SBFP Form 1

Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years /
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

1 ACUARDA, ARIANNE SOFIA Q. F 06/02/2014 06/07/2019 5,0 12 0.965 12.89 SW NO

2 ALANO,DENIEL B. M 03/25/2011 06/07/2019 8,2 1.15 1.08 0.9 SW NO
3 ALMAZAN, KARL LUI B. M 08/10/2013 06/07/2019 5 , 10 15 1.09 12.63 W NO
4 AMOLOZA,EVAN DALE Q. M 05/20/2010 06/07/2019 9,0 2.48 1.272 1.5 SW NO
5 ARMECIN, LEAH MAY M. F 05/11/2009 06/07/2019 10 , 0 18.5 1.195 12.9 W YES
6 ASAYTONO, JONABELLE R. F 09/26/2013 06/07/2019 5,9 13.6 1.04 12.57 W NO
7 BACOD, ROBERT L. M 05/24/2012 06/07/2019 7,0 18 1.18 12.9 W NO
8 BAHILLO, KEAN REI C. M 03/10/2014 06/07/2019 5,3 12.9 1.01 12.65 W YES
9 BANASIHAN, JELYN S. F 02/05/2014 06/07/2019 5,4 13.9 1.035 12.98 W NO
10 BANASIHAN, JOHN MARK A. M 07/05/2011 06/07/2019 7 , 11 15.2 1.224 10.1 SW NO
11 BANASIHAN, SHALLER ROSE P. F 05/09/2008 06/07/2019 11 , 0 28.1 1.442 13.5 W NO
12 BANASIHAN,CHASELYN A. F 08/22/2009 06/07/2019 9,9 21.7 1.283 13.1 W NO
13 BAROT, RYLIE A. M 09/03/2013 06/07/2019 5,9 14.7 1.005 14.55 W NO
14 BERDIN, JHON PAUL A. M 03/11/2012 06/07/2019 6,7 15.9 1.11 12.9 W NO
15 CECILLANO, JOHN PATRICK M. M 09/06/2013 06/07/2019 5,9 13.6 0.985 14.02 SW NO
16 CENAJO, MICO PRINCE V. M 03/24/2009 06/07/2019 10 , 2 21.9 1.292 13.1 W YES
17 CENTENO, FAITH AYESHA M. F 11/21/2012 06/07/2019 6,6 16.3 1.137 12.6 W NO
18 CERERA, PRINCESS NICOLE D. F 05/26/2010 06/07/2019 9,0 17.1 1.151 12.9 W NO
19 CHAVEZ, MARK M 01/21/2009 06/07/2019 10 , 4 19.5 1.21 13.3 W YES
20 CRUZ, JERBY A. M 11/15/2012 06/07/2019 6,6 15.4 1.088 13 W NO
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years /
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

21 CURCUERA, YUAN I. M 07/06/2009 06/07/2019 9 , 11 23 1.34 12.8 W NO

22 DALGUNTAS,KING C. M 11/14/2008 06/07/2019 10 , 6 25.1 1.39 12.9 W NO
23 DELA CRUZ, PROLAND B. M 01/08/2014 06/07/2019 5,5 14.6 1.04 13.50 W NO
24 DELMINGUEZ, JAMES MATTHEW C. M 05/13/2012 06/07/2019 7,0 18.9 1.21 12.9 W NO
25 DELMINGUEZ, YZABELLE C. F 10/16/2008 06/07/2019 10 , 7 23.3 1.328 13.2 W NO
26 DIJAN, AERA NHADINE D.V. F 05/02/2014 06/07/2019 5,1 11.7 0.993 11.87 SW NO
27 DIMAPILIS, ANGELICA T. F 01/16/2010 06/07/2019 9,4 20.3 1.25 12.9 W NO
28 DORADO, FALCONERI JR. C. M 03/23/2011 06/07/2019 8,2 20.2 1.26 12.7 W NO
29 DUMALAON, MAGUMI KEI Z. F 08/14/2011 06/07/2019 7,9 15.2 1.12 12.1 W NO
30 DUMALAON, SHANTAL MAE Z. F 03/26/2013 06/07/2019 6,2 13.5 1.032 12.6 W NO
31 ELEC, KYLE E. M 03/30/2010 06/07/2019 9,2 19.2 1.24 12.4 SW NO
32 FABIAN, JOHN MARVIN V. M 05/31/2011 06/07/2019 8,0 20.9 1.28 12.7 W NO
33 FABIAN, JOHN PAUL C. M 12/11/2008 06/07/2019 10 , 5 24.1 1.325 13.7 W NO
34 FLORES, JOHN ACE O. M 12/06/2013 06/07/2019 5,6 14.5 1.01 14.21 W NO
35 GALVEZ, ANGEL CATHLEEN C. F 03/25/2012 06/07/2019 7,2 17 1.185 12.1 W NO
36 GUILING, JERICHO J. M 12/01/2010 06/07/2019 8,6 15 1.1 12.3 SW NO
37 HUINDA, VIEN DOMINIC V. M 11/07/2011 06/07/2019 7,7 17.1 1.15 12.9 W NO
38 ILAGAN, JHAREL M. M 10/22/2009 06/07/2019 9,7 20.4 1.245 13.1 W NO
39 ILAGAN, KATE DIANNE L. F 06/04/2011 06/07/2019 8,0 13.2 1.16 9.8 SW YES
40 LANORIAS, ARNEL, Q. M 10/18/2009 06/07/2019 9,7 20.2 1.255 12.8 W NO
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years /
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

