Republic of the Philippines

Department of Education
Region IX, Zamboanga Peninsula
Division of Zamboanga City
SOUTHCOM NATIONAL HIGH SCHOOL
Upper Calarian, Zamboanga City
"BRIGADA ESKWELA 2016"

BE Form 1

PHYSICAL FACILITIES REPAIR AND MAINTENACE NEEDS ASSESSMENT FORM

(To be accomplished by the School Physical Facilities Coordinator)
Instruction: Conduct an ocular inspection of the school physical 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

Remarks

(Check One)

FACILITIES
Roofs / Gutters
Ceilings / Walls

Satisfactory

Unsatisfactory

Nature of
Improvement
Needed

If Unsatisfactory,
describe the
problem

(e.g. repair, repairing,

replacement, etc.)

Manpower
Needed

(Indicate kind &

quantity)

(Indicate quantity &

nature of labor services
needed)

Repair
Repair

Tin sheets 15 pcs..

Plywood 15pcs.

repair
repair

Good Lumber 20 pcs.

Paint 2 gal., nails 2
kgs.
Paint 2 gal., nails 2
kgs.
Paint 2 gal., nails 2
kgs.

repair

Satisfactory
damaged

Windows & Doors

damaged

Repair

Blackboards / Tables

damaged

Repair

Chairs / Desks / Tables

damaged

Repair

Comfort Rooms
Leaking Pipes

Repair

damaged
Satisfactory

School ground / Landscaping

Satisfactory

Material
Resources
Needed

repair
repair
repair

School signs / signage

Not visible

Need to provide

Electrical
Fire Suppression / Extinguisher

Not safe
Not visible

Need to fix
Need to provide

Spray paint, 10
cannisters
Wire 1 roll, e-tape 5
rolls
5 fire extinguishers

Need to provide

1 plywood & paint

Signage Making

School free sharp objects

Prepare directory of identified classroom for
evacuation
Drainage system
Signage for on-going construction /
condemn building
Exit plan / signage of high story building
Post of directory of emergency contact
Establish early warning devices in case of
emergency

Spray printing
Rewiring
Installation

Satisfactory

Not visible
Satisfactory
Satisfactory

Not visible
Not visible

Need to provide
Need to provide

Tarpauline
1 plywood & paint

Printing
Signage Making

Not visible

Need to provide

3 buzzers

Installation

School equipped with first aid kit

Others, Specify:
Prepared by:
Vincent Y. Librea
School Physical Facilities
Coordinator

Satisfactory

Noted:
May 2, 2016
Date of Inspection

Gloria P. Carpio
Principal II