UNIT
5%
5%
5%
Unit of Measure /
Indicator
QN-# of analysis
QL-% acceptability
T- # of days / analysis
QN-# of reports presented
QL-% completeness / accuracy
T-as scheduled
QN-# of validation tools collected
QL-% completeness / accuracy
T- # of days / tool
QN-# of LGU Scorecard report
QL-% acceptability
T- # of days / report
QN-# of analysis
QL-% acceptability
T- # of days / analysis
QN-# of feesback provided
QL-% completeness / accuracy
T- as scheduled
QN-# of APR Assisted
QL-% acceptability
T-# of days/ review
QN-# of reports prepared
QL-% acceptability
T-# of days/ report
QN-# of reports prepared
QUANTITY (QN)
Targets
: Planning Unit
QUALITY (QL)
TIME (T)
RATING
Targets
Accomp.
QN
SUPERVISOR
QL
T
APS
EPS
QN
EMPLOYEE
QL
T APS
90%
97%
3 days/
analysis
2 days/
analysis
10
8.33
0.42
10
8.33
90%
97%
as scheduled
as scheduled
10
9.50
0.48
10
9.50
All
All
90%
97%
1 week
2 days
10
9.50
0.95
10
9.50
1 reg'l. report
2
90%
98%
(including LGU report in SLA)
2 weeks
3 days
10
10
9.67
0.97
10
10
9.67
10
9.00
0.45
10
10
9.67
10.00 0.50
90%
97%
1 week
1 day
ANA
90%
98%
as scheduled
as scheduled
10
90%
98%
July 23-25
10
10
10
10.00 1.00
10
10
10
9.67
90%
98%
10
9.00
0.90
10
10
8.67
90%
97%
7.50
0.38
7.00
9.50
Weight
Alloc.
(%)
Unit of Measure /
Indicator
Work-KRA/Activity
Progress Report.
5%
QUANTITY (QN)
Targets
QUALITY (QL)
TIME (T)
QL-% acceptability
T-# of days/ report
Targets
Accomp.
& October
& October
90%
97%
All
All
90%
98%
As they come
75
90%
99%
As they come
31
90%
98%
RATING
QN
SUPERVISOR
QL
T
APS
EPS
QN
7.50
0.38
10
9.50
0.95
July-December
July-December
10
10.00 1.00
July-December
July-December
9.00
EMPLOYEE
QL
T APS
7.50
10
9.50
10
10.00
9.00
0.90
MICHELLE G. OLIMBA,RN.
Ratee
12-Dec-13
Date
Legend
QN
QL
T
APS
EPS
:
-
PERC Action:
Quantity
Quality
Time
Ave. Point Score
Equivalent Point Score
9.26
6.48
E EVALUATION FORM
July to December , 2013
RATING
EMPLOYEE
EPS
0.42
0.48
0.95
0.97
0.48
0.48
0.97
0.87
0.35
RATING
EMPLOYEE
EPS
0.38
0.95
1.00
0.90
9.20
6.44
1. COURTESY
2. HUMAN RELATIONS
3. INTEGRITY
4. STRESS TOLERANCE
5. INITIATIVE / RESOURCEFULLNESS
6. COMPLIANCE TO OFFICE RULES AND REGULATIONS
7. PUNCTUALITY AND ATTENDANCE
8. LEADERSHIP ( for supervisors only )
9. JUDGEMENT / DECISION MAKING ( for supervisors only )
Total Point Score
Divide by number of entries
Average Point Score (APS)
COMMENTS AND RECOMMENDATIONS BY THE IMMEDIATE SUPERVISOR
Strong Point
RATER
Supervisor Rater
Self - Rater
Subordinate
Peer Rater
Total Weighted Average Score (TWAS)
Total Weighted Average Score (TWAS) (Part I)
Total Overall Score (TWAS Part I + TWAS Part II)
Add : Intervening Task ( If any )
Final Numerical Rating
Adjectival Rating
10
10
10
10
10
10
8
10
10
10
10
10
10
8
68
7
9.71
68
7
9.71
S2
Weak Point
Weighted Ave.
Score (WAS)
(Part I)
6.48
6.44
-
Total (Sub)
P1
10
10
10
10
10
10
10
P2
10
10
10
10
10
10
10
P3
10
10
10
10
10
10
10
70
7
10.00
70
7
10.00
70
7
10.00
30.00
30.00
30.00
30.00
30.00
30.00
30.00
0.00
0.00
210.00
21
10.00
Recommendations
SUMMARY OF RATINGS
Percentage Weight Allocation
Total Weighted
With
Without
Ave.Score (TWAS)
Subordinate
Subordinate
(Part I)
65%
4.21
35%
2.25
-
Weighted Ave.
