SGLGB Form No.

SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY

Assessment Period: CY 2022
Data Capture Form

Identifying Information

Region : IV-A
Barangay : MAYMANGGA
City/Municipality : AMADEO
Province : CAVITE

CORE AREA 1: SAFETY, PEACE AND ORDER

INDICATORS DATA REQUIREMENTS DATA SOURCE HOW TO ASSIGNED PASSING SCORE DOCUMENT
DETERMINE THE SCORE SCORE SCORE OBTAINED SUBMITTED
BY THE
BARANGAY
1. Functionality of the Functionality of BADAC Barangay If the result is: 8 4 8 EXECUTIVE
Barangay Anti-Drug based on DILG-DDB JMC Secretary • High = 8 ORDER
Abuse Council (BADAC) No. • Moderate = 4
2018-01 and DILG MC DILG • Low = 2
No. 2018-135 City/Municipal • No data = 0
Office

2. Functionality of the BPOC Monitoring DILG If the result is: 5 4 5 EXECUTIVE

Barangay Peace and Form 2 based on DILG City/Municipal • Ideal = 5 ORDER
Order Committee MC No. 2008-101 Office • Mature = 4
(BPOC) • Progressive = 3
• Basic = 2
• BPOC organized = 1
• No BPOC= 0
• No data = 0
3. Performance Rate in the LTIA Form 003 based on DILG If the result is: 4 2 4 AWARD
Lupong Tagapamayapa DILG MC No. 201658 City/Municipal • 85-100= 4 MEETINGS
Incentives Awards Office • 80-84 = 3 DOCUMENTATION
(LTIA) • 75-79 = 2
• Below 75 = 1
• No data = 0

4. Maintenance of Record of RBI or similar system Barangay Secretary  With RBI = 2 1 1 1 RBI FORMS WITH
Barangay Inhabitants Date of last update:  Without RBI = 0 HOUSEHOLD AND
(RBI) DEC. 2022 INDIVIDUALS

5. Professinalizing the EO or similar issuance on Barangay With EO or similar 1 1 1 TRAININGS /

barangay Tanod based on the organization of the Secretary issuance SEMINAR
DILG MC No. 2003-42 Barangay Tanod Yes = 1 CERTIFICATE
No = 0 DOCUMENTATIONS
Training attended With trainings 1 1 1 TRAININGS/
For CY 2022 attende SEMINARS
d CERTIFICATE
DOCUMENTATIONS
Yes =1
No = 0

TOTAL 20 13 20
 SGLGB Form No. 1

SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY

Assessment Period: CY 2022
Data Capture Form

CORE AREA 2 : FINANCIAL ADMINISTRATION AND SUSTAINABILITY

INDICATORS DATA REQUIREMENTS DATA SOURCE HOW TO PERFECT PASSING SCORE DOCUMENT
DETERMINE THE SCORE SCORE OBTAINED BY SUBMITTED
SCORE THE
BARANGAY
1. Compliance with the BFDP Monitoring Form 1 DILG Presence of BFDP 2 2 2 DISCLOSURE BOARD
Barangay Full and Form 2 pursuant to City/Municipal Board DOCUMENTATIONS
Disclosure Policy DILG MC Office • Yes = 2
(BFDP) No. 2014-81 • No = 0
Onsite Inspection Compliance to the design 3 3 3 3 FULL DISCLOSURE
CY 2022, 4th Qtr pursuant to Annex 8 of BOARDS
compliance: the DILG MC No. 2014-
______________________ 81:
• Yes = 3
Location of the BFD • No = 0
Board: If the result of CY 2022, 8 6 8 DOCUMENTATON
4th Qtr compliance is: OF FULL
1.BRGY. MULTI – ●Full Compliance = 8 DISCLOSURE
PURPOSE HALL ●Partial Compliance: BOARDS
( COVERED COURT) o 7 financial documents
2. WAITING SHED posted = 7
3. BRGY. HEALTH o 5-6 financial documents
CENTER posted = 6
o 3-4 financial documents
posted = 4
o 1-2 financial documents
posted = 2
●Non-compliance = 0
●No data = 0
2. Percentage Increase in local Barangay Budget Barangay With increase? 3 3 3 BARANGAY
resources Preparation Form No. Treasurer • Yes = 3 BUDGET
2: Actual Income and • No = 0
Expenditure

