ANNEX B

DATA COLLECTION FORM

Department of Education SCHOOL PROFILE

School ID : 105176
School Name :
School Address
Barangay :
Street :
City/ Municipality :
District :
Division :
Region :
Province :
Q3. Number of
Q1. Number of Q2. Number of
Indigenous People
PROFILE Enrollees in 2017 Graduates in 2017
Studying in 2017
Males Females Males Females Males Females
TOTAL

Kinder

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

Non-Graded Classes

TOTAL 2015 2016

Q4. Enrollees

Q5. Graduates

Q6. Number of students living within (SPECIFIED DISTANCE) …

DISTANCE Total Students Indigenous People
2 km radius and below from school

2.1 to 5 km radius from school

5.1 km radius and beyond from school

Q7. In which indigenous groups do the students belong? Encircle all answers that apply.
1 Badjao 10 Kalagan 19 Subanon
2 B'laan 11 Kalinga 20 Tboli
3 Bontoc 12 Kankanaey 21 Teduray
4 Gaddang 13 Luwa'an 22 Tinguian
5 Ibaloi 14 Mangyan 23 Tumadok
6 Ifugao 15 Manobo 24 Yakan
7 Igorot 16 Matigsalug 25 Others
8 Ilongot 17 Palawan Tribes 26 No IP
Students
9 Isneg 18 Sama Banguingui

Q8. Headcount of Security Personnel and Technician

 ICT Coordinator
Security Guard
Watchman/ Tanod
Department of Education
SCHOOL PROFILE
Q9. Headcount of Teachers
Total
Nationally-paid Locally-paid
Number of Teachers
Number of Teachers
SUBJECTS with Major/ Minor in
Teaching the Subject
the Subject Taught
Filipino

English

Mathematics

Science

Computer/ ICT

EPP/ TLE

Araling Panlipunan (AP)

Edukasyon sa Pagpapakatao (EsP)

HEKASI

MAPEH

Number of Teachers
Number of Teachers
JHS AND SHS with Major/ Minor in
Teaching the Subject
the Subject Taught
HOME ECONOMICS

Beauty Care

Caregiving

Cookery

Dressmaking

Front Office Services

Handicraft

Household Services

Travel Services

Wellness Massage

AGRI-FISHERY ARTS

Agri-Crop Production

Animal Production

Aquaculture

Fish Processing

Horticulture

INDUSTRIAL ARTS

Automotive Servicing

Carpentry

Consumer Electronics Servicing

Electrical Installation and Maintenanc

Masonry

Plumbing
 Refrigeration and Airconditioning

Shielded Metal Arc Welding

INFORMATION AND
COMMUNICATION TECHNOLOGY
Computer Hardware Servicing

Contact Center Services

Illustration

Technical Drafting

Q10A. Does your school have a material recovery facility (recycling)?

1 Yes 2 No
Q10B. Does your school have a drainage system and/or canal?
1 Yes
2 No
Department of Education SCHOOL PROFILE
Q11. What are the available transportation going to school? Encircle all answers that apply.
1 Animal-driven carriage 6 Jeepney
2 Bicycle 7 Motorcycle
3 Boat/ Raft 8 Pedicab/ Tricycle
4 Bus 9 Train (i.e. MRT/ LRT/
PNR)
5 Grab/ Taxi/ Private Car 10 None
Q12. How far is the school gate to the nearest concrete road pavement? Please answer in km.

Q13. Which of the following vehicles can access the road going to the school? Encircle all answers that apply.
1 10-wheeler truck
2 Bus
3 Jeepney

Q14. Which of the following best describes the state of the Barangay Health Station (TSEKAP) in your school?
Encircle one answer that applies.
1 Complete
2 Partially constructed
3 Abandoned
4 No school-based Barangay Health Station

Q15. Are there incidences of armed conflict in the community in the past 12 months?
1 Yes
2 None