Score (WAS)
(Part II)
9.71
9.71
0.00
10.00
With
Without
Subordinate Subordinate
70%
15%
15%
6.47
6.47
9.39
Total (Peers)
Very Satisfactory
Supervisor
PERC Chairman
2.93
PROVINCE
: RIZAL
POSITION : RAIDERS
RAIDERS
PART I : PERFORMANCE (70%)
Weight
Unit of Measure /
Alloc.
Work-KRA/Activity
Indicator
(%)
A. Assists in the implementation of various health programs of the Local Gov't Unit in accordance with the
program goals and objectives of the DOH and the health sector
QN-# of ANC defaulters tracked
20%
A.1 Track ANC defaulters
QL-% effectivity
T- w/in 6 months
MUNICIPALITY
: CAINTA
20%
20%
20%
QUANTITY (QN)
QUALITY (QL)
TIME (T)
RATING
QN
SUPERVISOR
QL
T
APS
EPS
QN
QL
EMPLOYEE
T APS
Targets
Accomp.
Targets
Accomp.
Targets
Accomp.
100
203
95%
100%
10
10
8.67
1.73
10
10
8.67
1.73
60
85
95%
100%
10
8.00
1.60
10
8.00
1.60
120
200
200
158
285
399
95%
95%
90%
100%
100%
100%
6
6
6
6
6
6
10
10
10
10
10
10
6
6
6
8.67
8.67
8.67
10
10
10
10
10
10
6
6
6
8.67
8.67
8.67
8.67
1.73
1.60
685
1083
90%
100%
10
8.00
600
787
95%
100%
10
10
50
74
90%
100%
10
EPS
8.67
1.73
1.60
10
8.00
8.67
10
10
8.67
8.00
10
8.00
QL-% effectivity
T- w/in 6 months
A.5 Perform other related functions as may be assigned
A.5.1 Immunization services
20%
A.5.2 Track deworming defaulters
8.33
1.67
8.33
1.67
100%
Total Equivalent Point Score (EPS)
Multiply by Percentage Weight Allocation (70%)
Weighted Average Score (WAS)
DISCUSS AND AGREE ON THE ABOVE TARGETS :
CHARLYN R. FERNANDEZ, RN
Ratee
29-Dec-15
Date
Legend
QN
QL
T
APS
EPS
PERC Action:
-
Quantity
Quality
Time
Ave. Point Score
Equivalent Point Score
8.33
8.33
5.83
5.83
1. COURTESY
2. HUMAN RELATIONS
3. INTEGRITY
4. STRESS TOLERANCE
5. INITIATIVE / RESOURCEFULLNESS
6. COMPLIANCE TO OFFICE RULES AND REGULATIONS
7. PUNCTUALITY AND ATTENDANCE
8. LEADERSHIP ( for supervisors only )
9. JUDGEMENT / DECISION MAKING ( for supervisors only )
Total Point Score
Divide by number of entries
Average Point Score (APS)
COMMENTS AND RECOMMENDATIONS BY THE IMMEDIATE SUPERVISOR
Strong Point
10
10
10
8
8
10
8
S1
10
10
10
8
8
8
8
8
8
78
9
8.66
64
7
9.14
S2
Weak Point
Total (Sub)
P2
P3
Total (Peers)
10.00
10.00
10.00
10.00
8.00
10.00
8.00
66
7
9.43
66.00
7
9.43
Recommendations
SUMMARY OF RATINGS
RATER
Supervisor Rater
Self - Rater
Subordinate
Peer Rater
Total Weighted Average Score (TWAS)
Total Weighted Average Score (TWAS) (Part I)
Total Overall Score (TWAS Part I + TWAS Part II)
Add : Intervening Task ( If any )
Final Numerical Rating
Adjectival Rating
Weighted Ave.
Weighted Ave.
Score (WAS)
With
Without
Ave.Score (TWAS)
Score (WAS)
With
Without
Score (TWAS)
(Part I)
Subordinate
Subordinate
(Part I)
(Part II)
Subordinate
Subordinate
(Part II)
5.83
5.83
-
60%
30%
10%
65%
35%
-
3.79
2.04
-
8.66
9.14
0.00
9.43
70%
10%
10%
10%
70%
15%
15%
6.06
1.37
1.41
8.84
5.83
5.83
8.48
2.65
8.00
Very Satisfactory
CHARLYN R. FERNANDEZ, RN
Rater
Ratee
Total Weighted
29-Dec-15
Confirm by Next Higher
Date
Supervisor
PERC Chairman