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Child Protection Reports Format.

This school-based report summarizes incidents of bullying, child abuse, and children at risk (CAR) during the 2022-2023 school year. It includes tables documenting the date, nature and details of each incident, as well as the action taken and recommendations. A separate section reports on children in conflict with the law, with details of violations and the intervention programs initiated by the school to facilitate reintegration. The report was prepared and validated by the relevant school personnel.

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Franklin Pabello
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71 views13 pages

Child Protection Reports Format.

This school-based report summarizes incidents of bullying, child abuse, and children at risk (CAR) during the 2022-2023 school year. It includes tables documenting the date, nature and details of each incident, as well as the action taken and recommendations. A separate section reports on children in conflict with the law, with details of violations and the intervention programs initiated by the school to facilitate reintegration. The report was prepared and validated by the relevant school personnel.

Uploaded by

Franklin Pabello
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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School-Based Report on

School Year 2

School: Classification: (Privat


Address: Level: (Kindergarten/

Nature of Bullying Victims


Date/ Place of Incident NAME
Gender- Cyber
Physical Social Retalliation (Last Name, First Age
Based Bullying Name, M.I.)

Note: Bullying is perpetrated by a student against another student which may be:
Physical - unwanted physical contact (punching, shoving, kicking, slapping, tickling, headlocks, etc.)
Social - refers to any deliberate, repetitive and aggressive social behavior intended to hurt or belittl
Gender-Based - refers to any act that humiliates or excludes a person on the basis of perceived or a
Cyber Bullying - any bullying done through the use of technology or any electronic means (texting, e

Reviewed and Conformed by:

Name and Designation

Date:
ol-Based Report on Incidents of Bullying
School Year 2022-2023

Classification: (Private/ Public) _________________________________


Level: (Kindergarten/ Elementary/ Secondary) _____________________

Victims Perpetrators
Action Taken Recommendation
Sex Sex
NAME Age
(M/F) (M/F)

tickling, headlocks, etc.)


ended to hurt or belittle an individual (name-calling, cursing, labelling, etc.)
e basis of perceived or actual sexual orientation and gender identity
ctronic means (texting, email, chatting, online games, etc.)

Prepared by:

Name and Designation

Date:
Status
(Resolved/ Pending/ Referred
to other agency)
School-Based Report o
School Ye

School:
Address:

Nature of Abuse Victims


Date/ Place of Incident NAME
Verbal/
Physical Sexual (Last Name, First
Psychological Name, M.I.)

Note:
* Child Abuse refers to the maltreatment of a child, whether habitual or not, which includes any of the
Physical - refers to acts that inflict bodily harm and which subjects children to perform tasks which
Sexual - refers to acts that are sexual in nature such as rape, sexual harassment, sexually demeanin
Psychological - refers to acts or omissions causing or likely to cause mental or emotional suffering t
merit as a form of punishment, and repeated verbal abuse.
* Relationship to the Victim refers to relatives (father, mother, cousin, etc.) or school personnel (teache
* No amicable settlement for any acts of child abuse

Reviewed and Conformed by:

Name and Designation

Date:
ool-Based Report on Incidents of Child Abuse
School Year 2022-2023

Classification: (Private/ Public) _________________________________


Level: (Kindergarten/ Elementary/ Secondary) _____________________

Victims Perpetrators
Relationship to the
Action Taken
Sex Sex Victim
Age NAME Age
(M/F) (M/F)

hich includes any of the following:


to perform tasks which are hazardous to their physical well-being;
ment, sexually demeaning remarks, forcing children to watch obscene publications or shows, etc; and
or emotional suffering to the child which include intimidation, harassment, stalking, public ridicule, threat of deduction from grade or

chool personnel (teachers and non-teaching staff)

Prepared by:

Name and Designation

Date:
Status
(Resolved/ Pending/ Referred
to other agency)

t of deduction from grade or


REPORT ON CASES OF CHILDREN-AT-RISK (CAR)
School Year 2022-2023
School: Classification: (Private/ Public) _____________
________________________________________
Address: Level: (Kindergarten/ Elementary/ Secondary) _
______________________________________
______________________________________________

No. of Students
Classification Action Taken
Male Female

1. Victim of abuse (sexual, physical, psychological,


mental, economic and other means)

2. Victim of Neglect

3. Coming from a dysfunctional family or without a


parent or guardian

4. Being a member of a gang

5. Living in a community with a higher level of


criminality

6. Living a situation of armed conflict

7. Committed a status Offense under Section 57, of RA


9344, as amended

8. Mendicant under PD 1563

9. Solvent/ Rugby user

10. Marijuana/ Drug Use/ Dependency

11. Smoking

12. Others

II. Descriptions of actions taken by the division to alleviate the risk facor of the CAR:
Prepared by: Validated by:

Designation School Head


Date: ______________________________________ Date: __________________________________
-AT-RISK (CAR)
3

rivate/ Public) ____________________________________


ten/ Elementary/ Secondary) ______________________

Action Taken Remarks


School Head
_____________________________
Report on Incidents of Children in C
School Year 2022

School:
District:
Period Covered:

Learner's Reference Sex


Number (LRN) Age (M/F) Case/ Violation

B. Description of any intervention or diversion program that the school initiated or adopted which facili

Prepared by:

School Child Protection Coordinator


idents of Children in Conflict with the Law (CICL)
School Year 2022-2023

Action Taken Intervention/ Diversion Program

tiated or adopted which facilitated the reintegration of the CICL in the school and community

Approved by:

____________________________________________
School Head
Remarks

and community

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