Name: Shenna Ann A.

Portiles Score:
Subject and Course: National Service Training Program Year and Section: BEED 1A
Instructor: Mrs. Marilen Matela Date:

COMMUNITY NEED ASSESSMENT FORM

1. Name of the Community/Institution Being Assessed

Barangay Sipsipin, Jala-jala Rizal

2. Venue or Description of the Location

Cover Court Sipsipin

3. Description of the Community and Basic Community Statistics

Jalajala also spelled as Jala-jala, officially the Municipality of Jalajala , is a 4th

class municipality in the province of Rizal, Philippines. According to the 2020 census, it has a
population of 34,017 people. Jala Jala faces the side of Laguna lake wherein you can see
the reflection of Mt. Maria Makiling to the water as you face the lake. You can also see the Sierra
Madre, the longest mountain range in our country, just beside you.

4. Background of the Community

Patterns and Trends in:

1. Political System: There are 42,046 barangays, 1488 municipalities, 146 cities, and 81
provinces in the Philippines' 17 regions. It has a democratic administration and the right
 to free speech is protected by law.
2. Economic System: Plant Vendor, fishing and hunting
3. Socio-Cultural System: Iglesia Ni Cristo, Saksi ni Jehova, Christian And Roman
Catholic.
4. Community Networks: ICM Jala Jala Retreat House, Reliant Community Network
Services and GMA TV-44 Jala Jala
5. Community Plans and Direction: To regularly conduct an Ecological Camp, dubbed
as Kilos Kabataan Para sa Lawa, is part of the plan strategy of CLEAR in its campaign to
educate the community, particularly the youth, on the need to conserve and protect
Laguna de Bay.
Name: (OPTIONAL) GENDER:

AGE:

Thank you for being one of our youth at Brgy. Sipsipin. Please complete this short 3-
minutes survey to let us know how satisfied you are with your overall youth experience. All
responses are recorded anonymously so feel free to provide honest feedback. Your
responses will help us improve our teaching and learning environment. 

If you have any questions about the survey, please email us:
portilesanna0604@gmail.com

We really appreciate your input!

SURVEY QUESTIONAIRE

1. What activities are usually/currently conducted?

____ Social ____Spiritual
____ Livelihood All of the Above

____ Others, please specify ___________________________

2. How frequent are the activities being conducted?

 ____ Weekly
 ____ Semi-monthly
 Monthly
 ____ Semi-annually
 ____ Annually
 ____ Others, please specify ___________________________
3. Who conducts the activities?

 Barangay Council
 ____ Nongovernment Organizations
 Combination
 Community/Civic Groups
 ____ Youth/Students
 ____ Others, please specify 4P’s
 4. What is the rating of the community leaders and members for the following
community current programs?

Encircle your rating for each question using the scale below:

1. Not in a position to evaluate/No idea at all

2. Poor/Never
3. Needs improvement/Very seldom
4. Satisfactory/ Seldom
5. Very satisfactory/Oftentimes
6. Excellent/Always

Social Activities (parties, singing/dancing contests,

feast day celebration, swimming, etc.) 0 1 2 3 4 5

Spritual activities (recollection, retreat, mass, etc)

0 1 2 3 4 5

Recreational activities (sportsfest, league, etc.)

0 1 2 3 4 5

Educational Activities (seminars, trainings,

workshops, etc.) 0 1 2 3 4 5

Livelihood Activities (microfinancing, subsidies,

etc.) 0 1 2 3 4 5

Environmental Activities (cleaning, waste

management, garbage collection, etc.) 0 1 2 3 4 5

5. Who are the active participants of the community activities being

conducted?

 Youth
  ____ Students
 ____ Out-of-school youth
 ___ Others, please specify:

Involvement of the Members of the Community in the Project

0 - Not in a position to evaluate/No idea at all

1 - Poor/Never
2 - Needs improvement/very seldom
3 - Satisfactory/Seldom
4 - Very satisfactory/Oftentimes
5 - Excellent/Always
Rate the following constituents in terms of involvement or participation in
community activities. Encircle your rating for each question using the scale below:
NGO’s 0 1 2 3 4 5
Community Personel 0 1 2 3 4 5
Students 0 1 2 3 4 5
Out-of-School Youth 0 1 2 3 4 5

1. Who benefits from the activities?

Barangay constituents
NGOs
Community
____ Others, please specify _______________________

2. What are the facilities available in the community?

 Plaza
 ___ Sports center
 Social hall
 Streets
 ___ Others, please specify _______________________

3. What activities are perceived to be mostly needed by the community?

 Livelihood activities
 Spiritual activities
 Social mobilization
 Environmental Activities
 ____ Others, please specify _______________________

4. Issues, problems, and opportunities present in the community

 Lack of support for activities

 ____ Lack of Awareness
 Garbage
 ____ Health
 Leadership
 Sanitation
 ____ Others, please specify __________________________

5. Issues/concerns that the community leaders/members think should be

prioritized

 Cleanliness
 Livelihood
 Leadership
 ____ Others, please specify

· Evaluation by the Team Conducting the Needs Assessment

 1. Needs identified by community leaders and members

More on Walis tingting, dustpan and some seeds and plant.

2. Current action being taken to meet community needs

Cleaning and planting by youth in community.

3. Local resources available to help meet community needs

____ Financial Resources-financial assets available

Cash allowance

____ Equipment and Materials-all equipment, materials and supplies

that will be available to support the activities

Cleaning material
Water

____ Community Organizations/Groups-agencies, organizations,

firms, and institutions within the community that can be consider

Youth

4. Name/s of Assessor/Evaluator:
Captain of the baranggay’s