Republic of the Philippines

Province of Bohol
MUNICIPALITY O F TRINIDAD

CRITERIA FOR THE IMPLEMENTATION OF CLEAN AND GREEN

PROGRAM IN THE BARANGAY 2007
(30%)

Barangay : ___________________

I. Physical Condition (55 Points) Expected Score Earned Score

General Cleanliness (24 Points)

1. Clean neat and well-arranged barangay hall and offices 8 ___________

2. Presence of well kept public toilet in the barangay hall 3 ___________
in the barangay
3. Absence of uncollected garbage /litters within the barangay 3 ___________
4. Presence of trash/garbage receptacles compost pit/pile
In the barangay hall 3 ___________
5. Well maintained barangay hall surroundings 3 ___________

A. Presence of Health and Environmentally Friendly Practicus (11pts.)

1. Individual household toilet 8 ___________

2. Presence of trash receptacles and compost pile within the
Strategic place of the barangay 3 ___________

B. Urban Space Greening (20 points)

1. Presence of Greenbelt areas ( Cluster of Trees/

Ornamentals plants) 4 ___________
2. Tree-lined thoroughfares 4 ___________
3. Road cleaned and Beautification 4 ___________
4. Gulayan sa Bayan 4 ___________
5. Functional Barangay Nursery 4 ___________

II – SUPPORT SYSTEM ( 25 POINTS)

1. Functional structure with specific area of assignment

( Purok/Sitio and School) and schedules of cleaning
And Community Participation 5 ___________
2. Budget on Clean and Green program and related projects 5 ___________
3. Ordinance and resolutions and issuances in support to clean
And green program 5 ___________
4. Barangay initiated mechanism/ innovations in the implementation
of clean and green program including IEC materials/ Billboards
or inter-purok contests. 10 ___________
 Republic of the Philippines
Province of Bohol
MUNICIPALITY OF TRINIDAD

CRITERIA FOR THE PUROK / SITIO CENTER EVALUATION

(15%)

Barangay : _____________________ Sitio Center: _____________

1. Building (30 points) EXPECTED SCORE EARNED SCORE

1.1 Structurally Safe 15 ________________

1.2 Big enough to accommodate members 10 ________________
1.3 With paint 5 _________________
Without paint 3 _________________

2. PHYSICAL SEP-UP/PRESENCE OF REQUIRED MATERIALS (25 POINTS)

2.1 Sitio profile 5 _________________

2.2 Spot Map 5 _________________
2.3 Updated list of Data Board 5 _________________
2.4 Chart and Graphs 2 _________________
2.5 Updated list of Purok / Sitio officers 2 _________________
2.6 Updated list of Members 2 _________________
2.7 Presence of sitio meeting 2 _________________
2.8 Other sitio / purok record 2 _________________

3. PUROK / SITIO CENTER TOILET (15 POINTS)

3.1 Concrete Flooring 5 _________________

Not Concrete 2 _________________
3.2 Availability 5 _________________
3.3 Structurally safe 5 _________________

4. GENERAL CLEANLINESS AND BEAUTIFICATION ( 30 POINTS)

4.1 Clean Surrounding 5 _________________

4.2 Decent Landscaping 5 _________________
4.3 Presence of compost pit / pile and receptacles 5 _________________
4.4 Beautification 5 _________________
4.5 Presence of Sitio Garden (herbal, vegetable) 5 _________________
4.6 Presence of sitio initiated nursery / cluster of trees 5 _________________

TOTAL SCORE 100 _________________

====================================================================================

EVALUATED BY:

________________________ ___________________________
PRINT NAME & SIGNATURE DESIGNATION

__________________
Date
 Republic of the Philippines
Province of Bohol
MUNICIPALITY OF TRINIDAD

CRITERIA FOR THE MAINTENANCE OF BARANGAY HEALTH CENTER

(15%)

Barangay : _______________

1. BUILDINNG AND STRUCTURE (40 POINTS) EXPECTED SCORE EARNED SCORE

a. Made of concrete materials with paint 15 ___________

b. Safe and Convenient 10 ___________
c. Can comfortably accommodate ten(10)patient ai a time
and well-ventilated 10 ___________
d. Presence of well-maintained toilet inside the building 5 ___________

II. BEAUTIFICATION / CLEANLINESS (30 POINTS)

a. With fence 10 ___________

b. Absence of eyesores 5 ___________
c. Planted with ornamentals / herbal and vegetables plants 10 ___________
d. Presence of compost pit/pile 5 ___________

III. RECORDS AND REPORTS (30 POINTS)

a. At least 10 visual aids covered with cellophanes 10 ___________

b. Complete with updated master list of household members 5 ___________
c. Updated OPT record 5 ___________
d. Updated list of household with sanitary toilet and without toilet 5 ____________
e. Completed BHW records in each of the 7 sitios 5 ___________

TOTAL SCORE 100 ___________

EVALUATED BY:

_________________________ _______________________
PRINT NAME & SIGNATURE DESIGNATION

_________________________
DATE
 Republic of the Philippines
Province of Bohol
Municipality of Trinidad

CRITERIA FOR THE MAINTENANCE OF DAY CARE CENTER

(15%)

Barangay : __________________

I. PHYSICAL FACILITIES (35 POINTS) EXPECTED SCORE EARNED SCORE

1.1 Well-maintained toilet facility within the center solely

For the use of children 10 ___________
1.2 Availability of potable drinking water 10 ___________
1.3 Building is structurally safe and big enough to
Accommodate children 15 ___________

II. CLEANLINESS AND SANITATION (30 POINTS)

1.1 Center is 100 meters away from hazardous places.

Unsanitary place of vices or crimes 10 ___________
1.2 Tidy room excluding a homey atmosphere and
Program Media materials are well arranged 10 ___________
1.3 Clean surroundings for indoor and outdoor play 10 ___________

III. PROGRAM ACTIVITIES (35 POINTS)

1.1 Day Care Worker is able to inculcate values to children

Integrated in the following activities ,wash up, toilet
Training clean up of space, gardening, etc…. 15 ___________
1.2 Parents are able to maintain a garden ( vegetable / herbal
Flower ) or undertaken projects to beauty and maintain the
General cleanliness of the surrounding of the center 20 ___________

TOTAL SCORE 100

EVALUATED BY:

__________________________ _______________________
PRINT NAME AND SIGNATURE DESIGNATION

______________________
DATE
 Republic of the Philippines
Province of Bohol
MUNICIPALITY OF TRINIDAD

CRETERIA FOR THE BARANGAY ADMINISTRATION EVALUATION

(25%)

Barangay : _________________________

1. ORGANIZATION AND MANAGEMENT: ( 20 points) EARNNED SCORE EPECTED SCORE

1.1 Organization and Functional Consolidated BPOC and BDC 20 ___________

2. FINANCIAL MANAGEMENT (20 points) 20 ___________

2.1 Presence of duly approved Annual Budget

2.2 Increased collection of barangay status
2.3 Barangay Fund Status
2.4 Significant improvement of locally generated revenues

3. BARANGAY LEGISLATION (20 points) 20 __________

3.1 Presence of filling system for resolutions and ordinance

3.2 Presence of filling system for minutes of sessions and assemblies conducted
3.4 Presence of updated IRP
3.5 Presence of updated master list of barangay assembly members
3.6 Presence of KP records/ filling system ( Book of cases filed records of
settlement records of proceeding, copies of summon / subpoena etc.
3.7 Presence of SK flies and records, minutes of meetings file of resolutions

4. PRESENCE OF GMAC CENTER (20 points) 20 ____________

4.1 Presence of all administrative requirements of GMAC Logo

Signboard pigeon holes, logbook, front desk, referral slips
Reading and references materials

5. PLANS AND PROGRAM ( 20 points) 20 ____________

5.1 Presence of Barangay Development Program

5.2 Presence of Annual Investment Plan (2004and 2005)
5.3 Presence of SK Plans and Budget
__________ ___________
TOTAL SCORE 100

EVALUATED BY:

__________________________ ________________________
PRINT NAME & SIGNATURE DESIGNATION

_________________
DATE
FAITH ( Food Always In The Home) (20 points)

1. Backyard Garden (5 or more variety of vegetables ) 5 ___________

2. Area of Garden 3 ___________
3. Domestic Fowls 5 ___________
4. Nutritional Value 5 ___________
5. Cleanliness 2 ___________
__________ ___________
TOTAL SCORE 100 pts.

EVALUATION BY:

_________________________ _______________________
PRINT NAME & SIGNATURE DESIGNATION

__________________
DATE