BE FORM 1

Republic of the Philippines

Department of Education
Region V-BICOL
Schools Division Office of Catanduanes
Virac South District
PALTA ELEMENTARY SCHOOL
Palta Virac

BRIGADA ESKWELA
SY. 2021-2022
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
(Check One) Manpower
Needed Material Resources
Needed(Indicate
FACILITIES Needed (Indicate
If Unsatisfactory, (e.g. repair, quantity and nature of
kind and quality)
Satisfactory Unsatisfactory describe the repainting, labor services needed)
problem replacement,
etc.)
Roofs/Gutters / Damaged by typhoon replacement Wood, nails, paint Carpentry
Rolly
/ Damaged by typhoon replacement Wood, nails, paint Carpentry
Ceilings
Rolly
/ Damaged by typhoon replacement Wood, nails, paint Carpentry, painter, masonry
Walls
Rolly
/ Damaged by typhoon replacement Wood, nails, paint Carpentry
Blackboards
Rolly
/ Damaged by typhoon replacement Wood, nails, paint Carpentry
Chairs/desks/tables
Rolly
Water facilities/ Drainage / Damaged by typhoon replacement Plumber
System Rolly
Signages /
School garden /

Lighting /

Windows / Damaged by typhoon replacement Carpentry

Rolly
Doors / Damaged by typhoon replacement Wood, nails, paint Carpentry
Rolly
Comfort Rooms / Damaged by typhoon replacement Wood, nails, paint Carpenter
Rolly
School Grounds /

/ Damaged by typhoon replacement Wood, nails, paint Carpenter

School Canteen/Clinic
Rolly
/ Under maintenance repainting
School Fence/ wall

Electricity / Damaged by typhoon replacement Wire, safety box, socket Electrical

Rolly
Alternative gate /

/ Damaged by typhoon replacement

Reference Materials
Rolly

Prepared by: Noted:

ROQUETA M. SARMIENTO GLORIA T. TEJADA

School Physical Facilities Coordinator Date of Inspection School Head

 Windows

Doors

Comfort Rooms

School Grounds

School Canteen/Clinic

School Fence/ wall

Electricity

Alternative gate

Reference Materials

Laboratory equipment

Prepared by: Noted:

School Physical Facilities Coordinator Date of Inspection School Head