BE Form 01

Republic of the Philippines

Department of Education
Region XIII
SCHOOLS DIVISION OF SURIGAO DEL SUR
MANAMBIA INTEGRATED SCHOOL
Manambia, Tagbina, Surigao del Sur
School Year 2019-2020

BRIGADA ESKWELA
PHYSICAL FACILITIES AND MAINTENANCE NEEDS ASSESSMENT FORM

Instruction: Conduct an ocular inspection of the school physical listed below. Then provide the needed information to facilitate the
improvement to be done on these identified facilities. (If needed you may use separate forms for each classroom or school facility)

CONDITION Nature of
Remarks improvement Manpower
(Check One) Material
Needed Needed(Indicate
If Resources
FACILITIES (e.g. repair, quantity and
Satisfacto Unsatisfact Unsatisfactory, Needed (Indicate
repainting, nature of labor
ry ory describe the kind and quality)
replacement, services needed)
problem etc)
 Roofs/Gutters Needs repainting Paints, paintbrush, 3/ Painters
etc.
 Ceilings Needs repainting Paints, paintbrush, 5
etc.
 Walls
 Blackboards
 Chairs/desks/tables
 Water facilities/
Drainage System
 Signages
 School garden
 Lighting Needs rewiring
 Windows
 Doors
  Comfort Rooms
 School Grounds
 School Canteen/Clinic Enclosed canteen
 School Fence/ wall
 Electricity
 Alternative gate /
 Reference Materials Other missing
modules, English 8
 Laboratory equipment Lab building not
turned over

Prepared by: Noted:

ALIX MONTILLA GAAS May 20, 2019 EDDIE

D ARAYAN, P-I
School Physical Facilities Coordinator Date of Inspection School
Head