Total amount collected City/Municipal

from fees and charges: Accountant

CY 2021
PhP 2,448,837.42
CY 2022
PhP 3,334,928.00

3. Conduct of Barangay
Assembly for the first and
second semester of CY 2022
Difference :
PhP
Percentage increase: _____
Monitor report on the Barangay Secretary Conducted Barangay 4 4 4 MINUTES /
compliance of the Assembly : ATTENDANCE
barangays to conduct 1st Semester = 2 DOCUMENTATIONS
barangay assembly to be 2nd Semester = 2
submitted thru shared No Data = 0
google drive

TOTAL 20 18 20

SGLGB Form No. 1

SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2022
Data Capture Form

CORE AREA 3: DISASTER PREPAREDNESS

EXECUTIVE
ORDER

BDRRM PLAN

LISTO
PLAN

NOTICE OF
THE
MEETING
MINUTES
 INDICATORS DATA REQUIREMENTS DATA SOURCE HOW TO ASSIGNED PASSING SCORE DOCUMENT
DETERMINE THE SCORE SCORE OBTAINED BY SUBMITTED
SCORE THE
BARANGAY
Utilization Report Utilization of the 70% 1 1 1 AIP / BUDGET
BDRRM Fund
50% and above = 1
Less than 50% = 0.5
• No = 0
• No data = 0

2. Accomplishment rate of the • Approved BDRRM Barangay Rate ofAccomplishment: 3 2 3 AIP / BUDGET
activities/projects reflected Plan Secretary • 60% and above = 3
in the • Accomplishment • 40 – 59% = 2
Barangay Disaster Risk Report • 20 – 39% = 1
Local Disaster Risk
Reduction and • 19% and Below = 0
How to compute? Reduction
Management (BDRRM) • No BDRRM Plan = 0
and Management
Plan or similar plan Officer
Accomplishment rate = (LDRRMO)
o A = Total number of
activities/projects
accomplished in the
BDRRM plan
o B= Total number of
activities/projects in
the BDRRM Plan

3. Extent of risk assessment Post activity report of the Barangay Conducted drills 1 1 1
and Early Warning System drills conducted Secretary • Earthquake/Fire/
(EWS) (Earthquake, fire, etc.) Others = 1 DRILL/
Local Disaster Risk • No = 0 DOCUMENTATION
Date of drill/s conducted: Reduction SEMINARS
_____________________ and Management With Post-Activity Report: 1 1
______ Officer 1
• Yes = 1
(LDRRMO) • No = 0

Early Warning System Presence of Early 1 1 1

(EWS) location: Warning System SIGNAGE/
____________________ • Yes = 1
PUBLIC
• No = 0
ADDRFESS
 Local risk map Presence of Local risk 1 1 1 DOCUMENTATION
map  Yes = 1
 No = 0

3. Extent of preparedness for EO or similar issuance Barangay With EO or similar 1 1 1 EXECUTIVE

effective response and creating the Barangay Secretary issuance creating the ORDER
recovery Emergency Search and Barangay Emergency DOCUMENTATION
Rescue Team/s Local Disaster Risk Search and Rescue
Reduction Team/s
Total number of and Management • Yes = 1
Emergency Search and Officer • No = 0
Rescue Team/s: _________ (LDRRMO)
Provision of training to the 1 1 1
Emergency Search and DRILL
Rescue Team/s:
• Trained in the past
12 months = 1
• No training in the past 12
months = 0
Designated/Evacuation Presence of Evacuation 1 1 1
Center location : Center/Designated
BRGY. HALL/ COVERED Evacuation Center DOCUMENTATION
COURT • Yes = 1
NATL.DEV. CENTER • No = 0
Disaster equipment: Disaster equipment 2 1 2
• 2-way radio / mobile • 2-way radio / mobile
phone phone = 0.5
• Rescue • Rescue DOCUMENTATION
vehicle/Barangay patrol vehicle/Barangay
• Generator set patrol = 0.5
• First aid kit • Generator set = 0.5
• Flashlight with batteries • First aid kit / Flashlight
with batteries = 0.5

