filled out ipcrf form sample

1. Republic of the Philippines
Department of Education
Region 02
Schools Division of Quirino
BANNAWAG INTEGRATED SCHOOL
Bannawag Sur, Diffun Quirino
INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM (IPCRF) FOR TEACHERS
Name of Employee: NAPOLEON N. COSTALES Name of Rater: ERLITO B. MADRIAGA, Ph. D.
Position: Teacher I Position: Principal I
School: Bannawag Integrated School Date of Review: October 26, 2015 / April 6, 2016
Rating Period: June 2015 to April 2016
TO BE FILLED IN DURING PLANNING TO BE FILLED DURING EVALUATION
MFOs
Key Result
Areas (KRAs)
OBJECTIVES
TIME-
LINE
Weight
per
KRA
PERFORMANCE INDICATORS (Quality,
Efficiency, Timeliness)
ACTUAL
RESULTS
RATING SCORE*
Q E T Ave.
Basic
Education
Services
Teaching-
Learning
Process
30%
1. Prepare 180
lesson plans or
daily lesson logs
June
2015 to
March
2016
10%  5 - 100% (180 or more) updated lesson plans/logs
prepared in SMART way
 4 - 85% to 99% (153 to 179) updated lesson plans/logs
prepared in SMART way
 3 - 70% to 84% (126 to 152) updated lesson plans/logs
prepared in SMART way
 2 - 55% to 69% (99 to 125) updated lesson plans/logs
prepared in SMART way
 1 - 54% and below (98 and below) updated lesson
plans/logs prepared in SMART way
 Prepared 253
DLL with
complete parts
and Objectives
2. Facilitate
learning through
the use of at
least 10
instructional
materials per
subject area
preparation
June
2015 to
March
2016
10%  5 - 100% of the targeted instructional materials
developed and used were appropriate and updated
 4 - 85% to 99% of the targeted instructional materials
developed and used were appropriate and updated
 3 - 70% to 84% of the targeted instructional materials
developed and used were appropriate and updated
 2 - 55%-69% of the targeted instructional materials
developed and used were appropriate and updated
 1 - 54% and below of the targeted instructional
materials developed and used were appropriate
 Prepared and
used 10
appropriate and
updated SIM on
my every subject

2. 3. Initiate
discipline of
students
June
2015 to
March
2016
5%  5- 100% of the indicators in classroom walkthrough
are observed
 4- 85% to 99% of the indicators in classroom
walkthrough are observed
 3 - 70% to 84% of the indicators in classroom
walkthrough are observed
 2- 55% to 69% of the indicators in classroom
walkthrough are observed
 1- 54% and below of the indicators in classroom
walkthrough are observed
 75% of the
indicators in
classroom
walkthrough
were
demonstrated
4. Monitor
attendance
June
2015 to
March
2016
5%  5–100% of the reports on monthly learner movement
and attendance weresubmitted on the last day of the
month
 4- 85%-99%of the reports on monthly learner
movement and attendance weresubmitted on the last
day of the month
 3- 70%-84%of the reports on monthly learner
movement and attendance weresubmitted on the last
day of the month
 2- 55%-69%of the reports on monthly learner
movement and attendance weresubmitted on the last
day of the month
 1- 54% and belowof the reports on monthly learner
movement and attendance weresubmitted on the last
day of the month
 Monitored daily
students’
attendance and
submitted 100%
of the reports on
monthly learner
movement and
attendance (with
SF2)
Sub-Total
Score
Pupils/Stude
nts Learning
Outcomes
30%
1. Monitor,
evaluate and
maintain
pupils/students’
progress
June
2015 to
March
2016
8% Indicators:
1. Test Bank / Quarterly Assessment with TOS
 5-100% prepared and submitted two weeks before the
scheduled conduct of Quarterly Assessment
 4-85%-99% prepared and submitted one week before
the scheduled conduct of Quarterly Assessment
 3- 70%-84% prepared and submitted 3 days before the
scheduled conduct of Quarterly Assessment
 2-55%-69% prepared andsubmitted 2 days before the
scheduled conduct of Quarterly Assessment
 1-54% and below prepared and submitted a day before
the scheduled conduct of Quarterly Assessment
 All test
questions and
TOS were
prepared and
submitted one
week before the
scheduled exam.

