TESDA-OP-CO-01-F02

(Rev.No.00-03/08/17)

CERTIFICATION OF CONCURRENCE

Date

I,/We (Name) (Designation/Position) of

(Name of Technical Vocational Institution (TVI)/Company)
located at (Address of TVI/Company) hereby certify
that I/we have fully understood and will abide by the requirements and pro-
cedures under the TESDA Unified TVET Program Registration and Ac-
creditation System (UTPRAS) outlined as follows:

1. Program registration requirements, policies and procedures;

2. Compliance Audit;
3. Sanctions and penalties to be imposed to erring institutions; and
the
4. Payment of the non-refundable application fee of P2,000.00 for program
registration.

As representative/s of the TVI/Company, I/we will inform the

owner(s)/Head/President of our TVI/Company on the orientation conducted by
TESDA relative to the Program Registration requirements and procedures.

Done this ___day of ______________ in the year _______.

_______________________
Signature

_______________________
Position

Noted by:

Provincial Director
Date:
 TESDA-OP-CO-01-F03
(Rev.No.00-
03/08/17)

(Letter Head of the TVI/Company)

LETTER OF APPLICATION/INTENT

Date

The Provincial Director

__________________
__________________
__________________

Dear Sir/Madam:

We would like to express our intention to apply for program registration for the
following qualification(s):
Qualification Training Duration
(No. of Hours)

1.
2.
3.

Enclosed are the required documents.

We hope for your immediate action on this application.

Very truly yours,

Signature over Printed Name

(President/Head TVI/Company)

Attachments: (As indicated in the Program Registration Checklist)

1. Corporate Administrative Documents
2. Curricular Requirements
3. Faculty and Personnel
4. Program Guidelines
5. Support Services
 TESDA-OP-CO-01-F04
(Rev.No.00-03/08/17)

Program Registration Requirement Checklist

(For Institution-based Programs)

Name of TVI
Address Tel/Fax No.:
Program Applied Duration: (in hrs.)
No. of trainees per batch:
Training Capacity
No. of batches per year:
Program Registration Requirements
Compliant
Remarks
Yes No
1. CORPORATE AND ADMINISTRATIVE
DOCUMENTS
a) Letter of Application/Intent (TESDA-
OP-CO-F03)
b) Board Resolution/Academic Council
Resolution to offer the program signed
by the Board Secretary and attested
by the Chairperson (SUCs, LCUs, and
private institutions) Board
Resolution/Academic Council
Resolution must specifically cover the
training delivery site)
c) Special law creating the institution
(for public institution) e.g. Republic
Act, Executive Order, Sanggunian
Resolutions)
d) Securities and Exchange Commission
(SEC) Registration for private
institutions
e) Articles of Incorporation (indicate main
address)
f) Proof of building Ownership or
contract of lease (covering at least two
years) upon application for new
program. For succeeding application a
valid contract of lease
g) Current Fire Safety Certificate
(training site)
h) For Institutions that will branch out
Name of TVI
Address Tel/Fax No.:
Program Applied Duration: (in hrs.)
No. of trainees per batch:
Training Capacity
No. of batches per year:
Program Registration Requirements
Compliant Remarks
The Articles of Incorporation & Bylaws
must state reasons for opening of the
branch. The Articles of Incorporation
signed by majority of the Incorporators
must be notarized and received by
SEC
2. CURRICULAR REQUIREMENTS
a) Competency-based Curriculum
(TESDA-OP-CO-01-F11) indicating
the qualification being addressed and
the competencies to be developed
a.1 Course Design
a.2 Modules of Instruction
b) List of Equipment (TESDA-OP-CO-01-
F13), Tools (TESDA-OP-CO-01-F14)
and Consumables/Materials (TESDA-
OP-CO-01-F15) necessary to deliver
the program
c) List of instructional materials (TESDA-
OP-CO-01-F16) (such as reference
materials, slides, video tapes, internet
access and library resource necessary
to deliver the program
d) List of Physical Facilities (TESDA-
OP-CO-01-F17) and List of Off-Cam-
pus Physical Facilities TESDA-OP-CO-
01-F18)
e) Shop layout of training facilities
indicating the floor area
f) Institutional Assessment
Note: Actual Assessment Tools should
be shown during inspection
3. FACULTY AND PERSONNEL
a) List of Officials (TESDA-OP-CO-01-
F19)
Name of TVI
Address Tel/Fax No.:
Program Applied Duration: (in hrs.)
No. of trainees per batch:
Training Capacity
No. of batches per year:
Program Registration Requirements
Compliant Remarks
b) List of Trainers (TESDA-OP-CO-01-
F20) with their qualifications, areas of
expertise, and courses/seminars
attended with supporting evidence
available, such as relevant NTTC/
trainer qualification certificates and
certification of employment. For NTR
programs, copy of Training Certifi-
cate on Trainers Methodology I or
other Trainer Methodology Certifi-
cates, and evidence of spe-
cialization of the trainer of the
program. A certified true copy of
notarized contract of employment by
the applicant TVI is required.
c) List of Non-Teaching Staff
(TESDA-OP-CO-01-F21) with their
qualifications with supporting
evidences available, such as copies of
certificates/contracts of employment,
etc.
4. PROGRAM GUIDELINES
a) Program fees, with breakdown of
tuition and other fees and schedule of
fee payment duly signed by the school
head indicating the effectivity of school
year
b) Documented grading system, details
of which are provided to students/
trainees at the start of their program
c) Entry requirements for the program
comply with the relevant training
regulations if applicable
Name of TVI
Address Tel/Fax No.:
Program Applied Duration: (in hrs.)
No. of trainees per batch:
Training Capacity
No. of batches per year:
Program Registration Requirements
Compliant Remarks
d) Rules on attendance

