3-badac Self-assessment And Audit Form 6i5e5i
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Republic of the Philippines
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT DILG-NAPOLCOM Center, EDSA cor. Quezon Ave., Quezon City Telephone Number (02) 925-1137
BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM for the Year __________ Region:
III
City/Municipality:
Province:
NUEVA ECIJA
Barangay:
ZARAGOZA #
Instruction: Put a check ✓ on the box that corresponds to the given questions. INDICATORS
YES
NO
FOR C/MLGOO / CD USE ONLY
MEANS OF VERIFICATION
1. Is BADAC composed of at least seven (7) ?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to BADAC Appointment papers Others, please specify: ______________________
2. Did the BADAC organize a Committee on Operations?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to BADAC Appointment papers Others, please specify: ______________________
3. Did the BADAC organize a Committee on Advocacy?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to BADAC Appointment papers Others, please specify: ______________________
4. Did the BADAC organize a BADAC Auxiliary Team?
Executive Order w/ attached list of updated BAT (Required) BADAC Organizational Structure Copies of IDs issued to BAT Appointment papers Others, please specify: ______________________
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
POINTS
REMARKS
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
5. Did the BADAC organize House Clusters?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to House Cluster Leaders Appointment papers Others, please specify: ______________________
6. Did the BADAC designate Barangay Duty Officers (BDO)?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to Barangay Duty Officers Appointment papers Others, please specify: ______________________
7. Is there a desk or space in the barangay designated as Referral/BADAC Desk?
Actual photo of the desk (Required) Others, please specify: ______________________
8. Did the Punong Barangay attend training on Strengthening BADACs, or other relevant trainings?
Copy of Certificate of Participation (Required) Copy of attendance sheet w/ the title of the activity, date/time, and venue Attestation from the lead organizer Others, please specify: ______________________
INDICATORS
YES
9. Did the Punong Barangay attend any training or planning session on Community , Aftercare, and Reintegration Program (CSAR)?
In case the CADAC/MADACs were not able to organize any consultation or planning workshop on reintegration program, the BADACs should check the corresponding box for “N/A” in page 2, item number nine (9) of BADAC Self-Assessment and Audit Form. With respect to this, the C/M LGOO or CD shall allocate the corresponding one (1) point
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
NO
N/A
MEANS OF VERIFICATION Copy of Cert. of Participation (Required) Copy of attendance sheet w/ the title of the activity, date/time, and venue Attestation from the lead organizer Others, please specify: _______________
POINTS
REMARKS
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
10. Did the BADAC conduct at least one (1) training for the BADAC House Cluster Leaders?
BADAC Activity Report with attendance sheets (Required) Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of Certificate of Participation awarded to cluster leaders Others, please specify: ______________________
11. Did the BADAC conduct at least one (1) training for the BADAC Auxiliary Team (BAT)?
BADAC Activity Report with attendance sheets (Required) Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of Certificate of Participation awarded to BAT Others, please specify: ______________________
12. Did the Barangay Duty Officers attend at least one (1) training on Community-Based Rehabilitation Program or other relevant trainings?
Copies of Certificate of Participation (Required) Copy of attendance sheet with title of the activity, date/time, and venue Photo documentation Attestation from lead organizer Others, please specify: ______________________
13. Did the BADAC conduct at least one (1) consultative meeting with stakeholders?
BADAC Activity Report with attendance sheets (Required) Photo/video documentation Minutes of the meeting/proceedings Others, please specify: ______________________
14. Did the BADAC conduct regular monthly meetings? Number of months in which meetings were conducted 10-12 months 8-9 6-7 4-5 1-3 0
Copies of BADAC monthly meeting minutes with attendance sheets (Required) Photo/video documentation Minutes of the meeting/proceedings Others, please specify: ______________________
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
POINTS
REMARKS
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
15. Did the BADAC organize / co-organize at least two (2) community-based IEC campaign activities?
BADAC Activity Report (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: _______________________
16. Did the BADAC organize / co-organize at least one (1) school-based IEC campaign activity?
BADAC Activity Report (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: _______________________
17. Did the SK or any youth organizations in the barangay conduct at least one (1) drug awareness campaign activity?
Activity report by the youth organization (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: _______________________
18. Did any Civil Society Organizations (CSOs) conduct at least one (1) drug awareness campaign activity in the barangay?
Activity report by the CSO (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: ______________________
19. Did the BADAC organize / co-organize any activities in observance of the International Day Against Drug Abuse and Illicit Trafficking (IDADAIT)?
BADAC Activity Report (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
POINTS
REMARKS
Copy of IEC materials used Others, please specify: ______________________
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
20. Did the BADAC organize / co-organize any activities in observance of the Drug Abuse Prevention and Control Week (DAPC)?