3. 2. Conduct
remediation/en
richment
programs to
improve
performance
indicators
June
2015 to
March
2016
7%  5-100% pupils/students were given
remediation/enrichment successfully
 4-85%-99%pupils/students were given
remediation/enrichment successfully
 3-70%-84%pupils/students were given
remediation/enrichment successfully
 2-55%-69%pupils/students were given
remediation/enrichment successfully
 1-54% and belowpupils/students were given
remediation/enrichment successfully
 Remediation /
Enrichment
Program was
offered to 54%
who need it
3. Maintain
updated
pupils/students
’ school
records
*Class Record
*Rating Sheet
June
2015 to
March
2016
5%  5-100% of the pupils/students records were prepared
and submitted before the scheduled time without error
 4-85%-99%of the pupils/students records were
prepared and submitted on or before the scheduled
time without error
 3-70%-84%of the pupils/students records were
prepared and submitted on or before the scheduled
time with minimal error
 2-55%-69%of the pupils/students records were
prepared and submitted one week after the due time
 1-54% and belowof the pupils/students records were
prepared and submitted two weeks before the due time
 100% of the
students have an
updated school
records
4. Attain at least
85% Grade
Point Average
(GPA) for
Grade level
and learning
areas
June
2015 to
March
2016
5%  5-100% of the pupils/students attained 85% and above
GPA
 4- 85-99% of the pupils/students attained 85% and
above GPA
 3- 70%-84% of the pupils/students attained 85% and
above GPA
 2- 55%-69%of the pupils/students attained 85% and
above GPA
 1 - 54% and belowof the pupils/students attained 85%
and above GPA
 All students had
a grade of 85
and above.
5. Attain 75%
MPS per
subject area in
the National
Achievement
Test
June
2015 to
March
2016
5%  5-Attained 75% and above NAT MPS per subject area
 4-Attained 64%-74% NAT MPS per subject area.
 3-Attained 53%-62% NAT MPS per subject area.
 2-Attained 41%-52% NAT MPS per subject area.
 1-Attained 40% and below NAT MPS per subject area.
 Attained 53%
average NAT
MPS in the
subject area
Sub-Total
Score

4. Community
Involvement
20%
1. Conduct 5 PTA
meetings/confe
rences
Every
Quarter
8%  5-100%of the target objectives were achieved;
accomplishments of set agreements were fully
documented.
 4-85%-99% of the target objectives were achieved;
accomplishments of set agreements were fully
documented.
 3-70%-84% of the target objectives were achieved;
accomplishments of set agreements were fully
documented.
 2-55%-69% of the target objectives were achieved;
accomplishments of set agreements were fully
documented.
 1-54%-below of the target objectives were achieved;
accomplishments of set agreements were fully
documented.
 Conducted 85%
Parent-Teacher
Conferences
with minutes of
meeting and
attendance.
2. Conduct at least
5 home visits to
pupils/students
needing
academic
monitoring/follo
w up
Every
Quarter
7%  5-100%of the parents of the students needing academic
monitoring was followed up supported with
documents.
 4-85%-99% of the parents of the students needing
academic monitoring was followed up supported with
documents.
 3-70%-84% of the parents of the students needing
academic monitoring was followed up supported with
documents.
 2-55%-69 of the parents of the students needing
academic monitoring was followed up supported with
documents.
 1-54%-below of the parents of the students needing
academic monitoring was followed up supported with
documents.
 Conducted
home visitation
3.Undertake/initiat
e
project/event/act
ivity with
external
funding/sponsor
ship
June
2015
5%  5-100%of the project is achieved with full
documentation.
 4-85%-99% of the project is achieved with
documentation.
 3-70%-84% of the project is achieved with
documentation.
 2-55%-69 of the project is achieved with
documentation.
 1-54%-below of the project is achieved with
documentation.
 Conducted
Cultural
presentation that
is funded by the
parents and
achieved with
documents
Sub-Total
Score

5. Professional
Growth and
Development
15%
1. Prepare Action
Plan
June
2015
5%  5-100%of the objectives/activities in the Action Plan
were achieved with full documentation duly signed by
the proper authority
 4-85%-99% of the objectives/activities in the Action
Plan were partially achieved with documentation.
 3-70%-84% of of the objectives/activities were
partially achieved with documentation.
 2-55%-69 of of the objectives/activities were partially
achieved with documentation.
 1-54%-below of the objectives/activities were partially
achieved with documentation.
 100% of the
objectives set
in the Action
Plan were
achieved
2. Attend relevant
trainings/
workshops/conf
erences /
seminars or earn
9 units of post
graduate
education
June
2015 to
March
2016
5%  5-Attended an aggregate of 48 hours of relevant
trainings at least in the Division level and earned at
least 9 units in post graduate studies
 4-Attended an aggregate of 48 hours of relevant
trainings at least in the Division level.
 3-Attended an aggregate of 24 hours of relevant
trainings at least in the Division level and earned at
least 9 units in post graduate studies
 2-Attended an aggregate of 24 hours of relevant
trainings at least in the Division level.
 1-Attended an aggregate of 24 hours training at least in
the District level
(Attach certificate of participation and grades)
 Attended 24
hours of relevant
training at the
Division Office
on Web page
 Attended
Training Service
Program on
Literacy and
Livelihood
3. Received
special awards/
citation/recognit
ion for
exemplary
performance
June
2015 to
March
2016
5%  5-Received certificate of recognition as winning coach
in the National level.
 4-Received certificate of recognition as winning coach
in the Regional level
 3-Received certificate of recognition as winning coach
in the Division level
 2- Received certificate of recognition as winning coach
in the District level
 1-Received certificate of recognition as winning coach
in the School level
 Awarded as
winning coach
of Zumba dance
(School Level)
Sub-Total
Score
Plus Factor
5%
Attain five of the
following:
June
2015 to
5%  5-Attained 5 indicators with documents
 4- Attained 4 indicators with documents
 3- Attained 3 indicators with documents
 Served as a
committee on
decoration

