Be Form 1 Physical Facilities and Maintenance Needs Assessment Form

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BE Form 01

Republic of the Philippines


Department of Education
Region IV-A CALABARZON
SCHOOLS DIVISION OF ____________________________
(Name of School)
(School Address)
School Year _________

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
Remarks Manpower
(Check One) improvement Needed Material Resources
Needed(Indicate
FACILITIES (e.g. repair, Needed (Indicate kind
If Unsatisfactory, quantity and nature of
Satisfactory Unsatisfactory repainting, and quality)
describe the problem labor services needed)
replacement, etc)
 Roofs/Gutters / Rusty roofs repainting 7 tin of Baguio Green laborer
 Ceilings / dirty Repainting/.cleaning 3 tin of QDE white laborer
 Walls / dirty repainting 10 tin of Latex paint
 Blackboards /
 Chairs/desks/tables / Some chairs are Repainting./ repair Plywood, nail , hammer
broken , saw , nail, paints 5
gallon of Temptation
green
 Water facilities/ /
Drainage System
 Signages /.
 School garden / Untrimmed plants trimming Mower, broom , dustpan
BE Form 01

Republic of the Philippines


Department of Education
Region IV-A CALABARZON
SCHOOLS DIVISION OF ____________________________
(Name of School)
(School Address)
School Year _________
 Lighting / Not working Replacement
 Windows /
 Doors /
 Comfort Rooms / dirty Cleaning / repainting 1 tin latex ./
 School Grounds / Tall grasses mowering
 School Canteen/Clinic / uncleaned Repainting
 School Fence/ wall / dirty repainting
 Electricity / Not working bulb replacement
 Alternative gate /
 Reference Materials /
 Laboratory equipment /

/
Prepared by: Noted:

_______________________________ _________________ ____________________________________

School Physical Facilities Coordinator Date of Inspection School Head


BE Form 01

Republic of the Philippines


Department of Education
Region IV-A CALABARZON
SCHOOLS DIVISION OF ____________________________
(Name of School)
(School Address)
School Year _________

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