CDD B-01:
Form
BARANGAY PROFILE FORM
BASIC INFORMATION
Region
Province
Municipality
Barangay
Cycle
No. of Sitios/Puroks
Inclusive Years under KC
Population Profile
1. Total number of households
2. Total number of families
3. No. of male
4. No. of female
5. No. of male children ages 0-5 years old
6. No. of female children ages 0-5 years old
7. No. of male children ages 6-12 years old
8. No. of female children ages 6-12 years old
9. No. of male children ages 13-17 years old
10. No. of female children ages 13-17 years old
11. Total male voting population
12. Total female voting population
13. Total male labor force
14. Total female labor force
17
Indigenous People
Are there indigenous people (IP) in your barangay? ____________
IP group
Location/Sitio
Total households
Total families
Total male
Total female
Total
Conflict-affected / Pantawid Pamilya and SLP Beneficiaries
Is the barangay affected by armed conflict? ________
If yes, please give additional details of the armed conflict in the area
_______________________________________________________________________________________________
_______________________________________________________________________________________________
No. of Pantawid Pamilya household beneficiaries in the barangay ____________
No. of Pantawid Pamilya family beneficiaries in the barangay
____________
No. of SLP household beneficiaries in the barangay
____________
No. of SLP family beneficiaries in the barangay
____________
AREA PROFILE
Is this a Poblacion Barangay? __________________
If not, how many hours does it take to travel to Poblacion? __________________
No. of kilometers from the Poblacion __________________
What is the geographic characteristic of the Barangay? (i.e upland, hilly, lowland, island, coastal)? _________________
Is the barangay isolated from the rest of the barangays? __________________
Affected by any of the following Peace and Social Cohesion issues? Check if Yes.
____ Armed conflict
____ Boundary and territorial disputes
____ Political and extra judicial killings
____ Family and gender-based violence
____ RIDO or clan wars/Tribal wars of pangayao
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____ Crime
BARANGAY ORGANIZATION
What organizations operate within the barangay? (Use another sheet for more organizations)
Organization 1
Organization 2
Name
Type of Organization (ex. PO, NGO, Private
institution/CSR)
Formal? (Registered, answer yes or no)
LGU-accredited? (Yes or No)
Advocacy (Savings, religious, farmers,
fisherfolk, women, etc.)
Area of operation (ex. nationwide, municipal,
different barangays, etc.)
Years operating in barangay
Active or inactive organization?
Activities (Identify major activities)
Total male members from barangay
Total female members from barangay
Male IP members from barangay
Female IP members from barangay
Marginalized sectors represented
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LOCAL GOVERNANCE
BLGU Officials Profile
Name
Sex
Age
Civil
Status
IP Group
Educational
Attainment
Position in
Barangay
Council
Inclusive Date
(Start and End Date)
Name of Non-KC
Organization
*to be updated once the Program starts
20
Barangay Development Council Profile (Identify only those not listed in BLGU Officials Profile)
Name
Sex
Age
Civil
Status
IP Group
Educational
Attainment
Position in
Barangay
Council
Inclusive
Date
(Start and
End Date)
Name of NonKCOrganization
Sector Represented
*to be updated once the Program starts
During the past year, how many times were the BAs conducted?
On the average, how many barangay households are present during the meetings?
How many male residents were present?
How many female residents were present?
How many IP households were present?
What other sectors were present?
During the past year, how many times did the BDC meet?
How many, on the average, attend the BDC meetings? (refer to attendance sheet)
Male BLGU Officials
Female BLGU Officials
Male PO/CBO representatives
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Female PO/CBO representatives
What is the total annual budget of the barangay? How much was the IRA the past year? What are other sources of funds of the barangay?
Source of Funds
Amount
IRA
Other Sources:
TOTAL
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How were the barangay funds allocated in the previous year? (Refer to Barangay Annual Investment Plan)
Category
Amount
Environment
Economic Sector
Infrastructure
Social development
Institutional Sector
Gender and Development
DRRM
Other allocation
TOTAL
How was the 5% GAD fund utilized by the barangay?
Activity
Cost
TOTAL
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Over the past year, what development project/s has/have been implemented in your barangay?
