03 - Annex C - Form 6 CM - National Validation

Department of the Interior and Local Government
Assessment for the Seal of Good Local Governance

CY 2023 / Document Code: Final as of Sept. 14, 2023
Seal of Good Local Governance – NATIONAL VALIDATION
Form 6 CM - Findings, Observations and Final Recommendation
City/Municipality : Income Class :

Province of : Region :
LGU Type :
INSTRUCTIONS: PLEASE READ BEFORE PROCEEDING TO THE ITEMS.
For the Validators:
Based on your document review/interview/onsite inspection, please provide data on the below-listed focus criteria. (1) Tick
the box of the applicable LGU condition and supply required information indicated by the blank fields. PLEASE MAKE SURE
THAT ALL ANSWER FIELDS ARE DULY FILLED-OUT and ALL SIGNIFICANT OBSERVATIONS CAPTURED, as this validation report shall
serve as the primary reference of the Council of Good Local Governance during the final deliberation. (2) Refer to the List of
Identified Issues provided by the BLGS for additional indicators that require further verification. Validators are strongly
encouraged to verify other SGLG criteria besides those included in the Focus Criteria and BLGS List of Issues. (3) In case of a
correction/erasure, the Validator must affix signature parallel to corrected portion. (4) Affix signature on all pages. (5) This
accomplished Form, along with the Annexes and all MOVs, must be submitted on or before October 9, 2023.
REMINDER: PLEASE DO NOT DISTRIBUTE THIS FORM TO LGUs. THANK YOU!
Part I. Focus Criteria Determine accuracy and completeness of the documentary evidence of the items listed below.
Interviewing the concerned LGU Department Head(s) and conducting on-site inspection may be necessary to
substantiate presented documents. Please attach MOVs. Note that shaded rows mean that on-site inspection is the
prescribed mode of validation.
FINANCIAL ADMINISTRATION AND SUSTAINABILITY

1. FDP Compliance in Conspicuous Place within LG Building (C|M Hall)
FDP Board: Yes No

1.1. Is posted in a conspicuous place within provincial capitol ☐ ☐
or city/municipal hall premises
1.2. Is made of sturdy material ☐ ☐
1.3. Contains complete and readable documents for CY 2023 ☐ ☐

3rd Quarter posting period
NOTE TO VALIDATOR: Re-check list of issues. For LGUs with pending FDP data verification, Validator is required to
check the LGU’s status of compliance with FDPP posting.
Status of FDP Portal Posting Yes No

All required documents are uploaded ☐ ☐
If not yet uploaded, specify below the issues encountered:
2. Utilization of 20% Component of NTA/IRA [Reference document is SRE from the Local Treasurer for
the CY 2023 NTA from DBM]
Total Utilized Funds:

20% of NTA for CY 2022:
In % [To compute: (TUF/20% of NTA)*100: %
NOTE TO VALIDATOR: For LGUs with pending BLGF appeal for NTA/IRA, Validator is required to fill-out Form 6.2: Fund
utilization.
1
For DILG SGLG Validator’s use only.
Not to be distributed to LGUs.
3. LGSF Utilization of beneficiary-LGUs in 2021 [Reference document is Certified Form 2A of the
Accounting Office and Certified Form 2E.1 of the DILG Field Office]
Yes No N/A
CY 2021 LGSF grants fully utilized ☐ ☐ ☐
by December 31, 2022
All unexpended balances ☐ ☐ ☐
reverted back to National
Treasury
DISASTER PREPAREDNESS
4. Evacuation center
4.1 Inspecting the EC
Name of identified evacuation
center (Indicated in Form 3.2 DP):
Located in barangay:
Features present in identified EC (tick all available facilities)

