Memorandum Circular No: 13

Series of 2020

SUBJECT: 2020 Omnibus Guidelines on Domestic Adoption

I. Rationale

Adoption, in its context is a professional service to protect the child’s rights and welfare. It is a social
work intervention to ensure that family life can be restored to a child deprived of his/her biological
family.

The State through the Department of Social Welfare and Development is the competent authority to
implement the Adoption program. Related guidelines and policies are in place that ensures systematic
and effective implementation of child placement thru adoption. Amendments to existing guidelines
and policies is being done as necessary, in consultation with concerned agencies/offices, to address the
issues and gaps in the implementation of the program.

There had been several efforts initiated by the Department to review the adoption process towards
policy enhancement to fast track the placement of children legally available for adoption. This includes
the amendment of the current guidelines, Memorandum Circular No. 7, series of 2015 to address the
identified challenges in the implementation of adoption services.

Memorandum Circular No. 07, Series of 2015 or Amended Administrative Order No. 11, Series of 2009,
entitled Omnibus Guidelines on the Domestic Adoption Process was issued to provide guidance in
executing the amended policies and procedures in domestic adoption. One of the significant changes is
the return of the matching conference to the Field Office of the Department. However, the Guidelines
do not provide for the conduct of interregional matching for domestic adoption. The child is cleared
immediately for inter-country adoption (ICA) if not matched at the regional level, which denotes that
not all efforts are done to match the child to a Filipino couple. This is not compliant to the Subsidiarity
Principle of the Hague Convention of 1993.

Further, post-placement supervisory period prior to the issuance of Consent to Adoption by the
Department was not indicated, which is a key to prevention of adoption disruption, as it determines
the adjustment and emotional readiness of both adopter/s and adoptee in stabilizing their filial
relationship.

Citing the above rationale, MC 7, series of 2015 is hereby amended.

II. LEGAL BASIS

The State values the dignity of every person and guarantees respect for the individual rights including
that of children. Towards this end, it shall give highest priority and importance to the enactment of
measures that will ensure the rights and welfare of children for their full and healthy development and
well-being. (Article 2, Sec. 11, 1987 Philippine Constitution)

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 The State also recognizes the rights of children, as enshrined and guaranteed in the following
international instruments, national laws and regulations:

A. International Instruments

1. United Nations Convention on the Rights of the Child, adopted by the UN General Assembly on
November 20, 1989 and ratified by the Philippine Government on July 26, 199 ,which took effect on
September 2, 1990;
2. United Nations Declaration on Social and Legal Principles Relating to the Protection and Welfare of
Children with Special Reference to Foster Placement and Adoption nationally and internationally,
adopted by the UN General Assembly on December 3, 1986;
3. The Hague Convention on the Protection of Children and Cooperation in respect of Inter-Country
Adoption

B. National Policies

1. Republic Act No. 8552 or The Domestic Adoption Act of 1998 and its Implementing Rules and
Regulations;
2. Supreme Court En Banc Resolution on the Proposed Rule on Adoption (July 31, 2002);
3. Republic Act No. 9523 or “An Act Requiring the Certification of the DSWD to Declare a Child Legally
Available for Adoption”;
4. Republic Act No. 8043 or The Inter-Country Adoption of 1995 and its Implementing Rules and
Regulations;
5. Republic Act No. 10165 of 2012 or “An Act to Strengthen and Propagate Foster Care and to provide
funds therefore;
6. Republic Act No. 10364 or An act expanding Republic Act No. 9208 entitled “An act to institute
policies to eliminate trafficking in persons especially women and children”;
7. RA No. 7610 or “An act to providing for stronger deterrence and special protection against child
abuse, exploitation and discrimination, and for other purposes;
8. Presidential Decree No. 603 or “Child and Youth Welfare Code”.

C. Other Related Issuances

1. Department Administrative Order No. 18, series of 2005 entitled, “Turn-Around Period of Local and
Inter-Country Adoption”;
2. Department Administrative Order No. 1, series of 2010 entitled, “Amended Standards for
Community-based Services”;
3. Administrative Order No. 23, series of 2004, or the Guidelines on Post Adoption Services;
4. Administrative Order No. 12, series of 2011 entitled, Guidelines on the Issuance of DSWD
Certification Declaring a Child Legally Available for Adoption.

III. OBJECTIVES

General:

Ensure immediate permanent placement of a child who is legally available for adoption.

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 Specific:

1. Improve the quality of the management of cases of children and prospective adoptive parents.
2. Facilitate the exhaustion of local placement through matching of legally available children for
adoption to approved prospective adoptive parents.
3. Enhance the Department’s monitoring system and the placement of children nationwide.
4. Institutionalize the prescribed timeline for clearing children available for intercountry adoption.
5. Systematize the assessment and placement of children that are already in the care of unrelated
person/s prior to application for adoption.
6. Define the roles and functions of the child welfare specialist group to serve as matching committee.

IV. DEFINITION OF TERMS

1. Abandoned Child – refers to a child who has no proper parental care or guardianship, or whose
parent/s have deserted him/her for a period of at least three (3) continuous months, which
includes foundling (IRR of RA 8552).
2. Certificate of Consent to Adoption (CA) – refers to a document issued by the Department that gives
consent for the adoption of a child by his/her prospective adoptive parents. (See Annex E).
3. Certification Declaring a Child Legally Available for Adoption (CDCLAA) - refers to a document
signed by the DSWD Secretary or his/her duly authorized representative, administratively declaring
that the child is legally available for adoption, which is a pre-requisite to local and intercountry
adoption. (See Annex A)
4. Certificate of Matching (COM) - refers to written document issued by DSWD certifying that the
child/ren was/were matched to PAPs during the matching conference. (See Annex C).
5. Child – refers to a person below eighteen (18) years of age or over but unable to fully take care of
him/herself or protect him/herself from abuse, neglect, cruelty, exploitation or discrimination
because of physical or mental disability or condition.
6. Child Legally Available for Adoption– refers to a child in whose favor a certification was issued by
the Department that he/she is legally available for adoption after the fact of abandonment or
neglect has been proven through the submission of pertinent documents, or one who has
voluntarily committed by his/her parent/s or legal guardian.
7. Child Caring Agency (CCA) – refers to a duly licensed and accredited agency by the Department
that provides 24-hour residential care services for abandoned, orphaned, neglected or voluntarily
committed children (RA 8552).
8. Child-Placing Agency (CPA) – refers to a duly licensed and accredited agency by the Department to
provide comprehensive child welfare services including but not limited to, receiving applications for
adoption, evaluating the prospective adoptive parents, preparing the adoption home study (RA
8552).
9. Adoption Resource and Referral Division (ARRD) - refers to the office at Department’s Central
Office that is the over all in-charge of managing the adoption process including monitoring of cases
and provision of technical assistance to Adoption Resource and Referral Section (ARRS) and other
service providers on the adoption program. It shall be manned by adoption experts.
10. Adoption Resource and Referral Section (ARRS) – refers to a unit in the DSWD Field Office that is
in-charge or managing the adoption process and cases in the region. It shall be composed of

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 licensed social workers trained on adoption and shall develop and manage cases of prospective
adoptive parents.
11. Child Study Report (CSR) – refers to a written report on the assessment and findings by a social
worker as to the psychosocial, socio-cultural and economic condition, past and current functioning
and facts of abandonment, neglect of the child or termination of parental authority over the child.
The report shall also state the efforts of social worker in locating the child’s biological
parents/relatives and the interventions in the helping relationship and his/her recommendation/s
on the placement of the child and other intervention/services.
12. Court - refers to a family court, or in places where there are no family courts, any regional trial
court that hears and decide the petition for adoption of children.
13. Deed of Voluntary Commitment (DVC) – refers to the written and notarized instrument relinquishing
parental authority and committing the child to the care and custody of the Department executed by the
child’s biological parent/s or by the child’s legal guardian in their absence, mental incapacity or death, to
be signed in the presence of a licensed social worker of the Department, LGU or Child-Caring Agencies
after counseling and other services have been made available to encourage the child’s biological
parent/s to keep the child (IRR of RA 8552). (See Annex B)
14. Disruption of Pre-Adoptive Placement– occurs when adoption placement is not completed or
discontinued due to problems either or both on the part of the child and/or adoptive family.
During this time, the issued Pre-Adoption Placement Authority (PAPA) and Certificate of Consent to
Adoption (CA) may be suspended, cancelled or terminated by the Department based on the
thorough assessment, findings and recommendation of the handling social worker.
15. DSWD – refers to the Department of Social Welfare and Development.
16. Domestic/Local Adoption- refers to the socio-legal process of placing a Filipino child who is legally
free for adoption permanently to an eligible parent/s based on the requirements stipulated in RA
8552 or the Domestic Adoption Act of 1998 of the Philippines.
17. Field Office – refers to the Regional Office of the Department.
18. Final Post-Placement Supervision Report – refers to the final report of a social worker, indicating
that the post-placement supervisory period is satisfactory, thus recommending for the finalization
of the adoption.
19. Foundling – refers to a child whose facts of birth are unknown.
20. Home Study Report (HSR) - refers a to written report prepared by a social worker citing facts on the
situation and family background of prospective adoptive parents (PAPs) such as psychosocial, socio-
cultural and economic condition/s, cognitive, psychological, medical information. The report also
emphasizes the motivation and capacity of the PAPs to provide a home that meets the needs of the
child (IRR of RA 8552).
21. ICAB – refers to the Intercountry Adoption Board.
22. Independent Placement – an act when the biological parent/s make a direct placement of the child
either to a non-relative or a relative beyond the 4th degree of consanguinity or affinity with whom
they relinquish their child for adoption.
23. Intercountry Adoption - refers to the socio-legal process of adopting a Filipino child by a foreigner
or a Filipino citizen permanently residing abroad where the petition is filed, the supervised trial
custody is undertaken, and the decree of adoption is issued outside the Philippines (RA 8043).
24. Intercountry Adoption (ICA) Clearance – refers to written document issued by the Department
certifying that efforts for domestic adoption have been exhausted and therefore clearing or
endorsing the case of the of the child to Intercountry Adoption Board (ICAB) for intercountry

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 adoption placement in accordance with Section 7 and 11 of the Intercountry Adoption Law of 1995.
(See Annex H.1-H.2).
25. Involuntarily Committed Child – refers to a child whose parent/s, known or unknown, have been
permanently and judicially deprived of parental authority over him/her due to abandonment;
substantial, continuous or repeated neglect and/or abuse; or incompetence to discharge parental
responsibilities (RA 8552).
26. Managing Social Worker – A licensed social worker from government or non-government agency
that handles the case management of a child for adoption or of a prospective adoptive parent.
27. Matching – refers to the judicious selection of a family for a child based on the child’s needs and in
his/her best interest as well as the capability and commitment of the adoptive parents to provide
such needs and promote a mutually satisfying parent-child relationship (IRR of RA 8552).
28. National Child Welfare Specialist Group (NCWSG) – refers to the Matching Committee organized
by the DSWD-Central Office that carry out the interregional matching of child/ren not matched in
the regional level to prospective adoptive parent/s approved by the DSWD-Field Offices (IRR of RA
8552).
29. Neglected Child – refers to a child whose basic needs have been deliberately unattended to or
inadequately attended to, physically or emotionally, by his parents or guardian within a period of
three (3) consecutive months. Neglect may occur in two ways:
(a) There is physical neglect when the child is malnourished, ill-clad and without proper shelter. A
child is unattended when left by him/herself without proper provisions and/or without proper
supervision.
(b) There is emotional neglect when the child is maltreated, raped, seduced, exploited,
overworked, or made to work under conditions not conducive to good health; or is made to
beg in the streets or public places; or when children are in moral danger, or exposed to
gambling, prostitution and other vices.
30. Post-Placement Supervision Report – refers to a document prepared by a social worker after the
physical transfer of the child to the adoptive parents, where monthly home visits are conducted to
monitor the adjustment of both the child and PAPs.
31. Pre-Adoption Placement Authority (PAPA) - refers to a document issued by the Department
authorizing or confirming the placement of a child to his/her prospective adoptive parents. (See
Annex D)
32. Prospective Adoptive Parent/s (PAPs) – refers to a person/couple who have filed an application for
adoption or whose application for adoption has been approved (IRR of RA 8552).
33. Post-Adoption Services – refers to psycho-social and support services provided to the adoptee,
adoptive parents and birth parents by trained social workers of the Department, the social services
units of local government, family courts, accredited child-caring/placing agency and such other
individuals or entities involved in adoption as may be authorized by the Department, after the
issuance of the Decree of Adoption. This includes post-adoption counselling, establishment of
adoption support group, provision of intermediary services and Heritage Tour/Camp (IRR of RA
8552).
34. Regional Adoption Clearance - refers to written document issued by DSWD Field Office certifying
that the child/ren/PAPs was not matched during the regional matching conference and therefore
endorsing the case to the Central Office for interregional matching/issuance of intercountry
adoption clearance. (See Annex F.1-F.4).

