Name of Student: SOMINE, MARY ROSE SALVATERA
Student No: 03-2021-03387
LEVEL II – FIRST SEMESTER (HEALTH CARE I)
Department/
Grade
Area of Assignment
Month/Year
Hospital/Agency
September 2021
Flex-Learning
Obstetric Ward
October 2021
Flex-Learning
Delivery Room / Nursery
November 2021
Flex-Learning
Obstetric Ward / Pediatric Ward
December – April
2021-2022
Flex-Learning
Community Health Nursing (CHN)
Clinical Instructor
Name
Krishanne L. Roces, RN
Mary Mar N. Espital, RN
Liza D. Fucanan, RN, MAN
Krishanne L. Roces, RN
Mary Mar N. Espital, RN
Liza D. Fucanan, RN, MAN
Krishanne L. Roces, RN
Mary Mar N. Espital, RN
Liza D. Fucanan, RN, MAN
Zenrex M. Dela Cruz, RN
Liza D. Fucanan, RN, MAN
LEVEL II – SECOND SEMESTER (HEALTH CARE II)
Clinical Instructor
Department/
Grade
Area of Assignment
Name
Raymond Mark A. Mata, RN
Birthing Facility / Delivery Room
Rebenson F. Sison, RN, MSN
Month/Year
Hospital/Agency
December – January
2021-2022
Flex-Learning
February 2022
Flex-Learning
Delivery Room
Raymond Mark A. Mata, RN
Rebenson F. Sison, RN, MSN
March 2022
Flex-Learning
Delivery Room / Operating Room
Rebenson F. Sison, RN, MSN
Rebenson F. Sison, RN, MSN
April 2022
Flex-Learning
Recovery Room
Raymond Mark A. Mata, RN
Rebenson F. Sison, RN, MSN
Signature
Signature
FINAL GRADE: __________
Name of Student: SOMINE, MARY ROSE SALVATERA
Month/Year
September 2022
Hospital/
Agency
Nazareth General
Hospital (NGH)
Student No: 03-2021-03387
LEVEL III – FIRST SEMESTER (NCM 112 / NUR 156)
Clinical Instructor
Department/
Grade
Area of Assignment
Name
Neonatal Intensive Care Unit /
General Ward
Leonardo R. Sanchez IV, RN, LPT, MAN
Operating Room / Delivery
Room / Medical Ward /
Intensive Care Unit
October 2022
Luzon Medical
Center (LMC)
April-May 2022
Flex Learning
Community Health Nursing
(CHN)
September –
November 2022
Flex Learning
Geriatric Ward
December 2022
Hospital/
Agency
Mapandan Rural
Health Unit
January 2023
Nazareth General
Hospital (NGH)
Month/Year
February – March
2023
March 2023
Jobelle A. Lomibao, RN
Jesus C. Rabe, RN, MSN
Belinda S. De Vera, RN, MSN
Liza D. Fucanan, RN, MAN
Jasper Lemuel V. Caragay, RN
LEVEL III – SECOND SEMESTER (NCM 116 / NUR 150)
Clinical Instructor
Department/
Grade
Area of Assignment
Name
Dennis S. Baylon, RN / Virgie F. Bauzon,
RN, CNN, MAN
Ward
Intensive Care Unit / Medical
Ward
Floro C. Carreon Jr., RN, MAN
Ward
Amelita D. Dumaguin, RN, MAN
Ward / Special Area
Annie V. Mapula, RN
Virgie F. Bauzon, RN, CNN, MAN
Jesus Nazarene
General Hospital
(JNGH)
Jesus Nazarene
General Hospital
(JNGH)
Signature
December – March
2022-2023
Flex Learning
Psychiatric Ward
Christian V. Caluza, RN / Dr. Sheree G.
