Barangay Profile Questionnaire

Year

NOTE: The respondent for this questionnaire should be the Chairperson or the Secretary of the Barangay

Name of Respondent:

Position:

Date:

Time Started:

Time Ended:

Name of Enumerator:

Signature of Enumerator:

I. Physical and Demographic Characteristics

(1) Province:

(2) City/Municipality:

(3) Barangay:

(4) Classification: 1 Rural 2 Urban (enter code)

(5) Number of Puroks/ Sitios:

(6) Land Area:

(7) General Description and Characteristics
of the Barangay: 1 Yes 2 No
Total Area (in square kilometer
[km])
1 Plain
Residential
2 Upland
Commercial
Industrial 3 Mountainous

Agricultural 4 Coastal

Mineral 5 Others, specify

Timberland
Special Classes
Total Land Area
(8) Boundaries:

East
West
North
Sout
(9) Major Sources of Livelihood:
h
 Barangay ID

Demographic Reference:
(10) Population: Male: (enter

Female: number)

Total: (enter
Reference period:
number)
Source of data:
(enter

number)

(11) Number of Households/Families Households: (enter number)

Families: (enter number)

Reference period:
Source of data:

(12) Registered Voters: Male: (enter

Female: number)

Total: (enter

Reference period: number)

Source of data:
(enter

number)

(13) Number of Barangay Personnel:

Total Female Male

a. Tanod (enter number)

b. Health Worker (enter number)

c. Nutrition Scholar (enter number)

(enter number)
d. Purok Leaders
(enter number)
e. Librarian
(enter number)
f. Day Care Worker
(enter number)
g. Utility Worker
Total Female Male (enter number)
h.Above
Others, specify
normal (e.g. Midwife)
Normal Reference period:
Below normal (moderate)
Below normal (severe)
(14) Nutritional Status of Children 0–5 Years Old:
Total

(enter number)
(enter number)
(enter number)
(enter number)
CBMS Form 2
Page 2
 Barangay ID
(enter number)
Reference period:
Source of data:

CBMS Form 2
Page 3
 Barangay ID

II. Service Institutions and Infrastructure

(15) IF YES IN (15) IF NO IN (15)
Is the facility (16) (17) (18) (19) (20)
present in the How many facilities are present in the Does the facility Does the facility Geopoint What is the
barangay? barangay? List the name/s of facilities in have access to have access to distance from
Facility the space provided. safe drinking sanitary toilets? the barangay
1 Yes (GO TO 16) water? 1 Yes 2 No hall to the
Latitude Longitude
1 Yes 2 No nearest
2 No (GO TO 20)
facility (in
km)?

Health Facility (16A) (16B)

a. Barangay Health Center

1.
b. Hospitals
2.

1.
c. Maternity Clinic
2.

1.
d. Child Clinic
2.

1.
e. Maternity and Child Clinic
2.

1.
f. Private Medical Clinic
2.

g. Botika ng Barangay 1.

h. Botika ng Bayan 1.

1.
i. Private Drugstores
2.

1.
j. Others, specify
2.

(16C) Levels
Educational Facility (15) (16A) (16B) offered (e.g., (17) (18) (19) (20)
Grade 1–4)

1.
a. Day Care Centers
2.

1.
b. Preschool
2.

1.
c. Elementary
2.

1.
d. Secondary
2.

1.
e. Vocational
2.

1.
f. College/University
2.

1.
g. Others, specify
2.

CBMS Form 2
Page 4
 Barangay ID

(15) IF YES IN (15) IF NO IN (15)

(16) (17) (18) (19) (20)
Is the facility
How many facilities are present in the Does the Does the What is the
present in the Geopoint
barangay? List the name/s of facilities facility have facility have distance from
Facility and Input Dealer barangay?
in the space provided. access to access to the barangay
safe drinking sanitary hall to the
Latitude Longitude
1 Yes (GO TO 16) water? toilets? nearest facility
2 No (GO TO 20) 1 Yes 2 No 1 Yes 2 No (in km)?

