BE Form 01

Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OF CABADBARAN CITY
Antonio Luna Elementary School
Brgy. Antonio Luna, Cabadbaran City
School Year 2019-2020

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
Needed Needed(Indicate
If Resources
FACILITIES (e.g. repair, quantity and
Satisfacto Unsatisfact Unsatisfactory, Needed (Indicate
repainting, nature of labor
ry ory describe the kind and quality)
replacement, services needed)
problem etc)
 Gutters/roof  destroyed Replacement, 2 bundles 1x6x8 2 carpenters, 4
repaint lumber and 2 kls. labors
CN #3
3 gals. Roof paint

 Ceilings  Old and needs to Repainting 15 pcs. plywood, 5 persons voluntary

renovate Replacement 20 bundles. Sticks
2x2x8, 2 kls. CN #3
4 gals. Latex paint,
4 pcs. Paintbrush
4”
  Walls  Fade, have Repainting 6 gals. Latex paint 6 persons voluntary
vandals Repair and 4pc.rulerbrush
3pcs. Roller pad
4 pcs paint brush
(2 small, 2 medium
size)
8PCS. Plywood and
5 bundles 2 x 10
stick

 Lighting  Some bulbs were Replacement 6 pcs. Light bulbs 1 electrician

not functional
 Chairs/desks/tables  fade Repainting 10 gals. Enamel 6 persons voluntary
paint

 Water  destroyed Repair 6 sacks cement 3 persons

facilities/drainage Water pipe, 4 set
system faucet
 Signage  none Printing Tarpaulin 24 pcs. Exit signs, 2 persons voluntary
1 pc. 3’x4’
tarpaulin, 10 pcs.
1’x1 ½’ tarp
 School fence  Fade, dirty Repainting, Repair 8 gals. Latex paint, 4 persons voluntary
2 paint roll, 2 roller
pad
 Wirings  Not properly Repair, Re-wiring 200m.#14 duplex 1 electrician
installed wirings wire, 2 boxes staple
wire
20 gal. latex paint

Prepared by: Noted:

_______ _DAISY A. DAGUPLO__________ _________________ RAQUEL P. NAKILA

School Physical Facilities Coordinator Date of Inspection School Head