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 35. Regional Child Welfare Specialist Group (RCWSG) – refers to the “matching” committee organized
by the DSWD Field Office that carry out the regional matching of children legally available for
adoption and approved prospective adoptive parents.
36. Regional Director - refers to the Head of the Field Office of DSWD.
37. Relative Adoption – refers to the adoption of a child by a relative within 4th degree of
consanguinity or affinity, on which petition for adoption is directly filed in Family Courts/Regional
Trial Courts.
38. Residential Care Facility (RCF) – refers to a government-owned facility, which provides 24-hour
residential group care to children on a temporary basis whose needs cannot at the time, be
adequately met by their biological parents and other alternative family care arrangements. It is an
approximation of family life to children under the guidance of staff especially trained for the
purpose.
39. Secretary – refers to the Secretary of the Department of Social Welfare and Development or
his/her duly authorized representative.
40. Post-Placement Supervision Period – refers to the period of adjustment within the first three
months after the placement of a child in the adoptive home whereby a social worker helps the
adoptive family and the child in the adjustment process to facilitate the legal union through
adoption.
41. Voluntarily Committed or Surrendered Child – refers to a child whose parent/s or legal guardian
knowingly and willingly relinquished parental authority to the DSWD or any duly accredited child-
placement or child-caring agency or facility. This refers to a child who has been surrendered in writing
by his/her parent/s or guardian through a notarized Deed of Voluntary Commitment (IRR of RA 8552).

V. GUIDING PRINCIPLES

 UN-CRC Article 3 (Best interests of the child): The best interests of children must be the primary concern
in making decisions that may affect them. All adults should do what is best for children. When adults
make decisions, they should think about how their decisions will affect children. This particularly applies
to budget, policy and law makers.
 UN-CRC Article 21 (Adoption): Children have the right to care and protection if they are adopted or in
foster care. The first concern must be what is best for them. The same rules should apply whether they
are adopted in the country where they were born, or if they are taken to live in another country.

VI. GENERAL POLICIES

1. The biological parent/s shall be safeguarded from hurried decisions by providing them thorough
counseling and other services, focusing on their strengths as parent/s with emphasis that poverty
should not be the sole reason for giving up their child for adoption.
2. Exhaust all efforts to prevent the child from unnecessary separation from his/her biological
parent(s).
3. Sibling children for adoption should not be separated from each other and should be adopted by
one family.
4. Any child placed to unrelated person/s should be reported immediately to the DSWD or nearest
Local Social Welfare Office for appropriate action. The managing social worker shall assess
whether the stay of the child with the current custodian/s is for his/her best interest. Qualified
custodian/s will be assisted towards legalizing the adoption.

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 5. Licensed foster parents may adopt the foster child/ren under their care under extreme condition or
with a strong justification for the child’s best interest, provided that they are qualified to adopt and
that the child they want to adopt is legally available for adoption and not yet matched with an
approved adoptive parent, either domestic or intercountry; provided also that the adoption shall
still be governed by RA 8552. Foster care should not be used as prelude or to pre-identify a child
for adoption.
6. Preparation of Child/Home Study Report should be based on the actual visit and interview of the
managing social worker to which he/she is accountable for such assessment.
7. The regional matching conference, which is at least twice a month shall be instituted at the
regional level by the DSWD Field Office. The interregional matching conference shall be conducted
at the Central Office at least once a month but not to exceed four (4) meetings a month.
8. Children with special needs such as, but not limited to: (a) with medical needs like cerebral palsy, heart
or kidney ailments, blindness, Attention-Deficit Hyperactivity Disorder (ADHD) or affected by Human
Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS); (b) Mentally challenged
and/or with mental/developmental delay/history; (c) With disabilities; (d) Born out of incestuous
relations/rape/victim of rape; (e) Sibling group; and (f) Older child beyond 3 years old and up shall be
immediately cleared for intercountry adoption, if not matched during the first presentation at the
regional and interregional matching level.
9. If there are no available approved adoptive applicants at the time of the scheduled matching, the case
of the child whose circumstances not covered by number 8 of this General Policy shall still be reviewed
by the R/NCWSG who will recommend whether or not Regional Adoption Clearance/Intercountry
Adoption Clearance shall be issued. However, children below three years old shall not be cleared
immediately for intercountry adoption under the principle of exhaustion of local adoptive families.
10. Religion or “religious affiliation” should not be a requirement for the selection/matching of a child
to an adoptive family except for cases of children 6 years old and above (UN-CRC Child 21: Child’s
Right to Participation).
11. Application to adopt another child is not allowed when previous placement of a child with the
adoptive parent has not yet been finalized.
12. The managing social worker can only consider the case closed once the Adoption Decree,
Certificate of Finality and Amended Birth Certificate are issued.
13. Post-Adoption and other Support Services, which shall include counseling, shall be made available
by the social workers of the Department, social services unit of the local government, child
placing/caring agencies to the adoptee, adopter and the biological parents.
14. A central depository of original documents and databank of children legally available for adoption
and placed-out for domestic adoption shall be maintained and updated by the Department’s
Central Office for record keeping, monitoring and other purposes. Each Field Office of the
Department is expected to maintain its own certified true copy of documents of the child and PAPs
for reference and legal purposes. All agencies concerned in the implementation of the domestic
adoption law shall maintain, preserve and protect the documentation of children for adoption and
adopted children.
15. A licensed social worker shall be designated to solely handle adoption and other alternative
parental care program on a full-time basis, both in the Field Office and in the Central Office.
16. A person of legal age could be adopted legally by his/her known parents, provided that he/she has
been consistently considered and treated by them as his/her/their own child since minority. A
petition for adoption shall be filed directly in court thru a legal counsel.

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 VII. IMPLEMENTING PROCEDURES

The following procedures shall be undertaken for the implementation of this guideline based on the
turn-around period of case management towards placement of the child to prospective adoptive
parents.

A. Child Case Management by DSWD Residential Care Facility/Child-Caring/Placing Agency and

Provincial/City/Municipal Social Welfare and Development Office (P/C/MSWDO)

Within the first 4 months upon receipt of the case of the child

1. Upon the receipt and acceptance of the case of the child for management, the managing social
worker shall gather all information and assess the case whether or not the child is for
permanent placement through adoption.

i. Conduct collateral interviews and validation and if it was assessed that the child has no
birth record, facilitate the child’s birth registration at the local civil registrar, covering
the locality where the child was found/born;

a. For cases of children with simulated birth record but not qualified to avail RA
11222, facilitate/assist in the filing of the cancellation of simulated birth record
of the child in the local court and register the child’s birth according to his/her
true identity.
b. For the case of a child with Foundling Certificate but has an existing birth
certificate, facilitate/assist in the filing of the cancellation of Foundling
Certificate of the child in the local court.
c. In case the child was born outside the city or municipality where he/she was
found, an Out-of-Town Reporting of Birth shall be facilitated by the managing
social worker to the nearby Civil Registrar, which will forward the Certificate of
Live Birth to the city or municipality where the child’s birth occurred for
registration.
d. In case the child was born outside the Philippines, the managing social worker
shall submit to the Department of Foreign Affairs (DFA) the child’s travel
documents to facilitate issuance of the child’s Report of Birth (ROB) from the
Philippine Embassy (PE)/Philippine Consulate General (PCG) in the country
where the child came from. The PE/PCG shall facilitate issuance of ROB and
transmits the same to the DFA once available. The DFA shall then forward the
ROB to the Philippine Statistics Authority (PSA) for issuance of said document
in Security Paper (SECPA). The managing social worker shall obtain the
authenticated copy of the child’s ROB from the PSA once available.

ii. If assessed not for adoption, provide appropriate assistance or intervention based on
the child’s needs, such as reunification to birth parents or relatives, or if found
necessary, removal of the child from the current custodian, among others;

iii. If for adoption, facilitate the submission of requirements for petition or application for
issuance of a Certification Declaring the Child Legally Available for Adoption (CDCLAA).

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 The case management shall be guided by the existing Guidelines on the Issuance of
DSWD Certification Declaring a Child Legally Available for Adoption.

Within 5th to 6th month

2. Within fifteen (15) working days from the receipt of CDCLAA, the managing social worker shall
submit to the DSWD Field Office, an updated (prepared not later than 3 months prior to
submission to Field Office) Child Study Report (CSR) with recommendation for permanent
placement of the child through adoption together with the following documents:

a. SECPA copy of Birth Certificate or Foundling Certificate;

b. Notarized Deed of Voluntary Commitment;
c. Written consent of the child if at least ten (10) years old, signed in the presence of the
social worker of the Department, LGU or child caring/placing agency as witness after
proper counseling as prescribed in Section III of the IRR of the Domestic Adoption Law;
d. Death Certificate of biological parents, as appropriate;
e. DSWD Certification declaring the child as legally available for adoption (CDCLAA);
f. Medical Certificate/Health Profile of the child;
g. Psychological evaluation, when appropriate;
h. Recent Picture of the child (taken at least within 3 months upon submission of dossier to
DSWD)

For cases needing registration of Foundling Certificate in the Local Civil Registrar, this shall be
facilitated within 30 days upon receipt of the DSWD CDCLAA (in consideration of the process
that must be completed by the agency issuing the Foundling Certificate) and thereafter, secure
a SECPA copy from the Philippine Statistics Authority.

The dossier for local matching shall be submitted to the Field Office within 30 working days
from the receipt of Foundling Certificate in Security Paper.

Two sets of these complete documents (1 set of original and 1 set of photocopies) of the child
shall be submitted to ARRS.

Any comment on the Case Study Report or required documents shall be communicated by the
Department to the concerned agency within three (3) days after the receipt of the dossier and
shall be complied within fifteen (15) days from receipt of the memorandum or letter from the
Department. In case the required documents will not be available within the prescribed period
of submission, a status report on the action taken by the agency shall be submitted to the
Department.

3. The social worker managing the case shall be invited officially to the local matching conference
through their agency. He/she shall attend and present the case he/she handles in the matching
conference. If the managing social worker would not be available to present the case, his/her
immediate supervisor or any representative who has the knowledge on the case/s shall be
authorized by the head of the Agency to present the case in the matching conference.

4. Once the matching of a child to the PAP is approved by the Department through a Certificate of
Matching, the managing social worker of the child and of the adoptive family shall prepare

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 them both emotionally and psychologically before the actual placement. The preparation for
the child’s placement shall be consistent with the child’s age, understanding and emotional
maturity. An older child shall be helped to understand why he/she is being placed, where
he/she will be going and what adoption means (refer to the Domestic Adoption Manual for the
step-by-step procedure on child’s pre-placement preparation).

5. A Pre-Adoptive Placement Authority (PAPA) shall be issued once the Department receives the
written acceptance letter of the PAP/s.

6. In case the Head of the residential care facility or of a social welfare and development
agency/CCA opposes or objects to the proposed placement of the child to the PAPs as
recommended by the matching committee, he/she shall submit to the Department a written
explanation for the opposition or objection within two (2) days after receipt of notice on the
result of matching conference. The Department and the R/NCWSG shall evaluate such
explanation and determine whether such is acceptable and shall communicate its decision to
the opposing party.

7. The physical transfer of the child shall take place within ten (10) days from the receipt of the
PAPA duly conformed by the PAPs. The schedule of the actual transfer of the child to the PAPs
shall be agreed upon by the concerned parties.

Before the actual schedule of transfer of the child to the PAPs, the managing social worker
should advise the PAPs to have at least two consecutive visits or 2 days stay in the residential
care facility/CCA with the child matched to them to establish familiarity, bonding and rapport.

Within 7th to 15th month

8. Upon placement of the child to the PAPs, the managing social worker of the PAPs shall conduct the
necessary monthly monitoring to assist the adoptive family and the child in their emotional
adjustment and readiness for the adoption. A documentation report on the post-placement
supervisory period shall be prepared by the managing social worker after every visit for submission
to the Department. After a thorough assessment of satisfactory adjustment where bonding and
rapport has taken place between the child and PAPs, a final supervisory report and
recommendation for issuance of a Certificate of Consent to Adoption (CA) shall be prepared by the
social worker for approval of the Department.

The managing social worker is responsible in monitoring the placement on a monthly basis. The
post-placement supervisory period may be shortened, lengthened or waived as the case may be
and a petition for adoption may be filed immediately as recommended by the managing social
worker.

9. Within 30 days upon receipt of the CA, the PAPs shall immediately cause the filing of the
Petition for Adoption in the court with jurisdiction of their residence with the assistance of the
PAPs’ social worker.

10. As so required by the court, the managing social worker of the PAPs shall attend to court
hearings and ensure the issuance of Adoption Decree and Certificate of Finality and the
subsequent filing of an Amended Birth Certificate, of which copy shall also be duly secured and
must be filed to complete the documents prior to closure of the case. Further, child’s

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 managing social worker shall ensure coordination with the PAPs’ managing social worker for a
copy of Adoption Decree, Certificate of Finality and Amended Birth Certificate to form part of
the child’s case folder for the closure of the case. Likewise, the Department shall be provided
with copies of said documents for case monitoring purposes.

Turn-Around Period of Case Management towards permanent placement of the child:

Below is the matrix showing the turn-around period of case management as far as the child is
concerned until he/she has been permanently placed with PAPs.
1st-4th month 5th-6th month 7th-15th month

•Preparation of documents and •Completion of requirements for •Monitoring of case from post-
submission of dossier to the local matching placement period of 3 months,
Department for CDCLAA •Presentation of the case to the issuance of Consent to Adoption
regional/interregional matching and until filing a petition for
issuance adoption in court to issuance of
conference
•Issuance of PAPA Adoption Decree and Finality with
Amended Birth Record
•Physical transfer of the child to the
PAPs •Closure of the case

B. Development and Management of Case of Adoptive Parents by ARRS of DSWD Field Office and Child-
Placing Agencies

The social worker of ARRS/CBSU-DSWD-Field Office or Child Placing Agency shall conduct the following:

Within the first two months upon receipt of the case of the PAPs

1. Convene/conduct pre-adoption seminar/forum for adoptive applicants and issue a Certificate

of Attendance to participants within the day. PAPs that are outside the jurisdiction of the FO
can attend the adoption forum. The social worker shall advise the participants that such
Certificate shall be attached to their application for adoption and Petition for adoption in court
later on.

