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BS Form 1

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BE FORM 1

School Logo
Sangay ng Paaralang Lungsod
Paaralang Elementaryang Sentral ng
DISTRITO NG
Lungsod ng

BRIGADA ESKWELA
SY. 2021-2022
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
(Check One) Manpower
Needed Material Resources
Needed(Indicate
FACILITIES Needed (Indicate
If Unsatisfactory, (e.g. repair, quantity and nature of
kind and quality)
Satisfactory Unsatisfactory describe the repainting, labor services needed)
problem replacement, etc)

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/ wall

Electricity

Alternative gate

Reference Materials

Laboratory equipment

Prepared by: Noted:

School Physical Facilities Coordinator Date of Inspection School Head

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