BE Form 01

Republic of the Philippines

Department of Education
Region IV-A
Division of San Pablo City
SMARIA MAGDALENA ELEMENTARY SCHOOL
San Pablo City
School Year 2016-2017

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)
Roofs/Gutters / Leaking roofs Vulcaseal 2 qrt.vulcaseal Security guard
application
Ceilings / No ceiling construction 18 pcs.plywood carpenter
Walls / repainting paint Painter,volunteer
Blackboards / repainting paint volunteer
Chairs/desks/tables / broken repair Nail,paint volunteer
Water facilities/ /
Drainage System
Signages /
School garden / Tall Trimming,weeding Bolo,grass volunteer
trees,weeds,grass lawn mowing cutter,10 l.
es gasoline,2T oil
Lighting /
 Windows /
Doors /
Comfort Rooms / Broken doors repair Nail,,paint volunteer

School Grounds / Grasses were full Mowered/sweeping Mower,grass cutter Utility,Brgy. Officials
grown/untidy Broomstick,dust
pan
School Canteen/Clinic / Dis-organize Properly arranged Cleaning materials Canteen teacher,
volunteer
School Fence/ wall / dilapidated repaint Paint, roller, brush PTA Officers
Electricity / Defective bulb replacement Bulb, flourescent electrician
Alternative gate
Reference Materials /
Laboratory equipment /

Prepared by: Noted:

SERGIO P. CORNISTA 6-5-2016 HELEN M. ACERES

School Physical Facilities Coordinator Date of Inspection School Head