BE Form 01

Republic of the Philippines

Department of Education
Region XIII-CARAGA
SCHOOLS DIVISION OF BISLIG CITY
NEW JERUSALEM ELEMENTARY SCHOOL
Purok 20, San Jose, Bislig City, Surigao del Sur
School Year 2023-2024

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 Manpower
(Check One) improvement Needed Material Resources
Needed(Indicate
FACILITIES If Unsatisfactory, (e.g. repair, Needed (Indicate kind
quantity and nature of
Satisfactory Unsatisfactory describe the repainting, and quality)
labor services needed)
problem replacement, etc)
 Roofs/Gutters ✓ Leaking roofs, gutter Repair Vulca seal 10
 Ceilings ✓ Unpainted repainting Paint, paint brush, 10
paint thinner
 Walls ✓ Faded paint Repainting Paint, paint brush, 10
paint thinner
 Blackboards ✓ Minimal damaged Repainting, repair Paint, paint brush, 10
paint thinner
 Chairs/desks/tables ✓ Unserviceable Repair Paint, paint brush, 10
paint thinner, plywood,
nails
 Water facilities/ ✓ Unserviceable Repair 4
Drainage System
 Signages ✓ Unserviceable Repainting Paint, paint brush, 4
paint thinner
 School garden ✓ Tall grasses/plants Trimming of Grass cutter 20
plants/grasses
 Lighting ✓ Misalignment of Repair Wires, electrical tape 6
wires and others
 Windows ✓ Window railings are Replacement, repair Window railings 10
damaged Window pane
 Doors ✓ Doorknobs are Replacement, repair Doorknobs 6
damaged
  Comfort Rooms ✓ Dirty Clean Soap, brush 6
 School Grounds ✓ Overgrown grass Trimming of Cleaning tools 20
plants/grasses
 School Canteen/Clinic ✓ Unserviceable Repair Plywood, nails, paint, 6
paint brush, paint
thinner
 School Fence/ wall ✓ Unserviceable Repair Paint paint brush, post 20
 Electricity ✓ Misalignment of Repair Wires, electrical tape 6
wires and others
 Alternative gate ✓ Unserviceable Repair, repainting Wood, cyclone wire 6
 Reference Materials ✓ Not sorted sort Paint, paint brush, 8
paint thinner
 Laboratory equipment ✓ Not sorted sort Paint, paint brush, 10
paint thinner

Prepared by: Noted:

JUDY AN Q. TORREJOS August 11, 2022 RAMEL R. VILLANUEVA, HT-II

School Physical Facilities Coordinator Date of Inspection School Head