Minimum Required Facilities and Systems
☐ Kitchen area ☐ Waste disposal system
☐ Water supply ☐ System for registration
☐ Communication means ☐ Info guide written in local dialect
☐ Toilet and bath facilities; ☐ Info guide showing facilities and services
hand-washing facilities ☐ Posted map
Other functional requirements
☐ Health service station ☐ Storage area
☐ Power supply with back-up ☐ Laundry area
system ☐ Provision for management of livestock and
☐ Administrative Office domestic animals
Socially-inclusive facilities
☐ Breastfeeding station ☐ Child-friendly learning space
☐ Couples’ room ☐ Ramps or other assistive device for PWDs and
elderly
Has Evacuation Center Management Plan or other camp management-related

protocol/system integrating the minimum health protocols?
Yes No
In LDRRM Office ☐ ☐
In Barangay Hall/Evacuation Center inspected ☐ ☐
4.2 EC Management Team/Committee
Yes No
Has an organized EC Management Team/Committee ☐ ☐
Organized thru EO No..:
Date approved:
5. Early Warning System [Verifying the EWS thru onsite inspection and interview]
Tick all that applies:

☐ At least one marker is present in high-risk ☐ Information on EWS is present in conspicuous
areas (for top 1 hazard) places
2
☐ At least one marker is present in high-risk ☐ With SOP on end-to-end use of EWS and
areas (for top 2 hazard) feedbacking mechanisms communicated to
☐ Audible and wide-ranging warning and residents in high-risk areas
alarm system
☐ Automated rain gauge/locally-innovated
technology
6. LDRRM Operations Center
6.1 Based on the Onsite Visit to OpCen, kindly tick all that applies.
Permanent (functions 24/7 daily) ☐

Temporary (functions 24/7 during disasters) ☐
Has Standard Operating Procedures (SOP)/Manual for the ☐
coordination and monitoring of actions in the event of disasters
Has no LDRRM Operations Center ☐
6.2 Based on the interview with LDRRMO, please provide adequate information. [Refer to Form 6.1
for CM]
Strongly Disagree Agree Strongly

Disagree Agree
The LDRRMO/C representative is knowledgeable ☐ ☐ ☐ ☐
on how the OpCen operates.
The LDRRMO/C representative is knowledgeable ☐ ☐ ☐ ☐
on the interplay of OpCen’s functions with other
DRRM systems in the LGU.
7. Approved CBDRRM Plan

[Based on LDRRMO’s Certification Form CM 2F, randomly select one barangay listed with approved CBDRRM Plan
and conduct an interview with the Punong Barangay concerned]
(Refer to Form No. 6.1 for CM]

Disagree Agree
The PB was able to clearly explain how the Plan ☐ ☐ ☐ ☐
was formulated
The PB is fully aware of the contents of the Plan ☐ ☐ ☐ ☐
The CBDRRM Plan guides the barangay in DRRM ☐ ☐ ☐ ☐
budgeting.
SOCIAL PROTECTION and SENSITIVITY
8. VAWC desk [Randomly select one barangay that shall be inspected]
Located in barangay:
Yes No
Has a VAWC desk within the barangay hall ☐ ☐
There is a VAW desk person trained in gender-sensitive ☐ ☐
handling of cases
All gender-based violence handled by the barangay are ☐ ☐
being recorded
3
9. LSWDO
9.1 Magna Carta grant benefits
Benefits granted to all ☐ Hazard allowance

public social workers ☐ Transportation allowance
(tick all that applies) ☐ Housing and living quarters allowance
☐ Longevity pay
☐ Clothing allowance
Proof of granting ☐ Yes
Magna Carta benefits ☐ No
was provided
9.2 CBMS
Database being used as a registry for beneficiaries of
social development programs:
CBMS ☐
Data coverage: ________
Other database/tracking system ☐
Please specify: ________
Efforts to implement CBMS
Ongoing CBMS data gathering ☐
Proposed PAPs to implement CBMS ☐
Others, Please specify: ________ ☐
10. Population Office/Officer [Onsite inspection of the Population Office and interview with the
appointed/designated Population Officer]
10.1. Interview with Population Officer

