2023 SGLGB-Form 2-Data Capture Form-DCF

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2023 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY

Year Under Review: CY 2022 SGLGB Form No. 2


Data Capture Form

BARANGAY:

CITY/MUNICIPALITY:

PROVINCE:

REGION:

Core Governance Area No. 1:


Financial Administration and Sustainability

1.1 Compliance with the Barangay Full Disclosure Policy (BFDP)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

1.1.1 Posted the following CY 2022 financial documents in the BFDP BFDP Monitoring Form A of the DILG Advisory dated
board, pursuant to DILG MC No. 2014-81 and DILG MC No. 2022- March 25, 2022
027:

Photo Documentation of the BFDP board displaying the


Instruction: Put a check ✓ on the box that following documents:
YES NO corresponds to your assessment.

ANNUAL REPORT
ANNUAL REPORT a. Barangay Financial Report

a. Barangay Financial Report; b. Barangay Budget;

b. Barangay Budget; c. Summary of Income and Expenditures;

c. Summary of Income and Expenditures; d. 20% Component of the NTA Utilization;

d. 20% Component of the NTA Utilization; e. Annual Procurement Plan or Procurement List;

e. Annual Procurement Plan or Procurement List;


QUARTERLY REPORT

QUARTERLY REPORT f. List of Notices of Award (4th Quarter of CY 2022);

f. List of Notices of Award (4th Quarter of CY


and
2022); and

MONTHLY REPORT MONTHLY REPORT

g. Itemized Monthly Collections and g. Itemized Monthly Collections and Disbursements


Disbursements (Oct-Dec, CY 2022). (Oct-Dec, CY 2022).

October 2022

November 2022

December 2022

1.1.2 Accomplished prescribed BFR form with the "stamp receipt" of the Barangay Financial Report on Statement of Receipt and
Office of the C/M Accountant. Expenditure (Annex 7)

YES NO Instruction: Put a check ✓ on the box that


corresponds to your assessment.
PROCESSING OF RESULTS REMARKS
YES NO
Met all the minimum requirements on
Compliance with the Barangay Full Disclosure
Policy (BFDP)?

1.2. Innovations on revenue generation or exercise of corporate powers


MINIMUM REQUIREMENT MEANS OF VERIFICATION

1.2.1 Increase in local resources in 2022.


Barangay Budget Preparation Form 2 of 2021 and 2022

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.
To compute for the percentage increase in local resources:
Total amount obtained from local resources in CY 2022 - Total
amount obtained from local resources in CY 2021 = n

(n / Total amount obtained from local resources in 2021) x 100 =


percentage increase in local resources

Total amount obtained from local resources in:


CY 2021:
CY 2022:

Percentage Increase:

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on innovations
on revenue generation or exercise of corporate
powers?

1.3. Approval of the Barangay Budget on the Specified Timeframe


MINIMUM REQUIREMENT MEANS OF VERIFICATION

1.3.1 Presence of a Barangay Appropriation Ordinance approved on or Approved Barangay Appropriation Ordinance
before December 31, 2021.

YES NO Instruction: Put a check ✓ on the box that Date of Approval:


corresponds to your assessment.

Approved on or before December 31, 2021

Approved within January 1, 2022 - March 31,


2022 (Consideration)

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on Approval of
the Barangay Budget on the Specified
Timeframe?

1.4. Allocation for Statutory Programs and Projects as Mandated by Laws and/or Other Issuances
MINIMUM REQUIREMENT MEANS OF VERIFICATION

Approved Barangay Appropriation Ordinance


1.4.1 With allocated funds for the following statutory programs and
projects:

Instruction: Put a check ✓ on the box that


YES NO corresponds to your assessment.
a. Senior Citizens (per R.A. 9994 and DBM Local
Budget Memorandum No. 82);

b. Persons with Disability (per R.A. 7277 and


DBM Local Budget Memorandum No. 82);

c. At least 20% of the NTA is allocated for


development programs (DILG-DBM JMC No.
2017-01);

d. At least 1% of the NTA for the Barangay


Council for the Protection of Children (BCPC) per
RA 9344;

e. At least 5% from total budget allocated for


GAD plans and programs per RA 9710.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on Allocation for
Statutory Programs and Projects as Mandated
by Laws and/or Other Issuances?

