BE Form 01

Republic of the Philippines

Department of Education
Region XII
SCHOOLS DIVISION OF TACURONG
(Tacurong National High School)
(New Isabela, Tacurong City)
School Year 2019-2020

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
Satisfacto Unsatisfact Unsatisfactory, Needed (Indicate
repainting, labor services
ry ory describe the kind and quality)
replacement, needed)
problem etc)
 Roofs/Gutters / leak R 1 pack Vulcaseal
 Ceilings / w-o-p Repainting 2 gal. white latex
 Walls / w-o-p Repainting 2 gal white latex
 Blackboards /
 Chairs/desks/tables /
 Water facilities/ / No drainage
Drainage System
 Signages
 School garden
 Lighting / dim Rep 5 pcs 18w bulb, 5
pcs receptacle
 Windows /
 Doors /
 Comfort Rooms / damage Rep 1 pc door knob
 School Grounds
 School Canteen/Clinic
 School Fence/ wall
  Electricity
 Alternative gate
 Reference Materials
 Laboratory equipment

Prepared by: Noted:

_____________________ _______ _________________ ____________________________________

School Physical Facilities Coordinator Date of Inspection School Head