Republic of the Philippines

Department of Education
Region IV-A CALABARZON
City Schools Division of Dasmariñas

HTN:__________________
To be filled out by HRD
ACTIVITY PROPOSAL FORM

TITLE OF PROJECT/ACTIVITY:

LEVEL:
☐ Division-Wide ☐ Division Level
☐ District ☒ School Level (GAD with Budget)
TYPE OF ACTIVITY:

☐ Program ☐ Project
☐ General Assembly ☐ Orientation
☐ Exhibit ☐ Sports/ Tournament
☐ Spiritual Activity ☐ Media-Related Activity
☐ Publicity/Awareness Campaign ☐ Contest/ Competition
☐ Awarding Ceremony ☒ Others: LAC

QUARTER: (1st, 2nd, 3rd, or TRAINING TYPE: (Type A CLUSTER: (Put NA if not
4th) 1ST [Included in AIP/WFP], Type B applicable)
[Scope Creep]) NA
Included in AIP
CONDUCTING OFFICE/ SCHOOL: CONDUCTING UNIT/
ORGANIZATION:
Langkaan II Nationa High School (Put NA if not applicable)

NA
PROPONENT: Amy S. Peyra

EMAIL ADDRESS: CONTACT NUMBER:

Amy.peyra@deped.gov.ph 09565041469

AMOUNT REQUESTED: FUND SOURCE: (GASS, SARO, etc.)

NA
NA
CATEGORY OF PARTICIPANTS: TYPE OF PARTICIPANTS: (Division
(Teaching, Teaching-Related, Non-Teaching, Job Personnel, Teachers 1-3, Master Teachers 1-2,
Order and/or Local School Board) etc.)
Teacher 1-3, Master Teacher
(Teaching, Teaching-Related job

TOTAL NUMBER OF NUMBER OF FEMALE NUMBER OF MALE

Address: CSDO Bldg., DasCA Compound, Burol-II, City of Dasmariñas, 4115

Telephone No: (046) 432 9355
Email Address: dasmarinas.city@deped.gov.ph Doc. Ref. Code QMS-HRD-F03 Rev 04
Website: https://depeddasma.edu.ph Effectivity 01.13.23 Page 1 of 8
 Page 2 of 8

PARTICIPANTS: PARTICIPANTS: PARTICIPANTS:

15 10 5

Start Date of Implementation: End Date of Implementation:

February 24, 2023 February 24, 2023

Start Time of Implementation: End Time of Implementation:

10:30am 12:00noon
Venue: (Put Virtual if Online) Online Platform: (Put NA if not
applicable)
In-person NA
PARTNERS: (If any. Put NA if none)

NA

RATIONALE:

In pursuant to Section 3 Republic Act No. 10533 known as the Enhanced Basic Education
Act of 20213 and Section 8 and 8.2 from its Implementing Rules and Regulations, DepEd
issues an Order No. 044, series of 2021 also known as Policy Guidelines on the Provision
of Educational Programs and for Learners with Disabilities in the K to 12 Basic Education
Program.
This policy aims to provide an over direction and guidance in the organization,
management and implementation of appropriate and relevant programs, services and other
educational interventions, at the different levels of governance in the department, for
learners with disabilities status. This is anchored on the inclusive education Policy
Framework for Basic Education under Annex No. 5 of D. O. No. 21 series of 2019.

OBJECTIVES:

In connection with this order it aims to:

 Capacitate receiving teacher of the DepEd No. 044, series of 2021 and in
handling and learners with special educational needs (LSENs)focusing on
pedagogical knowledge, skills, and attitudes in the New Normal such as:

A. Policy and Guidelines on Provision of Educational Programs and

Services for Learners with Disabilities in the K to 12 Basic Education
Program DepEd No. 044, s. 2021
B. Difficulty in Hearing, Remembering/Concentrating, Difficulty in
Learning and Applying Knowledge
C. Learning modifications and accommodations

