BE Evaluation Form

Republic of the Philippines
DEPARTMENT OF EDUCATION
Region 1
City of San Fernando, La Union 2500
1. SCOPE OF REPAIR AND MAINTENANCE WORK (30%)
School: CATALINO D. CEREZO NHS School ID: 321121

Level: c Elementary c Secondary
Category: c Small c Medium
c c Large c c Mega
School Head: DOMINADOR
c V. NABOR
c c
JR. Contact
c Number: c c
c c c c Number c c
School BE Coordinator: RUBY B. SEBASTIAN Contact
c c c c c c
c c c c % of
PARTICULARS Planned Actual
Completion
Repair/Replacement/Repainting
Roof
 wooden trusses and purlins
 corrugated G.I. roofings, ridge roll/valley
roll
 fascia board
 gutters
 downspouts
Ceiling
 ceiling joist and hangers
 1/4 thick marine plywood or 1/4 thick
hardiflex
Walls
 CHB wall
 Tongue and grove/wooden panels
 Plastering of CHB wall
Windows
 Window jambs
 Jalousie frames
 Glass blade
Doors
 Door jambs
 Hinges
 Door knobs
 Flush door/panel doors
 Double lock/hasp lock
Flooring
 elevated floors
 tiling
 repair of cracks
 plain cement finished
 topping
School Furniture
 Blackboards
 Teacher’s table and chair
Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

Revision : 00 (072)-607-8136 region1@deped.gov.ph
Effectivity Date : 7-13-2018
Region 1
 Armchair
Comfort Rooms
 Pipe lines
 Gate valve
 Angle valve
 Flexible hose
 Floor drain
 Faucet
 Toilet bowl
 Tank fittings and p-trap
 Bidet
Handwashing/Water Facilities
 Distribution pipe
 Supply pipe
 Faucets
 Water tank
 Lavatory
Electrical Works
 Repair/replacement of
fluorescent/incandescent bulbs
 Repair/replacement of convenience
outlets, switches and breaker
 Upgrading/rewiring of classroom building
School Grounds
 Landscaping
 School signs
 Concrete foot paths
 Covered pathways
 Perimeter Fence
 Gate
 Shades/parks
Contruction Works
 Classroom or building
 Multipurpose hall
 Kiosks
 Plant boxes
 Drainage system
 Wash facilities
 Comfort Rooms
Other Works






Region 1
TOTAL
Total percentage of completion x 35

Score =
Number of works done
SCHOOL
HEAD: Signature over Printed Name Date
EVALUATOR:
Signature over Printed Name Date

Region 1
2. DIVERSE VOLUNTEER PARTICIPATION (25%)

Level: Elementary Secondary
Category: c Small c Medium c Large c Mega
c V. NABOR
c JR. Contact
c Number: c
c c
School BE Coordinator: RUBY B. SEBASTIAN c Number
Contact c
c c c c
c c
Computation of Actual versus Target c c
- Schools will be making plans to promote enhanced percentage increment in
participation and generated resources based on the Action Plan. The Action
Plan should be the basis for Physical and Financial Targets.
- BE Form 1 is the basis for the Work Plan. It must be pre-validated by the
Division Monitoring Team. It is the declaration of Scope of Work.
2.1 Parents 15% ( %) of the current enrollment)
Formula: Turnout/Target x 15% x 100
Turnout – actual number of parent volunteer
Target – set as stated in the work plan
Example: DP = 800/1000
DP = 0.8 x 15%
DP = 0.12 x 100
DP = 12
2.2 Other Volunteers 10% (1-4 entity per category = 1; 5 and above = 2) then add
to get the total)
 NGAs and other government organization and public corporations
 LGUs (Barangay/Municipal/Provincial)
 Community Involvement including NGOs and Professional
Associations
 Private Sector Involvement including Corporate Foundations and
Private Schools
 Pupil/Student Organization (SSG/SPG) and Alumni Associations
TOTAL
SCHOOL
EVALUATOR:

Region 1
3. GENERATED RESOURCES (15%)

(Note: In-kind donations converted into peso-worth, including the labor cost)

