Department of Social Welfare and Development SFP Form 1

Field Office V

Supplementary Feeding Program

MASTERLIST OF BENEFICIARIES
FY 20__-20__

Province: Name of Child Develeopment Center / Supervised Neighborhood Play:

C/Municipality: Address of Child Development Center / Supervised Neighborhood Play :
Barangay:
SFP Beneficiaries REMARKS
Date of Weighing:
Nutritional Status (Put # 1 if the child belong to the following)
(Put # 1 if the child belong to the following)
Weight for Age Weight for Height Height for Age
Birthdate
Gender Day/ Age in Age in Weight Height Severely
No. Name of Children Under Over Severely Over Severely w/ solo Lactose Name of Parent or Guardian
M/F Month/ mos years in kgs in cm. Normal under Wasted Obese Stunted Tall IPs PWD 4Ps
Year weight
weight
weight wasted weight stunted parent Intolerance

M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Prepared by: Noted by:

Reviewed by:

________________________________________________________ _________________________________________ _______________________________________________________________________

Child Development Worker BNS/BHW C/MSWDO

Note: Please list the children alphabetically and by Gender. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

SUMMARY LIST
CY 2023-2024

Province: ALBAY Total Number of Child Development Center: _______

City/Municipality: _______________________ Total Number of Children Beneficiaries: _________

Number of Children Beneficiaries

Weight for Age Weight for Height Height for Age
Severly Name of CDW/ Authorized Contact
Barangay Name of CDC / SNP Solo Lactose Under Over Severely Overwigh Severely
Male Female Grand PWD 4P's IP's Normal Under Total Wasted Obese Stunted Tall Representative Number
Total Total Parent Intolerance weight weight Total wasted t Stunded
weight
Total
2 3 4 5 2 3 4 5 M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F
1 0 0 0 0 0 0
2 0 0 0 0 0 0
3 0 0 0 0 0 0
4 0 0 0 0 0 0
5 0 0 0 0 0 0
6 0 0 0 0 0 0
7 0 0 0 0 0 0
8 0 0 0 0 0 0
9 0 0 0 0 0 0
10 0 0 0 0 0 0
11 0 0 0 0 0 0
12 0 0 0 0 0 0
13 0 0 0 0 0 0
14 0 0 0 0 0 0
15 0 0 0 0 0 0
16 0 0 0 0 0 0
17 0 0 0 0 0 0
18 0 0 0 0 0 0
19 0 0 0 0 0 0
20 0 0 0 0 0 0
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GRAND TOTAL

Prepared By: Noted by: Approved By:

________________________________________________________ __________________________________________________________ _____________________________________________

SFP Focal C/MSWDO City/Municipal Mayor

Note: Please list barangays alphabetically. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

WEIGHT MONITORING RECORD
CY 20__-20__

Name of CDC/SNP: __________________________________________________________________________

Name of CDW/Volunteer: ________________________________________________________________________
Address of Child Development Center: ___________________________________________________________
Date of Weighing:____________________________________________________________________________

Before Feeding (Put # 1 if the child belong to the following)

Nutritional Status
Day/ Vit.
Gender Age in Age in Weight Height Deworming Severely Severely Lactose
No. Name of Child Month/Year Supplementation Underw Over Severely Over Stunted
M/F mos. years in kgs in cm. Date Normal Under Wasted Obese Stunted Tall Intolerance REMARKS
Birthdate Date eight Weight Wasted weight (St)
Weight (SSt)
M F M F M F M F M F M F M F M F M F M F M F M F
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Page __ of __

Prepared by: Reviewed by:

________________________________________________________ ________________________________________________________
Child Developmen Worker/Educare Teacher Barangay Nutrition Scholar (BNS) / Barangay Health Worker (BHW)

Note: Please list the children alphabetically and by Gender. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

WEIGHT MONITORING RECORD
CY 20__-20__

Name of CDC/SNP: __________________________________________________________________________

Name of CDW/Volunteer: ________________________________________________________________________
Address of Child Development Center: ___________________________________________________________
____________________________________________________

AFTER 30 DAYS (Put # 1 if the child belong to the following)