Name of Population Officer:
Position Title:
Salary-Grade:
Date of appointment:
Nature of appointment: ☐ Permanent
☐ Temporary
☐ Designated

Disagree Agree
The PO is fully aware of his/her roles ☐ ☐ ☐ ☐
The PO was able to share his/her ☐ ☐ ☐ ☐
accomplishments for CY 2022
The PO was able to identify the needs of ☐ ☐ ☐ ☐
his/her office
10.2. Onsite inspection of Population Office
Yes No
There is a Local Population Office ☐ ☐
Location:
Date established:
4
11. Teen Center (for cities and 1st to 3rd class municipalities)
Yes No
Teen Center is community-based ☐ ☐
Teen Center is school-based ☐ ☐
Name of Teen Center:

Date established:
HEALTH COMPLIANCE AND RESPONSIVENESS
12. LIPH
12.1 LIPH for 2022
LIPH: Yes No
a) Has a complete and validated LIPH for 2022 ☐ ☐
b) LIPH is concurred by the CHD Director/MOH-BARMM ☐ ☐
Minister, OR endorsed to PHO
12.2 Local Health Officer [Refer to Form 6.1 for CM]

Disagree Agree
The LHO is fully aware of the health issues in ☐ ☐ ☐ ☐
the LGU
The LHO was able to discuss the ☐ ☐ ☐ ☐
interventions needed to address the health
issues
The LHO is knowledgeable of the 2022 AOP ☐ ☐ ☐ ☐
SUSTAINABLE EDUCATION
13. LGU-initiated planned reforms aligned with identified local priority education reform areas
Interview with the DepEd Representative (Reference document is Certified Form 2D) [Refer to Form
6.1 for CM]

Disagree Agree
The DepEd representative is aware of the ☐ ☐ ☐ ☐
LGU’s PAPs aligned with the identified
priority education reform areas of DepEd
The DepEd representative was able to share ☐ ☐ ☐ ☐
the usual agenda items during LSB meetings
BUSINESS-FRIENDLINESS AND COMPETITIVENESS

14. Citizen’s Charter
Yes No
a) Visible within the BPLO ☐ ☐
b) Reflects current fees ☐ ☐
c) Reflects the processing time for new business permit ☐ ☐
applications
d) Reflects the processing time for business permit renewals ☐ ☐
e) Year last updated:
5
15. BOSS/eBOSS
eBOSS ☐ Fully automated

☐ Transitioning to fully automated
☐ None
No. of steps based on the
simulation with the BPLO
(Validator should act as if
he/she is registering a new
business)
Mode of operation per ☐ All-year round
MOA/any document ☐ Seasonal
establishing BOSS ☐ None
SAFETY, PEACE AND ORDER

16. Support to Local PNP (interview with Local PNP Chief) [Refer to Form 6.1 for CM]

Disagree Agree
The Local PNP Chief was able to share the ☐ ☐ ☐ ☐
specific assistance extended by the LGU to
PNP
The Local PNP Chief is fully aware of the LGU ☐ ☐ ☐ ☐
actions to address the crime volume in the
locality
ENVIRONMENTAL MANAGEMENT
17. Access to sanitary landfill (SLF) and segregated collection of wastes per interview with ENRO:
☐ LGU-owned sanitary landfill

☐ Access to sanitary landfill through partnership with: ________
☐ Ongoing construction of an LGU-owned sanitary landfill; Date started: ________
☐ With programs for access to authorized SLF, budgeted under the LGU’s Approved 10-Year
SWM Plan
☐ Operates a controlled/open dumpsite, LGU/private entity-owned, used as waste disposal
facility
☐ Operational Temporary Residual Containment Area. Year operation started: ________
☐ Is covered with a roof, and/or is shielded from the rain
☐ Area is concreted or elevated
☐ No signs of leakages or liquid drippings from the waste pile
Additional Information (For example: re-opening of dumpsite per media reports and DENR
issuances; use of other technology/facility/ initiatives of the LGU that minimize residual wastes):
________
18. Status of the Inspected Materials Recovery Facility
Managed by:
• Province ☐
• City/Municipality ☐
• Barangay ☐
• Private Entity ☐
6
With the following facilities and systems (if available):
• Recording system of wastes ☐
• Sorting area (with separate storage for ☐
different types of wastes/materials)
• Composting area/technology (e.g., ☐
vermicomposting)
• Recycling facility/technology (e.g., plastic ☐
shredder, bricks making)
• Transfer area/station ☐
19. Interview with PB on Solid Waste Management (Refer to Form 6.1)

