SGLGB Form No.

1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

Identifying Information
Region : II
Barangay : TUCALANA
City/Municipality : LAL-LO
Province : CAGAYAN

CORE AREA 1: SAFETY, PEACE AND ORDER

SCORE
ASSIGN PASSI OBTAIN
DATA DATA HOW TO DETERMINE ED ED BY DOCUMENT
INDICATORS NG
REQUIREMENTS SOURCE THE SCORE THE SUBMITTED
SCORE SCORE BARAN
GAY
Barangay If the result is:
Secretary
1. Functionality of the ● High = 8
Functionality of BADAC
Barangay Anti-Drug
based on DILG-DDB ● Moderate = 4 8 4 8
Abuse Council
JMC No. 2018-01 DILG
(BADAC) ● Low = 2
City/Municip
al Office ● No data = 0
2. Functionality of the BPOC Monitoring Form DILG If the result is: 5 4 5
Barangay Peace No. 2 based on DILG City/Municip
● High = 5
and Order MC No. 2020-047 al Office
Committee (BPOC) ● Moderate = 4
● Low = 3
● Non-functional = 1

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

● No BPOC= 0
● No data = 0
If the result is:

3. Performance Rate ● 85-100 = 4

in the Lupong LTIA Form 003 based DILG ● 80-84 = 3
Tagapamayapa on DILG MC No. 2016- City/Municip 4 2 4
Incentives Awards 58 al Office ● 75-79 = 2
(LTIA) ● Below 75 = 1
● No data = 0
RBI form A of DILG MC
4. Maintenance of No. 2008-144 ● With RBI = 1
Barangay
Record of Barangay 1 1 1
Date of last update: Secretary ● Without RBI = 0
Inhabitants (RBI)

With EO or similar
EO or similar issuance issuance:
5. Professionalizing on the organization of 1 1 1
Yes = 1
the Barangay the Barangay Tanod
Barangay No = 0
Tanod based on
Secretary
DILG MC No. 2003- With trainings attended:
42 Training attended for
Yes = 1 1 1 0
CY 2019
No = 0
TOTAL 20 13 19

CORE AREA 2: FINANCIAL ADMINISTRATION AND SUSTAINABILITY

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

SCORE
OBTAIN
PERFE PASSI
DATA DATA HOW TO DETERMINE ED BY DOCUMENT
INDICATORS CT NG
REQUIREMENTS SOURCE THE SCORE THE SUBMITTED
SCORE SCORE
BARAN
GAY
1. Compliance with BFDP Monitoring Form Presence of BFDP
the Barangay Full 1 , Form 2 and Form 3 DILG Board
Disclosure Policy pursuant to DILG MC City/Municip 2 2 2
● Yes = 2
(BFDP) No. 2014-81 al Office
● No = 0
Onsite Compliance to the
CY 2019, 4th Qtr
Inspection design pursuant to
compliance:
Annex 7 of the DILG
MC No. 2014-81: 3 3 3
Location of the BFDP ● Yes = 3
Board:
● No = 0
If the result of CY 2019, 8 6 8
4th Qtr compliance is:
● Full Compliance = 8
● Partial Compliance:
o 7 financial
documents posted =
7
o 5-6 financial
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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

documents posted =
6
o 3-4 financial
documents posted =
4
o 1-2 financial
documents posted =
2
● Non-compliance = 0
● No data = 0
2. Percentage Barangay Budget Barangay With increase? 3 3 3
Increase in local Preparation Form No. Treasurer
● Yes = 3
resources 2: Actual Income and
Expenditure ● No = 0

Total amount collected

from fees and charges: City/Municip
al
Accountant
CY 2018:
PhP.
CY 2019:
PhP.

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

Difference:
PhP.
Percentage increase:

Monitor report on the Conducted Barangay

3. Conduct of Assembly:
compliance of the
Barangay Assembly
barangays to conduct Barangay 1st Semester = 2
for the first and 4 4 4
barangay assembly to Secretary
second semester of 2nd Semester = 2
be submitted thru
CY 2019
shared google drive No data = 0
TOTAL 20 18 20