2. Upon the receipt and acceptance of the case of the PAPs for management, managing social
worker shall gather information on the PAPs and assess their motivation to adopt (a) child/ren.

3. Facilitate the accomplishment of the application form (see Annex L) and advise the applicant to
submit the following requirements to the FO:

3.1 Birth Certificate of the prospective adoptive parent/s in security paper (SECPA) issued by
the Philippine Statistics Authority (PSA);

3.2 Marriage Certificate in SECPA form, if married or in case of termination of marriage,

Authenticated Divorce papers with copy of court decision and Certificate of Finality by their
Consulate if foreign applicant; Annulment Decree with Certificate of Finality, Declaration of
Nullity, or Legal Separation Documents for Filipino applicant;

3.3 Written Consent to the Adoption by the legitimate and adopted sons/daughters and
illegitimate sons/daughters if living with the applicant, who are at least 10 years old;

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 3.4 Physical and Medical Evaluation/Certification by a duly licensed physician. Certification
should: (a) indicate that the applicant has no medical condition that prevents him/her in
acting or assuming parental responsibilities; (b) taken at least six months from the time of
preparation of the Home Study Report;

3.5 Psychological Evaluation Report (when appropriate, as assessed by the social worker);

3.6. NBI or Police Clearance issued at least one year before the preparation of the Home Study
Report;

3.7. Latest Income Tax Return (ITR) or any other documents showing financial capability, e.g.
Certificate of Employment, Bank Certificate or Statement of Assets and Liabilities;

3.8. Three (3) letters of Character References (e.g. the local church/Minister, the employer and
a non-relative member of the immediate community who have known the applicant(s) for at
least 3 years);

3.9. 3x5 inch-sized photos of the applicants and his/her immediate family members, taken
within the last three (3) months from the date of submission of application; and

Other documents may be required by the R/NCWSG as deemed necessary based on their
assessment and recommendation (e.g., Affidavit of Temporary Custody, among others).

Additional Requirements for Foreign Nationals

3.10. Certification that the applicant(s) have legal capacity to adopt in his/her country and
that his/her country has a policy or is a signatory of an international agreement, which allows
a child adopted in the Philippines by its national to enter his/her country and permanently
reside therein as his/her legitimate child, which may be issued by his/her country’s diplomatic
or consular office or central authority on inter-country adoption or any government agency
that has jurisdiction over the child and family matters.

In the absence of any of the foregoing, the applicant may submit a Certification issued by the
Intercountry Adoption Board (ICAB), stating that the Philippines and the applicants’ country
have an existing agreement on inter-country adoption whereby a child who has been adopted
in the Philippines or has a pre-adoption placement approved by the Board is allowed to enter
and remain as permanent resident in the applicants’ country as his/her legitimate child.

For countries that have neither signed nor adhered to the 1993 Hague Convention on the
Protection of Children and Cooperation in Respect of Intercountry Adoption, the Department
may accept as an alternative based on its assessment, any document issued by the embassy
notifying the Department on the legal capacity to adopt of the PAPs in the Philippines and/or
the child’s possible entry to the PAPs’ country of origin.

3.11. Certificate of Residence in the Philippines issued by the Bureau of Immigration or

Department of Foreign Affairs, as appropriate.

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 3.12. Two (2) character references from non-relatives who knew the applicant(s) in the
country of which he/she is a citizen or was a resident prior to residing in the Philippines,
except for those who have resided in the Philippines for more than fifteen (15) years.

3.13. Police Clearance from all places of residence in the past years prior to residing in the
Philippines.

4. Conduct personal interview and counselling with the adoptive applicant/s’ family members and
significant others. Inform PAPs that their child preferences as to sex will be considered,
however, as to age of the child, only age bracket can be considered, (e.g., 0.6 months - 2 years
old, 2 and a half years old, more than 3 years old, among others) however, subject to
deliberation by the matching committee.

5. Prepare a Home Study Report based on all information gathered within a month from the date
of filing of application for adoption of the PAPs, along with complete set of requirements.

6. FOR INDEPENDENT PLACEMENT CASES:

Adoptive applicant that has not yet filed their petition in a family court shall be assessed by the
managing social worker in terms of PAPs’ and child’s eligibility for adoption. Their
circumstances shall also be assessed in terms of fulfilling the rights and needs of the child while
under their care. In case of unfavorable findings, the child shall be removed immediately from
the family. If favorable, the managing social worker shall assist the PAPs and manage the case
from presentation to local matching conference to finalization of the petition for adoption in
court.

For cases referred by the Family Court to DSWD either for issuance of CDCLAA and/or CA,
conduct an assessment of the case and recommend for the issuance or non-issuance of the
said document/s.

A certified true copy of the documents submitted by the PAPs to the court may be accepted by
the ARRS on cases when the petition has been filed in court prior to the Department’s
engagement.

Within 3rd to 4th month

7. Submit two (2) sets of complete documents (1 set of original and 1 set of photocopies) of the
PAPs to the ARRS for review for matching conference.

Any comment on the Case Study Report or required documents shall be communicated by the
Department to the concerned social worker through the agency within three (3) days after the
receipt of the dossier. The same shall be complied by the case manager within fifteen (15) days
from receipt of the memorandum or letter from the Department. In case the required
documents will not be available within the prescribed period of submission, a status report on
the action taken by the case manager shall be submitted to the Department.

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 8. The managing social worker shall attend and present the case in the matching conference. If
he/she would not be available to present the case, the immediate supervisor or any
representative who has the knowledge on the case/s shall be authorized by the Head of Agency
to present the case in the matching conference.

9. Inform the PAPs on the result of the matching, a day after the matching conference. For
regular adoption cases, advise the PAPs to prepare an Acceptance Letter if they accepted the
child matched to them. The social worker shall endorse the Acceptance Letter of the PAPs to
ARRS as basis for issuance of PAPA. The PAPA shall be issued by the Field Office Director or
his/her authorized representative within two (2) days from the receipt of the acceptance letter
from the PAPs.

In case the PAPs decline the proposed placement of the child, require the PAPs to submit to the
Department a written explanation citing the reason/s for non-acceptance within two (2) days
after receipt of notice on the result of matching. The reason/s of the PAPs will be evaluated by
the Department and shall communicate its decision to the PAP/s through the Field Office.

Prospective adoptive parent/s (PAPs) or any party who choose not to accept the child/ren
matched to them for a valid reason will still be considered. For any party who have refused
twice, their presentation will be indefinitely put on hold pending reassessment of their case.

10. Secretariat to coordinate with the PAPs and the managing social worker of the child on the
schedule of child’s entrustment to the PAPs once the matching of a child to the PAP is
approved by the Department through a Certificate of Matching and issuance of PAPA. The
physical transfer of the child from the DSWD residential facilities/CCAs/CPAs shall take place
within ten (10) working days upon receipt of the approved PAPA.

Within 5th to 15th month

11. Same procedure on page 10, nos. 8-10 shall apply.

12. File a manifestation in court, in case of disruption of the child’s adoption placement or in case
of unsatisfactory findings of the DSWD/CPA social worker and recommend appropriate action
for the best interest and welfare of the child.

Turn-Around Period of Case Management towards completion of the adoption of PAPs:

Below is the matrix showing the turn-around period of case management as far as the PAPs are
concerned until the adoption process is completed.

1st-2nd month 3rd-4th month 5th-15th month

•Conduct of assessment, homevisit/s •Presentation of the case to •3 months post-placement
and preparation of Home Study supervisory period
Report along with other required
the regional/interregional
•Issuance of Consent
documents for adoption matching conference • Monitoring of case from filing a
•Submission of dossier to the •Issuance of PAPA petition for adoption in court to
Department for the local issuance of Adoption Decree and
•Physical transfer of the child Finality
matching conference to the PAPs • Closure of the case

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 C. Procedure for Matching and Issuance of Intercountry Adoption Clearance

1. Regional Matching

Upon receipt of the child and PAPs’ dossiers by the Field Office, the ARRS social workers who
act as Secretariat to the matching conference shall conduct the following:

1.1. Review case/home study reports and other documentary requirements and make
assessment and recommendation on the case within two (2) days upon receipt of the
child and PAPs dossier.

Inform the concerned residential care facility/CCA/CPA on the comments through an

official letter or memorandum within three (3) days from the receipt of the dossier, in
case of discrepancies/inconsistencies of information in the Child/Home Study Report or
any of the requirements. Submission of the requested/required documents by the social
worker shall be within fifteen (15) days from receipt of the memorandum or letter from
the Department. In case the required documents will not be available within the
prescribed period of submission, a status report on the action taken shall be submitted
by the agency/facility to the Regional Director.

Dossier of child/ren and PAPs received by the FO beyond 7 working days prior to the
scheduled matching conference shall be tabled in the next scheduled matching.

1.2 Recommend the presentation of a child/ren to the matching committee to exhaust

regional placement.

1.2.a. Dossiers of children and PAPs not matched at the regional level after second
presentation shall be endorsed to the Central Office within three (3) days from the date
of the matching conference for review and as recommended for interregional matching.

1.2.b. Children below three years old may be presented more than twice in the regional
matching to exhaust local placement.

1.2.c. Endorse immediately the dossiers of children, cited in this guideline under General
Policy No. 8, to the Central Office if not matched during the first presentation.

1.3 Prepare roster of children and PAPs available for regional matching conference, if the
Child/Home Study Report and documentary requirements are sufficient in form and in
substance five (5) days before the matching conference.

1.4 Inform and invite the managing social worker through an official letter or memorandum
to the Head of Agency/Office at least three (3) days prior to the schedule of the
matching conference for her/his presence and for the presentation of the case/s in the
matching conference.

1.5 Inform/invite the members of RCWSG to the matching conference at least three (3) days
before the matching conference. If the principal RCWSG member would not be
available, identify an alternate member to avoid delay or postponement of the matching
conference. Ensure a quorum of the RCWSG members (three members out of five),

15 | P a g e
 together with an ARRS staff as the secretariat, to proceed with the matching
conference.

1.6 Provide the RCWSG members advance copies of dossiers of children/PAPs for their
review at least five (5) working days before the matching schedule.

1.7 Conduct the regional matching conference at least twice a month, but not exceeding
four times a month.

1.8 The FO shall provide the Central Office through electronic mail the result of the regional
matching conference two (2) days after the said regional conference, including the
names of the children and PAPs that were matched for monitoring purposes.

1.9 Facilitate the signing of Certificate of Matching for children matched by the RCSWG
members immediately after the matching conference and endorse the same to the
Regional Director or his/her duly authorized representative for his/her approval.

The result of the matching shall only be final upon approval of the Regional Director.

For cases of children not matched, a Regional Clearance for interregional matching
together with the child’s dossier shall be transmitted to the Central Office immediately
upon approval of the Regional Clearance by the Regional Director.

1.10 All relative intercountry adoption cases shall not be presented in the regional
matching conference and shall be issued with Regional Clearance based on a
favorable assessment and recommendation by the social worker managing the case.

1.11 Facilitate the approval of the PAPA by the Regional Director or his/her duly authorized
representative within the day from the receipt of the Acceptance Letter from the PAPs
and endorse to DSWD residential facilities/CCA/CPAs concerned.

If any party declines/opposes the proposed placement of the child to the PAPs as
recommended by the RCWSG, the secretariat shall inform the managing social worker of
the PAPs to submit a written explanation within two (2) days after receipt of notice on
the result of matching from the managing social worker. Acceptability on the reason/s
of any party shall be based on the evaluation of the Regional Director or his/her duly
authorized representative.

1.12 Facilitate the issuance of Certificate of Consent to Adoption approved/signed by the FO

Regional Director. The Final Post-Placement Supervisory Report shall be attached to the
said document, which will be submitted to the court for the finalization of the adoption.

1.13 There are cases filed in court where the Judge ordered the PAPs to present the original
copies of adoption documents they submitted to the Department. To preserve the
original documents submitted to the Department, free from any suspicion of alteration
or destruction that may occur at the time of possession of the PAPs, a Certificate of
Authenticity of documents shall be issued by the Department to the PAPs, to certify that
the original documents were indeed submitted and are in the possession of the
Department.

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 1.14 Coordinate closely with the PAP/s social worker who monitors the movement of the case
until such time that the Adoption Decree and Certificate of Finality are issued from the
court. Once the Adoption Decree, Certificate of Finality and new Birth Certificate of the
child are secured, the Central Office and the child’s social worker shall be furnished a
copy of the said documents to consider the case closed.

2. Interregional Matching

Upon receipt of the child and PAPs’ dossiers, the PMB-ARRD matching secretariat shall conduct
the following:

2.1. Review the Child Study Report and other documentary requirements and prepare the
roster/profile of child/ren for matching within the day.