Yes No
The interviewed barangay is covered by the ☐ ☐
segregated collection of wastes.
The interviewed barangay has access to an MRF. ☐ ☐
Note: For Item Nos. 20 to 22, the Validator shall choose one (1) question that applies to the LGU based
on Form 3.8.
20. Provide at least two of the LGU’s initiatives contributing to biodiversity conservation and
enhancement focusing on inland wetlands and water bodies (interview with ENRO and if feasible,
onsite inspection)
21. Provide at least two of the LGU’s initiatives on water quality management (interview with ENRO and
if feasible, onsite inspection)
22. Provide at least two of the LGU’s initiatives on park and green space (interview with ENRO and if
feasible, onsite inspection)
TOURISM, HERITAGE DEVELOPMENT, CULTURE AND THE ARTS

23. Tourist Information and Assistance Center/Desk (if the LGU met the requirement per regional
assessment)
Yes No
There is an actual tourist information and ☐ ☐
assistance center/desk
The tourist information and information ☐ ☐
center/desk has promotional materials and/or
references
24. Local Tourism Development Plan (interview with Tourism Officer)
[Refer to Form No. 6.1 for CM]

Disagree Agree
The TO is aware of the plans and ongoing initiatives ☐ ☐ ☐ ☐
of the LGU in the formulation of its LTDP
7
The TO is knowledgeable of the LGU’s efforts to ☐ ☐ ☐ ☐
integrate the DOT’s campaign in its tourism plan
and strategies
The TO is fully aware of the status of the LGU’s ☐ ☐ ☐ ☐
cultural property inventory
YOUTH DEVELOPMENT
25. LYDC
Interview with one LYDC member from the SK [Refer to Form 6.1 for CM]

Disagree Agree
The LYDC member was able to identify the support ☐ ☐ ☐ ☐
provided by LGU to youth in terms of policies
provided by LGU to youth in terms of facilities
provided by LGU to youth in terms of programs
26. Support for youth development
Presence of a Youth Development Facility

Yes No
There is a facility/designated space for youth- ☐ ☐
related programs/activities
Name of facility/designated space: ___________
Location: ___________
Part II. Other Observations

Indicate here findings referring to the BLGS List of Issues. This may also include the Validator’s
personal observations/actual findings on LGU compliance with other SGLG criteria (e.g.,
COA recommendations, IPMR). Use additional sheets if necessary.
Indicator MOV and Significant Observation
1.
2.
3.
8
Indicator MOV and Significant Observation
4.
5.
9
Part III. Photo Documentation
Document LGU compliance by taking photographs appropriate for the boxes provided for
select indicators. Photos should represent the subject matter with clarity and without any
form of distortion. Use of a high-resolution camera is recommended. Write down your
observations or findings (e.g., address/location, status) on the space provided; short bullet-
type statements will do.
FINANCIAL ADMINISTRATION AND

SUSTAINABILITY: FDP Board
DISASTER PREPAREDNESS: Evacuation

Center
DISASTER PREPAREDNESS: Early Warning

System for Top 1 Hazard (specify the hazard)
10
DISASTER PREPAREDNESS: Early Warning

