Republic of the Philippines

DEPARTMENT OF EDUCATION
Region 02, Cagayan Valley
SCHOOLS DIVISION OFFICE OF NUEVA VIZCAYA

QUALITY ASSURANCE MONITORING & EVALUATION FORM

(CLASSROOM READINESS FOR START OF CLASSES)
School Year 2019-2020

School: ________________________ Teacher ______________________________ Grade: ____________

Evident Partly Not Remarks
Indicators Evident Evident

I. CLASSROOM FACILITIES & ATMOSPHERE

1. Classroom premises/class zones –clean, friendly & welcoming
2. Classroom is clean, properly structured/decongested, no hazardous
corners/areas (No other structure except for the pupils’ armchairs, teacher’s
table & chair, small cabinet/box/table for teacher’s references, DLLs, SFs,
Assessment Results & other reports , demonstration table, open shelves for
instructional materials & divan)
3. Pupils’ chairs -clean, painted with light colors & arranged to accommodate
needs of diverse learners
4. Presence of clean toilets and urinals
5. Availability of water supply (potable)
6. Properly installed lighting & ventilation system
7. Windows are free from any obstruction
8. Bulletin Board/updated (lessons for the day/week instead of the unit are
posted , pupils outputs displayed)
9. Walls painted/clean
II CURRICULUM & LEARNING
1. Complete CG, TG, LM (Fill in CG etc.data)
2. Classroom program signed, updated and displayed at the door
3. LP/DLL , up to date, checked & signed by the school head
4. All learners are in the classroom
5. There is actual teaching-learning scenario where learners are engaged
6. Presence of varied & appropriate instructional materials displayed &
accessible to the learners
7. Complete Form 137/SF10 with attached ECCD Checklist & NSO
8. Accomplished basic education enrolment forms
9. Beginning of SY School Forms Updated
a. SF 1
b. SF 2
c. SF 3
10. PHIL-IRI Pretest Result
11. EGMA Pretest Result
12. EGRA Pretest Result
13. MYS Pretest
14. MFAT/ECD Result
15. Summative Assessment File/Notebook/Journal/Folios
16. STAR/COT Notes and other feedback forms issued by the school
heads
 17. Coaching & annotation notebooks/journals

III. ADMINISTRATIVE AND TEACHING STAFF

1. Teacher is in complete and proper uniform
2. Form 48 & Teachers’ Logbook, Updated
IV. Practices NO COLLECTION POLICY
V. Practices CHILD PROTECTION POLICY
VI. Practices SOLID WASTE MANAGEMENT PROGRAM
Other Comments/Findings:

Evaluation made by: ______________________________ Date: __________________

Conforme: ______________________________________ Date: __________________

School: _______________________________________ Grade: ________________
Teacher: ______________________________________ Enrolment: _____________

DATA ON CGS, TGs andLMs (As of June 2018)

Learning Curriculum Teachers Learners Materials Remarks

Area Guide Guide Delivered Actual Need
(Existing)
MTB
English
Filipino
Math
Science
AP
ESP
Music
Arts
PE
EPP

DATA ON ARMCHAIR/DESK & TEACHERS’ TABLE & CHAIR

(As of June 2018)

FURNITURE Number Number Need Remarks

( DepED (From (Indicate Quantity, Quality &
Issued) other Source if Not Deped Issue)
source)
Armchair
Desk
Set of Table &
Chair
Teachers’ Table
Teachers’ Chair

Other concerns/problems (describe briefly)

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

Note: Please accomplish this form and submit to the M&E team during their visit. To be attached to the M&E form.