BE Form 01

Republic of the Philippines

Department of Education
Region III
Division of Bulacan
ALEXIS G. SANTOS NATIONAL HIGH SCHOOL
School Year 2018-2019

BRIGADA ESKWELA
PHYSICAL FACILITIES REPAIR AND MAINTENANCE NEEDS ASSESSMENT FORM
(To be accomplished by the School Physical Facilities Committee)

Instruction: Conduct an ocular inspection of the school facilities listed below. Then provide the needed information to facilitate the improvement to be done on these identified facilities.
(If needed, you may use separate form for each classroom or school facility.)

Condition Nature of Improvement Material Resources Manpower Needed

Remarks
(Check One) Needed Needed (Indicate quantity and
FACILITIES
If unsatisfactory, (e.g. repair, repainting, (Indicate kind and nature of labor services
Unsatisfactory
Satisfactory describe the problem. replacement, etc.) quantity) needed)
Roofs/gutters √ Broken PVC pipes for Replacement of PVC Roof sealant Roof Repair (Carpentry)
gutter pipes PVC pipes Plumber Service
Roof holes Fixing of roof holes Paint Painting Job
repair/replacement of
ceiling

Ceilings √ Leaking ceiling Repair/replacement of Plywood Ceiling Repair

Faded paint ceiling Cement (Carpentry)
Cracked Ceiling repaint Paint Painting job
repair of cracked portion
Walls Cracked Wall repair of cracked portion Cement Wall Repair
√
Faded paint repaint Paint Painting Job
Blackboards Broken Blackboards Replacement of Blackboards Painting job
√ Stained blackboards Paint
repaint
Chairs/desks/tables Broken Chairs Fixing of arm chairs Wood
√ Missing screws Replacement of screws Screws Carpentry Service
Broken Drawers Repair of tables/drawers. Carpentry Materials
Signage √ Old and Faded Replacement Signage Welding
School garden √ Disorganized Landscaping job Landscaping Materials Landscaping Service
Lighting Misaligned switch Repair
Switch
Faulty wiring Replacement
√ Wirings Electrical Service
Burnout bulbs Installations of electrical
Fluorescent light
lack of electrical lines lines
Windows broken windows, grills Repair / replacement Windows/handles Carpentry Service
and handles Replacement of window Jalousies Painting Job
√
missing jalousies frames Window frame
rusty windows repaint Paint
Doors Broken door and Replacement of new door Door/ Door frames
doorknobs frames Door knobs
√ Carpentry Service
Replacement of
Door/doorknobs
Comfort rooms Repair of clogged toilets
Clogged toilet bowls and
and sink
sink
replacement of flush Pipelines
Broken flush handles
handles, lavatories Elastoseal Plumbing Service
√ Broken lavatory
replacement/repair of Paint Painting Job
Leaking water pipelines
lavatory Flush handles
Dysfunctional flush
repair of flush and water
Faded paint
pipelines
School grounds Faded paint Repaint Paint Painting Job
√ Low land causing Landfill Landfill
flood/mud
School fence √ Cracked Wall repair of cracked portion Cement Wall Repair
Faded paint repaint Paint Painting Job
Others: Rusty and faded paint Repaint Paint
√ Painting Job
Steel matting
Stairs √ Rusty and faded paint Repaint Paint Painting Job
Electric fans; ceiling, wall Dysfunctional Repair / Replacement Electric fans
√ Electrical Service
and stand fans
Stage Faded paint Repaint/ Makeover Paint
√ Painting Job
Needs lighting
Spaces at the back of Grassy cutting of grass, clearing Landscaping Materials
the buildings √ Low land causing flood area and landscaping Landfill Landscaping Service
Landfill

Prepared by: Noted by:

EFREN R. CASTILLO June 13, 2018 NILO A. ABOLENCIA

School Physical Facilities Coordinator Date of Inspection Secondary School Principal I
BE Form 03
Republic of the Philippines
Department of Education
Region III
Division of Bulacan
ALEXIS G. SANTOS NATIONAL HIGH SCHOOL
School Year 2018-2019

BRIGADA ESKWELA
RESOURCE MOBILIZATION FORM
(To be accomplished by the Resource Mobilization Committee)

Instruction: Using the completed BE Form 01: Physical Facilities Needs Assessment Form as basis, summarize the resources (materials and manpower) needed
and list down the potential source or partners to be tapped. Add additional sheet if needed. The Status and Remarks columns should be updated regularly to
determine progress in acquiring resources needed.

Key Persons / Strategies/

Materials Needed Quantity Organizations Plan of Action Persons Status Remarks
to be tapped Responsible
Cement 200 bags
Hollow blocks 700 pcs.
Sand 3 dump truck Government officials Sending letter of Principal Successfully
Land filling 3 dump truck Private employees invitations Teachers Completed Completed
Paint 30 gal LGUs Sourcing out in-kind PTCA
Plywood 30 pcs. NGOs donations SSG
Pipe 27 pcs. Other stakeholders
Gutter 32 pcs.
Signage 31 stainless letters
Plants 2000 worth of plants
 Key Persons / Strategies/
Materials Needed Quantity Organizations Plan of Action Persons Status Remarks
to be tapped Responsible
Carpentry
Plumbing Government officials Sending letter of Principal
Ordinary labor Private employees invitations Teachers Successfully
Electrical N/A LGUs Sourcing out in-kind PTCA Completed Completed
Painting NGOs donations SSG
Landscaping Other stakeholders

Prepared by: Noted by:

MAR FLORENCE DC. SEBASTIAN NILO A. ABOLENCIA

Resource Mobilization Committee Secondary School Principal I