BE Form 01

Republic of the Philippines

Department of Education
REGION IVA-CALABARZON
SCHOOLS DIVISION OFFICE OF LAGUNA

BRIGADA ESKWELA

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 improvement Manpower Needed
(Check One) Material
Needed (Indicate quantity
If Resources
FACILITIES (e.g. repair, and nature of
Unsatisfactory, Needed (Indicate
Satisfactory Unsatisfactory repainting, labor services
describe the kind and quality)
replacement, needed)
problem etc)
 Roofs/Gutters / replacement
 Ceilings / repair
 Walls / improvement
 Blackboards /
 Chairs/desks/tables /
 Water facilities/ / renovation
Drainage System
 Signages / repair

Address: Provincial Capitol Compound, Santa Cruz, Laguna

Trunkline: (049) 831-9062 | 831-7924 | 566-5013
Page 1 of 2
Email: laguna@deped.gov.ph
Website: www.depedlaguna.com.ph
  School garden /
 Lighting / replacement
 Windows / replacement
 Doors / repair
 Comfort Rooms / improvement
 School Grounds /
 School Canteen/Clinic / repair
 School Fence/ wall /
 Electricity / need new
transformer
 Alternative gate /
 Reference Materials /
 Laboratory equipment /

Prepared by: Noted:

SHAILA ARELLANO AUGUST 19, 2023 ARTHUR ROBERT P. LIMONGCO

School Physical Facilities Coordinator Date of Inspection School Head

Address: Provincial Capitol Compound, Santa Cruz, Laguna

Trunkline: (049) 831-9062 | 831-7924 | 566-5013
Page 2 of 2
Email: laguna@deped.gov.ph
Website: www.depedlaguna.com.ph