(N4icTh

bull

tic( of I) irector Schoirl DIJCorinu ntraEd cation I larva na) ftrr1

ftiur ftkTrr-- ---Iri-7mdashwl gftzatrri r rCift-7oft ---Pint N 18 Stoksha Sa itOtuDarknoss (earl me to tight14i_vm tok iaodan Sector 5 Panchkula Haryana 134109 (India) Tel 91(01721-2560246f) ft fr4i (Pane 5 79)a1 134109 (vim) viirlt0e-mail edusecondaryhry(agmailcom 91 (0172) 2560246 Fax 91(0172)-256025344-ii 91 (0172) 2560253 - site wwwschooleducationharyanagovin

Inspection Performa for Inspection of Private

under RTE Rules 2011Schools for recognition Mote

DistrielSu Li Division V) tick mark the circle for appropriate

rrna ion)

(hue 01 inspection

1 Details of Schools A General

11101141 i713111 L177_EFILT191 Elf7_1- J 1

i Name of School

u Stage for which recognition applied for [6-P 7Tg-0 Primary 4 Middle

6-

iii Permission to establislunent or up-gradation of school granted by

NOM The school running in the State before 31012007 asrecognized or deemed recognized orUnreCogniied shall be deemed temporarily recognized or

to have been permitted under thisrole for the purpose of recognition or up gradation

0 Director 0 DEO

No Dante rL i

L_Lin W If already recognized mention stage along with

order no and date 0 Primary Middle

No Vif3NiB Locational Details of Schoolr Plot No Date 45-3 SectorMohalla

ET-iii CityTownVillage 1

BUDAMunicipal Council CommitteePanchanilbull--7 CD Block

vi Assembly Constituency viiy District

Telephone No with STD code

Fax No

Email address

2 Details of Authority to run the1 Name

trirfiVidua t association of indivi created und the Indian Trust Act Ior society registered under Societicompany registered under Companiof 1956)

__ tcer

1- ck uc Bahuwala-1 _bdquo11A4 iltst 13 (41Ba 3A

(Srs-F M( Sh1-)410401kii4v4

f 2 5607

2 NegIstiiior

- mlaquo1bullbullbull

bull 1

lsquo111111111 1 c)-9 117 - G6 v ERill t 4111bull11111eis of managum r ()immure

iv Composmim 111 mmtaging C011111111tee Y es 0 No V C11111 n1 6tr 11v inched 6101---Yes 0 No

C Type of SchoolCurriculum Type of seiloci 0 Boys 0 Girls 11Pro- Education

It Approximate number of students 21673T-1-1 iii Affiliating Board 4r4 Bose CBSF 0 ICSE iv 0 OthersCurriculum a) For 1-8 Class sllABose 0 CBSE 0 ICSE 0 Edu Dept

v 0Medium of Instructions Hindi 0 English Both 0 Others

Land Details Area Details

School New schools established after commencement of Han ma School Education Rules

2003 ie after

30012003

RanUrban

Controlled areas

Primary OS Acre

Middle 10 Acre

Secondary 20 Acre

Senior Secondary 2 0 Acre (i) Ant atld

Commerce (it) Ansi Commerce

and Science

Existing schools running as meognized or unrecognized before commencement of Haryana School Education Rules 2003 ie bd 31032007

RuralUrban Rural Urban Controlled areas Controlled arms (for single storey (for double

Wilding) storey building) 500 Square meters 350 Square

WW1 310 Square meters 600 Square

meters 2000 Square meters bull1500 Square

moms

3000 Square meters 2250 Square

meters 4000 Square meters

3010 Square Metal

In case of existing schools ie running before June 2011 these QIS shall provide or make arrangement for adequate play ground

the radius of 500 meter according to the number of students These schools may use the playground of Government schools within one Kilometer range or tie up for use of playground of any Aided School Educational Institution Park PanchayatMunicipal Land

