barangays as well. If there are no schools in a barangay, the District or Division office will initiate the child mapping in that area (following DO. No. 1 s. 2015).

Child mapping should be done at least every 3 years (preferably at the start of the SIP cycle), assuming that there are no major changes in the population of your community. After events causing major population changes (e.g. disasters), child mapping should be conducted to account for the children in your
community.
After mapping, consolidate the data. You can encode it in the School-Community Data Template for easy reference. Share the data with your District and Division offices, barangay, and with nearby schools and communities.

Barangay: ____ STA. INES EAST Division: _________ TARLAC PROVINCE

Municipality: SANTA IGNACIA Region: __________ III
TOOL FOR MAPPING OF 4-17 YR. OLD CHILDREN

NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY ECCD (FOR 4YO CHILDREN) EDUCATIONAL STATUS FUTURE ENROLLMENT

Number of Is residence If YES, Provided Planning to

With Birth years in Has a specify with ECCD Educational Currently If YES, specify name of If NO, state reason for not If studying through ADM, study next If YES, specify the name of If NO, state reason for not
Last First Middle Gender Age Date of birth Certificate? Present address present permanent?
1
disability?
type of Services? If YES, specify ECCD facility attainment3
studying?
school studying specify type of ADM school year? prospective school
planning to study next
(YES/NO) (YES/NO) (YES/NO) (YES/NO) school year
address disability2 (YES/NO) (YES/NO)

FACUN MARIEL ANGEL T F 8 03/18/10 YES Sta.Ines East,SIT 8 YES NO YES C2 YES Sta. Ines East,E/S YES Sta. Ines East,E/S

FACUN JOHN LLOYD C M 10 06/24/09 YES Sta.Ines East,SIT 10 YES NO YES C4 YES Sta. Ines East,E/S YES Sta. Ines East,E/S

FACUN DE-JAY T M 8 08/29/11 YES Sta.Ines East,SIT 8 YES NO YES C2 YES Sta. Ines East,E/S YES Sta. Ines East,E/S

VERSOZA JERALD C M 11 08/03/08 YES Sta.Ines East,SIT 11 YES NO YES C5 YES Sta. Ines East,E/S YES Sta. Ines East,E/S

BAYSA KYAN AARON T M 12 08/04/07 YES Sta.Ines East,SIT 12 YES NO YES C6 YES Sta. Ines East,E/S YES Sta. Ines East,H/S

BAYSA MARIE FRANCELLE T F 8 09/30/10 YES Sta.Ines East,SIT 8 YES NO YES C2 YES Sta. Ines East,E/S YES Sta. Ines East,E/S

SILLA JORENZ G M 12 10/11/07 YES Sta.Ines East,SIT 12 YES NO YES C6 YES Sta. Ines East,E/S YES Sta. Ines East,E/S

REBOLLEDO FIONA Middle F 12 04/03/07 YES Sta.Ines East,SIT 12 YES NO YES C6 YES Sta. Ines East,E/S YES Sta. Ines East,H/S

NOVIDA BLESSED FAITH B F 8 09/29/11 YES Sta.Ines East,SIT 8 YES NO YES C2 YES Sta. Ines East,E/S YES Sta. Ines East,H/S

NOVIDA JOHN PATRICK B M 6 06/18/13 YES Sta.Ines East,SIT 6 YES NO YES C1 YES Sta. Ines East,E/S YES Sta. Ines East,E/S

ASK: "Is the child a permanent resident?" (YES/NO) If YES, follow up "do the residents plan on moving out?"
1

2
TYPES OF DISABILITIES: (see DepED Order No. 2, s 2014 for detailed descriptions)
1- Visual Impairment 6- Serious emotional disturbance HELEN G. TAMONDONG
2- Hearing Impairment 7- Autism INTERVIEWER NAME AND SIGNATURE
3- Intellectual Disability 8- Orthopedic impairment
4- Learning Disability 9- Special health problems
5- Speech/language impairment 10- Multiple disabilities