1.5. Posting of the Barangay Citizens’ Charter (CitCha)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

1.5.1 Barangay Citizens’ Charter posted at a conspicuous place. (e.g., Photo documentation of the Barangay CitCha (name of
barangay hall, market, transport terminal or multi-purpose hall) the barangay should be visible)

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on the posting
of Barangay CitCha?

1.6. Release of the Sangguniang Kabataan (SK) Funds by the Barangay


MINIMUM REQUIREMENT MEANS OF VERIFICATION

1.6.1
Compliance with Section 20 of the SK Reform Act of 2015 and Item
3.2 of DBM-DILG-NYC JMC No. 1, s. 2019 dated January 23, 2019:

Instruction: Put a check ✓ on the box that


YES NO corresponds to your assessment.
MOVs for 1.6.1.1:

a) Copy of the written agreement; and


1.6.1.1. If the barangay is with Barangay-SK
Agreement for the annual or semestral or
quarterly release/deposit:
b) Proof of deposit reflecting the Account No./ Name of
Barangay SK (1 deposit slip for annual, 2 deposit slips
for semestral, 4 deposit slips for quarterly

MOV for 1.6.1.2:

a) 12 monthly deposit slips reflecting the Account No./


1.6.1.2. If the barangay is without an agreement Name of Barangay SK
with the SK, but with current account:
MOV for 1.6.1.3:

1.6.1.3. If the barangay is without SK Officials or


with SK Officials but no quorum and/or No SK
Bank Account:
a) Proof of transfer of the 10% SK fund to the trust fund
of the barangay such as deposit slip or Official Receipt
or corresponding legal form/document issued by the
city/municipal treasurer if the barangay opted that the
corresponding SK fund be kept as trust fund in the
custody of the C/M treasurer.

MOV for 1.6.2:

1.6.2 Presence of Approved Annual Barangay Youth Investment Program Certification from the C/MLGOO on current number of
(ABYIP) for CY 2022 SK officials

(Applicable only for Barangays with 5 and above SK


officials; NA if 4 and below SK Officials) Please supply information
Total Number of SK Officials:
YES NO NA
Instruction: Put a check ✓ on the box that
corresponds to your assessment. If with 5 and above SK officials:

Approved Annual Barangay Youth Investment Program


(ABYIP) for 2022

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on Release of
the Sangguniang Kabataan (SK) Funds by the
Barangay?

1.7. Conduct of Barangay Assembly for CY 2022 (2nd Semester)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

1.7.1 Conducted the 2nd semester Barangay Assembly for CY 2022 Post Activity Report on the conduct of the 2nd
( via any modality, i.e., online, face-to-face, hybrid).
semester barangay assembly duly signed/approved by
the Punong Barangay (Annex D of DILG MC No. 2022-
131)
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on Conduct of
Barangay Assembly for CY 2022 (2nd Semester)?

End of Core Governance Area No. 1: Financial Administration and Sustainability


2023 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Year Under Review: CY 2022 SGLGB Form No. 2
Data Capture Form

BARANGAY:

CITY/MUNICIPALITY:

PROVINCE:

REGION:

Core Governance Area No. 2:


Disaster Preparedness

2.1. Functionality of the Barangay Disaster Risk Reduction and Management Committee (BDRRMC)
MINIMUM REQUIREMENT MEANS OF VERIFICATION
Established BDRRMC with its composition compliant to the
2.1.1 Provisions of NDRRMC, DILG, DBM, and CSC JMC No. 2014-01 Executive Order or similar issuance creating the
BDRRMC compliant to composition requirements
covering CY 2022.
YES NO
Instruction: Put a check ✓ on the box that Date of EO or similar issuance:
corresponds to your assessment.