5. SUPPORT SERVICES
a) Health services are available to the
students/trainees. If these services are
contracted out or out-sourced, the
contract or MOA or similar documents
must be submitted.
b) Job Linkaging and Networking Services
(JLNS) which include Career Services
and Employment Facilitation available
to students/trainees/TVET graduates
(reference: Section IV, letter A –
Delivery Platforms of JLNS Nos. 1-4 of
the TESDA Circular No. 38, series of
2016)
c) Community outreach program –
optional
d) Research program, activities that will
support continuing development of the
program of the school – optional
6. Additional Requirements for DTS/DTP Applicants
a) Application Letter of the TVI and the
Establishment
b) Accomplished Application form for TVI
and for Establishment
c) Photocopy of TVI’s CTPR
d) Photocopy of Establishment SEC
Registration
e) Memorandum of Agreement with
partner Establishment/s
f) Training Plan (DTS Form 5)
g) Certification issued by the TVI
designating the Industrial Coordinator
 Name of TVI
Address Tel/Fax No.:
Program Applied Duration: (in hrs.)
No. of trainees per batch:
Training Capacity
No. of batches per year:
Program Registration Requirements
Compliant Remarks
h) Certification issued by the company
designating the In-plant Trainer
Forms – refer to TESDA Circular No. 31
Series 2012 - Guidelines in Implementing the
Dual Training System (DTS) Programs and
Dualized Training Programs (DTP)
7. Requirements for Mobile Training Application (Additional)
a) Copy of CTPR of the registered
institution-based program
b) Copy of the approved program
registration documents
c) LTO Registration of the prime mover of
the MBC ( for delivered in a self
contained van)
d) Design/lay-out of the MBC
Reference: TESDA Circular No. 27 Series of
2009 Operational Polices in the Registration
of Mobile Training Classrooms, Park and
Training Programs (MBC-MTP) and TESDA
Order 28 Series in 2012 – Addendum and
Amendments to the Guidelines and
Registration of Mobile Training Program
(MTP)
(Note: Erasure is not allowed on the submitted checklist of requirements)
General Comments/Remarks:

Prepared by: Noted by:

PO UTPRAS Focal Person Provincial Director

Date: Date:
 TESDA-OP-CO-00-F05
(Rev.No.00-03/08/17)

Program Registration Requirement Checklist

(Company/Enterprise-based Programs)
Name of Company
Address Tel/Fax No.:
Program Applied Duration: (in hrs.)
No. of Trainees per batch:
Training Capacity
No. of Batches per year:
Program Registration Requirements
Compliant
Program Registration Requirements Remarks
Yes No
1. CORPORATE AND ADMINISTRA-
TIVE DOCUMENTS
a) Letter of Application/Intent
(TESDA-OP-CO-F01)
b) Securities and Exchange
Commission (SEC) Registration for
Corporation.
For sole proprietorship, a DTI
Registration is required.
c) Proof of building ownership or
contract of lease (covering at least
two years) upon application for
new program. For succeeding ap-
plication a valid contract of lease)
d) Current Fire Safety Certificate
(training site)
2. CURRICULAR REQUIREMENTS
a) Competency-based Curriculum
(TESDA-OP- CO-01-F08)
indicating the qualification
being addressed and the com-
petencies to be developed
a.1 Course Design
a.2 Modules of Instruction
b) List of Equipment (TESDA-OP-
CO-01-F13), Tools (TESDA-OP-
CO-01-F14), and Consumables
(TESDA-OP-CO-01-F15)
necessary to deliver the program
 Name of Company
Address Tel/Fax No.:
Program Applied Duration: (in hrs.)
No. of Trainees per batch:
Training Capacity
No. of Batches per year:
Program Registration Requirements
Program Registration Requirements Compliant Remarks
c) List of Physical Facilities
(TESDA-OP-CO-01-F17) and List
of Off-Campus Physical Facilities
TESDA-OP-CO-01-F18) indicating
floor area
d) Shop layout of training facilities
indicating the floor area
3. Trainer/HRD Personnel
a) List of Trainers (TESDA-OP-CO-
01-F20) with their qualifications,
areas of expertise, and courses/
seminars attended with sup-
porting evidence available,
such as relevant NTTC/trainer
qualification certificates and
certification of employment.)
(Note: Erasure is not allowed on the submitted checklist of requirements)

General Comments/Remarks:

Prepared by: Noted by:

PO UTPRAS Focal Person Provincial Director

Date: Date:
 TESDA-OP-CO-01-F06
(Rev.No.00-03/08/17)

Program Registration Application

ACTION SLIP
No: S. 20__

REGION: PROVINCE:
NAME OF TVI/COMPANY: PROGRAM Applied for:

COPY FOR THE APPLICANT. Please bring this every time you transact with
the TESDA Provincial Office regarding your Program Application.
ACTION TAKEN:
1. REVIEW OF COMPLETENESS of APPLICATION DOCUMENTS:

_____ INCOMPLETE/RETURNED. Please see attached for the recommendations

to complete your application. Thank you!

COMPLETE / ACCEPTED. Please be back on __________ / ____________

(date) (time)
Thank you!

Issued by: Received by: Date:

_______________________ __________________________
Name and Signature Name and Signature
PO UTPRAS Focal Person TVI/Company Representative

nature
2.a. EVALUATION of APPLICATION DOCUMENTS:

NON-COMPLIANT. Attached is the list of deficiencies and recommen-

dations.

COMPLIANT. The schedule of Inspection: ____________ / ___________

(date) (time)
Thank you!
Issued by: Received by: Date:

________________________
Name and Signature Name and Signature
PO UTPRAS Focal Person TVI/Company Representative
2.b. EVALUATION of APPLICATION DOCUMENTS:

NON-COMPLIANT. Attached is the list of deficiencies and recommenda-

tions.

COMPLIANT. The schedule of Inspection: ________ / _________

(date) (time)
Thank you!
Issued by: Received by: Date:

_________________________ __________________________
Name and Signature Name and Signature
PO UTPRAS Focal Person TVI/Company Representative

3. INSPECTION of FACILITIES, EQUIPMENT, TOOLS, TRAINING SUP-

PLIES AND MATERIALS

NON-COMPLIANT. Attached is the list of deficiencies and recommenda-

tions.
Please comply within 30 days, otherwise, we will return your application
documents. You may re-apply when you are ready.

COMPLIANT. Congratulations! We are recommending approval of your

application to the Regional Office for issuance of CTPR.