Review the Home Study Report and other documentary requirements of

recommended PAPs and conduct prioritization for the National Child Welfare Specialist
Group’s (NCWSG) consideration and assessment.

Inform the concerned FO, copy furnished the concerned agency, on the comments
through an official letter or memorandum within three (3) days from the receipt of the
dossier, in case of discrepancies/inconsistencies of information in the Child/Home
Study Report or any clarification/s on the requirements. Submission of the
requested/required documents by the social worker shall be within fifteen (15) days
from receipt of the memorandum or letter from the Department. In case the required
documents will not be available within the prescribed period of submission, a status
report on the action taken shall be submitted by the FO to PMB.

The secretariat shall inform the managing social worker thru the fastest means of
communication (either thru text or e-mail) if there are minor concerns/comments on
the case for presentation, for immediate compliance. However, non-compliance of
which, within 3 days from the notice, an official memo to FO shall be sent by the
secretariat and the case will be considered for the next matching schedule.

On the other hand, dossier of child/ren and PAPs received by the Secretariat beyond 7
working days prior to the scheduled matching conference shall be tabled in the next
scheduled matching.

2.2 Endorse immediately the dossiers of children, cited in this guideline under General
Policy No. 8, to ICAB if not matched during the first presentation.

2.3 Inform and invite the managing social worker through an official letter or
memorandum to the Head of Agency/Office, a day after the child/PAPs’ dossier was
reviewed by the matching secretariat or at least five (5) working days prior to the
schedule of the matching conference for her/his presence and for the presentation of
the case/s in the matching conference.

2.4 Inform/invite the members of NCWSG to the matching conference at least five (5) days
before the matching conference. If the principal NCWSG member would not be

17 | P a g e
 available, identify an alternate member to avoid delay or postponement of the
matching conference. Ensure a quorum of the NCWSG members (three members out
of five), together with a CPD staff as the secretariat, to proceed with the matching
conference.

2.5 Provide the NCWSG members advance copies of dossiers of children/PAPs for their
review at least five (5) working days before the matching schedule.

2.6 Conduct interregional matching conference at least once a month but no to exceed
four (4) meetings a month, whenever the documents of child and PAPs are available.

2.7 Facilitate the signing of Certificate of Matching for children matched by the NCWSG
members right after the matching conference and endorse to the Bureau Director of
PMB or his/her duly authorized representative for his/her approval. The result of the
matching shall only be final upon approval of the Bureau Director or his/her authorized
representative.

Children not matched during first presentation for interregional matching shall
immediately be issued with ICA Clearance except for children below three years old.

2.8 Facilitate the approval of the PAPA by the PMB Bureau Director or his/her duly
authorized representative within the day from the receipt of Acceptance Letter from
the PAPs and endorse to DSWD residential facilities/CCAs/CPAs concerned.

If any party declines/opposes the proposed placement of the child to the PAPs as
recommended by the NCWSG, the secretariat shall inform the managing social worker
of the PAPs to submit a written explanation within two (2) days after receipt of notice
on the result of matching from the managing social worker. Acceptability on the
reason/s of any party shall be based on the evaluation of the PMB Bureau Director or
his/her duly authorized representative.

2.9 Facilitate the issuance of written Certificate of Consent to Adoption approved by the
Undersecretary for Protective Operations and Programs. The Final Post-Placement
Supervisory Report shall be attached to the said document, which will be submitted to
the court for the finalization of the adoption.

2.10 Coordinate closely with the FO on the movement of the case until such time that the
Adoption Decree, Certificate of Finality and Amended Birth Certificate are issued.

3. Issuance of Intercountry Adoption Clearance

The ARRD social worker shall conduct the following:

3.1 Facilitate the issuance of Intercountry Adoption Clearance within two (2) days for cases
of children that are not matched in the interregional matching conference.

3.2 All relative intercountry adoption cases shall not be presented in the interregional
matching conference and shall be issued with Intercountry Adoption Clearance by the
Department’s Central Office based on a favorable eligibility assessment and

18 | P a g e
 recommendation by the Field Office that the child intercountry adoption would redound
to his/her best interest.

3.3 Endorse immediately to ICAB, the original copy of the child’s dossier, along with the
original copy of the Intercountry Adoption Clearance, as signed/approved by the Bureau
Director of PMB or his/her authorized representative.

3.4 Coordinate with ICAB on the status of cases endorsed/cleared for intercountry adoption
on a quarterly basis.

D. Procedure for Disrupted Pre-Adoptive Placement

Disruption occurs when adoption placement is not completed or discontinued due to problems either
or both on the part of the child and/or adoptive family. No termination of placement shall be made
unless it is shown that the managing social worker has exhausted all efforts to remove the cause of the
unsatisfactory relationship/placement within a reasonable period. Hence, the following procedures
shall be undertaken:

1. If during one of the monitoring visit/s, the removal of the child is initially assessed by the managing
social worker of the PAP/s, conduct frequent visits to the home to arrive at a decision as soon as
possible. Conduct a case conference together with the immediate Supervisor to resolve the issues
identified.
2. Hold a case conference, as necessary, wherein participation of each family member is maximized
given the following objectives: to explore feelings related to the disruption; to assess the child’s
situation and to plan for the future.
3. On the other hand, if found that the continuation of the placement is to the detriment of the child,
the child shall be immediately removed from the home and arrange for the child’s temporary care
while considering another possible placement.
4. The managing social worker shall prepare and submit to the Department within 3 working days an
assessment report, indicating thorough assessment, findings and recommendation to suspend,
cancel or terminate the issued PAPA and CA.
5. The Department shall act on the case and recommend immediate action, in close coordination with
the matching committee and concerned offices/agencies. The PAPA and CA shall be suspended,
cancelled or revoked by the approving authority. Assessment with strong justification and
recommendation from the managing social worker shall be endorsed to the Department’s
Central/Field Office for the suspension, cancellation or revocation of the PAPA and CA.

VIII. Institutional Arrangements

A. DSWD Central Office

The DSWD Central Office through the PMB-ARRD shall provide guidance and technical assistance to
the DSWD-Field Offices.

1. Composition:

 Headed by a Division Chief

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  At least 2 SWO IV to manage the adoption and foster programs
 At least five Social Welfare Officer III that reviews the dossier of children for Certification
declaring the child legally available for adoption (CDCLAA);
 At least four Social Welfare Officer III that reviews the dossier for interregional matching/
issuance of clearance for intercountry adoption and acts as secretariat in the interregional
matching conferences;
 At least five Social Welfare Officer III in charge for the policy and program development,
monitoring and provision of technical assistance to FO counterpart;
 One Statistician on adoption program that manage the national data of children and PAP;
 One Administrative Officer IV who will act as budget officer of the Division;
 At least two administrative assistants in charge of printing of CDCLAA, ICA Clearance, in-
coming, out-going of communication and records management.

2. Functions:

1. Monitor the existence, number and status of children legally available for adoption and
prospective adopter/s, so as to facilitate their matching;
2. Conduct and maintain nationwide information and advocacy campaigns on domestic
adoption, in coordination with the Social Marketing Service of the Department;
3. Keep adoption files and maintain profiling and database of children and prospective
adoptive parents;
4. Conduct program implementation review on adoption to monitor and evaluate the flow of
the domestic adoption process;
5. Review the child/ren and family/ies’ child/home study reports and other documentary
requirements endorsed by the ARRS for issuance of CDCLAA, interregional matching and
clearance for intercountry adoption;
6. Provide technical assistance to ARRS in DSWD Field Offices and other partner agencies on
the implementation of the domestic adoption program;
7. Recommend policy enhancement/formulation on the improvement of implementation of
alternative family care program; and
8. Act as the Secretariat to the NCWSG during interregional matching conferences.

B. DSWD Field Office

The DSWD Field Office shall operate and manage its Adoption Resource and Referral Section
(ARRS).

1. Composition:
 Headed by a Social Welfare Officer III who will act as focal for monitoring/provision of
technical assistance to CCAs/CPAs/LGUs on case management of children for alternative
family care, lead in the conduct of advocacies, trainings, capability-buildings and
orientations/adoption fora related to alternative family care program.
 At least one Social Welfare Officer II per province or city that will be assigned in the
development of prospective adoptive families and in the review of dossiers of children for
issuance of Certification declaring a child legally available for adoption, for adoption, ICAB
and Court referrals, among others.

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  At least two Social Welfare Officer II as secretariat to the regional matching conference;
 One Statistician that will be assigned in data management and reportings;
 One Administrative Assistant.

2. Functions:

 Monitor the existence, number and status of children legally available for adoption and
prospective adopter/s in the region, to facilitate their matching;
 Conduct, disseminate and maintain region wide information and advocacy campaigns on
domestic adoption;
 Organize and assist support groups for adoptive parents, biological parents and adoptees,
provide parent and family life education sessions and referrals for specialized services,
among others (Section 6, IRR of RA 8552);
 Provide counseling services, as necessary, to parents surrendering their children;
 Recruit/develop and maintain a pool of PAPs, including Muslim parents for possible
placement of Muslim children available for adoption;
 Attend and present the case being handled in the matching conferences
 Conduct Adoption Forum and orientations on adoption-related laws, policies and issuances
 Maintain profiling and database of children available for adoption and prospective adoptive
parents;
 Keep adoption files of child and PAPs;
 Review the child/ren and family/ies’ child/home study report and other documentary
requirements endorsed by the DSWD/NGO residential care facilities and LGUs for issuance
of CDCLAA and regional matching within the prescribed turn-around time for case
management;
 Follow-up submission of documents with noted discrepancies from DSWD residential care
facilities and CCAs/CPAs and LGUs within the prescribed timeline;
 Act as Secretariat to the RCWSG in the regional matching process;
 Endorse to CO within 30 days the dossier of children and PAP/s that are not matched at the
regional level;
 Prepare/submit monthly regional matching reports every 5th day of the month and other
reports as instructed by the Central Office in relation to adoption program.
 Report cases of disrupted pre-placement to the Central Office for monitoring purposes.
 Conduct quarterly meetings, dialogues together with child caring and child placing
agencies, Family Courts, and, Local Government Units, hospitals and other concerned
agencies on the implementation of domestic adoption process;
 Conduct annual regional program implementation review on alternative family care;
 Respond to the referrals of other offices or agencies, such as conduct of eligibility
assessment/case conferences, among others;
 Network with the Association of Child-Caring Agencies of the Philippines (ACCAP) and other
groups or communities on matters related to domestic adoption particularly on advocacy
and resource development and generation;
 Coordinate with the Standards Unit and harmonize the schedule of providing technical
assistance and conduct of monitoring to DSWD residential care facilities and NGO child-
caring/placing agencies, including LGUs to ensure fast movement of cases of children for
adoption;

21 | P a g e
  Facilitate capability-building activities to enhance the social workers’ knowledge, attitude
and skills (KAS) on adoption and foster care;
 Monitor and ensure compliance of PAPs to file the petition for adoption in court not later
than 30 days from the date of receipt of the Department’s certificate of consent to
adoption;
 If the case is already filed in court, the managing social worker of ARRS to monitor and
coordinate regularly on a monthly basis with the court social worker on the progress of the
case until the Adoption Decree, Finality and amended Birth Certificate are issued. A status
report shall be submitted to PMB;
 Provide post-adoption services to the child and adoptive families after the issuance of the
decree of adoption, as necessary.

C. DSWD Centers/Residential Care Facilities, Child-Caring Agencies and LGU Facilities

 Ensure proper case management in accordance with the standard turn-around time.
 Ensure that the documentary requirements of children for issuance of CDCLAA and child for
local matching are complied with. In the absence of essential requirements, such as the
birth/foundling certificate, among others, the concerned social worker must undertake
necessary actions to ensure that the lacking documents will be complied.
 Accomplish and submit all pertinent documentary requirements within the prescribed timeline.
 Attend and present the case being handled in the matching conferences.
 Provide psychosocial services to the child prior to the placement with PAPs.
 Participate in the capability building of social workers and other recognized training
institutions.
 Submit a case load inventory of children for adoption every quarter to the Regional
Director of DSWD-FO.
 Establish a system for and facilitate detecting, reporting and providing appropriate
intervention on children that are directly entrusted to family.

D. Child-Placing Agencies (CPAs)

 Recruit/develop and maintain a pool of PAPs

 Conduct Adoption Forum and orientations on adoption-related laws, policies and issuances
 Ensure proper case management, accomplish and submit all pertinent documentary
requirements in accordance to the prescribed timeline
 Ensure that the documentary requirements of developed PAPs for local matching are
complied with. In the absence of essential requirements, the managing social worker must
undertake necessary actions to ensure that the lacking documents will be complied within
the standard turn-around time
 Attend and present the case being handled in the matching conferences
 Provide psychosocial services to the PAPs prior to the child’s placement with them
 Participate in the capability building of social workers and other recognized training
institutions.
 Refer to the FO cases of prospective adoptive parents under independent placement for
assessment and appropriate intervention.
 Ensure compliance of PAPs to file the petition for adoption in court not later than 30 days
from the date of receipt of the Department’s certificate of consent to adoption.

