LEARNING

RESOURCE
AREA

Caregiving Document No.

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Support to Infants Date Revised:
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FORM 1.1 SELF-ASSESSMENT CHECK

INSTRUCTIONS: This Self-Check Instrument will give the trainer

necessary data or information which is essential in
planning training sessions. Please check the appropriate
box of your answer to the questions below.

CORE COMPETENCIES
CAN I…? YES NO
1. PROVIDE CARE AND SUPPORT TO INFANTS AND TODDLERS
1.1 Comfort infants and toddlers /
1.2 Bathe and dress infants and toddlers /
1.3 Feed infants and toddlers /
1.4 Put infants and toddlers to sleep /
1.5 Enhance social, physical, intellectual, creative /
and
emotional activities of infants and toddlers

2. PROVIDE CARE AND SUPPORT TO CHILDREN

2.1 Instill personal hygiene practices to children /
2.2 Bathe and dress children /
2.3 Feed children /
3. FOSTER THE SOCIAL, INTELLECTUAL, CREATIVE AND
EMOTIONAL DEVELOPMENT OF CHILDREN
3.1 Foster children’s independence and autonomy /
3.2 Encourage children to express their feelings, /
ideas
and needs
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CORE COMPETENCIES
CAN I…? YES NO
1. PROVIDE CARE AND SUPPORT TO INFANTS AND TODDLERS
3.3 Stimulate children’s awareness and creativity /
3.4 Foster children’s self esteem and development of /
self concept

4. FOSTER PHYSICAL DEVELOPMENT OF CHILDREN

4.1 Enhance physical activities of children /
4.2 Enhance physical activities of children /
4.3 Provide experience to support physical /
development
of children
5. PROVIDE CARE AND SERVICES TO ELDERLY
5.1 Establish and maintain an appropriate /
relationship
with the elderly
5.2 Provide appropriate support to the elderly /
5.3 Provide assistance with elderly’s personal care /
needs
5.4 Provide assistance with the elderly’s personal /
care
needs
6. PROVIDE CARE AND SUPPORT TO PEOPLE WITH SPECIAL
NEEDS
6.1 Establish and maintain appropriate relationship /
with people with special needs
6.2 Provide appropriate support to people with /
special
needs

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CORE COMPETENCIES
CAN I…? YES NO
1. PROVIDE CARE AND SUPPORT TO INFANTS AND TODDLERS
6.3 Assist in maintaining well being of people with /
special needs
6.4 Assist people with special needs to identify and /
meet their needs
6.5 Assist people with special needs in maintaining /
an
environment that enables maximum
independent
living

7. MAINTAIN A HEALTHY AND SAFE ENVIRONMENT

7.1 Maintain a clean and hygienic environment /
7.2 Provide a safe environment /
7.3 Supervise the safety of clients /

8. RESPOND TO EMERGENCY
8.1 Implement procedures for infection control and /
prevention
8.2 Recognize and respond to signs of potential /
illness
8.3 Respond to emergencies and accidents /
8.4 Administer medication within guidelines /
8.5 Respond to threats and situations of danger /
9. CLEAN LIVING ROOM, DINING ROOM, BEDROOMS,
TOILETS,
BATHROOMS AND KITCHEN
9.1 Clean surfaces and floors /

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CORE COMPETENCIES
CAN I…? YES NO
1. PROVIDE CARE AND SUPPORT TO INFANTS AND TODDLERS
9.2 Clean furnishing and fixtures /
9.3 Make up beds and cots /
9.4 Clean toilet and bathroom /
9.5 Sanitize rooms /
9.6 Maintain clean room environment /
9.7 Clean kitchen /
10. WASH AND IRON CLOTHES, LINEN AND FABRIC
10.1 Check and sort clothes, linens and fabrics /
10.2 Remove stains /
10.3 Prepare washing equipment and supplies /
10.4 Perform laundry /
10.5 Dry clothes, linen and fabric /
10.6 Iron clothes, linens and fabrics /
11. PREPARE HOT AND COLD MEALS/FOOD
11.1 Prepare ingredients according to recipes /
11.2 Cook meals and dishes according to recipes /
11.3 Present cooked dishes /
11.4 Prepare sauces, dressings and garnishes /
11.5 Prepare Appetizers /
11.6 Prepare desserts and salads /
11.7 Prepare sandwiches /
11.8 Store excess foods and ingredients /
11.9 Convert unconsumed cooked food /

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Note: In making the Self-Check for your Qualification, all required competencies
should be specified. It is therefore required of a Trainer to be well- versed of
the CBC or TR of the program qualification he is teaching.