41 LAPIE, JOHNZELLE JOHN T. M 07/07/2010 06/07/2019 8 , 11 20.3 1.26 12.7 W NO

42 LAPITAN, GABRIEL ROSS M 06/25/2013 06/07/2019 6,0 14.2 1.09 11.95 W NO
43 LAPITAN, JOHN ARDEE G. M 01/19/2008 06/07/2019 11 , 4 25.9 1.373 13.7 W NO
44 LAPITAN,KHAZIE L. F 11/18/2011 06/07/2019 7,6 18.4 1.24 11.9 W NO
45 LAYNO, KRISTINE CASSANDRA C. F 08/26/2008 06/07/2019 10 , 9 23 1.293 13.7 W NO
46 LOPEZ, JERWIN A. M 04/08/2014 06/07/2019 5,2 13.7 0.99 13.98 W NO
47 LOPEZ, SHANE D.C. F 03/29/2008 06/07/2019 11 , 2 26 1.375 13.7 W NO
48 MANCIO, CHRISTIAN NOAH C. M 08/08/2011 06/07/2019 7,9 16.2 1.118 12.9 W NO
49 MARTINEZ, MARIA JHEN F 09/17/2013 06/07/2019 5,9 14.3 0.955 15.68 W NO
50 MAZO, GIMZ RALVY J. M 08/25/2010 06/07/2019 8,9 16.8 1.18 12 SW NO
51 MAZO,GENESIS B. F 12/30/2007 06/07/2019 11 , 5 23.7 1.333 13.3 W NO
52 MEDALLON, LANCE AXZELL L. M 11/13/2012 06/07/2019 6,6 15.8 1.105 12.9 W NO
53 MEDALLON, REXTOR D. M 08/20/2007 06/07/2019 11 , 9 25.9 1.438 12.5 SW NO
54 MEDENILLA, ALEJANDRE E. M 04/07/2008 06/07/2019 11 , 2 21.6 1.281 13.1 W NO
55 MELODILLAR, VINCE A. M 10/24/2013 06/07/2019 5,8 14.6 1.08 12.52 W NO
56 MENDIOLA,JOANNA ROSE C. F 03/14/2009 06/07/2019 10 , 2 21.2 1.265 13.2 W NO
57 MENIA ,ADRIAN V. M 06/28/2009 06/07/2019 9 , 11 23.9 1.342 13.2 W YES
58 MONDRAGON, CLARRISE F 12/22/2009 06/07/2019 9,5 20.4 1.27 12.6 W NO
59 MONTAŇO JR., JONIE M. M 07/03/2014 06/07/2019 4 , 11 12.6 0.955 13.82 W NO
60 MONTERO, ALIANA S. F 07/26/2013 06/07/2019 5 , 11 12 0.95 13.30 SW YES
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years /
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

61 MONTERO, JOHN ALBERT S. M 07/30/2007 06/07/2019 11 , 10 22.1 1.292 13.2 SW NO

62 MUDLONG, JAZMINE L. F 01/12/2009 06/07/2019 10 , 4 25.5 1.384 13.3 W YES
63 MUDLONG,JEFFREY- M 01/26/2006 06/07/2019 13 , 4 31.2 1.453 14.7 W YES
64 OBIN, JOHN RONIO D. M 03/23/2011 06/07/2019 8,2 19.7 1.23 13 W NO
65 OGALIN, JHON PRANCIS V. M 03/26/2009 06/07/2019 10 , 2 22.7 1.285 13.7 W YES
66 OROGO, LORAINE C. F 07/23/2013 06/07/2019 5 , 11 14.9 1.038 13.83 W NO
67 PAMULAKLAKIN, LANCE T. M 07/10/2011 06/07/2019 7 , 10 16.5 1.13 12.9 W NO
68 PASCUAL, EDZELE E. M 03/15/2008 06/07/2019 11 , 2 23.5 1.342 13 SW NO
69 PASQUA, GABRIEL T. M 02/01/2012 06/07/2019 7,4 19 1.21 12.9 W NO
70 PETRAS, CHRISTIAN A. M 06/22/2010 06/07/2019 8 , 11 21.8 1.3 12.8 W NO
71 RAMOS, MARK ALEXANDER M 01/02/2012 06/07/2019 7,5 18 1.17 13.1 W NO
72 RAMOS, YURI M. M 02/25/2014 06/07/2019 5,4 14.4 1.04 13.31 W NO
73 RECTO, RHIANNE MAE G. F 08/14/2014 06/07/2019 4 , 10 12.8 0.98 13.33 W NO
74 REGONDOLA, RODEL JR. M. M 08/22/2013 06/07/2019 5 , 10 15.2 1.041 14.03 W NO
75 ROMANES, PATRICIA B. F 04/17/2014 06/07/2019 5,2 13.7 0.99 13.98 W NO
76 ROMERO,RHIAN VENICE B. F 08/21/2007 06/07/2019 11 , 9 31.4 1.489 14.1 W NO
77 SAMADAN,CHEZTER XAVIERY E. M 01/21/2009 06/07/2019 10 , 4 21.6 1.271 13.3 W NO
78 SY, HYACINTH SUMMER S. F 03/25/2014 06/07/2019 5,3 13.3 1.02 12.78 W NO
79 SY, JIHAN F. F 07/27/2010 06/07/2019 8 , 10 16.7 1.164 12.3 W NO
80 TANDANG QUIEL ANTHONY E. M 03/12/2012 06/07/2019 7,2 21 1.74 6.9 SW NO
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years /
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

81 TANDANG, JOHN PAOLO J. M 10/02/2009 06/07/2019 9,8 20.3 1.224 13.5 W NO

82 TANDANG, LORENZ B. M 07/13/2008 06/07/2019 10 , 10 23.6 1.326 13.4 W NO
83 TANDANG,GENCEL L. F 04/28/2009 06/07/2019 10 , 1 17.8 1.201 12.3 SW YES
84 TANDANG,JOHN CELLE, G. M 09/19/2006 06/07/2019 12 , 8 29.3 1.458 13.7 W YES
85 TERROBIAS, RALPH JUSTINE D. M 12/14/2008 06/07/2019 10 , 5 23 1.312 13.3 W NO
86 TOLEDANO, JHAIRO B. M 06/29/2014 06/07/2019 4 , 11 13.5 0.97 14.35 W NO
87 VIERNEZA, YURI M. F 01/07/2014 06/07/2019 5,5 13.7 1.01 13.43 W NO
88 VILLAMAR,JANNA V. F 04/25/2012 06/07/2019 7,1 16.7 1.17 12.1 W NO
89 YANEZA, FRANCESCA E. F 12/07/2009 06/07/2019 9,6 20.5 1.25 13.1 W NO
90 YANEZA, RECCA E. M 01/17/2014 06/07/2019 5,5 13.7 1.01 13.43 W NO
91 YANEZA,PRINCE ANGEL E. M 04/20/2007 06/07/2019 12 , 1 24.7 1.314 14.3 W NO

