SBFP Form 1

Department of Education
Region VIII

Master List Beneficiaries for School-Based Feeding Program (SBFP) (SY 2021-2022)

Division/Province: ORMOC CITY Name of Principal : JOVEN T. TOMADA

City/ Municipality/Barangay : ORMOC CITY Name of Feeding Focal Person : JOVELYN L. RANIN
Name of School / School District : HUGPA ELEMENTARY SCHOOL
School ID Number: 124154

Nutritional Beneficiary of
Date of Age in BMI for 6 Dewormed Parent's Participation SBFP in
Date of Birth Years / Weight Height y.o. and Status (NS) consent for in 4Ps
Weighing /
No. NAMES Sex Grade/ Section (MM/DD/YYYY
Measuring Month (Kg) (cm)
?
milk?
Previous
) above (yes or no) (yes or no) Years (yes or
(MM/DD/YYYY) s (yes or no)
no)
BMI-A HFA
1 GRAVILLO, MATHEW M KINDER 03/31/2016 YES NO NO
2 LEQUIN, JHON MARK M KINDER 06/04/2016 YES NO NO
3 LONZAGA, EJHEL C. M KINDER 09/08/2016 YES NO NO
4 OMBAL, JOSHUA P. M KINDER 02/25/2016 YES NO NO
5 AUTES, JENIFER F KINDER 09/13/2016 YES NO NO
6 CERNA, CATAHEMA PRINCESS F KINDER 09/04/2015 YES NO NO
7 DADOR, JESSIE MAY Q. F KINDER 11/04/2015 YES NO NO
8 GALOLA, RHEA MAE F KINDER 04/30/2015 YES NO NO
9 JUNDIT, PRINCESS REYVAN F KINDER 12/16/2015 YES NO NO
10 JUNDIT,SAVANAH JULIA KATE F KINDER 02/02/2016 YES NO NO
11 PALOMA,ALJHEAN T. F KINDER 10/25/2015 YES NO NO
12 RAÑIN, CLEOFE JANE L. F KINDER 01/24/2016 YES NO NO
13 CUYO,PRINCESS ASHLEY KATE F KINDER 02/05/2015 YES NO NO
14 SANCHEZ, JASHA MICHELLE A. F KINDER 4/27/2016 YES NO NO
15 ABERO, CHARLES P. M GRADE I 01/07/2015 July 9, 2021 6,7 14 1.1 12.48 SW S YES YES NO YES
16 BOLANTE, JESSIE S. M GRADE I 05/10/2014 July 9, 2021 7.3 15.9 1.11 12.5 SW N YES YES NO YES
17 GINDOY, REEDRICK H. M GRADE I 01/29/2015 July 9, 2021 71 14.5 1.12 12.47 W N YES YES NO YES
18 LAURENTE, KRIZ JOHN M GRADE 1 05/06/2015 July 9, 2021 6.4 14.5 1.09 11.78 W S YES YES NO YES
19 TALABOC, SOFIA T. F GRADE I 06/20/2015 July 9, 2021 6,1 14.6 1.07 11.69 SW S YES YES NO YES
20 ABERO, ARWIN M GRADE II 5/13/2014 YES YES NO YES
21 AUTES, KENNETH M GRADE II 06/26/2014 YES YES NO YES
22 BELACHO, ROLDAN JR. M GRADE II 1/13/2014 YES YES NO YES
23 BOLANTE, SAMMY M GRADE II 08/15/2012 YES YES NO YES
24 DADOR, DANTE JR. M GRADE II 12/30/2013 YES YES NO YES
25 GAYO, GENO M GRADE II 07/04/2014 YES YES NO YES
26 JUNDIT, KEVIN M GRADE II 01/12/2014 YES YES YES YES
27 LAMA, GILBERT S. M GRADE II 01/23/2014 YES YES NO YES
28 AUTES, JOHN JESLLER M GRADE II 01/15/2014 YES YES NO YES
29 SEGUIDO, JHONRIL JR. M GRADE II 07/23/2013 YES YES NO YES
30 SEGUIDO, JOHN KENNETH M GRADE II 06/23/2012 YES YES NO YES
31 AUTES, AHN B. F GRADE II 8/12/2014 YES YES NO YES
32 SEGUIDO, JHAZENA MAE F GRADE II 05/29/2014 YES YES NO YES
33 CERNA, NICOLE ANN F GRADE II 05/29/2014 YES YES NO YES
34 GALOLA, HAZEL P. F GRADE II 05/23/2014 YES YES NO YES
35 MACARON, JAZZY G. F GRADE II 07/05/2014 YES YES NO YES
36 NUÑEZ, JUVEINIAH F GRADE II 11/23/2013 YES YES NO YES
37 SIOC, CARLA JEAN F GRADE II 10/12/2013 YES YES NO YES
38 TAÑEZA, AIESHA MAE F GRADE II 05/10/2014 YES YES NO YES
39 AUTES, MYRA E. F GRADE II 12/07/2013 YES YES NO YES
40 BANAY, DAISY LEI P. F GRADE II 07/18/2013 YES YES NO YES
41 CERNA, DANIEL P. M GRADE II 05/05/2013 YES YES NO YES
42 CERNA, KIAN G. M GRADE III 05/23/2013 YES YES NO YES
43 DIVINAGRACIA, JHONMER M GRADE III 02/25/2013 YES YES NO YES
44 FUENTES, JASON R. M GRADE III 02/06/2012 YES YES YES YES
45 JUNDIT, JOHN RJ M GRADE III 03/21/2013 YES YES NO YES
46 OMBAL, JAMES M GRADE III 04/13/2013 YES YES NO YES
47 SEGUIDO, PAUL JAKE M GRADE III 08/30/2012 YES YES NO YES
48 FERNANDEZ, JEFFREY M GRADE III 01/12/2012 YES YES NO YES
49 SIOC, XYDIL YURI KHIRT C. M GRADE III 03/18/2013 YES YES YES YES
50 GRABILO, ROSELYN L. F GRADE III 05/14/2012 YES YES NO YES
51 SUMAYANG, JESBERT M GRADE III 06/08/2015 YES YES NO YES
52 CERNA, ANTHONY JR. M GRADE III 07/31/2015 YES YES NO YES
53 AUTES, ABEGAIL B. F GRADE III 03/21/2013 YES YES NO YES
54 BELACHO, HANNAH THEA A. F GRADE III 05/14/2013 YES YES NO YES
55 CAYETANO, JENN MARIE F GRADE III 10/03/2012 YES YES NO YES
56 GALICIO, NICOLE F GRADE III 10/10/2013 YES YES NO YES
57 GINDOY, GILIAN KATE F GRADE III 05/12/2013 YES YES NO YES
58 POLINIO, ANGELINE F GRADE III 06/23/2013 YES YES NO YES
59 LABAJO, MIRASOL F GRADE III 03/16/2011 YES YES NO YES
60 SUMAYANG, JENADEN F GRADE III 11/17/2012 YES YES NO YES
61 PEREZ, CHARMEN H. F GRADE III 04/30/2012 YES YES NO YES
62 BANAY, LEE ANTONIO P. M GRADE IV 12/15/2011 YES YES NO YES
63 BELLARMINO, ARJIE C. M GRADE IV 12/12/2011 YES YES NO YES
64 BOLANTE, HAYDE M GRADE IV 03/25/2011 YES YES YES YES
 65 SIOC, EUGENE L. M GRADE IV 08/28/2012 YES YES NO YES
66 AUTES, RONYL JR. M GRADE IV 10/03/2011 YES YES NO YES
67 AUTES,KRISTELLE N. F GRADE IV 10/03/2011 YES YES NO YES
68 DIVINAGRACIA,MARY JOY F GRADE IV 04/27/2012 YES YES YES YES
69 OMBAL, SATURNINO IV M GRADE IV 10/30/2012 YES YES NO YES
70 BATIS, BEA E. F GRADE IV 07/20/2012 YES YES NO YES
71 CABACOY, JISSIEL S. F GRADE IV 03/21/2012 YES YES NO YES
72 CASTAÑAS, ANA MAE F GRADE IV 02/04/2012 YES YES NO YES
73 LAURENTE, JASMINE G. F GRADE IV 03/31/2012 YES YES YES YES
74 PEREZ, CHARITY H. F GRADE IV 06/14/2011 YES YES NO YES
75 GRABILLO, MARIAN L. F GRADE IV 06/14/2011 YES YES YES YES
76 RIM, SAMANTA C. F GRADE IV 08/02/2012 YES YES NO YES
77 SIOC, GWYNETH ASHLEY KATE F GRADE IV 06/06/2012 YES YES NO YES
78
79
80