Category: c Small c Medium
c c Large c c Mega
c V. NABOR
c c
JR. Contact
c Number: c c
c c c c Number c c
c c c c c c
c
Generated c for Elementary Level
Resources c (15%) c
Pts
Small School Medium School Large School Mega School
6,666.60 & below 100,000 – 113,333 300,000 – 313,332 500,000 – 513,332 1
6,666.61 – 13, 333.20 113,334 – 126,667 313,333 – 326,666 513,333 – 526,666 2
13,333.21 – 19,999.80 126,668 – 140,000 326,667 – 339,999 526,667 – 539,999 3
19,999.81 – 26,666.40 140,001 – 153,333 340,000 – 353,332 540,000 – 553,332 4
26,666.41 – 33,333.00 153,334 – 166,667 353,333 – 366,666 553,333 – 566,666 5
33,333.01 – 39,999.60 166,668 – 180,000 366,667 – 379,999 566,667 – 579,999 6
39,999.61 – 46,666.20 180,001 – 193,333 380,000 – 393,332 580,000 – 593,332 7
46,666.21 – 53,332.80 193,334 – 206,667 393,333 – 406,666 593,333 – 606,666 8
53,332.81 – 59,999.40 206,668 – 220,000 406,667 – 419,999 606,667 – 619,999 9
59,999.41 – 66,666.00 220,001 – 233,333 420,000 – 433,332 620,000 – 633,332 10
66,666.01 – 73,332.60 233,334 – 246,667 433,333 – 446,666 633,333 – 646,666 11
73,332.61 – 79,999.20 246,666 – 260,000 446,667 – 459,999 646,667 – 659,999 12
79,999.21 – 86,665.80 260,001 – 273,333 460,000 – 473,332 660,000 – 673,332 13
86,665.81 – 93,332.40 273,334 – 266,667 473,333 – 486,666 673,333 – 686,666 14
93,332.41 – 99,999.00 286,668 – 300,000 486,667 – 499,999 686,667 – 699,999 15
Generated Resources for Secondary Level (15%) Pts

Small School Medium School Large School Mega School
6,666.60 & below 100,000 – 113,333 300,000 – 346,667 1,000,000 – 1,046,667 1
6,666.61 – 13, 333.20 113,334 – 126,667 346,668 – 393,333 1,048,668 – 1,093,333 2
13,333.21 – 19,999.80 126,668 – 140,000 393,334 – 440,000 1,093,334 – 1,140,000 3
19,999.81 – 26,666.40 140,001 – 153,333 440,001 – 486,666 1,140,001 – 1,186,666 4
26,666.41 – 33,333.00 153,334 – 166,667 486,667 – 533,333 1,186,667 – 1,233,333 5
33,333.01 – 39,999.60 166,668 – 180,000 533,334 – 580,000 1,233,334 – 1,280,000 6
39,999.61 – 46,666.20 180,001 – 193,333 580,001 – 626,666 1,280,001 – 1,326,666 7
46,666.21 – 53,332.80 193,334 – 206,667 626,667 – 673,333 1,326,667 – 1,373,333 8
53,332.81 – 59,999.40 206,668 – 220,000 673,334 – 719,999 1,373,334 – 1,419,999 9
59,999.41 – 66,666.00 220,001 – 233,333 720,000 – 766,666 1,420,000 – 1,466,666 10
66,666.01 – 73,332.60 233,334 – 246,667 766,667 – 813,333 1,466,667 – 1,513,333 11
73,332.61 – 79,999.20 246,666 – 260,000 813,334 – 859,999 1,513,334 – 1,559,999 12
79,999.21 – 86,665.80 260,001 – 273,333 860,000 – 906,666 1,560,000 – 1,606,666 13
86,665.81 – 93,332.40 273,334 – 266,667 906,667 – 953,332 1,606,667 – 1,653,332 14
93,332.41 – 99,999.00 286,668 – 300,000 953,333 – 999,999 1,653,333 – 1,699,999 15
SCHOOL
EVALUATOR:

Region 1
4. ALIGNMENT OF THE MAINTENANCE EFFORT TO CURRENT THEME OF

BRIGADA ESKWELA (15%)

