SCHOOL SAFETY ASSESSMENT TOOL

FOR THE PILOT STUDY ON FACE-TO-FACE OF LEARNING MODALITY

School Name: Division:

1. For the past 28 days has the Barangay where your school is located recorded any Y N N/A
confirmed COVID-19 cases?
2. Is the school accessible through public transportation?
3. Is the school accessible through walking?

If the Barangay where the school is located has not recorded any confirmed COVID- 19 cases in the
past 28 days, and the school is accessible by public transportation or walkable, proceed in answering
this safety assessment tool, otherwise your school cannot be nominated as a participating school for
the limited implementation of face- to-face learning modality.

SAFETY SEAL ELIGIBILITY CHECK

REQUIREMENTS Y N N/A
Mayor’s Permit
Registration with IAM SAFE
Compliance with Minimum Health Safety Standard
Most teachers, non teaching personnels, employees are fully vaccinated
MINIMUM HEALTH AND SAFETY STANDARD
1. Available screening on triage area at different points of entry where:
a. Learners, teaching and non-teaching personnels submit health declaration and/or
symptom are assessed
b. Non contact temperature check is performed to all individuals who enter the school
c. Is there isolation room for symptomatic, suspected COVID- 19 individual
2. Hand washing stations, soap, sanitizer, and hand drying equipment or supplies are
available to learners, teaching and non teaching personnel, client/visitors and placed
in strategic locations
3. Observation of physical distancing or spacing through installation of physical
barriers in enclosed areas where physical distancing may be compromised
4. Adequate air exchange in enclosed(indoor) area
4.1 For non- airconditioned spaces / workplace
a. Windows are kept open, are clean free from all types of dust/ debris
b. There is no lingering smell, stuffiness of room, feeling of humidity, or smokiness of
room
c. The nearby space of the open able windows is free from toxic gases and other
pollutants
d. There are ventilating fans circulating air in the school
e. Supply only ventilation fans are installed where fresh air cannot be obtained by
natural ventilation
f. Exhaust fan s are continuously running during occupancy.
 MINIMUM HEALTH AND SAFETY STANDARD Y N N/A
g. Number of exhaust fan is enough with respect to the volume of the room to have air
exchange.
FOR AIRCONDITIONED SPACES/CLASSROM Y N N/A
a. HVAC system or air conditioning unit provides outdoor air and maintained free from
dust, molds, etc
b. Air handling unit or AC unit uses and can handle MERV 13 or higher filter rating and
regular change/ cleaning of filters are done and lowers are in upward position
c. There is no lingering smell, stuffiness of room, feeling of humidity and/or smokiness
of room
d. Windows, doors, or other openings can be or is regularly opened to increase
ventilation
e. Ventilating fans does not blow air from person to person
f. Portable air purifier, if used has HEPA filter
g. Air change per hour of 6-12 within occupied classroom maintains CO2 level below
1,000 ppm at all times
h. Indoor room temperature has no sudden variations or is not excessively hot or cold
5.Regular sanitization of chairs ,desk, tables, doorknobs, equipments, devices,
workstations, comfort rooms and other high touch surfaces
6.Designation of Safety Officer
a. Coordinate with the appropriate bodies for support and referral to community
based isolation facilities for confirmed cases, and to health facilities for severe and
critical care
b. Undertake contact tracing or coordinate the conduct thereof
c. Monitor status of learners, teaching and non teaching personnels quarantined or
isolated
d. Implement policies and protocols
7.Facility for proper storage, collection, treatment, and disposal of used face mask and
other infectious waste
a. Designated yellow bin for infectious waste
b. Signages on how to properly dispose used face mask
SCHOOL CANTEEN Y N N/A
1.Learners, teachers and non teaching personnels strictly comply with the physical
distancing of at least 1 meter and are prohibited from talking with each other
2.The school provides signages, physical barriers, and such other means to ensure
compliance with the prescribed protocols
3.The use of communal items such as, but not limited to, dipping sauces condiments,
utensils and straw dispensers is strictly prohibited
4. Serving of buffet meals and other similar set up is prohibited
CLASSROOM LAYOUT AND STRUCTURE
1.The school has established mechanism inside the classroom to ensure minimal to
zero risk of Covid-19 transmission
a. Number of seats to be occupied must not exceed from the required number of
maximum students in the classroom.
b. Seats must be at least 1-2 meters apart.
c. Presence of stickers and markers on the floor to manage traffic system and physical
distancing.
d. Installation of appropriate ventilation equipment such as general and exhaust
CLASSROOM LAYOUT AND STRUCTURE Y N N/A
ventilation and CO2 monitoring devices.
e. Availability of sterilization box where outputs will be placed for disinfection.
f. Usage of high-efficiency particulate air (HEPA) filtration system.
SCHOOL TRAFFIC MANAGEMENT
1. The school has set up clear and easy to understand signages.
a. Display of school map at the entrance and exit points in the school.
b. Designation of separate entrance and exit points in high traffic areas
c. Designated entrance and exit points in the classroom
d. Hallway ground markings for walking direction guide
PROTECTIVE MEASURES,HYGIENE PRACTICES, AND SAFETY PROCEDURES
1.Availability of surgical masks at school entrance reserved for symptomatic
individuals
2.The school has established DRRM team
3.The school set up a proper sanitation and hygiene facility for school goer
COMMUNICATION STRATEGY
1.The school has developed a communication plan(platform for communication)
2. Data base of contact details including contact number and address of
