Department of Social Welfare and Development, Field Office XI

Supplementary Feeding Program

14th Cycle Implementation - SY 2024-2025

MASTERLIST OF BENEFICIARIES
Province: DAVAO DE ORO City / Municipality: MACO
Child Development Center: CALABCAB SNPP Barangay: CALABCAB

NUTRITIONAL STATUS
Name of Child Sex Actual Date Weight in Height in Age in Months / Years Summary of Vitamin A Pantawid Member
Date of Birth Deworming (pls specify
NO. of Weighing Weight for Weight for Height for
Undernourished Supplementation
(Surname, First Name, M.I) (M/F) (mm/dd/yyyy) kg. cm. Children (mm/dd/yyyy) (mm/dd/yyyy)
RCCT / 4P's or
(mm/dd/yyyy)
Age Height Age MCCT)
Month Year (Wasting) (Stunting)

1 BALOZ ANTONETTE F 10/6/2021 6/6/2024 12 87.9 32 2 N N N Apr-24 Apr-24

2 CANILLO ATHALIA F 4/3/2022 6/6/2024 11.1 85 26 2 N N N Apr-24 Apr-24
3 CARULLA RHEYCYLHARA F 5/29/2022 6/6/2024 12.5 85.5 24 2 N N N Apr-24 Apr-24
4 CUAMAG NOVELYN F 6/1/2022 6/6/2024 10.5 87.2 24 2 N N N Apr-24 Apr-24
5 DUGAO BRILLE ELLISE F 11/20/2021 6/6/2024 14 90 30 2 N N N Apr-24 Apr-24
6 GELLA RHEANA F 8/7/2021 6/6/2024 12.5 90.4 34 2 N N N Apr-24 Apr-24
7 MALISA JULIANA F 4/28/2022 6/6/2024 12 85.5 25 2 N N N Apr-24 Apr-24
8 PENALVER JIARA MAE F 10/27/2021 6/6/2024 10.5 87 31 2 N N N Apr-24 Apr-24
9 TAGWAY IVY F 8/28/2021 6/6/2024 13.5 87.5 33 2 N N N Apr-24 Apr-24
10 TIMBOCO MYRA TRIXIE F 10/3/2021 6/6/2024 11.5 89.9 32 2 N N N Apr-24 Apr-24
11 YEC YEC ZIA ANDREA F 12/8/2021 6/6/2024 10 85 29 2 N N N Apr-24 Apr-24
12 BALANGGIT DAVID KING M 9/6/2021 6/6/2024 11.5 87.5 33 2 N N N Apr-24 Apr-24
13 BALUCAN ZEDEEN KYSER M 8/21/2021 6/6/2024 12 88.9 33 2 N N N Apr-24 Apr-24
14 BANDALA SAM M 10/17/2021 6/6/2024 11 88.8 31 2 N N N Apr-24 Apr-24
15 CORDERO MIKE M 6/4/2022 6/6/2024 10 80.5 24 2 N N N Apr-24 Apr-24
16 MALISA ZION M 10/23/2021 6/6/2024 13.5 95 31 2 N N N Apr-24 Apr-24
17 PATAGAN ANDRIE M 6/24/2022 6/6/2024 10 86.1 23 2 N N N Apr-24 Apr-24
18 SAFRA AJ M 6/19/2022 6/6/2024 11 80.7 23 2 N N N Apr-24 Apr-24
19 TRAYA ARIANE BLYTHE F 10/23/2021 6/6/2024 13.5 95 31 2 N N N Apr-24 Apr-24

This is to certify that the above

has been Dewormed an
Supplementation with the date
implementation.
Prepared by: Validated by: Noted by: Approved by: Certified by:

_________________________
JANET A. ARRANGUEZ BHEN ZAR M. SAM, RM, MSPH AGNES E. PERIAS ELIZABETH D. UY, RSW Midwife/Nurse/BNS/BHW
Barangay Nutrition Scholar SFP Focal Person C/MSWDO/District Head
Midwife II / MNC / SNPP Focal Person

SFP FORM 1 (c/o CDW/CDT) Page 1 of

 Child of
IPs Lactose
PWD (pls Solo
Intolerant
(pls put a
specify) Parent (pls (pls put a
check mark) put a check check mark)
mark)

s to certify that the above list of children beneficiaries

been Dewormed and received Vitamin A
ementation with the date indicated prior to the feeding
mentation.

ed by:

___________________________
fe/Nurse/BNS/BHW

SFP FORM 1 (c/o CDW/CDT) Page 2 of

 Department of Social Welfare and Development, Field Office XI
Supplementary Feeding Program
14th Cycle Implementation - SY 2023-2024