BADAC Activity Report (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: ______________________
21. Did the BADAC submit an updated number of residents who surrendered through the Barangay Duty Officers and other mandated agencies?
Copy of the Barangay Duty Officer's logbook, or copy of the logbook/reports from mandated agencies where the resident surrendered (Required) Others, please specify: ______________________
22. Did the BADAC submit an updated number of residents who were referred to higher ADACs and other law enforcement agencies for assessment?
Copy of referral letter from the barangay, received by CADAC/MADAC, or other law enforcement agencies (Required) BDO's logbook showing the referral date Others, please specify: _______________________
23. Did the BADAC submit an updated number and status of residents who were assessed and enrolled in any Wellness and Recovery Interventions?
List of updated number and status of residents enrolled in Wellness and Recovery Interventions issued by CADAC/MADAC (Required) Copies of Individual Treatment Card/Book Others, please specify: _______________________
24. Did the BADAC submit an updated number of residents who have completed prescribed Wellness and Recovery Inteventions?
List of updated number of residents who completed their prescribed Wellness and Recovery Interventions issued by CADAC/MADAC (Required) Copies of Certificate of Completion Copies of clearance certificate issued by authorized service provider Others, please specify: _______________________
25. Did the BADAC submit an updated number of residents enrolled in CSAR or any equivalent reintegration program?
List of updated number of residents enrolled in CSAR program, or its equivalent, issued by
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
POINTS
REMARKS
CADAC/MADAC (Required) Copies of Individual Treatment Card/Book Others, please specify: _______________________
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
26. Did the BADAC submit an updated number of residents who completed the CSAR or any equivalent reintegration program?
List of updated number of residents who completed the CSAR Program issued by CADAC/MADAC (Required) Copies of Certificate of Completion, or copy of Clearance Certificate issued by authorized service provider Others, please specify: _______________________
27. Did the BADAC submit the Summary of Consolidated Information Report (CIR)?
Certificate of submission from CADAC/MADAC and local PNP unit (Required) Copy of received transmittal form Others, please specify: _______________________
28. Did the BADAC submit an updated CIR to CADAC/MADAC and local PNP unit?
Certificate of submission from CADAC/MADAC and local PNP unit (Required) Copy of received transmittal form Others, please specify: _______________________
29. Did the BADAC submit its Barangay CSAR or any equivalent reintegration plan as incorporated in their BADPA?
Copy of approved Barangay CSAR Plan, or equivalent, received by CADAC/MADAC (Required) Others, please specify: _______________________
30. Did the BADAC prepare its own BADAC Plan of Action (BADPA) for FY 2017?
Copy of approved BADPA or copy of approved BPOPS Plan with BADPA (Required) Others, please specify: _______________________
31. Did the BADAC appropriate a substantial budget for its anti-illegal drug activities for FY 2017?
Copy of approved Barangay Annual Budget w/ budget allocation for BADAC (Required) Others, please specify: _______________________ Total annual budget: _______________________ Allocation for BADAC: _______________________
32. Did the BADAC submit its Annual BADAC Accomplishment and Fund Utilization Report to CADAC/MADAC and other agencies? IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
Copy of Annual BADAC Accomplishment and Fund Utilization Report (Required) Others, please specify: _______________________
POINTS
REMARKS
Audited by: _________________________________________________________
TOTAL POINTS
Signature over Printed Name of City/Municipal LGOO or City Director Date signed: ________________
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
LEVEL OF FUNCTIONALITY
Republic of the Philippines
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT DILG-NAPOLCOM Center, EDSA cor. Quezon Ave., Quezon City Telephone Number (02) 925-1137
BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM for the Year 2018
CERTIFICATION OF TRUTH, ACCURACY, AND COMPLETENESS The undersigned certify under penalty of law, based on information and belief formed after reasonable inquiry, the statements and information contained in this document are true, accurate, and complete.
BELINDA GABRIEL Chair of Committee on Advocacy Date signed: MARCH 13, 2019
ROMEO O. DE GUZMAN Chair of Committee on Operations Date signed: MARCH 13, 2019
AGUSTIN DG. BAO JR. Punong Barangay / BADAC Chairperson Date signed: MARCH 13, 2019
Noted by:
MARCELINA A. JAVIER Municipal LGOO Date signed: MARCH 14, 2019
LOVELLA DG. BELMONTE-ESPIRITU Municipal Mayor Date signed: MARCH 14, 2019
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT DILG-NAPOLCOM Center, EDSA cor. Quezon Ave., Quezon City Telephone Number (02) 925-1137
BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM for the Year __________ Region:
III
City/Municipality:
Province:
NUEVA ECIJA
Barangay:
ZARAGOZA #
Instruction: Put a check ✓ on the box that corresponds to the given questions. INDICATORS
YES
NO
FOR C/MLGOO / CD USE ONLY
MEANS OF VERIFICATION
1. Is BADAC composed of at least seven (7) ?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to BADAC Appointment papers Others, please specify: ______________________
2. Did the BADAC organize a Committee on Operations?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to BADAC Appointment papers Others, please specify: ______________________
3. Did the BADAC organize a Committee on Advocacy?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to BADAC Appointment papers Others, please specify: ______________________
