Republic of the Philippines

Department of Education
Region II – Cagayan Valley
Schools Division of Cagayan

Form 8:
Monitoring and Evaluation Tool for Special Support Programs

DAP/ELLN PRIMALS Elem PRIMALS JHS Critical Content

Rondalla Cross Specialization MFAT SHS Pedagogy

Others Specify______________

School/District:________________________________________ School ID Number:____________

District Focal Person:___________________________________ Date of Visit:_________________
School Head:_________________________________________ School Coordinator:______________
Address:____________________________________________ Contact Number:________________

Description: This tool is designed to monitor the outcome and impact of special support programs
implemented by the division dully supported and funded by the Central Office for the purpose of
conducting School Learning Action Cells (LAC) sessions. The M and E focal person of the core team for
program/project implementation together with the external M and E team at the division level will respond
to this tool.

Directions: Please tick the appropriate blanks that correspond to your observation and available
documentary evidences.

1. Training Status

Title of Training Level (National, Number of No. of Trained Total No. of Untrained Total
Teachers
(DAP/ELLN, Region, Division, and SHs
Primals, Critical District, School) SH Teachers School Teachers School Teachers
etc) Heads Head

Address: Regional Government Center, Carig Sur, Tuguegarao City, 3500

Telephone Nos.: PLDT (078) 377-1065; Globe Landline (078) 255-5317, (078) 255-5318
Email Address: sdo.cagayan@deped.gov.ph Doc Code: FM-CLM-005 Rev: 00
Website: deped-sdocagayan.com.ph As of: July 02, 2018 Page: 1
 Republic of the Philippines
Department of Education
Region II – Cagayan Valley
Schools Division of Cagayan

2. School LAC Session Status

Activities Yes No MOVs Suggestions Comments
1. The school has LAC plan
developed a LAC Plan LAC schedules
identifying the topics, LAC facilitators
schedules, facilitators, LAC groupings
LAC groupings LAC minutes
LAC outputs
2.The school has List of LAC leaders
identified LAC leaders Pictorials
3.The school has Resource outsourcing
identified resources for MOOE/AIP
LAC implementation Stakeholders’
donations

4.The school has List of mentor-

identified list of mentor- mentees
mentees Accomplishment
report
5. Others
specify______________

3. Observable Data:
List of Learning Resources Yes No Findings Comments/Suggestions
1. The school has maintained literacy
and numeracy classrooms (for
ELLN/PRIMALS only)
2. School head/department
head/district /school coordinator is
aware of the support program/s as
indicative in the SIP/AIP, in-service
programs and training needs

Address: Regional Government Center, Carig Sur, Tuguegarao City, 3500

Telephone Nos.: PLDT (078) 377-1065; Globe Landline (078) 255-5317, (078) 255-5318
Email Address: sdo.cagayan@deped.gov.ph Doc Code: FM-CLM-005 Rev: 00
Website: deped-sdocagayan.com.ph As of: July 02, 2018 Page: 2
 Republic of the Philippines
Department of Education
Region II – Cagayan Valley
Schools Division of Cagayan

analysis.
3.Teachers exhibit ability in
demonstrating the skills learned in
the program as appeared in their
DLLs, classroom activities and LAC
sessions.

4.Students/learners display
understanding of the program/s
through gallery of outputs,
engagements and NAT/Quarterly
grades and Phil-IRI results.
5.LRs relative to the program/s are in
placed, contextualized, and available.
6. Others specify________________

4. Challenges met in the implementation of the program

Problems Encountered Solutions Made

5. Future Plans and Issues and Concerns need to raise

Concerns/Issues/Plans

Address: Regional Government Center, Carig Sur, Tuguegarao City, 3500

Telephone Nos.: PLDT (078) 377-1065; Globe Landline (078) 255-5317, (078) 255-5318
Email Address: sdo.cagayan@deped.gov.ph Doc Code: FM-CLM-005 Rev: 00
Website: deped-sdocagayan.com.ph As of: July 02, 2018 Page: 3
 Republic of the Philippines
Department of Education
Region II – Cagayan Valley
Schools Division of Cagayan

Monitored by:
________________________________________
________________________________________
________________________________________
________________________________________
Date of Visit:___________________
Date of Visit:___________________
Date of Visit:___________________
Date of Visit:__________________

Conforme:
________________________________________
________________________________________
________________________________________
Date:____________________________________

Address: Regional Government Center, Carig Sur, Tuguegarao City, 3500

Telephone Nos.: PLDT (078) 377-1065; Globe Landline (078) 255-5317, (078) 255-5318
Email Address: sdo.cagayan@deped.gov.ph Doc Code: FM-CLM-005 Rev: 00
Website: deped-sdocagayan.com.ph As of: July 02, 2018 Page: 4