Province: CAMARINES SUR

City/Municipality: _______________________

Barangay

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

Prepared By:

_____________________________________________
SFP Focal
Note: Please list barangays alphabetically. You may use additional sheet as nec
AMARINES SUR
ity: _______________________

Name of CDC / SNP

Male

2 3 4 5
_____________________________________
SFP Focal
angays alphabetically. You may use additional sheet as necessary. Fill out line provided for th
 Department of So

Supplem

Nu

Solo
Female Grand PWD
Parent
4P's
Total Total
Total
2 3 4 5 M F M F M F
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 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

Noted by:

______________________

ut line provided for the page number (i.e. Page 1 of 2)

ment of Social Welfare and Development
Field Office V

Supplementary Feeding Program

SUMMARY LIST
CY 2023-2024

Number of Children Beneficiaries

Weight for Age
Severly
Lactose Underwe Overweig
IP's Normal Underwei Total
Intolerance ight ht
ght

M F M F M F M F M F M F M
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

_____________________________________________
C/MSWDO
 Total Number of Child Development Center:
Total Number of Children Beneficiaries:

e Weight for Height Height for Age

Severely Overwigh Severely
Total Wasted Obese Stunted
wasted t Stunded
Total
F M F M F M F M F M F M
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
0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Approve

__________ _________
nt Center: _______
aries: _________

eight for Age

Name of CDW/ Authorized
Severely Representative
Tall
Stunded

F M F
 0 0 0

Approved By:

____________________________________________
City/Municipal Mayor
Contact
Number
_________________
yor
 Department of Social Welfare and Development SFP Form 1
Field Office V

Supplementary Feeding Program

MASTERLIST OF BENEFICIARIES
FY 2025-2026

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
Gend
Day/ Age in Age in Weight Height Severely Severel Lactose
No. Name of Children er w/ solo Name of Parent or Guardian
Month/ mos years in kgs in cm. Normal Underwei underweig Overweig Wasted Severely Overwigh Obese Stunted y Tall IPs PWD 4Ps Intoleranc
M/F ght ht wasted t parent
Year ht stunted e
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)
Insert LGU Logo

NAME OF LGU (CITY/MUNICIPALITY)

15TH CYCLE SUPPLEMENTARY FEEDING PROGRAM (FY 2025-2026)
LIST OF REHABILITATED BENEFICIARIES

UPON ENTRY 120 DAYS AFTER

Name of Gender Age in Weight for Age Weight for Age
Seq. No. Barangay Name of CDC/SNPs Birthdate REMARKS
Beneficiaries (M/F) Months Nutritional Nutritional
Height Weight Height Weight
Status Status
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Prepared by: Validated by: Noted by:

SFP LGU Focal City/Municipal Nutrition Action Officer City/Municipal Social Welfare and Development Officer
 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)

Day/ Nutritional Status
Age Age Weigh Vit. Severe
Gender Month/ Height Dewormin Severel Severel Lactose
No. Name of Child in in t in Supplement Under Over Over Stunte ly
M/F Year in cm. g Date Normal y Under Wasted y Obese Tall Intolerance REMARKS
mos. years kgs ation Date weight Weight weight d (St) Stunte
Birthdate Weight Wasted
d (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: ___________________________________________________________
Date of Weighing:____________________________________________________________________________

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

Day/ Nutritional Status
Age Age Weigh Vit. Severe
Gender Month/ Height Dewormin Severel Severel Lactose
No. Name of Child in in t in Supplement Under Over Over Stunte ly
M/F Year in cm. g Date Normal y Under Wasted y Obese Tall Intolerance REMARKS
mos. years kgs ation Date weight Weight weight d (St) Stunte
Birthdate Weight Wasted
d (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: ___________________________________________________________
Date of Weighing:____________________________________________________________________________

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

Day/ Nutritional Status
Age Age Weigh Vit. Severe
Gender Month/ Height Dewormin Severel Severel Lactose
No. Name of Child in in t in Supplement Under Over Over Stunte ly
M/F Year in cm. g Date Normal y Under Wasted y Obese Tall Intolerance REMARKS
mos. years kgs ation Date weight Weight weight d (St) Stunte
Birthdate Weight Wasted
d (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: ___________________________________________________________
Date of Weighing:____________________________________________________________________________

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

Day/ Nutritional Status
Age Age Weigh Vit. Severe
Gender Month/ Height Dewormin Severel Severel Lactose
No. Name of Child in in t in Supplement Under Over Over Stunte ly
M/F Year in cm. g Date Normal y Under Wasted y Obese Tall Intolerance REMARKS
mos. years kgs ation Date weight Weight weight d (St) Stunte
Birthdate Weight Wasted
d (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: ___________________________________________________________
Date of Weighing:____________________________________________________________________________

AFTER 120 DAYS (Put # 1 if the child belong to the following)

Day/ Nutritional Status
Age Age Weigh Vit. Severe
Gender Month/ Height Dewormin Severel Severel Lactose
No. Name of Child in in t in Supplement Under Over Over Stunte ly
M/F Year in cm. g Date Normal y Under Wasted y Obese Tall Intolerance REMARKS
mos. years kgs ation Date weight Weight weight d (St) Stunte
Birthdate Weight Wasted
d (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)
 Republic of the Philippines
Province of Camarines Sur
Municipality of _________________
Municipal Social Welfare and Development Officer

CONSOLIDATED NUTRITIONAL STATUS

Province: CAMARINES SUR Total Number of Beneficiaries: 1000

City/Municipality:

Weight for Age

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

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

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

Prepared by: Validated by: Noted by:

_________________________________________________ _______________________________________________ _________________________________________
SFP Focal Person City/Municipal Nutrition Action Officer 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/ Supplem Severely Stunted
No. Name of Child
M/F Year Birthdate
ING
entation
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/ Supplem Severely Stunted
No. Name of Child
M/F Year Birthdate
ING
entation
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)