BE Form: Condition (Check One)

BE Form 01 Republic of the Philippines
Department of Education
Region VII
Division of Negros Oriental
S.Y. 2015-2016
BRIGADA ESKWELA
PHYSICAL FACILTIES REPAIR AND MAINTENANCE NEEDS ASSESSMENT FORM
(To be accomplished by the School Physical Facilities Coordinator)
Instruction: Conduct and 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 forms for each classroom or school facility.)
FACILTIES Remarks Nature of Improvement Material Resources Needed Manpower Needed
Condition (If Unsatisfactory, Needed (Indicate kind and quantity) (Indicate quantity and nature of labor service needed)
describe the problem) (e.g. repair, repainting,
(Check One) replacement, etc.
Satisfactory Unsatisfactory
 Roof/gutters √ Lack of materials Repair/Replacement 10 GI sheets and 2 kls umbrella nails Dagyaw – 6 carpenters
 Ceilings √ The ceilings are worn out Repair/replacement 4 pcs plywood, 1 kl. nail Dagyaw – 3 carpenters
Walls √ Wall paints are fading Repainting 16 gallons of paint Dagyaw – 20 carpenters

Blackboards Paints are fading Repainting 4 gallons of paint Dagyaw – 6 carpenters
 Chairs/desk/tables √
 Water facilities/drainage √
system
 Signages √
 School garden √
 Lighting √
 Windows √ Lack of materials Repair 3 pairs frame holder, 10 smooth glass Dagyaw – 1 carpenter
 Doors √ Paints are fading Repainting 2 gallons of paint Dagyaw – 2 carpenter
 Comfort rooms √ Lack of materials Repair 1 kl nails Dagyaw – 1 parent
 School grounds √
 School canteen/clinic √
 School fence √
 Others, please √
specifyinstallation of
culverts
Prepared by: Noted:
JAYSON SOLAMILLO ELLEN K. SELARDE

School Facilities Coordinator School Principal
Date Prepared:
Region VII
S.Y. 2015-2016
BRIGADA ESKWELA
SCHOOL WORK PLAN
(To be accomplished by the School Head)
Instruction: List down all the specific activities that you will be undertaking in relation to BrigadaEskwela in your school and fill in the required information. Add another sheet if needed. Once completed, submit
a copy to the Adopt-A-School Program Coordinator of your division on or before January 31.
KRA Activities Timeline Person/s Responsible Materials Needed Budget

5/18/2015 Teachers/SH Banners, Posters, Tarpaulin P 500.00
1. Advocacy and Marketing Posting of campaign materials like tarpaulin, etc.
House to house campaign.
2. Resource Mobilization
Inform PTA officials and Parents. 5/19/2015 Teachers/SH Letter
3. Implementation Launching of Brigada Eskwela 5/20/2015 Different Committee Charts, AIP P 1,000.00
Chairs/SH/Teachers
4. Monitoring and evaluation 1. Attendance of Parents 5/21/2015 Teachers, PTA official Forms, attendance sheet P 1,500.00
2. Ocular inspection of Brigada Task Force
3. Prepare reports before during and after
5. Reporting 1. Pass the pertinent report to the district office

2. Reproduction of the reports 5/22/2015 School Head, SBE Coordinator Camera P 150.00
Prepared by: Noted by:
JOCELYN B. CENAS ASP Division Coordinator/BE Coordinator

Signature over Printed Name
Region VII
S.Y. 2015-2016
BRIGADA ESKWELA
RESOURCE MOBILIZATION FORM
(To be accomplished by the Resource Mobilization Committee)
Instruction: Using the completed BE Form 01: Physical Facilities Needs Assessment Form as basis, summarize the resources (materials and manpower needed and list down the potential source or partners to be
tapped. Add additional sheet if needed. The Status and Remarks columns should be updated regularly to determine progress in acquiring resources needed.
Materials Needed Quantity Key Persons/Organizations to Strategies/Plan of Persons Responsible Status Remarks
be Tapped Action
Paint 22 gallons PTA, Parents, Pupils Solicitation PTA, Parents, Pupils Accomplished
Paint brush 10 pcs PTA, Parents, Pupils Solicitation PTA, Parents, Pupils Accomplished
Nails 1 kl PTA, Parents, Pupils Solicitation PTA, Parents, Pupils Accomplished
Labor Skills/Volunteers Quantity Key Persons/Organizations to Strategies/Plan of Persons Responsible Status Remarks
Needed be Tapped Action
Gardening/landscaping 30 PTA, Teachers, Parents Ask for volunteers Teachers, parents, pupils Accomplished
Carpenting 18 PTA, Teachers, Parents Ask for volunteers Teachers, parents, pupils Accomplished
Plumbing 18 PTA, Teachers, Parents Ask for volunteers Teachers, parents, pupils Accomplished
Painting 30 PTA, Teachers, Parents Ask for volunteers Teachers, parents, pupils Accomplished
others 702 PTA, Teachers, Parents Ask for volunteers Teachers, parents, pupils Accomplished
Prepared by: Noted:
JAYSON SOLAMILLO ELLEN K. SELARDE