Prepared by: Noted by:

GISELA I. PINGAD
AIDA C. LITARGO Unit Chief
Feeding Focal Person
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years / Name of Parents
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

1 ACUARDA, ARIANNE SOFIA Q. F 06/02/2014 06/07/2019 5,0 12 0.965 12.89 SW NO QUIATZON, EDMALYN F.
2 ALANO,DENIEL B. M 03/25/2011 06/07/2019 8,2 1.15 1.08 0.9 SW NO BECISLAO, LOVELY JOY
3 ALMAZAN, KARL LUI B. M 08/10/2013 06/07/2019 5 , 10 15 1.09 12.63 W NO BLANCO, OLIVIA T.
4 AMOLOZA,EVAN DALE Q. M 05/20/2010 06/07/2019 9,0 2.48 1.272 1.5 SW NO AMOLOZA, DAVE S.
5 ARMECIN, LEAH MAY M. F 05/11/2009 06/07/2019 10 , 0 18.5 1.195 12.9 W YES ARMECIN, BERNANRD M.
6 ASAYTONO, JONABELLE R. F 09/26/2013 06/07/2019 5,9 13.6 1.04 12.57 W NO REPLAN, ANNABEL S.
7 BACOD, ROBERT L. M 05/24/2012 06/07/2019 7,0 18 1.18 12.9 W NO BACOD, RINA L.
8 BAHILLO, KEAN REI C. M 03/10/2014 06/07/2019 5,3 12.9 1.01 12.65 W YES CABRAL, CLAUDINE ERIKA A.
9 BANASIHAN, JELYN S. F 02/05/2014 06/07/2019 5,4 13.9 1.035 12.98 W NO SORIZO, EVANGELINE E.
10 BANASIHAN, JOHN MARK A. M 07/05/2011 06/07/2019 7 , 11 15.2 1.224 10.1 SW NO BANASIHAN, MARILOU
11 BANASIHAN, SHALLER ROSE P. F 05/09/2008 06/07/2019 11 , 0 28.1 1.442 13.5 W NO BANASIHAN, SANDY E.
12 BANASIHAN,CHASELYN A. F 08/22/2009 06/07/2019 9,9 21.7 1.283 13.1 W NO BANASIHAN, APOLONIO N.
13 BAROT, RYLIE A. M 09/03/2013 06/07/2019 5,9 14.7 1.005 14.55 W NO ABAD, MARY ROSE C.
14 BERDIN, JHON PAUL A. M 03/11/2012 06/07/2019 6,7 15.9 1.11 12.9 W NO BERDIN, RAMEL
15 CECILLANO, JOHN PATRICK M. M 09/06/2013 06/07/2019 5,9 13.6 0.985 14.02 SW NO MORENO, MARILYN P.
16 CENAJO, MICO PRINCE V. M 03/24/2009 06/07/2019 10 , 2 21.9 1.292 13.1 W YES CENAJO, MANUEL
17 CENTENO, FAITH AYESHA M. F 11/21/2012 06/07/2019 6,6 16.3 1.137 12.6 W NO CENTENO, RUBEN
18 CERERA, PRINCESS NICOLE D. F 05/26/2010 06/07/2019 9,0 17.1 1.151 12.9 W NO CERERA, EDGAR
19 CHAVEZ, MARK M 01/21/2009 06/07/2019 10 , 4 19.5 1.21 13.3 W YES CHAVEZ, MARY ANN S.
20 CRUZ, JERBY A. M 11/15/2012 06/07/2019 6,6 15.4 1.088 13 W NO CRUZ, JULIUS
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years / Name of Parents
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

21 CURCUERA, YUAN I. M 07/06/2009 06/07/2019 9 , 11 23 1.34 12.8 W NO CORCUERA, MA. THERESA

22 DALGUNTAS,KING C. M 11/14/2008 06/07/2019 10 , 6 25.1 1.39 12.9 W NO DALGUNTAS, ARCENIA C.
23 DELA CRUZ, PROLAND B. M 01/08/2014 06/07/2019 5,5 14.6 1.04 13.50 W NO DELA CRUZ, MARITES
24 DELMINGUEZ, JAMES MATTHEW C. M 05/13/2012 06/07/2019 7,0 18.9 1.21 12.9 W NO CANAWAY, ANDREA MAE B.
25 DELMINGUEZ, YZABELLE C. F 10/16/2008 06/07/2019 10 , 7 23.3 1.328 13.2 W NO DELMINGUEZ, MILAGROS
26 DIJAN, AERA NHADINE D.V. F 05/02/2014 06/07/2019 5,1 11.7 0.993 11.87 SW NO DE VILLA, MARITESS Q.
27 DIMAPILIS, ANGELICA T. F 01/16/2010 06/07/2019 9,4 20.3 1.25 12.9 W NO DIMAPILIS, MARY GRACE
28 DORADO, FALCONERI JR. C. M 03/23/2011 06/07/2019 8,2 20.2 1.26 12.7 W NO DORADO, FALCONERI
29 DUMALAON, MAGUMI KEI Z. F 08/14/2011 06/07/2019 7,9 15.2 1.12 12.1 W NO DUMALAON, ROWENA M.
30 DUMALAON, SHANTAL MAE Z. F 03/26/2013 06/07/2019 6,2 13.5 1.032 12.6 W NO DUMALAON, ROWENA M.
31 ELEC, KYLE E. M 03/30/2010 06/07/2019 9,2 19.2 1.24 12.4 SW NO ELEC, PILAMER
32 FABIAN, JOHN MARVIN V. M 05/31/2011 06/07/2019 8,0 20.9 1.28 12.7 W NO FABIAN, MARVIN
33 FABIAN, JOHN PAUL C. M 12/11/2008 06/07/2019 10 , 5 24.1 1.325 13.7 W NO FABIAN, MARIO R.
34 FLORES, JOHN ACE O. M 12/06/2013 06/07/2019 5,6 14.5 1.01 14.21 W NO ORDANZA, JENNIFER S.
35 GALVEZ, ANGEL CATHLEEN C. F 03/25/2012 06/07/2019 7,2 17 1.185 12.1 W NO GALVES, CHRISTIAN
36 GUILING, JERICHO J. M 12/01/2010 06/07/2019 8,6 15 1.1 12.3 SW NO GULING, JENNIFER
37 HUINDA, VIEN DOMINIC V. M 11/07/2011 06/07/2019 7,7 17.1 1.15 12.9 W NO HUINDA, EDISON O.
38 ILAGAN, JHAREL M. M 10/22/2009 06/07/2019 9,7 20.4 1.245 13.1 W NO ILAGAN, JOAN F.
39 ILAGAN, KATE DIANNE L. F 06/04/2011 06/07/2019 8,0 13.2 1.16 9.8 SW YES ILAGAN, ANGELITO
40 LANORIAS, ARNEL, Q. M 10/18/2009 06/07/2019 9,7 20.2 1.255 12.8 W NO LANORIAS, KLARISSA D.
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years / Name of Parents
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

