BE Form 01

Republic of the Philippines

Department of Education
Region III
SCHOOLS DIVISION OF BATAAN
Mariveles National High School (Annex) Alion
Alion Mariveles Bataan
School Year 2020 -2021

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 Manpower
(Check One) improvement Needed Material Resources
Needed(Indicate quantity
FACILITIES (e.g. repair, Needed (Indicate kind
If Unsatisfactory, and nature of labor
Satisfactory Unsatisfactory repainting, and quality)
describe the problem services needed)
replacement, etc)
 Roofs/Gutters √
 Ceilings √ Broken/dilapidated Rehabilitation Marine Plywood
ceiling
 Walls √ Faded walls Repainting Paints
 Blackboards √ Broken Repairs Hammer/ nails
 Chairs/desks/tables √ Protruding nails Repairs Pieces of woods/ nails
 Water facilities/ √ Broken water pipes replaces Pipes/
Drainage System
 Signages √
 School garden √
 Lighting √ Busted bulb/ damage Replace Outlets/ Copper wire
electrical facilities
 Windows √ Broken jalouse replace jalouse
 Doors √ Broken/Swinging in Repairs Welding machine
 doors
 Comfort Rooms √ Broken toilet bowl / repairs Toilet bowl/ paints/
faded paint / Broken Doorknobs
door
 School Grounds √ Slippery pathway Cleaning Water broom
 School Canteen/Clinic √
 School Fence/ wall √ Damage / Crack fence Repair Cements/ Sands/ Hollow
blocks/ steel bar
 Electricity √ Exposed electrical Remove / Replace Copper wires
wire
 Alternative gate √
 Reference Materials √
 Laboratory equipment √

Prepared by: Noted:

________JARVEN T. SAGUIN__________ _____MAY 20, 2019___ ______THELMA O. ZULUETA_________

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School Physical Facilities Coordinator Date of Inspection School Head