`urn etc

b Owner Details

(1) The Name of individual or Association of individuals or Trust or Society or Company or school whom ownership vests

(ii) The ownership title documents attached

C Leasors Detail (i) Name

(ii) Address

D Lessee Detail

Total Land Area [1-1 Acre 1-34mdash Kanal Li Marla L J Sqm

0 Yes 0 No

If yes then Area Distance J

IIIIIIIIIIIIIIIIIIII TT I

(i) Name of the lessee (President of Se r retary or Manager) ELL__L_ (viii) Whether autho d by the authorit FITF f=11-

fficerbdquobdquospck Ed u Wuwala-I bull Tuff

16araWANaTraTre r$a

MCSarpacficA

111I

iltg 2 of 5

IS 1 34 10r Icebull bulli ) 112 1

E Locaticn 01 land (II

kindIII Whel ilti 111 1 Phubdquo rote patch of molt Nonther of patch

lull If nan hLii out patch a of land duly 0 Yesmaul by the 1 ellisildai be attached) No

(iv) WhitHal pares rd land adjat eni and easih Yes () Noappioachable and functionally suitable

Building Details

A Existing Plan Existing plan of building duly signed by registered 0 OwnerLesseearchitect and owner or lessee (PresIdent or Manager or Secretaryl 0 Architect

Ili I Covered Area

(a) Ground coverage-(for New Schools it should be 3 sa15-71conforming to Urban Development Department Town and Country Planning Department Panchayat and Development Department whichever is applicable

(b) Total covered area (if more than one floor)

(c) Percentage of ground coverage

(d) FAR Floor area ratted For New Schools(

B Rooms Details i) Total No of Rooms

ii) Number of Class Rooms (one class room for each section) Size otClass Room

a) for new School - 24x 18s I0 (FS 10SqftStudentb) for Existing School -

1-VIII Class- 9 Sqft Student

TotalTYPe Lentered Area No ofSize (in ft) TotalRoom (SqFt each Students toClass Room No of0 room)O No be adjusted StudentFe) ] 11lsquo41-2f4s Room O Yes O No mdash6mdash Q xlaquo E=- -is Room 0 Yes O No xmum

Class Room O Yes O No o )Claes Room 0 Yes O No l e l

i1R x

261Eof I ) bullI- IN

) lt 6 I -Others Room IN is bdquo -is ILL-degdice of Head V wrO Yc 0 No L Stall Rom O Yes 0 No CP]Oilier Room O Yes 0 No Lo I

Library 0 Yes 0 No No of books availableCOMpOSited Lab 0 Yes- 0 No

CornputerEdusel Room O Yes 0 No

Store-Room O Ybulls- 0 N

Block - e 0 af DE g arkjuo FLT uwala-I NitiAarpanch-o-EF atrET zr (Sirsa)

ftrrolrTAYNI

i4es 4 of

16 in-wens 511010 2tdare-th

E Locaticn 01 land (II

kindIII Whel ilti 111 1 Phubdquo rote patch of molt Nonther of patch

lull If nan hLii out patch a of land duly 0 Yesmaul by the 1 ellisildai be attached) No

(iv) WhitHal pares rd land adjat eni and easih Yes () Noappioachable and functionally suitable

Building Details

A Existing Plan Existing plan of building duly signed by registered 0 OwnerLesseearchitect and owner or lessee (PresIdent or Manager or Secretaryl 0 Architect

Ili I Covered Area

(a) Ground coverage-(for New Schools it should be 3 sa15-71conforming to Urban Development Department Town and Country Planning Department Panchayat and Development Department whichever is applicable

(b) Total covered area (if more than one floor)