41 LAPIE, JOHNZELLE JOHN T. M 07/07/2010 06/07/2019 8 , 11 20.3 1.26 12.7 W NO LAPIE, LUCY
42 LAPITAN, GABRIEL ROSS M 06/25/2013 06/07/2019 6,0 14.2 1.09 11.95 W NO LAPITAN, ROSALYN
43 LAPITAN, JOHN ARDEE G. M 01/19/2008 06/07/2019 11 , 4 25.9 1.373 13.7 W NO LAPITAN, ARDEE
44 LAPITAN,KHAZIE L. F 11/18/2011 06/07/2019 7,6 18.4 1.24 11.9 W NO LAPITAN, DOMINGO A.
45 LAYNO, KRISTINE CASSANDRA C. F 08/26/2008 06/07/2019 10 , 9 23 1.293 13.7 W NO LAYNO, RUDY C.
46 LOPEZ, JERWIN A. M 04/08/2014 06/07/2019 5,2 13.7 0.99 13.98 W NO ALVAREZ, FLORA C.
47 LOPEZ, SHANE D.C. F 03/29/2008 06/07/2019 11 , 2 26 1.375 13.7 W NO LOPEZ, GRACIE O.
48 MANCIO, CHRISTIAN NOAH C. M 08/08/2011 06/07/2019 7,9 16.2 1.118 12.9 W NO MANCIO, ANGELO
49 MARTINEZ, MARIA JHEN F 09/17/2013 06/07/2019 5,9 14.3 0.955 15.68 W NO ALVARADO, JERALYN
50 MAZO, GIMZ RALVY J. M 08/25/2010 06/07/2019 8,9 16.8 1.18 12 SW NO MAZO, GIMBER
51 MAZO,GENESIS B. F 12/30/2007 06/07/2019 11 , 5 23.7 1.333 13.3 W NO BIJAR, ROSANA
52 MEDALLON, LANCE AXZELL L. M 11/13/2012 06/07/2019 6,6 15.8 1.105 12.9 W NO MEDALLON, CHARDEN D.
53 MEDALLON, REXTOR D. M 08/20/2007 06/07/2019 11 , 9 25.9 1.438 12.5 SW NO MEDALLON, FLORENCE
54 MEDENILLA, ALEJANDRE E. M 04/07/2008 06/07/2019 11 , 2 21.6 1.281 13.1 W NO MEDENILLA, ARTHUR R.
55 MELODILLAR, VINCE A. M 10/24/2013 06/07/2019 5,8 14.6 1.08 12.52 W NO MELODILLAR, AN AROSE A.
56 MENDIOLA,JOANNA ROSE C. F 03/14/2009 06/07/2019 10 , 2 21.2 1.265 13.2 W NO MENDIOLA, FEDERICO JR.
57 MENIA ,ADRIAN V. M 06/28/2009 06/07/2019 9 , 11 23.9 1.342 13.2 W YES MENIA, MARK ANDREW C.
58 MONDRAGON, CLARRISE F 12/22/2009 06/07/2019 9,5 20.4 1.27 12.6 W NO MONDRAGON. JERICO L.
59 MONTAŇO JR., JONIE M. M 07/03/2014 06/07/2019 4 , 11 12.6 0.955 13.82 W NO MOSQUEDA, GINA
60 MONTERO, ALIANA S. F 07/26/2013 06/07/2019 5 , 11 12 0.95 13.30 SW YES MENESES, LEAS S.
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years / Name of Parents
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

