District Structures Form - Lesotho Purpose Driven Church Peace Plan

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Methodist Primary School Moshoeshoe II, Maseru Lesotho
john.maphephe@pdcpeaceplan.org.ls

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District Structures Form

Home » Resources » Forms » District Structures Form

District Information

District Name

District Code

Location

Date

Structure Information

Structure TypeSchoolHealth CenterCommunity CenterOther

Please specify

Structure Name

Structure Code

Location

ConditionGoodFairPoor

Capacity

Current Usage

Infrastructure

Is the structure connected to:

ElectricityYesNo

WaterYesNo

SanitationYesNo

Are there any infrastructure challengesYesNo

If yes, please describe

Security

Is the structure secure?YesNo

Are there any security concerns?YesNo

If yes, please descibe

Maintenance

Is the structure well-maintained?YesNo

Are there any maintenance needs?YesNo

If yes, please describe

Usage

How is the structure currently being used

Are there any plans to change the usage of the structure?YesNo

If yes, please describe

Capacity Building

Are there any capacity building needs for the structure?YesNo

If yes, please describe

Support

Is the structure receiving adequate support?YesNo

Are there any support needs?YesNo

If yes, please describe

Are there any recommendations for improving the structure or its usage?

Consent *

I, certify that the information provided is accurate and true

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