(c) Percentage of ground coverage

(d) FAR Floor area ratted For New Schools(

B Rooms Details i) Total No of Rooms

ii) Number of Class Rooms (one class room for each section) Size otClass Room

a) for new School - 24x 18s I0 (FS 10SqftStudentb) for Existing School -

1-VIII Class- 9 Sqft Student

TotalTYPe Lentered Area No ofSize (in ft) TotalRoom (SqFt each Students toClass Room No of0 room)O No be adjusted StudentFe) ] 11lsquo41-2f4s Room O Yes O No mdash6mdash Q xlaquo E=- -is Room 0 Yes O No xmum

Class Room O Yes O No o )Claes Room 0 Yes O No l e l

i1R x

261Eof I ) bullI- IN

) lt 6 I -Others Room IN is bdquo -is ILL-degdice of Head V wrO Yc 0 No L Stall Rom O Yes 0 No CP]Oilier Room O Yes 0 No Lo I

Library 0 Yes 0 No No of books availableCOMpOSited Lab 0 Yes- 0 No

CornputerEdusel Room O Yes 0 No

Store-Room O Ybulls- 0 N

Block - e 0 af DE g arkjuo FLT uwala-I NitiAarpanch-o-EF atrET zr (Sirsa)

ftrrolrTAYNI

i4es 4 of

16 in-wens 511010 2tdare-th

Veranda

1J1 vi rot FI

bt lot Extsung Cr hoot ittgl ln lilt loidrt Ft

ISA Stair

al lot nein St - hrnil Sit Width Yes I) No II NO Size ID tin

distanlaquo- of 100 lbull 6wulth Atifill10110i Staff abet linen] 0 Yes (1 No If No Size

v) Rau

a) for new School bull 6 width 0 Yes 0 No If No Size b) for Existing School- 6 width If the school does provide ramp 0 Yes 0 No If No Size

then it should arrange the classes for the handicapped students at the ground floor

Drinking water facility (Mode of water supply) 64es 0 No Mode L i) Toilets and Urinals separate for boys and girls to Yes 0 No

(a) Number of toilets for the girls Int 181 (b) Number of toilets for the boys 1TE

Total toilets 1 1 61 5 Pledge Money

Pledge money atleast equal to six months basic pay of the staff but in no case less than the amount as mentioned below shall be deposited in the name of 0 Yes 0 No If yes Amount (15O 0 0 e9 Director School Education (by designation) in the shape of fixed deposit or bank guarantee not less than a period of three yearsmdash

State Class Rs Primary I-V 50000 Middle I-V111 100000

6 Certificates Ownership Lad

or Tehsildar Yes 0 No

2

3

Constructina of Building Safety of Buddinc

District town planner municipalityregistered architect empanelled architect

Nellie works Depanment Municipality Remseted Engineerempanelled Itttineer

4 e

Yes

Yes

0

0

No

No 4 fin Safety 11teOffIcer authorized agency rn Central Government or State Government Ara-9Yes 0 No 5 ilygimiir

6 Na Objection Certificate

t fuer Medical Officer Senior Medical Officer empanelled Medical Office

MIMICipal area municipalitymunicipal councillocal authority

bull

61bull

yes

Yes 0 0

No No

regarding bold IMO

Wt side municipality inhan area controlled

area like areairural

As notified under relevant laws 0 Yes 0 No t1

Note - The schools running in the state before 31032007 as recognized or deemed recognized or temporarily recognized or unrecognized shall require to attach certificate referred above at Sr No 6 ie no objection certificate regarding land use with application for the purpose of

recognition or up gradation 7 Staff statement lb Yes 0 No 8 Rules and Regulations for staff under rule 162 4 Yes 0 No

9 Fee structure -

i) class mdashwise fee and funds (no funds except Red Cross CWF and Sports Fund) ft Yes 0 No ti) to be displayed on the notice board bull Yes 0 No iii) issue of fee receipt Yes 0 No iv) fees charged is according to the facilities provided by the school bull Yes 0 No

