Republic of the Philippines

Department of Education
REGION II – CAGAYAN VALLEY
SCHOOLS DIVISION OF ISABELA
RANIAG HIGH SCHOOL
RANIAG, RAMON, ISABELA

PHYSICAL FACILITIES REPAIR AND MAINTENANCE NEEDS ASSESMENT FORM

(To be accomplished by the School Physical Facilities Coordinator)
Instruction: Conduct an ocular inspection of the school facilities listed below. Then provide the needed information to facilitate the improvement to be done on these
identified favilities. (If needed, you may separate forms for each classroom or school facility)
Nature of
FACILITIES Condition Remarks Improvement Material Resources Manpower Needed
  (Check One)   Needed Needed (Indicate quantity and
nature of labor
  Satisfactory   If Unsatisfactory, (e.g. repair, repainting, (Indicate kind and services
Unsatisfactor
    y Describe the Replacement, etc.) Quantity) needed)
      problem      
* Ceilings √          
* Walls √     Need wall repainting   painter
* Blackboards √          
* Chairs/desks/tables √     Repainting/varnish varnish/PAINT painter
* Water facilities/drainage √          
system            
* Signage’s √          
* garden √          
* Lighting √          
* Windows √          
* Doors √          
* Comfort Rooms √        
* Classroom Grounds √          

Prepared by Date: _______________ Noted by:

ALBERTO A. PERALTA Date of Inspection EFREN L. SANTIAGO
Adviser Secondary School Principal I