Please call on: ________________ / __________________

(date) (time)

Date:
Issued by: Received by

__________________________ _________________________
Name and Signature Name and Signature
PO UTPRAS Focal Person TVI/Company Representative

Noted by:
Provincial Director
4. ISSUES OF APPROVED CERTIFICATE OF TVET PROGRAM
REGISTRATION
I hereby agree to the Affidavit of Undertaking of the TESDA Program
Registration as provided in the Certificate of TVET Program Registration.

Noted by: Noted by: Date:

________________________
Provincial Director

________________________ Issued by:

Regional Director ________________________
Name and Signature
PO UTPRAS Focal Person

Received by:
________________________
Name and Signature
TVI/Company Representative

--------------------------------------------------------------------------------------------------------
(Please detach and drop in the Customer Satisfaction Box)
CUSTOMER SATISFACTION RATING: From 1 (Needs Improvement) to 5 (Excellent)
Measures 1 2 3 4 5

1. Clarity of orientation on program application

Requirements
2. Efficient action on the application documents
3. Courtesy of staff in dealing with the applicant/s
4. Other Comments and Recommendations:
Accomplished by: (Optional) Date:

________________________________
Name and Signature

Name of TVET Institution: _______________________________

 TESDA-OP CO-01-F11
(Rev.No.00-03/08/17)

COMPETENCY-BASED CURRICULUM

A. Course Design

Course Title: ________________________________________

Nominal Duration: ________________________________________
Qualification Level: ________________________________________
Course Description: ________________________________________
________________________________________
________________________________________

Trainee Entry ________________________________________

Requirements: ________________________________________
________________________________________

Course Structure
Basic Competencies
No. of Hours: (_____)
Unit of Competency Module Title Learning Nominal
Outcomes Duration

Common Competencies
No. of Hours: (_____)
Unit of Compe- Module Title Learning Out- Nominal
tency comes Duration

Core Competencies
No. of Hours:(_____)
Unit of Competency Module Title Learning Out- Nominal
comes Duration

Elective Competencies ( if any)

No. of Hours: (_____)
Unit of Competency Module Title Learning Nominal
Outcomes Duration

Assessment Methods: __________________________________________

___________________________________________
___________________________________________

Course Delivery: ___________________________________________

___________________________________________
___________________________________________
 Resources:

(List of recommended tools, equipment and materials for the training of

(no. of trainees) trainees for (title of program/qualification).

Qty. Tools Qty. Equipment Qty. Materials

Facilities: _____________________________________________
_____________________________________________
_____________________________________________
Qualification of _____________________________________________
Instructors/Trainers: _____________________________________________
_____________________________________________

B. Modules of Instruction

Basic Competencies : _____________________________________________

Unit of Competency : _____________________________________________
Modules Title: _____________________________________________
Module Descriptor: _____________________________________________
Nominal Duration: _____________________________________________
Summary of Learning Outcomes:
LO1. ____________________________________________________________
LO2. ____________________________________________________________
LO3. ____________________________________________________________

Details of Learning Outcomes:

LO1 . ____________________________________________________________

Assessment Contents Conditions Methodologies Assessment

Criteria Methods

LO2 . ____________________________________________________________

Assessment Contents Conditions Methodologies Assessment

Criteria Methods

LO3 . ____________________________________________________________

Assessment Contents Conditions Methodologies Assessment

Criteria Methods
(Note: Copy format for modules of instructions for Common and Core Competencies)
 TESDA-OP-CO -01-F13
(Rev.No.00-03/08/17)

LIST OF EQUIPMENT
(As listed in the respective TR)

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Name of Specifica- Quantity Quantity Difference Inspector’s

Equipment tion Required on Site Remarks
(1) (3) (4) (5) (6)
(2)
Projector Screen EZ Screen 1 1 0
LCD Epson 1 1 0
Electric Fan Asahi, Stan- 2 2 0
dard Stand
Fan
First Aid Cabinet Wooden 1 1 0
Instructor’s desk chairs Plastic 1 1 0
Fire Extinguisher Krizler 3 3 0
Emergency Light LED Auto- 2 2 0
matic Emer-
gency Light
Directional Signage Wooden 2 2 0
Air Condition Sharp 2 2 0
Armed Chairs or Rec- 3D, 230 V 25 25 0
tangular Table & Chairs
for 25 Students
Telephone Panasonic 1 1 0
Computer Acer 1 1 0
TV ACE 1 1 0
Video Player Fukuda 1 1 0
Refrigerator or Mini Bar Singer 1 1 0
Refrigerator
Hairdryer American Her- 1 1 0
itage
Shelving 1 1 0
Cart/Trolley Plastic 1 1 0
Coffee Maker Imarflex/10 1 1 0
cups capacity
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date:
 TESDA-OP-CO -01-F13
(Rev.No.00-03/08/17)