CONSOLIDATED NUTRITIONAL STATUS (NS) PER AGE BRACKET

UPON ENTRY

Province: DAVAO DE ORO City / Municipality: MACO

Child Development Center: CALABCAB SNPP Barangay: CALABCAB

2 Years Old 3 Years Old 4 Years Old 5 Years Old

WEIGHT FOR AGE
Male Female Male Female Male Female Male Female
Normal (N) 10 13
Underweight (UW)
Severely Underweight (SUW)
Overweight (OW)

WEIGHT FOR HEIGHT 2 Years Old 3 Years Old 4 Years Old 5 Years Old
(Wasting) Male Female Male Female Male Female Male Female
Normal (N) 10 13
Wasted (W)
Severely Wasted (SW)
Overweight (OW)
Obese (Ob)

HEIGHT FOR AGE 2 Years Old 3 Years Old 4 Years Old 5 Years Old
(Stunting) Male Female Male Female Male Female Male Female
Normal (N) 10 13
Stunted (S)
Severely Stunted (SS)
Tall (T)

2 Years Old 3 Years Old 4 Years Old 5 Years Old

Male Female Male Female Male Female Male Female
Summary of Undernourished
Children
Deworming 10 13
Vitamin A Supplementation 10 13
4Ps Member
Ips Member
PWD
Child of Solo Parent
Lactose Intolerant
ss Validated by: Noted by: Approved by:

SFP FORM 1.1 (c/o CDW/CDT) Page 3 of

 JANET A. ARRANGUEZ BHEN ZAR M. SAM, RM, MSPH AGNES E. PERIAS ELIZABETH D. UY, RSW
Barangay Nutrition Scholar Midwife II / MNC / SNPP Focal Person SFP Focal Person C/MSWDO/District Head

SFP FORM 1.1 (c/o CDW/CDT) Page 4 of

 TOTAL:
Male Female
10 13

TOTAL:
Male Female
10 13

TOTAL:
Male Female
10 13

TOTAL:
Male Female

10 13
10 13

SFP FORM 1.1 (c/o CDW/CDT) Page 5 of

ZABETH D. UY, RSW
MSWDO/District Head

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 Department of Social Welfare and Development, Field Office XI
Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024

WEIGHT AND HEIGHT MONITORING

Province: ____________________________________ City / Municipality: _______________________________

Child Development Center: ____________________________________ Barangay: ______________________________________

NS UPON ENTRY NS AFTER 120 FEEDING

Actual Age in Age in
Name of Child Date of Weight in Height in month/ year Summary of Actual Date Weight in Height in month/ year
No. SEX Date of Undernourished
(M/F) Birth kg. cm. Weight For Height For of Weighing kg. cm.
(Surname, First name, M.I)
(mm/dd/yyyy) Weighing Weight Children (mm/dd/yyyy) Weight Weight
(mm/dd/yyyy) For Age Height Age For Age For Height
Month Year (Wasting) (Stunting) Month Year

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

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31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

Prepared by: Noted by: Approved by:

Child Development Worker/Teacher SFP Focal Person C/MSWDO/District Head

SFP FORM 2 (c/o CDW/CDT) Page 8 of

_____________

__________

0 FEEDINGS
Summary of
Undernourished
Height For Children
Age

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 Department of Social Welfare and Development
Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.1 FEEDING No.2 FEEDING No.3 FEEDING No.4 FEEDING No.5 FEEDING No.6 FEEDING No.7 FEEDING No.8
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

10

11

12

13

14

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 15

Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.11 FEEDING No.12 FEEDING No.13 FEEDING No.14 FEEDING No.15 FEEDING No.16 FEEDING No.17 FEEDING No.18
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

10

11

12

13

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15

Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.21 FEEDING No.22 FEEDING No.23 FEEDING No.24 FEEDING No.25 FEEDING No.26 FEEDING No.27 FEEDING No.28
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

10

11

12

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.31 FEEDING No.32 FEEDING No.33 FEEDING No.34 FEEDING No.35 FEEDING No.36 FEEDING No.37 FEEDING No.38
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

10

11

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.41 FEEDING No.42 FEEDING No.43 FEEDING No.44 FEEDING No.45 FEEDING No.46 FEEDING No.47 FEEDING No.48
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