Address: CSDO Bldg., DasCA Compound, Burol-II, City of Dasmariñas, 4115

Telephone No: (046) 432 9355
Email Address: dasmarinas.city@deped.gov.ph Doc. Ref. Code QMS-HRD-F03 Rev 04
Website: https://depeddasma.edu.ph Effectivity 01.13.23 Page 2 of 8
 Page 3 of 8

EXPECTED OUTPUT/S:
 Receiving Teachers are expected to create modifications and
accommodations in their lessons in class to the receiving students.
 Receiving teachers of HI learners are expected to learn basic ALS
(American Sign Language)
 Classes with HI students are expected to familiarize basic sign language
with the help of the LSENs and the teachers.

RESOURCE REQUIREMENT:

Speaker, microphone, smart TV, computer

Declaration: 

The information provided in this training proposal are true and correct and there
have been no misleading statements, omission of any relevant facts nor any
misinterpretation made. 

The Program Management Team have fully reviewed and agreed with Division
Memorandum No. 109, s. 2022 on Human Resource Development (HRD) training
guidelines and other additional training guidelines on the nationwide
implementation of alert level system for covid-19 response.

Furthermore, the Program Management Team have fully understood and shall
comply with the Division Order No. 1, s. 2019 titled Regulating the Use of Plastic
Products in Schools and Offices in the City Schools Division of Dasmariñas and
Division Memorandum No. 45, s. 2021 titled Banning of Single-Use Plastic
Products in All Division and School Training and Activities.

Sign off by the Proponent and immediate head or its equivalent.

Prepared by:

Amy S. Peyra
(Signature over Printed Name)

Address: CSDO Bldg., DasCA Compound, Burol-II, City of Dasmariñas, 4115

Telephone No: (046) 432 9355
Email Address: dasmarinas.city@deped.gov.ph Doc. Ref. Code QMS-HRD-F03 Rev 04
Website: https://depeddasma.edu.ph Effectivity 01.13.23 Page 3 of 8
 Page 4 of 8

Designation:
Date: February 7, 2023

Recommending Approval as to Purpose:

RUCHELLE A. BAYSAN
(Signature over Printed Name)
School Head/Chief
Designation: Principal II
Date:

Attachment No. 2
PROGRAMME/ SCHEDULE OF ACTIVITY

PERSONS
DATE/ TIME ACTIVITIES
INVOLVED
10:00AM- Registration & Opening Program Receiving
10:30AM Teachers

10:30AM- LAC PROPER Receiving

10:45AM Teachers
Speaker: Amy S. Peyra
Topics:
A. Difficulty in Hearing,
Remembering/Concentrati
ng, Difficulty in Learning
and Applying Knowledge
B. Learning modifications
and accommodations

11:45- Open Forum Receiving

12:00PM Teachers

12:00PM End of the session Receiving

Teachers

Attachment No. 3
RESOURCE SPEAKER’S PROFILE
(Remove if not applicable)

Address: CSDO Bldg., DasCA Compound, Burol-II, City of Dasmariñas, 4115

Telephone No: (046) 432 9355
Email Address: dasmarinas.city@deped.gov.ph Doc. Ref. Code QMS-HRD-F03 Rev 04
Website: https://depeddasma.edu.ph Effectivity 01.13.23 Page 4 of 8
 Page 5 of 8

FULL NAME: (First Name, Middle Initial, Last Name)

Hernandez, Vilie Ann Saquing

TOPIC ASSIGNED:

Equipping Teachers on Effective Strategies to Recover Reading Logs

AGE: 33 SEX: Female GENDER: (Cisgender, Gay,
Lesbian, Transgender, etc.)