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  If the case is already filed in court, the managing social worker of the CPA to monitor this
case continuously and coordinate regularly on a monthly basis with the court social worker
on the progress of the case until the Adoption Decree, Finality and amended Birth
Certificate are issued. A status report on this shall be submitted to the Department.
 Maintain profiling and database of prospective adoptive parents
 Keep adoption files
 Coordinate with the concerned DSWD-Field Office to provide post-adoption services to the
child and adoptive families after the issuance of the decree of adoption, as necessary

E. Child Welfare Specialist Group (CWSG) for Regional and Interregional Matching

Membership to the Regional CWSG shall be approved by the Regional Director through a Regional
Special Order. On the other hand, membership to the National CWSG shall be approved by the
Secretary or his/her authorized representative through a Special Order/Authority. The National and
Regional CWSG shall compose the following members:

 One (1) registered social worker of the Department with at least a Social Welfare Officer (SWO)
III position whose expertise is on child welfare cases;
 A lawyer specializing on child and youth welfare cases;
 A pediatrician or a physician specialized on children;
 A psychologist/psychometrician/psychiatrist; and
 A representative of a non-government organization

The alternate members of the N/RCWSG shall be identified by DSWD, both in the Field Office and in the
Central Office, to ensure a continuous conduct of the matching conference and to avoid delay or
postponement of such. The DSWD Social Worker representative shall serve as Chair of the committee.
However, presiding officer for the matching conference could be on rotation basis, as determined and
agreed by the R/NCSWG.

The R/NCWSG shall perform the following functions:

 Match children for domestic adoption.

 Recommend the matching of children to available local adoptive family/ies to the Regional
Director for regional matching, or to the Bureau Director for interregional matching.
 Recommend for possible intercountry placement.
 Implement an integrated system and network of selection and matching of children and local
PAPs.
 Formulate internal rules and policies in relation to the matching of children and families.
 Initiate, review and recommend changes on policies concerning permanent placement of
children through adoption.
 Perform other functions as may be defined by the Department thru PMB or FO-ARRS.

The Department shall issue a Special Order/Authority to the R/NCWSG members who shall serve for a
term of two (2) years, which may be renewed for another term based on the recommendation of the
Department. Only the R/NCWSG members who are not employees or officials of the Department shall
be entitled to an honorarium to be determined and approved by the Secretary. Funds for the matching

23 | P a g e
 conferences shall be included in the Work and Financial Plan of the Central Office and Field Offices.
The functions of the R/NCWSG shall commence upon effectivity of this Memorandum Circular.

IX. Effectivity

This Memorandum Circular shall take effect immediately. All previous issuances inconsistent with this circular
are hereby repealed/revoked accordingly.

Issued in Quezon City this 7th day of May, 2020.

(originally signed)
ROLANDO JOSELITO D. BAUTISTA
DSWD Secretary

24 | P a g e
 ANNEXES
Templates Page
A Certification Declaring A Child Legally Available for Adoption 26

B Deed of Voluntary Commitment (DVC) in English format 27

C Certificate of Matching (COM) 30

D Pre-Adoptive Placement Authority (PAPA) 31

E Certificate of Consent to Adoption (CA) 32

F.1 Regional Adoption Clearance for Children (for cases presented in the 33
matching conference)
F.2 Regional Adoption Clearance for Children (for cases not presented in the 34
matching conference)
F.3 Regional Adoption Clearance for Relative Intercountry Adoption 35

F.4 Regional Adoption Clearance for PAPs 36

G Affidavit of Temporary Custody 37

H.1 Intercountry Adoption Clearance 38

H.2 Intercountry Adoption Clearance (for Relative) 39

I Child Study Report for Adoption 40

J Home Study Report for Adoption 45

K Parenting Capability Assessment Report (PCAR) 48

L Application Form for PAPs 53

M Certificate of Attendance to Adoption Fora/um 56

N Child Profile 57

O Adoptive Family Profile 58

P Roster of Children and Family for Local Matching 59

Q Certificate of Authenticity of Documents 60

R Template for Post-Placement Supervisory Report 61

S Flowchart on the Domestic Adoption Process 63

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 ANNEX A

Control Number: ____________

This is to certify that

________________________________________________________________________,
(Name of Child)

born on __________________, with ______________________________ is legally

(Date) (Petition/Application Control No.)

available for adoption, pursuant to the provisions of Republic Act 9523.

Issued on _____________, at Quezon City, Metro Manila, Philippines.

______________________
Secretary

This certificate is not valid without the official seal.

26 | P a g e
 ANNEX B
DEED OF VOLUNTARY COMMITMENT
(KASULATAN NG BOLUNTARYONG PAGKAKALOOB)

KNOW ALL MEN BY THESE PRESENTS:

(IPINAPABATID SA LAHAT:)

I/We, ___________________________________ Filipino, _______ years old and

Ako/Kami, Pilipino, taong gulang at

___________________________________, Filipino, _____ years old with residence postal

Pilipino, taong gulang at nakatira sa
address at ____________________________________________________.

After having been duly sworn to in accordance with law, hereby depose and say:
Ay sumusumpa ng naaayon sa batas at nagsasabi na:

That I am/We are the parents/grandparents/sibling/legal guardian of the child/ren/grand

Ako/Kami ang magulang/lolo/lola/kapatid/legal na tagapag-alaga ni/ ng mga bata na sina

children____________________________, ______(male/female) born on

Lalaki/Babae na ipinanganak noong
_______________________ at ________________________________________________.
sa

That I am/We are not capable to raise, care and perform parental obligations for my/our
Na ako/kami ay walang kakayahan na palakihin, mag-alaga at gampanan ang aming tungkulin

child/dren/grand children and believe that his/her/their welfare and best interest will be protected
sa aming anak/apo at naniniwala na magkakaroon sya ng magandang kinabukasan at maaalagaan

and promoted by giving and surrendering him/her/them to the custody of the government;
ng maayos kung ibibigay namin ang karapatan ng pangangalaga sa pamahalaan.

That I/We have received counseling services regarding my/our decision. Support
Na ako/kami ay sumailalim sa masusing pagpapayo hinggil sa aming desisyon. May tulong

services were provided to help us keep my/our child/ren;

at ibat- ibang serbisyo na ibinigay/inialok upang manatili ang mga bata sa akin/amin;

Several options were explored like kinship care, foster care and residential care;
Tinalakay ang mga pagpipilian tulad ng pagpapa- alaga sa kamag-anak, foster at institusyon;

That I/We have voluntarily and unconditionally give and commit my/our child/ren/grand
Na ako/kami ay boluntaryo na isinusuko ang pangangalaga ng aking/aming anak/apo

children to the care and custody of the Department of Social Welfare and Development
sa Kagawaran ng Kagalingang Panlipunan at Pagpapaunlad

pursuant to PD 603 & RA 8552;

alinsunod sa PD 603 at RA 8552;

That this voluntary and unconditional commitment of my/our child/dren/grand children to

Na ang kusa at walang pasubali na pagkakaloob ng aking/aming anak/apo

the Department of Social Welfare and Development shall become final three (3) months after
sa Kagawaran ay magkakaroon ng bisa tatlong buwan matapos

27 | P a g e
the execution of this document resulting in the termination of my/our parental rights over my/our
ang paggawa ng dokumentong ito na nagbunga ng pagkaputol ng akin/aming karapatan sa

child/dren/grand children;
akin/aming anak/apo;

That placing my/our child in an adoptive home at the earliest possible time is for his/her
Na ang agarang pagpapaampon sa akin/aming anak/apo ay para sa kanyang

best interest;
kabutihan at interes;

That the content of this document was read and explained to me/us in a language/dialect
Na ang nilalaman ng dokumentong ito ay binasa at ipinaliwanang sa akin/amin sa wika/salita

known to me/us and consequently made this informed decision fully aware of the consequences
na aking/aming alam at naunawaan at ginawa ang pasyang ito na batid ng lubos ang mga
kahihinatnan

and legal implications of the same;

at legal na implikasyon kaugnay nito;

That I/We have not been forced, coerced, intimidated, or unduly influenced by anyone to
Na ako/kami ay hindi pinilit, ginamitan ng dahas, tinakot o inimpluwensyahan ng sinuman
upang

execute and sign this document;

gawin at lagdaan ang dokumentong ito;

That I/We have not received any payment, compensation or any consideration,
Na ako/kami ay hindi tumanggap ng bayad o anumang kapalit

monetary or in kind, or any offer thereof for the purpose and in exchange of this document;
na salapi, bagay o dili kaya ay alok na may kaakibat na layunin bilang kapalit ng dokumentong ito;

I/We declare that I/we fully understood the above statements.

Ako/Kami ay malayang nagsasabi na lubos ko/naming naunawaan ang mga nabanggit na
pahayag.

IN WITNESS WHEREOF, I/We have hereunto set my/our signature/s this___ day
Sa harap ng mga saksi, Ako/Kami ay lumalagda ngayong ika____ araw

of_________ year_____ at _________________.

ng taon sa

_____________________________________ ____________________________________
Signature of Mother/Grandparent/Sibling/Legal Guardian Signature of Father/Grandparent/Sibling/Legal Guardian
Lagda ng Nanay/Lolo/Lola/Kapatid/Legal na Nag-aalaga Lagda ng Tatay/Lolo/Lola/Kapatid/Legal na Nag-aalaga

Left Thumb -Thumbmark- Right Thumb Left Thumb -Thumbmark- Right Thumb

Signed in the Presence of:

Nilagdaan sa harap nina:

____________________________________ ____________________________________
Signature over Printed Name/Designation Signature over Printed Name/Designation

28 | P a g e
 Attestation:
Patotoo:

I hereby attest that I have explained thoroughly and clearly to the child's
Pinapatotohanan ko na ipinaliwanag ko ng maigi at malinaw sa

parent/s/grandparent/s/sibling/legal guardian the content of this document using the language

Magulang/Lolo/Lola/Kapatid/Legal na Nag-aalaga ang nilalaman ng dokumentong ito gamit ang wika

or dialect they understood and that the latter was/were provided with intensive counseling prior
o salita na kanyang nauunawaan at nagkaroon ng masusing pagpapayo bago

to execution of this document.

ang paggawa ng dokumentong ito.

_______________________________________
Signature over printed name of the Social Worker

ACKNOWLEDGEMENT
Republic of the Philippines )
City/Municipality of ___________) S.S

BEFORE ME, NOTARY PUBLIC in the City/Municipality of ________________________ this

_____ day of ________________ 20___ personally appeared, _______________________with
(Mother/Grandparent/Sibling/Legal Guardian)
________________ No.______ issued on _______________ issued at _____________,
(Valid ID)
and ______________________ with ________________ No.______ issued on ____________
(Father/Grandparent/Sibling/Legal Guardian) (Valid ID)
issued at _____________; All known to me by virtue of the photograph and signature appearing
on the foregoing complete evidence of identity, and to me known to be the same person/s who
executed the foregoing Deed of Voluntary Commitment and the same is his/her/their own free,
voluntary act and deed.

This instrument consists of three (3) pages including this page where the notarial seal is affixed.

WITNESS WITH MY HAND AND SEAL on the date above written.

______________________
Notary Public
Doc. No.
Page No.
Book No.
Series of

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 ANNEX C

CERTIFICATE OF MATCHING

This is to certify that the child, _________________________, (age), (date of birth) was
matched to Prospective Adoptive Parents (PAPs) M/M (name of prospective adoptive parents)
of (address of the PAPs) during the local matching conference held on (date of the matching
conference) at (office address)

Anent to this, the (National) Child Welfare Specialist Group (N/CWSG) recommends the
placement of (name of the child) to (name of PAPs) and issuance of Pre-Adoption Placement
Authority (PAPA) and Certificate of Consent to Adoption (CA) as a pre-requisite of filing the
petition for adoption in court.

Issued on ____________________ in _____________________________, Philippines.

_______________________________
Presiding Officer
Child Welfare Specialist

The undersigned concurred/approved the result of the matching of (name of child) to (name of
PAPs) on (date of matching)

Signed on ___ day of __________________in ____________________, Philippines

______________________________

Director/Head

(Name of Office)

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 ANNEX D
PRE-ADOPTION PLACEMENT AUTHORITY

The Department of Social Welfare and Development, which is the welfare arm of the Philippine
Government hereby authorizes the placement of (name of child), (sex), born on (date of birth) with
(name of prospective adoptive parents), residing at (address of PAPs) effective (date of child’s placement
to PAPs) preparatory to adoption.

This placement is in accordance with Republic Act 8552 and the Adoption policy of the Department of
Social Welfare and Development, subject to the following conditions:

(a) The family shall be responsible for the care, safety, and welfare of the child and shall report to the
social worker handling the case, periodically and anytime, problem arises relative to placement of
the child.
(b) The managing social worker shall visit the family at least once a month for a purpose of determining
the adjustment of the child to the family and extending social services and guidance in the care of
said child by the adoptive family.
(c) Said child could be removed from the family when the placement no longer meets his/her best
interest and welfare, i.e. if the placement of the child is a failure, subject to the proper management
of the case with emphasis on the separation of the child from the prospective adoptive parents.
(d) The final proceedings for adoption shall take place in the court which has jurisdiction over the
residence of the adoptive parents.

Supervision of the placement, which shall be observed for a period of _____ months, will be the
responsibility of ______________________, Social Worker of ________________________ to ensure
the adjustment of the child with his/her new found home and emotional readiness of both child and
adoptive family for the legal union. Monthly Post-Placement Supervisory Report shall be submitted to
the Department. In case the extension of period of supervision is necessary, a corresponding report
justifying this need should be prepared by the social worker and approved by the Director.

