Republic of the Philippines Document Code: SDO-SHS-

Region III 004

Schools Division of Bulacan Revision:00
Effectivity date: 11-16-2017
Name of Office: SGOD – SHS
WORK IMMERSION PERFORMANCE APPRAISAL
(Work Immersion Venue)

WORK IMMERSION PERFORMANCE APPRAISAL

Name: ________________________________________ Grade, Strand & Section: ___________________
Partner Institution:
Address: Contact No.
Work Immersion Supervisor: Position:
Training Period: to Total No. of Hours Rendered:

Directions. For each behavioral item listed within the competency bands, with 5 being the most and 1 is the least,
please select the evaluation most suited.

5 Outstanding Performance exceeds the required standard.

Performance fully met job requirements. Was able to
4 Very Satisfactory
perform what was expected of a person in his/her position.
Performance has met the required standard. Can perform
3 Satisfactory
duties with minimal supervision.
Performance partially meets the required standard. Less
2 Fair
than satisfactory could be doing better.
Performance does not meet the required standard. Major
1 Needs Improvement
Improvements needed.

NA Not Applicable Performance indicator is nor relevant to the job.

COMPETENCIES 5 4 3 2 1
TEAM WORK
1. Consistently works with others to accomplish goals and tasks.
2. Treats all team members in a respectful courteous manner.
3. Actively participates in activities and assigned tasks required.
4. Willing to work with team members to improve team
collaboration on a continuous basis.
5. Considers the feedback and views of team members when
completing an assigned task.
TEAM WORK Total Score/5

Tel No.: (044) 815-6739 . E-mail: shabulacan@gmail.com

 Republic of the Philippines Document Code: SDO-SHS-
Region III 004
Schools Division of Bulacan Revision:00
Effectivity date: 11-16-2017
Name of Office: SGOD – SHS
WORK IMMERSION PERFORMANCE APPRAISAL
(Work Immersion Venue)

COMPETENCIES 5 4 3 2 1
COMMUNICATION
1. Actively listens to supervisor and/or co-workers.
2. Comprehends written and oral information.
3. Consistently delivers accurate information both written and oral.
4. Reliably provides feedback as required, both internally and
externally.
COMMUNICATION Total Score/5

ATTENDANCE AND PUNCTUALITY 5 4 3 2 1

1. Is punctual on a regular basis.
2. Maintains good attendance.
3. Informs supervisor in a timely manner when absenteeism and
tardiness may occur.
ATTENDANCE AND PUNCTUALITY Total Score/3
3. Demonstrates food judgment in handling routine problems.
JUDGEMENT/DECISION MAKING Total Score/3 5 4 3 2 1
1. Consistently produces quality results.
PRODUCTIVITY/RESILIENCE
2. Meets deadlines and manages time well.
DEPENDABILITY/RELIABILITY 5 4 3 2 1
3. Canthe
1. Has do ability
multitasking.
to follow through and meet deadlines.
4.
2. Can work under pressure
Has commitment andaction.
for his/her delivers the required tasks.
5.
3. Effective
Can adjustand efficient
easily in timeinmanagement.
to changes workplace.
6. Efficiently
4. Displays highinforms
level ofsupervisor of atany
performance challenge or hindrance
all times.
relatedDEPENDABILITY/RELIABILITY
to given task or assignment. Total Score/4
PRODUCTIVITY/RESILIENCE Total Score/6
ATTITUDE 5 4 3 2 1
INITIATIVE/PROACTIVITY
1. Offers assistance willingly. 5 4 3 2 1
1. Completes assignments with minimum supervision.
2. Shows a positive work attitude.
2. Completes tasks independently and consistently.
3. Shows sensitivity to and consideration for other’s feelings.
3. Seeks support as need arises.
4. Accepts criticism positively.
4. Recognizes
5. Shows pride inand takes immediate action to effectively address
work.
problems and opportunities.
ATTITUDE Total Score/5
5. Engages in continuous learning
6. Contributes new ideas and shares skills to improve the
PROFESSIONALISM
department/organization.
1. Respects persons in authority.
INITIATIVE/PROACTIVITY Total Score/6
2. Uses all tools, equipment and facilities responsibly.
JUDGEMENT/DECISION MAKING 5 4 3 2 1
3. Follows all policies and procedures when issues and conflict
1. Analyzes
Arises. problems effectively.
4. Physical
2. appearance
Has the ability to makeconforms
creative with the workplace
and effective solutions and
to
placement
problems. rules.

PROFESSIONALISM Total Score/4

Weighte
d
Average
. E-mail: shabulacan@gmail.com
OVER
Tel ALL815-6739
No.: (044) RATING
 Republic of the Philippines Document Code: SDO-SHS-
Region III 004
Schools Division of Bulacan Revision:00
Effectivity date: 11-16-2017
Name of Office: SGOD – SHS
WORK IMMERSION PERFORMANCE APPRAISAL
(Work Immersion Venue)

3. Demonstrates food judgment in handling routine problems.

JUDGEMENT/DECISION MAKING Total Score/3

DEPENDABILITY/RELIABILITY 5 4 3 2
1. Has the ability to follow through and meet deadlines.
2. Has commitment for his/her action. 1
3. Can adjust easily to changes in workplace.
4. Displays high level of performance at all times.
DEPENDABILITY/RELIABILITY Total Score/4

ATTITUDE 5 4 3 2
1. Offers assistance willingly.
1
2. Shows a positive work attitude.
3. Shows sensitivity to and consideration for other’s feelings.
4. Accepts criticism positively.
5. Shows pride in work.
ATTITUDE Total Score/5

PROFESSIONALISM
1. Respects persons in authority.
2. Uses all tools, equipment and facilities responsibly.
3. Follows all policies and procedures when issues and conflict
Arises.
4. Physical appearance conforms with the workplace and
placement rules.

PROFESSIONALISM Total Score/4

Weighted Equivalent
Average Grade

OVER ALL RATING

________ ________

Tel No.: (044) 815-6739 . E-mail: shabulacan@gmail.com

 Republic of the Philippines Document Code: SDO-SHS-
Region III 004
Schools Division of Bulacan Revision:00
Effectivity date: 11-16-2017
Name of Office: SGOD – SHS
WORK IMMERSION PERFORMANCE APPRAISAL
(Work Immersion Venue)

SUMMARY OF SCORES

WEIGHTED
CRITERIA
AVERAGE
TEAM WORK
COMMUNICATION
ATTENDANCE & PUNCTULAITY
PRODUCTIVITY/RESILIENCE
INITIATIVE/PROACTIVITY
JUDGEMENT/DECISION MAKING
DEPENDABILITY/RELIABILITY
ATTITUDE
PROFESSIONALISM
Over-All Weighted Average
Equivalent Grade

REMARKS: (Comments/ Suggestions)

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

Student’s Signature: ____________________________________ Date: _____________________________

Work Immersion Supervisor’s Signature: ______________________________________________________

Transmutation Table
Computed Weighted Average Equivalent Grade
4.20 – 5.00 100
3.40 – 4.19 95
2.60 – 3.39 90
1.80 – 2.59 85
1.00 – 1.79 80

Tel No.: (044) 815-6739 . E-mail: shabulacan@gmail.com