4. Did the BADAC organize a BADAC Auxiliary Team?
Executive Order w/ attached list of updated BAT (Required) BADAC Organizational Structure Copies of IDs issued to BAT Appointment papers Others, please specify: ______________________
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
POINTS
REMARKS
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
5. Did the BADAC organize House Clusters?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to House Cluster Leaders Appointment papers Others, please specify: ______________________
6. Did the BADAC designate Barangay Duty Officers (BDO)?
Executive Order (Required) BADAC Organizational Structure Copies of IDs issued to Barangay Duty Officers Appointment papers Others, please specify: ______________________
7. Is there a desk or space in the barangay designated as Referral/BADAC Desk?
Actual photo of the desk (Required) Others, please specify: ______________________
8. Did the Punong Barangay attend training on Strengthening BADACs, or other relevant trainings?
Copy of Certificate of Participation (Required) Copy of attendance sheet w/ the title of the activity, date/time, and venue Attestation from the lead organizer Others, please specify: ______________________
INDICATORS
YES
9. Did the Punong Barangay attend any training or planning session on Community , Aftercare, and Reintegration Program (CSAR)?
In case the CADAC/MADACs were not able to organize any consultation or planning workshop on reintegration program, the BADACs should check the corresponding box for “N/A” in page 2, item number nine (9) of BADAC Self-Assessment and Audit Form. With respect to this, the C/M LGOO or CD shall allocate the corresponding one (1) point
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
NO
N/A
MEANS OF VERIFICATION Copy of Cert. of Participation (Required) Copy of attendance sheet w/ the title of the activity, date/time, and venue Attestation from the lead organizer Others, please specify: _______________
POINTS
REMARKS
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
10. Did the BADAC conduct at least one (1) training for the BADAC House Cluster Leaders?
BADAC Activity Report with attendance sheets (Required) Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of Certificate of Participation awarded to cluster leaders Others, please specify: ______________________
11. Did the BADAC conduct at least one (1) training for the BADAC Auxiliary Team (BAT)?
BADAC Activity Report with attendance sheets (Required) Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of Certificate of Participation awarded to BAT Others, please specify: ______________________
12. Did the Barangay Duty Officers attend at least one (1) training on Community-Based Rehabilitation Program or other relevant trainings?
Copies of Certificate of Participation (Required) Copy of attendance sheet with title of the activity, date/time, and venue Photo documentation Attestation from lead organizer Others, please specify: ______________________
13. Did the BADAC conduct at least one (1) consultative meeting with stakeholders?
BADAC Activity Report with attendance sheets (Required) Photo/video documentation Minutes of the meeting/proceedings Others, please specify: ______________________
14. Did the BADAC conduct regular monthly meetings? Number of months in which meetings were conducted 10-12 months 8-9 6-7 4-5 1-3 0
Copies of BADAC monthly meeting minutes with attendance sheets (Required) Photo/video documentation Minutes of the meeting/proceedings Others, please specify: ______________________
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
POINTS
REMARKS
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
15. Did the BADAC organize / co-organize at least two (2) community-based IEC campaign activities?
BADAC Activity Report (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: _______________________
16. Did the BADAC organize / co-organize at least one (1) school-based IEC campaign activity?
BADAC Activity Report (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: _______________________
17. Did the SK or any youth organizations in the barangay conduct at least one (1) drug awareness campaign activity?
Activity report by the youth organization (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: _______________________
18. Did any Civil Society Organizations (CSOs) conduct at least one (1) drug awareness campaign activity in the barangay?
Activity report by the CSO (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: ______________________
19. Did the BADAC organize / co-organize any activities in observance of the International Day Against Drug Abuse and Illicit Trafficking (IDADAIT)?
BADAC Activity Report (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
POINTS
REMARKS
Copy of IEC materials used Others, please specify: ______________________
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
20. Did the BADAC organize / co-organize any activities in observance of the Drug Abuse Prevention and Control Week (DAPC)?
BADAC Activity Report (Required) Attendance sheets Photo/video documentation Copies of evaluation or forms Copy of signed liquidation report Copy of IEC materials used Others, please specify: ______________________
21. Did the BADAC submit an updated number of residents who surrendered through the Barangay Duty Officers and other mandated agencies?
Copy of the Barangay Duty Officer's logbook, or copy of the logbook/reports from mandated agencies where the resident surrendered (Required) Others, please specify: ______________________
22. Did the BADAC submit an updated number of residents who were referred to higher ADACs and other law enforcement agencies for assessment?
Copy of referral letter from the barangay, received by CADAC/MADAC, or other law enforcement agencies (Required) BDO's logbook showing the referral date Others, please specify: _______________________
23. Did the BADAC submit an updated number and status of residents who were assessed and enrolled in any Wellness and Recovery Interventions?
List of updated number and status of residents enrolled in Wellness and Recovery Interventions issued by CADAC/MADAC (Required) Copies of Individual Treatment Card/Book Others, please specify: _______________________
24. Did the BADAC submit an updated number of residents who have completed prescribed Wellness and Recovery Inteventions?
List of updated number of residents who completed their prescribed Wellness and Recovery Interventions issued by CADAC/MADAC (Required) Copies of Certificate of Completion Copies of clearance certificate issued by authorized service provider Others, please specify: _______________________
25. Did the BADAC submit an updated number of residents enrolled in CSAR or any equivalent reintegration program?
List of updated number of residents enrolled in CSAR program, or its equivalent, issued by
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
POINTS
REMARKS
CADAC/MADAC (Required) Copies of Individual Treatment Card/Book Others, please specify: _______________________
FOR C/MLGOO / CD USE ONLY INDICATORS
YES
NO
MEANS OF VERIFICATION
26. Did the BADAC submit an updated number of residents who completed the CSAR or any equivalent reintegration program?
List of updated number of residents who completed the CSAR Program issued by CADAC/MADAC (Required) Copies of Certificate of Completion, or copy of Clearance Certificate issued by authorized service provider Others, please specify: _______________________
27. Did the BADAC submit the Summary of Consolidated Information Report (CIR)?
Certificate of submission from CADAC/MADAC and local PNP unit (Required) Copy of received transmittal form Others, please specify: _______________________
28. Did the BADAC submit an updated CIR to CADAC/MADAC and local PNP unit?
Certificate of submission from CADAC/MADAC and local PNP unit (Required) Copy of received transmittal form Others, please specify: _______________________
29. Did the BADAC submit its Barangay CSAR or any equivalent reintegration plan as incorporated in their BADPA?
Copy of approved Barangay CSAR Plan, or equivalent, received by CADAC/MADAC (Required) Others, please specify: _______________________
30. Did the BADAC prepare its own BADAC Plan of Action (BADPA) for FY 2017?
Copy of approved BADPA or copy of approved BPOPS Plan with BADPA (Required) Others, please specify: _______________________
31. Did the BADAC appropriate a substantial budget for its anti-illegal drug activities for FY 2017?
Copy of approved Barangay Annual Budget w/ budget allocation for BADAC (Required) Others, please specify: _______________________ Total annual budget: _______________________ Allocation for BADAC: _______________________
32. Did the BADAC submit its Annual BADAC Accomplishment and Fund Utilization Report to CADAC/MADAC and other agencies? IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
Copy of Annual BADAC Accomplishment and Fund Utilization Report (Required) Others, please specify: _______________________
POINTS
REMARKS
Audited by: _________________________________________________________
TOTAL POINTS
Signature over Printed Name of City/Municipal LGOO or City Director Date signed: ________________
IN COMPLIANCE WITH DILG-DDB T MEMORANDUM CIRCULAR NO. 2018-01
LEVEL OF FUNCTIONALITY
Republic of the Philippines
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT DILG-NAPOLCOM Center, EDSA cor. Quezon Ave., Quezon City Telephone Number (02) 925-1137
BADAC FUNCTIONALITY SELF-ASSESSMENT AND AUDIT FORM for the Year 2018
CERTIFICATION OF TRUTH, ACCURACY, AND COMPLETENESS The undersigned certify under penalty of law, based on information and belief formed after reasonable inquiry, the statements and information contained in this document are true, accurate, and complete.
BELINDA GABRIEL Chair of Committee on Advocacy Date signed: MARCH 13, 2019
ROMEO O. DE GUZMAN Chair of Committee on Operations Date signed: MARCH 13, 2019
AGUSTIN DG. BAO JR. Punong Barangay / BADAC Chairperson Date signed: MARCH 13, 2019
Noted by:
MARCELINA A. JAVIER Municipal LGOO Date signed: MARCH 14, 2019
LOVELLA DG. BELMONTE-ESPIRITU Municipal Mayor Date signed: MARCH 14, 2019
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