Project
Location
Scope
(Coverage,
Unit, Physical
Target)
Examples of Development Projects
1 Roads
2 Water Supply
3 Toilet
4 Livelihood
5 Education
6 Electrification
7 Health and Nutrition
8 Others
Cost of
Project
Source
of
Funds
Cost Sharing
(%)
Beneficiaries
M
IPs
Types of Source of Funds
1 Barangay Fund
2 Municipal Fund
3 Provincial Fund
4 National government agencies
(e.g. DSWD, DA, etc.)
5 ODA ( Foreign-assisted projects)
6 Others
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POVERTY
Identify top three economic activities in the barangay
1. ____________________________________
2. ____________________________________
3. ____________________________________
Identify major crops in the barangay
1. ____________________________________
2. ____________________________________
3. ____________________________________
What is the average annual household income in the barangay? ______________
What is the average annual income for males?
______________
What is the average annual income for females?
______________
What is the average annual income for IPs?
______________
What types of road traverse through the barangay?
Types of Road
Dirt
Gravel
Asphalted
Cemented/All Weather Road
What are the modes of transportation available?
1. ____________________________________
2. ____________________________________
3. ____________________________________
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Which of the following establishments and services are available in the barangay? If not available, how far is your
barangay to the nearest establishment/service provider? (if the listed services and establishments are not applicable or
no use to your barangay, write n/a)
Facilities/Establishments/Services
Please check if
available
If none, distance to
nearest facility
(hours)
Mode of Transport
and cost
Barangay hall
Multi-purpose building
Tribal hall
Evacuation center
Market place/bagsakan center
Stores
Mini port
Daycare center
Elementary School
Secondary School
College or university
Health station
Hospital
Irrigation
Pre/Post Harvest Facilities
Water supply system
Drainage System
Waste facility
Cemetery
Electricity
Telecommunication Access
Bank
Credit facility
Tanod/police
Emergency services
Environmental protection
Postal service
Capability/skills training
Health
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Facilities/Establishments/Services
Organizational development
Agriculture and enterprise
Education
Others
Please check if
available
If none, distance to
nearest facility
(hours)
Mode of Transport
and cost
What are the main problems in the barangay? Identify.
Problem
Details
Are these problems
being addressed
properly?
Remarks
Access/ Mobility
Water and Sanitation
Health and Nutrition
Literacy/Education
Employment/Income
Generation
Land Ownership/Asset
Distribution
Agricultural Service
Facilities (i.e. post-harvest)
Peace and Order
Environment
Power Supply
Communications
Others, specify
27
Poverty Profile
Indicators
Value
Reference
Health
1.
Proportion of children aged 0-5 years old who died
a) Number of children aged 0-5 years old who died
b) Total children aged 0 -5 years old
2.
Proportion of women who died due to pregnancy-related causes
a) Number of pregnant women who died due to pregnancy-related
causes
b) Total pregnant women
Nutrition
3.
Proportion of children aged 0-5 years old who are malnourished
a) Number of children aged 0-5 years old who are malnourished
b) Total children aged 0-5 years old
Access to Basic Amenities
4.
Proportion of households with access to safe water
a) Number of households with access to potable water (within 250m)
b) Total number of households
5.
Proportion of households with access to sanitary toilet facilities
a)
Number of households with access to sanitary toilet
facilities
b)
Total number of households
Shelter
6.
Proportion of households who are squatting
a) Number of households who are squatting
b) Total number of households
7.
Proportion of households living in makeshift housing
a) Number of households living in makeshift housing
b) Total number of households
Peace and Order
8.
Proportion of households with members victimized by crimes
a) Number of households with members victimized by crimes
b) Total number of households
Income
9.
Proportion of households with income less than the poverty
threshold
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Indicators
Value
Reference
a) Number of households with income less than the poverty threshold
b) Total number of households
10.
Proportion of households with income less than the food threshold
a) Number of households with income less than the food threshold
b) Total number of households
11.