__________________________
Director/ Head
(Name of Office)
Date Issued: _________
PAPA No. _________

CONFORME
We acknowledge the responsibility and conditions stipulated:

__________________/_________________ ______________________________
Name and Signature of Adopting Parent/s Managing Social Worker

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 ANNEX E

CERTIFICATE OF CONSENT TO ADOPTION

This is to certify that I, _(name of the DSWD Official)_, Filipino, of legal age and the
(Position/Designation)of Department of Social Welfare and Development of the Republic of the Philippines, with
office address at__( office address_)_, after having been duly sworn to in accordance with the law sayeth;

That child, ___________________was born on __________________ at __________________;

That herein child was declared legally available for adoption by virtue of the Certification
Declaring a Child Legally Available for Adoption with control number ___________ issued on
_________________ by the DSWD Secretary per Republic Act No. 9523;

That the placement of child, ____________________with Mr./Mrs. ___________________ of

(home address of the PAPs), was approved by the Department of Social Welfare and Development,
located at __________________________________________________________ through the issuance
of Pre-Adoption Placement Authority (PAPA) on ___________________;

That based on the report submitted by _______________________, (Brief description of minor’s

adjustment with the adoptive family).

That in the view of the foregoing facts, I, as (position/designation) of the Department of Social
Welfare and Development in accordance with Section 26 of the IRR of RA 8552, do voluntarily consent
to the adoption of herein child, _____________by Mr./Mrs.__________________________________;

That the prospective adoptive parent shall initiate judicial proceeding by filing the petition to
adopt not later than 30 days from date of issuance of the Department’s certificate of consent to
adoption.

In witness whereof, I have hereunto set my hand on this ______day of _______________.

_____________________________________
Name and Signature of Head of Office
DSWD-____________

32 | P a g e
 ANNEX F.1

REGIONAL CLEARANCE FOR INTERREGIONAL MATCHING

(For Children)

This is to certify that the child, ______________, (sex), born on ____ at _____ and whose present address
is ________________________, ___________ Philippines, was not matched during the Regional
Matching Conference due to the following reasons:
1. _________________________________________
2. _________________________________________

The above mentioned child is therefore cleared and endorsed for interregional matching in accordance
with Section 20 of the Implementing Rules and Regulations (IRR) of the Republic Act 8552. Enclosed are
the following documents of the child:

 Child Study Report

 Birth/Foundling Certificate
 Death Certificate of Parent/s (if applicable)
 Deed of Voluntary Commitment
 Certification Declaring a Child Legally Available for Adoption
 Health and Medical Profile
 Photos
 Others (e.g. psychological evaluation report, etc)

Recommending Approval: (by RCWSG members)

1. _________________________ ______________________
(Social Worker representative) (Signature)
2. ________________________ ______________________
(Lawyer) (Signature)
3. ________________________ ______________________
(Pediatrician) (Signature)
4. ________________________ ______________________
(Psychologist) (Signature)
5. ________________________ ______________________
(NGO representative) (Signature)

__________________________

Regional Director

Field Office ______

Date Issued :______________________

Ref. No. :______________________

33 | P a g e
 ANNEX F.2

REGIONAL CLEARANCE FOR INTERREGIONAL MATCHING

(For Children not presented in the regional matching)

This is to certify that the child, _____________________, _ (sex)_, born on ________, at

_______________and whose present address is ____________________________________,
Philippines, was assessed and recommended by DSWD-Field Office _________ to be eligible for
intercountry adoption, due to the following reason/s:

1. _____________________________________________
2. _____________________________________________
3. _____________________________________________

The above named child is therefore cleared in the regional level and endorsed to the DSWD-Central
Office for issuance of Intercountry Adoption Clearance, in accordance with the General Policy of the
amended DSWD Memorandum Circular No. 7, series of 2017.

 Child Study Report

 Birth/Foundling Certificate
 Death Certificate of Parent/s (if applicable)
 Deed of Voluntary Commitment
 Certification Declaring a Child Legally Available for Adoption
 Health and Medical Profile
 Photos
 Consent to Adoption (for 10 years old and above)
 Others (e.g. psychological evaluation report, etc)

_______________________
Regional Director
DSWD Field Office ______

Date Issued :______________________

Ref. No. :______________________

34 | P a g e
 ANNEX F.3

REGIONAL CLEARANCE FOR INTERCOUNTRY ADOPTION

(for Relative Intercountry Adoption)

This is to certify that the child, _____________________, _ (sex)__, born on ________, at

_______________and whose present address is __________________________ _______, Philippines,
was assessed and recommended by DSWD Field Office _________to be eligible for intercountry
adoption.

The above named child is therefore cleared and endorsed to the DSWD-Central Office for
issuance of Intercountry Adoption Clearance in accordance with Section 7 and 11 of the Intercountry
Adoption Law (RA 8043) for the consideration of the Intercountry Adoption Board.

Enclosed are the following documents of the child/ren:

 Child Study Report

 Certificate of Live Birth
 Deed of Voluntary Commitment
 Marriage Certificate of the Parents (or Certificate of No Marriage of the birth parents)
 Health and Medical Profile of the child
 Recent Photo
 Birth Certificates of the pertinent individuals in the genogram
 Notarized Oath and Undertaking by the guardian/relatives
 Psychological evaluation (when appropriate, for child/ren age 5 years and above)
 Death Certificate/s of birth parent/s (if applicable)
 Consent to Adoption of child (for 10 years old and above)

________________________________
Regional Director
DSWD Field office ________

Date Issued : ___________________

Ref. No. : ___________________

35 | P a g e
 ANNEX F.4
REGIONAL CLEARANCE FOR INTERREGIONAL MATCHING
(For Prospective Adoptive Parents)

This is to certify that spouses, __________________________________, (age), with present address at

________________________ Philippines, was not matched during the Regional Matching Conference
due to the following reasons:

1. _________________________________________
2. _________________________________________

The above named prospective adoptive parent/s is/are therefore cleared and endorsed for interregional
matching in accordance with Section 20 of the Implementing Rules and Regulations (IRR) of the Republic
Act 8552. Enclosed are the following documents of the prospective adoptive parents:

 Home Study Report

 Birth Certificate/s
 Marriage Contract
 Authenticated Divorce papers/Annulment Decree, Declaration of Nullity or Legal
Separation Documents (if applicable)
 Written Consent to the Adoption (if applicable)
 Physical and Medical Evaluation/Certification
 Psychological Evaluation Report (as necessary)
 NBI or Police Clearance
 Latest Income Tax Return/Proof of Income
 Three letters of Character References from non-relatives
 Photos
 Affidavit of Temporary Custody

Recommending Approval: (by RCWSG members)

1. _______________________________________________
(Social Worker representative) (Signature)
2. ________________________ ______________________
(Lawyer) (Signature)
3. ________________________ ______________________
(Pediatrician) (Signature)
4. ________________________ ______________________
(Psychologist) (Signature)
5. ________________________ ______________________
(NGO representative) (Signature)

Regional Director
Field Office ______
Date Issued :______________________
Ref. No. :_____________________

36 | P a g e
 ANNEX G

REPUBLIC OF THE PHILIPPINES

CITY OF ________ ) S.S.

AFFIDAVIT OF TEMPORARY CUSTODY

I/We ________________________(married to) ________________________, (a) Filipino citizen/s and

of legal age, with postal address at__________________________, after having been duly sworn in
accordance with law, hereby depose and state that:

1. That, I am/ we are the___________________ of Mr/& Mrs./Ms_______________________.

(relationship to the PAPs) (name of PAP/s)

2. That, in the event of incapacity on their part to continue taking care of the child to be
adopted, I am/we, (together with our child/ren) are willing to be the temporary custodian of
the child to be adopted.

3. That, I am/we are morally sound and financially capable to act as temporary custodian/s of
the child to be adopted in the event of the untimely death or incapacity of Mr. &/Mrs./Ms.
________________________during the pendency of adoption.
(name of PAP/s)

4. That, I/ we executed this affidavit to attest to the truth and veracity of the foregoing, and
for all intents and purposes this may serve.

IN WITNESS Whereof, I/we have hereunto affixed my/our signature on this _____ day of ________ 20__
at ___________________________, Philippines.

___________________________________ ____________________________________
Name and Signature of Male Temporary Custodian Name and Signature of Female Temporary Custodian

SUBSCRIBE AND SWORN to before me this _____ day of __________, 20___ affiant exhibited before me
their respective proof of Identification stated above.

Doc. No.__________
Page No. _________
Book No. _________
Series of 20_______

37 | P a g e
 ANNEX H.1

CLEARANCE FOR INTER-COUNTRY ADOPTION

This is to certify that efforts for domestic adoption have been exhausted for the
child__________________, _(sex)__, born on ________________, at _______________and whose
present address is __________________________ _______, Philippines.

The above minor is therefore cleared and endorsed for Inter-country Adoption in accordance with
Section 7 and 11 of the Inter-country Adoption Law of 1995 (RA 8043) for the consideration of the Inter-
country Adoption Board.

Enclosed are the following documents of the child:

 Child Study Report

 Birth/Foundling Certificate
 Death Certificate of Parent/s (if applicable)
 Deed of Voluntary Commitment
 Certificate of Authority for a Notarial Act
 Certification Declaring a Child Legally Available for Adoption
 Health and Medical Profile
 Photos
 Consent to Adoption (for 10 years old and above)
 Others (e.g. psychological evaluation report, etc)

____________________________
Director
Name of Office

Date Issued : ___________________

Ref. No. : ___________________

38 | P a g e
 ANNEX H.2

CLEARANCE FOR INTERCOUNTRY ADOPTION

(Relative Adoption)

This is to certify that the case of the child ____________________, (sex), born on _________ at
______________________ and whose present address is at ________________________ was reviewed
and assessed by the DSWD to be eligible for intercountry adoption.

The above child is therefore cleared and endorsed for Intercountry Adoption in accordance with Section
7 and 11 of the Intercountry Adoption Law (RA 8043) for the consideration of the Intercountry Adoption
Board.

Enclosed are the following documents of the child:

 Child Study Report

 Certificate of Live Birth
 Deed of Voluntary Commitment
 Certificate of Authority for a Notarial Act
 Marriage Certificate of the Parent (or Certificate of No Marriage of the birth parents)
 Health and Medical Profile of the child
 Recent Photo
 Birth Certificates of the pertinent individuals in the genogram
 Notarized Oath and Undertaking by the guardian/relatives
 Psychological Evaluation Report(for child/ren age 5 years and above)
 Death Certificate/s of birth parent/s (if applicable)
 Consent to Adoption of child (for 10 years old and above)

______________________________
Director
Name of Office

Date Issued : ___________________

Ref. No. : ___________________

39 | P a g e
 ANNEX I
CHILD STUDY REPORT for LOCAL/INTERCOUNTRY ADOPTION

I. IDENTIFYING INFORMATION

Name- Please indicate not only the child’s first and last name but also the middle name if he/she has
one as stated in the Birth Certificate. For cases of foundling, please indicate the alias or a.k.a. or given
first and last name of the child.
Sex/Age
Date of Birth
Place of Birth

For Foundling:
Given Date of Birth
Date and Age when Found
Place when Found

Date of Admission to Agency

Date of Placement to Custodian (for FA/IP)
Birth Status (Legitimate/ Non-marital Child)
Category (Surrendered/Abandoned/Foundling)
Date Surrendered/Declared Abandoned in Court
Present Whereabouts (Name of Custodian/Agency and Address)

II. SOURCES OF INFORMATION and CIRCUMSTANCES OF THE REFERRAL –Indicate what are the
circumstances surrounding the referral or admission of the child to the Child Caring Agency (e.g.
reason for referral; where the child was referred; who was responsible for referral; when was
the referral made and when was the child finally admitted)

III. BACKGROUND INFORMATION

1. THE CHILD

Description of the child and date upon admission.

This should cover the following in specific, accurate and actual method:

 Age, personality, habits and other significant observations about the child upon admission.
 Data on anthropometric measurements of the child.
 Description of the child’s overall appearance to indicate whether the child was properly cared
for;
 Type of clothing and hygiene (i.e., clean or unkempt). (Graphic details should not be included,
especially if it is negative.)
 If the child is a Foundling, the child’s condition/ physical appearance (without including graphic
details) and behavior when found.
 Information on who named the child and the significance of the name.

40 | P a g e
  Basic information about the finder (i.e., age, occupation, civil status) and rule out if he/ she is
related to the child.

Developmental History of the Child.

This should include the following:

1. Salient information on the child’s development history prior to admission to the Child Caring
Agency (i.e., circumstances of child birth that is type of delivery, place of birth, birth weight/
length, head and chest circumference, result of newborn screening, immunizations received,
etc).

Age of gestation in weeks must be on record if the child was born in the hospital, including
Ballard, APGAR score.

If child was with the birth mother or stayed with relatives or institutions for some period prior to
the admission, information from the concerned party should be included. Did the birth mother
breastfeed the child?

2. Medical History – previous illness and treatment/medication given to the child

3. For a child ages 5 years old and above, include the highlights of the psychological evaluation
(i.e., result of the psychological evaluation and the interventions required). Child’s progress as a
result of carrying out the recommendations of the psychologist should be discussed in this
section.