10 School Record (under rule 28) Yes 0 No 11 General report regarding mdash

1No business premises in any part of ildin of schools bull Yes 0 No 2Furniture and equipment arc ade uate d suitable for S Yes 0 No

insutunon 3 Salary 01 teat ers and non-teachi staff are p id regularly bull Yes 0 No

as notified b he school

ice 650( ala-I CSarpanchfift1 B1f7c- ri r Barag

(Sir a)firm 1 )1

itxt I -bull

f ff 011 I 11t 1111 111111

111011tk

Sfil of I 111 01 Icitt [Mfg 0111 fit paid ItT11111 N 110111

Srhoot boddo o III 0111(-1 StIl11- 1111 t 1 W1111111 are 1501 Used dUtIng dsi in night for commercial (Si residential purpose lex(epl septiate residence lot employees of school) of

wilittual or non -educauon alt tn-ity of any kind 8 There is no thoroughfare or public passage through any part

of school premises 9 Sanitary arrangements at school are adequate and kept in

good order 10 Drinking water arrangement adequate 11 Provisions of electricity fitting and electric fans in each

class rooms

12 No teacher or student is completed to attend a class or religious instruction (except in minority school)

13 No complaininquiry pending against school building management committee seeking recognition An undertaking in this effect that land building in this effect that land building is free from litigation be submitted 12 Audit Report (as per rule 30)

13 Processing Fee + Form Fee (For 51 Rs 1000- for 8th Rs 2500- plus Rs 500- fee of the

form)

14 Recommendations -

bull +Y es

bull Yes

if Yes bull Yes

O Yes

bull Yes

bull Yes

11 Yes

I) No

0 No

0 No 0 No

0 No

0 No

0 No

t) No

We the members of the Inspection Committee have satisfied ourselves that the school fulfills all conditions of recognitionupgradation laid down in Haryana School Education Rules 2003RTE Rules 2011 amended from time to time and guidelines issued by the Department We therefore recommend that the school be granted recognitionupgradation from Class 4 to Class9 Abdquo

OR We find that school is not fit for recognition up gradation and has the following deficiencies discrepancies -1

2

3

4

5

6

We therefore recommend rejection of thbull resuest for ecognitapnlup gradation applied for Class to Class

M SaTatieh

Pau

IS sforfsf

f ff 011 I 11t 1111 111111

111011tk

Sfil of I 111 01 Icitt [Mfg 0111 fit paid ItT11111 N 110111

Srhoot boddo o III 0111(-1 StIl11- 1111 t 1 W1111111 are 1501 Used dUtIng dsi in night for commercial (Si residential purpose lex(epl septiate residence lot employees of school) of

wilittual or non -educauon alt tn-ity of any kind 8 There is no thoroughfare or public passage through any part

of school premises 9 Sanitary arrangements at school are adequate and kept in

good order 10 Drinking water arrangement adequate 11 Provisions of electricity fitting and electric fans in each

class rooms

12 No teacher or student is completed to attend a class or religious instruction (except in minority school)

13 No complaininquiry pending against school building management committee seeking recognition An undertaking in this effect that land building in this effect that land building is free from litigation be submitted 12 Audit Report (as per rule 30)

13 Processing Fee + Form Fee (For 51 Rs 1000- for 8th Rs 2500- plus Rs 500- fee of the

form)

14 Recommendations -

bull +Y es

bull Yes

if Yes bull Yes

O Yes

bull Yes

bull Yes

11 Yes

I) No

0 No

0 No 0 No

0 No

0 No

0 No

t) No

We the members of the Inspection Committee have satisfied ourselves that the school fulfills all conditions of recognitionupgradation laid down in Haryana School Education Rules 2003RTE Rules 2011 amended from time to time and guidelines issued by the Department We therefore recommend that the school be granted recognitionupgradation from Class 4 to Class9 Abdquo

OR We find that school is not fit for recognition up gradation and has the following deficiencies discrepancies -1

2

3

4

5

6

We therefore recommend rejection of thbull resuest for ecognitapnlup gradation applied for Class to Class

M SaTatieh

Pau

IS sforfsf