Republic of the Philippines

Department of Education
Region V
Division of Albay
SAN FERNANDO NATIONAL HIGH SCHOOL

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM

Name of Employee: EDMAR D. JANE Name of Rater: ROSIE G. BOLOFER
Position: TEACHER I Position: PRINCIPAL I
Review Period: Date of Review:
School/District: SAN FERNANDO NATIONAL HIGH SCHOOL / ALBAY
TO BE FILLED IN DURING PLANNING TO BE FILLED IN DURING EVALUATION
MFOs KRAs OBJECTIVES TIMELIN WEIGHT PERFORMANCE INDICATORS ACTUAL RESULTS RATING SCORE
E per KRA (Quality, Efficiency, Timeliness)
Q E T

Basic Community 1 (5%) To establish partnership with June 10% 5- 5 of the action steps/activities were
Edu- Partnerships the community 2016 to done and met with valid MOVs
cation Rendered services in the March 4- 4 of the action steps/activities were
Services
community as requested 2017 done and met with valid MOVs
(Delivery)
Conducted community 3- 3 of the action steps/activities were
outreach project done and met with valid MOVs
Solicited help from 2- 2 of the action steps/activities were
stakeholders to improve done and met with valid MOVs
school 1- 1 of the action steps/activities were
Invited experts from the done and met with valid MOVs
locality to assist in the
school activity
Mobilized PTA to improve
learning outcomes
2 (5%) To participate in various 5- Participated in at least 5 activities in
community activities the locality
4- Participated in at least 4 activities in
the locality
3- Participated in at least 3 activities in
the locality
2- Participated in at least 2 activities in
the locality
1- Participated in at least 1 activities in
the locality
OVERALL RATING FOR
ACCOMPLISHMENTS
Ratee: Rater: Approving Authority:

EDMAR D. JANE ___________________________ ROSIE G. BOLOFER

Teacher I Principal I
 Republic of the Philippines
Department of Education
Region V
Division of Albay
SAN FERNANDO NATIONAL HIGH SCHOOL

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM

Name of Employee: Name of Rater:
Position: Position:
Review Period: Date of Review:
School/District:
TO BE FILLED IN DURING PLANNING TO BE FILLED IN DURING EVALUATION
MFOs KRAs OBJECTIVES TIMELINE WEIGHT PERFORMANCE INDICATORS ACTUAL RESULTS RATING SCORE
per KRA (Quality, Efficiency, Timeliness)
Q E T

Basic Personal and 1 (10%) To uphold the nobility of
Edu- Professional the teaching profession through
cation Growth continuous personal and
Services professional growth
(Delivery) Prepare Individual Plan
for Professional
Development (IPPD)
Enrol in professional
school
Consult and coordinate
with fellow teachers
Join professional
organization/s
Subscribe to
professional
magazines/journals
2 (5%) To attend DepEd required
training programs and other
seminars offered by professional
organizations with the following
MOVs
1. Authority to Travel
2. Memorandum
3. Certificate of
Participation
4. Narrative Report
5. Proof of application
of KSA gained from
June 2016 15% 5- 5 of the action steps/activities have
to March been done and with complete MOVs
2017 4- 4 of the action steps/activities have
been done and with complete MOVs
3- 3 of the action steps/activities have
been done and with complete MOVs
2- 2 of the action steps/activities have
been done and with complete MOVs
1- 1 of the action steps/activities have
been done and with complete MOVs
5- Has attended all DepEd required
training programs and other seminars
offered by professional organizations
with 5 MOVs
4- Has attended all DepEd required
training programs and other seminars
offered by professional organizations
with 4 MOVs
3- Has attended all DepEd required
training programs and other seminars
offered by professional organizations
with 3 MOVs
 the 2- Has attended all DepEd required
training/seminar training programs and other seminars
offered by professional organizations
with 2 MOVs
1- Has attended all DepEd required
training programs and other seminars
offered by professional organizations
with 1 MOVs

OVERALL RATING FOR

ACCOMPLISHMENTS

Ratee: Rater: Approving Authority:

EDMAR D. JANE ____________________________ ROSIE G. BOLOFER

Teacher I Principal I
 Republic of the Philippines
Department of Education
Region V
Division of Albay
SAN FERNANDO NATIONAL HIGH SCHOOL