Level: Elementary Secondary
Category: c Small c Medium c Large c Mega
c V. NABOR
c JR. Contact
c Number: c
c
School BE Coordinator: c
RUBY B. SEBASTIAN c Number
Contact c
c c c c
c 6%
4.1 WASH in School c c c
Formula: (Raw score/12) x 6
 Provision of water supply, through connection to barangay water
networks, construction of water pumping system, and/or installation of
rainwater catchments
 Construction of additional toilets, particularly gender-segregated toilets
for boys and girls
 Repair and improvement of existing toilets, including desludging, to
ensure functionality, privacy, comfort and security for learners,
especially girls
 Construction/improvement of individual and group handwashing
facilities
 Improving accessibility to water, toilet and handwashing facilities
through provision of concrete footpaths, disability ramps and roofing
 Provision of rest space for menstruating girls that are private, secure
and comfortable
 Improvement of drainages, cleaning of roof gutters, and elimination of
stagnant water
 Provision of hygiene supplies – soap, toothpaste, toothbrush, sanitary
pads, etc. – and cleaning materials
 Improvement of solid waste management, including the provision of
garbage bins for waste segregation, compost pits and material
recovery facilities and/or securing local garbage collection services
 Putting-up of hygiene messages in strategic places (toilets and eating
places) to motivate proper use of toilets and handwashing at critical
times, especially after using the toilet and before eating
 Orientation of parents and other stakeholders on WinS and engaging
their support for developing proper WASH practices at home and the
community
 Orientation and certification of canteen operators, vendors and food
handlers on proper hygiene and sanitary food preparation and
handling

Region 1
4.2 School Safety and Preparedness Guide 6%

Not
CRITERIA Evident
Evident
On Safe Learning Facilities
 Facilitate the assessment of school electrical system to
make necessary repairs and/or upgrades to prevent fire
incident.
 Repair minor classroom damages such as broken
windows, doors, blackboards, roofs, etc.
 Install appropriate and available fire suppression
equipment or resources such as fire extinguishers, water
source, and other indigenous materials.
 Make sure that corridors and pathways are unobstructed
and that all sharp, protruding objects which may cause
harm to students are removed.
 Clean and clear drainage to prevent clogging. Cover
drainage canals and provide necessary warnings.
 Cordon off and post safety signage for on-going
construction, unfinished, damaged and condemned
buildings.
 Secure cabinets and drawers and ensure that heavy
objects are below head level.
 Post safety measures in laboratories and workshops.
 Prepare an evacuation/exit plan and directional signage
on every floor of the building
 Identify evacuation areas and classrooms that can be
used as temporary shelters during disasters and
emergencies
 Prune trees to avoid entanglement from electrical wirings
and avoid potential harm to life and property.
On School Disaster Management
 Post a directory of emergency contact numbers of
relevant government agencies and offices in various
areas of the school.
 Establish early warning mechanisms and inform all
learners and personnel on this.
 Equip school with first aid kits, flashlights, megaphones
and other necessary supplies that may be needed in
times of emergencies. Ensure that these items can be
easily located and accessed.
 Identify alternative sources and/or maintain supply of
drinking water within the school.
 Ensure that learners, teachers and personnel have
identification cards with relevant information
 Create database of learners with the contact details of
their family.
 Secure and safely store vital school records.
 Coordinate with barangay officials on pedestrian safety of
learners.
 Document accidents experienced by learners and
personnel within the school to improve prevention and
mitigation measures.
On Disaster Risk Reduction Education
Region 1
 Identify a storage area for safekeeping of vital school

records, textbooks, teaching manuals, computers, and
other school equipment.
TOTAL: (number of evident items/21) x 6 = Points
Note: Deduct the number of NA’s to the total criteria to serve as
the divisor
4.3 Advocacy on Brigada Eskwela Theme translated into school overall
experiences and learnings 3%
Conducted any one (1) of the following special activities not
included in Creativity and Innovation (MOV is required)
 Press Conference/Media Forum/Media Interview
purposely for Brigada Eskwela (BE)
 Stakeholders’ Forum/Summit
 Bloodletting
 Fun run/walk/cycling for a cause
 Poster/Slogan Making Contest
 House to house distribution of BE flyers/brochures
 Posting of BE Advocacy Tarp by Partner
Agencies/Private Partners
 Others
SCHOOL
EVALUATOR:

Region 1
5. CREATIVITY AND INNOVATION (10%)

Level: Elementary c Secondary
Category: c Small c Medium c Large c c c Mega
c V. NABORc JR. Contact
c Number: c c c
c c c Number c c c
c c c c c c
Category c Small c
Medium Largec Mega c c
Points
Number of 8 & below 12 & below 28 & below 60 & below 0.5
Beneficiaries for 9-17 13-24 29-56 61-120 1
each Creativity 18-24 25-35 57-80 121-180 1.5
& Innovations 25 & above 36 & above 81 & above 181 & above 2
Note: Based from the formula that indigents/under privilege is 15% to 20% of the total
enrollment and mostly half of these recipients could come.
Number of
Particulars Score
Beneficiaries
5.1 Provision of School supplies, uniforms, goods, etc.
(1%)
5.2 Medical/Dental/Optical Mission
 Free medical check-up/consultation
 Free basic medicines/vitamins
 Free eye check-up and distribution of eye glasses
 Free dental check-up, cleaning and tooth extraction
 Wellness program
Total Beneficiaries:
5.3 Special Services
 Livelihood trainings
 Free haircut
 Other services
5.4 Awareness/Literacy Campaign
 Seminar on topic special concern of the school
 First aid training
 Disaster preparedness
 Awareness program on HIV, Rabies, Early Pregnancy,
Drug Addiction, etc.
5.5 Others – please specify

Region 1
SCHOOL
EVALUATOR:

Region 1
6. INCREMENT OF RESOURCES AND VOLUNTEERS (5%)
School: School ID:

Category: Small c
Medium Large c Mega
c c c c
School Head: c Contact Number: c
c c c c
c c
c
School BE Coordinator: c c
Contact Number c
c c
c c c c
Formula: c c c c
% increase in GR = GR SY 2019 – GR SY 2018 x 100

GR SY 2018
% increase in V = V SY 2019 – V SY 2018 x 100

V SY 2018
Where: GR = Generated Resources

V = Volunteers
Generated Number of
% Increase Points
Resources Volunteers
0–4 0.5
5 – 10 0.625
11 – 16 0.75
17 – 22 0.875
23 – 28 1
29 – 34 1.125
35 – 40 1.25
41 – 46 1.375
47 – 52 1.5
53 – 58 1.625
59 – 64 1.75
65 – 70 1.875
71 – 76 2
77 – 82 2.125
83 – 88 2.25
89 – 94 2.375
95 – 100 2.5
SCHOOL
EVALUATOR:


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Republic of the Philippines

1. SCOPE OF REPAIR AND MAINTENANCE WORK (30%)

School: CATALINO D. CEREZO NHS School ID: 321121

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

Total percentage of completion x 35

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

2. DIVERSE VOLUNTEER PARTICIPATION (25%)

School: CATALINO D. CEREZO NHS School ID: 321121

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

3. GENERATED RESOURCES (15%)

School: CATALINO D. CEREZO NHS School ID: 321121

Generated Resources for Secondary Level (15%) Pts

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

4. ALIGNMENT OF THE MAINTENANCE EFFORT TO CURRENT THEME OF

School: CATALINO D. CEREZO NHS School ID: 321121

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

4.2 School Safety and Preparedness Guide 6%

 Identify a storage area for safekeeping of vital school

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

5. CREATIVITY AND INNOVATION (10%)

School: CATALINO D. CEREZO NHS School ID: 321121

5.5 Others – please specify

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

6. INCREMENT OF RESOURCES AND VOLUNTEERS (5%)

School: School ID:

% increase in GR = GR SY 2019 – GR SY 2018 x 100

% increase in V = V SY 2019 – V SY 2018 x 100

Where: GR = Generated Resources

Document Code : RO1-LQF-ESSD-SPPS-001 (072)-607-8137 depedregion1

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