Resource Mobilization Committee Chairman School Principal
Region VII
S.Y. 2015-2016
BRIGADA ESKWELA
RECORDS OF DONATIONS RECEIVED
(To be accomplished by the Documentation Committee)
ITEMS OR MATERIALS QUANTITY DATE NAME OF DONOR ASSUMED COST OF ITEM
RECEIVED
Per Unit Total
Paint 22 gal May 18-18,2015 Parents 500 gal P 11,000
Paint brush 10 pcs May 18, 2015 Parents 450 gal P 450
Nails 1kl May 19, 2015 Parents 70 kl P 70
Prepared by: Noted:
FELYAN ROSE R. NUIQUE ELLEN K. SELARDE

Committee on Documentation Chair/Member School Principal
Region VII
S.Y. 2015-2016
BRIGADA ESKWELA
DAILY ACCOMPLISHMENT REPORT
(To be accomplished by the Program Implementation Committee)
Day 11 2 3 4 5 Date: May 18, 2015
Instruction: List down all the activities that needs to be undertaken for each day of the BrigadaEskwela week. At the end of each day, please mark the appropriate column that corresponds to the status of each activity.
Cite reasons for non-completion.
Activities STATUS REMARKS/RECOMMENDATIONS
Completed Started by not yet completed Not Done
Launching of Brigada Eskwela Accomplished
Putting up of streamer Accomplished
Pruning of trees Not accomplished
Cleaning of surroundings Not accomplished
Repainting of classrooms Not accomplished
HENRY CENAS ELLEN K. SELARDE

Program Implementation Committee Chair/Member Date Prepared : School Principal
Region VII
S.Y. 2015-2016
BRIGADA ESKWELA
Day 1 2 3 4 5 Date: May 19, 2015
Landscaping Not all
Cleaning of surrounding Not all
Repainting of classroom Not all

Program Implementation Committee Chair/Member Date Prepared: School Principal
Region VII
S.Y. 2015-2016
BRIGADA ESKWELA
Day 1 2 3 4 5 Date: May 20, 2015
Instruction: List down all the activities that needs to be undertaken for each day of the BrigadaEskwela week. At the end of each day, please mark the appropriate column that corresponds to the status of each activity
. Cite reasons for non-completion.
Repairing of chairs, tables Not all
Replacement of ceilings Accomplished
Pruning of trees -do-
Landscaping

Region VII
S.Y. 2015-2016
BRIGADA ESKWELA
Day 1 2 3 4 5 Date: May 21, 2015
Cleaning of surroundings Not all
Repainting of classrooms Not all
Repairing of CR’s Not all

Program Implementation Committee Chair/Member Date Prepared School Principal
Region VII
S.Y. 2015-2016
BRIGADA ESKWELA
Day 1 2 3 4 5 Date: May 22, 2015
Cleaning of surroundings Accomplished
Repairing of classrooms Accomplished

Region VII
S.Y. 2013-2014
BRIGADA ESKWELA
Day 1 2 3 4 56 Date: May 24, 2012
Cleaning of surroundings Accomplished
Repairing of classrooms Accomplished


BE Form: Condition (Check One)

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BE Form: Condition (Check One)

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BE Form 01 Republic of the Philippines

JAYSON SOLAMILLO ELLEN K. SELARDE

KRA Activities Timeline Person/s Responsible Materials Needed Budget

5. Reporting 1. Pass the pertinent report to the district office

Prepared by: Noted by:

JOCELYN B. CENAS ASP Division Coordinator/BE Coordinator

JAYSON SOLAMILLO ELLEN K. SELARDE

Prepared by: Noted:

FELYAN ROSE R. NUIQUE ELLEN K. SELARDE

Prepared by: Noted by:

HENRY CENAS ELLEN K. SELARDE

Prepared by: Noted by:

HENRY CENAS ELLEN K. SELARDE

Prepared by: Noted by:

HENRY CENAS ELLEN K. SELARDE

Prepared by: Noted by:

HENRY CENAS ELLEN K. SELARDE

Prepared by: Noted by:

HENRY CENAS ELLEN K. SELARDE

Prepared by: Noted by:

HENRY CENAS ELLEN K. SELARDE

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