Surveypoint

Q01

District

Q02

Block

Q03

School Name

Q04

DISE Code

Q05

HPS/HS

Q06

Co-ed/Girls Only/Boys Only

Co-ed

Girls Only

Boys Only

Q07

Date

Q08

Status

Q09

Name of Enumerator

Q10

CSR Activities Present

Q10_1

WASH

Yes

No

Q10_2

Drinking Water related activities

Yes

No

Q10_3

Classroom Infrastructure

Yes

No

Q10_4

Classroom Items

Yes

No

Q10_5

ICT

Yes

No

Q10_6

School Infrastructure

Yes

No

Q11

Sanitation Facility

Q11_1

Number of Urinals (girls)

Q11_2

Number of Urinals (boys)

Q11_3

Number of WCs (girls)

Q11_4

Number of WCs (girls)

Q12

Done By CSR?

Q12_1

Washroom

Yes

No

Q12_2

Wash Basins

Yes

No

Q12_3

Functional Taps

Yes

No

Q12_4

Water Flow (taps & flush)

Yes

No

Q12_5

Roof / Shade

Yes

No

Q12_6

Privacy (Doors / Latches)

Yes

No

Q12_7

Drainage & Plumbing

Yes

No

Q12_8

Tiling

Yes

No

Q12_9

Mirrors

Yes

No

Q13

Agency Name

Q13_1

Washroom

Q13_2

Wash Basins

Q13_3

Functional Taps

Q13_4

Water Flow (taps & flush)

Q13_5

Roof / Shade

Q13_6

Privacy (Doors / Latches)

Q13_7

Drainage & Plumbing

Q13_8

Tiling

Q13_9

Mirrors

Q14

Water Drinking Facilities

Q14_1

Number of Taps

Q14_2

Number of Washbasins

Q15

Done By CSR?

Q15_1

Storage tank

Yes

No

Q15_2

Water Purifier / RO

Yes

No

Q15_3

Taps

Yes

No

Q15_4

Flow of water

Yes

No

Q15_5

Drainage

Yes

No

Q15_6

Tiling / Flooring

Yes

No

Q15_7

Water Supply

Yes

No

Q16

Agency Name

Q16_1

Storage tank

Q16_2

Water Purifier / RO

Q16_3

Taps

Q16_4

Flow of water

Q16_5

Drainage

Q16_6

Tiling / Flooring

Q16_7

Water Supply

Q17

Basic Infrastructure

Q17A

Done By CSR?

Q17A_1

Condition of Plastering in Classroom

Yes

No

Q17A_2

Condition of School Corridors

Yes

No

Q17A_3

Color Work

Yes

No

Q17A_4

Educational Paintings

Yes

No

Q17A_5

Condition of Blackboards

Yes

No

Q17A_6

Availability of dustbins

Yes

No

Q17A_7

Classroom Lighting

Yes

No

Q17A_8

Condition of Classroom Walls

Yes

No

Q17A_9

Condition of Desk/Chairs

Yes

No

Q17A_10

Condition of Classroom

Yes

No

Q17A_11

Open Space Utilization

Yes

No

Q17B

Agency Name

Q17B_1

Condition of Plastering in Classroom

Q17B_2

Condition of School Corridors

Q17B_3

Color Work

Q17B_4

Educational Paintings

Q17B_5

Condition of Blackboards

Q17B_6

Availability of dustbins

Q17B_7

Classroom Lighting

Q17B_8

Condition of Classroom Walls

Q17B_9

Condition of Desk/Chairs

Q17B_10

Condition of Classroom

Q17B_11

Open Space Utilization

Q18

School Transport

Q18A

Number of Buses

Q19

Done By CSR?

Q19_1

Condition of School Bus

Yes

No

Q19_2

Condition seats in the school Bus

Yes

No

Q20

Agency Name

Q20_1

Condition of School Bus

Q20_2

School Observation 3 -Form Fill

District

Block

School Name

DISE Code

HPS/HS

Co-ed/Girls Only/Boys Only

Date

Status

Name of Enumerator

CSR Activities Present var statement=document.write(localStorage.getItem('total'));

WASH

Drinking Water related activities

Classroom Infrastructure

Classroom Items

ICT

School Infrastructure

Sanitation Facility var statement=document.write(localStorage.getItem('total'));

Number of Urinals (girls)

Number of Urinals (boys)

Number of WCs (girls)

Number of WCs (girls)

Done By CSR? var statement=document.write(localStorage.getItem('total'));

Washroom

Wash Basins

Functional Taps

Water Flow (taps & flush)

Roof / Shade

Privacy (Doors / Latches)

Drainage & Plumbing

Tiling

Mirrors

Agency Name var statement=document.write(localStorage.getItem('total'));

Washroom

Wash Basins

Functional Taps

Water Flow (taps & flush)

Roof / Shade

Privacy (Doors / Latches)

Drainage & Plumbing

Tiling

Mirrors

Water Drinking Facilities var statement=document.write(localStorage.getItem('total'));

Number of Taps

Number of Washbasins

Done By CSR? var statement=document.write(localStorage.getItem('total'));

Storage tank

Water Purifier / RO

Taps

Flow of water

Drainage

Tiling / Flooring

Water Supply

Agency Name var statement=document.write(localStorage.getItem('total'));

Storage tank

Water Purifier / RO

Taps

Flow of water

Drainage

Tiling / Flooring

Water Supply

Basic Infrastructure var statement=document.write(localStorage.getItem('total'));

Done By CSR? var statement=document.write(localStorage.getItem('total'));

Condition of Plastering in Classroom

Condition of School Corridors

Color Work

Educational Paintings

Condition of Blackboards

Availability of dustbins

Classroom Lighting

Condition of Classroom Walls

Condition of Desk/Chairs

Condition of Classroom

Open Space Utilization

Agency Name var statement=document.write(localStorage.getItem('total'));

Condition of Plastering in Classroom

Condition of School Corridors

Color Work

Educational Paintings

Condition of Blackboards

CSR Activities Present

Sanitation Facility

Done By CSR?

Agency Name

Water Drinking Facilities

Done By CSR?

Agency Name

Basic Infrastructure

Done By CSR?

Agency Name

School Transport

Done By CSR?

Agency Name