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ANNEX 1

Republic of the Philippines


DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT

BARANGAY DEVELOPMENT COUNCIL FUNCTIONALITY ASSESSMENT


SELF - ASSESSMENT FORM
YEAR UNDER REVIEW: CY 2019
(to be filled-out by the Punong Barangay)

Region: III Municipality: DIPACULAO


Province: AURORA Barangay:

Instruction: Put a check (Ö ) on the box that corresponds to the given questions

A. STRUCTURE
1 The BDC is organized/reconsitituted YES NO MEANS OF VERIFICATION
Sangguniang Barangay Resolution
Executive Order
Others: (Please Specify)

2 The BDC is organized/reconstituted within 100 YES NO MEANS OF VERIFICATION


days upon assumption to office Oath of Office of the Punong Barangay
Date of organization/reconstitution: ______________ Sangguniang Barangay Resolution
Executive Order
Others: (Please Specify)

3 The BDC Executive Committee is constituted YES NO MEANS OF VERIFICATION


Sangguniang Barangay Resolution
Executive Order
Others: (Please Specify)

4 The BDC Secretariat is constituted YES NO MEANS OF VERIFICATION


Sangguniang Barangay Resolution
Executive Order
Minutes of the meetings prepared by the Secretary
Others: (Please Specify)

5 BDC sectoral or functional committees are YES NO MEANS OF VERIFICATION


organized Sangguniang Barangay Resolution
Executive Order
Others: (Please Specify)

B. PEOPLE
1 BDC membership is in accordance with YES NO MEANS OF VERIFICATION
prescribed members per Section 107 of RA 7160 Sangguniang Barangay Resolution
Number of members of BDC: _________ Executive Order
Others: (Please Specify)

2 At least 4 or 1/4 members of the BDC are YES NO MEANS OF VERIFICATION


representatives from accredited NGOs Sangguniang Barangay Resolution
Number of representative from Executive Order
accredited NGOs: _______________ Certification of NGO/CSO accreditation
Directory/List of accredited NGOs
Certification/Endorsement to represent the NGO
Others: (Please Specify)

3 At least 6 or 40% of all the BDC members are YES NO MEANS OF VERIFICATION
composed of women pursuant to RA 9710 or the Sangguniang Barangay Resolution
Magna Carta of Women of 2009 Executive Order
Total Number of BDC Members: ________________ Directory/Profile of BDC Members
Number of female BDC Members: ________________ Others: (Please Specify)
Number of male BDC Members: _________________

4 BDC members attended any related trainings YES NO MEANS OF VERIFICATION


or orientation at least once in the previous year Post-activity Report of the Training
Attendance Sheets
Photocopy of Certficate of Participation/Attendance
Photo documentation with date and time stamp
Others: (Please Specify)

C. SYSTEM
1 Conduct of Meetings
a BDC conducts meeting at least twice a year YES NO MEANS OF VERIFICATION
Date of 1st semester meeting: _______________ Minutes of the meetings
Date of 2nd semester meeting: _______________ Attendance sheets
Photo documentation with date and time stamp
Others: (Please Specify)

b BDC Executive Committee conducts meetings YES NO MEANS OF VERIFICATION


at least once every quarter Minutes of the meetings
Date of 1stQ Meeting: __________ Attendance sheets
Date of 2ndQ Meeting: ________ Photo documentation with date and time stamp
Date of 3rdQ Meeting:__________ Agenda of the meeting with BDC related concerns
Date of 4thQ Meeting: __________ Others: (Please Specify)

c Sectoral and Functional Committee Meetings YES NO MEANS OF VERIFICATION


are conducted Minutes of the meetings
Attendance sheets
Photo documentation with date and time stamp
Others: (Please Specify)

2 Fomulation of Plans and Programs


a Barangay Development Plan is formulated YES NO MEANS OF VERIFICATION
Barangay Development Plan (BDP)
Resolution of the BDC approving BDP
Sangguniang Barangay Resolution adopting BDP
Others: (Please Specify)

b Sectoral plans are integrated in the BDP YES NO MEANS OF VERIFICATION


Barangay Development Plan (BDP)
Integrated sectoral plans/BBI plans in the BDP
Resolution of Sectors/BBIs submitting the
plan to BDC
Resolution of BDC adopting the plans

Agenda of BDC meetings reflecting recommendations


from BBIs /sectoral committees members
Others: (Please Specify)

c Local Development Investment Program/Annual YES NO MEANS OF VERIFICATION


Investment Program is formulated LDIP/AIP
Resolution of the BDC approving AIP
Sangguniang Barangay Resolution adopting AIP
Others: (Please Specify)

d Sanggunian Barangay approved BDP is submitted YES NO MEANS OF VERIFICATION


to the City/Municipal level for inclusion in the CDP Resolution of the SB approving the BDP
Transmittal Letter/Resolution of the BDC/SB
the city/municipality
Copy of the BDP with stamp received by
submitting the BDP to the city/municipality
Others: (Please Specify)

3 Planned Projects are Being Implemented


a Percentage of accomplished PPAs vis-à-vis PERCENTAGE MEANS OF VERIFICATION
targeted PPAs in the AIP 100% - 85% LDIP/AIP
Number of target PPAs: ________ 84% - 50% Certification by the PB of accomplishment rate
Number of accomplished PPAs: ________ 49% - 25% per PPAs
Below 25% Accomplishment Report
Project Status Report
Terminal or Post-Activity Reports
Minutes of the BDC meeting discussing project
status/accomplishments
Others: (Please Specify)

b Percentage of utilization of allocated budget PERCENTAGE MEANS OF VERIFICATION


Amount of annual budget: _____________ 100% - 85% Approved appropriations ordinance
Amount of utilized budget: _____________ 84% - 50% Certification of utilization rate by the barangay treasurer
49% - 25% Financial Reports
Below 25% Accomplishment Report
Others:

c Submission of annual accomplishment report YES NO MEANS OF VERIFICATION


Narrative Accomplishment Report
Physical and Financial Reports
State of the Barangay Address presented
during Barangay Assembly Days
Others: (Please Specify)

D. PEOPLE'S PARTICIPATION IN LOCAL DEVELOPMENT


1 Voluntary participation of the residents in the YES NO MEANS OF VERIFICATION
implementation of barangay PPAs Certificate of Appreciation/Recognition
Photo Documentation with date and time stamp
After-activity reports
Attendance sheets
Others: (Please Specify)

2 Conduct of public hearing/barangay assemblies YES NO MEANS OF VERIFICATION


for public consultation Minutes of the meetings
Minutes of the Barangay Assembly Days
Photo Documentation with date and time stamp
Attendance Sheets
Others: (Please Specify)

3 Attendance of CSOs to the regular meetings YES NO MEANS OF VERIFICATION


of the BDC Minutes of the meetings
Attendance sheets
Photo Documentation with date and time stamp
Others: (Please Specify)

4 Conduct of consultation meetings with various YES NO MEANS OF VERIFICATION


sectors Minutes of the meetings
Attendance sheets
Photo Documentation with date and time stamp
Others: (Please Specify)

5 Attendance of BDC members to the meetings/ YES NO MEANS OF VERIFICATION


consultation initiated by higher LGUs (P/C/M) Minutes of the meetings
Attendance sheets
Photo Documentation with date and time stamp
Others: (Please Specify)

E. BDC INNOVATIONS AND GOOD PRACTICES YES NO MEANS OF VERIFICATION


BDC implements processes, mechanisms and programs Program brief
as innovation to provisions of existing policies Resolution/Ordinace implementing innovation
Photo Documentation with date and time stamp
Minutes of the meeting
Recognition and awards
Newspaper clips
Others: (Please Specify)

Prepared by : Date accomplished:

Punong Barangay

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