6. 1. Serve as
coordinator in
any working
committee in the
school
2. Publish an article
in national
circulation
3. Serve as
demonstration
teacher/resource
speaker/cooperati
ng teacher
4. Receive an
outstanding
employee award
at least in the
district/municipal
level
5. Conduct action
research or
innovation
6. Participate in any
activities as
member of a
professional
organization
March
2016
 2- Attained 2 indicators with documents
 1-Attained 1 indicator with documents
during the
Commencement
Exercises of
Bannawag
Integrated
School
 Awarded as
Outstanding
MAPEH
TEACHER of
BANNAWAG
INTEGRATED
SCHOOL
 Attained the
zero-drop-out
for the S.Y
2015-2016
 Member of
QPSTERA
 NDEP and
REDCROSS
coordinator
Sub-Total
Score
*To get the score, the rating is multiplied by the weight assigned. OVERALL
RATINGFOR
ACCOMPLISH-
MENTS
Rater: Ratee: Approving Authority: Noted: Noted:
ERLITO B. MADRIAGA, Ph. D. NAPOLEON N. COSTALES SONIA C. PAGBILAO, Ph.D. EDUARDO C. ESCORPISO, JR., Ed. D CESE ORLANDO E. MANUEL, Ph.D., CESO VI
Principal I Teacher I District Supervisor OIC, Assistant Schools Division Superintendent Schools Division Superintendent

7. NUMERICAL
RATING
ADJECTIVAL RATING DESCRIPTION OF MEANING OF RATING
5 Outstanding Performance represents an extraordinary level of achievement and commitment in terms of quality and time, technical skills
and knowledge, ingenuity, creativity and initiative. Employees at this performance level should have demonstrated
exceptional job mastery in all major areas of responsibility. Employee achievement and contributions to the organization are
of marked excellence.
4 Very Satisfactory Performance exceeded expectations. All goals, objectives and targets were achieved above the established standards.
3 Satisfactory Performance met expectations in terms of quality of work, efficiency and timeliness. The most critical annual goals were
met.
2 Unsatisfactory Performance failed to meet expectations, and/or one or more of the most critical goals were not met.
1 Poor Performance was consistently below expectations, and/or reasonable progress toward critical goals was not made. Significant
improvement is needed in one or more important areas.
This rating scale is based on the Civil Service Commission Circular No. 06, series of 2012 that sets the guidelines on the establishment and implementation of the Strategic
Performance Management System (SPMS) in all government agencies.
The overall rating/assessment for the accomplishments shall fall
within the following adjectival ratings and shall be in three (3)
decimal points.
RANGE ADJECTIVAL RATING
4.500 – 5.000 Outstanding
3.500 – 4.499 Very Satisfactory
2.500 – 3.499 Satisfactory
1.500 – 2.499 Unsatisfactory
below 1.499 Poor
Competencies shall be monitored for developmental purposes. In
evaluating the individual’s demonstration of competencies, this rating
scale shall apply.
SCALE DEFINITION
5 Role model
4 Consistently demonstrates
3 Most of the time demonstrates
2 Sometimes demonstrates
1 Rarely demonstrates
Grievances and Appeals
3. A GrievanceCommittee shall becreated in each level of the organization to actas
appeals board and final arbiter of all issues relating to the implementation of the
RPMS.
4. The office performance assessment as discussed in the performance review and
evaluation phaseshall befinal and notappealable.Any issue/appeal on the initial
performance assessment of an office shall be discussed and decided during the
performance review conference.
5. Individual employees who feel aggrieved or dissatisfied with their final
performance ratings can filean appeal with theGrievanceCommittee at their level
within ten (10) working days from date of receipt of notice of their final
performance
evaluation rating from the rater. The rate, however, shall not be allowed to protest
the performance ratings of co-employees. Ratings obtained by the rate can only be
used as basis for reference for comparison in appealing the individual performance
rating.
1. The Grievance Committee shall decide on the appeals within one (1) month from
receipt. Appeals lodged at any Grievance Committee shall follow the hierarchical
jurisdiction of various Grievance Committees within the agency. For example, the
decision of theDivision GrievanceCommittee is appealableto theRegional Grievance
Committee, which decision is in turn appealable to the Central Office Grievance
Committee.
2. The decision of the Central Office Grievance Committee is final.

