Republic of the Philippines

DEPARTMENT OF EDUCATION
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF CAGAYAN
Regional Government Center, Carig, Tuguegarao City, 3500
AMULUNG EAST DISTRICT
MANALO ELEMENTARY SCHOOL

BRIGADA ESKWELA
PHYSICAL FACILITIES AND MAINTENANCE NEEDS ASSESSMENT FORM
CONDITION Nature of
Remarks Manpower
(Check One) improvement Material
Needed(Indicate
Needed Resources
If Unsatisfactory, quantity and nature
FACILITIES (e.g. repair, Needed (Indicate
Satisfactory Unsatisfactory describe the of labor services
repainting, kind and quality)
problem needed)
replacement, etc)
 Roofs/Gutters /
 Ceilings /
 Walls /
 Blackboards / There are Acquisition plywood Carpentry
classrooms that
needs
replacement of
blackboards and
acquisition
 Chairs/desks/tables /
 Water facilities/ /
Drainage System
 Signage /
 School garden /
 Lighting /
 Windows /
 Doors /
 Comfort Rooms /
 School Grounds /
 School Canteen/Clinic /
  School Fence/ wall /
 Electricity /
 Alternative gate
 Reference Materials /
 Laboratory equipment /

Prepared by: Noted:

LAILANIE M. DELA CRUZ JOEFREY D. CACATIAN

Grade VI Adviser School Principal I
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF CAGAYAN
Regional Government Center, Carig, Tuguegarao City, 3500
AMULUNG EAST DISTRICT
MANALO ELEMENTARY SCHOOL

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 improvement Manpower
(Check One) Material Resources
Needed Needed(Indicate
FACILITIES If Unsatisfactory, Needed (Indicate
(e.g. repair, quantity and nature of
Satisfactory Unsatisfactory describe the kind and quality)
repainting, labor services needed)
problem replacement, etc)
 Roofs/Gutters
 Ceilings
 Walls
 Blackboards
 Chairs/desks/tables
 Water facilities/
Drainage System
 Signages
 School garden
 Lighting
 Windows
  Doors
 Comfort Rooms
 School Grounds
 School Canteen/Clinic
 School Fence/ wall
 Electricity
 Alternative gate
 Reference Materials
 Laboratory equipment

Prepared by: Noted:

_______________________________ _________________ ____________________________________

School Physical Facilities Coordinator Date of Inspection School Head