Republic of the Philippines

Department of Education
Region 02
Division of Isabela
RANIAG HIGH SCHOOL
School Year 202_-202_

BRIGADA ESKWELA
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 facilities. (If needed, you may
separate forms for each classroom or school facility)
FACILITIES Condition Remarks Nature of Improvement Material Resources Manpower Needed
(Check One) Needed Needed (Indicate quantity and nature
Satisfactory Unsatisfactory If Unsatisfactory, (e.g. repair, repainting, (Indicate kind and of labor services needed)
Describe the problem Replacement, etc.) Quantity)
Glass windows / Broken glass replacement Glass window 1 laborer
Ceiling / Dirty ceiling Repainting/replacement 1L Paints, paint brush,2 flywood 2 laborer

Prepared by: Date:

MARY ANN I. BERSOLA

Adviser __________Julyl __, 2020_______________
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
RANIAG HIGH SCHOOL
School Year 2009-2010

BRIGADA ESKWELA
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 facilities. (If needed, you may
separate forms for each classroom or school facility)
FACILITIES Condition Remarks Nature of Improvement Material Resources Manpower Needed
(Check One) Needed Needed (Indicate quantity and nature
Satisfactory Unsatisfactory If Unsatisfactory, (e.g. repair, repainting, (Indicate kind and of labor services needed)
Describe the problem Replacement, etc.) Quantity)
* Roofs/gutters (Administration Bldg.)  No gutters 30 pcs. Gutter Carpentry Work
* Ceilings (Administration Bldg.) 
* Walls (Administration Bldg.)  Need double wallings 12 pcs. Plywood Carpentry Work
* Blackboards 
* Chairs/desks/tables  Damaged Replacement 260 pcs. Carpentry Work
* Water facilities/drainage system  Lacking Construct 500 CHB/30 Bags Cement Masonry Work
* Signages 
* School garden 
* Lighting  Replacement 44 pcs. Flourescent lamp/Bulb Electrical Work
* Windows  Dilapidated Replacement 4 Windows (Steel) Carpentry Work
* Doors  Damaged Replacement 2 Doors Carpentry Work
* Comfort Rooms  Damaged Replacement 5 Doors Carpentry Work
* School Grounds  Not Leveled Leveling Backfill Carpentry Work
* School Canteen/Clinic  No Flooring Repair 30 Bags Cement Masonry Work
*School Fence  Barbed Wires Needed Additional 2 Rolls Carpentry Work
* Others, please specify: Main Gate 

Prepared by: Noted by:

BENTCHELL D. MEJIA January 12 2011 ARLENE L. JACINTO

School Physical Facilities Coordinator Date of Inspection Officer-in-Charge