Approved Barangay Disaster Risk Reduction and Management Approved BDRRM Plan CY 2022
2.1.2 (BDRRM) Plan covering CY 2022

Coverage Year:
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

Allocation of 5% of the Estimated Revenue from Regular Sources Enacted Appropriation Ordinance
2.1.3 as BDRRM Fund

YES NO
Instruction: Put a check ✓ on the box that To compute % allocation for BDRRMF:
corresponds to your assessment. (BDRRMF Allocated / Estimated Total Revenue from Regular Sources)
x 100

Please supply the following information:

Estimated revenue
from regular sources:
Amount of BDRRMF
for FY 2022:
Percent-allocation for
BDRRMF:

2.1.4 Physical/Financial Accomplishment:


Accomplishment Report
Instruction: Put a check ✓ on the box that
YES NO corresponds to your assessment. To compute Physical Accomplishment Rate:

a. At least 50% accomplishment of the physical (Total number of activities/projects accomplished / Total number of
targets in the BDRRM Plan activities/projects reflected in the BDRRM plan) x 100

Please supply the following information:


% of programs, project, and activities are completed
OR

Annual Report on the utilization of the LDRRMF

To compute % utilization:
b. At least 50% fund utilization of the 70% (Total Amount Utilized)/(Total Amount Allocated) x 100
component of CY 2022 BDRRMF - Preparedness
component as of December 31, 2022.
b. At least 50% fund utilization of the 70%
component of CY 2022 BDRRMF - Preparedness
component as of December 31, 2022.
Please supply the following information:
Amount utilized (as of Dec. 31,
2022):
Amount allocated for LDRRMF CY
2022 (Preparednessfor
Percent-utilization component):
BDRRMF:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Functionality of the Barangay Disaster Risk
Reduction and Management Committee
(BDRRMC)?

2.2. Extent of Risk Assessment and Early Warning System (EWS)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

2.2.1 Conducted an activity in relation to Risk Assessment in the Post-Activity Report of activities such as Climate and
barangay not earlier than 2019 Disaster Risk Assessment, Participatory Disaster Risk
Assessment, BDRRM Planning, etc.
YES NO
Instruction: Put a check ✓ on the box that Please supply the following information:
corresponds to your assessment.
Activity Title:
Date of Activity:

2.2.2 A certified Barangay Risk/Hazard Map Photo documentation of the certified Barangay
Risk/Hazard Map
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

2.2.3 An established Early Warning System for at least the top two (2) Photo documentation of EWS for the top two (2)
hazards present in the barangay hazards in the barangay

YES NO TOP 1 Hazard:


Instruction: Put a check ✓ on the box that
corresponds to your assessment.
TOP 2 Hazard:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the Extent
of Risk Assessment and Early Warning System
(EWS)?

2.3. Extent of Preparedness For Effective Response And Recovery


MINIMUM REQUIREMENT MEANS OF VERIFICATION

2.3.1 A barangay must have a permanent or alternate evacuation Photo documentation of the permanent/alternate
center evacuation center

YES NO Please supply the following information:


Instruction: Put a check ✓ on the box that
corresponds to your assessment.

Permanent evacuation center Location:


OR
Alternate evacuation center Location:

2.3.2
A barangay must have the following disaster supplies/equipment: Photo Documentation of disaster supplies equipment

Instruction: Put a check ✓ on the box that


corresponds to your assessment.
Instruction: Put a check ✓ on the box that
YES NO corresponds to your assessment.

a. Communication equipment (i.e., 2 way


radio,mobile phone)

b. Rescue vehicle/Barangay patrol

c. Generator set/alternative sources of energy

d. First aid kit

e. Flashlight with batteries

f. Personal Protective Equipment (PPE)

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the Extent
of Preparedness For Effective Response And
Recovery?

End of Core Governance Area No. 2: Disaster Preparedness


2023 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Year Under Review: CY 2022 SGLGB Form No. 2
Data Capture Form

BARANGAY:

CITY/MUNICIPALITY:

PROVINCE:

REGION:

Core Governance Area No. 3:


Safety, Peace and Order

3.1. Functionality of the Barangay Anti-Drug Abuse Council (BADAC)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

3.1.1 Organized BADAC with its composition and appropriate Executive Order or similar issuance creating the BADAC
committees (Committees on Operations and on Advocacy) with its composition and appropriate committees
compliant to DILG-DDB JMC No. 2018-01 (Committees on Operations and on Advocacy)

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.1.2 Established Rehabilitation Referral Desk with Designated Duty EO or similar issuance establishing the Rehabilitation
Officer Referral Desk

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.1.3 Approved Barangay Appropriation Ordinance


