ANNEX 1

Republic of the Philippines

DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT

BARANGAY DEVELOPMENT COUNCIL FUNCTIONALITY

ASSESSMENT SELF - ASSESSMENT FORM
YEAR UNDER REVIEW: ____________
(to be filled-up by the barangay)

Region:
Province:

Instruction: Put a check () on the box that corresponds to the given questions

1 The BDC is organized/reconsitituted YES NO MEANS OF VERIFICATION

Sangguniang Barangay Resolution

Executive Order
Others: (Please Specify)
2 The BDC is organized/reconstituted within 100 YES NO MEANS OF
VERIFICATION
days upon assumption to office Sangguniang Barangay Resolution
Date of organization/reconstitution: ______________ Executive Order
Others:
(Please Specify)
3 The BDC Executive Committee is constituted YES NO MEANS OF
VERIFICATION
Sangguniang Barangay Resolution

Executive Order
Minutes of the meetings prepared by the
Secretary Others: (Please Specify)
4 BDC sectoral or functional committees are YES NO MEANS OF
VERIFICATION
organized Sangguniang Barangay Resolution

Executive Order
Others: (Please Specify)
5 BDC membership is in accordance with YES NO MEANS OF
VERIFICATION
prescribed members of Section 107 of RA 7160 Sangguniang Barangay Resolution
Number of members of BDC: _________Executive Order
Others:
(Please Specify)
6 At least 1/4 of the members of the BDC are YES NO MEANS OF
VERIFICATION
representatives for accredited NGO Sangguniang Barangay Resolution Number of
representative fromExecutive Order accredited NGOs: _______________Others:
(Please Specify)
7 At least 40% of all the BDC members are YES NO MEANS OF
composed VERIFICATION
 of women pursuant to RA 9170 or the Magna Carta Sangguniang
Barangay Resolution of Women of 2009Executive Order
Number of female BDC Members: ________________Directory/Profile of BDC Members Number of male
BDC Members: _________________Others: (Please Specify)
8 BDC members attended any related trainings YES NO MEANS OF
VERIFICATION
or orientation at least once in the previous year Post-activity Report of the Training
Attendance Sheets

Certficate of Participation/Attendance
Photo documentation with date and time stamp

Others: (Please Specify)

9 BDC conducts meeting at least twice a year YES NO MEANS OF VERIFICATION

Date of 1st semester meeting: _______________ Minues of the meetings
Date of 2nd semester meeting: _______________ Attendance sheets

Photo documentation with date and time

stamp Others: (Please Specify)
10 BDC Executive Committee conducts meetings YES NO MEANS OF
VERIFICATION
at least once every quarter Minues of the meetings
Date of 1stQ Meeting: __________Attendance sheets
Date of 2ndQ Meeting: ________ Photo documentation with date and time stamp
Date of 3rdQ Meeting:__________Agenda of the meeting with BDC related concerns Date of 4thQ Meeting:
__________Others: (Please Specify)
11 Sectoral and Functional Committee Meetings YES NO MEANS OF
VERIFICATION
are conducted Minues of the meetings

Attendance sheets
Photo documentation with date and time stamp
Others: (Please Specify)
12 Barangay Development Plan is formulated YES NO MEANS OF
VERIFICATION
Barangay Development Plan (BDP)

Resolution of the BDC approving BDP

Sangguniang Barangay Resolution adopting BDP
Others: (Please Specify)
13 Sectoral plans are intgerated in the BDP YES NO MEANS OF
VERIFICATION
Barangay Development Plan (BDP)
Integrated sectoral plans/BBI plans in the BDP Resolution of Sectors/BBIs submitting the plan to BDP

Resolution of BDC adopting the plans

 Agenda of BDC meetings reflecting
recommendations from BBIs /sectoral committees
members
Others: (Please Specify)
14 Local Developmet Investment Program/Annual YES NO MEANS OF
VERIFICATION
Investment Program is formulated LDIP/AIP

Resolution of the BDC approving AIP

Sangguniang Barangay Resolution adopting
AIP Others: (Please Specify)
15 BDP is submitted to the City/Municipal level for YES NO MEANS OF
VERIFICATION
inclusion in the CDPTransmittal Letter/Resolution of the BDC/SB

submitting the BDP to the city/municipality

Copy of the BDP with stamp received by
the city/municipality
Others: (Please Specify)
16 Percentage of accomplished PPAs vis-à-vis PERCENTAGE MEANS OF
VERIFICATION
targeted PPAs in the AIP100% - 85%LDIP/AIP
Number of target PPAs: ________84% - 50%Accomplishment Report
Number of accomplished PPAs: ________49% - 25%Preject Status Report
Below 25%Others:
(Please Specify)
17 Percentage of utilization of allocated budget PERCENTAGE MEANS OF
VERIFICATION
Amount of annual budget: _____________100% - 85%Approved appropriations
ordinance
Amount of utilized budget: _____________84% - 50%Financial Reports

YES NO

49% - 25%Accomplishment
Report Below 25%Others:
(Please Specify)

18 Submission of annual accomplishment reportMEANS OF VERIFICATION

Narrative Accomplishment Report
Physical and Financial Reports State of
the Barangay Address presented during

Barangay Assembly Days Others:

(Please Specify)

19 Voluntary participation of the residents in the YES NO MEANS OF

VERIFICATION
implementation of barangay PPAs Certificate of Appreciation/Recognition

Photo Documentation
 After-activity reports
Attendance sheets Others:
(Please Specify)
20 Conduct of public hearing/barangay assemblies YES NO MEANS OF
VERIFICATION
for public consultation Minutes of the meetings

Minutes of the barangay assembly days

Photo Documentation with date and time stamp
Others: (Please Specify)
21 Attendance of CSOs to the regular meetings YES NO MEANS OF
VERIFICATION
of the BDC Minutes of the meetings

Attendance sheets
Photo Documentation with date and time stamp
Others: (Please Specify)
22 Conduct of consultation meetings with various YES NO MEANS OF
VERIFICATION
sectors Minutes of the meetings

Attendance sheets
Photo Documentation with date and time stamp
Others: (Please Specify)
23 Attendance of BDC members to the meetings/ YES NO MEANS OF
VERIFICATION
consultation initiated by higher LGUs (P/C/M) Minutes of the meetings

Attendance sheets
Photo Documentation with date and time stamp
Others: (Please Specify)
Prepared by : Date accomplished: _____________

(Name and Signature of Punong Barangay)