System for Top 2 Hazard (specify the hazard)
DISASTER PREPAREDNESS: Operations

Center
SOCIAL PROTECTION: VAWC desk
SOCIAL PROTECTION: Population Office
11
SOCIAL PROTECTION: Teen Center (for cities
and 1st- 3rd class municipalities only)
BUSINESS-FRIENDLINESS AND
COMPETITIVENESS: Citizen’s Charter
ENVIRONMENTAL MANAGEMENT: Materials

Recovery Facility
THDCA: TOURIST INFORMATION AND

ASSISTANCE CENTER/DESK
12
YOUTH DEVELOPMENT: Youth Development

Facility
Other Facility/Service (if any, please specify)
13
Part IV. Final Recommendation
☐ Recommended as Passer ☐ Not recommended as Passer
Provide brief explanation of final recommendation. (Validator is required to fill out this portion).
CERTIFICATION
1. I/we have reviewed SGLG Forms of the above-named LGU i.e., Form 3 (RAT Forms of all assessment
areas), all certifications of LGU Department Heads, and other additional documents provided.
2. I/we certify that the information contained in this validation report are true and correct, and are
correspondingly supported by documents and other means of verifications as reviewed by the
undersigned.
Validator #1
Signature over Printed Name and Designation DILG-Place of Assignment
Validator #2
Signature over Printed Name and Designation DILG-Place of Assignment
14

03 - Annex C - Form 6 CM - National Validation

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03 - Annex C - Form 6 CM - National Validation

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Department of the Interior and Local Government

Assessment for the Seal of Good Local Governance

City/Municipality : Income Class :

REMINDER: PLEASE DO NOT DISTRIBUTE THIS FORM TO LGUs. THANK YOU!

FINANCIAL ADMINISTRATION AND SUSTAINABILITY

FDP Board: Yes No

1.3. Contains complete and readable documents for CY 2023 ☐ ☐

Status of FDP Portal Posting Yes No

Total Utilized Funds:

Features present in identified EC (tick all available facilities)

Has Evacuation Center Management Plan or other camp management-related

4.2 EC Management Team/Committee

Tick all that applies:

Permanent (functions 24/7 daily) ☐

Strongly Disagree Agree Strongly

7. Approved CBDRRM Plan

(Refer to Form No. 6.1 for CM]

Benefits granted to all ☐ Hazard allowance

10.1. Interview with Population Officer

Strongly Disagree Agree Strongly

10.2. Onsite inspection of Population Office

Name of Teen Center:

Strongly Disagree Agree Strongly

Strongly Disagree Agree Strongly

BUSINESS-FRIENDLINESS AND COMPETITIVENESS

eBOSS ☐ Fully automated

SAFETY, PEACE AND ORDER

Strongly Disagree Agree Strongly

☐ LGU-owned sanitary landfill

18. Status of the Inspected Materials Recovery Facility

19. Interview with PB on Solid Waste Management (Refer to Form 6.1)

TOURISM, HERITAGE DEVELOPMENT, CULTURE AND THE ARTS

[Refer to Form No. 6.1 for CM]

Strongly Disagree Agree Strongly

26. Support for youth development

Presence of a Youth Development Facility

Part II. Other Observations

Indicator MOV and Significant Observation

Indicator MOV and Significant Observation

FINANCIAL ADMINISTRATION AND

DISASTER PREPAREDNESS: Evacuation

DISASTER PREPAREDNESS: Early Warning

DISASTER PREPAREDNESS: Early Warning

DISASTER PREPAREDNESS: Operations

SOCIAL PROTECTION: VAWC desk

SOCIAL PROTECTION: Population Office

ENVIRONMENTAL MANAGEMENT: Materials

THDCA: TOURIST INFORMATION AND

YOUTH DEVELOPMENT: Youth Development

Other Facility/Service (if any, please specify)

Other Facility/Service (if any, please specify)

Other Facility/Service (if any, please specify)

Part IV. Final Recommendation

☐ Recommended as Passer ☐ Not recommended as Passer

Signature over Printed Name and Designation DILG-Place of Assignment

Signature over Printed Name and Designation DILG-Place of Assignment

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