Allocation of substantial amount for anti-illegal drugs initiative

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.1.4 Approved BADAC Plan of Action covering 2022 as year under Approved BADAC Plan of Action
review

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.1.5 Submission of Consolidated Information Report (CIR) to Transmittal of CIR (stamp received) to CADAC/MADAC
CADAC/MADAC and Local PNP Unit. and Local PNP Unit

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.1.6 Physical/Financial Accomplishment:


Annual BADAC Accomplishment and Fund Utilization
Report submitted not later than the 20th day of January
(stamp received) to the CADAC/MADAC

Instruction: Put a check ✓ on the box that


YES NO corresponds to your assessment.
To compute Physical Accomplishment Rate:
(Total number of activities/projects accomplished / Total number of
a. At least 50% accomplishment of the physical activities/projects reflected in the BADAC Plan of Action) x 100
targets in the BADAC Plan of Action

Please supply the following information:


% of programs, project, and activities are completed
OR
b. At least 50% fund utilization rate of the PAPs To compute % utilization:
in the BADAC Plan of Action (Total Amount Utilized)/(Total Amount Allocated) x 100

Please supply the following information:


Amount utilized (as of Dec. 31,
2022):
Amount allocated for BADAC
PAPs:
Percent-utilization:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Functionality of the Barangay Anti-Drug Abuse
Council (BADAC)?

3.2. Functionality of the Barangay Peace and Order Committee (BPOC)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

3.2.1 Organized BPOC through an Executive Order or Sangguniang


Executive Order or similar issuance indicating correct
Barangay Resolution, with its composition compliant to the membership in accordance to the EO 366 s. of 1996
provisions of EO 366 s. of 1996

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.2.2 Approved Barangay Peace and Order and Public Safety (BPOPS) Approved BPOPS Plan
Plan in accordance to DILG MC 2017-142 covering 2022 as year
under review

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.2.3 Physical/Financial Accomplishment:


Accomplishment Report (in any format) submitted to
the C/M POC on the prescribed schedules (stamp
received)
Instruction: Put a check ✓ on the box that
YES NO corresponds to your assessment.

a. At least 50% accomplishment of the physical To compute Physical Accomplishment Rate:


targets in the BPOPS Plan (Total number of activities/projects accomplished / Total number of
activities/projects reflected in the BPOPS Plan) x 100

Please supply the following information:


% of programs, project, and activities are completed
OR
b. At least 50% fund utilization rate of the PAPs To compute % utilization:
in the BPOPs Plan (Total Amount Utilized)/(Total Amount Allocated) x 100

Please supply the following information:


Amount utilized
(as of Dec. 31, 2022):
Amount allocated for Peace and
Order PAPs:
Percent-utilization:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Functionality of the Barangay Peace and Order
Committee (BPOC)?

3.3. Functionality of the Lupong Tagapamayapa (LT)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

3.3.1 Organized Lupong Tagapamayapa Appointment of the Lupong Tagapamayapa

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.3.2 Systematic maintenance of records (record of cases)

Instruction: Put a check ✓ on the box that


YES NO corresponds to your assessment.

For barangays of cities: Computer database


with searchable information For barangays of cities: 2 photos with caption of the
computer database with searchable information

For barangays of municipalities: Manual For barangays of municipalities: 1 photo, with caption
Records (Case Record Book) OR Digital Record on the manual and digital file
Filing (scanned copy of KP files)

3.3.3 Copies of minutes of meetings with attendance sheets


Conducted monthly meetings for the administration of the
Katarungang Pambarangay (at least 3 minutes covering meetings conducted in
2022)

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.3.4 Certified true copy of any proof of training such as


Attendance of LT to KP training or seminar not earlier than 2019
Certificate of Completion and/or Participation (at least
1)

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on
theFunctionality of the Lupong Tagapamayapa
(LT)?

3.4. Organization and Strengthening Capacities of Barangay Tanod


MINIMUM REQUIREMENT MEANS OF VERIFICATION

3.4.1 Organized Barangay Tanod EO or similar issuance on the organization of the


Barangay Tanod covering 2022
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.4.2 Attendance of barangay tanod to necessary training not earlier Certified true copy of any proof of training such as
than 2019 Certificate of Completion and/or Participation (at least
1)
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Organization and Strengthening Capacities of
Barangay Tanod?

