MINISTRY OF EDUCATION

DEPARTMENTAL DIRECTION
DATE:

FORM
PHYSICAL INFRASTRUCTURE EVALUATION
TO BE COMPLETED BY PRIVATE SCHOOLS FOR
PROCESS –REVALIDATION AND/OR AUTHORIZATION-

1. SCHOOL DATA:

1.1 NAME OF THE SCHOOL : “San Josecito” School

1.2 ADDRESS: 8va. Calle 2-67 zone 4, Barrio San José Palo Negro, Esquipulas, Chiquimula

DATA 1 2 3 4 5 6
CODE 20-07-0120-42 20-07-0121-42
LEVEL Pre-primary Pre-primary Primary Primary
WORKING Morning Evening Morning Evening
DAY

1.3 GEOGRAPHICAL COORDINATES:

8 9 2 1 ‘ 2 6 “ W
X: °
AND: 1 4 3 3 ‘ 4 8 “ N
°

2. PARTICULAR CRITERIA

2.1 TERRAIN
300.00 2
2.1.1 LAND AREA: M

2.1.2 PERCENTAGE OF BUILT AREA: 91.23 %

2.1.3 PERCENTAGE OF FREE AREA: 8.77 %

2.1.4 PUBLIC SERVICES:

2.1.4.1 DRINKING WATER: TYPE OF MAIN SUPPLY: Municipal Service

OTHER TYPE OF SUPPLY:

2.1.4.2 DRAINAGE: TYPE OF WASTEWATER DISPOSAL: Municipal Collector

2.1.4.3 ELECTRICITY: DISTRIBUTION SOURCE: Deorsa Service
2.2 ENVIRONMENT

* Do not place those that are DISTANCE THAT IS

more than 500 linear meters LOCATED IN CURRENT MITIGATION MEASURE
away from the School. LINEAR METERS *

HOSPITAL, HEALTH CENTER AND HEALTH POST 240.00

CEMETERY AND DUMP

NOISE, ODOR OR EMMANATION GENERATOR

CENTER

CANTINES, BARS, BROTHERS AND NIGHT

CENTERS
SALES OF ALCOHOLIC BEVERAGES

TOWERS AND ELECTRICAL TRANSMISSION LINES

ROADS AND ACCESS ROADS 268.00 ROUTE CA-10
RIVER, STREAM, LAKE AND SEA
BOULDER
RAVINE
GEOLOGICAL FAILURE AND VOLCANO
DAMAGED TREES

NUMBER OF ABILITY
GRADE/ STUDENTS OF USE
SECTION PER M2
THEORETICA BY FOLDING FOLDABLE
L CLASSR WINDOW DOOR OUTWARDS
LEVEL CLASSROOM OOM AREA WIDTH (YES - NO)
Morning
Preschool TO 7 13.00 1.74 m2 1.00 NO 7
Morning
Preschool b 6 13.00 1.74 m2 1.00 NO 7
Morning
Preschool c 5 13.00 1.74 m2 1.00 NO 7
Evening Pre-
Primary TO 6 13.00 1.74 m2 1.00 NO 7
Evening Pre-
Primary b 6 13.00 1.74 m2 1.00 NO 7
Evening Pre-
Primary c 5 13.00 1.74 m2 1.00 NO 7
Morning
Primary 3rd. 36.63 0.75 m2 0.95 NO 29
Morning
Primary 2nd. 21.12 0.95 YEAH 17
Morning
Primary 1st. 18.37 0.50 0.90 NO 15
Evening
Primary 6th. 36.63 0.75 m2 0.95 NO 29
Evening
Primary 5th. 21.12 0.95 YEAH 17
Evening
Primary 4th. 18.37 0.50 0.90 NO 15
2.2 ENVIRONMENT

* Do not place those that are DISTANCE THAT IS

more than 500 linear meters LOCATED IN CURRENT MITIGATION MEASURE
away from the School. LINEAR METERS *
HOSPITAL, HEALTH CENTER AND
HEALTH POST
CEMETERY AND DUMP
NOISE, ODOR OR EMMANATION
GENERATOR CENTER
CANTINES, BARS, BROTHERS AND
NIGHT CENTERS
SALES OF ALCOHOLIC BEVERAGES
TOWERS AND ELECTRICAL
TRANSMISSION LINES
ROADS AND ACCESS ROADS
RIVER, STREAM, LAKE AND SEA
BOULDER
RAVINE
GEOLOGICAL FAILURE AND
VOLCANO
DAMAGED TREES

