Appendex B BE FORM 1 PHYSICAL ASSESSMENT FORM

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Appendex B

BE Form 01

Republic of the Philippines


Department of Education
Region VII
Division of Bohol
Cantam-is Elementary School
School Year 2022-2023

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

Instruction: Conduct an ocular inspection of the school physical facilities 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.)
Condtion 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
Satisfactory Unsatisfactory
describe the problem. replacement, etc.) quantity) needed)
 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
 Others, please
specify:
Prepared by: Noted:

_____________________________ _________________________________
School Physical Facilities Coordinator Date of Inspection TIC/Head Teacher/Principal

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