3.5. Barangay Initiatives During Health Emergencies


MINIMUM REQUIREMENT MEANS OF VERIFICATION

3.5.1 Organized Barangay Health and Emergency Response Team


EO or similar issuance on the organization of BHERTs
(BHERT) with its composition compliant to the provisions of DILG
MC No. 2020-023

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

3.5.2 Poster or tarpaulin containing the active telephone and/or Photo documentation of poster and/or tarpaulin
cellphone Numbers of the Barangay, Punong Barangay and BHERT
Members posted in conspicuous public places within the
barangay jurisdiction

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Barangay Initiatives During Health
Emergencies?

3.6. Conduct of Monthly Barangay Road Clearing Operations (BaRCO)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

3.6.1 Conducted BaRCO on a monthly basis in 2022 Monthly BarCo Reports for October-December 2022

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Conduct of Monthly Barangay Road Clearing
Operations (BaRCO)?

End of Core Governance Area No. 3: Safety, Peace and Order


2023 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Year Under Review: CY 2022 SGLGB Form No. 2
Data Capture Form

BARANGAY:

CITY/MUNICIPALITY:

PROVINCE:

REGION:

Essential Governance Area No. 1:


Social Protection and Sensitivity

4.1. Functionality of Barangay Violence Against Women (VAW) Desk


MINIMUM REQUIREMENT MEANS OF VERIFICATION

4.1.1 Established Barangay VAW Desk and designated Barangay VAW Executive Order or similar issuance on the
Desk Officer establishment of Barangay VAW Desk and designated
VAW Desk Officer
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.1.2 Attendance of the Barangay VAW Desk Officer to at least one (1) Certified true copy of any proof of training such as
training/orientation related to gender-sensitive handling of VAW Certificate of Completion and/or Participation (at least
Cases not earlier than 2019 1)

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.1.3 Approved 2022 Barangay Gender and Development (GAD) Plan Approved 2022 Barangay Gender and Development
and Budget (GAD) Plan and Budget

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.1.4 Monthly Accomplishment Reports for CY 2022


Submission of Monthly Accomplishment Reports on the incidence (October-December 2022)
of VAW and violence against children (VAC) to C/MSWDO and
C/MLGOO within 10 working days of the ensuing month (stamp
received), pursuant to the Advisory dated March 3, 2021

Consideration: Submission of 4th Quarter Report of 2022 on the


incidence of VAW and VAC to C/MSWDO and C/MLGOO
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.1.5 Updated database on VAW cases reported to the barangay, with Updated database on VAW cases reported to the
the following information at the minimum: barangay

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

Total number of VAW cases received

Total number of cases documented for violating


RA 9262
Total number of cases documented for violating
other VAW-related laws

Assistance provided to victim-survivors

4.1.6 Physical/Financial Accomplishment: CY 2022 GAD Accomplishment Report

To compute Physical Accomplishment Rate:


Instruction: Put a check ✓ on the box that
YES NO corresponds to your assessment. (Total number of activities/projects accomplished / Total number of
activities/projects reflected in the GAD Plan) x 100

a. At least 50% accomplishment of the physical Please supply the following information:
targets in the GAD Plan % of programs, project, and activities are completed
OR
b. At least 50% fund utilization rate of the CY To compute % utilization:
2022 GAD Budget (Total Amount Utilized)/(Total Amount Allocated) x 100

Please supply the following information:


Amount utilized
(as of Dec. 31, 2022):

Amount allocated for GAD PAPs:


Percent-utilization:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Functionality of Barangay Violence Against
Women (VAW) Desk?

4.2. Access to Health and Social Welfare Services in the Barangay


MINIMUM REQUIREMENT MEANS OF VERIFICATION

4.2.1 Presence of a Barangay Health Station/Center Photo documentation of the BHS/C

YES NO Instruction: Put a check ✓ on the box that


corresponds to your assessment.