CORE AREA 3: DISASTER PREPAREDNESS

SCORE
OBTAI
ASSIGN PASSI NED
DATA DATA HOW TO DETERMINE ED DOCUMENT
INDICATORS NG BY
REQUIREMENTS SOURCE THE SCORE SUBMITTED
SCORE SCORE THE
BARA
NGAY
1. Functionality of the 5% BDRRM Fund in the Barangay With at least 5% 2 2 2
Barangay Disaster Barangay: Secretary/ BDRRM Fund
Risk Reduction and Barangay allocation
PhP.
Management Treasurer
● Yes = 2
Committee

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

(BDRRMC) To compute % Local

allocation for LDRRMF: Disaster
Risk
(BDRRMF Allocated / Reduction ● No = 0
Estimated Total and
Revenue from Regular Management
Sources) x 100 Officer
(LDRRMO) Organization of the
BDRRMC
EO or similar issuance ● Yes = 1 1 1 1
creating the BDRRMC
● No = 0
● No data = 0
Approved Barangay With Approved BDRRM
Disaster Risk Reduction Plan
and Management
● Yes, using the
(BDRRM) Plan under 2 2 2
prescribed template =
NDRRMC
2
Memorandum Circular
No. 01, Series of 2018 ● No = 0
Minutes of the quarterly Conduct of quarterly 2 1 2
meeting meeting
● 4 out of 4 = 2
● 2 or 3 out of 4 = 1
● 1 out of 4 = 0
● No = 0
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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

● No data = 0
Utilization Rate of the
70% component of the
BDRRM Fund Utilization of the 70%
BDRRM Fund

To compute for % ● 50% and above = 1

utilization: 1 1 1
● Less than 50% = 0.5
% utilization of the 70% ● No = 0
BDRRMF = (Total
Amount Utilized / Total ● No data = 0
Amount Allocated) x
100
● Accomplishment Barangay Accomplishment Rate 3 2 3
Report Secretary of the Activities/Projects
Reflected in the
How to compute?
Barangay Disaster Risk
Accomplishment rate = Local Reduction and
A Disaster Management Plan
x 100
B Risk (BDRRMP)
Reduction
● 60% and above = 3
and
o A = Total number of Management ● 40 – 59% = 2
activities/projects Officer
● 20 – 39% = 1
accomplished in the (LDRRMO)
BDRRM plan ● 19% and Below = 0

o B= Total number of ● No BDRRM Plan = 0

activities/projects in
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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

the BDRRM Plan

With Post-Activity
Date of drill/s Report:
conducted: 1 1 1
● Yes = 1
Barangay ● No = 0
Secretary
Conducted drills
Drills conducted ● Earthquake/Fire/
1 1 1
(Earthquake, fire, etc.) Local Others = 1
2. Extent of risk Disaster
assessment and ● No = 0
Risk
Early Warning Reduction Presence of Local risk
System (EWS) and map
Local risk map Management 1 1 1
● Yes = 1
Officer
(LDRRMO) ● No = 0
Presence of Early
Early Warning System Warning System
(EWS) location: 1 1 1
● Yes = 1
● No = 0
3. Extent of EO or similar issuance Barangay With EO or similar 1 1 1
preparedness for creating Barangay Secretary issuance creating the
effective response Emergency Search and Barangay Emergency
and recovery Rescue Team/s Search and Rescue
Team/s

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

Local ● Yes = 1
Disaster
● No = 0
Risk
Reduction Provision of training to
and the Emergency Search
Total number of Management and Rescue Team/s:
Emergency Search and Officer
● Trained in the past
Rescue Team/s: (LDRRMO)
12 months (CY 2019) 1 1 1
=1
No training in the past
12 months (CY 2019) =
0
Presence of Evacuation
Designated/Evacuation Center/Designated
Center location: Evacuation Center
1 1 1
● Yes = 1
● No = 0
Disaster equipment: Disaster equipment 2 1 2
● 2-way radio / mobile ● 2-way radio / mobile
phone phone = 0.5
● Rescue ● Rescue
vehicle/Barangay vehicle/Barangay
patrol patrol = 0.5
● Generator set ● Generator set = 0.5

