BE FORM 1

School Logo
Sangay ng Paaralang Lungsod
Paaralang Elementaryang Sentral ng
DISTRITO NG
Lungsod ng

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 / Old and rusting replacement G.I sheets NHCP

/ Dilapidated replacement plyboard NHCP

Ceilings
/ Dilapidated replacement Gravel, sand, cements, NHCP
Walls
12mm.
/ Termite Ridden/ Old replacemet wood NHCP
Flooring
Water facilities/ Drainage / Old G.I.- Leak/ Minimal Replacement, installation PPR MOOE
System no. of handwashing of additional handwashing
facility facility
Old and Lack of Reprinting, reproduction Paint, tarpaulin Scrap Proceeds
Signages
signages of signages
School garden / Neglected garden due to Re-cultivate, replant Seedlings, organic School fund
pandemic fertilizer
/ Busted light bulbs Replacement Bulbs, Circuit breaker NHCP
Lighting
 / Broken windows Replacement New window panes NHCP
Windows
Rough flooring low Elevation and tiling Newly tiled flooring of the MOOE/DepEd \fund
School Canteen
level school canteen

Clinic
Incomplete facilities Restructured clinic with Newly structured and MOOE/DepEd \fund
complete amenities ready to use Division/
School Clinic

Classroom Health Essentials Lack of health essentials procurement of health Alcohol, face mask, hand MOOE/DepEd \fund
essentials sanitizer, face shields,
vitamins
Overloading /tripping/ Improvement/reinstallatio Upgraded school MOOE
Electricity
lack of electrical supply n of electrical wiring electrical wiring/system
Reference Materials Lack of materials in Production/procurement/ Bond paper, printers, ink MOOE, LGU, Donations
module production repair
Incomplete set of Provision and delivery of Delivered and functional DepEd Fund
Laboratory equipment
laboratory equipment for additional set of Science Science equipment
Science equipment
Incomplete set of ICT Provision and delivery of Delivered and ready for LGU 3.488 M
21st Century Classroom
Equipment additional set of ICT use
equipment
Lack of Fund Construction of eaves G. I Sheets ,angle bars DPWH Program and Projects
Extension of Eaves

Prepared by: Noted:

School Physical Facilities Coordinator Date of Inspection School Head