Name of School Head (Optional) : ____________________________________ Public : _______ Elem. _______ Sec.

Name of School : __________________________________________________ Private : ______ Elem. _______ Sec.

Instruction : This survey focuses on the existence or absence of a hand washing facility in our school. Please answer the
questions below honestly as you can. Rest assured that the result of this survey will be strictly
confidential and will serve as basis for improving school facility. Thank you.

1. Does your school have WASH facility? _____ Yeas _____ No. If YES, please do not answer item no. $. If NO,

Please do not answer Nos. 2 & 3.

2. Where did you get funding for this facility?

a) From the School MOOE

b) Donations From stakeholders

c) Others, please specify _______________________________________________________________________

3. Who introduce the WASH facility in your school?

a) DepEd
b) Department of Health

b) NGO/Other agency, please specify _____________________________________________________________

4. Aside from funding, what factor/s you believe prohibit the school for having WASH facility?

a) No water supply from the local water authority (Water District)

b) Deep-well cannot be made possible due to high elevation

c) Both a and b

d) Others. Please specify _______________________________________________________________________

5. Does your school have rain catching container/tank? ______ Yes ______ No

6. If YES, how did you make use of the collected water?

a) Watering the plants in the school

b) For the use in the comfort rooms

c) Others, please specify _______________________________________________________________________

7. In terms of behavior/attitude, how do you describe your learners in coming to their school? - Please restate/
 a) Happy reconstructthis statement and its option - ang gusto nako e pangutana

b) Passive malipayon ba o ganado mo eskwela ang bata.

c) Others, please specify _____________________________________________________________________

8. On the current total number of enrollees of learners in your school today, what is the average daily attendance of

Learners (in percent) attending to the regular classroom activities in school?

a) 90 - 100% class attendance

b) 80 - 89% class attendance

c) 70 - 79 class attendance

d) 60% and below, class attendance

9. On the previous school year (last SY 2018-2019), how much is the drop out rate of your school? Please specify the

Figure ____________________

10. What is the latest National Achievement Test (NAT) rating of your school? Please, specify the figure ____________