Service Facility (16A) (16B)

a. Multipurpose Hall

b. Police Station

c. Women's/Crisis Center

1.
d. Bank
2.
e. Post Office

f. Market

g. Others, specify

Agricultural Facility (16A) (16B)

1.
a. Rice Mill
2.
b. Corn Mill 1.
2.
c. Feed Mill 1.
2.
d. Agricultural Produce Market 1.

(bagsakan/bulungan) 2.
1.
e. Others, specify
2.
Input Dealer
1.
a. Fertilizer Dealer
2.
1.
b. Pesticide Dealer
2.
1.
c. Seeds Dealer
2.
1.
d. Feeds Dealer
2.
1.
e. Others, specify
2.
Public Transport
(21)
What types of public transportation are present in the barangay? 1-Yes 2-No
1 Bus
2 Taxi
3 Van/FX
4 Jeepney
5 Tricycle
6 Pedicab
7 Boat
8 Others, specify

CBMS Form 2
Page 5
 Barangay ID

Road Network
IF YES IN (22)
(22)
(23) (24) (25)
Are any of the following roads/streets present in What is the length of the road/street? What is the present condition of the Who is maintaining the
the barangay? 1-Yes (GO TO 23) (IN KM) road/street? road/street?
2-No (SEE CODES BELOW) (SEE CODES BELOW)

a. Concrete (IF NO, GO TO 26)

b. Asphalt (IF NO, GO TO 27)
c. Gravel (IF NO, GO TO 28)
d. Natural/Earth surface (IF NO, GO TO 28)

(24) Present condition of the road/street (25) Maintained by

1. Good 1. Private 4. Municipality/City
2. Fair 2. National Government 5. Barangay
3. Poor 3. Province 6. Others, specify
(26) If there are no concrete roads or streets in the barangay, what is the
distance from the barangay to the nearest concrete road or street? (in kilometers)
(27) If there are no asphalt roads or streets in the barangay, what is the
distance from the barangay to the nearest asphalt road or street? (in kilometers)

Water Supply
(28) Is the barangay being served by a water IF YES IN (28)
station/company ?
(29) (30) (31) (32)
1-Yes (GO TO 29) Is the source located
How many Geopoint
2-No What is the name of the water in the barangay?
households are
company? 1 Yes (GO TO 32) Latitude Longitude
being served?
2 No (GO TO 33)

1
a Level II water system
1
b Level III water system
2
(33) Are any of the following water facilities IF YES IN (33)
present in the barangay?
(34) (35) (36) (37) (38)
1-Yes (GO TO 34)
How many Is the facility How many Geopoint
2-No
units/stations? Name functioning? households are being
(Total)
1 Yes (GO TO 37)
served? Latitude Longitude
2 No
1.
a. Deep Well (Level I)
2.
1.
b. Artesian Well (Level I)
2.
1.
c. Shallow Well (Level I)
2.
1.
d. Commercial Water Refill Stations
2.
1.
e. Others, specify
2.
Garbage/Waste Disposal System

IF YES IN (39) IF NO IN (39)

(39)
(40) (41) (42) (43) (44)
Are any of the following community garbage
How many Geopoint What is the distance
disposal facilities present in the barangay? How many
1 - Yes (GO TO 40) households from the barangay to
units? Name
2 - No are being Latitude Longitude the nearest disposal
(Total)
served? facility? (in km)

1.
a. Open Dump Site
2.
1.
b. Sanitary Landfill
2.
1.
c. Compost Pits
2.
1.
d. Material Recovery Facility (MRF)
2.
1.
e. Others, specify
2.

CBMS Form 2 Page 5

 Barangay ID

Electricity Service
(45 What is the source of IF YES IN (45)
) electricity in the barangay? (46) (47) (48) (49)
1 - Yes What is the name of the How many Is there an electric Geopoint
(GO TO 46) company or association households are substation present
2 - No that is providing or being served by in the barangay?
Latitude Longitude
maintaining the 1 Yes (GO TO 49)
the electricity supply? source of electricity?
2 No (GO TO 51)
1 Electric Company
2 Generator
3 Solar
4 Battery
5 Others, specify
6 None
IF NO IN (45.1)
(50)
What is the distance from the barangay to the nearest electrical station/company?
(in kilometers)
Credit Institutions
(51 Are there credit institutions IF YES IN (51)
) operating in the barangay? (52) (53)
Contact person and details
What are the names of the credit institutions?
(Office Address, Telephone, E-mail)
1 Yes (GO TO 52) 1
2 No (GO TO 54) 2
3
Registered Business Firms (based on latest records of the barangay)

(54 How many business firms/establishments are registered in the barangay?

