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    DepED XII Incident Report - No. 1

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    Nouiea Bernardelle Acabal
    1) The incident report describes a class suspension in multiple municipalities in Region XII due to heavy rain. 2) Preliminary findings indicate the cause of the incident was heavy rain. 3) No injuries, damages, or other consequences were reported from the class suspension.

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    DepED XII Incident Report - No. 1

    Uploaded by

    Nouiea Bernardelle Acabal
    3K views2 pages
    1) The incident report describes a class suspension in multiple municipalities in Region XII due to heavy rain. 2) Preliminary findings indicate the cause of the incident was heavy rain. 3) No injuries, damages, or other consequences were reported from the class suspension.

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    DepED XII Incident Report_no. 1.doc

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    1) The incident report describes a class suspension in multiple municipalities in Region XII due to heavy rain. 2) Preliminary findings indicate the cause of the incident was heavy rain. 3) No injuries, damages, or other consequences were reported from the class suspension.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    3K views2 pages

    DepED XII Incident Report - No. 1

    Uploaded by

    Nouiea Bernardelle Acabal
    1) The incident report describes a class suspension in multiple municipalities in Region XII due to heavy rain. 2) Preliminary findings indicate the cause of the incident was heavy rain. 3) No injuries, damages, or other consequences were reported from the class suspension.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    You are on page 1of 2

    REPUBLIC OF THE PHILIPPINES

    DEPARTMENT OF EDUCATION
    REGION XII
    City of Koronadal, Philippines
    Telefax No. (083) 228-8825; email:region12@deped.gov.ph

    INCIDENT REPORT

    Enclosure 1 to Region Memo 2015: Incident Report

    Initial Incident Report (signed report due within 24-hr)


    Site: Incident Register Number:
    Division:

    Location of Incident: Date and Time of Incident:

    Type of Incident:
    Injury Environment Suspension of Classes Security School Property/Equipment
    Safety – Type of Injury (if applicable): Environment:
    First Aid Injury Restricted Work Injury 1 Negligible 4 Serious
    Lost Time Injury Other Medical Treat Injury 2 Minor Disastrous 5 Disastrous 3
    Significant
    DepEd Employee Students and Teachers
    Brief Description of Incident:
    Class suspension of the above mentioned Municipalities due to heavy rain.
    Preliminary findings/Causes of incident:
    Actual Consequences (injuries / environment / property equipment / financial impact/administrative or legal
    liability):

    Potential Consequences (injuries / environment / property equipment / financial impact/administrative or legal


    liability):

    Person(s) Involved:
    None

    Name(s) of Witness(es):

    Initial Action(s) Taken:


    LGU Declaration

    Level of Incident (potential or actual consequence weighting, whichever is higher): Statutory Notification:
    Safety & Health 1 2 3 4
    Yes No
    Environment 1 2 3 4 5 Division RO XII
    School Property / Equipment 1 2 3 4 Central Others
    _______
    Legal Context
    Is legal advice necessary? Does the incident qualify as an Does the incident or administrative
    Yes (contact DepED Legal Team immediately) administrative case*? case have potential civil or criminal
    No Yes liability?
    No Yes (contact DepEd Legal Team
    immediately)
    No
    Media Attention:
    Regional Director School Division Superintendent Supervisor

    ALLAN G. FARNAZO, CESO IV

    Investigation Team: (if required)


    Prepared by: R Algarme/S Sato Status: Approved Issue date: May 9, 2012 Next review date: On event of change Page: 2 of 2

    Approved by: C Pocknee Version: 2.0 Effective date: May 10, 2012 Document owner: SDC

    Unless stamped in RED, this is an ‘Uncontrolled Document’

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