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Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF BILIRAN
BE Form 01 BRIGADA ESKWELA 2021
PHYSICAL FACILITIES REPAIR AND MAINTENANCE NEEDS
ASSESSMENT FORM SCHOOL: CAPIÑAHAN ELEMENTARY SCHOOL
(To be accomplished by the School Physical Facilities
Coordinator) ROOM NUMBER:
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 (Check one) Remarks
Manpower Needed
Nature of Improvement Material Resources
(indicate quantity and
FACILITIES If Unsatisfactory, Needed (e.g. repair, Needed (indicate kind
nature of labor services
Satisfactory Unsatisfactory
describe the problem repainting, replacement, etc.) and quantity)
needed)
Roofs/gutters
Ceilings/walls
Windows and doors
Blackboards/tables
Chairs/desks/tables
Comfort Rooms
Leaking Pipes
School Ground/Landscaping
School Signs/Signage's
Electrical
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Fire Suppression/Extinguisher
School free from sharp objects
Prepare directory of identified
classroom for evacuation
Drainage System
Signage's for on-going
construction/condemn building
Exit Plan/Signage's of high storey
building
Post of directory of emergency
contact
Establish early warning devices in
case of emergency
School equipped with First Aid Kit
Others: Please specify
Prepared by: Noted:
School Physical Facilities Coordinator Date of Inspection TIC/Head Teacher/Principal
Include this form in the Brigada Eskwela Accomplishment Report
Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF BILIRAN
BRIGADA ESKWELA 2021
BE Form 02
SCHOOL WORK PLAN SCHOOL: CAPIÑAHAN ELEMENTARY SCHOOL
(To be accomplished by the School Head)
Instruction: List down all the specific that you will be undertaking in relation to the conduct of Brigada Eskwela 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.
PERSONS
KEY RESULT AREA ACTIVITIES TIMELINE MATERIALS NEEDED BUDGET
RESPONSIBLE
1) Advocacy & Marketing
2) Resource Mobilization
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3) Implementation
4) Monitoring and Evaluation
5) Reporting
Prepared by: Noted:
Signature over Printed Name Date Prepared TIC/Head Teacher/Principal
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Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF BILIRAN
BRIGADA ESKWELA 2022
BE Form 04 SCHOOL: INASUYAN INTEGRATED SCHOOL
DAILY ATTENDANCE OF VOLUNTEERS
Date:
Instructions: Volunteers themselves should personally fill in the details required by this form under the supervision of any of the committee members. For
the last column, indicate if masonry, carpentry, plumbing, painting, electrical, gardening/landscaping, ordinary labor, or others.
TIME
TOTAL
ADDRESS/ NATURE OF
POSITION/ NUMBER
NAME DESIGNATION
ORGANIZATION/ CONTACT NUMBER SIGNATURE
OF HOURS
VOLUNTEER SERVICE
AFFILIATION IN OUT RENDERED
SERVED
Noted:
JENNIFER D. VERUEN
School Head Date
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Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF BILIRAN
BRIGADA ESKWELA 2021
BE Form 03
RESOURCE MOBILIZATION FORM SCHOOL: CAPIÑAHAN ELEMENTARY SCHOOL
(To be accomplished by the Resource Mobilization Committee)
Instruction: Using the completed BE Form 01: Physical Facilities Needs Assessment Form as basis, summarize the resource (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.
Key Persons/
Person
Materials Needed Quantity Organizations to Strategies/ Plan of Action Status Remarks
Responsible
be tapped
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Key Persons/
Labor Skills/Volunteers Person
Quantity Organizations to Strategies/ Plan of Action Status Remarks
Needed Responsible
be tapped
Prepared by: Noted:
Resource Mobilization Committee Chairperson TIC/Head Teacher/Principal
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AN ELEMENTARY SCHOOL
) needed and list
o determine
Remarks
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Include this form in the Brigada Eskwela Accomplishment Report
Remarks
her/Principal
Include this form in the Brigada Eskwela Accomplishment Report
Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF BILIRAN
BRIGADA ESKWELA 2021
BE Form 05 SCHOOL: CAPIÑAHAN ELEMENTARY SCHOOL
RECORDS OF DONATIONS RECEIVED
(To be accomplished by the Documentation Committee)
ASSUMED COST OF ITEMS
ITEMS OR MATERIALS QUANTITY DATE RECEIVED NAME OF DONOR
PER UNIT TOTAL
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Prepared by:
Committee on Documentation Chair/ Member Date
Noted:
School Head
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Include this form in the Brigada Eskwela Accomplishment Report
Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF BILIRAN
BRIGADA ESKWELA 2021
BE Form 06 SCHOOL:
DAILY ACCOMPLISHMENT REPORT
(To be accomplished by the Program Implementation Committee)
Day 1 2 3 4 5 6 Date
Instructions: List down all the activities that needs to be undertaken for each of the Brigada Eskwela week. At the end of each day, please mark the appropriate column
that corresponds to status of each activity. Cite reason for non-completion.
STATUS
ACTIVITIES REMARKS / RECOMMENDATIONS
Completed Not yet completed Not Done
Prepared by:
Program Implementation Committee Chair/Member Date Noted:
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School Head
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opriate column
DATIONS
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ool Head
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Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF BILIRAN
BRIGADA ESKWELA 2021
BE Form 07
SCHOOL ACCOMPLISHMENT REPORT
(To be accomplished by the School Head)
SCHOOL: SCHOOL ID:
SCHOOL ADDRESS:
(Please check appropriate box)
Level: Type of School:
Elementary Central School
Non-Central
Multigrade
Primary School/Incomplete
Secondary Integrated School
SCHOOL HEAD: CONTACT NUMBER:
PTA PRESIDENT: CONTACT NUMBER:
A. SCOPE OF REPAIR AND MAINTENANCE WORK COMPLETED BASED on SIP & Enclosure No. 2 to DepEd Memo
No. 35, s. 2016 (all accomplishments supported with pictures) (Please check appropriate column)
What was done?
New
FACILITIES Equipment Construction Replaced Repaired Repainted
1. Roofs/rain gutter
2. Walls/Ceilings
3. School Building Directory
4. Windows and Doors
5. Chairs/Desks, Tables and Blackboards
6. Comfort Rooms
7. Leaking Pipes
8. School Grounds/Landscaping
9. School Signs/Signage's
10. Electrical
11. Fire Extinguishers(Suspended Outside)
12. School free from any sharp objects
13. Prepare directory of emergency contact
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14. Drainage
15. Signage's for on-going construction/
condemned buildings
16. Exit Plan/Signage of high storey building
17. Post directory of emergency contact
18. Establish early warning devices in case of
emergency
19. School equip with first aid kits
20. Vegetable Garden
21. Waste depository (with segregation)
22. Disaster Organizational Chart
23. Others (specify)
B. DONATIONS/MATERIAL RESOURCES GENERATED (Use separate sheet, if needed)
Type of Donations Source Estimated Cost
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
TOTAL P
C. VOLUNTEER SERVICES (Use separate sheets of daily attendance)
Name of Individual/ Number of Volunteers
Type of Volunnteer
Organization Day 1 Day 2 Day 3 Day 4 Day 5 Day 6
A. PRIVATE SECTOR
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1. NGO
2. PTA
3. SGC
4. Gawad Kalinga
5. Corporation
6. Etc.
B. COMMUNITY
1. Parents
2. Alumni
3. Private Individual/ Community
Members
4. Religious Organization
(Youth & Adult)
C. Gov't. Agencies(LOCAL &
NAT'L)
1. Congressional Officials & Staff
2. Provicial Officials
3. Barangay Officials
4. SK Officials
5. Provincial Employees
6. Firemen/PNP, etc.
7. AFP (PA, Marine, etc.)
8. Barangay Workers
10. Other Volunteers
TOTAL
D. ESTIMATED COST OF VOLUNTEER SERVICES RENDERED (Use separate sheets, if needed)
Rate per Rate per Total Number of Total Number of Total Estimated
TYPE OF SERVICES
Day Hour Volunteers Hours Rendered Costs
Masonry
Carpentry
Plumbing
Electrical/Electronic
Landscaping
Painting
Ordinary Labor
Others
TOTAL
E. IMPACT OF BRIGADA ESKWELA (enrollment Rate)% of increase/decrease
Enrolment June 2017 minus Enrolment Yearend April 2017-2018 =
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F. SIGNIFICANT EVENTS / EXPERIENCES (Use separate sheets, if needed)
What is/are its important contribution to the
What happened? Who were involved? When? operation of the school or to the existing needs of
the school?
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G. ISSUES AND CONCERN (Decribe briefly problems encountered and how resolved)
H. LESSONS LEARNED / BEST PRACTICES
I. SUGGESTION TO STRENGTHEN BRIGADA ESKWELA PROJECT (Include support needed from Central, Region and
Schools Division Office that can increase the impact of Brigada Eskwela Project in the school)
J. EVIDENCES / ATTACHMENTS
a. Photos (before, during and after)
b. Photocopy of all completed BE Forms:
1. Form 01 3. Form 03 5. Form 05
2. Form 02 4. Form 04 6. Form 06
Prepared by: Date:
Name of School Head with signature and Designation
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No. 2 to DepEd Memo
n)
Repainted Others
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Estimated Cost
nteers
Day 6 TOTAL
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Total Estimated
Costs
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nt contribution to the
to the existing needs of
ool?
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m Central, Region and