LIST OF EQUIPMENT
(As listed in the respective TR)

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Name of Specifica- Quantity Quantity Difference Inspector’s

Equipment tion Required on Site Remarks
(1) (3) (4) (5) (6)
(2)
Electric Kettle/Electric Imarflex/ 1.8 1 1 0
Jug/Thermal Jug liters
Tiolet Caddy Plastic cov- 1 1 0
ered thick
wire
Carpet Sweeper Plastic/ 3 in 1 1 0
1/ amazing
mop
Vacuum Cleaner(Dry Electrolux 2 2 0
and Wet)
Polisher(electric w/ 1 1 0
complete accessories)
Washers Dowell WM - 1 1 0
600
Dryer Dowell WM - 1 1 0
600
Flat Iron Hanabishi 1 1 0
Ironing Board Steel 1 1 0
Steam pressers Asahi 1 1 0
Sorting Shelves Wooden 1 1 0
Drying Cleaning Ma- ED Mark 1 1 0
chine
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date:
 TESDA-OP-CO 01-F14
(Rev.No.00-03/08/17)

LIST OF TOOLS
(As listed in the respective TR)

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Name of Tools Specification Quantity Quantity Difference Inspector’s

(1) Required on Site Remarks
(2) (3) (4) (5) (6)
Mops Cloth 5 5 0
Brushes Nylon/Electric 5 5 0
Brush
Brooms Soft/ Walis Tingt- 5 5 0
ing
Buckets Plastic 5 5 0
Dust Pans Plastic/ Alu- 5 5 0
minum
Garbage Receptacles Plastic 5 5 0
Sorting Baskets/ Laun- Plastic 2 2 0
dry Baskets
Step Ladder Steel 1 1 0
Squeegee 12’’ Silicon (Rub- 2 2 0
ber)
Water Hoses Rubber 2 2 0
Lint Free Cleaning All – purpose Mi- 10 10 0
Cloths cro Fiber
Scrubbing Foam Foam/ Nylon 10 10 0
Dish Sponges Foam/ Scotch 10 10 0
Bright
Spray Bottles Plastic 5 5 0
Anti – Static Dusters Feather/ Cloth 5 5 0
Gloves Rubber 25 25 0
Caution Signs Tarpaulin 5 5 0
Mop Squeezer Plastics/ 3 in 1 2 2 0

Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date:
 TESDA-OP-CO-01-F15
(Rev.No.00-03/08/17)

LIST OF CONSUMABLES/MATERIALS
(As listed in the respective TR)

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

List of Specification Quantity Quantity Difference Inspectors

Consumables/ Required on Site (5) Remarks
Materials (2) (3) (4) (6)
(1)
Bond paper Hard Copy 2 rms. 2 rms. 0
Folders System Folder 20 pcs. 20 pcs. 0
Logbook 1 pc. 1 pc. 0
White Board 2 2 0
Whiteboard Markers 5 5 0
Whiteboard Eraser 2 2 0
Marking Pen 5 5 0
Stationery Metro Bond #20 2 2 0
Linen (For single bed) Cloffman White 2 sets 2 sets 0
Linen (For queen bed) Cloffman White 2 sets 2 sets 0
Glassware Clear Glass 1 set 1 set 0
Cutlery Stainless 1 set 1 set 0
Tea Lipton 1 pac 1 pac 0
Coffee Batangas Brew 1 pack 1 pack 0
Creamer White 1 pack 1 pack 0
Biscuits Skyflakes 1 pack 1 pack 0
Bed (Single) Wooden 1 1 0
Bed (Queen) Wooden 1 1 0
Holy Bible Cloth bound 1 1 0
Slippers Rubber/ Cloth 2 pairs 2 pairs 0
Flashlight Eveready 5 5 0
Light Fittings 1 set 1 set 0
Mirrors Aluminum Lined 1 1 0
Wardrobes Wooden 5 5 0
Hangers Wire 5 5 0
Variety of linen and Cotton/Silk/Linen 5 each 5 each 0
clothing items and fab- Pants/Blouse/ item item
rics Dresses
Note: Columns 1-4 to be filled out by Institution; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date:
 TESDA-OP-CO-01-F15
(Rev.No.00-03/08/17)

