Summer School Health and Safety Checklist

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Summer School Health and Safety Checklist

SCHOOL ID SCHOOL NAME


SCHOOL HEAD CONTACT #

SCHOOL INFORMATION
1 Number of Enrollees Male Female
2 Number of Utilized Classrooms
3 Maximum number of Learners per Classroom
4 Average number of Electric Fans per Classroom

HEALTH
1 Are safe drinking water present in hallways (or strategic areas)? Y N
2 How many water stations (for drinking) are present?
3 Are there cold compress bags available in the School Clinic? Y N
4 If yes, how many are available?
Over the past seven (7) days, were there Learners who experienced the following? How
many?
heat rash dizziness heat cramps
5 boils (furuncle) fainting (heat syncope) cough and/or colds
mumps chickenpox nose bleeding (epistaxis)
others
other findings and/or suggestions

FACILITIES AND SAFETY


stand fan air conditioner
1 Sources of ventilation wall fan air purifier
ceiling fan windows
2 Are air passages (e.g. windows) obstructed with curtains, cabinets, etc.? Y N
3 Are air passages (e.g. windows and doors) kept open to allow airflow? Y N
4 Do you experience fluctuating electricity supply? Y N
5 Are wash facilities present? Y N
Have you established a communication plan with the Barangay Local
6 Government Unit (BLGU) or the Barangay Health Emergency Response Team Y N
(BHERT) in case an emergency happens?
other findings and/ or suggestions

COMMUNICATION
1 Did the School conduct strategic planning to address the situation? Y N
2 If YES, what are the strategic plans formulated?

3 Did the School conduct a coordination meeting with the Parents (PTA)? Y N
4 If YES, what are the agreements and items for implementation?

other findings and/ or suggestions

AGREEMENTS

SCHOOL HEAD/PERSONNEL SIGNATURE

DATE

MONITORING PERSONNEL SIGNATURE

DATE

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