Ganzon, RN, LPT, MPH
June 2023
Marian Care Birthing
Home (MCBH)
Delivery Room
Jhenalyn P. Calizar, RN, MAN
Virgie F. Bauzon, RN, CNN, MAN
Signature
FINAL GRADE: __________
Name of Student: SOMINE, MARY ROSE SALVATERA
Student No: 03-2021-03387
AFFILIATION – (SUMMER - NUR 199)
Grade
Clinical Instructor
Name
Hospital/Agency
Inclusive Dates of Assignment
Villa Herzon Mental Health Center (VHMHC)
May 22-26, 2023
Dr. Sheree G. Ganzon, RN, LPT, MPH
Ortigas Hospital & Healthcare Center
Incorporated (OHHC)
May 22-26, 2023
Rushel E. Berdeguel, RN, MAN
FINAL GRADE: __________
Signature
Name of Student: SOMINE, MARY ROSE SALVATERA
Month/Year
Hospital/Agency
July 2023
Cuison Hospital
Incorporated (CHI)
August – September
2023
Mapandan
Community Hospital
(MaPCH)
September 2023
October 2023
Manaoag
Community Hospital
(MCH)
Nazareth General
Hospital (NGH)
Month/Year
Hospital/Agency
July 2023
Cuison Hospital
Incorporated (CHI)
August – September
2023
Mapandan
Community Hospital
(MaPCH)
September 2023
October 2023
Student No: 03-2021-03387
LEVEL IV – FIRST SEMESTER (NCM 118 / NUR 201)
Department/
Grade
Area of Assignment
Emergency Room / Intensive
Care Unit / Head Nursing
Delivery Room / Emergency
Room / Head Nursing
Delivery Room / Emergency
Room / Head Nursing
Intensive Care Unit / Emergency
Room / Head Nursing
Clinical Instructor
Name
Glyness Ventinilla, RN
Dennis S. Baylon, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
John Emar N. De Guzman, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Anniecar C. Camagay, RN
Leonardo T. Kindom II, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Janice D. Belen, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
LEVEL IV – FIRST SEMESTER (NCM 119 / NUR 217)
Department/
Grade
Area of Assignment
Head Nursing
Head Nursing
Manaoag
Community Hospital
(MCH)
Head Nursing
Head Nursing
Nazareth General
Hospital (NGH)
Signature
Clinical Instructor
Name
Glyness Ventinilla, RN
Dennis S. Baylon, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Signature
John Emar N. De Guzman, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Anniecar C. Camagay, RN
Leonardo T. Kindom II, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Janice D. Belen, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
FINAL GRADE: __________
Name of Student: SOMINE, MARY ROSE SALVATERA
Student No: 03-2021-03387
LEVEL IV – FIRST SEMESTER (NCM 121 / NUR 218)
Department/
Grade
Area of Assignment
Month/Year
Hospital/Agency
July 2023
Cuison Hospital
Incorporated (CHI)
Emergency Room / Intensive
Care Unit / Head Nursing
Clinical Instructor
Name
Glyness Ventinilla, RN
Dennis S. Baylon, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
August – September
2023
Mapandan
Community Hospital
(MaPCH)
Delivery Room / Emergency
Room / Head Nursing
John Emar N. De Guzman, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
September 2023
October 2023
Manaoag
Community Hospital
(MCH)
Nazareth General
Hospital (NGH)
Month/Year
Hospital/Agency
November 2023
City Health Office,
Dagupan City (CHO)
December 2023
Mapandan
Community Hospital
(MaPCH)
January 2024
Nazareth General
Hospital (NGH)
February 2024
Nazareth General
Hospital (NGH)
Delivery Room / Emergency
Room / Head Nursing
Intensive Care Unit / Emergency
Room / Head Nursing
Anniecar C. Camagay, RN
Leonardo T. Kindom II, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Janice D. Belen, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
LEVEL IV – SECOND SEMESTER (NCM 122 / NUR 038)
Clinical Instructor
Department/
Grade
Area of Assignment
Name
Emergency Room /
Jesus C. Rabe, RN, MSN
Operating Room / Delivery
Room /
Head Nursing
Emergency Room / Delivery
Room /
Head Nursing
Emergency Room /
Delivery Room / Head Nursing
Emergency Room / Delivery
Room /
Head Nursing
FINAL GRADE: __________
Signature
Emmanuel Lopez, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Raquel C. Molina, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Raquel C. Molina, RN
Leonardo R. Sanchez IV, RN, LPT, MAN
Signature