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

● First aid kit ● First aid kit /

● Flashlight with Flashlight with
batteries batteries = 0.5

TOTAL 20 17 20

ESSENTIAL AREA 1: SOCIAL PROTECTION AND SENSITIVITY

SCORE
ASSIGN PASSI OBTAIN
DATA DATA HOW TO DETERMINE ED NG ED BY DOCUMENT
INDICATORS
REQUIREMENTS SOURCE THE SCORE SCOR THE SUBMITTED
SCORE E BARAN
GAY
If the result is:
Functionality of the
● Ideal = 1
Violence Against
Women (VAW) Desk ● Mature = 0.5
Barangay 1 1 1
based on MC No. 2017-
Secretary ● Basic - Progressive =
114 dated 30 August
0.25
2017
1. Functionality of the
Violence Against ● No Functionality = 0
Local Social
Women (VAW) Desk VAWC Cases Quarterly
Welfare and Submission of Quarterly
Reports Developmen Reports on VAWC
● 1st Qtr submitted: t Officer Cases
2 1 2
● 1st Qtr report
● 2nd Qtr submitted: submission = 0.5
● 2nd Qtr report
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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

submission = 0.5
● 3rd Qtr submitted:
● 3rd Qtr report
submission = 0.5
● 4th Qtr submitted:
● 4th Qtr report
submission = 0.5
Certificate of VAW Desk Person is
Attendance/Participatio trained
n and Date of 1 1 1
Training/Seminar ● Yes = 1
● No = 0

2. Access to health Barangay Presence of EO or

and social welfare EO or similar issuance Secretary similar issuance on the
services in the on the Appointment of appointment of BHW
1 1 1
barangay Barangay Health
● Yes = 1
Worker (BHW) On-site
inspection ● No = 0
Presence of EO or
EO or similar issuance similar issuance on the
on the appointment of appointment of BNS
1 1 1
Barangay Nutrition
● Yes = 1
Scholar (BNS)
● No = 0
Barangay Health Presence of a BHS/C 1 1 1
Station/Center (BHS/C)
● Maintained BHS/C =
Location: 1

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

● With access to other

BHS/C = 0.5
● None = 0
Availability of services
BHS/C (check the in the BHS/C
corresponding answer)
● Expanded Program
Barangay on Immunization
owned/maintained (EPI) = 0.5
2 1 2
With access to ● Maternal Care = 0.5
other BHS/C
● Nutrition Care = 0.5
● Other Services = 0.5
● None = 0
If the result is:
DILG-MC No. 2019-69 ● High - Ideal = 1
DILG MC No. 2019-112 Punong
● Moderate = 0.5
3. Functionality of the Barangay
Barangay ● Annex 3 (C/MAT ● Low = 0.25
Audit Form) 1 1 1
Development
● Non-Functional =
Council (BDC) ● Annex 4 (C/M Barangay
0.15
Consolidated Results Secretary
Form) ● None = 0
● No data = 0

4. Representation of EO or similar issuance Barangay With EO or similar 1 1 1

CSOs in the organizing each of the Secretary issuance organizing the
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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

following:

Barangay Based 1. BDC

Institutions (BBIs) 2. BADAC BBIs (with CSO
a. BDC 3. BDRRMC representative that is
accredited by the
b. BADAC 4. BPOC Sangguniang
c. BDRRMC 5. BESWMC Barangay):
d. BPOC 6. BCPC ● 4 to 7 BBIs = 1
e. BESWMC 7. Barangay GAD ● 1-3 out of 7 BBIs =
Focal Point System 0.5
f. BCPC
● No EO or similar
g. Barangay GAD
issuance = 0
Focal Point CSO Assembly/Election
System Report

5. Registration of DILG MC No. 2013-061 Barangay With established 2 2 2

Kasambahay and Secretary kasambahay desk:
● KR Form 5 –
Establishment of
Barangay Yes = 1
Kasambahay Desk
Consolidated
Public No = 0
Kasambahay Report
Employment
Service
Office Maintained and
updated kasambahay
masterlist KR Form 5:

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

Yes = 1
No = 0
If the result is:
● Ideal = 1
6. Functionality of the DILG MC No. 2008-126 Barangay
Barangay Council for Secretary ● Mature = 0.5
● LCPC Form 1-A 1 1 1
the Protection of
● Basic - Progressive =
Children (BCPC)
0.25
● No Functionality = 0
With approved
7. Allocation for the PCW, DILG, DBM and Barangay Annual Plan
Barangay
Annual Gender and NEDA JMC No. 2016- and Budget:
Secretary 1 1 1
Development (GAD) 01
Yes = 1
Plan and Budget ● Annex D-1
No = 0
TOTAL 15 13 16