8. CORE BEHAVIORAL COMPETENCIES
Self-Management Result Focus Service Orientation
√ 1. Sets personal goals and direction, needs and development. 1. Achieves results with optimal use of time and resources most of
the time.
√ 1. Can explain and articulate organizational directions, issues
and problems.
√ 2. Undertakes personal actions and behaviors that are clear and
purposive and takes into account personal goals and values
congruent to that of the organization.
2. Avoids rework, mistakes and wastage through effective work
methods by placing organizational needs before personal
needs.
√ 2. Takes personal responsibility for dealing with and/or
correcting customer service issues and concerns.
3. Displays emotional maturity and enthusiasm for and is
challenged by higher goals.
3. Delivers error-free outputs most of the time by conforming to
standard operating procedures correctly and consistently. Able
to produce very satisfactory quality of work in terms of
usefulness/acceptability and completeness with no supervision
required.
3. Initiates activities that promotes advocacy for men and
women empowerment.
4. Prioritizes work tasks and schedules (through Gantt charts,
checklists, etc.) to achieve goals.
√ 4. Expresses a desire to do better and may express frustration at
waste or inefficiency. May focus on new or more precise ways
of meeting goals set.
4. Participates in updating of office vision, mission, mandates
and strategies based on DepEd strategies and directions.
5. Sets high quality, challenging, realistic goals for self and others. 5. Makes specific changes in the system or in own work methods
to improve performance. Examples may include doing
something better, faster, at a lower cost, more efficiently, or
improving quality, customer satisfaction, morale, without setting
any specific goal.
5. Develops and adopts service improvement programs through
simplified procedures that will further enhance service
delivery.
Professionalism and Ethics Teamwork Innovation
1. Demonstrates the values and behavior enshrined in the Norms
of Conduct and Ethical Standards for public officials and
employees (RA 6713).
√ 1. Willingly does his/her share of responsibility. 1. Examines the root cause of problems and suggests effective
solutions. Fosters new ideas, processes, and suggests better
ways to do things (cost and/or operational efficiency).
2. Practices ethical and professional behavior and conduct taking
into account the impact of his/her actions and decisions.
2. Promotes collaboration and removes barriers to teamwork and
goal accomplishment across the organization.
√ 2. Demonstrates an ability to think “beyond the box”.
Continuously focuses on improving personal productivity to
create higher value and results.
3. Maintains a professional image: being trustworthy, regularity of
attendance and punctuality, good grooming and communication.
√ 3. Applies negotiation principles in arriving at win-win agreements. 3. Promotes a creative climate and inspires co-workers to
develop original ideas or solutions.
4. Makes personal sacrifices to meet organization’s needs. √ 4. Drives consensus and team ownership of decisions. √ 4. Translates creative thinking into tangible changes and
solutions that improve the work unit and organization.
5. Acts with a sense of urgency and responsibility to meet
organization’s needs, improve systems and help others improve
their effectiveness.
5. Works constructively and collaboratively with others and across
organizations to accomplish organizational goals and
objectives.
5. Uses ingenious methods to accomplish responsibilities.
Demonstrates resourcefulness and the ability to succeed with
minimal resources.
PART II: COMPETENCIES