4. The developmental milestones, which the child achieved (i.e., when did the child started to hold
his head up, roll over, crawl, stand, walk, etc.) since his/her admission to the center. Information
on the child’s developmental achievement is important, as this will help determine if the child’s
development is within normal limits. There should be a baseline assessment of what the child
could already do at the time of admission so that the prospective adoptive parents would know
how the child has developed.

5. Information whether the child has begun toilet training must be included. If the child is being
toilet trained, information about the progress must be specified (e.g., child can tell if he/she is
wet; can sit on the potty; can indicate if he/she needs to go to the comfort room).

6. Activities of the child (e.g. in home, school, center or foster home)

Current Functioning of the Child – This should cover how the child is in terms of his development
physically, mentally, emotionally, socially at the time the Child Study Report was prepared.

1. The social worker should include how does the child relate to other children, caregivers,
strangers, or whether or not the child has developed emotional attachment to a specific person
in the child caring agency. For older children, please include how they are being prepared for
adoption and his/her attitude towards it.
2. Grade/ year level; academic functioning (Strongest and weakest subject); perspective of
authority must be discussed in this section.

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 3. Socio-Emotional Aspect – How is the child’s socio-emotional development? How does he/she
interact with children and adults? What makes him sad? How is he/she pacified? What kind of
discipline works well for him/her? Does he/she have any behavioral concerns that the parents
have to know?
4. For children who are attending to play, occupational or speech therapy, information must be
included as to the progress of the child after he/she has attended such intervention/s.

Description of the Child’s Present Environment. This includes the present environment of the child.
Description of foster family/center personnel/PAPs (for IP cases) from the time of admission/placement
with the family (for IP cases) to child’s discharge for placement.

The date when the child was placed/transferred to the present custodian/child caring agency is vital to
determine how long have been the child under the care and custody of the PAPs/ child caring agency.

2. THE FAMILY –This tackles the composition and pertinent background information on biological
family such as:

 Physical description of the family, such as physical appearance of birthmother/father, body built, height,
complexion, hair, eyes, nose and disability/deformity.
 Health history (physical and mental such as heredity non-heredity illness/es, medication given and pre-
natal history)
 Education/occupation/income and earnings
 Personality, Psychological and emotional make-up of the birth parent such as:

1. Character/trait/how is he/she as a person

2. Hobbies, interest, talents
3. Quality of intra-familiar relationship, family dynamic (nature of marital relationship of birth parents,
birthparents relationship with their children and siblings relationship)
4. Information on the birthparents, such as number of their siblings and their relationship with each
other; how the parents met, and if they were married or not, etc. If they have medical illnesses,
medication that they took and if such illnesses hinders/affects their parental capability should be
specified in the report. If a parent is detained in jail, the status of the case filed should be stated.
5. Childhood experiences of birthparents (positive/negative that may have an impact on quality of
parenting assessment of mental ability level of intelligence/personality)
6. Negative history of substance/alcohol abuse, sexual abuse, domestic violence, imprisoned
parents/criminal record. If the birth mother has history of substance abuse while pregnant, indicate the
frequency, duration, and amount of substance consumption.
7. Birth parent’s attitude towards the child during the time that he was still in her care.
8. Feelings/reactions of the birth parent/s in giving up the child for adoption. His/ her feeling about
being separated from his/ her child must be solicited.

 Circumstances leading to the child’s being given up for placement. (Please refrain from making
judgments such as birth parent is unstable, incapacitated, etc.)

1. Incapacity of parent/s to perform parental duties and obligations due to death, poor health
condition or mental and psychological incapacity among others, that may render the family,
particularly the parents to be incapacitated to care for, support or protect the child;

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 2. Child was born out of non-marital relationship, incestuous rape or sexual abuse where child
could be stigmatized or further abused if he/she would remain in the custody of the
parents/family and protection of the child is not guaranteed
3. Imprisoned birthparent
4. Rejection by birth family
5. Birthparents were minors when child was born
6. Physical disability/illness of the child warranting further interventions
7. Serious life threatening illness
8. The birth family has dysfunctional relationship that may be caused by marital problem
9. Children who are physically and/or mentally abused, neglected or trafficked by their own
biological family

IV. TERMINATION OF PARENTAL RIGHTS/FACTS OF ABANDONMENT-

This section should indicate the following:

(TERMINATION OF PARENTAL RIGHTS)

1. Assistance rendered to the birth parents-Poverty cannot be accepted as a sole reason for
surrendering the child for adoption. Therefore, case management requires that in response to
circumstances influencing the decision of the parents to relinquish their parental authority, an
appropriate service/s should be provided. The reasons for the failure of these services from assisting
the parents to achieve this goal should be clearly stated in the report.
2. For victims of rape, counseling services must include goals to help the birth mother in overcoming
trauma brought by sexual abuse and regaining of security and worth. Please specify what has been
the intervention to help the birth mother recover from the sexual abuse. Where is the birth mother
now?
3. Efforts exerted by the social worker to place the child with his relatives should be carefully
considered.
4. Date when the birth parent/s signed the Deed of Voluntary Commitment and the date it was
notarized. (A valid ID of the parent/s should be presented before the notary public)
5. Counseling conducted by the social worker before, during & after the signing of the DVC. Include
the dates and goals of the counseling. It should not be merely focused on orientation on the
meaning of the DVC. The birth parent should be helped in processing loss, grief, and trauma
associated with relinquishing the child for adoption.
6. Social worker’s effort exerted to prevent the child to be given up for adoption.
7. The following information must also appear under this section: (1) That the birth parent is aware
that the Deed of Voluntary Commitment shall become irrevocable three months after he/she signed
the same, thus, he/she has time to reconsider her decision; (2) That the content of the DVC was
explained to the birth parent in the vernacular that he/she understands.

(FACTS OF ABANDONMENT)

Cite the circumstances of abandonment, such as WHO found the child, WHERE he/she was found,
WHEN he/she was found, how old was the child when found, WHAT was the condition of the child when
found, HOW the finder facilitated placing the child to an institution/agency.
2. Efforts exerted by the social worker to locate the whereabouts of the birth parent(s)/family (indicate
the date of media certification, newspaper publication, blotter reports, registered mail, etc.).

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AO 12, series of 2011 requires home visit to the birth mother (or family member’s) last known address,
if possible aside from sending a registered mail, as part of the exhaustion of efforts in locating the child’s
birth family.

V. Assessment – Summary statement on why the child’s needs adoption. Facts stated here should not
be discriminatory and judgmental.

 Evaluate the overall accomplishments of the child and indicate it here. No need to summarize
events leading to adoption.
 Include what has the child become as a result of intervention of the child caring agency? (if
applicable)
 What are the areas that the prospective parents have to follow up once they assume custody
over the child?

VI. Recommendation – Summary statement to indicate the type of family that would be suitable given
the parenting needs of the child.

The assessment should provide an overview of the child’s strength and weaknesses that the prospective
adoptive parents should know as their guide in relating to the child and providing the child’s needs once
they assume the child’s custody.

Prepared By: Date Prepared:_____________

(Signature)
(Name of Social Worker)
(License Number and Validity Date)

Noted By:

(Immediate Supervisor)

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 ANNEX J

HOME STUDY REPORT

I. Identifying Information
• Name
• Age
• Date of Birth
• Place of Birth
• Civil Status
• Date of Marriage/ No. of Years Married
• Citizenship
• Religion
• Educational Attainment
• Occupation/ Position
• Annual Income
• Employer
• Home Address/ Municipal/City/Provincial
• Email Address
• Contact number/s

II. Family Composition

Name Age Relationship Educational Occupation/ Disability/sickness,

to the Attainment Income if any (specify)
applicant

III. Applicant’s Background Information

• Childhood experiences of the couple
• How they were reared by their family and the significant others in their lives
• Discipline pattern of the family including such sensitive areas as history of child abuse,
alcohol and substance abuse, obsessive gambling and their corresponding sanctioning
penalties and coping mechanisms in handling stress/ crises and conflicts
• Applicant’s physical description and personal traits
• Information about their parents and siblings and nature of relationships (past and
present)
• Attitude towards adoption

IV. Motivation and Child Preference

• Reason(s) for wanting to adopt
• Who wants to adopt?
• When did they decide to adopt?
• How decision was arrived at?
• Attitude and resolution of feelings towards infertility, if applicable.

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 • Child preference should be in terms of:
– Age
– Sex
– characteristics and the extent of physical, medical and mental capacity of
the child acceptable to the couple
– Reason(s) for such preference

V. Child Care Plan

• Plans of the couple for the child upon placement
• Identifying persons to act as designated guardian of the child in case of the untimely
death or accidents which will temporarily or permanently hamper their parenting
responsibility over the child and how adoption will be discussed with child, etc.

VI. Marital and Family Relationship/ Functioning

• The couple should be legally married for a minimum of three (3) years
• Provide description on:
– nature and extent of marital relationship
– patterns of resolving conflict,
– annulment history/ discussion of circumstances and relationship
– children from previous marriage/s with whom they are currently living
– current family relationships particularly husband/wife, parent/child, sibling
and their extended families.
• Description of the children, their significant traits and characteristics, their role in the
home and their preparation for the coming of another child, their feelings and attitudes
towards adoption
• Previous history of adoption disruption if any
• Descriptive paragraph of every person living in the home should also be included, adult
family members should be asked the same questions re: substance abuse, sexual or child
abuse and their responses discussed.

VII. Parenting Experiences with Children

• The couple’s experience in taking care of a child/ren either on a temporary or prolonged
basis should be indicated.
• Past experience in parenting and/or knowledge of child caring as well as their expressed
disposition, philosophy and attitude towards discipline patterns that have influenced their
beliefs/behavior, ability to provide nurturing care and supervision in an atmosphere of
affection and moral and material security should be indicated.

VIII. Employment History/ Financial Resources

• Present source of income, sufficient enough to meet the requirements of the family’s
lifestyle.
• Reasons why they moved or changed work
• Summarized value of assets and liabilities and statement on whether the child can be
beneficiary of each plan are to be given

IX. Description of Home/ Community

• Describe the family’s home, child’s accommodation, membership and participation in
community organizations, community organizations, community projects and activities.

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 • Community resources and facilities should be included
• Indicators should be given on the degree of racial tolerance and how this may affect the
adjustment of the child in the community.
• Discussion of extended family and community acceptance of adoption.

X. Social, Ethno-cultural, Linguistic and Religious Identity

• spiritual/philosophical/ moral beliefs
• affiliations
• attitudes and practices
• value system and principles

XI. Health History (Physical and Psychological)

• Indicate any serious illness, physical disabilities or history of mental illness.
• A medical report on the family’s health status and health history
• Psychological information includes:
– Description of the spouses mental ability/ intelligence,
– Personality
– Character/ trait
– Criminal record,
– Any negative history of substance/alcohol/sexual abuse, family dynamics and
relationship.

XII. Character References

• Source of information are from three (3) persons who are not related to the PAPs who
have known the applicant(s) for at least three (3) years
1. Local Church/Minister
2. The employer
3. A non-relative member of the immediate community
• Impressions on the adoptive family’s relationship and family life
• Strengths and weaknesses as adopting parents
• Foreign nationals shall submit a certification that the applicant(s) have legal capacity to
adopt in his/her country and that his/her country has a policy or is a signatory of
international agreement which allows a child adopted in the Philippines by its national to
enter his/her country.

XIII. Evaluation/ Assessment

• Strengths and weaknesses of the family
• Details of the child preference (age, sex, number of child/ren, acceptance of siblings
{number, gender}, special needs child)
• Reasons/justification for endorsement of the approval of the PAPs

XIV. Recommendation
Summary statement why the applicants are recommended for adoptive placement of a specific
type of child.

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 ANNEX K
PARENTING CAPABILITY ASSESSMENT REPORT
(For: Name of Child)

Date of Report: ____________

I. IDENTIFYING INFORMATION

: (father) (mother) (grandparent/custodian)

(to be filled-up in case parents are
Name of Biological Parent/s deceased or nowhere to be found)
(indicate n/a in this column if
single/separated/widowed)
Address :
Age :
Religion
Date of Birth :
Place of Birth :
Marital Status :
Date of Marriage (if :
applicable)
Place of Marriage (if :
applicable)
Educational Attainment :
Occupation/Company (if :
applicable) and Monthly
Income

Immediate Family Member/s:

Name Relationship Age Sex Educational Occupation/Mo. Disability/sickness, Whereabouts

Attainment Income if any(specify)

Other Household Members: (list all individuals living in the same house where the child resides or resided)

Name Relationship Age Educational Occupation/Mo. Income

Attainment

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 II. CIRCUMSTANCES OF THE REFERRAL / PROBLEM PRESENTED
Include the date and source of referral and the description of current problem/concern as reported by the
referring party. Summarize the circumstances which led to the need for an assessment; should answer to
questions What, Who, When, Where & How

III. DESCRIPTION OF THE :

A. FAMILY ENVIRONMENT (Description of the environment and house living condition of the
family)
B. COMMUNITY (describe the purok/brgy/mun./ resources/etc.)
C. FAMILY HISTORY/BACKGROUND (To be presented in narrative form; indicate details about
grandparents/other relatives in the absence of the birth parents)

(Aspect) (Facts/Information to be gathered and explored)

Physical Description Physical condition/appearance of birthmother/father, body built, height,

complexion, hair, eyes, nose and disability/deformity. Birth order may be
included

Parent’s personal history Childhood; experience of being parented (positive/negative that may have an
impact on quality of parenting assessment of mental ability level of
intelligence/personality), history of abuse; adolescence, substance
misuse/abuse, domestic violence

Include information on socio-cultural practices; lifestyle, values and attitude,

religion and spiritual belief; Marital history and current marital relationship
(how they make decisions, solve problems, communicate and show affections
to each other)

If the birth mother has history of substance abuse while pregnant, indicate
the frequency, duration, and amount of substance consumption.

Health history (physical and mental such as heredity, non-heredity illness/es,

medication given and pre-natal history). If they have medical illnesses,
medication that they took and if such illnesses hinders/affects their parental
capability.

If a parent is detained in jail, the status of the case filed should be stated.

Educational attainment/vocational skills/income and earnings

Information on the birthparents, such as number of their siblings and their

relationship with each other; how the parents met, and if they were married
or not, etc.

Emotional/Mental Health: Indicate issues on emotional/mental health of the parent/s, if there is any.
Should there be significant findings regarding the psychological / mental
health of the parents, it should be supported with psychological or psychiatric
evaluation

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 Personality, psychological and emotional make-up of the birth parent such
as:
1. Character/trait/how is he/she as a person
2. Hobbies, interest, talents
3. Hygiene and self-care

Parenting Skills and Style: Birth parent’s attitude towards the child during the time that he/she was still
in their care

Describe how the parent/s implement discipline towards their children and
other family members; child rearing patterns/discipline
methods/problems in rearing children

Description of parenting skills focusing on the following:

 meeting child/ren’s health and developmental needs
 putting child/ren’s needs first
 providing consistent care, discipline and safety, acknowledging
problems and engaging with support services

Basic Physical Needs: Description of the financial and housing difficulties and quality of the home
environment.

Family Relationships: Quality of intra-familiar relationship, family dynamic (nature of marital

relationship of birth parents, birthparents relationship with their children and
siblings relationship. How the family communicates in order to function in a
unified and balanced manner and how they share information or relate with
each other?)

A. COUPLE
B. PARENT – CHILD
C. AMONG SIBLINGS

Any information of family history of giving up a child for adoption:

-why is that child being preferred for adoption among all siblings?
-how long did it take for the family to decide for the adoption of the child?
-how do the couple, siblings and other family members/relatives feel about
the adoption?

Communication/Interpersonal Assess the parents’ ability to provide routines; effectively manage child’s
Skills: behaviour and monitor the child (know where they are and who they are
with)

Social Support System: Cite availability of social support and parents’ willingness to engage with this
support; include assessment/identification of other members o the
family/relatives who could extend support and act as guardian to the
child/ren

Employment/Income State and assess how the parents manage financial resources (income =
Management: expenses)

Community Resource Include other support services from the Barangay/Government/No-

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Utilization: Government facilities, Church/Spiritual Org., if any

Child/ren Characteristics: Description of the child/ren’s personality, behaviour and attitude under their
custody; One child’s relationship with other siblings; attachment and
separation; Include other members of the family where the child was
attached to, if any.

IV. CIRCUMSTANCES LEADING TO THE CHILD’S BEING GIVEN UP FORALTERNATIVE PLACEMENT

 Indicate circumstance, if in case the child is unborn yet but parents planned to give him/her up for
adoption.
 For victims of rape, counseling services must include goals to help the birth mother in overcoming trauma
brought by sexual abuse and regaining of security and worth. Please specify what has been the
intervention to help the birth mother recover from the sexual abuse. Where is the birth mother now? Was
a case filed in court? Status? Was the victim safe from the perpetrator and its supporters?
 Efforts exerted by the social worker to place the child with his relatives should be carefully considered.
 Date when the birth parent/s signed the Deed of Voluntary Commitment and the date it was notarized. (A
valid ID of the parent/s should be presented before the notary public)
 Counseling conducted by the social worker before, during & after the signing of the DVC. Include the dates
and goals of the counseling. It should not be merely focused on orientation on the meaning of the DVC.
The birth parent should be helped in processing loss, grief, and trauma associated with relinquishing the
child for adoption. Plans of the birthparent/s may be included to determine the assistance that could be
extended to the family.
 May also include one or many of the following:
1. Incapacity of parent/s to perform parental duties and obligations due to death, poor health condition or
mental and psychological incapacity among others, that may render the family, particularly the parents
to be incapacitated to care for, support or protect the child;
2. Child was born out of non-marital relationship, incestuous rape or sexual abuse where child could be
stigmatized or further abused if he/she would remain in the custody of the parents/family and
protection of the child is not guaranteed
3. Imprisoned birthparent
4. Rejection by birth family
5. Birthparents were minors when child was born
6. Physical disability/illness of the child warranting further interventions
7. Serious life threatening illness
8. The birth family has dysfunctional relationship that may be caused by marital problem
9. Children who are physically and/or mentally abused, neglected or trafficked by their own biological
family

V. SOCIAL WORKER’S INTERVENTION/S

Assistance and counseling rendered to the birth parents - Poverty cannot be accepted as the sole reason
for surrendering the child for adoption. Therefore, case management requires that in response to
circumstances influencing the decision of the parents to relinquish their parental authority, an appropriate
service/s should be provided. The reasons for the failure of these services from assisting the parents to
achieve this goal should be clearly stated in the report.

Also include in this portion, the date/s of home visits to the family and the person/s interviewed, the
purpose of the visit and the agreements reached

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Support Services and After Care Plan

Identified Immediate Strategy/Support Responsible Time Frame Result/Outcome

Problem/s Services/After Care Person
Provided
Lack of financial i.e., counseling, referral (to be filled up during
resources to provide to LGU, CIU, Pantawid or the evaluation of the
the immediate needs other offices based on case)
of the children, such the need of the family
as food, clothing,
schooling, among
others
Parents and other Referral for medical
family members have assistance
chronic medical
needs

VI. ASSESSMENT, EVALUATION AND RECOMMENDATION/S

The PCAR must be finished after 2 to 3 home visits. After gathering all the needed information, the professional
assessment of the social worker on the parenting capability of the parents of the child must be presented

The result of the assessment can be:

-parents are capable to take care of the child and would need minimal assistance i.e. livelihood assistance;

-parents are not capable and would need further intervention/assistance. (During this time, a SCSR should
be prepared by the SW identifying the family as the client. The format of which, must follow the generic
SCSR, which includes the intervention plans and contract setting, goal setting, recommendations among
others. In this case, process recordings must also be kept for all the meetings conducted with the
parents/guardians.)

Decisions should always be led by what is in the child’s best interest. If the decision is taken that a child will return
home, practice should take account of evidence on factors that appear to support enduring reunifications. On the
other hand, if the decision is taken that a child is best to place in alternative family care, indicate factors or
evidences to support the recommendation.

Prepared By: Reviewed/Approved By:

_______________________________ _________________________
Name of Case Manager/Social Worker Name of Supervisor/Head
License No./Validity Date:_______

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 ANNEX L
APPLICATION FORM FOR PROSPECTIVE ADOPTIVE PARENT/S

Identifying Data:

Husband/Man Wife/Woman
Full Name
Age
Date of Birth
Place of Birth
Religion
Nationality/Citizenship
Residence Address
Home Phone Number
Fax Number
Mobile Number
E-mail Address
Civil Status
If married, date and place of marriage
Educational Attainment
Present Occupation
Monthly Income
Name of Employer/Agency
Business Address
Business Phone Number
Monthly Income
Membership in Association/Clubs
Other Sources of Income (specify)
Hobbies/Interest
Recreational Activities

Household Composition: (List of all persons living with family)

Name Relation to Age Sex Educational Disability/Sickness,

Applicants Attainment specify
1.
2.

How did you learn about Adoption?

_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

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Reasons for adopting a child:
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

Description of Child Desired: If given a choice, I prefer a child

Age______ Others ____________ (e.g. siblings; foundling)

Sex______

Alternate care for the child: If for some reasons, I cannot personally attend to the needs of the child, I
have the following alternative:
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

Kindly check your available time for forum:

Weekdays Saturday

9:00AM – 11:00AM 9:00AM – 11:00AM Other Specify:

2:00PM – 4:00PM 2:00PM – 4:00PM ___________

Please give three (3) character references (non-relatives):

Name Address Telephone No.

1.
2.
3.
(Please attach latest picture of the couple)

__________________________ _____________________________
Name of Applicant Name of Applicant
(Husband/Man) (Wife/Woman)

__________________________ _____________________________
Date Date

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Note: to be filled up by the social worker

Type of Adoption: ________________

Assessment:

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________

__________________________
Social Worker

Noted By:

________________________________
Immediate Supervisor

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 ANNEX M

CERTIFICATE OF ATTENDANCE TO ADOPTION FORUM

This is to certify that Mr. and Mrs. / Mr. / Ms. ________________________________________

(Name of PAP/s)

attended the Adoption Fora/Forum conducted by the Adoption Resource and Referral Unit of
DSWD-Field Office _____ with address at _________________________________________.

Given this ________ day of _______________________________.

______________________________________
Head, Adoption Resource and Referral Unit
(Signature over Printed Name)

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 ANNEX N

CHILD PROFILE
(for regular adoption cases)

Name of Child_________________________ Sex_______ Date of Birth__________________ Age______

Religion __________________________ Birth Status (legitimate/non-marital/acknowledged illegitimate)

Present Address _______________________________________________________________________

 Under Residential Care since (date)

 Under Foster Care since (date)

Status: Declared Legally Available for Adoption on ________________with Control No. ______________

Case Category (abandoned/foundling/surrendered/orphaned/IVC)

Present Health Status ___________________________________________________________________

Previous Illness/Hospitalization/Operation: _________________________________________________

Current Functioning of Child: _____________________________________________________________

Special Needs or distinguishing features characteristics, if any:

_____________________________________________________________________________________
_____________________________________________________________________________________

Significant Social Background of biological parent/s (e.g. organic/non-organic illness, incest, ethnic
background, etc.) ______________________________________________________________________

Characteristics of Adoptive Family Recommended:

_____________________________________________________________________________________
_____________________________________________________________________________________

Date/s Presented for Matching Recommendation/s

(e.g., for second presentation, matched; for

interregional matching)

Prepared By:___________________________
ARRU/CPD Secretariat
(Signature Over Printed Name)

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 ANNEX O
ADOPTIVE FAMILY PROFILE FORM

Husband/Man Wife/Woman
Name
Age
Nationality/Citizenship
Religion
Educ. Attainment
Employment
Income/month
Marital Status
Address: ______________________________________________________________________
Children in the Family:

Age Sex Check if Living with the Nationality Health/

Family Special needs
A. Biological
B. Adopted
C. Foster

Child Preference: Age ______________ Sex _______________

Will Accept/Consider:
 Handicapped (specify)
 With emotional problem
 Slow learner
 Delayed development
 Siblings (indicate how many, sex, age)
 Malnourished
 With negative family background (mental illness, unwed, rape, incest, imprisoned, etc.)
Characteristics of Child/ren preferred: ______________________________________________
Description of Current Functioning of the Family: ______________________________________
______________________________________________________________________________

Prepared By:

----------------------------------------------------
(Social Worker’s name and signature)

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 ANNEX P
ROSTER OF CHILDREN AND FAMILY FOR MATCHING (DATE:________________)
A.
PAPs FOR LOCAL MATCHING

No. Name of Civil Status Citizenship Occupation Region/ Date Applied Child/ren preference Remarks
PAPs/Age Place of Origin
1

B.
CHILDREN FOR LOCAL MATCHING

No. Name of Child/ren Sex Age Case Category Region/Present Date of Special Needs Remarks
Whereabouts CDCLAA

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 ANNEX Q
Department of Social Welfare and Development
(Protective Services Bureau/Field Office _____)

Certificate of Authenticity

This is to certify that the following photocopy of documents with the stamp and signature of
the authorized representative of the Bureau/Field Office, are the faithful representation of the
original documents of (____Name of PAPs____) as submitted by the latter and found in the official
records of the Department.

 State the type of document/s provided to the (PAP/s)




Further, this Certification is issued for the purpose of presenting the documentary
requirements to the court for the filing of the petition for adoption of (Name of Child/ren being
adopted) by the above-named PAP/s.

Issued this ____ of _____________, _____ at ____________________, Philippines.

Mr./Ms. (Name of Social Worker)

(Position)
(Name of Division/Unit)

Noted By: Conformed by:

Name of Division Chief Name of Head of Office

Bureau/Unit Bureau/Field Office

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 ANNEX R
1ST POST-PLACEMENT SUPERVISORY REPORT

Family
Child
Sex/Age
Date of Birth/ Place of Birth
Date of Placement
Date of Supervision

1. Child’s progress, problems (physical, social, emotional, medical):

___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

2. Child integration into family and reaction to each family members:

___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

3. Adoptive parent’s adjustment to the child and vice versa:

___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

4. Other children/family members at home and their reactions to new child; parent’s handling of children:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

5. Home Condition:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

6. Discussion on legal adoption (at appropriate time)

___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

7. Assessment and Recommendation

___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

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 Prepared by:

______________________________
Social Worker
(Signature Over Printed Name)

Approved:

__________________________________
Head of Office
(Signature Over Printed Name)

Note: Accomplish in duplicate: 1 for Field/Central Office and 1 for SW’s file.

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 ANNEX S

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