61 MONTERO, JOHN ALBERT S. M 07/30/2007 06/07/2019 11 , 10 22.1 1.292 13.2 SW NO MONTERO, LAMBERTO M.
62 MUDLONG, JAZMINE L. F 01/12/2009 06/07/2019 10 , 4 25.5 1.384 13.3 W YES MUDLONG, CHRISTY
63 MUDLONG,JEFFREY- M 01/26/2006 06/07/2019 13 , 4 31.2 1.453 14.7 W YES MUDLONG, CHRISTY
64 OBIN, JOHN RONIO D. M 03/23/2011 06/07/2019 8,2 19.7 1.23 13 W NO OBIN, WILMER
65 OGALIN, JHON PRANCIS V. M 03/26/2009 06/07/2019 10 , 2 22.7 1.285 13.7 W YES OGALIN, PRINCESS V.
66 OROGO, LORAINE C. F 07/23/2013 06/07/2019 5 , 11 14.9 1.038 13.83 W NO OROGO, GLORIA C.
67 PAMULAKLAKIN, LANCE T. M 07/10/2011 06/07/2019 7 , 10 16.5 1.13 12.9 W NO PAMULAKLAKIN, ALLAN
68 PASCUAL, EDZELE E. M 03/15/2008 06/07/2019 11 , 2 23.5 1.342 13 SW NO PASCUAL, IGNACIO
69 PASQUA, GABRIEL T. M 02/01/2012 06/07/2019 7,4 19 1.21 12.9 W NO PASCUA, RAFAEL
70 PETRAS, CHRISTIAN A. M 06/22/2010 06/07/2019 8 , 11 21.8 1.3 12.8 W NO PETRAS, LESLIE
71 RAMOS, MARK ALEXANDER M 01/02/2012 06/07/2019 7,5 18 1.17 13.1 W NO RAMOS, LORENA
72 RAMOS, YURI M. M 02/25/2014 06/07/2019 5,4 14.4 1.04 13.31 W NO MORILLO, JENNY C.
73 RECTO, RHIANNE MAE G. F 08/14/2014 06/07/2019 4 , 10 12.8 0.98 13.33 W NO GARCIA, JOANA LYNN S.
74 REGONDOLA, RODEL JR. M. M 08/22/2013 06/07/2019 5 , 10 15.2 1.041 14.03 W NO MARFORI, ANN MARIE M.
75 ROMANES, PATRICIA B. F 04/17/2014 06/07/2019 5,2 13.7 0.99 13.98 W NO BRON, JENELY B.
76 ROMERO,RHIAN VENICE B. F 08/21/2007 06/07/2019 11 , 9 31.4 1.489 14.1 W NO ROMERO, VENUS
77 SAMADAN,CHEZTER XAVIERY E. M 01/21/2009 06/07/2019 10 , 4 21.6 1.271 13.3 W NO SAMADAN, MA. ANACEL E.
78 SY, HYACINTH SUMMER S. F 03/25/2014 06/07/2019 5,3 13.3 1.02 12.78 W NO SY, JOVETH H.
79 SY, JIHAN F. F 07/27/2010 06/07/2019 8 , 10 16.7 1.164 12.3 W NO FERNANDEZ, AGNES
80 TANDANG QUIEL ANTHONY E. M 03/12/2012 06/07/2019 7,2 21 1.74 6.9 SW NO TANDANG, JOBELLE E.
SBFP Form 1
Department of Education
Region IV-A (CALABARZON)

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

Division/Province: LAGUNA Name of Principal : GISELA I. PINGAD

City/ Municipality/Barangay : LOS BAÑOS/BAYOG Name of Feeding Focal Person : AIDA C. LITARGO
Name of School / School District : BAYOG E/S / LOS BAÑOS

BMI for Participation

Date of Weighing / Age in
Date of Birth Weight Height 6 y.o. Nutritional in 4Ps
No. Name Sex Measuring Years / Name of Parents
(MM/DD/YYYY)
(MM/DD/YYYY) Months
(Kg) (cm) and Status (NS) (yes or
above no)

81 TANDANG, JOHN PAOLO J. M 10/02/2009 06/07/2019 9,8 20.3 1.224 13.5 W NO TANDANG, SUNSHINE
82 TANDANG, LORENZ B. M 07/13/2008 06/07/2019 10 , 10 23.6 1.326 13.4 W NO TANDANG, CALVERT M.
83 TANDANG,GENCEL L. F 04/28/2009 06/07/2019 10 , 1 17.8 1.201 12.3 SW YES TANDANG, CELERINA L.
84 TANDANG,JOHN CELLE, G. M 09/19/2006 06/07/2019 12 , 8 29.3 1.458 13.7 W YES TANDANG, NUMERIANO JR.
85 TERROBIAS, RALPH JUSTINE D. M 12/14/2008 06/07/2019 10 , 5 23 1.312 13.3 W NO TERROBIAS, RENATO
86 TOLEDANO, JHAIRO B. M 06/29/2014 06/07/2019 4 , 11 13.5 0.97 14.35 W NO BAKLAS, MARY JOY G.
87 VIERNEZA, YURI M. F 01/07/2014 06/07/2019 5,5 13.7 1.01 13.43 W NO MORENO, EMERLYN
88 VILLAMAR,JANNA V. F 04/25/2012 06/07/2019 7,1 16.7 1.17 12.1 W NO VILLAMAR, JOSE
89 YANEZA, FRANCESCA E. F 12/07/2009 06/07/2019 9,6 20.5 1.25 13.1 W NO YANEZA, DONNALYN
90 YANEZA, RECCA E. M 01/17/2014 06/07/2019 5,5 13.7 1.01 13.43 W NO ESTOLE, DONALYN S.
91 YANEZA,PRINCE ANGEL E. M 04/20/2007 06/07/2019 12 , 1 24.7 1.314 14.3 W NO YANEZA, DONNALYN

Prepared by: Noted by:

GISELA I. PINGAD
AIDA C. LITARGO Unit Chief
Feeding Focal Person
SBFP Form 2
Department of Education
Region IV - A (CALABARZON)

SCHOOL-BASED FEEDING PROGRAM (SBFP) LIST OF SCHOOLS

Division/Province: LAGUNA
School District/City/ Municipality : LOS BAÑOS

Name of District Supervisors/ Total

Name of Schools BEIS ID No. School Address Name of Barangay Contact Number
School Principal or OICs Beneficiaries

BAYOG ELEM. SCHOOL 108304 Tagpuan St., Brgy. Bayog, L.B.L. Bayog GISELA I. PINGAD 0492533599 91

Prepared by: Noted by:

AIDA C. LITARGO GISELA I. PINGAD

SBFP DepED Focal Unit Chief

Note: This form shall be prepared by the DO, for final consolidation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
SBFP Form 3
Department of Education
Region IV-A (CALABARZON)

SCHOOL-BASED FEEDING PROGRAM (SBFP) SUMMARY OF BENEFICIARIES & START OF FEEDING

Division/Province: LAGUNA
City/ Municipality/Barangay : LOS BAÑOS
Name of School / School District : BAYOG E/S / LOS BAÑOS

Date of Start of Feeding: July 8, 2019

Nutritional Status at Start of Feeding

Number of Undernourished School
Children by Grade Level No. of Pupils who are
No. of Severely Total No. of 4 Ps beneficiaries in
Wasted No. of Wasted Beneficiaries Beneficiaries previous years

1. Kinder 4 18 22 2 0

2. Grade I 1 10 11 0 6

3. Grade II 2 11 13 0 8

4. Grade III 2 3 5 2 4

5. Grade IV 4 9 13 1 6

6. Grade V 1 14 15 6 11

7. Grade VI 2 10 12 1 3

Total 16 75 91 12 38

Prepared by: Noted by:

GISELA I. PINGAD
AIDA C. LITARGO Unit Chief
SBFP DepEd Focal

Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DepEd-HNC
T OF FEEDING

Remarks

GISELA I. PINGAD
Unit Chief

, for submission to DepEd-HNC

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

FOR THE MONTH OF JULY-AUGUST , SY 2019-2020

Region IV-A CALABRZON
Division LAGUNA School: BAYOG ELEMENTARY SCHOOL
District LOS BAÑOS Grade: KINDERGARTEN

ACTUAL FEEDING
PRE FEEDING
4Ps
NAME OF PUPIL Beneficiary Beneficiary Nutritional Status Deworming
(y or n) of Previous Ht Wt Date
SBFP
Age Birth Date Sex (√ ) or Date
NS
(y or n) cm kg Taken (X) Taken 8 9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30 21 1 2
1 ACUARDA, ARIANNE SOFIA QUIATZON N N 5.00 06/02/2014 F 96.50 12.00 7/6/2019 SW
2 MONTERO, ALIANA SAMIANO Y N 5.11 07/26/2013 F 95 12.00 7/6/2019 SW
3 CECILLANO, JOHN PATRICK MORENO N N 5.9 09/06/2013 M 98.50 13.60 7/6/2019 SW
4 DIJAN, AERA NHADINE DE VILLA N N 5.10 05/02/2014 F 99.30 11.70 7/6/2019 SW
5 BAHILLO, KEAN REI CABRAL Y N 5.3 03/10/2014 M 101 12.90 7/6/2019 W
6 BANASIHAN, JELYN SORIZO N N 5.4 02/05/2014 F 103.50 13.90 7/6/2019 W
7 FLORES, JOHN ACE ORDANZA N N 5.6 12/06/2013 M 101 14.50 7/6/2019 W
8 ALMAZAN, KARL LUI B. N N 5.10 08/10/2013 M 109 15.00 7/6/2019 W
9 DELA CRUZ, PROLAND B. N N 5.5 01/08/2014 M 104 14.60 7/6/2019 W
10 MELODILLAR, VINCE AARON N N 5.8 10/24/2013 M 108 14.60 7/6/2019 W
11 RAMOS, YURI M. N N 5.4 02/25/2014 M 104 14.40 7/6/2019 W
12 YANEZA, RECCA E. N N 5.5 01/17/2014 M 101 13.70 7/6/2019 W
13 ASAYTONO, JONABELLE R. N N 5.9 09/26/2013 F 104 13.60 7/6/2019 W
14 ROMANES, PATRICIA B. N N 5.2 04/17/2014 F 99 13.70 7/6/2019 W
15 SY, HYACINTH SUMMER S. N N 5.3 03/25/2014 F 102 13.30 7/6/2019 W
16 VIERNEZA, YURI M. N N 5.5 01/07/2014 F 101 13.70 7/6/2019 W
17 BAROT, RYLIE ABAD N N 5.9 09/03/2013 M 100.50 14.70 7/6/2019 W
18 MONTAŇO JR., JONIE MOSQUEDA N N 4.11 07/03/2014 M 95.50 12.60 7/6/2019 W
19 MARTINEZ, MARIA JHEN N N 5.9 09/17/2013 F 95.50 14.30 7/6/2019 W
20 RECTO, RHIANNE MAE GARCIA N N 4.10 08/14/2014 F 98 12.80 7/6/2019 W
21 LOPEZ, JERWIN ALVAREZ N N 5.2 04/08/2014 M 99 13.70 7/6/2019 W
22 TOLEDANO, JHAIRO BAKLAS N N 4.11 06/29/2014 M 97 13.50 7/6/2019 W

TOTAL:
Prepared by:
LEGEND
AIDA C. LITARGO A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght
O - Obese

Note: This form shall be prepared by the school to be consolidated using SBFP Form 5
Page 14
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF JULY-AUGUST , SY 2019-2020

Region IV-A CALABRZON
Division LAGUNA School: BAYOG ELEMENTARY SCHOOL
District LOS BAÑOS Grade: ONE

ACTUAL FEEDING
PRE FEEDING
4Ps
NAME OF PUPIL Beneficiary Beneficiary Nutritional Status Deworming
(y or n) of Previous Ht Wt Date
SBFP
Age Birth Date Sex (√ ) or Date
NS
(y or n) cm kg Taken (X) Taken 8 9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30 21 1 2
1 ALANO,DENIEL,BECISLAO N Y 8.2 03/25/2011 M 108 1.15 7/6/2019 SW
2 CRUZ, JERBY A. N N 6.6 11/15/2012 M 108.80 15.4 7/6/2019 W
3 DUMALAON, SHANTAL MAE Z. N Y 6.2 03/26/2013 F 103.20 13.5 7/6/2019 W
4 BERDIN, JHON PAUL A. N Y 6.7 03/11/2012 M 111 15.9 7/6/2019 W
5 LAPITAN, GABRIEL ROSS N Y 6.0 06/25/2013 M 109 14.2 7/6/2019 W
6 OROGO, LORAINE C. N N 5.11 07/23/2013 F 103.80 14.9 7/6/2019 W
7 CENTENO, FAITH AYESHA M. N N 6.6 11/21/2012 F 113.70 16.3 7/6/2019 W
8 MEDALLON, LANCE AXZELL L. N N 6.6 11/13/2012 M 110.50 15.8 7/6/2019 W
9 REGONDOLA, RODEL JR. M. N Y 5.10 08/22/2013 M 104.10 15.2 7/6/2019 W
10 LAPITAN,KHAZIE,LUGA N N 7.6 11/18/2011 F 124 18.4 7/6/2019 W
11 VILLAMAR,JANNA,VERGARA N Y 7.1 04/25/2012 F 117 16.7 7/6/2019 W

TOTAL:
Prepared by:
LEGEND
AIDA C. LITARGO A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght
O - Obese

Page 15
Note: This form shall be prepared by the school to be consolidated using SBFP Form 5

Page 16
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF JULY-AUGUST , SY 2019-2020