Female
CONTACT NUMBER: CIVIL STATUS: RELIGION:
Married Christian
09499228736
COMPLETE ADDRESS:

Blk. 8, Lot 1, Mahogany st. Greenbreeze cityland, Langkaan II,

Dasmarinas City, Cavite

EDUCATIONAL BACKGROUND
SCHOOL (COLLEGE):

Cagayan State University

YEAR GRADUATED: DEGREE RECEIVED:
2012 Bachelor in Secondary Education -Filipino

SCHOOL (POSTGRADUATE):

36 Units earned MA-Filipino

YEAR GRADUATED: DEGREE RECEIVED:

NA NA
EMPLOYMENT RECORD
CURRENT COMPANY/ INSITUTION
Langkaan II Nationa High School

POSITION: YEARS IN SERVICE:

Teacher II
9 years
SPECIALIZATION: Filipino

TRAINING/ SEMINAR(s) ATTENDED RELATED TO THE TOPIC TO BE

DISCUSSED
TITLE OF THE TRAINING/ YEAR
SEMINAR(S) N/A

LAC on Receiving Teachers

Address: CSDO Bldg., DasCA Compound, Burol-II, City of Dasmariñas, 4115

Telephone No: (046) 432 9355
Email Address: dasmarinas.city@deped.gov.ph Doc. Ref. Code QMS-HRD-F03 Rev 04
Website: https://depeddasma.edu.ph Effectivity 01.13.23 Page 5 of 8
 Page 6 of 8

Attachment No. 4
PROGRAM MANAGEMENT TEAM
(Samples are in red)
EXECUTIVE COMMITTEE

Ruchelle A. Baysan
Principal II

Amy S. Peyra
Teacher I/Inclusion Coordinator

PLANNING COMMITTEE

Amy S. Peyra
School-based Inclusion Coordinator

TECHNICAL COMMITTEE

Registration/ Accommodation
Analiza Bello
Cherry R. Solijon

Attendance, Evaluation and Certification

Erica Gallandez
Jay-ar G. Velante
Marinel Competente

Secretariat
Raquel Bautista
Jessy Lou Padernos

Documentation
Ma. Diane Kristine Tejero
Jordan Aurea
___________________________________

Welfare and Benefits

Larry G. Tan
Maritess C. Chavez

**Add other TWG if necessary

Address: CSDO Bldg., DasCA Compound, Burol-II, City of Dasmariñas, 4115

Telephone No: (046) 432 9355
Email Address: dasmarinas.city@deped.gov.ph Doc. Ref. Code QMS-HRD-F03 Rev 04
Website: https://depeddasma.edu.ph Effectivity 01.13.23 Page 6 of 8
 Page 7 of 8

TECHNICAL WORKING GROUP AND MANAGEMENT TEAM

Program Manager: Mrs. Rea C. Bunan

Mrs. Amy S. Peyra

Program Invitation Ma. Diane Kristine Tejero

Monitoring & Evaluation: Jay-ar G. Velante

Registration: Analiza Bello

Cherry R. Solijon

Documenter(s): Ma. Diane Kristine Tejero

Jordan Aurea

Technical: Rolando Tamayo Jr.

E-Certificates: Jay-ar G. Velante

Erica Gallandez

LAC Manager: Anne P. Chuca

Flex Ko Lang Narrative Ma. Diane Kristine Tejero

Address: CSDO Bldg., DasCA Compound, Burol-II, City of Dasmariñas, 4115

Telephone No: (046) 432 9355
Email Address: dasmarinas.city@deped.gov.ph Doc. Ref. Code QMS-HRD-F03 Rev 04
Website: https://depeddasma.edu.ph Effectivity 01.13.23 Page 7 of 8
Attachment No. 5 (For Program/ Project proposal ONLY)
ACTION PLAN
(Remove if not applicable)

TITLE: LAC on Receiving Teachers of LSENs

DATE: February 24, 2023 VENUE/ ONLINE PLATFORM: In-person

No. of Resources Target Person in Source of

Activity Objectives Venue
Participants Needed Date Charge Fund
LAC on Introduce the Policy 15 Februar Compu Amy S. Peyra NA
Receiving and Guidelines on y 24, ter
Teachers of Provision of 2023 Labora
LSENs Educational Programs tory
and Services for
Learners with
Disabilities in the K to
12 Basic Education
Program Deped No.
044, s. 2021