) Reference period:

III. Significant Events in the Barangay During the Past 3 Years

(55) During the past 3 years, how many times did the event occur? Write the number in the box provided.
1 Typhoon 7 Tsunami 13 Armed Conflict
2 Flooding 8 Fire in Houses/Properties 14 Closure of Large Firm
3 Drought 9 Forest Fire 15 Closure of Many Small Firms
4 Earthquake 10 Epidemic 16 Mass Layoff
5 Volcanic Eruption 11 Pest Infestation 17 Opening of Large Firm
6 Landslide 12 Livestock/Poultry Diseases 18 Opening of Many Small Firms

IV. Disaster Risk Reduction and Preparedness

(56) Does the barangay have a written disaster risk reduction plan?
1-Yes 2-No
(57) Does the barangay have a disaster/emergency response team?
1-Yes 2-No

(58) Does the barangay have any of the following disaster/emergency response equipment? 1-Yes 2-No
1 Rubber Boats 5 Flashlights 9 Others, please
2 Handheld Radios 6 Medicines/First Aid Supplies specify
3 Rain Gear (e.g., raincoats and boots) 7 Life Vests
4 Emergency/Service Vehicle 8 Megaphone
(59) Does the barangay have IF YES IN (59)
designated evacuation
(60) (61)
centers?
Geopoint
List the names of the evacuation centers
Latitude Longitude
1 Yes (GO TO 60) 1
2 No (GO TO 62) 2
3

CBMS Form 2 Page 6

 Barangay ID

V. Peace and Order

(62) Does the barangay have reported 1 - Yes IF YES IN (62)
cases on the following crimes during (GO TO 63) (63) How many were the victims in the reported cases?
the past 12 months? 2 - No Male Female
Total 18 years 18 years
0–17 years 0–17
Crimes against Persons Total old & Total old &
old years old
above above
a. Murder/Homicide
b. Physical Injury
c. Rape
Crimes against Property
a. Theft
b. Robbery
Other Crimes
a. Prohibited Drug Use
b. Human Trafficking
c. Illegal Recruitment
d. Prostitution
e. Spousal/Partner Abuse
f. Sexual Harassment
g. Other types of crimes, specify

VI. Programs, Projects, and Activities (based on the barangay's Annual Investment Program during the past year)
(64) (65) (66) (67)
What programs, projects, and activities Provide a brief description of the How much was allotted for the How many benefited
(PPAs) were implemented in the PPA. PPA? from the PPA during
barangay during the past year? the past year?
(Indicate unit)
a.
b.
c.
d.
e.
f.
g.
h.
VII. Budget, Revenue, and Expenditure
(68) How much was the barangay's budget, revenue, and expenditure during the past 3 years?
Year Budget Revenue Expenditure
1
2
3
VIII. Spotmap
(Attach a duly accomplished spotmap of the barangay before submitting this form to the supervisor.)
(69) When was the spotmap prepared? (MM/DD/YY)
(70) Does the spotmap contain the locations of the following?: 1- Yes 2-No 3-Not Applicable

1. Creeks, Rivers, Waterfalls 4. Barangay Boundaries 8. Barangay Hall,

2. Road Networks, Bridges, 5. Schools Multipurpose Hall
Railroads 6. Hospitals, Clinics 9. Church, Chapel
3. Purok Boundaries 7. Barangay Health Center 10. Public Market
Note: For mobile data capture system, answer only the items 70.1 to 70.4, and indicate 3-Not Applicable for items 70.5 to 70.10

CBMS Form 2 Page 7