Region IV-A CALABRZON
Division LAGUNA School: BAYOG ELEMENTARY SCHOOL
District LOS BAÑOS Grade: TWO

ACTUAL FEEDING
PRE FEEDING
4Ps
NAME OF PUPIL Beneficiary Beneficiary Nutritional Status Deworming
(y or n) of Previous Ht Wt Date
SBFP
Age Birth Date Sex (√ ) or Date
NS
(y or n) cm kg Taken (X) Taken 8 9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30 21 1 2
1 BANASIHAN, JOHN MARK ARCIBAL N N 7.11 07/05/2011 M 122.4 15.2 7/6/2019 SW
2 TANDANG QUIEL ANTHONY ESTOLANO N N 7.2 03/12/2012 M 174 21.0 7/6/2019 SW
3 BACOD, ROBERT L. N N 7.0 05/24/2012 M 118 18.0 7/6/2019 W
4 PETRAS, CHRISTIAN ALPINO N Y 8.11 06/22/2010 M 130 21.8 7/6/2019 W
5 RAMOS, MARK ALEXANDER N Y 7.5 01/02/2012 M 117 18.0 7/6/2019 W
6 DUMALAON, MAGUMI KEI ZOLETA N Y 7.9 08/14/2011 F 112 15.2 7/6/2019 W
7 GALVEZ, ANGEL CATHLEEN CHAVEZ N N 7.2 03/25/2012 F 118.50 17.0 7/6/2019 W
8 MANCIO, CHRISTIAN NOAH C. N Y 7.9 08/08/2011 M 111.80 16.2 7/6/2019 W
9 HUINDA, VIEN DOMINIC VALDEZ N N 7.7 11/07/2011 M 115 17.1 7/6/2019 W
10 PASQUA, GABRIEL TANDANG N Y 7.4 02/01/2012 M 121 19.0 7/6/2019 W
11 DELMINGUEZ, JAMES MATTHEW C. N Y 7.0 05/13/2012 M 121 18.9 7/6/2019 W
12 FABIAN, JOHN MARVIN V. N Y 8.0 05/31/2011 M 128 20.9 7/6/2019 W
13 PAMULAKLAKIN, LANCE T. N Y 7.10 07/10/2011 M 113 16.5 7/6/2019 W

TOTAL:
Prepared by:
LEGEND
AIDA C. LITARGO A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght
O - Obese

Page 17
Note: This form shall be prepared by the school to be consolidated using SBFP Form 5

Page 18
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF JULY-AUGUST , SY 2019-2020

Region IV-A CALABRZON
Division LAGUNA School: BAYOG ELEMENTARY SCHOOL
District LOS BAÑOS Grade: THREE

ACTUAL FEEDING
PRE FEEDING
4Ps
NAME OF PUPIL Beneficiary Beneficiary Nutritional Status Deworming
(y or n) of Previous Ht Wt Date
SBFP
Age Birth Date Sex (√ ) or Date
NS
(y or n) cm kg Taken (X) Taken 8 9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30 21 1 2
1 GUILING, JERICHO J. N Y 8.6 12/01/2010 M 110 15.0 7/6/2019 SW
2 ILAGAN, KATE DIANNE L. Y Y 8.0 06/04/2011 F 116 13.2 7/6/2019 SW
3 CHAVEZ, MARK Y Y 10.4 01/21/2009 M 121 19.5 7/6/2019 W
4 DORADO, FALCONERI JR. C. N N 8.2 03/23/2011 M 126 20.2 7/6/2019 W
5 OBIN, JOHN RONIO D. N Y 8.2 03/23/2011 M 123 19.7 7/6/2019 W

TOTAL:
Prepared by:
LEGEND
AIDA C. LITARGO A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght
O - Obese

Page 19
Note: This form shall be prepared by the school to be consolidated using SBFP Form 5

Page 20
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF JULY-AUGUST , SY 2019-2020

Region IV-A CALABRZON
Division LAGUNA School: BAYOG ELEMENTARY SCHOOL
District LOS BAÑOS Grade: FOUR

ACTUAL FEEDING
PRE FEEDING
4Ps
NAME OF PUPIL Beneficiary Beneficiary Nutritional Status Deworming
(y or n) of Previous Ht Wt Date
SBFP
Age Birth Date Sex (√ ) or Date
NS
(y or n) cm kg Taken (X) Taken 8 9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30 21 1 2
1 AMOLOZA,EVAN DALE Q. N N 9.0 05/20/2010 M 127.2 2.5 7/6/2019 SW
2 MONTERO, JOHN ALBERT S. N N 11.10 07/30/2007 M 129.2 22.1 7/6/2019 SW
3 ELEC, KYLE E. N Y 9.2 03/30/2010 M 124 19.2 7/6/2019 SW
4 MAZO, GIMZ RALVY J. N N 8.9 08/25/2010 M 118 16.8 7/6/2019 SW
5 CENAJO, MICO PRINCE V. Y N 10.2 03/24/2009 M 129.2 21.9 7/6/2019 W
6 CERERA, PRINCESS NICOLE D. N N 9.0 05/26/2010 F 151.1 17.1 7/6/2019 W
7 FABIAN, JOHN PAUL C. N N 10.5 12/11/2008 M 132.5 24.1 7/6/2019 W
8 SY, JIHAN F. N Y 8.1 07/27/2010 F 116.4 16.7 7/6/2019 W
9 YANEZA, FRANCESCA E. N Y 9.6 12/07/2009 F 125 20.5 7/6/2019 W
10 CURCUERA, YUAN I. N N 9.11 07/06/2009 M 134 23.0 7/6/2019 W
11 LAPIE, JOHNZELLE JOHN T. N Y 8.11 07/07/2010 M 126 20.3 7/6/2019 W
12 DIMAPILIS, ANGELICA T. N Y 9.4 01/16/2010 F 125 20.3 7/6/2019 W
13 MONDRAGON, CLARRISE N Y 9.5 12/22/2009 F 127 20.4 7/6/2019 W

TOTAL:
Prepared by:
LEGEND
AIDA C. LITARGO A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght
O - Obese