TOTAL 20 17 19

SGLGB Form No. 1

SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY

 Assessment Period: CY 2022
Data Capture Form

ESSENTIAL AREA 1: SOCIAL PROTECTION AND SENSITIVITY

INDICATORS DATA REQUIREMENTS DATA SOURCE HOW TO ASSIGNED PASSING SCORE DOCUMENT
DETERMINE THE SCORE SCORE OBTAINED SUBMITTED
SCORE BY THE
BARANGAY
1. Functionality of the Functionality of the Barangay If the result is: 1 1 1 EXECUTIVE
Violence Against Violence Against Women Secretary • Ideal = 1 ORDER
Women (VAW) Desk (VAW) Desk based on • Mature = 0.5
MC No. 2017-114 dated Local Social • Basic
30 August 2017 Welfare and Progressive = 0.25
Development • No Functionality
Officer =0
VAWC Cases Quarterly Submission of 2 1 2 QUARTERLY
Reports Quarterly Reports on REPORT TO
• 1st Qtr submitted: VAWC Cases DILG
MARCH 2022 • 1st Qtr report submission DSWD
• 2nd Qtr submitted: = 0.5
JUNE 2022 • 2nd Qtr report
• 3rd Qtr submitted: submission = 0.5
SEPTEMBER 2022 • 3rd Qtr report submission
= 0.5
• 4th Qtr submitted:
DECEMBER 2022 • 4th Qtr report submission
= 0.5
Certificate of VAW Desk Person is 1 1 1 CERTIFICATE
Attendance/Participation trained  DOCUMENTATION
and Date of Yes = 1
Training/Seminar No = 0
____________

2. Access to health services in Appointment of Barangay Presence of Appointment 1 1 1 EXECUTIVE

the barangay Barangay Health Secretary or ORDER /
Worker (BHW) similar issuance APPOINMENT
On site inspection • Yes = 1
• No = 0
Appointment of Presence of Appointment 1 1 1 EXECUTIVE
Barangay Nutrition or ORDER/
Scholar (BNS) similar issuance RESOLUTION
• Yes = 1 APPOINMENT
• No = 0
 Barangay Health Presence of a BHS/C 1 1 1 DOCUMENTATION
Station/Center (BHS/C) • Maintained BHS/C
Location: =1
PUROK 5 MAYMANGGA • With access to other
BHS/C (check the BHS/C = 0.5
corresponding answer) • None = 0

√ Barangay Availability of services in 2 1 2 IMMUNIZATION

owned/maintained the BHS/C RECORD
____ With access to other • Expanded Program on DOCUMENTATION
BHS/C Immunization
(EPI) = 0.5
• Maternal Care = 0.5
• Nutrition Care = 0.5
• Other Services = 0.5
• None = 0
3. Functionality of the DILG MC No. 2009-109 Punong If the result is: 1 1 1 MINUTES OF THE
Barangay Development • BDC Monitoring Form 2 Barangay • Ideal = 1 MEETING
Council (BDC) • BDC Monitoring • Moderate = 0.5 DOCUMENTATION
Form 3 Barangay • Low = 0.25
Secretary • Non - Functional =
0 .15
• No data = 0
4. Representation of CSOs in EO or similar issuance Barangay With EO or similar 1 1 1 EXECUTIVE
the Barangay organizing each of the Secretary issuance organizing the ORDER
Based Institutions following: BBIs (with CSO
(BBIs) 1. BDC representative):
a. BDC 2. BDRRMC • 4 to 7 BBIs = 1
b. BDRRMC 3. BPOC • 1-3 out of 7 BBIs = 0.5
c. BPOC • No EO or similar
4. BADAC
issuance = 0
d. BADAC 5. BESWMC
e. BESWMC 6. BCPC
f. BCPC 7. Barangay GAD Focal
g. Barangay GAD Point System
Focal Point System
CSO Assembly /Election
Report
5. Registration of DILG MC No. 2013-061 Barangay With establishment 2 2 2 QUARTERLY
Kasambahay and  KR FORM 5- Secretary kasambahay desk : REPORTS
Establishment Of Barangay Consolidated Yes = 1 DOCUMENTATION
Kasambahay Desk Kasambay Report Public No = 0
Employment
Service Maintained and updated
office Kasambahay masterlish
KR Form 5
Yes = 1
No = 0

6. Functionality of Barangay DILG MC No. 2008-126 Barangay If the result is : 1 1 1 EXECUTIVE ORDER
Council for the  LCPC Form 1-A Secretary  Ideal = 1 MEETINGS
Protection of Children  Mature = 0.5 DOCUMENTATION
(BCPC)
 Basic –
Progressive = 0.5
 No
Functionalty = 0

7. Allocation for the Annual PCW , DILG, DBM and Barangay With approved Barangay 1 1 1 AIP/BRGY. BUDGET
Gender and Development NEDA JMC No. 2016-01 Secretary Annual Plan and Budget
( GAD) Plan and Budget  Annex D-1 Yes = 1
No = 0

TOTAL 15 13 15
 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2022
Data Capture Form

ESSENTIAL AREA 2: BUSINESS-FRIENDLINESS AND COMPETITIVENESS

INDICATORS DATA REQUIREMENTS DATA SOURCE HOW TO ASSIGNED PASSING SCORE DOCUMENT
DETERMINE THE SCORE SCORE OBTAINED BY SUBMITTED
SCORE THE
BARANGAY
1. Enactment of Barangay Tax Barangay Tax Ordinance Barangay Presence of Barangay Tax 5 5
Ordinance Secretary Ordinance:
• Yes = 5
Barangay • No = 0
Treasurer
2. Issuance of Barangay Record book Barangay Timeliness of issuance of 10 8
Clearance Treasurer barangay clearance (within
7 working days):
• 90%-100% of
applications met = 10
• 80%-89% of
applications met = 8
• 70%-79% of
applications met = 6
• 60%-69% of
applications met = 4
• 50%-59% of
applications met = 2
• 49% below of
applications met = 0

TOTAL 15 13

SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY

Assessment Period: CY 2022
Data Capture Form

ESSENTIAL AREA 3: ENVIRONMENTAL MANAGEMENT

INDICATORS DATA REQUIREMENTS DATA SOURCE HOW TO ASSIGNED PASSING SCORE DOCUMENT
DETERMINE THE SCORE SCORE OBTAINED BY SUBMITTED
SCORE THE
BARANGAY
1. Presence of a Materials • MRF (check the Onsite inspection Presence of MRF: 3 2
Recovery Facility corresponding answer) • Yes = 3
(MRF) pursuant to R.A. ____ Barangay owned • None but with other
9003 ____ Clustered Brgys materials recovery
scheme = 2
• None = 0
• Location of MRF
• MOA

2. Presence of a Ordinance on Barangay Secretary Presence of Ordinance on 4 4

Collection System to segregation of wastes- segregation of wastes-at-
atsource source
INDICATORS DATA REQUIREMENTS DATA SOURCE HOW TO ASSIGNED PASSING SCORE DOCUMENT
DETERMINE THE SCORE SCORE OBTAINED BY SUBMITTED
SCORE THE
BARANGAY
Ensure Segregation of • Yes = 4
Wastes at Source • No = 0
3. Organization of the EO or similar issuance Barangay Secretary With EO organizing 2 2
Barangay Ecological on the organization of the BESWMC  Yes
Solid Waste the BESWMC =2
Management  No = 0
Committee
(BESWMC) Approved Solid Waste Approved BESWMC 2 2
Management Program/Plan
Program/Plan (Any • Yes =1
template or • No = 0
annotated)
Monthly reports on the Submitted monthly 4 3
progress of the program reports
• 12 = 4
• 9-11 = 3
• 6-10 = 2
• 1-5 = 1
• None = 0
TOTAL 15 13

We certify to the correctness of the above information.

City/Municipal Assessment Team:

____________________________________
Chairperson
____________________________________
Vice-Chairperson

____________________________________
Member

____________________________________
Member