Republic of the Philippines

Department of Education
REGION IV-A CALABARZON
Schools Division of Rizal
___________________________________________________________________________________________________________________________________________
BRIGADA ESKWELA
PANTAY ELEMENTARY SCHOOL
Sitio Pantay, Brgy. Dalig, Teresa, Rizal
School Year 2022-2023
BE FORM 1

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 Manpower Needed
(Check One) improvement Needed Material Resources
(Indicate quantity and
FACILITIES (e.g. repair, Needed (Indicate kind
nature of labor services
If Unsatisfactory, repainting, and quality)
needed)
Satisfactory Unsatisfactory describe the replacement, etc)
problem
 Roofs/Gutters ✔ Lack of roofs and Adding roofs and Gutter 3 carpenters for roofing
gutters in the washing gutters Roof
area and pathway Steel
Nail
Welding machine
Paint
 Ceilings ✔

 Walls ✔ Chipped and dirty Repainting Acrylic paint 2 carpenters for painting
walls Paint brush per building
Paint roller
Wall putty
 Blackboards ✔ No longer able to Repainting Chalkboard paint 2 carpenters for painting
write it using some Paint brush per building
___________________________________________________________________________________________________________________________________________

Address: DepEd Bldg., Cabrera Road, Brgy. Dolores, Taytay, Rizal 1920
Telephone No: OSDS 8571-4284/ 8650-2615 / 8650-2639 / 8650-2612 / 8695-3877
SGOD 7061720 / CID 650-2610
Email Address: rizal@deped.gov.ph Website: depedrizal.ph

“Sulong Blue Rizal”

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chalk Paint roller

 Chairs/desks/tables ✔ Hole in the chair seat, Replacement

cut off handle of
tables, not attach
table to the stand
 Water facilities/ ✔ Creating new Adding washing areas Cement 3 carpenters
Drainage System washing areas Steel
Pipe
Valve
Faucet
 Signages ✔

 School garden ✔ Needed to plow and Renovations Soil 3 garderners

to plant new Vegetable seeds
vegetable plants for Fertilizer
the gulayan sa Gardening materials
paaralan
 Lighting ✔ Replacing broken Replacement Light bulb 2 electricians per building
light Fluorescent light
Bulb socket
Fluorescent socket
 Windows ✔ Replacing broken Replacement jalousie glass 2 installer per building
jalousie glass and
have a cover to
prevent dengue
 Doors ✔ Replacing doorknobs Replacement doorknobs 2 installer per building

 Comfort Rooms ✔

 School Grounds ✔

 School Canteen/Clinic ✔ Needs of cleaning Renovation Cement 2 carpenters

Steel
___________________________________________________________________________________________________________________________________________

Address: DepEd Bldg., Cabrera Road, Brgy. Dolores, Taytay, Rizal 1920
Telephone No: OSDS 8571-4284/ 8650-2615 / 8650-2639 / 8650-2612 / 8695-3877
SGOD 7061720 / CID 650-2610
Email Address: rizal@deped.gov.ph Website: depedrizal.ph

“Sulong Blue Rizal”

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Broom
Mop
Detergent
 School Fence/ wall ✔

 Electricity ✔

 Alternative gate ✔

 Reference Materials ✔

 Laboratory equipment ✔

Prepared by: Noted:

ROMEO F. REDITA JR. JULY 25, 2022 NANCY N. DE JESUS

_______________________________ _________________ ____________________________________
School Physical Facilities Coordinator Date of Inspection School Head

NOTE: Schools can utilize the hazard map made by the Student-led Watching Team and generate other improvement plans from School Governing Council.

___________________________________________________________________________________________________________________________________________

Address: DepEd Bldg., Cabrera Road, Brgy. Dolores, Taytay, Rizal 1920
Telephone No: OSDS 8571-4284/ 8650-2615 / 8650-2639 / 8650-2612 / 8695-3877
SGOD 7061720 / CID 650-2610
Email Address: rizal@deped.gov.ph Website: depedrizal.ph

“Sulong Blue Rizal”