Prepared by: Approved by:

JOVEN T. TOMADA
JOVELYN L. RANIN School Head
Feeding Focal Person

Note: This form shall be prepared by the school before the start of feeding to be compiled by the SDO.
SBFP Form 2
Department of Education
Region VIII

SCHOOL-BASED FEEDING PROGRAM (SBFP) LIST OF SCHOOLS (SY 2021-2022)

Division/Province: ORMOC CITY

School District/City/ Municipality : II HUGPA ELEMENTARY SCHOOL ORMOC CITY

Name of District
Supervisors/ Contact Number or
Name of Schools BEIS ID No. School Address Name of Barangay Total Beneficiaries
School Principal or & Email Address
OICs

HUGPA ELEMENTARY SCHOOL 124154 Brgy. HUGPA ORMOC CITY HUGPA JOVEN T. TOMADA 9235692046 77

Prepared by: Approved by:

SBFP DepED Focal Schools Division Superintendent

Note: This form shall be prepared by the SDO before the start of feeding, for final consolidation by the RO.
SBFP Form 3
Department of Education
Region VIII

SCHOOL-BASED FEEDING PROGRAM (SBFP) SUMMARY OF BENEFICIARIES & START OF FEEDING (SY 2021-2022)
Division/Province: Leyte
City/ Municipality/Barangay : Ormoc City, Brgy. Hugpa
Name of School / School District : HUgpa Elementary School-II
School ID Number: 124154
Date of Start of Feeding: __________________________
Last Mile School: ___Y ___N
Nutritional Status at Start/End of Feeding No. of Secondary Targets No. of No. of 4 Ps No. of Pupils Date Feeding
Learners Beneficiarie who are Started/Ended
SW W N OW+O SS S N T No. of Pupils- No. of No. of No. of Dewormed s beneficiaries
Number of Undernourished at-risk-of- Stunted/ Indigent Indigenous in previous
School Children by Grade Level dropping-out Severely Learners Peoples years
(PARDOs) (Repeaters)
Stunted (IPs)

KINDER 20 5 10 5 0 8 7 5 20 20 1 17 February 2,2022

GRADE 1 5 1 4 0 0 2 2 1 5 5 2 22

GRADE 2 22 0 7 14 1 5 7 10 22 22 1 20

GRADE 3 20 0 3 17 0 4 6 10 20 20 2 18

GRADE 4 10 0 2 8 0 0 3 7 10 10 6 0

GRADE 5 0 0 0 0 0 0 0 0 0 0 0

TOTAL 77 6 26 44 1 19 25 33 77 77 12 77

Prepared by: Approved by:

JOVELYN L. RANIN JOVEN T. TOMADA

SBFP DepEd Focal School Head

Note: This form shall be prepared by the school before the start of feeding and after feeding, to be compiled by the SDO, and for final compilation by the RO, for submission to DepEd BLSS-
SHD
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF FEBRUARY , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: KINDER Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1 RHOCO B. ABERO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
2 JAY-R O. BOGANE / / / / / / / / / / / / / / / / / / / / / / / / / / / /
3 LORENS S. CARILLO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
4 JHONMARK J. LIQUIN / / / / / / / / / / / / / / / / / / / / / / / / / / / /
5 EJAY C. LONZAGA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
6 JARED B. MUTYA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
7 JHON CARLO P. OMBAL / / / / / / / / / / / / / / / / / / / / / / / / / / / /
8 JOSHUA P. OMBAL / / / / / / / / / / / / / / / / / / / / / / / / / / / /
9 NEIL SEBASTIAN S. SITOY / / / / / / / / / / / / / / / / / / / / / / / / / / / /
10 JENIFER AUTES / / / / / / / / / / / / / / / / / / / / / / / / / / / /
11 CATCHEMA PRINCESS L. CERNA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
12 PRINCESS ASHLEY KATE S. CUYO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
13 JESSE MAY O. DADOR / / / / / / / / / / / / / / / / / / / / / / / / / / / /
14 RHEA MARIE I. GALOLA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
15 PRINCESS REYVAN KATE JUNDIT / / / / / / / / / / / / / / / / / / / / / / / / / / / /
16 SAVANAH JULIA KATE JUNDIT / / / / / / / / / / / / / / / / / / / / / / / / / / / /
17 ALJHEAN T. PALOMA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
18 CLEOFE JANE L. RANIN / / / / / / / / / / / / / / / / / / / / / / / / / / / /
19 JASHA MICHELLE A. SANCHEZ / / / / / / / / / / / / / / / / / / / / / / / / / / / /
20 CRECHELLE C. SANICO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
TOTAL:
Prepared by:

JOVELYN L. RANIN
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
JOVEN T. TOMADA ( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF FEBRUARY , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 1 Section :MATAPAT
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1 JESSIE S. BOLANTE / / / / / / / / / / / / / / / / / / / / / / / / / / / /
2 KRIZ JOHN G. LAURENTE / / / / / / / / / / / / / / / / / / / / / / / / / / / /
3 ROSELYN GRABILLO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
4 MIRASOL LABAJO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
5 SOPHIA T. TALABOC / / / / / / / / / / / / / / / / / / / / / / / / / / / /
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF FEBRUARY , SY :2021-2022

Region VIII
 Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 2 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1 RONYL AUTES / / / / / / / / / / / / / / / / / / / / / / / / / / / /
2 ANTHONY CERNA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
3 JOHN KENNETH SEGUIDO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
4 EUGENE SIOC / / / / / / / / / / / / / / / / / / / / / / / / / / / /
5 JESBERT SUMAYANG / / / / / / / / / / / / / / / / / / / / / / / / / / / /
6 KRISTELLE AUTES / / / / / / / / / / / / / / / / / / / / / / / / / / / /
7 DAISY LEI P. BANAY / / / / / / / / / / / / / / / / / / / / / / / / / / / /
8 MARY JOY E. DIVINAGRACIA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
9 JHAZENA SEGUIDO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
10 CHARMEN PEREZ / / / / / / / / / / / / / / / / / / / / / / / / / / / /
11 ROLDAN JR. BELACHO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
12 KENT ANGELO CUYO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
13 DANTE DADOR / / / / / / / / / / / / / / / / / / / / / / / / / / / /
14 J.U EWAN / / / / / / / / / / / / / / / / / / / / / / / / / / / /
15 ERASMO GAYO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
16 GILBERT LAMA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
17 ARJAY MAGHANOY / / / / / / / / / / / / / / / / / / / / / / / / / / / /
18 SAMME BOLANTE / / / / / / / / / / / / / / / / / / / / / / / / / / / /
19 AHN AUTES / / / / / / / / / / / / / / / / / / / / / / / / / / / /
20 MYRA AUTES / / / / / / / / / / / / / / / / / / / / / / / / / / / /
21 RONAMAE SACAY / / / / / / / / / / / / / / / / / / / / / / / / / / / /
22 NICOLE CERNA / / / / / / / / / / / / / / / / / / / / / / / / / / /
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF FEBRUARY , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 3 Section :MASUNURIN
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1 HAZEL GALOLA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
2 AISHA MAE TANEZA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
3 JHONRIL SEGUIDO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
4 JAZZY MACARON / / / / / / / / / / / / / / / / / / / / / / / / / / / /
5 DANIEL CERNA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
6 KIAN CERNA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
7 JHONMER E. DIVINAGRACIA / / / / / / / / / / / / / / / / / / / / / / / / / / / /
8 JASON FUENTES / / / / / / / / / / / / / / / / / / / / / / / / / / / /
9 JOHN RJ JUNDIT / / / / / / / / / / / / / / / / / / / / / / / / / / / /
10 JAMES OMBAL / / / / / / / / / / / / / / / / / / / / / / / / / / / /
11 PAUL JAKE SEGUIDO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
12 XYDIL YURI KHIRT SIOC / / / / / / / / / / / / / / / / / / / / / / / / / / / /
13 HANNAH THEA BELACHO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
14 JENN MARIE CAYETANO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
15 NICOLE GALICIO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
16 GILLIAN GINDOY / / / / / / / / / / / / / / / / / / / / / / / / / / / /
17 ANGELINE POLINIO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
18 ARJIE BELLARMINO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
19 HAYDE BOLANTE / / / / / / / / / / / / / / / / / / / / / / / / / / / /
20 SATURNINO OMBAL / / / / / / / / / / / / / / / / / / / / / / / / / / / /
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
 ( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF FEBRUARY , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 4 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1 JISSIEL CABACOY / / / / / / / / / / / / / / / / / / / / / / / / / / / /
2 ANA MAE CASTANAS / / / / / / / / / / / / / / / / / / / / / / / / / / / /
3 MARIAN GRABILLO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
4 JASMINE LAURENTE / / / / / / / / / / / / / / / / / / / / / / / / / / / /
5 CHARITY PEREZ / / / / / / / / / / / / / / / / / / / / / / / / / / / /
6 SAMANTA RIM / / / / / / / / / / / / / / / / / / / / / / / / / / / /
7 GWYNETH ASHLEY KATE SIOC / / / / / / / / / / / / / / / / / / / / / / / / / / / /
8 JENADEN SUMAYANG / / / / / / / / / / / / / / / / / / / / / / / / / / / /
9 REZLYN CABUDLAY / / / / / / / / / / / / / / / / / / / / / / / / / / / /
10 ARWIN ABERO / / / / / / / / / / / / / / / / / / / / / / / / / / / /
TOTAL:
Prepared by:
 B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF MARCH , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: KINDER Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF MARCH , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 1 Section :MASINOP
School ID Number: 124154
 ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
3
4
5
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF MARCH , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 2 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
 3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING
 FOR THE MONTH OF MARCH , SY :2021-2022
Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 3 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF MARCH , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 4 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
3
4
5
6
7
8
9
10
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF APRIL , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: KINDER Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
 TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF APRIL , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 1 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
3
4
5
TOTAL:
Prepared by:
 B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF APRIL , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 2 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF APRIL , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 3 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
 2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF APRIL , SY :2021-2022

Region VIII
Division: School: HUGPA ELEMENTARY SCHOOL
District: Grade: GRADE 4 Section :MASINOP
School ID Number: 124154

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
1
2
3
4
5
6
7
8
9
10
TOTAL:
Prepared by:

B. Deworming D. Actual Feeding

Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60

ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
 ACTUAL FEEDING
36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
SBFP Form 5 (2020)

DEPARTMENT OF EDUCATION
REGION VIII

REGION/DIVISION/DISTRICT: VIII/ORMOC/II
NAME OF SCHOOL: HUGPA ELEM. SCHOOL
SCHOOL ID NO.: 124154

SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT

LIST OF AUTHORIZED CONSIGNEES

NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN SIGNATURE

1
JOVEN T. TOMADA 9235692046

2 (School Feeding Coordinator)

JOVELYN L. RANIN 9631167978 [email protected].

3 (School Property Custodian)

JESSA J. SIOC 9109788349 [email protected]

Note: This form shall be filled-up by School Drop-off points to be given to the NDA/Dairy Cooperative supplier on the first
delivery of milk. Only authorized consignees are allowed to receive the goods.
SBFP Form 6 (2020)

DEPARTMENT OF EDUCATION
Region VIII

REGION/DIVISION/DISTRICT: VIII/ORMOC/II
NAME OF SCHOOL: HUGPA ELEM. SCHOOL
SCHOOL ID NO.: 124154

SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT

LIST OF BENEFICIARIES (SY 2021-2022)

Classification of Students in terms of Milk Tolerance (Please check one)
Without milk With milk Not allowed by parents to participate in milk
intolerance and will intolerance but feeding
Name Grade & Section participate in milk willing to
feeding participate in milk
feeding
1 RHOCO B. ABERO KINDER /
2 JAY-R O. BOGANE KINDER /
3 LORENS S. CARILLO KINDER /
4 JHONMARK J. LIQUIN KINDER /
5 EJAY C. LONZAGA KINDER /
6 JARED B. MUTYA KINDER /
7 JHON CARLO P. OMBAL KINDER /
8 JOSHUA P. OMBAL KINDER /
9 NEIL SEBASTIAN S. SITOY KINDER /
10 JENIFER AUTES KINDER /
11 CATCHEMA PRINCESS L. CERNA KINDER /
12 PRINCESS ASHLEY KATE S. CUYO KINDER /
13 JESSE MAY O. DADOR KINDER /
14 RHEA MARIE I. GALOLA KINDER /
15 PRINCESS REYVAN KATE JUNDIT KINDER /
16 SAVANAH JULIA KATE JUNDIT KINDER /
17 ALJHEAN T. PALOMA KINDER /
18 CLEOFE JANE L. RANIN KINDER /
19 JASHA MICHELLE A. SANCHEZ KINDER /
20 CRECHELLE C. SANICO KINDER /
21 JESSIE S. BOLANTE GRADE 1 /
SBFP Form 6 (2020)

22 KRIZ JOHN G. LAURENTE GRADE 1 /

23 ROSELYN GRABILLO GRADE 1 /
24 MIRASOL LABAJO GRADE 1 /
25 SOPHIA T. TALABOC GRADE 1 /
26 RONYL AUTES GRADE 2 /
27 ANTHONY CERNA GRADE 2 /
28 JOHN KENNETH SEGUIDO GRADE 2 /
29 EUGENE SIOC GRADE 2 /
30 JESBERT SUMAYANG GRADE 2 /
31 KRISTELLE AUTES GRADE 2 /
32 DAISY LEI P. BANAY GRADE 2 /
33 MARY JOY E. DIVINAGRACIA GRADE 2 /
34 JHAZENA SEGUIDO GRADE 2 /
35 CHARMEN PEREZ GRADE 2 /
36 ROLDAN JR. BELACHO GRADE 2 /
37 KENT ANGELO CUYO GRADE 2 /
38 DANTE DADOR GRADE 2 /
39 J.U EWAN GRADE 2 /
40 ERASMO GAYO GRADE 2 /
41 GILBERT LAMA GRADE 2 /
42 ARJAY MAGHANOY GRADE 2 /
43 SAMME BOLANTE GRADE 2 /
44 AHN AUTES GRADE 2 /
45 MYRA AUTES GRADE 2 /
46 RONAMAE SACAY GRADE 2 /
47 NICOLE CERNA GRADE 2 /
48 HAZEL GALOLA GRADE 3 /
49 AISHA MAE TANEZA GRADE 3 /
50 JHONRIL SEGUIDO GRADE 3 /
51 JAZZY MACARON GRADE 3 /
52 DANIEL CERNA GRADE 3 /
53 KIAN CERNA GRADE 3 /
54 JHONMER E. DIVINAGRACIA GRADE 3 /
55 JASON FUENTES GRADE 3 /
56 JOHN RJ JUNDIT GRADE 3 /
57 JAMES OMBAL GRADE 3 /
58 PAUL JAKE SEGUIDO GRADE 3 /
SBFP Form 6 (2020)