parents/guardians of the students are kept to inform them in case their child shows flu
like symptoms
3. Development of child friendly IEC materials on hygiene
4.The school has prepared an orientation session for learners, parents , guardians at
least 1 week prior to the conduct of face- to-face classes
5.The school has proactive COVID- 19 local hotline that connects and coordinates to
the hospitals, testing facilities, and LGU
CONTINGENCY PLAN
1.The school has followed a decision model and contingency plan for re-closing and re-
opening the school in case of COVID- 19 resurgence in the community
a. Inclusion of decision point for school lockdown dependent on the assessment and
decision of the Local Task Force against COVID- 19 (LTF)
a.1 When there is suspected, probable, or confirmed COVID- 19 case to facilitate
disinfection and contact tracing
a.2 Change number of community transmission and quarantine risk classification
identified by IATF
a.3 Violations/instances of non compliance of learners or personnels with the MHSS
a.4 In the event the school lockdown, all learners shall revert to distance learning
a.5 Implementation of a 24 hour granular lockdown period for disinfection following
identification/detection of suspect, probable, or confirmed COVID- 19 confirmed cases
only after which can it be opened for use to occupants
a.6 Consideration of the following for the re opening of classes after a school lockdown
Completed contact tracing
Completed disinfection activities
14 days without confirmed cases in the school
1. School is in the Barangay with low to no community transmission
2.The school has developed strategies for the continuity of learning while the school is
closed until the local authorities have determined the safe resumption of face to face
classes
FOCUSING ON TEACHING AND LEARNING Y N N/A
1.The school has secured supply of learning resources needed for the face-to-faceclasses
LIMITED FACE TO FACE CLASSES Y N N/A
1.The school has designed class programs/ that cater both learners of the limited face-
to-face classes arrangement and distance education while observing the maximum 6
hours classroom teaching hours of teachers
2.The school has comprehensively profiled learners who will participate in the
implementation of the face to face classes
3.The school has ensured an attendance monitoring of learners to determine which
participating learners are exhibiting difficulties in coming to school and which learners
who cannot participate in face- to- face classes will revert to full distance learning
4.The school has informed teachers to conduct consultation with parents, provision of
feedback and institutional support for learners, facilitation of assessment, preparation
of weekly home learning plan and other related task after face to face classes
5.The school has ensured prohibition of conduct of face- to- face large gatherings,
group works, or activities that will require close contact or where physical distancing
may not be possible
WELL BEING AND PROTECTION (PPE)
1.The school has secured sufficient supply of PPE for learners and school personnel
2.The school has secured that the available sanitation and disinfection materials are
approved by the FDA
COVID -19 CASE MANAGEMENT
1.The school has developed strategies to prevent COVID- 19
2.The school has identified strategies to detect COVID- 19
3.The school has developed strategies to isolate and treat COVID- 19
4.The school has developed strategies in providing psychosocial support for learners,
teachers, and personnel
5.The school has established a clear procedure of referral system for COVID -19
confirmed and suspected personnel and learner
6.The school has established a clear contact tracing and quarantine system for close
contacts of COVID- 19 confirmed positive cases
7.The school has identified learners who are most vulnerable and disadvantaged in
terms of access to learning as indicated in the eligibility of learner
8.The school has developed learning strategies to cater the needs of the marginalized
learners such as modules in braille, mother tongue languages, and uses of Filipino sign
language
9.The school has ensured participation in school based services which include but is
not limited to feeding and nutrition programs, immunization, mental health and
psychosocial support, prevention of violence against children and other health services
10.The school has coordinated with their respective local government units with the
implementation of routine school based immunization and other school based related
services such as but not limited to deworming and weekly iron folate acid
supplementation
11.The school has developed a plan in coordinating with the Barangay Local
Government Unit or the Barangay Health Emergency Response Team in ensuring that
protocols are observed properly
12.The school has developed a strategy in orienting parents on health protocols and
safety measures
13.The school has identified a designated waiting area with proper ventilation for
parents/ guardians

UNDERTAKING AND REPRESENTATIONS

I am voluntarily applying for the Safety Seal Certification Program. As applicant, I commit continuous
compliance of my establishment with the minimum public health standards, including the use of I
AM SAFE or a digital contact tracing application integrated therewith and agree to implement
corrective actions, if any, with the time period agreed with DTI and the Municipal Local IATF. If
granted the seal and for any reason, I receive a notification or order revoking my Safety Seal .I also
commit to remove the said seal in my establishment or website upon receipt of notification / order.

_____________________________________________________________

Signature over Printed Name of Owner/President, Representative of School

Place:___________________ Email Address:______________________

Date: ___________________ Contact Number:____________________

Date Inspected: Time: