INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM

Name of Employee: Name of Rater:

Position: Teacher I Position: HEAD TEACHER III
Division: Date of Review:
Rating Period: April 2016 to March 2017

TO BE FILLED IN DURING PLANNING TO BE FILLED IN DURING EVALUATION

Weight Performance Indicators Actual Results Rating
MFOs KRAs Objectives Timeline ed per Score
Quality Efficiency Timeliness Quality Efficiency Timeliness Q E T Ave.
KRA
1. Prepared instructional plans and daily Prepared 135 instructional plans and 7-Apr-17 Prepared 175 lesson plans prepared 1-Apr-17
135 lesson plans prepared including 175 lesson plans prepared of
logs of activities including appropriate, April 2016- daily logs of activities including of activities including appropriate,
10% appropriate, adequate and updated activities including appropriate, 4 4 4 4 0.400
adequate and updated instructional March 2017 appropriate, adequate and updated adequate and updated instructional
instructional materials adequate and updated instructional
materials. instructional materials. materials
2. Facilitated learning in elementary Facilitated 75% learning in 75% learning facilitated in elementary 7-Apr-17 Facilitated 95% learning in 95% learning facilitated in 1-Apr-17
schools through functional lesson plans, April 2016- elementary schools through functional schools through functional lesson plans, elementary schools through functional elementary schools through
10% 4 4 4 4 0.400
daily logs and innovative teaching March 2017 lesson plans, daily logs and innovative daily logs and innovative teaching lesson plans, daily logs and functional lesson plans, daily logs and
strategies. teaching strategies. strategies. innovative teaching strategies. innovative teaching strategies.
1. Teaching 7-Apr-17 1-Apr-17
Learning 3. Initiated discipline of students including Initiated 2 discipline of students 2 initiated discipline of students including Initiated 4 discipline of students 4 Initiated discipline of students
April 2016-
Process(40%) classroom rules, guidelines and 10% including classroom rules, guidelines classroom rules, guidelines and including classroom rules, guidelines including classroom rules, guidelines 5 4 4 4.3333 0.433
March 2017
individual and group tasks. and individual and group tasks. individual and group tasks. and individual and group tasks. and individual and group tasks.

4. Monitored attendance, diversity
appreciation, safe, positive and
motivating environment overall physical
atmosphere, cleanliness and and
orderliness of classrooms including
proper waste disposal.
Monitored 4 indicators attendance,
diversity appreciation, safe, positive
and motivating environment overall
April 2016- physical atmosphere, cleanliness and
10%
March 2017 and orderliness of classrooms
including proper waste disposal.
4 indicators monitored attendance,
diversity appreciation, safe, positive and
motivating environment overall physical
atmosphere, cleanliness and and
orderliness of classrooms including
proper waste disposal.
7-Apr-17 Monitored 5 indicators attendance,
diversity appreciation, safe, positive
and motivating environment overall
physical atmosphere, cleanliness and
and orderliness of classrooms
including proper waste disposal.
5 indicators monitored attendance, 27-Mar-17
diversity appreciation, safe, positive
and motivating environment overall
physical atmosphere, cleanliness and
5 5 5 5 0.500
and orderliness of classrooms
including proper waste disposal.

Quaterly Quarterly
1. Monitored, evaluated and maintained April 2016- Monitored, evaluated and maintained 75% pupils/students progress were Monitored, evaluated and maintained 85% pupils/students progress were
5% 4 4 4 4 0.200
pupils/students' progress. March 2017 75% pupils/students' progress. monitored, evaluated and maintained. 85% pupils/students' progress. monitored, evaluated and maintained.

2. Conducted remediation/enrichment Conducted 4 remediation/enrichment 4 remediation/enrichment programs Quarterly Conducted 6 remediation/enrichment 6 remediation/ enrichment programs Quarterly
April 2016-
programs to improve performance 5% programs to improve performance conducted to improve performance programs to improve performance conducted to improve performance 4 5 4 4.3333 0.217
2.Pupils/ Students indicators. March 2017
indicators. indicators. indicators. indicators.
outcome (20%)
3. Maintained updated pupils/students' Maintained 75% updated 75% maintained updated Quarterly Maintained 95% updated 95% maintained updated Quarterly
school records April 2016- pupils/students' school records pupils/students' school records pupils/students' school records pupils/students' school records
5% 4 4 4 4 0.200
March 2017

