BE Form 01

Republic of the Philippines

Department of Education
Region V111
SCHOOLS DIVISION OF Eastern Samar____
(Maybocog Elementary School
(Maydolong Eastern Samar )
School Year : 2019-20120__

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 improvement

Remarks Material Resources Manpower Needed(Indicate
(Check One) Needed
FACILITIES Needed (Indicate kind quantity and nature of
If Unsatisfactory, (e.g. repair, repainting,
Satisfactory Unsatisfactory and quality) labor services needed)
describe the problem replacement, etc) Prepared
 Roofs/Gutters √ Some are damaged Repair, repainting Wood/plywood/ Paint 2-3 persons painters/laborer by:
 Ceilings √ Some are damaged Repair, repainting Wood/plywood/paint 2-3 painters/laborers
 Walls √
 Blackboards √
 Chairs/desks/tables √
 Water facilities/ √
Drainage System
 Signages
 School garden √ Not yet implementing Planning to have this Seedlings( pechay, sitaw, 5-6 persons/weeding/ grass
school year okra ,eggplant) cutting
 Lighting √
 Windows √
Noted:
 Doors √ damaged repair Good lumber 2 labores
 Comfort Rooms √
 School Grounds √
 School Canteen/Clinic
 School Fence/ wall √ Not yet finished Repair, still continuing Hollow blocks/sand and 5-6 person as needed
gravel,cement, steel bars
 Electricity √
 Alternative gate √
 Reference Materials √ Grade Six and Grade 5 Download from Internet Internet Connection Monthly expenses
not yet completed
 Laboratory equipment
_______CLETO L. AMADO___ ___May 6, 2019__ ________LITO B. YAONA____

School Physical Facilities Coordinator Date of Inspection School Head