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Barangay Profile Questionnaire: Year
Barangay Profile Questionnaire: Year
NOTE: The respondent for this questionnaire should be the Chairperson or the Secretary of the Barangay
Name of Respondent:
Position:
Date:
Time Started:
Time Ended:
Name of Enumerator:
Signature of Enumerator:
(1) Province:
(3) Barangay:
Residential 1 Plains
Commercial 2 Upland
Industrial 3 Mountainous
Agricultural 4 Coastal
Mineral 5 Others, specify
Timberland
Special Classes
Total Land Area
(8) Boundaries:
East West
North South
Reference period:
Source of data:
1.
b. Hospitals
2.
1.
c. Maternity Clinic
2.
1.
d. Child Clinic
2.
1.
e. Maternity and Child Clinic
2.
1.
f. Private Medical Clinic
2.
g. Botika ng Barangay 1.
h. Botika ng Bayan 1.
1.
i. Private Drugstores
2.
1.
j. Others, specify ________
2.
(16C) Levels
Educational Facility (15) (16A) (16B) offered (e.g., (17) (18) (19) (20)
Grade 1–4)
1.
a. Day Care Centers
2.
1.
b. Preschool
2.
1.
c. Elementary
2.
1.
d. Secondary
2.
1.
e. Vocational
2.
1.
f. College/University
2.
1.
g. Others, specify ___________
2.
a. Multipurpose Hall
b. Police Station
c. Women's/Crisis Center
1.
d. Bank
2.
e. Post Office
f. Market
b. Corn Mill 1.
2.
c. Feed Mill 1.
2.
(bagsakan/bulungan) 2.
1.
e. Others, specify ________
2.
Input Dealer
1.
a. Fertilizer Dealer
2.
1.
b. Pesticide Dealer
2.
1.
c. Seeds Dealer
2.
1.
d. Feeds Dealer
2.
1.
e. Others, specify __________
2.
Public Transport
(21) What types of public transportation are present in the barangay?
1-Yes 2-No
1 Bus
2 Taxi
3 Van/FX
4 Jeepney
5 Tricycle
6 Pedicab
7 Boat
8 Others, specify
CBMS Form 2 Page 4
Barangay ID __________
Road Network
IF YES IN (22)
(22)
(23) (24) (25)
Are any of the following roads/streets present in What is the length of the road/street? What is the present condition of the Who is maintaining the
the barangay? 1-Yes (GO TO 23) (IN KM) road/street? road/street?
2-No (SEE CODES BELOW) (SEE CODES BELOW)
Water Supply
(28) Is the barangay being served by a water IF YES IN (28)
station/company ?
(29) (30) (31) (32)
1-Yes (GO TO 29) Is the source located
How many Geopoint
2-No What is the name of the water in the barangay?
households are
company? 1 Yes (GO TO 32) Latitude Longitude
being served?
2 No (GO TO 33)
2
(33) Are any of the following water facilities IF YES IN (33)
present in the barangay?
(34) (35) (36) (37) (38)
1-Yes (GO TO 34)
How many Is the facility How many Geopoint
2-No
units/stations? Name functioning? households are being
1 Yes (GO TO 37) Latitude Longitude
(Total) 2 No
served?
1.
a. Deep Well (Level I)
2.
1.
b. Artesian Well (Level I)
2.
1.
c. Shallow Well (Level I)
2.
1.
d. Commercial Water Refill Stations
2.
1.
e. Others, specify
2.
Garbage/Waste Disposal System
1.
a. Open Dump Site
2.
1.
b. Sanitary Landfill
2.
1.
c. Compost Pits
2.
1.
d. Material Recovery Facility (MRF)
2.
1.
e. Others, specify
2.
Electricity Service
(45) What is the source of IF YES IN (45)
electricity in the barangay? (46) (47) (48) (49)
1 - Yes What is the name of the How many Is there an electric Geopoint
(GO TO 46) company or association that households are substation present
2 - No is providing or maintaining being served by the in the barangay?
Latitude Longitude
the electricity supply? source of electricity? 1 Yes (GO TO 49)
2 No (GO TO 51)
1 Electric Company
2 Generator
3 Solar
4 Battery
5 Others, specify
6 None
IF NO IN (45.1)
(50)
What is the distance from the barangay to the nearest electrical station/company?
(in kilometers)
Credit Institutions
(51) Are there credit institutions IF YES IN (51)
operating in the barangay? (52) (53)
Contact person and details
What are the names of the credit institutions?
(Office Address, Telephone, E-mail)
1 Yes (GO TO 52) 1
2 No (GO TO 54) 2
3
Registered Business Firms (based on latest records of the barangay)
(56) Does the barangay have a written disaster risk reduction plan?
1-Yes 2-No
(58) Does the barangay have any of the following disaster/emergency response equipment? 1-Yes 2-No
1 Rubber Boats 5 Flashlights 9 Others, please
specify __________
2 Handheld Radios 6 Medicines/First Aid Supplies
3 Rain Gear (e.g., raincoats and boots) 7 Life Vests
4 Emergency/Service Vehicle 8 Megaphone
VI. Programs, Projects, and Activities (based on the barangay's Annual Investment Program during the past year)
(64) (65) (66) (67)
What programs, projects, and activities Provide a brief description of the How much was allotted for the How many benefited
(PPAs) were implemented in the PPA. PPA? from the PPA during
barangay during the past year? the past year?
(Indicate unit)
a.
b.
c.
d.
e.
f.
g.
h.
VII. Budget, Revenue, and Expenditure
(68) How much was the barangay's budget, revenue, and expenditure during the past 3 years?
Year Budget Revenue Expenditure
1
2
3
VIII. Spotmap
(Attach a duly accomplished spotmap of the barangay before submitting this form to the supervisor.)
(69) When was the spotmap prepared? (MM/DD/YY) _______________________
(70) Does the spotmap contain the locations of the following?: 1- Yes 2-No 3-Not Applicable