Republic of the Philippines

Department of Education
Region VI – Western Visayas
DIVISION OF NEGROS OCCIDENTAL
District of Manapla

BASIC CLASSROOM FACILITIES, STRUCTURING, SCHOOL SAFETY & PREPAREDNESS EVALUATION CHECKLIST

Name of Class Adviser: _________________________________________________________ Evaluation Date: ________________________

1. CLASSROOM FACILITIES 5 4 3 2 1 Rate

Outstanding Very Satisfactory Unsatisfactory Poor
Satisfactory
1. CHAIRS/TABLES/DESK PAINTED AND LABELED WITH PUPILS’
NAME
2. TEACHERS TABLE WITH TOP GLASS & CHAIRS
(FRONT/BACK/SIDE)
3. DIVAN/SALA SET/BROOM BOX/TOOL BOX
4. CABINETS WITH LABELS
5. CHALKBOARD WITH LEGDE AND CURTAIN
6. HANDWASHING/DRINKING FACILITIES WITH SOAP, MIRROR,
TOOTHBRUSH AND TOOTHPASTE AND COMB
7. COMFORT ROOM WITH LIGHT, LOCK, WATER CONTAINER W/
DIPPER, SOAP, BRUSH & BROOM
8. GARBAGE BINS (NABUBULOK, DI-NABUBULOK, RECYCLABLE)
9. UPDATED BULLETIN BOARDS (INFORMATION, STATISTICAL,
UNIT/LESSON/PERFORMANCE OUTPUT)
10. FILING SHELVES/STORAGE WITH LABELS
11. Deped FORMS RACKS
12. UTILITY BOX WITH LABELS
13. CHART STAND WITH CLIP/POCKET CHARTS
14. FIRST AID KIT/CABINET
2. CLASSROOM STRUCTURING (25%) 5 4 3 2 1 Rate
Outstanding Very Satisfactory Unsatisfactory Poor
Satisfactory
ENTRANCE
1. With Teacher’s/Class Program and Teacher’s Nameplate (A framed
copy of the teacher’s class/program & teacher’s nameplate are
displayed on the door or any conspicuous are of the classroom at adult
eye-level).
FRONT WALL:
2. FRAMED PORTRAIT OF THE PHILIPPINE PRESIDENT (CENTER)
(Optional)
3. FRAMED PORTRAIT OF JOSE P. RIZAL (CENTER, BELOW THE
PRESIDENT) (Optional)
4. FRAMED PORTRAITS OF DEPED OFFICIALS
5. FRAMED SCHOOL MISSION (UPPER RIGHT); FRAMED VISION
(UPPER LEFT) (Optional)
6. SCHOOL MOTTO: “UGYON LAURON, ATON LABUTON ANG ATON
NGA HANDOM” (Optional)
7. GRADE KINDER-VI: ALPHABET STRIPS (K& I- Upper & Lower Case;
II-VI Cursive- capital and small case)
3. SCHOOL SAFETY AND PREPAREDNESS (50%) 5 4 3 2 1 Rate
Outstanding Very Satisfactory Unsatisfactory Poor
Satisfactory
3.1 Safe Learning Facilities (20%)
3.1.1 Facilitate the assessment of classroom building structure and
electrical wiring.
3.1.2 Provide recommendation to SH/PTA/SGC necessary repairs
and/or upgrades to prevent unnecessary incidents.
3.1.3 Repair minor classroom damages such as broken window, doors,
blackboard, roofs and other furniture, etc.
3.1.4 Install appropriate and available fire suppression, including sand,
fire extinguishers, water source and relevant indigenous materials.
3.1.5 Make sure that corridors and pathways are unobstructed and that
all sharp, protruding objects which may cause harm to pupils are
removed.
3.1.6 Clean and clear drainage to prevent clogging. Cover drainage
canals and provide necessary warnings.
3.1.7 Cordon off and post safety signage for on-going construction,
unfinished, damaged and condemned buildings.
3.1.8 Secure cabinets and drawers and ensure that heavy objects are
below head level.
3.1.9 Post safety measures in laboratories and workshops.
3.1.10 Prepare an evaluation/exit plan and directional signage on every
floor of the building.
3.1.11 Identify evacuation areas and classrooms that may be used as
temporary shelters during disasters and emergencies.
3.1.12 Prune trees to avoid entanglement from electrical wirings and
avoid potential harm to life and property.

S.Y. 2019-2020
 BASIC CLASSROOM FACILITIES, STRUCTURING, SCHOOL SAFETY & PREPAREDNESS EVALUATION CHECKLIST

Name of Class Adviser: ___________________________________________ Evaluation Date: ___________________

3.2 School Disaster Management (20%) 5 4 3 2 1 Rate

Outstanding Very Satisfactory Unsatisfactory Poor
(Adapted DM #36, series 2019) Satisfactory
3.2.1 Post a directory of emergency contact numbers
of relevant government agencies in an area of a
classroom.
3.2.2 Establish and maintain early warning
mechanisms in the classroom.
3.2.3 Equip classroom with first aid kits, flashlights,
megaphones, and other supplies necessary in cases of
emergency. Ensure that these items are highly
accessible and can be easily located.
3.2.4 Identify alternative sources and/or maintain
supply of drinking water within the school.
3.2.5 Ensure that learners, teachers, and personnel
have identification cards with relevant information.
3.2.6 Create a database of learners with the contact
details of their immediate family
members/relatives/guardians.
3.2.7 Secure and safely store vital score records.
3.2.8 Coordinate with barangay officials on pedestrian
safety of pupils.
3.2.9 Document accidents experienced by pupils and
personnel within the school to improve prevention
and mitigation measures.
3.3 Risk Reduction and Resilience Education (10%)
(Adapted DM #36, series 2019)
3.3.1 Identify a storage area for safekeeping of vital
school records, textbooks, teaching materials,
manuals, computers, and other classroom equipment.
OVERALL RATING

AGREEMENT/S:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
_____________________________.

ADJECTIVAL RATING EQUIVALENCES Formulae:

RANGE ADJECTIVAL RATING
4.500-5.000 Outstanding 1. Sum of Scores/Total # of items x .25=
3.500-4.499 Very Satisfactory 2. Sum of Scores/Total # of items x .25=
2.500-3.499 Satisfactory 3. 1 Sum of Scores/Total # of items x .20=
1.500-2.499 Unsatisfactory 3.2 Sum of Scores/Total # of items x .20=
B=below 1.499 Poor 3.3 Sum of Scores/Total # of items x .10=

Confirmed: ______________________________________________
Signature Over Printed Name of Teacher

Evaluated by: _________________________________________

School Principal

S.Y. 2019-2020