Bullying Child Abuse Cases Templates CAR CICL

School Consolidated Report on Incidents of Bullying
School Year 2018-19
Elementary/Secondary: IRENEO R. CASTRO MEMORIAL ES
Nature of bullying No. of Bullying incidents

Total
GRADE Total No. of
Gender- Cyber No. of
Physical Social Retaliation FEMALE Total
based Bullying MALE
victims
victims
1 KINDERGRTEN
2 GRADE 1
3. GRADE 2
4. GRADE 3
5. GRADE 4
6. GRADE 5
7. GRADE 6
8
9
10
11
12
13
14
15
16
17
18
19
20
Note: Bullying is perpetrated by a student against another student which maybe:

Physical - uwanted physical contact (punching,shoving, pushing, kicking slapping, tickling, headlocks etc.)
Social- refers to any deliberate, repetitive and aggressive social behvior intended to hurt or belittle an individual (name calling, cursing,
labelling, etc.)
Gender-based- refers to any act that humiliates or excludes a person on the basis of perceived or actual sexual orientation and gender
identity
Cyber Bullying- any bullying done through the use of technology or any electronic means (texting, email, chatting, online games, etc.)
Reviewed and Confirmed

_____________________________
by: Prepared by: _____________________
Name and Designation Name/Designation
Date:_______ Date:_________
District Consolidated Report on Incidents of Bullying
School Year 2016-2017
Elementary/Secondary: ____________
Public/Private: ____________
District/Cluster: ____________________________________
Total Number of Schools: __________
Nature of bullying No. of Bullying incidents

Total
NAME OF SCHOOL Total No. of
Gender- Cyber No. of
Physical Social Retaliation FEMALE Total
based Bullying MALE
victims
victims
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Note: Bullying is perpetrated by a student against another student which maybe:
Physical - uwanted physical contact (punching,shoving, pushing, kicking slapping, tickling, headlocks etc.)
Social- refers to any deliberate, repetitive and aggressive social behvior intended to hurt or belittle an individual (name calling, cursing,
labelling, etc.)
Gender-based- refers to any act that humiliates or excludes a person on the basis of perceived or actual sexual orientation and gender
identity
Cyber Bullying- any bullying done through the use of technology or any electronic means (texting, email, chatting, online games, etc.)
Reviewed and Confirmed

_____________________________
by: Prepared by: _____________________
Date:_______ Date:_________
SCHOOL Report on Incidents of Child Abuse
School Year 2018-19
Elementary/Secondary: IRENEO R. CASTRO MEMORIAL ES
Nature of Abuse No. of incidents of child abuse
NAME OF SCHOOL Verbal/P Total No. Total No. of Perpetrators

Physical Sexual sycholo of Male Female Total
gical Victims victims
School
Relatives
Personnel
1 KINDERGRTEN
2 GRADE 1
3. GRADE 2
4. GRADE 3
5. GRADE 4
6. GRADE 5
7. GRADE 6
8
9
10
11
12
13
14
15
Note: Child Abuse refers to the maltreatment of a child, whether habitual or not, which includes any of the following:
Physical - refers to acts that inlict bodily harm and which subjects children to perform task which are hazardous to their physical well-being
Sexual- refers to acts that are sexual in nature such as rape, sexual harassments, sexually deameaning remarks, forcing children to watch obscene
publications or shows etc; and
Psychological- refers to acts or omissions causing or likely to cause mental or emotional suffering to the child which include intimidation,
harassment, stalking, public ridicule, threat of deduction from grade or merit as a form of punishment and repeated verbal abuse
Relationship to the victim refers to the relatives (Father, Mother, Cousins, etc.) or school personnel (Teachers and Non-teaching staff).
No Amicable settlement for any acts of child abuse
Reviewed and Conformed by: _______________________ Prepared by: _____________________

Date:_______ Date:_________
District Consolidated Report on Incidents of Child Abuse
Elementary/Secondary: ____________
Public/Private: ____________
District/Cluster: ____________________________________
Total Number of Schools: __________
Nature of Abuse No. of incidents of child abuse
NAME OF SCHOOL Verbal/P Total No. Total No. of Perpetrators