3
EDUCATIONAL ATTAINMENT:
CK- Completed Kindergarten C7- Completed Grade 7 SK- Some Kindergarten S7- Some Grade 7
C1- Completed Grade 1 C8- Completed Grade 8 S1- Some Grade 1 S8- Some Grade 8
C2- Completed Grade 2 C9- Completed Grade 9 S2- Some Grade 2 S9- Some Grade 9 DATE OF INTERVIEWS
C3- Completed Grade 3 C10- Completed Grade 10 S3- Some Grade 3 S10- Some Grade 10
C4- Completed Grade 4 C11- Completed Grade 11 S4- Some Grade 4 S11- Some Grade 11
C5- Completed Grade 5 C12- Completed Grade 12 S5- Some Grade 5 S12- Some Grade 12
C6- Completed Grade 6 S6- Some Grade 6
 NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY ECCD (FOR 4YO CHILDREN) EDUCATIONAL STATUS FUTURE ENROLLMENT

Number of If YES, Provided Planning to

With Birth years in Is residence Has a specify with ECCD Educational Currently If YES, specify name of If NO, state reason for not If studying through ADM, study next If YES, specify the name of If NO, state reason for not
Last First Middle Gender Age Date of birth Certificate? Present address present permanent?
1
disability? type of Services? If YES, specify ECCD facility attainment3 studying? school studying specify type of ADM school year? prospective school planning to study next
(YES/NO) address (YES/NO) (YES/NO) disability2 (YES/NO) (YES/NO) (YES/NO) school year

BAYSA ASHLEY ANN B F 7 03/26/12 YES Sta.Ines East,SIT 7 YES NO YES C1 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

CATAINA DAISYREE A F 12 01/13/07 YES Sta.Ines East,SIT 12 YES NO YES C6 YES Sta.Ines East.H/S YES Sta.Ines East.H/S

CATAINA PRINCESS A F 6 03/22/13 YES Sta.Ines East,SIT 6 YES NO YES CK YES Sta.Ines East.E/S YES Sta.Ines East.E/S

AGUSTIN JECEL ANN C F 10 01/13/09 YES Sta.Ines East,SIT 10 YES NO YES C4 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

AGUSTIN ANDRIE C M 7 11/29/12 YES Sta.Ines East,SIT 7 YES NO YES C1 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

AGUSTIN MARYROSE C F 8 06/04/11 YES Sta.Ines East,SIT 8 YES NO YES C2 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

DAGUIOAN PRINCE ARNIE U M 12 08/11/07 YES Sta.Ines East,SIT 12 YES NO YES C6 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

MANUEL NEIL JOSEPH M 8 05/01/11 YES Sta.Ines East,SIT 8 YES NO YES C2 YES Sta.Ines East.H/S YES Sta.Ines East.H/S

MILLET KIMBERLY N F 8 03/23/01 YES Sta.Ines East,SIT 8 YES NO YES C2 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

MILLET PRINCESS ANNA I F 7 11/20/12 YES 7 YES NO YES C1 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

MANALO ALMARK F M 10 11/03/08 YES 10 YES NO YES C4 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

CASTRO AQUISHA C F 8 04/13/11 YES 8 YES NO YES C2 YES Sta.Ines East.E/S YES Sta.Ines East.E/S

ASK: "Is the child a permanent resident?" (YES/NO) If YES, follow up "do the residents plan on moving out?"
1

2
TYPES OF DISABILITIES: (see DepED Order No. 2, s 2014 for detailed descriptions)
1- Visual Impairment 6- Serious emotional disturbance
2- Hearing Impairment 7- Autism
3- Intellectual Disability 8- Orthopedic impairment
4- Learning Disability 9- Special health problems
5- Speech/language impairment 10- Multiple disabilities

3
EDUCATIONAL ATTAINMENT:
CK- Completed Kindergarten C7- Completed Grade 7 SK- Some Kindergarten S7- Some Grade 7
C1- Completed Grade 1 C8- Completed Grade 8 S1- Some Grade 1 S8- Some Grade 8
C2- Completed Grade 2 C9- Completed Grade 9 S2- Some Grade 2 S9- Some Grade 9
C3- Completed Grade 3 C10- Completed Grade 10 S3- Some Grade 3 S10- Some Grade 10
C4- Completed Grade 4 C11- Completed Grade 11 S4- Some Grade 4 S11- Some Grade 11
C5- Completed Grade 5 C12- Completed Grade 12 S5- Some Grade 5 S12- Some Grade 12
C6- Completed Grade 6 S6- Some Grade 6
 TOOL FOR MAPPING OF 4-17 YR. OLD CHILDREN

NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY ECCD (FOR 4YO CHILDREN) EDUCATIONAL STATUS FUTURE ENROLLMENT

With Birth Number of Is residence Has a If YES, Provided Currently Planning to If NO, state reason for not
years in specify with ECCD Educational If YES, specify name of If NO, state reason for not If studying through ADM, study next If YES, specify the name of
Last First Middle Gender Age Date of birth Certificate? Present address present permanent?
1
disability?
type of Services? If YES, specify ECCD facility attainment3
studying?
school studying specify type of ADM school year? prospective school
planning to study next
(YES/NO) (YES/NO) (YES/NO) (YES/NO) school year
address disability2 (YES/NO) (YES/NO)

TAMPUS KIM SEDRICK C M 9 08/17/10 YES Sta. Ines East,SIT 9 YES NO YES C3 YES Sta. Ines East E/S YES Sta. Ines East E/S

FACUN LHIELEEN ANGELITAO F 8 04/11/11 YES Sta. Ines East,SIT 8 YES NO YES C2 YES Sta. Ines East E/S YES Sta. Ines East E/S

BAUTISTA JENNY ROSE F F 10 07/19/09 YES Sta. Ines East,SIT 10 YES NO YES C4 YES Sta. Ines East E/S YES Sta. Ines East E/S

BAUTISTA JASMINE F F 8 11/16/11 YES Sta. Ines East,SIT 8 YES NO YES C2 YES Sta. Ines East E/S YES Sta. Ines East E/S

TURLA BEA P F 6 03/16./13 YES Sta. Ines East,SIT 6 YES NO YES CK YES Sta. Ines East E/S YES Sta. Ines East E/S

OPEÑA MARK JOSEPH D M 12 10/4/7 YES Sta. Ines East,SIT 12 YES NO YES C6 YES Sta. Ines East E/S YES Sta. Ines East E/S

OPEÑA MARVIN P M 8 4/10/11 YES Sta. Ines East,SIT 8 YES NO YES C3 YES Sta. Ines East E/S YES Sta. Ines East E/S

CORDERO GLYSA NICOLE M F 11 10/15/08 YES Sta. Ines East,SIT 11 YES NO YES C6 YES Sta. Ines East H/S YES Sta. Ines East H/S

TURLA JOHN MARK M M 11 12/2/8 YES Sta. Ines East,SIT 11 YES NO YES C6 YES Sta. Ines East H/S YES Sta. Ines East H/S

CORDERO GINALYN M F 7 11/17/12 YES Sta. Ines East,SIT 7 YES NO YES C1 YES Sta. Ines East E/S YES Sta. Ines East E/S

ASK: "Is the child a permanent resident?" (YES/NO) If YES, follow up "do the residents plan on moving out?"
1

2
TYPES OF DISABILITIES: (see DepED Order No. 2, s 2014 for detailed descriptions)
1- Visual Impairment 6- Serious emotional disturbance HAZEL LEIN I. GRANIL
2- Hearing Impairment 7- Autism INTERVIEWER NAME AND SIGNATURE
3- Intellectual Disability 8- Orthopedic impairment
4- Learning Disability 9- Special health problems
5- Speech/language impairment 10- Multiple disabilities

3
EDUCATIONAL ATTAINMENT:
CK- Completed Kindergarten C7- Completed Grade 7 SK- Some Kindergarten S7- Some Grade 7
C1- Completed Grade 1 C8- Completed Grade 8 S1- Some Grade 1 S8- Some Grade 8
C2- Completed Grade 2 C9- Completed Grade 9 S2- Some Grade 2 S9- Some Grade 9 DATE OF INTERVIEWS
C3- Completed Grade 3 C10- Completed Grade 10 S3- Some Grade 3 S10- Some Grade 10
C4- Completed Grade 4 C11- Completed Grade 11 S4- Some Grade 4 S11- Some Grade 11
C5- Completed Grade 5 C12- Completed Grade 12 S5- Some Grade 5 S12- Some Grade 12
C6- Completed Grade 6 S6- Some Grade 6
 NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY ECCD (FOR 4YO CHILDREN) EDUCATIONAL STATUS FUTURE ENROLLMENT

Number of If YES, Provided Planning to

With Birth years in Is residence Has a specify with ECCD Educational Currently If YES, specify name of If NO, state reason for not If studying through ADM, study next If YES, specify the name of If NO, state reason for not
Last First Middle Gender Age Date of birth Certificate? Present address present permanent?
1
disability? type of Services? If YES, specify ECCD facility attainment3 studying? school studying specify type of ADM school year? prospective school planning to study next
(YES/NO) address (YES/NO) (YES/NO) disability2 (YES/NO) (YES/NO) (YES/NO) school year

DUMANTAY MARK ANGELO P M 10 9/27/09 YES Sta. Ines East,SIT 10 YES NO YES C5 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

DUMANTAY MARKY CIELO P M 8 8/18/11 YES Sta. Ines East,SIT 8 YES NO YES C2 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

FACUN JANICE P F 8 10/01/11 YES Sta. Ines East,SIT 8 YES NO YES C2 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

POLITIKO ROLAND KYLE F M 8 7/25/11 YES Sta. Ines East,SIT 8 YES NO YES C2 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

TOLENADA MARC JAMES O M 12 4/7/7 YES Sta. Ines East,SIT 12 YES NO YES C6 YES Sta.Ines East , H/S YES Sta.Ines East , H/S

PORLUCAS REYNALDO JR D M 9 10/13/10 YES Sta. Ines East,SIT 9 YES NO YES C3 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

RUZ ROSE ANN MAE L F 11 6/16/8 YES Sta. Ines East,SIT 11 YES NO YES C6 YES Sta.Ines East , H/S YES Sta.Ines East , H/S

RUZ APRIL JOY V F 9 4/13/10 YES Sta. Ines East,SIT 9 YES NO YES C3 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

RUZ KRISTINE JOY V F 7 7/16/12 YES Sta. Ines East,SIT 7 YES NO YES C1 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

VALDEZ ALFRED J M 9 6/30/10 YES Sta. Ines East,SIT 9 YES NO YES C3 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

VALDEZ NATHAN J M 7 1/17/12 YES Sta. Ines East,SIT 7 YES NO YES C1 YES Sta.Ines East , E/S YES Sta.Ines East , E/S

MADARANG JENILLE F M 12 11/18/07 YES Sta. Ines East,SIT 12 YES NO YES C6 YES Sta.Ines East , H/S YES Sta.Ines East , H/S

ASK: "Is the child a permanent resident?" (YES/NO) If YES, follow up "do the residents plan on moving out?"
1

2
TYPES OF DISABILITIES: (see DepED Order No. 2, s 2014 for detailed descriptions)
1- Visual Impairment 6- Serious emotional disturbance
2- Hearing Impairment 7- Autism
3- Intellectual Disability 8- Orthopedic impairment
4- Learning Disability 9- Special health problems
5- Speech/language impairment 10- Multiple disabilities

3
EDUCATIONAL ATTAINMENT:
CK- Completed Kindergarten C7- Completed Grade 7 SK- Some Kindergarten S7- Some Grade 7
C1- Completed Grade 1 C8- Completed Grade 8 S1- Some Grade 1 S8- Some Grade 8
C2- Completed Grade 2 C9- Completed Grade 9 S2- Some Grade 2 S9- Some Grade 9
C3- Completed Grade 3 C10- Completed Grade 10 S3- Some Grade 3 S10- Some Grade 10
C4- Completed Grade 4 C11- Completed Grade 11 S4- Some Grade 4 S11- Some Grade 11
C5- Completed Grade 5 C12- Completed Grade 12 S5- Some Grade 5 S12- Some Grade 12
C6- Completed Grade 6 S6- Some Grade 6
 TOOL FOR MAPPING OF 4-17 YR. OLD CHILDREN

NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY ECCD (FOR 4YO CHILDREN) EDUCATIONAL STATUS FUTURE ENROLLMENT

With Birth Number of Is residence Has a If YES, Provided Currently Planning to If NO, state reason for not
years in specify with ECCD Educational If YES, specify name of If NO, state reason for not If studying through ADM, study next If YES, specify the name of
Last First Middle Gender Age Date of birth Certificate? Present address present permanent?
1
disability?
type of Services? If YES, specify ECCD facility attainment3
studying?
school studying specify type of ADM school year? prospective school
planning to study next
(YES/NO) (YES/NO) (YES/NO) (YES/NO) school year
address disability2 (YES/NO) (YES/NO)

MUÑOZ ARRIANNE P F 8 03/25/11 Sta. Ines East, SIT 8 YES NO YES C2 YES Sta.Ines E/S YES Sta.Ines E/S

ESQUIDA IAN HARVEY T M 10 1/1/9 Sta. Ines East, SIT 10 YES NO YES C4 YES Sta.Ines E/S YES Sta.Ines E/S

MAGSILANG JADE ANDRIE E M 11 5/23/8 Sta. Ines East, SIT 11 YES NO YES C5 YES Sta.Ines E/S YES Sta.Ines E/S

MAGSILANG THEA KARYLLE E F 8 7/25/11 Sta. Ines East, SIT 8 YES NO YES C2 YES Sta.Ines E/S YES Sta.Ines E/S

LACAYANGA JENICA T F 9 12/24/10 Sta. Ines East, SIT 9 YES NO YES C3 YES Sta.Ines E/S YES Sta.Ines E/S

LACAYANGA JERENCE A M 6 8/12/13 Sta. Ines East, SIT 6 YES NO YES CK YES Sta.Ines E/S YES Sta.Ines E/S

LACAYANGA JOHN PAUL R M 9 1/18/10 Sta. Ines East, SIT 9 YES NO YES C3 YES Sta.Ines E/S YES Sta.Ines E/S

LACAYANGA MARK LAWRENCE O M 12 03/06/07 Sta. Ines East, SIT 12 YES NO YES C6 YES Sta.Ines H/S YES Sta.Ines H/S

LACAYANGA JASMINE NICOLE O F 11 12/15/08 Sta. Ines East, SIT 11 YES NO YES C4 YES Sta.Ines E/S YES Sta.Ines E/S

CONCEPCION JAY OLIVER V M 12 7/24/7 Sta. Ines East, SIT 12 YES NO YES C6 YES Sta.Ines E/S YES Sta.Ines H/S

ASK: "Is the child a permanent resident?" (YES/NO) If YES, follow up "do the residents plan on moving out?"
1

2
TYPES OF DISABILITIES: (see DepED Order No. 2, s 2014 for detailed descriptions)
1- Visual Impairment 6- Serious emotional disturbance HELEN G. TAMONDONG
2- Hearing Impairment 7- Autism INTERVIEWER NAME AND SIGNATURE
3- Intellectual Disability 8- Orthopedic impairment
4- Learning Disability 9- Special health problems
5- Speech/language impairment 10- Multiple disabilities

3
EDUCATIONAL ATTAINMENT:
CK- Completed Kindergarten C7- Completed Grade 7 SK- Some Kindergarten S7- Some Grade 7
C1- Completed Grade 1 C8- Completed Grade 8 S1- Some Grade 1 S8- Some Grade 8
C2- Completed Grade 2 C9- Completed Grade 9 S2- Some Grade 2 S9- Some Grade 9 DATE OF INTERVIEWS
C3- Completed Grade 3 C10- Completed Grade 10 S3- Some Grade 3 S10- Some Grade 10
C4- Completed Grade 4 C11- Completed Grade 11 S4- Some Grade 4 S11- Some Grade 11
C5- Completed Grade 5 C12- Completed Grade 12 S5- Some Grade 5 S12- Some Grade 12
C6- Completed Grade 6 S6- Some Grade 6
 NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY ECCD (FOR 4YO CHILDREN) EDUCATIONAL STATUS FUTURE ENROLLMENT

Number of If YES, Provided Planning to

With Birth years in Is residence Has a specify with ECCD Educational Currently If YES, specify name of If NO, state reason for not If studying through ADM, study next If YES, specify the name of If NO, state reason for not
Last First Middle Gender Age Date of birth Certificate? Present address present permanent?
1
disability? type of Services? If YES, specify ECCD facility attainment3 studying? school studying specify type of ADM school year? prospective school planning to study next
(YES/NO) address (YES/NO) (YES/NO) disability2 (YES/NO) (YES/NO) (YES/NO) school year

CONCEPCION JASMINE V F 11 6/26/8 YES Sta. Ines East ,SIT 11 YES NO YES C5 YES Sta. Ines East E/S YES Sta. Ines East H/S

TORRES GIAN ZEN M M 7 6/18/12 YES Sta. Ines East ,SIT 7 YES NO YES C1 YES Sta. Ines East E/S YES Sta. Ines East E/S

MILLA LYN HEART A F 9 6/20/10 YES Sta. Ines East ,SIT 9 YES NO YES C3 YES Sta. Ines East E/S YES Sta. Ines East E/S

MILLA ANGELYN A F 7 2/20/12 YES Sta. Ines East ,SIT 7 YES NO YES CK YES Sta. Ines East E/S YES Sta. Ines East E/S

LACON CARLO M M 10 6/21/9 YES Sta. Ines East ,SIT 10 YES NO YES C5 YES Sta. Ines East E/S YES Sta. Ines East E/S

REMARIM RIO JOSHUA M M 10 7/21/9 YES Sta. Ines East ,SIT 10 YES NO YES C4 YES Sta. Ines East E/S YES Sta. Ines East E/S

REMARIM REYNALYN M F 9 11/18/10 YES Sta. Ines East ,SIT 9 YES NO YES C3 YES Sta. Ines East E/S YES Sta. Ines East E/S

URBANO KARLYN T F 11 11/5/8 YES Sta. Ines East ,SIT 11 YES NO YES C4 YES Sta. Ines East E/S YES Sta. Ines East H/S

LACAYANGA QUEENLYN U F 7 5/4/12 YES Sta. Ines East ,SIT 7 YES NO YES CK YES Sta. Ines East E/S YES Sta. Ines East E/S

LACAYANGA JASLYN U F 6 11/30/13 YES Sta. Ines East ,SIT 6 YES NO YES CK YES Sta. Ines East E/S YES Sta. Ines East E/S

ALINGOG JOHN MATTEW O M 6 1/17/13 YES Sta. Ines East ,SIT 6 YES NO YES CK YES Sta. Ines East E/S YES Sta. Ines East E/S

CACAYORIN JOSHUA S M 9 7/4'10 YES Sta. Ines East ,SIT 9 YES NO YES CK YES Sta. Ines East E/S YES Sta. Ines East E/S