Page 21
Note: This form shall be prepared by the school to be consolidated using SBFP Form 5

Page 22
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF JULY-AUGUST , SY 2019-2020

Region IV-A CALABRZON
Division LAGUNA School: BAYOG ELEMENTARY SCHOOL
District LOS BAÑOS Grade: FIVE

ACTUAL FEEDING
PRE FEEDING
4Ps
NAME OF PUPIL Beneficiary Beneficiary Nutritional Status Deworming
(y or n) of Previous Ht Wt Date
SBFP
Age Birth Date Sex (√ ) or Date
NS
(y or n) cm kg Taken (X) Taken 8 9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30 21 1 2
1 TANDANG,GENCEL L. Y Y 10.1 04/28/2009 F 120.1 17.8 7/6/2019 SW
2 ILAGAN, JHAREL M. N Y 9.7 10/22/2009 M 124.5 20.4 7/6/2019 W
3 TERROBIAS, RALPH JUSTINE D. N N 10.5 12/14/2008 M 131.2 23.0 7/6/2019 W
4 ARMECIN, LEAH MAY M. Y Y 10.0 05/11/2009 F 119.5 18.5 7/6/2019 W
5 LAYNO, KRISTINE CASSANDRA C. N Y 10.9 08/26/2008 F 129.3 23.0 7/6/2019 W
6 DALGUNTAS,KING C. N Y 10.6 11/14/2008 M 139 25.1 7/6/2019 W
7 MENIA ,ADRIAN V. Y Y 9.11 06/28/2009 M 134.2 23.9 7/6/2019 W
8 OGALIN, JHON PRANCIS V. Y Y 10.2 03/26/2009 M 128.5 22.7 7/6/2019 W
9 BANASIHAN,CHASELYN A. N Y 9.9 08/22/2009 F 128.3 21.7 7/6/2019 W
10 MENDIOLA,JOANNA ROSE C. N N 10.2 03/14/2009 F 126.5 21.2 7/6/2019 W
11 LANORIAS, ARNEL, QUISING N Y 9.7 10/18/2009 M 125.5 20.2 7/6/2019 W
12 TANDANG,JOHN CELLE, GARCIA Y N 12.8 09/19/2006 M 145.8 29.3 7/6/2019 W
13 SAMADAN,CHEZTER XAVIERY, E. N Y 10.4 01/21/2009 M 127.1 21.6 7/6/2019 W
14 TANDANG, JOHN PAOLO J. N Y 9.8 10/02/2009 M 122.4 20.3 7/6/2019 W
15 MUDLONG, JAZMINE L. Y N 10.4 01/12/2009 F 138.4 25.5 7/6/2019 W

TOTAL:
Prepared by:
LEGEND
AIDA C. LITARGO A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght
O - Obese

Page 23
Note: This form shall be prepared by the school to be consolidated using SBFP Form 5

Page 24
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF JULY-AUGUST , SY 2019-2020

Region IV-A CALABRZON
Division LAGUNA School: BAYOG ELEMENTARY SCHOOL
District LOS BAÑOS Grade: SIX

ACTUAL FEEDING
PRE FEEDING
4Ps
NAME OF PUPIL Beneficiary Beneficiary Nutritional Status Deworming
(y or n) of Previous Ht Wt Date
SBFP
Age Birth Date Sex (√ ) or Date
NS
(y or n) cm kg Taken (X) Taken 8 9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30 21 1 2
1 MEDALLON, REXTOR D. N Y 11.9 08/20/2007 M 143.8 25.9 7/6/2019 SW
2 PASCUAL, EDZELE E. N N 11.2 03/15/2008 M 134.2 23.5 7/6/2019 SW
3 MUDLONG,JEFFREY- Y N 13.4 01/26/2006 M 145.3 31.2 7/6/2019 W
4 YANEZA,PRINCE ANGEL ESTOLE N N 12.1 04/20/2007 M 131.4 24.7 7/6/2019 W
5 MAZO,GENESIS BEJAR N Y 11.5 12/30/2007 F 133.3 23.7 7/6/2019 W
6 ROMERO,RHIAN VENICE BANASIHAN N N 11.9 08/21/2007 F 148.9 31.4 7/6/2019 W
7 LAPITAN, JOHN ARDEE G. N N 11.4 01/19/2008 M 137.3 25.9 7/6/2019 W
8 MEDENILLA, ALEJANDRE E. N N 11.2 04/07/2008 M 128.1 21.6 7/6/2019 W
9 TANDANG, LORENZ B. N N 10.10 07/13/2008 M 132.6 23.6 7/6/2019 W
10 BANASIHAN, SHALLER ROSE P. N N 11.0 05/09/2008 F 144.2 28.1 7/6/2019 W
11 DELMINGUEZ, YZABELLE C. N Y 10.7 10/16/2008 F 132.8 23.3 7/6/2019 W
12 LOPEZ,SHANE D.C. N N 11.2 03/29/2008 F 137.5 26 7/6/2019 W

TOTAL:
Prepared by:
LEGEND
AIDA C. LITARGO A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght
O - Obese

Page 25
Note: This form shall be prepared by the school to be consolidated using SBFP Form 5

Page 26
SBFP Form 5

SCHOOL-BASED FEEDING PROGRAM

CONSOLIDATED NUTRITIONAL STATUS AND ATT

Region: _______
Division/District: ________________________
School: ________________________________
BEIS ID No.: ___________________________

NUTRITIONAL STATUS
No. of Pupils
GRADES AND SECTIONS BEFORE
Dewormed
SW/SU W/U N Ow Ob Total
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL
Legend:
For 6-19 y.o For below 6 y.o
SW - Severely Wasted SU - Severely Underweight
W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overweight Ow - Overweight
O - Obese
Prepared by: Noted by:
_____________________________ ___________
Classroom Adviser / School Nurse Sch

Note: This form shall be prepared by the school using the data from SBFP Form 4.
SED FEEDING PROGRAM

AL STATUS AND ATTENDANCE REPORT

NUTRITIONAL STATUS PERCENTA

GE
AFTER ATTENDAN
SW/SU W/U N Ow O Total 11 CE

AVERAGE:

___________________________
School Head