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM

Name of Employee: Name of Rater:
Position: Position:
Review Period: Date of Review:
School/District:
TO BE FILLED IN DURING PLANNING TO BE FILLED IN DURING EVALUATION
MFOs KRAs OBJECTIVES TIMELINE WEIGHT PERFORMANCE INDICATORS ACTUAL RESULTS RATING SCORE
per KRA (Quality, Efficiency, Timeliness)
Q E T

Basic Curriculum 1 (20%) To provide interesting June 2016 30% 5- 5 of the action steps/activities
Edu- Delivery learning activities and utilized to March were done and met with valid
cation appropriate instructional 2017 MOVs, resulting to 100%
Services materials aligned to the promotion rate
(Delivery objectives of the lesson
4- 4 of the action steps/activities
) Utilized technology in
teaching the subject at
were done and met with valid
Improve least once a week MOVs, resulting to 95%-99%
d Prepared at least 4 SIM promotion rate
PL/MPS to facilitate learning 3- 3 of the action steps/activities
in Utilized appropriate were done and met with valid
written/ teaching strategies to MOVs, resulting to 90%-94%
Performa make the lesson promotion rate
nce interesting 2- 2 of the action steps/activities
based Demonstrated teaching were done and met with valid
evaluatio strategies to other
MOVs, resulting to 85%-89%
n teachers
Employed differentiated
promotion rate
learning 1- 1 of the action steps/activities
activities/pedagogical were done and met with valid
approaches to close MOVs, resulting to 84% or less
teaching-learning gaps promotion rate

2 (10%) To utilize instructional 5- Has spent 180-day non-negotiable

time to the fullest observing the contact time with students without
180-day non-negotiable contact tardiness in reporting to school and to
time with students class

3 (10%) To prepare daily lesson
logs/plans based on TG and CG
following the format stipulated in
DepEd Order No. 42, s.2016
Ratee:
EDMAR D. JANE ____________________________
Teacher I
4- Has spent 180-day non-negotiable
contact time with students with 1-2
instances of tardiness
3- Has spent 180-day non-negotiable
contact time with students with 3-4
instances of tardiness
2- Has spent 180-day non-negotiable
contact time with students with 5-6
instances of tardiness
1- Has spent 180-day non-negotiable
contact time with students with 7 or
more instances of tardiness
5- 100% complete lesson logs/plans
prepared and submitted on time
4- 100% complete lesson logs/plans
prepared with 1-2 instances of late
submission
3- 100% complete lesson logs/plans
prepared with 3-4 instances of late
submission
2- 90% complete lesson logs/plans
prepared with 5-6 instances of late
submission
1- 80% or less lesson logs/plans
prepared with 7 or more instances of
late submission
OVERALL RATING FOR
ACCOMPLISHMENTS
Rater: Approving Authority:
ROSIE G. BOLOFER
Principal I

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM
Name of Employee:
Position:
Review Period:
School/District:
TO BE FILLED IN DURING PLANNING
MFOs KRAs OBJECTIVES
Basic Planning, 1 (10%) To develop and use a
Edu- Assessing, and variety of appropriate
cation Reporting assessment strategies to monitor
Services Learning and evaluate learning
(Delivery Outcomes Prepared standard
) periodic test with table
of specifications
Prepared formative tests
for every competency
and summative test for
each lesson
Provided opportunities
for demonstration of
performance standards
among students
Submitted grades of
students accurately and
promptly
Utilized technology in
computing the grades of
the students
2 (5%) To provide feedback on
learners performance to parents,
superiors, and learners
themselves
Call for parents meeting
every grading period on
Republic of the Philippines
Department of Education
Region V
Division of Albay
SAN FERNANDO NATIONAL HIGH SCHOOL
Name of Rater:
Position:
Date of Review:
TO BE FILLED IN DURING EVALUATION
TIMELINE WEIGHT PERFORMANCE INDICATORS ACTUAL RESULTS RATING SCORE
per KRA (Quality, Efficiency, Timeliness)
Q E T
5- 5 of the action steps/activities were
June 2016 25% done and met with valid MOVs, resulting
to March to 100% promotion rate
4- 4 of the action steps/activities were
2017
done and met with valid MOVs, resulting
to 100% promotion rate
3- 3-4 of the action steps/activities were
done and met with valid MOVs, resulting
to 95%-99% promotion rate
2- 2-3 of the action steps/activities were
done and met with valid MOVs, resulting
to 90%-94% promotion rate
1- 1-2 of the action steps/activities were
done and met with valid MOVs, resulting
to 89% or less promotion rate
5- 4 of the action steps have been done
with complete MOVs, resulting to 0%
dropout and 100% promotion of students
4- 3 of the action steps have been done
with complete MOVs, resulting to 0%
dropout and 100% promotion of students
 a Saturday or as the
need arises
Discuss to superior
possible intervention for
those at-risk of dropping
out or failing in the
subject
Conduct home visitation
to prevent student from
dropping out/ failing
Give feedback to
students about their
performance regularly
3 (10%) To conduct appropriate
measures for those at-risk of
dropping out or failing in the
subject or excelling in the
learning area
Ratee:
EDMAR D. JANE ____________________________
Teacher I
3- 2 of the action steps have been done
with complete MOVs, resulting to 0%
dropout and 100% promotion of students
2- 1 of the action steps have been done
with complete MOVs, resulting to 0%
dropout and 100% promotion of students
1- 4 of the action steps have been done
with complete MOVs, resulting to 0%
dropout and 100% promotion of students
After each
rating
period
5- All students passed the subject, no one
has dropped out, and winners emerged in
various contests outside the school
4- All students passed the subject, no one
has dropped out, and students
participated in various contests outside
the school
3- All students passed the subject, no one
has dropped out, but no students
participated in various contests
2- 1 or 2 students have failed in the
subject, have dropped out, and no one
participated in various contests
1- 3 or more students have failed in the
subject, have dropped out and no one
participated in various contests
OVERALL RATING FOR
ACCOMPLISHMENTS
Rater: Approving Authority:
ROSIE G. BOLOFER
Principal I
 Republic of the Philippines
Department of Education
Region V
Division of Albay
SAN FERNANDO NATIONAL HIGH SCHOOL

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM

Name of Employee: Name of Rater:
Position: Position:
Review Period: Date of Review:
School/District:
TO BE FILLED IN DURING PLANNING TO BE FILLED IN DURING EVALUATION
MFOs KRAs OBJECTIVES TIMELINE WEIGHT PERFORMANCE INDICATORS ACTUAL RESULTS RATING SCORE
per KRA (Quality, Efficiency, Timeliness)
Q E T

Basic Leaning 1 (10%) To make sure that the June 20% 5-Classroom is always clean, orderly,
Edu- Environment classroom is safe and 2016 to hazard-free, well-lighted, well- structured,
and properly ventilated, thereby having
cation conducive to learning. March been recognized as model classroom
Services 2017 4- Classroom is most of the time clean,
orderly, hazard-free, well-lighted, well-
structured and properly ventilated
3- Classroom is clean, orderly, hazard-free,
well-lighted, well-structured and properly
ventilated but has been noted to have
failed expectations 3-5 times
2- Classroom is clean, orderly, hazard-free,
well-lighted, well-structured and properly
ventilated but has been noted to have
failed expectations 6-10 times
1- Classroom is clean, orderly, hazard-free,
well-lighted, well-structured and properly
ventilated but has been noted to have
failed expectations10 or more times
2 (5%) To create an 5- No student has filed any complaint
environment that promotes against anyone in the school and talks
about the school with pride
fairness, peace and harmony
4- 1 student has filed a complaint against
anyone in the school
3- 2 student has filed a complaint against
anyone in the school
2-3 student has filed a complaint against
anyone in the school

3 (10%) To establish and
maintain consistent standards
of learners behavior
Students show respect to
everyone
Students observe proper
waste disposal
Students attend the flag
ceremony regularly
Students behave properly
inside and outside the
class
Students follow school rules and
regulations
Ratee:
EDMAR D. JANE ____________________________
Teacher I
1-4 or more student has filed a complaint
against anyone in the school
5- 5 of the behavioral indicators have been
manifested by the students all the time
4- 4 of the behavioral indicators have
been manifested by the students most of
the time
3- 3 of the behavioral indicators have
been manifested by the students most of
the time
2- 2 of the behavioral indicators have been
manifested by the students most of the
time
1- 1-2 of the behavioral indicators have
been manifested by the students
sometimes
OVERALL RATING FOR
ACCOMPLISHMENTS
Rater: Approving Authority:
ROSIE G. BOLOFER
Principal I