Barangay Health Station/Center operated by


the barangay

Clustered Clustered Health Station/Center


accessed by several barangays in a
city/municipality (Consideration)

4.2.2 Appointment of Barangay Health Worker (BHW) EO or similar issuance on the appointment of BHW

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.2.3 Appointment of Barangay Nutrition Scholar (BNS) EO or similar issuance on the appointment of BNS

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.2.4 Availability of health services in the Barangay Health


Photo documentations of the operations of the BHS/C
Station/Center (BHS/C):
Instruction: Put a check ✓ on the box that Barangay Issuances on the provision of health services
YES NO corresponds to your assessment.

a. Immunization

b. Maternal and child healthcare

c. Family Planning

d. Health Education

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the Access
to Health and Social Welfare Services in the
Barangay?

4.3. Functionality of the Barangay Development Council (BDC)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

4.3.1 Organized BDC with its composition compliant to Section 107 of EO or similar issuance organizing the BDC with its
RA 7160 composition compliant to Section 107 of RA 7160

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.3.2 Conducted public hearings/ barangay assemblies for public


consultation Minutes (at least 2) of the public hearings/barangay
assemblies with attendance sheet

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.3.3 Approved Barangay Development Plan Barangay Development Plan with BDC and SB
Resolutions adopting such
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.3.4 Physical/Financial Accomplishment: CY 2022 Accomplishment Report of the BDP

To compute Physical Accomplishment Rate:


Instruction: Put a check ✓ on the box that
YES NO corresponds to your assessment. (Total number of activities/projects accomplished / Total number of
activities/projects reflected in the BDP) x 100

a. At least 50% accomplishment of the physical Please supply the following information:
targets in the BDP % of programs, project, and activities are completed
OR
b. At least 50% fund utilization rate of the CY To compute % utilization:
2022 BDP Budget (Total Amount Utilized)/(Total Amount Allocated) x 100

Please supply the following information:


Amount utilized
(as of Dec. 31, 2022):
Amount allocated for PAPs in the
BDP:
Percent-utilization:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Functionality of the Barangay Development
Council (BDC)?

4.4. Implementation of the Kasambahay Law


MINIMUM REQUIREMENT MEANS OF VERIFICATION

4.4.1 Kasambahay desk with a designated Kasambahay Desk Officer EO or similar issuance designating a Kasambahay Desk
(KDO) and a KDO

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.4.2 Maintenance/updating of Kasambahay Masterlist Updated Kasambahay Report Form 2 (Kasambahay


Masterlist) as of December 2022
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Implementation of the Kasambahay Law?

4.5. Functionality of the Barangay Council for the Protection of Children (BCPC)
MINIMUM REQUIREMENT MEANS OF VERIFICATION

4.5.1 Organization of the Barangay Council for Protection of Children Executive Order or similar issuance on the
(BCPC) with its composition compliant to the provisions of DILG establishment Barangay Council for Protection of
MC No. 2021-039 Children (BCPC)

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.5.2 Certified true copy of any proof of training such as


Attendance of the Members of the Barangay Council for Certificate of Completion and/or Participation (at least
Protection of Children (BCPC) to at least one (1) 1)
training/orientation related to their functions not earlier than
2019
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.5.3 Approved BCPC Annual Work and Financial Plan Approved BCPC Annual Work and Financial Plan (AWFP)

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.5.4 Database on Children disaggregated by age, sex, ethnicity, with or Updated database on children
with disabilities, OSCY, etc. updated as of December 31, 2022

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.5.5 Updated Localized Flow Chart of Referral System not earlier than Updated Localized Flow Chart of Referral System
2019

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

4.5.6 Physical/Financial Accomplishment: CY 2022 Approved Accomplishment Report on BCPC


Plan
To compute Physical Accomplishment Rate:
Instruction: Put a check ✓ on the box that
YES NO corresponds to your assessment. (Total number of activities/projects accomplished / Total number of
activities/projects reflected in the BCPC Plan) x 100

a. At least 50% completion rate on PPAs in the Please supply the following information:
BCPC Plan % of programs, project, and activities are completed
OR
b. At least 50% utilization rate of CY 2022 BCPC To compute % utilization:
AWFP Budget (Total Amount Utilized)/(Total Amount Allocated) x 100

Please supply the following information:


Amount utilized
(as of Dec. 31, 2022):
Amount allocated for PAPs in the
BCPC Plan:
Percent-utilization:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Functionality of the Barangay Council for the
Protection of Children (BCPC)?