LIST OF CONSUMABLES/MATERIALS
(As listed in the respective TR)

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

List of Specification Quantity Quantity Difference Inspectors

Consumables/ Required on Site (5) Remarks
Materials (2) (3) (4) (6)
(1)
CLEANING AGENTS
Cleaning Detergent Zonrox 5 5 0
Liquid Detergent Surf Liquid Deter- 5 5 0
gent
Cleaning Solution Pledge, Mr. Muscle 5 5 0
Sanitizing Agents Isoprophyl Alcohol 5 5 0
Fabric Softener Downy/ Glide 5 5 0
Chlorine Bleach Chlorox 5 5 0
All – purpose Detergent Tide Powder/ Bar 5 5 0
Stain Removing Agents Chlorine 5 5 0
Furniture and floor pol- Wax 2 2 0
ishers
Air Freshener Glade/ Classique 5 5 0
Pesticides Baygon/ Raid/ Off 5 5 0
Lotion
Deodorizers 5 5 0
Toilet Disinfectant Mr. Muscle/ Home 5 5 0
Clean Home
Overalls Cloth/ Water Re- 2 2 0
pelant
Jackets Cloth 2 2 0
Aprons Cloth 25 25 0
Goggles Plastic 2 2 0
Masks Cheese Cloth 2 2 0
Headwear Knitted/ Nylon 2 2 0
Waterproof clothing Rain Coat/ Rubber 2 2 0
and footwear Boats
Note: Columns 1-4 to be filled out by Institution; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date:
 TESDA-OP-CO-01-F15
(Rev.No.00-03/08/17)

LIST OF CONSUMABLES/MATERIALS
(As listed in the respective TR)

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

List of Specification Quantity Quantity Difference Inspectors

Consumables/ Required on Site (5) Remarks
Materials (2) (3) (4) (6)
(1)
DISCRETIONARY SUPPLIES
Fruits (assorted) (On Season) 5 5 0
Beverages (assorted) Coffe/ Tea/ Nestea 5 cans 5 cans 0
Chocolates (assorted) Chocolate Cakes/ 5 pcs. 5 pcs. 0
Toblerone

Note: Columns 1-4 to be filled out by Institution; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date:
 TESDA-OP-CO -01-F16
(Rev.No.00-03/08/17)

LIST OF INSTRUCTIONAL MATERIALS/LIBRARY HOLDINGS

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Title Classification* Date of No. of Copies Inspector’s

Publication (where applicable) Remarks
Good House- Magazine April 2012/ 1 copy each Good House-
keeping Nov. 2011/ keeping
April 2006
Yes! Maga- Magazine April 2012 2 copies Yes! Magazine
zine
Southern Liv- Magazine October 1 copy Southern Living
ing (Modern 2011 (Modern Chic
Chic Home) Home)
Manila Bul- Newspaper 2012 2 copies Manila Bulletin/
letin/ Philip- Philippine Star
pine Star
Week End/ Lodging 2012 1 copy Week End/
Week Long Agreement Week Long
Let’s Cook w/ Recipe Book 1969/ 1996/ 1 copy each Let’s Cook w/
Nora/ The 2002 Nora/ The Best
Best of of Celebrity
Celebrity Recipes/ All –
Recipes/ All – time Favorite
time Favorite Casseroles
Casseroles
T.L.E 1,2,3,4 Textbooks 1999/ 2000/ 1 copy each T.L.E 1,2,3,4
2006
Metro Smart Local Tourist 2010/ 2011 1 copy each Metro Smart
Parenting, Information Parenting,
Working Working Mom,
Mom, Smile, Smile, Mega
Mega
Note *Classify whether journal, book, magazine, electronic materials available on electronic media
or in the internet, etc.
Columns 1-4 to be filled out by Institution/Company; Column 5 to be filled out by PO/Expert
Continue in additional sheet

Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:
 PO UTPRAS Focal Person Expert
Date: Date:

TESDA-OP-CO-01-F17

(Rev.No.00-03/08/17)

LIST OF PHYSICAL FACILITIES

(As listed in the respective TR)

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Facility Description Quantity Inspector’s Remarks

Building/ Class-5 m x 12 m, perma- 1
room nent structure (w/
Kithchen, Labora-
tory Area, peptalk/
Assessment Area
Dental/ Medical 2.5 m x 6 m, perma- 1
Office nent structure
Computer Room 7 m x 8 m, perma- 1
nent structure
Office Building 4mx8m 1

Note: Columns 1-3 to be filled out by Institution/Company; Column 4 to be filled out by PO/Expert
Continue in additional sheet

Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date:
 TESDA-OP-CO-01-F18
(Rev.No.00-03/08/17)

LIST OF OFF-CAMPUS PHYSICAL FACILITIES

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Facility Description Quantity Inspector’s Remarks

Dry Cleaning On MOA 1
Machine

Note: Columns 1-4 to be filled out by Institution/Company

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Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date:
 TESDA-OP-CO-01-F19
(Rev.No.00-03/08/17)

LIST OF OFFICIALS

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Submitted by: Contactby:

Attested Details
Name Position
JOANNE (Address)
PAULINE T. RUELA ContactDR.
No.RIZALINA
Email H.Address
ANGELES Nature of Educational
TVI/Company Representative TVI/Company Head Appointment Attainment
Rhodora Bus- Date:President Catubig N. Date: Designation BSCE
tamanteInspected by: Samar
Emerson H. School Catubig N. 09367837489 Rizalinaange- Designation BSBA – BSED
Angeles Principal/Guid-
PO UTPRAS Focal PersonSamar Expertles45@gmail.-
ance Counselor
Date: Date: com
Joanne School Registrar Catubig N. Designation BSComsci
Pauline T. Ru- Samar
ela
Beatriz T. Bu- School Librarian Catubig N. Part Time BS Librarian
lagnir Samar
Note: Columns 1-5 to be filled out by Institution
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TESDA-OP-CO-01-F20
(Rev.No.00-03/08/17)

LIST OF TRAINERS

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Name Position Nature of Educational No. of No. of Years of Trainer’s

Appointment Attainment Years of Industry Experience Qualification
 Teaching Relevant to the
Experience Qualification
(with Certificate of NTTC*
Validity
Employment), if Number
applicable
RECKY M. Trainer Part – time BSA 1614084
ACO 8120001
0

Note: For NTR Title of Trainers Training or other licenses/certificates

Columns 1-8 to be filled out by Institution/Company
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Submitted by: Attested by:
JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES
TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:
PO UTPRAS Focal Person Expert
Date: Date:
 TESDA-OP-CO-01-F21
(Rev.No.00-03/08/17)

LIST OF NON-TEACHING STAFF

Program: HOUSEKEEPING NCII

Name of Institution/Company: FAIR GEMS ACADEMY INC.

Experience
Nature of Educational
Name Position Related to
Appointment Attainment
Position
Eleodoro J. TESDA – Permanent BSAT 40 years
Angeles ATI Training
Specialist
Rizalina H. School Ad- Permanent BSEED/MAT 41 years
Angeles ministrator 15 FGA
School Ad-
ministrator
Emerson H. School Prin- Permanent BSBA 15 years
Angeles cipal/ 10 years
Guidance
Counselor
Joanne School Reg- Regular BSComsci/PTCP 3 years
Pauline T. Ru- istrar
ela
Thomas Rigor School Part Time BSN
M. Cabenian Nurse
Dr. Clarita R. School Den- Part Time DMD
Celajes tist

Note: Columns 1-5 to be filled out by Institution

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Submitted by: Attested by:

JOANNE PAULINE T. RUELA DR. RIZALINA H. ANGELES

TVI/Company Representative TVI/Company Head
Date: Date:
Inspected by:

PO UTPRAS Focal Person Expert

Date: Date: