Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
SBFP Form 11
School-Based Feeding Program
QUESTIONNAIRE FOR THE PROGRESS MONITORING AND EVALUATION
(Division Level)
SY 2023 - 2024
School: _____________ Date: _______________
1. Preparation of Data for the Program
List of beneficiaries
Nutritional Assessment
Number Number
SW SS
W S
N N
OW T
O Total
Total
School Work and Financial Plan __________________
Cycle Menu _________________
Project Procurement Management Plan ________________
2. Release of funds from SDO to School
Amount released in School
1st tranche __________ ___________
2nd tranche __________ ___________
Date Received ___________ ___________
No funds Allocated ___________ ___________
3. Orientation of SBFP
with orientation __________________
no orientation __________________
4. Partnership with various stakeholders in the School
NGO ________________
GO ________________
LGU ________________
Foundation ________________
5. Program Management
Address: Macabulos Drive, San Roque, Tarlac City
Telephone No.: (045) 982-0374 / (045) 923-1380
Email Address:
[email protected] Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
Date Started __________________
Expected no. of days of completion _________________
Procurement method followed ________________
Nutrition Education during feeding _______________
Weighing scale used in school ______________
Compliance to cycle menu _____________
Attendance of the beneficiaries _____________
Parents Involvement _____________
6. Development of Health and Nutrition Values
Proper handwashing _____________
Prayer before and after meal _____________
Good grooming and personal hygiene _____________
7. Complementary Activities
No. of beneficiaries dewormed _____________
With functional School Garden ______________
Waste segregation and composting _____________
Adherence to food safety _____________
8. Submission of SBFP forms
with report _____________
without report _____________
9. Submission of Liquidation Report
with liquidation _____________
without liquidation _____________
10. Issues and concerns
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________
School SBFP Focal Person/School Head/Principal
Monitored by/Submitted by:
_________________________________________
Address: Macabulos Drive, San Roque, Tarlac City
Telephone No.: (045) 982-0374 / (045) 923-1380
Email Address:
[email protected] Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
Address: Macabulos Drive, San Roque, Tarlac City
Telephone No.: (045) 982-0374 / (045) 923-1380
Email Address:
[email protected]