ESSENTIAL AREA 2: BUSINESS-FRIENDLINESS AND COMPETITIVENESS

INDICATORS DATA DATA HOW TO DETERMINE ASSIGN PASSI SCORE DOCUMENT
REQUIREMENTS SOURCE THE SCORE ED NG OBTAIN SUBMITTED
SCOR ED BY
SCORE
E THE
BARAN
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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

GAY
Presence of Barangay
Barangay Ordinance:
Barangay Tax Secretary
1. Enactment of Ordinance ● Presence of
Barangay Tax Barangay Tax 3 3 3
Ordinance Barangay Revenue Ordinance = 3
Code Barangay
Treasurer ● No Barangay Tax
Ordinance = 0
2. Enactment of an Presence of Barangay
ordinance relative Barangay Ordinance:
to Barangay Secretary
Barangay Ordinance ● Presence of
Clearance fees on
Barangay Ordinance 3 3 3
business permit
=3
and locational Barangay
clearance for Treasurer ● No Barangay Tax
building permit Ordinance = 0
3. Approval of a Barangay Resolution Barangay Presence of Barangay 2 2 2
resolution Secretary Resolution:
authorizing the
● Presence of
City/Municipal
Barangay Resolution
Treasurer to collect Barangay
=2
fees for Barangay Treasurer
Clearance for ● No approved
Business permit Barangay Resolution

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

and locational
=0
clearance purposes

4. Issuance of Timeliness of issuance

Barangay of barangay clearance
Clearance1 within
● 90%-100% of
seven (7) working
applications met = 7
days (for
businesses which ● 80%-89% of
do not require applications met = 5
occupancy
Barangay ● 70%-79% of
permits). For Record book 7 5 7
Treasurer applications met = 3
locational
clearance, issuance ● 60%-69% of
of Barangay applications met = 2
Clearance in not
● 50%-59% of
more than three (3)
applications met = 1
working days from
application at the ● 49% and below of
city/municipality applications met = 0
TOTAL 15 13 15

1
Item 5.1 of DILG MC No. 2019-177 dated October 17, 2019 – Barangay Clearance refers to any and all documents issued by the barangays with or without
corresponding fees as defined in their ordinances relative to or in relation to the issuance of business permit and locational clearance by the city/municipality or
any other permit as may be required.

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

ESSENTIAL AREA 3: ENVIRONMENTAL MANAGEMENT

SCORE
OBTAI
ASSIGN PASSI DOCUMEN
NED
DATA DATA HOW TO DETERMINE ED NG T
INDICATORS BY
REQUIREMENTS SOURCE THE SCORE SCOR SUBMITTE
SCORE THE
E D
BARA
NGAY
● MRF (check the
corresponding
answer) Presence of MRF:

Barangay ● Yes = 2
1. Presence of a
Materials Recovery owned ● None but with other
Onsite
Facility (MRF) Clustered inspection materials recovery 2 1 2
pursuant to R.A. Brgys scheme = 1
9003
● None = 0

● Location of MRF
● MOA
Presence of Ordinance
2. Presence of a
on segregation of
Collection System 2
Ordinance on Barangay wastes-at-source
to Ensure 2 2
segregation-at-source Secretary
Segregation of ● Yes = 2
Wastes at Source
● No = 0
3. Functionality of EO or similar issuance Barangay If the result is: 2 2 2
Barangay on the organization of
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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

EO organizing the
BESWMC
the BESWMC
● Yes = 1
● No = 0
Approved Solid Waste Approved BESWMC
Management Program/Plan
Program/Plan 1 1 1
Ecological Solid ● Yes = 1
(Any template or
Waste Management ● No = 0
annotated) Secretary
Committee
(BESWMC) With fund allocation:
Allocation of barangay
funds, approved by the ● Yes =1 1 1 1
sangguniang barangay
● No = 0
Capacity-building
activity conducted:
Conduct of capacity-
2 2 2
building for BESWMC Yes = 2
No = 0
TOTAL 10 9 10

We certify to the correctness of the above information.

City/Municipal Assessment Team:

ROSHSEINEE O. GUMABAO
Chairperson

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 SGLGB Form No. 1
2021 SEAL OF GOOD LOCAL GOVERNANCE FOR BARANGAY
Assessment Period: CY 2019
Data Capture Form

WILSON C. PASCUAL
Vice-Chairperson

NEILBRANN T. COLUMNA, EnP

Member

RODOLFO BACUYAG
Member
Date Accomplished: October 11, 2021

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