Physical Sexual sycholo of Male Female Total
gical Victims victims
School
Relatives
Personnel
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Note: Child Abuse refers to the maltreatment of a child, whether habitual or not, which includes any of the following:
Physical - refers to acts that inlict bodily harm and which subjects children to perform task which are hazardous to their physical well-being
Sexual- refers to acts that are sexual in nature such as rape, sexual harassments, sexually deameaning remarks, forcing children to watch obscene
publications or shows etc; and
Psychological- refers to acts or omissions causing or likely to cause mental or emotional suffering to the child which include intimidation,
harassment, stalking, public ridicule, threat of deduction from grade or merit as a form of punishment and repeated verbal abuse
Relationship to the victim refers to the relatives (Father, Mother, Cousins, etc.) or school personnel (Teachers and Non-teaching staff).
No Amicable settlement for any acts of child abuse
Reviewed and Conformed by: _______________________ Prepared by: _____________________

Date:_______ Date:_________
CONSOLIDATED REPORT ON CASES OF CHILDREN-AT-RISK (CAR)
District/Cluster: _________________________
Elementary/Secondary: __________________
Public/Private: __________________________
I. CHILDREN-AT-RISK (CAR)
No. of Students
No. Classification Action Taken Remarks
Male Female
Victim of Abuse (sexual, physical,

1 psychological, mental, economic
and other mean)
2 Victim of Neglect
Coming from a dysfunctional
3 family or without parent or
guardian
4 Being member of a gang
5 Living in a community with a

higher level of criminality
6 living in a situation of armed

conflict
Committed a status Offense under
7 Section 57 of RA 9344, as
amended
8 Prostituted Children
9 Mendicant under PD 1563
10 Sovent/Rugby User
11 Others
II. Description of action taken by the district to alleviate the risk factors of the CAR:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Prepared by: Noted by:
ROSIFEL C. PONGASE DR. RENATO A. CORRE

Principal 1 District Supervisor
CONSOLIDATED REPORT ON INCIDENTS OF CHILDREN IN CONFLICT WITH THE LAW (CICL)
District/Cluster: Makilala East
Elementary/Secondary: __________________
Public/Private: __________________________
A. CHILDREN IN CONFLICT WITH THE LAW (CICL)

Learner's Reference Intervention/Diversion
Age Sex (M/F) Case/ Violation Action Taken Remarks
Number (LRN) Program
B. Description of any intervention program or diversion that the school or division initiated or adated which facilitated the reintegration
of the CILCL in the school and community.
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Prepared by: Noted by:
ROSIFEL C. PONGASE DR. RENATO A. CORRE

Principal 1 District Supervisor

Bullying Child Abuse Cases Templates CAR CICL

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School Consolidated Report on Incidents of Bullying

School Year 2018-19

Elementary/Secondary: IRENEO R. CASTRO MEMORIAL ES

Nature of bullying No. of Bullying incidents

Note: Bullying is perpetrated by a student against another student which maybe:

Reviewed and Confirmed

Nature of bullying No. of Bullying incidents

Reviewed and Confirmed

Elementary/Secondary: IRENEO R. CASTRO MEMORIAL ES

Nature of Abuse No. of incidents of child abuse

NAME OF SCHOOL Verbal/P Total No. Total No. of Perpetrators

Reviewed and Conformed by: _______________________ Prepared by: _____________________

NAME OF SCHOOL Verbal/P Total No. Total No. of Perpetrators

Reviewed and Conformed by: _______________________ Prepared by: _____________________

Victim of Abuse (sexual, physical,

5 Living in a community with a

6 living in a situation of armed

Prepared by: Noted by:

ROSIFEL C. PONGASE DR. RENATO A. CORRE

A. CHILDREN IN CONFLICT WITH THE LAW (CICL)

Prepared by: Noted by:

ROSIFEL C. PONGASE DR. RENATO A. CORRE

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