This document contains a teacher evaluation form that lists requirements and evidence for teacher performance measures (MOVs) in several categories such as classroom observation, student assessment, communication with stakeholders, professional development activities, and use of information and communication technology. For each measure, the form requires submission of documentation like observation and assessment forms, meeting minutes, lesson plans, reflection notes, certificates, and reports to demonstrate fulfillment of the objective.

1. Republic of the Philippines
School Division of
TYPE THE NAME OF
YOUR SCHOOL
School Year 2022-
2023
Teacher III
Name of Rater
Position

4. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

5. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

6. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

7. SAMPLE LESSON PLAN

9. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

10. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

11. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

12. SAMPLE LESSON PLAN

14. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

15. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

16. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

17. SAMPLE LESSON PLAN

19. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

20. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

21. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

22. SAMPLE LESSON PLAN

25. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

26. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

27. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

29. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

30. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

31. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

33. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

34. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

35. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

38. MOVs
1. Proof/s of attendance in LAC
sessions/FGDs/meetings/other collegial
discussions
2. Minutes of LAC
sessions/FGDs/meetings/other collegial
discussions on use of teacher and learner
feedback to enrich teaching practice
3. Reflection notes of teachers on their
demonstration of teaching practices
following participation from LAC
sessions/FGDs/meetings/other collegial
discussions that use of teacher and
learner feedback to enrich teaching
practice, with proof/s of attendance
4. Any equivalent ALS form/document that
highlights the objective

39. PROOF/S OF ATTENDANCE

40. MINUTES OF MEETING

41. MINUTES OF MEETING

42. MINUTES OF MEETING

43. REFLECTION NOTES

44. REFLECTION NOTES

46. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

47. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

48. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

49. SAMPLE LESSON PLAN

52. MOVs
Classroom Observation Tool (COT)
rating sheet/s or inter-observer
agreement form from/s done
through onsite/face-to-face/
in-person classroom observation.
If onsite / face-to-face/in-person
classes are not implemented,
through observation of
synchronous/asynchronous
teaching in other modalities; or
through observation of a
demonstration teaching* via LAC
session.

53. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT1

54. RATING SHEET/ INTER-OBSERVER AGREEMENT
FORM COT2

55. SAMPLE ASSESSMENT TOOL

56. SAMPLE ASSESSMENT TOOL

58. MOVs
Any one (1) of the following:
Individual Learning Monitoring Plan
(ILMP)
Peer assessment data
Sample of learners’ output with
reflection/self-assessment
Progress charts/anecdotal records
Class/e-class record/grading sheets
Lesson plans showing index of mastery
Frequency of errors with identified
least/most mastered skills
Any equivalent ALS form/document that
highlights the objective (e.g. Individual
Leaning Agreement (ILA), ALS
Assessment Form 2)
Others (Please specify and provide
annotations)

59. INDIVIDUAL LEARNING MONITORING PLAN

60. PEER ASSESSMENTS DATA

61. SAMPLE OF LEARNERS; OUTPUT

62. ANECDOTAL RECORDS

63. SAMPLE CLASS RECORD

64. LESSON PLAN SHOWING INDEX OF MASTERY

65. FREQUENCY OF ERRORS WITH IDENTIFIED
LEAST/MASTERED SKILLS

66. OTHERS

68. MOVs
Any one (1) of the following:
A sample of corrected test paper of a
learner in a learning area with parent’s
or guardian’s signature and date of
receipt
Minutes of meetings with key
stakeholders (e.g. PTA, SGC, SPT,
CPC) with proof of attendance
Report card with parent’s or guardian’s
signature in all quarters supported by
minutes of meeting
Communication with key stakeholders
(e.g., parent’s or guardian’s, co-
teachers, LGU)using various modalities
Anecdotal record showing entries per
quarter
Any equivalent ALS form/document that
highlights the objective
Others (Please specify and provide
annotations)

69. SAMPLE OF CORRECTED TEST PAPERS

70. MINUTES OF MEETING

71. MINUTES OF MEETING

72. SAMPLE OF REPORT CARD

73. COMMUNICATION WITH STAKEHOLDERS

74. ANECDOTAL RECORD

75. ANECDOTAL RECORD

76. OTHERS

79. MOVs
A reflection/journal entry
that highlights the application
of a learner-centered teaching
philosophy in the lesson plan
or community work

80. REFLECTION/JOURNAL ENTRY

81. REFLECTION/JOURNAL ENTRY

83. MOVs
Certification from the ICT
Coordinator/School Head/ Focal
Person in charge of e-SAT
IPCRF-DP
Mid-year Review Form (MRF)
Updated IPCRF-DP from Phase
II

84. CERTIFICATE OF ESAT

85. IPCRF-DP

86. Mid-year Review Form (MRF)

87. Updated IPCRF-DP from Phase II

90. MOVs
Any one (1) of the following:
Committee involvement;
Involvement as module/learning material
writer/validator;
Involvement as a resource
person/speaker/learning facilitator in the
RO/SDO/school-initiated TV/radio-based
instruction;
Book or journal authorship/ co-
authorship/contributorship
Advisorship/coordinatorship/
chairpersonship;
Participation in demonstration teaching;
Participation as research presenter in a
forum/conference;
Mentoring of pre-service/in-service
teachers;
Conducted research within the rating
period;
Others(please specify)
With annotation on how it contributed
to the teaching-learning process.

91. COMMITTEE INVOLVEMENT

92. MODULE/LEARNING MATERIAL WRITER/
VALIDATOR

93. INVOLVEMENT AS A RESOURCE
PERSON/SPEAKER/LEARNING FACILITATOR

94. INVOLVEMENT AS A RESOURCE
PERSON/SPEAKER/LEARNING FACILITATOR

95. BOOK OR JOURNAL AUTHORSHIP/CO-
AUTHORSHIP/ CONTRIBUTORSHIP

96. ADVISORSHIP/COORDINATORSHIP/
CHAIRPERSONHIP

97. PARTICIPATION IN DEMONSTRATION TEACHING

98. PARTICIPATION AS RESEARCH PRESENTER IN A
FORUM/CONFERENCE

99. MENTORING OF PRE-SERVICE INSERVICE
TEACHERS

100. CONDUCTED RESEARCH WITHIN THE RATING
PERIOD

101. OTHERS