Department of Education

Region VI—Western Visayas

Schools Division of Iloilo
BUGA NATIONAL HIGH SCHOOL
Buga, Leon, Iloilo

DISASTER RISK REDUCTION MANAGEMENT (DRRM) AWARENESS SURVEY FORM

Name of School: BUGA NATIONAL HIGH SCHOOL Address: BUGA, LEON, ILOILO

1. Please check (/) Type of School: Elementary _______ Secondary __/_____

2. Do you think disasters happen in this province? Yes ___/____ No _______

3. In the last five (5) years, which of the following disaster/major incidents affected your school?

Major Incident
Extreme Cold
Heavy Rain /
Floods
Landslides
Fire
Earthquake
Typhoons /
None: This is not a disaster prone area
Others: (Please State)

4. In the last five (5) years, which of the following disaster/major incidents affected your community?

Major Incident
Extreme Cold
Heavy Rain /
Floods
Landslides
Fire
Earthquake
Typhoons /
None: This is not a disaster prone area
Others: (Please State)
 If “None” was chosen in both 3 and 4: Skip Question 5.

5. What was the impact of the most recent disaster/major incident that struck you:

School Community

Emotional Trauma
Injuries to Individual
Displacement of Families
Financial and Economic Impact /
Damage/Destruction of Equipment Buildings
Infectious Diseases (Dengue, Leptospirosis, Flu) / /
Others

6. How likely (in your opinion) is it that disaster could strike your school in the future?

Yes No
Not all/No Chance (e.g. once in 20 years)
Somewhat likely/Little Possibility (e.g. one every
5 years)
Quite Likely/Strong Possibility (e.g. every
year/seasonal) /
Definitely (e.g. every week)

7. Do you know what to do if a disaster occurs today? Yes ___/_____ No _________

8. Do you think the teachers know what to do if a disaster occurs today? Yes ____/____ No ________

9. Does your school have an emergency plan? Yes ____/____ No _________

10. Does the plan cover disaster risk reduction and management? Yes ____/_____ No ________

11. What processes/activities were used to develop the emergency plan? (Kindly check)

School Hazard Mapping /

Formulating School Preparedness Plan /
Formulating Emergency and Evacuation Plan /
Conducting Fire/Earthquake Drills /
Others
12. Does the school conduct the school mapping exercise? Yes __/_____ No _______

13. Is the main entrance of the gate is located preferably along the main road? Yes ______ No __/____

14. Does the school installed fire alarm system and fire extinguisher? Yes ___/___ No ______

15. Does the school provided water system with a portable water supply? Yes ___/___ No ______

16. Does the school posted evacuation/exit plan on every floor of the building? Yes __/____ No ______

17. Does the school observed fire prevention month/disaster consciousness month? Yes __/__ No _____

18. Does the school constructed septic tank in proper location? Yes __/____ No ______

19. If/When you conduct mock drills/emergency drills, it is based

on specific disaster/major incidents that usually occurred in your area? Yes __/_____ No _________

20. Which disaster/major incidents do you include in your mock drills/emergency drills as examples?

Please read each of the possible disaster/major incidents and indicate with a check (/)
Heavy Rain
Landslide
Earthquake /
Fire
Typhoon

Name:__________________________________ Signature: __________________________

Date: _____________________

Prepared by:

JOSEPH P. CAGCON
DRRM Coordinator