Q92. Which of the following statements best describe the level of flood occurrence in the school?
1 Yellow warning (Flooding is possible with heavy (7.5-15mm) rain)
2 Green warning (Flooding is threatening with intense (15-30mm) rain )
3 Red warning (Serious flood is expected in low lying areas with more than 30 mm rain)
4 No flood occurrence
 Department of Education
BUILDING INVENTORY MODULE
Q16. Total Number of Buildings

If school has more than 10 buildings, please see additional sheets provided at the end
BUILDING BUILDING 1 BUILDING 2 BUILDING 3 BUILDING 4 BUILDING 5 BUILDING 6 BUILDING 7 BUILDING 8 BUILDING 9 BUILDING 10
Q17. Number of Floors/
Storey

Q18. Number of Classroom

Q19. Building Design

(Please refer to the
answer guide)

Q20. Area occupied by the

building (in sq meters)

Q21. Roofing Type (Gable

or Slab-type)
Q22. Building Condition
(Please refer to the
answer guide)
Q23. Construction Year
Started
Q24. Construction Year
Completed
Q25. Latest Reconstruction
Year

Q26. If there's on-going

reconstructions in the
building, cite Funding
Source (Please refer to
the answer guide. If not
applicable, input N/A.)

Department of Education
BUILDING INVENTORY MODULE
Q27. Number of Rooms (per building)

Number of Functional

Number of
Shared/ Total of NonFunctional
Male Female
Communal Functional

Q28A. TOILETS

Q91. TOILETS NOT INSIDE THE CLASSROOM

Q28B. TOILET BOWLS/ URINALS

Q28C. WASHING FACILITIES

BUILDING BUILDING 1 BUILDING 2 BUILDING 3 BUILDING 4 BUILDING 5 BUILDING 6 BUILDING 7 BUILDING 8 BUILDING 9 BUILDING 10
Makeshift rooms (rooms made of
temporary structure)
Administrative Office

Audio-Visual Room

Canteen

Clinic

Computer Laboratory

Conference Room

District Supervisor's Office

Faculty Room/ Teacher's Room

Guidance Office

Home Economics Laboratory

Industrial Arts Laboratory

 Library

Multi-Purpose Hall

Principal's Office

Science Laboratory

Speech Laboratory

Supply Room

Department of Education
BUILDING INVENTORY MODULE

Q29. Number of new building currently under construction

If there is none, skip to Q33.

Q30. What are the funding source of the new building currently under construction? Encircle all answers that apply. 1 PTA (Parent Teacher
Association)
2 SEF (Special Education Fund)/ LGU (Local Government Unit)
3 MOOE (Maintenance and Other Operating Expenses)
4 Local Private Sector
5 Congress
6 Foreign Fund/ Donor

Q31. Total Number of Instructional Classroom in the new building currently constructed based on plan
Q32. Total Number of Non-Instructional Classroom in the new building currently constructed based on plan
 Department of Education BUILDING INVENTORY MODULE

In answering Q19, Q22 and Q26, please refer to the answer guide below.
Q19. Building Design
1 Army Type School Building
2 Bagong Lipunan I
3 Bagong Lipunan II
4 Bagong Lipunan III
5 DECS 1 Room Building
6 DepED Multi-Storey School Building
7 DepED School Building (Modified)
8 DepED School Building (Standard)
9 DOST Science Laboratory Building
10 Economic Support Fund (ESF) Building
11 Educational Facilities Improvement Program (EFIP) – JICA 12 Fabricated Vigorous Room 2000
13 Federation of Filipino Chinese Chamber of Commerce and Industry, Inc. (FFCCCII) “Barrio School”
14 FVR 2000
15 Gabaldon Type
16 GOJ-EFIP Building
17 GOJ-TRSBP Building
18 Imelda Type
19 Learning and Public Use School Building (LAPUS)
20 Little Red School House
21 Magsaysay Type
22 Marcos Type
23 Multi-Purpose Workshop Building 24 PAGCOR Building
25 Pre-School/Kindergarten Building
26 Public-Private School Infrastructure Project (PSIP School Building)
27 RP-US Bayanihan
28 SB Readily Assembled Multi-Optima Shelter (RAMOS)
29 SBP4BE Building - AusAid
30 Science Laboratory Building
31 SEDIP Building
32 SEDP Building (Carino Type)
33 Spanish Grant School Building Package
34 SPHERE Building - AusAid
35 Third Elementary Education Project (TEEP) School Building 36 Typhoon Resistant School Building Program
(TRSBP) - JICA

