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Weight Monitoring Form

This document is a weight monitoring form used by day care workers to track the nutritional status of children in a supplemental feeding program over 2 months. It records each child's name, sex, age, height, weight, dates of deworming and vitamin A supplementation. The form is intended to monitor improvements in the children's nutritional status through monthly recordings. The day care worker is responsible for accurately filling out this information to determine if the children's health and weight are progressing after receiving supplemental feeding assistance.

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Christopher Torres
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3K views

Weight Monitoring Form

This document is a weight monitoring form used by day care workers to track the nutritional status of children in a supplemental feeding program over 2 months. It records each child's name, sex, age, height, weight, dates of deworming and vitamin A supplementation. The form is intended to monitor improvements in the children's nutritional status through monthly recordings. The day care worker is responsible for accurately filling out this information to determine if the children's health and weight are progressing after receiving supplemental feeding assistance.

Uploaded by

Christopher Torres
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT

Supplemental Feeding Program

WEIGHT MONITORING FORM


Name of DCC: _____STO. ROSARIO OLD DAY CARE CENTER__
Name of DCW: ______MERCEDITAS B. DE LEON _____________
Location: _____STO. ROSARIO OLD, ZARAGOZA, NUEVA ECIJA_

NUTRITIONAL STATUS
UPON ENTRY 1 MONTH AFTER 2 MONTHS AFTER
NAME OF CHILDREN SEX VIT. A VIT. A
VIT. A DEWOR DEWOR
DATE OF AGE HEIGH WEIGH DEWOR NUTRITIO SUPPLE NUTRITI DATE OF SUPPLE NUTRITI
SUPPLEMEN DATE OF AGE (in HEIGHT WEIGHT MING AGE (in HEIGHT WEIGHT MING
WIEGHIN (in T (in T (in MING (1st NAL MENTA ONAL WIEGHI MENTA ONAL
TATION (1st WIEGHING mos.) (in cm) (in kls.) (1st mos.) (in cm) (in kls.) (1st
G mos.) cm) kls.) DOSE) STATUS TION (1st STATUS NG TION (1st STATUS
DOSE) DOSE) DOSE)
DOSE) DOSE)

This form shall be used every month by the DCW in recording weight and height of the child to determine the improvement in child’s nutritional status.
DCW should indicate date or month & year when the child was dewormed & provided Vit. A
PREPARED BY: NOTED BY:
Nutritional Status: (Using GCS as reference)
SU- Severely Underweight EDEN M. BELMONTE
UW- Underweight MERCEDITAS B. DE LEON _______________________________
Day Care Worker MSWDO
N - Normal Name and Position
OW- Overweight

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