Republic of the Philippines

Department of Education
Region VI - Western Visayas
Division of Negros Occidental
Cottage Road, Bacolod City
INDIVIDUAL PERFORMANCE AND REVIEW FORM
Name of Employee:
Position:
Review Period:
Bureau/Center/Service/Division:

Name of Ratee:
Position:
Date of Review:

TO BE FILLED DURING PLANNING

KRA's
Instructional
Competence

Objectives

MFOs

Prepares daily logs and visual aids related Daily logs/LPs/Checklist of Visual
to the lessons
Aids

Timeline
Daily June 2015
to March 2016

Weight per
KRA
10%

Performance Indicators (Quality, Efficiency,Timeliness)

Efficiency
5 -100% LPs/daily log per
subject area per section /
class per day
4 - 90-99%
3 -80-89%
2 - 70-79%
1 - 69% and below

Conducts remedial

Schedule of

As Scheduled

5% 5-3 Remedial episodes

Effectiveness
5 - a. LP/Daily log PELC/
CG Based
b.relevant SIM
c.alignment of objectives,materials
activities and evaluation
d.value-focused
e.Instructional decision result
(Daily logs should be coupled with
the copies of TG referred to and
the formative test notebook)
4 -4 of the above indicators
3 -3 of the above indicators
2 -2 of the above indicators
1 -1 of the above indicators
5- Remedial Plan per episode

As Scheduled

Reporting
and
Assessing
Pupils
Progress

episodes classes
for slow learners

Remedial
List of Slow Learners
Remedial Activity
Log/Plan

Maintained Updated
School Records of pupils
a.SF 1
b.SF 2
c.SF 3
d.SF 5
e.Class Record
f.Form 138
g.Form 137
h.Test notebook
i. Anecdotal records.
j.Test results

Accomplished
a.SF 1
b.SF 2
c.SF 3
d.SF 5
e.Class Record
f.Form 138
g.Form 137
h.Test notebook
i. Anecdotal records.
j.Test results

5%
per week.
4-2 remedial episodes
per week.
3-1 remedial episode
per week.
2-incomplete remedial
episode
1-none

June 2015
to March
2016

5% 5-10 school records

4-9 school records
3-8 school records
2-7 school records
1-6 school records

is suitable to learning ability

of the pupils.
b.Provided opportunity
for greater participation
pupils.
c.varied and appropriate
d.Maximize utilization of
SIMs.
e.generated teacher learner
interaction.
4-4 of the above indicators.
3-3 of the above indicators
2-2 of the above indicators
1-1 of theabove inddicators
5-records were complete and
accurate up to date, no erasures
filed properly for easy access
4-presence of 4 of the above
indicators.
3-presence of 3 of the above
indicators.
2-presence of 2 of the above
indicators.
1-Presence of 1 of the above
indicators.

Updates parents on the children's progress Class records/ Records/record book quarterly
and problems through dialogues,
report card, permanent record,
conferences and PTA meetings
anecdotal records

Teaching - Learning

Improved performance indicators on the

following: A. NAT/PERIODICAL TEST

Copy of NAT / Periodical Test

Result

April 2016
45%
Quarterly 5%
5%

B. Drop Out

Report on Drop - out

March 2016

5% 5-At least 5 Homeroom PTA meetings,

4-4 Homeroom PTA
meetings
3-3
Homeroom PTA meetings
2-2 Homeroom PTA meetings
1-1 Homeroom PTA
metings

5-75% and above

74%
2-60% -64
1- below 60%

4-70% 3-65% - 69%

5- updates include pupils academic academic

achievement, attendance, class participation, subject
related assignments/project and participation to curricular
and co-curricular activities
4-presence of
4 the above indicators
3presence of 3 of above indicators
2-presence of 2 of above indicators
1-presence of 1 of the above indicators

5-least learned skills identified/analyzed and recomended

for specific intervention
4-least
learned skills identified/analyzed and recomended for
intervention
3-least learned skills
identified/analyzed
2-least learned skills
identified
1-none of the above(if
there's failure)

5% 5-0% dropout 4-0.1% - 1.0% 3-1.1%- 5- caused of problem identified/analyzed and recomended
2.0% 2-2.1% - 3.0% 1-3.1% and above for specific intervention 4 - caused of problem
identified/analyzed and recomended for intervention
3-caused of problem identified/analyzed 2problems identified 1- none of the above (if there's a
drop out)

C. Failure Rate

Report of Failure

March 2016

5% 5-% failure rate

4-0.1%1.0%
3-1.1% - 2.0%
2-2.1% - 3.0%
1-3.1% and above.

D. Promotion Rate

Report on Promotion

March 2016

2.50% 5-100%
99%

E. Nutritional Status

Nutritional Status Report-B and E

June 2015
February 2016

2.50% 5-0%-2.0% severely wasted

4-2.1%-4.0% severly
wasted
3-4.1%6.0% severely wasted
2-6.1%-8.0% severely wasted
1-8.1% and above
severely

5- caused of problem identified/analyzed and recomended

for specific intervention
4caused problem identified/analyzed and recomended for
intervention
3-caused of problem identified/
analyzedf
2 problems
identified
1-none of the above (if there's
failure)

4-90%- 5-caused of problem identified/analyzed and

3-80%-89%
recommended for specific intervention
2-70%-79%
4-caused of problem identified/analyzed and
1-69% and below
recommended for intervention
3-caused of problem
identified/analyzed
2-problems identified
1-none of the above (if there's failure)

5-caused of problem identified/analyzed and given

intervention
4-problem analyzed
and given intervention
3problems identified and analyzed
2-problems identified
1none of the above

F. Reading (Phil IRI)

PHIL IRI-Pre and Post

June 2015
February 2016

5% 5-0% frustration level

4-90%99% decreased from frustration level
3-80%-89% decrease from
frustration level
2-70%-79%
decreased from frustration level
1-below 70% dereased from frustration
level

5-caused of problem identified/analyzed and given

intervention
4-problem analyzed
and given intervention
3problems identified and analyzed
2-problems identified
1-none of
the above

G. Numeracy (elem)

Math Inventory-Pre and Post

June 2015
February 2016

5% 5-0% non numerate

4-90%-99%
decreased from non-numerate
3-80%-89% decrease from nonnumerate
2-70%-79%
decreased from non-numerate
1-below 70% decreased from non
numerate

5-Least learned facts identified, analyzed and given

intervention 4-least learned skills analyzed and given
intervention
3-least learned skills identified
and analyzed
2-least learned
skills identified 1- none of the above

Training Passbook Certificate of

Attendance

5% 5-100% of the mandatory

trainings/school activities
4-90% to 99%
3-80%
to 89%
2-70% to 79%
1-69% and below

5-Has shown marked improvement in teaching-learning

delivery
4-has shown
improvement
3-has shown minimal
improvement
2-has shown
minimal improvement
1-has
shown no improvement

Certification Chcklist of
behavior/practices/guidelines

5% 5-100% observance of the Code of

conduct for teachers ad employees
4-90 to 99 %
3-80 to 89
%
2-70 to 79 %
1-69 % and below

5-zero cases of reported violations 4-1 to 3 reported cases

of violations
3-4 to 7 cases of
reported violations
2-8 to 12
cases of reported violations
113 or more reported violations

*Professional Growth Attends professional meetings, In-Service

and Development 15% Trainings and related activities for selfgrowth and advancement

Observes proper decorum

School and
Community
Involvement (10%)

Conducts in depth studies or action

researches on instructional problems

Copy/copies of Action Research

5% 5-3 action researches conducted on

5-Problems were (a)clearly identified and defined,
instructional problems
4-2 action (b)several alternatives were proposed and selected
research conducted on instructional
(c)finigs were reported and (d)shared.
problems 3-1 action research on
4-presence of 3 of the above indicators
instructional problem
2-1 action
3-presence of 2 of the above indicators
research on any problem
2-presence of 1 of the above indicator
1-no action R
1-none

Maintains harmonious relationships with

superiors, students, local and public
officials and co-teachers.

Copies of Evaluation Sheet

June 2015 to
March 2016

Gets involved in school community and

civic-organization activities

Certificate of
Participation/Appreciation

June 2015 to
March 2016

5% 5-zero complaint/conflict 4-1 to 3

complaints/conflicts
3-4 to 6
complaints/conflicts
2-7 to 10
complaint/conflicts
1-11 and
more complaints/conflicts

5 5-100% of the required school,

community and civic organization
activities 5-100% of the mandatory
trainigs/school activities 4-90 to 99%
3-80 to 89%
2-70 to 79%
1-69%
and below

5-Excellent rating from superior, students, co-teachers and

local officals
4-Very
Satisfactory rating from superior, students, co-teachers,
and local officials
3-satisfactory rating
2-fair rating
1-poor
rating

Punctuality and
Attendance (15%)

Come to school and attended required

meetings, conferences, trainings, school
activities.

Logbook Attendance Sheet, Daily

Time Record

Daily

15% 5-not more than 3 times trdy or

undertime during the last 6 months
4-not more than 4
to 6 times tardy or undertime 3-not
more than 7 to 10 times tardy or
undertime 2-not more than 11 to 15
times tardy
1-16 or ore
times tardy

5-not more than 4 times absent except for absences

applied in accordance with regulations
4-not more
than 5 to 8 absences 3-not more than 9to 12 absences
2-not more than 13 to 16 absences
1-more than 17 times absent

Pus factor (not more

than 5%)
*To get the score, the rating is multiplied by the weight assigned.

Plus factor is included as one KRA. If teacher has additional assignment, reduce any one of the KRA by 5%

Rater

Ratee

TO BE FILLED DURING EVALUATION

ess)

Actual Results
Time
5- Prepared
a night before
4 -1 hour before class
3-30 minutes
before class
2-10 minutes
before
class
1-no plan/log

5- Prepared a night

Rating

Score

before.
4-1 hour before class
3-30 minutes before
class begins
2-10 minutes before
class begins
1-no plan/log

5- Submitted 2 days
before due date.
4- one day before due
date
3-On due date
2-1 day after due date
1-2 or more days after
the date.

5-agenda prepared a week before

scheduled meetings
4-3 days before
3-a
day before
2 on the
day
1 none of the
above

5-Submitted 2 days before due

date
4-1 days before
due date 3-on due date
2-1 days after due date 1-2 or
more days after due date

5- submitted two days before due

date 4-1 day before due date 3-on
due date 2-1 day after due date 12 or more days after due date

5-Submitted 2 days before due

date
4-1 days before
due date 3-on due date
2-1 days after due date 1-2 or
more days after due date

5-submitted 2 days before due

date
4-1 day before due
date 3-on due date
2-1 day after due date
1-2 or
more days after due date

5-Submitted 2 days before due

date
4-1 day before
due date
3-on due date
2-1 day after due
date
1-2 or more days after
due date

5-two days before schedule

4-one day before
3-as scheduled
2one day after schedule
1-two
days after schedule

5-two days before schedule

4-one day before
3-as scheduled
2-one
day after schedule
1-two days
after schedule

5-3 days after conduct of activity

4-5 days after
conduct of activity
3-a week after conduct of
activity
2-2
weeks after conduct of activity
1-3 weeks after
conduct of activity

5-a week before due date

4-3 days before due
date 3-on due date
2-2 to 3 dys after due date
1-4 days and above
after due date

5-a week before due date 4-3 days

before due date 3-on due date
2-2 to 3 days after due
date
1-4
days and above after due date

5-a week before due date

4-3 days
before due date 3-on due date
2-2 to 3 days after due
date
1-4
days and above after due date

5-a week before due date

4-3 days before
due date 3-on due date
2-2 to 3 days after due date
1-4 days and
above after due date

5-submitted DTR one day after

end of the month.
4-two
days after.
3-Three
days after.
2-Four
days after.
1-A
week after.

OVERAL
L
RATING
FOR
ACCOMP
LISHMEN
TS

KRA by 5%

Approval