4.6. Mechanism for Gender and Development (GAD)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

4.6.1 Organized Barangay GAD Focal Point System EO or similar issuance organizing the Barangay GAD
Focal Point System
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on the
Mechanism for Gender and Development
(GAD)?

4.7. Maintenance of Updated Record of Barangay Inhabitants (RBIs)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

4.7.1 Updated RBI for two semesters of CY 2022 Accomplished RBI Form A of two semesters of CY 2022

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on the
Maintenance of Updated Record of Barangay
Inhabitants (RBIs)?
Met the minimum requirement on the
Maintenance of Updated Record of Barangay
Inhabitants (RBIs)?

4.8. Functionality of the Barangay Nutrition Committee (BNC)


MINIMUM REQUIREMENT MEANS OF VERIFICATION

4.8.1 Organization of the Barangay Nutrition Committee (BNC) EO or similar issuance organizing the Barangay Nutrition
Committee (BNC)
YES NO
Instruction: Put a check ✓ on the box that Date of EO or similar issuance:
corresponds to your assessment.

4.8.2 Presence of Barangay Nutrition Action Plan (BNAP) Accomplished Barangay Nutrition Action Plan (BNAP) of
CY 2022
YES NO
Instruction: Put a check ✓ on the box that Coverage Year:
corresponds to your assessment.

4.8.3 Decrease in Malnutrition Rate in the barangay Report on Operation Timbang (OPT) Plus of CY 2021
and 2022
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment. To compute for the percentage decrease in malnutrition rate:

(Malnutrition Rate for CY 2021) - (Malnutrition Rate for CY 2022)


/(Malnutrition Rate for CY 2021) x 100

CY 2021:
CY 2022:

Percentage Decrease:

4.8.4 Physical/Financial Accomplishment: CY 2022 Accomplishment Report of the BNAP

To compute Physical Accomplishment Rate:


Instruction: Put a check ✓ on the box that
YES NO corresponds to your assessment. (Total number of activities/projects accomplished / Total number of
activities/projects reflected in the BNAP) x 100

a. At least 50% accomplishment of the physical Please supply the following information:
targets in the BNAP % of programs, project, and activities are completed
OR
b. At least 50% fund utilization rate of the CY To compute % utilization:
2022 BNAP Budget (Total Amount Utilized)/(Total Amount Allocated) x 100

Please supply the following information:


Amount utilized
(as of Dec. 31, 2022):
Amount allocated for PAPs in the
BNAP:
Percent-utilization:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Functionality of the Barangay Nutrition
Committee (BNC)?

End of Essential Governance Area No. 1: Social Protection and Sensitivity


2023 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Year Under Review: CY 2022 SGLGB Form No. 2
Data Capture Form

BARANGAY:

CITY/MUNICIPALITY:

PROVINCE:

REGION:

Essential Governance Area No. 2:


Business Friendliness and Competitiveness

5.1. Power to Levy Other Taxes, Fees, or Charges


MINIMUM REQUIREMENT MEANS OF VERIFICATION

5.1.1 Enacted Barangay Tax Ordinance pursuant to Sec. 129 of the LGC Enacted Barangay Tax Ordinance

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on the Power
to Levy Other Taxes, Fees, or Charges?

5.2. Compliance to Section 11 of RA 11032 of the Ease of Doing Business Law


MINIMUM REQUIREMENT MEANS OF VERIFICATION

5.2.1 Enacted Barangay Ordinance relative to Barangay Clearance fees


Enacted Barangay Ordinance relative to Barangay
on business permit and locational clearance for building permit Clearance Fees on business permit and locational
pursuant to DILG MC No. 2019-177 clearance for building permit, in accordance with MC
No. 2019-177.

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

5.2.2
Approved resolution authorizing the City/Municipal Treasurer to Approved resolution authorizing the City/Municipal
collect fees for Barangay Clearance for Business permit and Treasurer to collect fees for Barangay Clearance for
locational clearance purposes pursuant to DILG MC No. 2019-177. Business permit and locational clearance purposes.

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Compliance to Section 11 of RA 11032 of the
Ease of Doing Business Law?