Q22. Building Condition

1 Good Condition (Refers to a building which does not need repair)
2 Needs Minor Repair (Refers to the repair or replacement of school building components which are not subjected to critical
structural loads and stresses and which are estimated to cost less than ten percent (10%) of the cost of a standard building unit
such as repair of windows, doors, partitions and the like)
3 Needs Major Repair (Refers to the repair or replacement of school building components which are subjected to critical
structural loads and stresses and which are estimated to cost ten percent (10%) or more of the cost of a standard building unit
such as roof frames, posts and exterior walls)
4 On-going Construction (Refers to the school building/structure that are not yet completed and/or not yet turned over)
5 For Completion (Refers to a building/structure which was not completed according to the design (e.g. one storey building was
completed using a two storey design building plan))
6 For Condemnation (Refers to the school building/structure that are not safe for occupancy and not currently used but without
officail declaration from the Municipal/City Engineer)
7 Condemned/For Demolition (Refers to a building officially declared by the Municipal/City Engineer to be dangerous to the life,
health, property or safety of the public or its occupants)

Q26. Funding source of on-going reconstruction in the building

1 PTA (Parent Teacher Association)
2 SEF (Special Education Fund)/ LGU (Local Government Unit)
3 MOOE (Maintenance and Other Operating Expenses)
4 Local Private Sector
5 Congress
6 Foreign Fund/ Donor
 Department of Education SCHOOL LAND AND
UTILITIES
Q33. School Total Land Area (in sq meters)

Q34. Is the school land titled to DepEd?

1 Yes
2 No

Q35. What are the sources of the school electricity? Encircle all answers that apply. If school has no
electricity, skip to Q40.

1 Grid
2 Solar
3 Generator
4 Others
5 No electricity

Q36. If source of electricity is solar, where are the batteries located?

1 Inside the classroom
2 Outside the classroom

Q37. Number of hours that electricity is usually available in a day

Q38A. Who pays the electric bill of the school?

1 LGU
2 School
3 Others
Q38B. Amount of electricity bill (in Feb 2018)

Q39. How often do you experience electricity disruption in a month? Encircle one answer that applies.
1 Once a month or less
2 Two to three times a month
3 Four times a month (once a week) 4 More than four times a month

Q40. Is there a water connection available in the community?

1 Yes
2 No

Q41.What are the sources of the school water connection? Encircle all answers that apply. If school has no
water connection, skip to Q45 .

1 Piped water from local service provider

2 Deep Well
3 Free Flow/ Natural Source
4 Rainwater Catchment 5 No water connection

Q42. Number of hours that water connection is usually available in a day

Q43. Amount of water bill (in Feb 2018)

Q44. How often do you experience water connection disruption in a month? Encircle one answer that applies.
1 Once a month or less
2 Two to three times a month
3 Four times a month (once a week)
4 More than four times a month
 Department of Education E-CLASSROOM/ COMPUTER LABORATORY MODULE

Q45. DCP batch number received by the school (Encircle all batches that apply.) If there is no DCP received, skip
to Q49.
1 Batch 1 16 Batch 16 31 Batch 31
2 Batch 2 17 Batch 17 32 Batch 32
3 Batch 3 18 Batch 18 33 Batch 33
4 Batch 4 19 Batch 19 34 Batch 34
5 Batch 5 20 Batch 20 35 Batch 35
6 Batch 6 21 Batch 21 36 Batch 36
7 Batch 7 22 Batch 22 37 Batch 37
8 Batch 8 23 Batch 23 38 Batch 38
9 Batch 9 24 Batch 24 39 Batch 39
10 Batch 10 25 Batch 25 40 Batch 40
11 Batch 11 26 Batch 26 41 Batch 41
12 Batch 12 27 Batch 27 42 Batch 42
13 Batch 13 28 Batch 28 43 Batch 43
14 Batch 14 29 Batch 29 44 Batch 44
15 Batch 15 30 Batch 30 45 None
In answering Q52 please refer to the answer guide below. Q52. Funding Source
1 PTA (Parent Teacher Association) 3 Local Private Sector
2 SEF (Special Education Fund)/ LGU (Local 4 Congress
Government Unit) 5 Foreign Fund/ Donor
DepEd-Provided Non-DepEd-Provided

