BE Form 1 Republic of the Philippines Document Code:

Department of Education SDO-SCC-QF-SGOD-SMN-015

Region I Revision: 00
Schools Division of San Carlos City Effectivity date: 07-23-2018

BE FORM 1 (PHYSICAL FACILITIES AND MAINTENANCE NEEDS ASSESSMENT FORM)

Reference Number: _______________
Nature of improvement
CONDITION
Needed Material Resources Manpower Needed(Indicate
Remarks Needed (Indicate kind quantity and nature of labor
(e.g. repair, repainting, and quality) services needed)
FACILITIES (Check One)
replacement, etc)

Satisfactory Unsatisfactory
If Unsatisfactory, describe
the problem
·        
* old corrugated roofs of
Roofs/Gutter / grade 8 & 10 classrooms
repainting and cleaning boysen roofguard green 2 laborers
s
*some dilapidated walls of Termiticide to be
Termite proofing and to be provided by the termite
·         Ceilings / grade 7, 8 & 10 classrooms
treatment and repair
provided by the termite
company
caused by termites company

*some dilapidated walls of Termiticide to be

Termite proofing and to be provided by the termite
·         Walls / grade 7, 8 & 10 classrooms
treatment and repair
provided by the termite
company
caused by termites company
·        
/
Blackboards
·        
repainting of some varnish maple or boysen
Chairs/desks / wooden types black
2 laborers
/tables
·         Water
facilities/ Lack of lavatories, non
Additional lavatories &
/ functional pitcher pumps in
repair of pitcher pumps
2 laborers
Drainage Senior High School
System
·         Signage /
·         School
/
garden
 non-functional light
bulbs/fluorescents at g10 office, Replacing of light bulbs
1st bldg. SHS, TVE classrooms 22 LED light bulbs w/ some
and flourescents.
·         Lighting & 23, Tractor garage, FC's office
Additional light bulbs &
receptacles and 2 laborers
& Bayan Muna Bldg. and lack of flourescents
lighting in front of Admin's Bldg. flourescents
and piggery area

Dilapidated windows and Repair of windows and smoke type window

·         broken window glasses at
/ Academic Bldg. and Old
replacing of window glasses and 1 laborer
Windows glasses NihonWelding Rod
Filipino Bldg.

*some dilapidated walls of Termiticide to be

Termite proofing and
·         Doors / grade 7, 8 & 10 classrooms
treatment and repair
provided by the termite 2 laborers
caused by termites company

·         Comfort non-functional toilet bowls Replacing of toilet bowls Toilet bowls and pvc
/ of grade 8 rooms and pvc pipes pipes
2 laborers
Rooms
·         School
/
Grounds
·         School
Canteen/Clin /
ic
·         School
/
Fence/ wall
·        
/
Electricity
·        
Alternative / unused alternative gate
gate
·        
Reference /
Materials
·        
Laboratory /
equipment
tilted & cracked floor tiles at
·         Flooring / Admin Bldg. and Madam Replacing of floor tiles floor tiles, cement 2 laborers
Ludith's classroom in SHS

Prepared by:
_________________________________ _________________ _________________
School Physical Facilities Coordinator Date of Inspection School Head
Noted: