Brigada-eskwela Form 2015 Lawaan

Appendix B

Appendix B

BE Form 01

Republic of the Philippines

Department of Education

Region VII, Central VisayasDivision of Danao CityLAWAAN NATIONAL HIGH SCHOOLSchool Year 2015 - 2016BRIGADA ESKWELA

PHYSICAL FACILITIES REPAIR AND MAINTENANCE 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 forms for each classroom or the school facility.)

FACILITIESCondition

(Check One)RemarksNature of Improvement

Needed

(e.g. repair, repainting,

Replacement etcMaterials Resources Needed

(Indicate kind and quantity)Manpower Needed

(Indicate quantity and nature of labor services needed)

SatisfactoryUnsatisfactory

If Unsatisfactory

describe the problem

1. Roofs/ guttersGutters are clogged with dried leaves and other debri materialsCleaning of gutters1 Ladder 5 brooms5 cleaners8 hrs / cleaner

2. Ceilings

3. WallsDirty wallsCleaning of wallsPales, detergents

4. Windows and Doors

5. Chairs/desks/tables, and BlackboardsDamaged blackboards, chairsRepair of blackboards and chairs3 kilos common # 2 , 1 kilo #2 common nails, 2 sheets marine plywood, 4 liter blackboard slating paint5 carpenters16 hrs / carpenter

6. Comfort Rooms

7. Leaking PipesN/A

8. School Grounds/ LandscapingDamaged during the construction of three classroom building, damaged riprapGrounds near the new building needs filling and landscaping,Laying of stones for riprap

3 shovel, 3 digging barsStones for laying the riprap8 landscapers16 hrs / landscapers

9. School signs/signagesLoose building signagesProper fastening of signages 1 electric drill, 50 pcs tox and screws, extension wire1 laborer8 hrs / laborer

10. Electrical

11. Fire suppression equipments/ extinguishers

12. School free from any sharp objectsScattered wood debris and other potential hazard objectsPicking up of wood debris and disposing it to a proper place5 laborers8 hrs / laborer

13. Prepare directory of identified classroom for evacuationNone existence of directory for identified classroom for evacuationLay outing of directory in a tarpaulin and construction of its frame kilo # 2 nails3 - x16 lumber

1 hammer

1 cross cut saw

P240.00 for tarpaulin printing of directory

1 carpenter8 hrs / carpenter

1 graphic artist

8 hrs / graphic artist

14. DrainageNo canal for drainage in the newly constructed buildingDredging and digging of canal around the newly constructed building10 shovel, 10 digging bars

20 diggers

15. Signages for ongoing construction/ condemned buildings8 hrs / diggers

16. Exit plan/ signage of high story buildingN/A

17. Post directory of emergency contactNone existence of emergency contactLay outing of emergency contact directory and construction of its frame1 carpenter

8 hrs / carpenter

1 graphic artist

8 hrs / graphic artist

18. Establish Early warning devices in case of emergency

19. School equip with first aid kitsUsed up first aid kitsEvaluation of first aid kits1 clinic teacher1 medical personnel

20.Others specify

Prepared by:

Noted:

_______________________

______________________

JESSE M. CAPIN_School Physical Facilities Coordinator

Date of Inspection

School HeadAppendix CBE form 02



Region VII, Central VisayasDivision of Danao CitySANTICAN NATIONAL HIGH SCHOOLSchool Year 2014-2015BRIGADA 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 the conduct of Brigada Eskwela in your school and fill in the required information. Add another sheet if needed. One completed, submit a copy to the Adopt-A-School Program coordinator of your division on or before January 31.

KRAActivitiesTimelinePerson/s ResponsibleMaterials NeededBudget

1.Advocacy and Marketing

2. Resource Mobilization

3.Implementation

4.Monitoring and Evaluation

5. Reporting

Prepared by:

Noted by:

______________________________________

______________________

__________________________________

Signature over Printed Name

Date Prepared

ASP Division Coordinator/BE Coordinator

Appendix DBE Form 03




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 determined progress in acquiring resources needed.

Materials NeededQuantityKey

Persons/Organization to be TappedStrategies/Plan of ActionPerson ResponsibleStatusRemarks

Labor Skills/Volunteers NeededQuantityKey

Persons/Organization to be TappedStrategies/Plan of ActionPerson ResponsibleStatusRemarks

Prepared by:

Noted:______________________________________

JESSE M. CAPINResource Mobilization Committee Chairperson

School HeadAppendix EBE Form 04Republic of the Philippines



DAILY ATTENDANCE OF VOLUNTEERSInstructions: 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.

NAMEPOSITION/DESIGNATIONADDRESS/

ORGANIZATION/AFFILIATIONCONTACT

NUMBERTIMESIGNATURETOTAL NUMBER OF HOURS SERVED*NATURE OF VOLUNTEER SERVICES RENDERED

INOUT

Noted:JESSE M. CAPIN

____________________ School Head

DateAppendix FBE Form 05




RECORD OF DONATIONS RECEIVED

(To be accomplished by the Documentations Committee)

ITEMS OR MATERIALSQUANTITYDATE RECIEVEDNAME OF DONORASSUMED COST OF

TOTAL

PER UNITTOTAL

Prepared by:

Noted:____________________________________

JESSE M. CAPINCommittee on Documentation Chair/Member

School Head

Appendix G

BE Form 06Republic of the Philippines



DAILY ACCOMPLISHMENT REPORT

(To be accomplished by the Program Implementation Committee)DAY 1 2 3 4 5 6DATE:

Instruction: List down all the activities that needs to be undertaken for each day of the Brigada Eskwela 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.ActivitiesSTATUSREMARKS/RECOMMENDATIONS

CompletedStarted but not yet completedNot done

Prepared by:

Noted by:

__________________________________________

___________________

JESSE M. CAPINProgram Implementation Committee Chair/Member

Date Prepared

School Head

Appendix H

BE Form 07 Page 1 DEPARTMENT OF EDUCATION

BRIGADA ESKWELASCHOOL ACCOMPLISHMENT REPORT

(To be accomplished by the School Head)DIVISION:REGION:

SCHOOL:SCHOOL ID:

SCHOOL ADDRESS:

SCHOOL HEADCONTACT NO.

PTCA PRESIDENTCONTACT NO.

A. SCOPE OF REPAIR AND MAINTENANCE WORK COMPLETED(Please check appropriate column)

RepairedRepaintedReplacedOthers

(Brief Description)

1. Roofs

2. Ceilings

3. Walls

4. Windows and doors

5.Chairs/Desk, Tables and Blackboard

6.Comfort Rooms

7.Leeking Pipes

8. School Grounds/Landscaping

9. School Signs

10. Others (specify

B. DONATIONS/MATERIAL RESOURCES GENERATED (Use separate sheets, if needed

Type of DonationsSourceEstimated Cost

Total

BE Form 07 Page 2VOLUNTEER SERVICES

Type of VolunteerName of individuals/Organization

(Use separate sheets, if neededNo. of Volunteers

Day 1Day 2Day 3Day 4Day 5Day 6Total

1.PTCA Member

2.Barangay Officials

3. Municipal/City Government Officials

4. Provincial Government Officials

5. NGOs Civic

Organizations

6. Private Citizens

7. Private Companies/Corps

8. Other Government offices

9. Parents

10.Teachers

11. Pupils/Students

12. Others (specify)

13. Prominent Volunteers

Total

BE Form 07 Page 3D. ESTIMATED COST OF VOLUNTEER SERVICES RENDERED. Refer to Guide for Computing Labor Cost

(Use separate sheets, if needed)

Type of ServiceTotal Number of VolunteersTotal Number of Hours RenderedTotal Estimated Costs

Masonry

Carpentry

Plumbing

Electrical/Electronic

Landscaping/Gardening

Painting

Ordinary Labor

Others

Total

E. SIGNICANT EVENTS / EXPERIENCES (Use separate sheets, if needed)

What happened?Who were involved?When?What is/are important contribution to the operation of the school or to the existing needs of the school?

F. ISSUES AND CONCERNS (Describe briefly problems encountered and how resolved)

G. LESSONS LEARNED / BEST PRACTICES

BE FORM 07 Page 4H. SUGGESTIONS TO STRENGTHEN BRIGADA ESKWELA PROJECT (Include support needed from Central Region, and Division Office that can increase the impact of Brigada Eskwela Project in your school.)

I. EVIDENCES / ATTACHMENTS

a. Photos (before, during and after)

b. Photocopy of all completed BE Forms (check if attached)

____________ Form 01 _________ Form 05

____________ Form 02 _________ Form 06

____________ Form 03

____________ Form 04

Prepared by:JESSE M. CAPINTeacher-In-ChargeDate:

Documents

Brigada-eskwela Form 2015 Lawaan