Application for Construction Safety and Health Program (CSHP)
for the Construction of Private Residences or Small Commercial Construction Projects Directly administered by the owner.

(Pursuant to Administrative Order No. 24, s. of 2018.)
A. Project Details

C.Client Feedback Survey

Pakilagyan ng tsek (✓) ang kahon na nagsasaad ng iyong tugon. (Please put a check mark (✓) in the appropriate box corresponding to your response.)
Mga Detalye
Lubos na nasiyahan
(Very Satisfied)
Ni nasiyahan o hindi nasiyahan
(Neither Satisfied nor Dissatisfied)
Hindi nasiyahan
Lubos na hindi nasiyahan
(Very Dissatisfied)
0. I am satisfied with the service that I availed.
     ((Ako ay kontento sa serbisyo na aking napakinabangan)
1. I spent an acceptable amount of time to complete my transaction
     (Gumugol ako ng katanggap-tanggap na tagal ng oras upang makumpleto ang aking transaksyon)
2. The office accurately informed and followed the transaction’s requirements and steps
     (Ang opisina ay may wastong kaalaman at sinunod ang mga kinakailangan at hakbang ng transaksyon )
3. My online transaction (including steps and payment) was simple and convenient
     (Ang aking online na transaksyon (kabilang ang mga hakbang at pagbabayad) ay simple at maginhawa)
(Access and Facilities)
4. I easily found information about my transaction from the office or its website
     (Madali kong nahanap ang impormasyon tungkol sa aking transaksyon mula sa opisina o sa website nito)
5. I paid an acceptable amount of fees for my transaction
     (Nagbayad ako ng katanggap-tanggap na halaga ng mga bayarin para sa aking transaksyon)
6. I am confident my online transaction was secure
     (Ako ay tiwala na ang aking online na transaksyon ay naging matiwasay)
7. The office's online support was available, or (if asked questions) online support was quick to respond
     (Available ang online na suporta ng opisina, o (kung magtatanong) mabilis na tumugon ang online na suporta)
8. I got what I needed from the government office.
     (Nakuha ko ang kailangan ko sa opisina ng gobyerno.)
Reklamo sa serbisyong natanggap mula sa DOLE
(Complaint on the service provided by DOLE):
Mungkahi/Rekomendasyon upang mas mapaganda pa namin ang pangkalahatang Serbisyong naibigay
(Suggestion/ Recommendation on how we could improve our overall service):
Company Profile/License/Registration of Main/General Contractor
Project Type:
Project Name:
Project Address:
City / Municipality:

Project Duration:
Project Date Start:
Completion Date:
Estimated Project Cost:
Number of Male Workers:
Number of Female Workers:
Project Specific Construction Activites:
Owner Details
Name of Owner
Owner Address:
City / Municipality:
Email Address:
Contact Number:
Email Address:
OSH Personnel and Attachments
Name of Safety Officer
Date of Training:
Safety Officer Certificate File:
First Aider Name
Date of Training:
Date Valid:
First Aider Certificate File:
CSHP File Uploaded:

     I/We TEST do hereby commit and bind myself/ourselves to comply with the applicable provisions of the Occupational Safety and Health Standards (OSHS) governing Occupational Safety and Health in the Construction Industry.

I/We hereby commit to implement a suitable Construction Safety and Health Program in the construction of my/our residential house/small commercial building.

I/We also acknowledge our responsibilities to provide the appropriate personal protective equipment (PPE) and job safety and health instructions and training to all our workers during the duration of the construction.

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