BE Form 01

Republic of the Philippines

Department of Education
Region XI
SCHOOLS DIVISION OF DAVAO DEL NORTE
SAN ISIDRO ELEMENTARY SCHOOL
BRGY. SAN ISIDRO, CARMEN DISTRICT
School Year 2020-2021

BRIGADA ESKWELA

PHYSICAL FACILITIES AND MAINTENANCE NEEDS ASSESSMENT FORM

CONDITION Nature of
Remarks Manpower
(Check One) improvement Needed Material Resources
Needed(Indicate
FACILITIES (e.g. repair, Needed (Indicate
If Unsatisfactory, quantity and natur
Satisfactory Unsatisfactory repainting, kind and quality)
describe the problem labor services need
replacement, etc)
 Roofs/Gutters /
 Ceilings /
 Walls / Faded Repaint Paint and Roller Brush Teachers
 Blackboards /
 Chairs/desks/tables /
 Water facilities/ /
Drainage System
 Signages / Lost signage’s Put-up Tarpauline Parent Volunteer
 School garden / Uncultivated Clean and re-planting Materials for cleaning, Parents Voluntee
Plants and Vegetables
for re-planting, and re-
usable materials.

 Lighting /
 Windows /
 Doors /
 Comfort Rooms /
 School Grounds / Grassy and swampy Grass cutting and soil Grass cutter, and sand Parents Voluntee
filling and gravel
 School Canteen/Clinic /
 School Fence/ wall / Not completed Putting up of fence Hollow blocks, Mason and paren
 cement, and sand and volunteer
gravel
 Electricity /
 Alternative gate /
 Reference Materials
 Laboratory equipment

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).

Prepared by: Noted:

_______________________________ _________________ JUDYLENE E. RECAÑA

School Physical Facilities Coordinator Date of Inspection School Head