2.2 ENVIRONMENT
NUMBER OF ABILITY
GRADE/ STUDENTS OF USE
SECTION PER M2
THEORETICA BY FOLDING FOLDABLE
L CLASSR WINDOW DOOR OUTWARDS
LEVEL CLASSROOM OOM AREA WIDTH (YES - NO)
 * Do not place those that are DISTANCE THAT IS
more than 500 linear meters LOCATED IN CURRENT MITIGATION MEASURE
away from the School. LINEAR METERS *
HOSPITAL, HEALTH CENTER AND
HEALTH POST
CEMETERY AND DUMP
NOISE, ODOR OR EMMANATION
GENERATOR CENTER
CANTINES, BARS, BROTHERS AND
NIGHT CENTERS
SALES OF ALCOHOLIC BEVERAGES
TOWERS AND ELECTRICAL
TRANSMISSION LINES
ROADS AND ACCESS ROADS
RIVER, STREAM, LAKE AND SEA
BOULDER
RAVINE
GEOLOGICAL FAILURE AND
VOLCANO
DAMAGED TREES

2.2 ENVIRONMENT
NUMBER OF ABILITY
GRADE/ STUDENTS OF USE
SECTION PER M2
THEORETICA BY FOLDING FOLDABLE
L CLASSR WINDOW DOOR OUTWARDS
LEVEL CLASSROOM OOM AREA WIDTH (YES - NO)
 * Do not place those that are DISTANCE THAT IS
more than 500 linear meters LOCATED IN CURRENT MITIGATION MEASURE
away from the School. LINEAR METERS *
HOSPITAL, HEALTH CENTER AND
HEALTH POST
CEMETERY AND DUMP
NOISE, ODOR OR EMMANATION
GENERATOR CENTER
CANTINES, BARS, BROTHERS AND
NIGHT CENTERS
SALES OF ALCOHOLIC BEVERAGES
TOWERS AND ELECTRICAL
TRANSMISSION LINES
ROADS AND ACCESS ROADS
RIVER, STREAM, LAKE AND SEA
BOULDER
RAVINE
GEOLOGICAL FAILURE AND
VOLCANO
DAMAGED TREES

2.3 OCCUPANCY RATE

NUMBER OF ABILITY
GRADE/ STUDENTS OF USE
SECTION PER M2
THEORETICA BY FOLDING FOLDABLE
L CLASSR WINDOW DOOR OUTWARDS
LEVEL CLASSROOM OOM AREA WIDTH (YES - NO)
 ** IF YOU NEED MORE ROWS ATTACH ADDITIONAL SHEET

2.3.1 THERE ARE STUDENTS WITH SOME DISABILITIES, IF YOUR ANSWER IS YES, INDICATE HOW MANY.

2.4 NATURAL VENTILATION IN THEORETICAL CLASSROOMS

2.4.1 AVERAGE PERCENTAGE OF NATURAL VENTILATION IN THEORETICAL CLASSROOMS: 2%

2.5 ELECTRICAL INSTALLATIONS IN THEORETICAL CLASSROOMS

2.5.1 AVERAGE NUMBER OF POWER OUTLETS PER THEORETICAL CLASSROOM: 2

2.5.2 AVERAGE NUMBER OF LAMPS THAT WORK PER THEORETICAL CLASSROOM: 1

2.6 OTHER ENVIRONMENTS

2.6.1 HAS A COMPUTER CLASSROOM: YES: NO:

2.6.2 HAS A WAREHOUSE: BUT:

2.6.3 HAS A TEACHING ROOM YES: NO: YEAH

2.6.4 IT HAS EXTRA LABORATORIES YES: NO:

2.6.5 TYPE OF LABORATORIES:

2.7 HEALTH SERVICES

2.7.1 NUMBER OF OPERATING TOILETS FOR WOMEN: 3

2.7.2 NUMBER OF TOILETS OPERATING FOR MEN: 3

2.7.3 NUMBER OF HAND SINKS OPERATING FOR WOMEN: 3

2.7.4 NUMBER OF HAND SINKS OPERATING FOR MEN: 3

2.7.5 HAS A SHOWER FOR STUDENTS: YES: NO: NO

2.7.6 HAS HEALTH SERVICES FOR THE ADMINISTRATIVE SECTOR: YES: NO: YEAH
2.8 OPEN SECTOR

2.8.1 HAS A SPORTS COURT: YES: NO: YEAH

14.86
2.8.2 IF YOU ANSWER YES, WHAT MEASUREMENTS IS THE COURT: LENGTH: BROAD: 2.27

2.8.3 IF YOU MARK NO, INDICATE WHICH ALTERNATIVE YOU USE:

2.8.4 HAS FREE AREAS AND/OR PATIOS YES: NO: YEAH

2.8.5 IF YOU ANSWER YES, WHAT MEASURES ARE THE AREAS: LENGTH: 4.00 BROAD: 3.30

2.9 ACCESS TO PEOPLE WITH DISABILITIES

2.9.1 WHAT ELEMENTS OF ACCESS TO PEOPLE WITH DISABILITIES THE SCHOOL HAS, LIST THEM.

Access through the main street consists of a ramp, as well as the entrance to the classroom area.

2.10 Description of the Educational Building: (Materials used: Block, brick, sheet, earthenware, floor
material, etc.)

The building consists of a combination of adobe and block in the walls of the construction. It has finishes in
good condition. It has a cement and ceramic colored floor as well as a cement slab. Its roof is made of sheet
metal and cast slab.

Joel Rosas Contreras

NAME SIGNATURE COLLEGE SEAL

PROFESSIONAL WHO PREPARED EVALUATION

 SWORN DECLARATION

AFFIDAVIT MINUTE FOR THE REPORT, PLANS AND ANALYSIS OF AN ACTIVE

REGISTERED PROFESSIONAL.

AUTHORIZATION OR REVADILATION OF OPERATION FOR PRIVATE EDUCATIONAL

CENTERS
In Guatemala City on the day, 10th month , November _ year , 2017_ at_ 3:00 p.m., I, THE UNDERSCRIBED
NOTARY: constituted in my professional office located at
_________________________________________________________________________________at the
request of the Lord______ Joel Rosas Contreras __________________ who requests my notarial services for
the purpose to record and attest to the following: FIRST: Mr._______ Joel Rosas Contreras
_______________, who is___ 56 ___( years of age) ____ Married ____(Marital Status)_____ Guatemalan
_________________ (nationality) _ Civil Engineer _______(profession)_________ with ______ 4681
_______(active member number)_ 11 street “B” 0-34 zone 4, Colonia Quirio Cataño I, Esquipulas,
Chiquimula ______(address) who will be referred to in the course of this Minute only as “THE REQUIRED”.
SECOND: The applicant declares under oath and is aware of the penalties related to the crime of perjury,
that his name is as it was written and if he has the identification data indicated above, THIRD: that in
accordance with the provisions of Government Agreement fifty-one two indent two thousand fifteen (52-
2015) dated February 4 of the year two thousand fifteen which contains “REGULATION FOR THE
AUTHORIZATION AND OPERATION OF EDUCATIONAL CENTERS
PRIVATE" by this act and under oath of law declares that the information provided within the "PHYSICAL
INFRASTRUCTURE EVALUATION FORM", dated_ November 10, 2017 ____ signed and sealed by him, in his
capacity as an Active Member, evaluation carried out in the Educational Establishment ____COLEGIO “SAN
JOSECITO”__ ( name of the school) located on 8th. Calle 2-67 zone 4, Barrio San José, Esquipulas, Chiquimula
___; is true, complying with the terms of reference and requirements established by the Ministry of
Education. With nothing more to record for the moment, this document is terminated, in the same place
and date of its beginning, fifteen minutes later, which is contained on a sheet of bond paper, written on its
front, the which, after reading it, is accepted in its entirety by the applicant, who, well aware of its content,
object and validity, accepts, ratifies and signs it, with the undersigned Notary. ATTEST.

Signature of the Requestor Signature and seal of the Notary