EQUIPMENT Q46. Total Q47. Q49. Total Q50. Q52.

Q48. Number of Q51. Number of
number of Number of number of Number of Funding
Defective Defective
items received Working items received Working Source

Desktop
Computers
(Standalone)

Host PCs of
Virtual
Terminals

Virtual
Terminals

Laptop/
Notebook/ Netbook

Tablets/ Tablet
PCs

Interactive
Whiteboard

Router

Printer

Projector

Facilities in the Eclassroom/

Computer Laboratory
Q53. Number of Working Q54. Number of Defective

Aircondition Units

Chairs/ Mono chairs

Circuit Breaker

Computer Tables

Electic Fan

Electrical Lighting

Electrical Outlets

Generator

LAN (Local Area Network)

Q55A. Number of E-classroom with Standard Size (7mx18m)

Q55B. Number of E-classroom with Non-Standard Size

Department of Education
E-CLASSROOM/ COMPUTER LABORATORY MODULE
Write NA if not applicable.
Q58B.
Q56. Number of Computers/ Terminals Q57. With or without Q58A. Date Date
BATCH
that need repair warranty? Damaged Resolved

Batch 13

Batch 14

Batch 15

Batch 16

Batch 17

Batch 18

Batch 19

Batch 20

Batch 21

Batch 22

Batch 23

Batch 24

Batch 25

Batch 26

Batch 27

Batch 28

Batch 29

Batch 30

Batch 31

Batch 32

Batch 33

Batch 34

Batch 35

Batch 36

Batch 37

Batch 38

Batch 39

Batch 40

Batch 41

Batch 42

Batch 43

Batch 44
Q59. Does your school have a certification of proper electrical wiring and outlets?

1 Yes
2 No
Q60. Is there a group of 3 people designated to be the school inspectorate team?
1 Yes
2 No
Q61. Frequency of E-classroom Usage (Number of hours in a week)
Grade 1 Filipino
Grade 2English
Grade 3Mathematics
Grade 4Science
Grade 5EPP/ TLE
Grade 6Computer
Grade 7Araling Panlipunan (AP)
Grade 8Edukasyon sa Pagpapakatao (EsP)
Grade 9HEKASI
Grade 10MAPEH
Grade 11
Grade 12

Q62. Does your school access the Learning Resources Portal?

1 Yes
2 No
Q63. Reasons for not using the e-classroom at all
1 Absence of training on teachers 5 Terminals are not working
2 No access on online resources 6 No electricity
3 No internet access 7 No e-classroom/ computer laboratory
4 Slow internet
 Department of Education

SECURITY
Q64. What are the security mechanisms present in school? Encircle all answers that apply.
1 CCTV
2 Locks
3 Security Personnel/ Guard
4 Barangay Tanod/ Watchman
5 None

Q65. What are the security mechanisms present in e-classroom? Encircle all answers that apply.

1 Locks
2 Door Grills
3 Window Grills
4 None

Q66. What is the source of the salary of the security personnel? Encircle all answers that apply.
1 PTA (Parent Teacher Association)
2 SEF (Special Education Fund)/ LGU (Local Government Unit)
3 MOOE (Maintenance and Other Operating Expenses)
4 Local Private Sector
5 Congress
6 Foreign Fund/ Donor

Q67. Number of hours school has security personnel in a day

1 Less than 6 hours
2 6 to 12 hours
3 13 to 18 hours
4 19 to 24 hours

Q68. Number of theft incidence of ICT equipment (i.e. CPU, Monitor, Laptop, Projector, Tablet,
Interactive White Board) in the past 2 years
If school did not have theft incidence, skip to Q70.

Q69. Action taken by school regarding the last theft incidence

1 Report filed
2 Replaced by the school
3 Requested for a new equipment 4 None
CONNECTIVITY
In answering Q72, Q74 and Q77, please refer to the answer guide below.
Q72/Q77. Funding Source Q74. Type of Internet Connection
1 PTA (Parent Teacher Association) 1 Mobile Data
2 SEF (Special Education Fund)/ LGU (Local Government 2 DSL
 Department of Education

Unit) 3 Fiber
3 MOOE (Maintenance and Other Operating Expenses) 4 Mobile Broadband
4 Local Private Sector 5 Ethernet
5 Congress 6 VPN
6 Foreign Fund/ Donor

Phone Connection Q70. Number of Q71. Expense for Phone Q72. Funding Source for
Service Provider Phone Connection Connection (in Feb 2018) Phone Connection

1 Globe

2 Smart

3 PLDT

4 Digitel

5 AT&T

Q73. Number of Q74. Type of Q75. Access Q76. Expense Q77. Funding
Internet Connection Internet Point for Internet Source for
Internet Connection (LAN or Wifi Connection Internet
Connection Service If no internet or Both) (in Feb 2018) Connection
Provider connection, skip to
Q80

1 Globe

2 Smart

3 PLDT

4 Sky Cable

5 Others

Q78. In which areas is the internet available? Encircle all answers that apply.
1 Makeshift rooms 8 Computer
Laboratory
2 Classroom 9 Faculty room
3 Administrative Office 10 Guidance Office
4 Audio-Visual Room 11 Library
5 Basketball Court/ Gym 12 Science Laboratory
6 Clinic 13 Speech Laboratory
7 Conference room 14 Supply Room
Q79. Number of Desktop Computers and Virtual Terminals connected to the Internet

Desktop Computers
Virtual Terminals
 Department of Education

TRAINING AND MONITORING

Q80. Are there trainings conducted by the supplier for the teachers?
If there are no trainings conducted, skip to Q83.
1 Yes
2 None

Q81. What are the topics discussed during the training? Encircle all answers that apply.
1 Digital Concepts
2 Digital Operations and Management
3 Digital Applications
4 Digital System Network
5 Digital Devices
6 Digital Ethics 7 Others

Q82. Number of teachers trained

Q83. Is the DCP Manual (hardcopy or softcopy) given?

1 Yes
2 No

Q84. How frequent does the Division Office conduct visit inspection on DCP? Encircle the answer
that applies.
1 Weekly
2 Monthly
3 Quarterly
4 Bi-annually
5 Annually
6 Never
 Department of Education
BUILDING INVENTORY MODULE
Additional sheets:
BUILDING BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____

Q17. Number of Floors/ Storey

Q18. Number of Classroom

Q19. Building Design (Please refer to

the answer guide)

Q20. Area occupied by the building (in

sq meters)

Q21. Roofing Type (Gable or Slabtype)

Q22. Building Condition (Please refer

to the answer guide)

Q23. Construction Year Started

Q24. Construction Year Completed

Q25. Latest Reconstruction Year

Q26. If there's on-going

reconstructions in the building, cite
Funding Source (Please refer to the
answer guide. If not applicable, input
N/A.)

Department of Education
BUILDING INVENTORY MODULE
Q27. Number of Rooms (per building)
BUILDING BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____ BUILDING ____
Makeshift rooms (rooms made
of temporary structure)
Administrative Office

Audio-Visual Room

Canteen

Clinic

Computer Laboratory

Conference Room

District Supervisor's Office

Faculty Room/ Teacher's Room

Guidance Office

Home Economics Laboratory

Industrial Arts Laboratory

Library

Multi-Purpose Hall

Principal's Office

Science Laboratory

Speech Laboratory

Supply Room