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Chris / I.D No. UG016

Name of the Child Sex Age Date of Birth Out of School Orphan
Chris / I.D No. UG016 Female 11 YEARS 1 May, 2010 YES NO
Disabled Cronically ill Immunised HIV Status In HIV Care Has Birth reg. cert
NO NO YES NEGATIVE NO NO
BASELINE (ENROLMENT) AND MONITORING (FOLLOW-ON) CHILD VULNERABILITY STATUS
Time 0f Application
1      
Date of enrollment: 1 Sep, 2020
Name of Child: Chris / I.D No. UG016
Name of Care Giver: Emilie
Current Residence Kampala, Uganda
OVC ID Number: UG008
Sex of Child: Female
Sex of Care giver: Female
Parish: Namungoona
Date of birth: 1 May, 2010
Age of Caregiver: 42 years
HouseHold No: TOP/007/NAMUNGOONA
Vulnerability Type: DOUBLE ORPHAN
1.0 ECONOMIC STRENGTHENING
1.1 Child is an income earner (Indicate Yes/No) No      
1.2 Child has vocational /apprenticeship skills (indicate Yes/No/NA Skip if is enrolled in formal school or below 12 years) No      
1.3 Child who completed vocational/ apprenticeship training has startup kit (indicate Yes/No/NA Skip if child is enrolled in school or below 12 years) No      
2.1 How many meals does the child eat in a day? (tick appropriate option)    { C }
a. Three or more meals a day b. Two meals a day c. One meal a day d. Some days, child has no meal
2.2 Child is fed on a balanced diet regularly (indicate Yes/No and tick the appropriate option A to C and indicate score on appropriate column for time of application)     { NO }
Energy foods; potatoes, banana, oils, posho, millet, rice, maize, bread, cassava Body building foods; beans, meat, soya, peas, milk, eggs, chicken, fish Protective and regulative foods; tomatoes, oranges, pawpaw, mangoes, pineapples
Answers
a. Eats only one category b. Eats at least two categories c. Eats all categories/ breast feeding
3.0 HEALTH, WATER, SANITATION AND SHELTER
The following conditions apply to the child (indicate Yes/No/NA)
3.1 Does not sleep under insecticide treated (mosquito) bed net Yes      
3.2 Frequently sick with minimal access to health care Yes      
3.3 If child is chronically ill (HIV+), child has enrolled on ART (care and treatment) No      
3.4 Has not received required immunization for appropriate age (0-5 years only- check for immunization card) No      
4.0 EDUCATION
4.1 Child (5-17 years) is regularly attending school (tick appropriate option and indicate on appropriate column for time of application)
a. Never been to school b. Dropped out of school c. Child irregularly attends school d. Child regularly attends school
4.2 Child has needed scholastic materials (Yes/No/ skip if child is below schooling going age, dropped out of school /or never been to school) No      
4.3 Child is progressing well in school (Yes/No/NA. Skip if child is below schooling going age, dropped out of school /or never been to school) No      
5.0 PSYCHOSOCIAL SUPPORT AND BASIC CARE
5.1 Child has essential/basic requirements (Tick appropriate options)
a. Owns at least a pair of shoes b. Has at least 2 sets of clothing (Excluding school uniform) c. Has bedding (raised bed, mattress, blanket)
5.2 Within the last one month, child has often felt hopeless, sad, worried, stressed, withdrawn, depressed (Yes/No) No      
5.3 Child has at least one adult who provides consistent care, attention and support (Yes/No) Yes      
6.0 CHILD PROTECTION AND LEGAL SUPPORT
The following conditions apply to the child (indicate Yes/No)
6.1 Child physically abused within the last 3 months No      
6.2 Withheld a meal to punish within the last 3 months No      
6.3 Child separated from family (ran away, chased) No      
6.4 Child felt neglected within the last 3 months No      
6.5 Sexually abused, defiled, shown pornography, raped, forced sex within the last 12 months No      
6.6 Involved in child labour No