ASK: "Is the child a permanent resident?" (YES/NO) If YES, follow up "do the residents plan on moving out?"
1

2
TYPES OF DISABILITIES: (see DepED Order No. 2, s 2014 for detailed descriptions)
1- Visual Impairment 6- Serious emotional disturbance
2- Hearing Impairment 7- Autism
3- Intellectual Disability 8- Orthopedic impairment
4- Learning Disability 9- Special health problems
5- Speech/language impairment 10- Multiple disabilities

3
EDUCATIONAL ATTAINMENT:
CK- Completed Kindergarten C7- Completed Grade 7 SK- Some Kindergarten S7- Some Grade 7
C1- Completed Grade 1 C8- Completed Grade 8 S1- Some Grade 1 S8- Some Grade 8
C2- Completed Grade 2 C9- Completed Grade 9 S2- Some Grade 2 S9- Some Grade 9
C3- Completed Grade 3 C10- Completed Grade 10 S3- Some Grade 3 S10- Some Grade 10
C4- Completed Grade 4 C11- Completed Grade 11 S4- Some Grade 4 S11- Some Grade 11
C5- Completed Grade 5 C12- Completed Grade 12 S5- Some Grade 5 S12- Some Grade 12
C6- Completed Grade 6 S6- Some Grade 6
 TOOL FOR MAPPING OF 4-17 YR. OLD CHILDREN

NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY ECCD (FOR 4YO CHILDREN) EDUCATIONAL STATUS FUTURE ENROLLMENT

With Birth Number of Is residence Has a If YES, Provided Currently Planning to If NO, state reason for not
years in specify with ECCD Educational If YES, specify name of If NO, state reason for not If studying through ADM, study next If YES, specify the name of
Last First Middle Gender Age Date of birth Certificate? Present address present permanent?
1
disability?
type of Services? If YES, specify ECCD facility attainment3
studying?
school studying specify type of ADM school year? prospective school
planning to study next
(YES/NO) (YES/NO) (YES/NO) (YES/NO) school year
address disability2 (YES/NO) (YES/NO)

LOPEZ XYREENE S F 11 1/23/08 YES Sta. Ines East, SIT 11 YES NO YES C5 YES Sta. Ines East E/S YES Sta. Ines East H/S

LOPEZ XYRONE S M 10 06/05/09 YES Sta. Ines East, SIT 10 YES NO YES C4 YES Sta. Ines East E/S YES Sta. Ines East E/S

ROLEN GIAN C M 7 5/1/12 YES Sta. Ines East, SIT 7 YES NO YES CK YES ALA YES ALA

LOPEZ JANINE L F 12 9/28/7 YES Sta. Ines East, SIT 12 YES NO YES C6 YES Sta. Ines East H/S YES Sta. Ines East H/S

MILLA GERALD M M 10 1/9/9 YES Sta. Ines East, SIT 10 YES NO YES C4 YES Sta. Ines East E/S YES Sta. Ines East E/S

MILLA JEROME M M 9 6/23/10 YES Sta. Ines East, SIT 9 YES NO YES C2 YES Sta. Ines East E/S YES Sta. Ines East E/S

FELICIANO ARJAY M M 8 8/18/11 YES Sta. Ines East, SIT 8 YES NO YES C2 YES YES

FELICIANO ERIKA ROSE M F 11 10/19/8 YES Sta. Ines East, SIT 11 YES NO YES C5 YES YES

TRINIDAD JUDE NATHAN M M 10 11/8/9 YES Sta. Ines East, SIT 10 YES NO YES C4 YES Sta. Ines East E/S YES Sta. Ines East E/S

PORLUCAS ANGELA J F 12 9/6/7 YES Sta. Ines East, SIT 12 YES NO YES C6 YES Sta.Ines East H/S YES Sta.Ines East H/S

ASK: "Is the child a permanent resident?" (YES/NO) If YES, follow up "do the residents plan on moving out?"
1