10

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.51 FEEDING No.52 FEEDING No.53 FEEDING No.54 FEEDING No.55 FEEDING No.56 FEEDING No.57 FEEDING No.58
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.61 FEEDING No.62 FEEDING No.63 FEEDING No.64 FEEDING No.65 FEEDING No.66 FEEDING No.67 FEEDING No.68
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.71 FEEDING No.72 FEEDING No.73 FEEDING No.74 FEEDING No.75 FEEDING No.76 FEEDING No.77 FEEDING No.78
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.81 FEEDING No.82 FEEDING No.83 FEEDING No.84 FEEDING No.85 FEEDING No.86 FEEDING No.87 FEEDING No.88
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.91 FEEDING No.92 FEEDING No.93 FEEDING No.94 FEEDING No.95 FEEDING No.96 FEEDING No.97 FEEDING No.98
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.101 FEEDING No.102 FEEDING No.103 FEEDING No.104 FEEDING No.105 FEEDING No.106 FEEDING No.107 FEEDING No.108
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

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Department of Social Welfare and Development

Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024
ACTUAL FEEDING ATTENDANCE
PROVINCE : __________________________ CITY / MUNICIPALITY: ________________________________
CHILD DEVELOPMENT CENTER: _____________________________ BARANGAY: __________________________________

ACTUAL FEEDING ATTENDANCE

Name of Child FEEDING No.111 FEEDING No.112 FEEDING No.113 FEEDING No.114 FEEDING No.115 FEEDING No.116 FEEDING No.117 FEEDING No.118
No.
(Surname, First name, M.I)
Date: Date: Date: Date: Date: Date: Date: Date:

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10

11

12

13

14

15

Prepared by: Noted by: Approved by:

____________________________
Child Development Worker/Teacher SFP Focal Person C/MSWDO/District Head

SFP FORM 3 (c/o CDW/CDT) Page 23 of

____________
______

FEEDING No.9 FEEDING No.10

Date: Date:

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____________
______

FEEDING No.19 FEEDING No.20

Date: Date:

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____________
______

FEEDING No.29 FEEDING No.30

Date: Date:

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____________
______

FEEDING No.39 FEEDING No.40

Date: Date:

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____________
______

FEEDING No.49 FEEDING No.50

Date: Date:

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____________
______

FEEDING No.59 FEEDING No.60

Date: Date:

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____________
______

FEEDING No.69 FEEDING No.70

Date: Date:

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____________
______

FEEDING No.79 FEEDING No.80

Date: Date:

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____________
______

FEEDING No.89 FEEDING No.90

Date: Date:

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____________
______

FEEDING No.99 FEEDING No.100

Date: Date:

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____________
______

FEEDING No.109 FEEDING No.110

Date: Date:

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____________
______

FEEDING No.119 FEEDING No.120

Date: Date:

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SFP FORM 3 (c/o CDW/CDT) Page 36 of
 Department of Social Welfare and Development, Field Office XI
Supplementary Feeding Program
13th Cycle Implementation - SY 2023-2024

CONSOLIDATED NUTRITIONAL STATUS (NS) PER AGE BRACKET

AFTER 120 FEEDING DAYS

Province: ______________________ City / Municipality: ________________________________

Child Development Center: ________________________________ Barangay: ________________________________

2 Years Old 3 Years Old 4 Years Old 5 Years Old

WEIGHT FOR AGE
Male Female Male Female Male Female Male Female
Normal (N)
Underweight (UW)
Severely Underweight (SUW)
Overweight (OW)

WEIGHT FOR HEIGHT 2 Years Old 3 Years Old 4 Years Old 5 Years Old
(Wasting) Male Female Male Female Male Female Male Female
Normal (N)
Wasted (W)
Severely Wasted (SW)
Overweight (OW)
Obese (Ob)

HEIGHT FOR AGE 2 Years Old 3 Years Old 4 Years Old 5 Years Old
(Stunting) Male Female Male Female Male Female Male Female
Normal (N)
Stunted (S)
Severely Stunted (SS)
Tall (T)

2 Years Old 3 Years Old 4 Years Old 5 Years Old

Male Female Male Female Male Female Male Female
Summary of Undernourished
Children
Deworming
Vitamin A Supplementation
4Ps Member
Ips Member
PWD
Child of Solo Parent
Lactose Intolerant
Prepared by: Noted by: Approved by:

SFP FORM 2.1 (c/o CDW/CDT) Page 37 of

Child Development Worker/Teacher SFP Focal Person C/MSWDO/District Head

SFP FORM 2.1 (c/o CDW/CDT) Page 38 of

_______________________

________________

TOTAL:
Male Female

TOTAL:
Male Female

TOTAL:
Male Female

TOTAL:
Male Female

SFP FORM 2.1 (c/o CDW/CDT) Page 39 of

/District Head

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