Nutritional Status
Day/ Age Vit.
Gender Age in Weight Height Deworming Severely Severely
No. Name of Child Month/Year in Supplementation Underw Over Severely Over Stunted Lactose
M/F years in kgs in cm. Date Normal Under Wasted Obese Stunted Tall REMARKS
Birthdate mos. Date eight Weight Wasted weight (St) Intolerance
Weight (SSt)
M F M F M F M F M F M F M F M F M F M F M F M F
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Page __ of __

Prepared by: Reviewed by:

________________________________________________________ ________________________________________________________
Child Developmen Worker/Educare Teacher Barangay Nutrition Scholar (BNS) / Barangay Health Worker (BHW)

Note: Please list the children alphabetically and by Gender. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

WEIGHT MONITORING RECORD
CY 20__-20__

Name of CDC/SNP: __________________________________________________________________________

Name of CDW/Volunteer: ________________________________________________________________________
Address of Child Development Center: ___________________________________________________________
Date of Weighing:____________________________________________________________________________

AFTER 60 DAYS (Put # 1 if the child belong to the following)

Nutritional Status
Day/ Age Vit.
Gender Age in Weight Height Deworming Severely Severely
No. Name of Child Month/Year in Supplementation Underw Over Severely Over Stunted Lactose
M/F years in kgs in cm. Date Normal Under Wasted Obese Stunted Tall REMARKS
Birthdate mos. Date eight Weight Wasted weight (St) Intolerance
Weight (SSt)
M F M F M F M F M F M F M F M F M F M F M F M F
1
2

4
5

7
8

9
10

11

12
13

14

15

16
17

18

19

20

TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Page __ of __

Prepared by: Reviewed by:

________________________________________________________ ________________________________________________________
Child Developmen Worker/Educare Teacher Barangay Nutrition Scholar (BNS) / Barangay Health Worker (BHW)

Note: Please list the children alphabetically and by Gender. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

WEIGHT MONITORING RECORD
CY 20__-20__

Name of CDC/SNP: __________________________________________________________________________

Name of CDW/Volunteer: ________________________________________________________________________
Address of Child Development Center: ___________________________________________________________
Date of Weighing:____________________________________________________________________________

AFTER 90 DAYS (Put # 1 if the child belong to the following)

Day/ Nutritional Status
Age Age Weigh Vit.
Gender Month/ Height Dewormin Severely Severely Lactose
No. Name of Child in in t in Supplement Underw Over Severely Over Stunted
M/F Year in cm. g Date Intolerance
mos. years kgs ation Date Normal eight Under
Weight
Wasted
Wasted weight
Obese
(St)
Stunted Tall REMARKS
Birthdate Weight (SSt)
M F M F M F M F M F M F M F M F M F M F M F M F
1

2
3
4
5
6
7
8

9
10
11
12
13
14
15
16
17
18
19
20
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Page __ of __

Prepared by: Reviewed by:

________________________________________________________ ________________________________________________________
Child Developmen Worker/Educare Teacher Barangay Nutrition Scholar (BNS) / Barangay Health Worker (BHW)

Note: Please list the children alphabetically and by Gender. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

WEIGHT MONITORING RECORD
CY 20__-20__

Name of CDC/SNP: __________________________________________________________________________

Name of CDW/Volunteer: ________________________________________________________________________
Address of Child Development Center: ___________________________________________________________
Date of Weighing:____________________________________________________________________________

AFTER 90 DAYS (Put # 1 if the child belong to the following)

Day/ Nutritional Status
Age Age Weigh Vit.
Gender Month/ Height Dewormin Severely Severely Lactose
No. Name of Child in in t in Supplement Underw Over Severely Over Stunted
M/F Year in cm. g Date Intolerance
mos. years kgs ation Date Normal eight Under
Weight
Wasted
Wasted weight
Obese
(St)
Stunted Tall REMARKS
Birthdate Weight (SSt)
M F M F M F M F M F M F M F M F M F M F M F M F
1
2
3
4
5
6
7
8
9

10
11
12
13
14
15
16
17
18
19
20
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Page __ of __

Prepared by: Reviewed by:

________________________________________________________ ________________________________________________________
Child Developmen Worker/Educare Teacher Barangay Nutrition Scholar (BNS) / Barangay Health Worker (BHW)

Note: Please list the children alphabetically and by Gender. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Republic of the Philippines
Province of Camarines Sur
Municipality of _________________
Municipal Social Welfare and Development Officer

CONSOLIDATED NUTRITIONAL NUTRITIONAL STATUS

Province: CAMARINES SUR Total Number of Beneficiaries: 1000

City/Municipality:

Weight for Age

Normal Underweight Severely Underweight Overweight/Obes
BEFORE
FEEDING # of Children # of Children # of Children # of Children
% Share % Share % Share
MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE
0 0 0 0.0% 0 0 0 0.00% 0 0 0 0.00% 0
AFTER 60
FEEDING DAYS 0 0 0 0.0% 0 0 0 0.00% 0 0 0 0.00% 0
AFTER 120
FEEDING DAYS 0 0 0 0.0% 0 0 0 0.00% 0 0 0 0.00% 0

Wasting
Normal Wasted Severely Wasted Overweight
BEFORE
FEEDING # of Children # of Children # of Children # of Children
% Share % Share % Share
MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE
0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0
AFTER 60
FEEDING DAYS 0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0
AFTER 120
FEEDING DAYS 0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0

Stunting
Normal Stunted Severely Stunted Tall
BEFORE
FEEDING # of Children # of Children # of Children # of Children
% Share % Share % Share
MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE
0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0
AFTER 60
0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0
FEEDING DAYS
AFTER 120
0 0 0 0.00% 0 0 0 0.00% 0 0 0 0.00% 0
FEEDING DAYS

Prepare by: Validated by:

_________________________________________________ _______________________________________________
SFP Focal Person City/Municipal Nutrition Action Officer
cer

TATUS

Overweight/Obese Lactose Intolerance

# of Children # of Children
% Share % Share
FEMALE TOTAL MALE FEMALE TOTAL
0 0 0.00% 0 0 0 0.00%

0 0 0.00% 0 0 0 0.00%

0 0 0.00% 0 0 0 0.00%

Overweight Obese
# of Children # of Children
% Share % Share
FEMALE TOTAL MALE FEMALE TOTAL
0 0 0.00% 0 0 0 0.00%

0 0 0.00% 0 0 0 0.00%

0 0 0.00% 0 0 0 0.00%

Tall
# of Children
% Share
FEMALE TOTAL
0 0 0.00%
0 0 0.00%

0 0 0.00%

Noted by:
_________________________________________
Municipal Social Welfare and Development Officer
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

WEIGHT MONITORING RECORD
CY 2023-2024

Name of CDC/SNP:
Name of CDW/Volunteer:
Address of Child Development Center:
Date of Weighing:
30 DAYS AFTER
Vit. A
Age in Age in Height Weight DEWORM Severely
Gender Day/Month/ Suppleme Severely Stunted
No. Name of Child
M/F Year Birthdate
ING
ntation
N UW SUW OW Wasted
Wasted
Overweight Obese
(St)
Stunted Tall REMARKS
mos. years in cm. in kgs (DATE) (SSt)
(DATE)
M F M F M F M F M F M F M F M F M F M F M F

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page __ of __

Prepared by: Reviewed by:

________________________________________________________ ________________________________________________________
CDW BNS

Note: Please list the children alphabetically and by Gender. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

WEIGHT MONITORING RECORD
CY 2023-2024

Name of CDC/SNP:
Name of CDW/Volunteer:
Address of Child Development Center:
Date of Weighing:
90 DAYS AFTER
Vit. A
Age in Age in Height Weight DEWORM Severely
Gender Day/Month/ Suppleme Severely Stunted
No. Name of Child
M/F Year Birthdate
ING
ntation
N UW SUW OW Wasted
Wasted
Overweight Obese
(St)
Stunted Tall REMARKS
mos. years in cm. in kgs (DATE) (SSt)
(DATE)
M F M F M F M F M F M F M F M F M F M F M F

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page __ of __

Prepared by: Reviewed by:

________________________________________________________ ________________________________________________________
CDW BNS

Note: Please list barangays alphabetically. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)