2
TYPES OF DISABILITIES: (see DepED Order No. 2, s 2014 for detailed descriptions)
1- Visual Impairment 6- Serious emotional disturbance HAZEL LEIN I. GRANIL
2- Hearing Impairment 7- Autism INTERVIEWER NAME AND SIGNATURE
3- Intellectual Disability 8- Orthopedic impairment
4- Learning Disability 9- Special health problems
5- Speech/language impairment 10- Multiple disabilities

3
EDUCATIONAL ATTAINMENT:
CK- Completed Kindergarten C7- Completed Grade 7 SK- Some Kindergarten S7- Some Grade 7
C1- Completed Grade 1 C8- Completed Grade 8 S1- Some Grade 1 S8- Some Grade 8
C2- Completed Grade 2 C9- Completed Grade 9 S2- Some Grade 2 S9- Some Grade 9 DATE OF INTERVIEWS
C3- Completed Grade 3 C10- Completed Grade 10 S3- Some Grade 3 S10- Some Grade 10
C4- Completed Grade 4 C11- Completed Grade 11 S4- Some Grade 4 S11- Some Grade 11
C5- Completed Grade 5 C12- Completed Grade 12 S5- Some Grade 5 S12- Some Grade 12
C6- Completed Grade 6 S6- Some Grade 6
 NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY ECCD (FOR 4YO CHILDREN) EDUCATIONAL STATUS FUTURE ENROLLMENT

Number of If YES, Provided Planning to

With Birth years in Is residence Has a specify with ECCD Educational Currently If YES, specify name of If NO, state reason for not If studying through ADM, study next If YES, specify the name of If NO, state reason for not
Last First Middle Gender Age Date of birth Certificate? Present address present permanent?
1
disability? type of Services? If YES, specify ECCD facility attainment3 studying? school studying specify type of ADM school year? prospective school planning to study next
(YES/NO) address (YES/NO) (YES/NO) disability2 (YES/NO) (YES/NO) (YES/NO) school year

RUZ ALLYSA M F 8 11/28/11 Sta. Ines East, SIT 8 YES NO YES C5 YES Sta. Ines East E/S YES Sta. Ines East E/S

CABOTAJE KATE CASSANDRA A F 7 4/21/12 Sta. Ines East, SIT 7 YES NO YES C1 YES Sta. Ines East E/S YES Sta. Ines East E/S

AGUINALDO PEARL ANGELY J F 7 4/21/12 Sta. Ines East, SIT 7 YES NO YES CK YES ALA YES ALA

ASIO ROXZY NICOLE M F 11 8/13/8 Sta. Ines East, SIT 11 YES NO YES C5 YES Sta. Ines East E/S YES Sta. Ines East H/S

ASK: "Is the child a permanent resident?" (YES/NO) If YES, follow up "do the residents plan on moving out?"
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TYPES OF DISABILITIES: (see DepED Order No. 2, s 2014 for detailed descriptions)
1- Visual Impairment 6- Serious emotional disturbance
2- Hearing Impairment 7- Autism
3- Intellectual Disability 8- Orthopedic impairment
4- Learning Disability 9- Special health problems
5- Speech/language impairment 10- Multiple disabilities

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EDUCATIONAL ATTAINMENT:
CK- Completed Kindergarten C7- Completed Grade 7 SK- Some Kindergarten S7- Some Grade 7
C1- Completed Grade 1 C8- Completed Grade 8 S1- Some Grade 1 S8- Some Grade 8
C2- Completed Grade 2 C9- Completed Grade 9 S2- Some Grade 2 S9- Some Grade 9
C3- Completed Grade 3 C10- Completed Grade 10 S3- Some Grade 3 S10- Some Grade 10
C4- Completed Grade 4 C11- Completed Grade 11 S4- Some Grade 4 S11- Some Grade 11
C5- Completed Grade 5 C12- Completed Grade 12 S5- Some Grade 5 S12- Some Grade 12
C6- Completed Grade 6 S6- Some Grade 6