9. CORESKILLS
Achievement Managing Diversity Accountability
1. Enjoyworkinghard 1. Respectallkindsof classesof people 1. Canbe countedonto extend goalssuccessfully
2. Is action-orientedandfullofenergyfor the thingshe/she
sees as challenging
2. Dealseffectively with allraces,nationalities,cultures,
disabilities,agesandboth sexes
2. Steadfastly pushesself and otherstowards results
3. Forwardspersonal,professionalandworkunitneeds
andinterests in an issue.
3. Supportequaland fair treatmentandopportunityfor all 3. Get thingsdoneon timeand optimum useofresources
4. Seize moreopportunitiesthanothers √ 4. Applies equalstandardsandcriteriato allclasses 4. Buildsteam spirit
5. Strategic thinker √ 5. Manifestculturalandgendersensitivity whendealingwith
people
√ 5. Transactswithtransparency
OVERALL COMPETENCY RATINGS
CORE BEHAVIORAL
COMPETENCIES
CORE SKILLS
COMPETENCIES
OVERALL RATING
PART III: SUMMARY OF RATINGS FOR DISCUSSION
Rater-Ratee Agreement
The signatures below confirm that the employee and his/her superior have agreed on content of this appraisal form and the performance rating.
Final Performance Results Rating Adjectival Rating
Accomplishment of KRAs and Objectives
Name of Employee Name of Superior
NAPOLEON N. COSTALES
Teacher I
ERLITO B. MADRIAGA, Ph. D.
Principal I
Signature Signature
Date: April 8, 2016 Date: April 8, 2016

10. Strengths Development Needs Action Plan
(Recommended Developmental
Intervention)
Timeline Resources Needed
Feedback:
Rater: Ratee: Approving Authority: Noted: Noted:
ERLITO B. MADRIAGA,Ph.D. NAPOLEON N. COSTALES SONIA C. PAGBILAO, Ph. D. EDUARDO C. ESCORPISO, JR., Ed.D., CESE ORLANDO E. MANUEL, Ph.D., CESO VI
Principal I Teacher I District Supervisor OIC, Assistant SchoolsDivision Superintendent SchoolsDivision Superintendent
PART IV: DEVELOPMENT PLANS

11. Date Critical Incidence Description Output Impact on Job/Action Plan Signature of
Ratee Rater
January 2016
February 2016
March, 2016
PERFORMANCE MONITORING AND COACHING FORM

12. Strengths Development Needs Action Plan
(Recommended Developmental
Intervention)
Timeline Resources Needed

Feedback:
Rater: Ratee: Approving Authority: Noted: Noted:
ERLITO B. MADRIAGA NAPOLEON N. COSTALES SONIA C. PAGBILAO, Ph.D. EDUARDO C. ESCORPISO, JR., Ed.D., CESE ORLANDO E. MANUEL, Ph.D., CESO VI
Principal I Teacher I District Supervisor OIC, Assistant SchoolsDivision Superintendent SchoolsDivision Superintendent
EMPLOYEE FEEDBACK FORM

13. (Note: For School Heads and Head Teachers, use Leadership Competencies In lieu of Core Skills)
LEADERSHIP COMPETENCIES
LeadingPeople PeoplePerformanceManagement PeopleDevelopment
6. Uses basic persuasiontechniquesinadiscussionor
presentation,e.g., staff mobilization,appealstoreason
and/oremotions,uses data andexamples,visualaids.
6. Makespecific changesintheperformancemanagement
system or inown workmethodsto improveperformance
(e.g. does somethingbetter,faster, at lowercost, more
efficiently, improvesquality, customersatisfaction,morale,
revenues).
6. Improves the skillsand effectivenessof individuals
throughemployingarange of developmentstrategies.
7. Persuades,convincesorinfluencesothers,in orderto
have a specific impactoreffect.
7. Sets performancestandardsandmeasuresprogressof
employeesbasedonoffice anddepartmenttargets.
7. Facilitatesworkforceeffectivenessthroughcoachingand
motivating/developingpeoplewithinaworkenvironment
that promotesmutualtrust and respect.
8. “Sets a good example”,isa credibleandrespected
leader;and demonstratesdesiredbehavior.
8. Provides feedbackandtechnical assistancesuchas
coachingforperformanceimprovementandactionplanning.
√ 8. Conceptualizesandimplementslearninginterventionsto
meetidentifiedtrainingneeds.
9. Forwardspersonal,professionalandworkunitneeds
andinterests in an issue.
9. States performanceexpectationsclearlyandchecks
understandingandcommitment.
9. Doeslong-term coachingortrainingbyarranging
appropriateandhelpfulassignments,formaltraining,or
other experiencesforthepurposeof supportinga
person’slearninganddevelopment.
10. Assumes a pivotal role inpromotingthedevelopmentof
an inspiring,relevantvision for the organizationand
influencesothersto shareownershipof DepEdgoals,in
orderto createaneffective workenvironment.
10. Performsall the stagesof result-basedperformance
managementsystem supportedby evidenceandrequired
documents/forms.
√ 10. Cultivates a learningenvironmentbystructuring
interactiveexperiencessuchaslookingforfuture
opportunitiesthat arein support of achievingindividual
careergoals.
OVERALL COMPETENCY RATINGS
CORE BEHAVIORAL
COMPETENCIES
LEADERSHIP
COMPETENCIES
OVERALL RATING