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2023 SGLGB-Form 2-Data Capture Form-DCF
2023 SGLGB-Form 2-Data Capture Form-DCF
2023 SGLGB-Form 2-Data Capture Form-DCF
BARANGAY:
CITY/MUNICIPALITY:
PROVINCE:
REGION:
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:
ANNUAL REPORT
ANNUAL REPORT a. Barangay Financial Report
d. 20% Component of the NTA Utilization; e. Annual Procurement Plan or Procurement List;
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.
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
Percentage Increase:
1.3.1 Presence of a Barangay Appropriation Ordinance approved on or Approved Barangay Appropriation Ordinance
before December 31, 2021.
1.4. Allocation for Statutory Programs and Projects as Mandated by Laws and/or Other Issuances
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.
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:
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
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.
BARANGAY:
CITY/MUNICIPALITY:
PROVINCE:
REGION:
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
Estimated revenue
from regular sources:
Amount of BDRRMF
for FY 2022:
Percent-allocation for
BDRRMF:
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
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:
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
2.3.1 A barangay must have a permanent or alternate evacuation Photo documentation of the permanent/alternate
center evacuation center
2.3.2
A barangay must have the following disaster supplies/equipment: Photo Documentation of disaster supplies equipment
BARANGAY:
CITY/MUNICIPALITY:
PROVINCE:
REGION:
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.
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.
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.
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.
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)
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.
YES NO
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.
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.
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.
BARANGAY:
CITY/MUNICIPALITY:
PROVINCE:
REGION:
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.
4.1.5 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.
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
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.
a. Immunization
c. Family Planning
d. Health Education
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.
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.
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
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.
4.5. 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.
4.5.3 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.
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
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.
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.
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:
CY 2021:
CY 2022:
Percentage Decrease:
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
BARANGAY:
CITY/MUNICIPALITY:
PROVINCE:
REGION:
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.
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.
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.
BARANGAY:
CITY/MUNICIPALITY:
PROVINCE:
REGION:
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.
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.
YES NO
Instruction: Put a check ✓ on the box that
corresponds to your assessment.
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
Established MRF operated by the barangay For MRF operated by the barangay:
Photo documentation of the MRF/MRF Records of the
barangay
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.
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.
orrespondingly supported