Proportion of households who eat less than three (3) meals a day
a) Number of households who eat less than three (3) meals a day
b) Total number of households
Basic Education
12. Proportion of 6-12 years old children who are not in elementary
school
a) Number of children 6-12 years old who are not in elementary
school
b) Total number of children 6-12 years old
13. Proportion of 13-16 years old children who are not in secondary
school
a)
Number of children 13-16 years old who are not in
secondary school
b)
Total number of children 13-16 years old
Employment
14.
Proportion of the members of the labor force who are not working
a) Number of labor force who are not working
b) Total number of labor force
______________________________
Signature over Printed Name
Community Empowerment Facilitator
______________________________
Signature over Printed Name
Area Coordinator
Date Started: _________________________
Date Accomplished: ____________________
29
CDD B-02:
Form
MUNICIPAL PROFILE FORM
BASIC INFORMATION
Region
Province
Municipality
No. of Barangays
Cycle
Inclusive Years of KC
MUNICIPAL ORGANIZATION
What organizations operate within the municipality? (Use another sheet for more organizations)
Organization 1
Organization 2
Organization 3
Name
Type of Organization
(ex. PO, NGO,
Private
institution/CSR)
Formal?
(Registered, answer
yes or no)
LGU-accredited?
(Yes or No)
Advocacy (Savings,
religious, farmers,
fisher folk, women,
etc.)
Area of operation (ex.
nationwide,
municipal, different
barangays, etc.)
Years operating in
municipality
Active or inactive
organization?
Activities or Services
(identify major
activities)
Total male members
from municipality
Total female members
from municipality
Male IP members from
municipality
Female IP members
from municipality
Marginalized sectors
represented
30
LOCAL GOVERNANCE
MLGU Officials Profile
Name
Sex
Age
Civil Status
IP Group
Educational
Attainment
Current Position in
LGU
Inclusive Date
(Start and End Date)
Inclusive Date
(Start and End Date)
Sector Represented
*to be updated once the Program starts
Municipal Development Council Profile (Identify only those not listed in MLGU Officials Profile)
Civil
Educational
Name
Sex
Age
IP Group
Position in MDC
Status
Attainment
31
What is the total annual budget of the municipality? How much was the IRA in the previous year? What are
other sources of funds of the municipality?
Source of Funds
Amount
IRA
Other Sources:
TOTAL
How were municipal funds allocated in the previous year?
Category
Environment
Economic Sector
Infrastructure
Social development
Institutional Sector
Gender and Development
DRRM
Other allocation
TOTAL
How was the GAD fund utilized by the municipality?
Activity
Amount
Cost
TOTAL
How was the DRRM fund utilized by the municipality?
Activity
Cost
TOTAL
POVERTY/SOCIO-ECONOMIC SITUATION
Economic Activities
Identify top three income-generating activities in the Municipality, average income per activity and number of HHs
involved
Income-Generating Activity
Average Income
No. of HHs involved
Seasonality
Land Tenure Status
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Tenurial Status
No. of HHs
No. of HH Head
Male
Female
Owner
Tenant
Renting
Squatting
What is the average annual household income?
______________
What is the average annual income for male-headed HHs?
______________
What is the average annual income for female-headed HHs?
______________
What is the average annual income for IP-headed HHs?
______________
Mode of Transportation and Cost
Mode of Transport
Cost (Minimum Maximum)
1.
2.
3.
4.
5.
Etc.
___________________________
Signature over Printed Name
Area Coordinator
___________________________
Signature over Printed Name
Technical Facilitator
___________________________
Signature over Printed Name
Municipal Financial Analyst
Date Started: _________________________
Date Accomplished: ____________________
36
CDD B-03:
Tool
COMMUNITY MONITORING PLAN TEMPLATE
Areas of Monitoring
Required Key
Activities
Expected Outputs/
Beneficiaries
Sources of
Information
Accomplishments by
Mid Cycle
Accomplishments by
End of Cycle
Remarks
BAP
Commitments
KC-NCDDP
Implementation
SPI
CDD B-04:
Tool
35
COMMUNITY MONITORING WORK PLAN
Major Activities
Mid Cycle Monitoring
Specific Activities
When
Who are Involved?
Resources Needed
Ex. Community meeting,
Interview MPDC, Review KC
database
End of Cycle Monitoring
36