59 XYDIL YURI KHIRT SIOC GRADE 3 /

60 HANNAH THEA BELACHO GRADE 3 /
61 JENN MARIE CAYETANO GRADE 3 /
62 NICOLE GALICIO GRADE 3 /
63 GILLIAN GINDOY GRADE 3 /
64 ANGELINE POLINIO GRADE 3 /
65 ARJIE BELLARMINO GRADE 3 /
66 HAYDE BOLANTE GRADE 3 /
67 SATURNINO OMBAL GRADE 3 /
68 JISSIEL CABACOY GRADE 4 /
69 ANA MAE CASTANAS GRADE 4 /
70 MARIAN GRABILLO GRADE 4 /
71 JASMINE LAURENTE GRADE 4 /
72 CHARITY PEREZ GRADE 4 /
73 SAMANTA RIM GRADE 4 /
74 GWYNETH ASHLEY KATE SIOC GRADE 4 /
75 JENADEN SUMAYANG GRADE 4 /
76 REZLYN CABUDLAY GRADE 4 /
77 ARWIN ABERO GRADE 4 /
Prepared by: APPROVED BY:

JOVELYN L. RAÑIN JOVEN T. TOMADA

School Feeding Coordinator School Head
SBFP Form 7 (2020)

DEPARTMENT OF EDUCATION
Region VIII

REGION/DIVISION/DISTRICT: VIII/ORMOC/II
NAME OF SCHOOL: HUGPA ELEM. SCHOOL
SCHOOL ID NO.: 124154

SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT

MILK DELIVERIES (SY 2021-2022)

Grade Level Number of Date No. of Packs Received No. of Packs for Remarks
Beneficiaries Delivered Replacement/
New Replacemen Total (New + Rejected
t Replacement)
Kinder 20 Feb. 2,2022 77 0 0 0
Grade 1 5 Feb. 8,2022 77 0 0 0
Grade 2 22 Feb. 15,2022 77 0 0 0
Grade 3 20 Feb. 22,2022 77 0 0 0
Grade 4 10 March 1,2022 77 0 0 0
Grade 5 0 March 8,2022 77 0 0 0
Grade 6 0 ### 77 0 0 0
TOTAL: 77

Prepared by: APPROVED BY:

JOVELYN L. RANIN JOVEN T. TOMADA

School Feeding Coordinator School Head
SBFP Form 8 (2020)

DEPARTMENT OF EDUCATION
Region VIII

SCHOOL-BASED FEEDING PROGRAM MONTHLY/QUARTERLY REPORT (SY 2021-2022)

Region/Division:

Financial Status
Status of
Implementation
Amount Liquidation
Actual % (when Remarks (state if
Target No. Downloade Status of
No. of SDO No. of started, completed, fully/partially
Division/Schools of SBFP d to downloading of
Schools SBFP Schools/SD
(SBFP discontinue, for Amount liquidated &
Schools /Received funds to Schools Disbursed
Schools O Schools) continuation or number Allocated reason)
by SDOs or or to NDA/PCC
of feeding days 1st 2nd
NDA/PCC for milk
completed)
for milk

Prepared by: Approved by:

RO/SDO Focal Person Regional Director/ Schools Division Superintendent

RO/SDO Accountant