4. Attained the required GSA for grade April 2016- Yearly Yearly
5% Attained 75% of the required GSA 75% attained of the required GSA Attained 95% of the required GSA 95% attained of the required GSA 4 4 4 4 0.200
level and learning areas March 2017
Quarterly Quarterly
1. Conducted regular/ periodic PTA April 2016- Conducted 4 regular/ periodic PTA 4 regualr/periodic PTA Conducted 5 regular/ periodic PTA 5 regualr/periodic PTA meetings/
10% 4 4 4 4 0.400
meetings/ conferences March 2017 meetings/ conferences meetings/conferences conducted meetings/ conferences conferences conducted

December 5 parents of students needing December

2. Visited parents of students needing April 2016- Visited 2 parents of students needing 2 parents of students needing academic Visited 5 parents of students needing
3. Community 10% academic monitoring/ follow - up 3 5 3 3.6667 0.367
academic monitoring/ follow - up March 2017 academic monitoring/ follow - up monitoring/ follow - up visited academic monitoring/ follow - up
Involvement (30%) visited
3. Undertaken/initiated Undertaken/ initiated 1 April 2016- Undertaken/ initiated 2 April-March
1 projects/ events/ activities initiated with March 2017 projects/events/activities with external 2 project/ events/activities initiated
projects/events/activities with external April 2016- projects/events /activities with external
10% external funding/ sponsorship within the with external funding/sponsorship 3 4 3 3.3333 0.333
funding/sponsorship within the target March 2017 funding/ sponsorship within the target funding/sponsorship within the target
target date within the target date
date date date
April 2016- Yearly none none Yearly
1. Conducted Action Research 1% none none 1 1 1 1 0.010
March 2017
4. Professional 2.Participated in activities such as April 2016- Participated 1 activitiy such as 1 activitiy participated such as teachers' April 2016- Participated 1 activitiy such as 1 activitiy participated such as April- March
5% 3 3 3 3 0.150
Growth and teachers' association March 2017 teachers' association association March 2017 teachers' association teachers' association
Development June 2016- June 2016-
3. Produced publications/ creative work April 2016- March 2017 none March 2017
2% none none none 1 1 1 1 0.020
for school paper/division publications March 2017

4. Received special Received 1 special June 2016- Received 4 special 4 special awards/ citattion/ June 2016-
April 2016- 1 special awards/citattion/recognition for March 2017 awards/citattion/recognition for March 2017
awards/citattion/recognition for 2% awards/citattion/recognition for recognition for exemplary 4 4 4 4 0.080
March 2017 exemplary performance received
exemplary performance exemplary performance exemplary performance performance received

Page 1 of 3
 INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM

Name of Employee: Name of Rater:

Position: Teacher I Position: HEAD TEACHER III
Division: Date of Review:
Rating Period: April 2016 to March 2017

TO BE FILLED IN DURING PLANNING TO BE FILLED IN DURING EVALUATION

Weight Performance Indicators Actual Results Rating
MFOs KRAs Objectives Timeline ed per Score
Quality Efficiency Timeliness Quality Efficiency Timeliness Q E T Ave.
KRA

KRA 1 4.50 4.25 4.25 4.33 1.733

KRA 2 4 4.25 4 4.083 0.816
KRA 3 3.333 4.333 3.333 3.666 1.099
KRA 4 2.25 2.25 2.25 2.25 0.225

Rating for Accomplishment 3.873

Rater Ratee Approving Authority

Page 2 of 3
 SUMMARY OF RATINGS FOR DISCUSSION

FINAL PERFORMANCE RATING

ACCOMPLISHMENTS OF KRA'S AND OBJECTIVES 3.87
VS
Employee- Supervisor Agrreement

The signatures below confirm that the employee and his /her superior have agreed to the contents of the performance as captured in this form.

Name of Employee: DOREEN A. CALUMPANG Name of Superior: MERLYN S. ROSALES

Signature: Signature:
Date: MARCH, 2017 Date:

DEVELOPMENT PLANS

STRENGTHS
DEVELOPMENTACTION PLAN RECOMMENDED TIMELINE RESOURCES NEEDED
NEEDS DEVELOPMENTAL INTERVENTION

1. Watch service improvement

Professionalism Service
and Ethics Orientation program, practice public speaking June 2016 - March 2017 Media, magazines, books and entertainment shows
and watch open forum

DOREEN A.CALUMPANG MERLYN S. ROSALES LELANIE T. CABRERA,CESE

Ratee Rater Assistant Schools Division Superintendent