BE Form 01

Republic of the Philippines

Department of Education
Region X
SCHOOLS DIVISION OF LANAO DEL NORTE
Dalama Central Elementary School
Dalama, Baroy, Lanao del Norte
School Year 2016-2017

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
(Check One) Material
Needed Needed(Indicate
If Resources
FACILITIES (e.g. repair, quantity and
Satisfacto Unsatisfact Unsatisfactory, Needed (Indicate
repainting, nature of labor
ry ory describe the kind and quality)
replacement, services needed)
problem etc)
 Roofs/Gutters /
 Ceilings / Repair Plywood, nails 2 carpenters
 Walls / Unnecessary Repaint Paint, brush, 4 painters
marks, tainted thinner
 Blackboards /
 Chairs/desks/tables / Some are Repair, repaint, Lumber, nails, 10 carpenters
damaged replace paint, brush
 Water facilities/ / Leaking water Cleaning, repair Pvc pipes, water 3 plumbers
Drainage System pipes faucet
 Signages /
 School garden / Messy, tall Cleaning, weeding Brooms, dust pan 100 volunteer
grasses cleaners
 Lighting /
 Windows / Broken glass Repair, replace Window glass 5 volunteer
window, carpenters
damaged
window, casing
 Doors /
  Comfort Rooms / Untidy with Cleaning, repaint Brooms, dust pan, 5 cleaners
vandals clea
cleaning agent,
paint
 School Grounds / Full of trash, Cleaning, weeding Brooms, dust pan, 100 volunteer
messy with tall grass cutter cleaners
grasses
 School Canteen/Clinic /
 School Fence/ wall / Cracked wall, Repair, repaint Paint, cement, sand 10 painters, 1 mason
tainted
 Electricity /
 Alternative gate / Unfinished Fixing Bamboo, nails 100 volunteer
laborers
 Reference Materials / Lack of materials Repair, replace Cartolina, books, teachers
bond paper, printer
 Laboratory equipment /

Prepared by: Noted:

DOMIXANDER R. OANES ELLEN O. DE GUZMAN

School Physical Facilities Coordinator Date of Inspection School Principal