5.3. Issuance of Barangay Clearance not covered by DILG MC No. 2019-177 such as: residency, indigency, etc, within seven (7) working days
MINIMUM REQUIREMENT MEANS OF VERIFICATION
5.3.1 Presence of a Citizens’ Charter on the issuance of barangay Photo documentation of the Citizens’ Charter on the
clearance posted in the barangay hall issuance of barangay clearance only (name of the
barangay should be visible)
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on the
Issuance of Barangay Clearance not covered by
DILG MC No. 2019-177 such as: residency,
indigency, etc, within seven (7) working days?

End of Essential Governance Area No. 2: Business Friendliness and Competitiveness


2023 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Year Under Review: CY 2022 SGLGB Form No. 2
Data Capture Form

BARANGAY:

CITY/MUNICIPALITY:

PROVINCE:

REGION:

Essential Governance Area No. 3:


Environmental Management

6.1. Functionality of the Barangay Ecological Solid Waste Management Committee (BESWMC)
MINIMUM REQUIREMENT MEANS OF VERIFICATION

6.1.1 Organized BESWMC with composition compliant to DILG MC No. EO or similar issuance on the organization of the
2018-112 BESWMC

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

6.1.2 Approved Solid Waste Management Program/Plan with


Approved Solid Waste Management Program/Plan with
corresponding fund allocation corresponding fund allocation

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

6.1.3 Certified true copy of any proof of training such as


Attendance of BESWMC to necessary training relative to Certificate of Completion and/or Participation (at least
promoting environmental protection, preservation and awareness 1)
not earlier than 2019

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

6.1.4 Physical/Financial Accomplishment: Monthly Accomplishment Reports for 2022

To compute Physical Accomplishment Rate:


Instruction: Put a check ✓ on the box that
YES NO corresponds to your assessment. (Total number of activities/projects accomplished / Total number of
activities/projects reflected in the BESWMP) x 100

a. At least 50% completion rate on PPAs in the Please supply the following information:
BESWMP % of programs, project, and activities are completed
OR
b. At least 50% utilization rate of CY 2022 To compute % utilization:
BESWM Budget (Total Amount Utilized)/(Total Amount Allocated) x 100

Please supply the following information:


Amount utilized
(as of Dec. 31, 2022):
Amount allocated for PAPs in the
BESWM Plan:
Percent-utilization:

PROCESSING OF RESULTS REMARKS


YES NO
Met all minimum requirements on the
Functionality of the Barangay Ecological Solid
Waste Management Committee (BESWMC)?

6.2. Existence of a Solid Waste Management Facility Pursuant to R.A. 9003


MINIMUM REQUIREMENT MEANS OF VERIFICATION

6.2.1 Presence of a Materials Recovery Facility (MRF)/ Materials


Recovery System (MRS)

Instruction: Put a check ✓ on the box that


YES NO corresponds to your assessment.

Established MRF operated by the barangay For MRF operated by the barangay:
Photo documentation of the MRF/MRF Records of the
barangay

MRS For MRS:


MOA with junkshop;

Mechanism to process biodegradable wastes;

MOA with service provider for collection/treatment of


special, hazardous, and infectious waste

Clustered MRF For Clustered MRFs:

MOA with the host barangay (applicable for barangay-


clustered MRFs);

MOA or LGU document indicating coverage of


city/municipal MRF (applicable for barangays clustered
to the Central MRF of City/Municipality)

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on the
Existence of a Solid Waste Management
Facility Pursuant to R.A. 9003?

6.3. Provision of Support Mechanisms for Segregated Collection


MINIMUM REQUIREMENT MEANS OF VERIFICATION

6.3.1 Enacted Barangay Ordinance or similar issuance on segregation of Ordinance or similar issuance on segregation of wastes
wastes at-source at-source

YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.

PROCESSING OF RESULTS REMARKS


YES NO
Met the minimum requirement on the
Provision of Support Mechanisms for
Segregated Collection?

End of Essential Governance Area No. 3: Environmental Management


2023 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Year Under Review: CY 2022 SGLGB Form
Data Capture Form

CERTIFICATION

I hereby certify that all information contained in this assessment report are true and correct, and are correspondingly su
by MOVs as reviewed by the undersigned.

City/Municipal SGLGB Assessor

Name and Signature of the SGLGB Assessor (City Director/C/MLGOO)


GLGB Form No. 2

orrespondingly supported

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