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 Evidences/Proof of Current Competencies
Form 1.2: Evidence of Current Competencies acquired related to
Job/Occupation

Current
Proof/Evidence Means of validating
competencies
BASIC COMPETENCIES
Participate in Diploma, COE and Submit authenticated
workplace TOR documents and interview
communication
Work in a team Diploma, COE and Submit authenticated
environment TOR documents and interview
Practice career Diploma, COE and Submit authenticated
professionalism TOR documents and interview
Practice Diploma, COE and Submit authenticated
occupational health TOR documents and interview
and safety
procedures
COMMON COMPETENCIES
Implement and Diploma, COE and Submit authenticated
monitor infection TOR documents and interview
control policies and
procedures
Respond effectively Diploma, COE and Submit authenticated
to TOR documents and interview
difficult/challenging
behavior
Apply basic first aid Diploma, COE and Submit authenticated
TOR documents,
demonstration and
interview

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Maintain high Diploma, COE and Submit authenticated
standard of patient TOR documents and interview
services
CORE COMPETENCIES
Provide care and Diploma, COE, TOR Submit authenticated
support to and relevant documents,
infants/toddlers certificate of demonstration and
trainings interview
Provide care and Diploma, COE and Submit authenticated
support to children TOR, third party documents,
report demonstration and
interview

Foster social, Diploma, COE and Submit authenticated

intellectual, creative TOR documents and interview
and emotional
development of
children
Foster the physical Diploma, COE and Submit authenticated
development of TOR documents and interview
children
Provide care and Diploma, COE and Submit authenticated
services to elderly TOR, relevant documents and interview
certificate of
trainings
Provide care and Diploma, COE and Submit authenticated
support to people TOR, relevant documents,
with special needs certificate of demonstration and
trainings interview
Maintain healthy Diploma, COE and Submit authenticated
and safe TOR documents and interview
environment
Respond to Diploma, COE and Submit authenticated
emergency TOR, relevant documents and interview

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 certificate of
trainings
Clean living room, Diploma, COE and Submit authenticated
dining room, TOR, relevant documents,
bedrooms, toilet certificate of demonstration and
and bathroom trainings interview
Wash and iron Diploma, COE and Submit authenticated
clothes, linen and TOR, relevant documents,
fabric certificate of demonstration and
trainings interview
Prepare hot and Diploma, COE and Submit authenticated
cold meals TOR, relevant documents,
certificate of demonstration and
trainings interview

Identifying Training Gaps

Form 1.3 Summary of Current Competencies Versus Required
Competencies

Required Units of Training Gaps/

Competency/Learning Requirements
Current Competencies
Outcomes based on CBC

BASIC COMPETENCIES
[Link] IN [Link] IN
WORKPLACE WORKPLACE
COMMUNICATION COMMUNICATION
1.1 Obtain and convey 1.1 Obtain and convey
workplace information workplace
information
1.2 Participate in 1.2 Participate in
workplace meetings workplace meetings
and discussions and discussions

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 1.3 Complete relevant 1.3 Complete relevant
work related work related
documents documents
2. WORK IN TEAM 2. WORK IN TEAM
ENVIRONMENT ENVIRONMENT
2.1 Describe team role 2.1 Describe team
and scope role and scope
2.2 Identify own role 2.2 Identify own role
and responsibility and responsibility
within team within team
2.3 Work as a team 2.3 Work as a team
member member
3. PRACTICE CAREER 3. PRACTICE CAREER
PROFESSIONALISM PROFESSIONALISM
3.1 Integrate personal 3.1 Integrate personal
objectives with objectives with
organizational goals organizational
goals
3.2 Set and meet work 3.2 Set and meet
priorities work priorities
3.3 Maintain 3.3 Maintain
professional growth professional
and development growth and
development
4. PRACTICE 4. PRACTICE
OCCUPATIONAL OCCUPATIONAL
HEALTH AND SAFETY HEALTH AND
SAFETY
4.1 Identify hazards 4.1 Identify hazards
and risks and risks
4.2 Evaluate hazards 4.2 Evaluate hazards
and risks and risks

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4.3 Control hazards and 4.3 Control hazards
risks and risks
4.4 Maintain OHS 4.4 Maintain OHS
awareness awareness

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 Required Units of Current Competencies Training Gaps/
Competency/Learning Requirements
Outcomes based on CBC
COMMON COMPETENCIES
1. IMPLEMENT AND 1. IMPLEMENT AND
MONITOR INFECTION MONITOR
CONTROL POLICIES INFECTION
AND PROCEDURES CONTROL POLICIES
AND PROCEDURES

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 1.1 Provide information 1.1 Provide information
to the work group to the work group
about the about the
organization’s organization’s
infection control infection control
policies and policies and
procedures procedures
1.2 Integrate the 1.2 Integrate the
organization’s organization’s
infection control infection control
policy and procedure policy and
into work practices procedure into work
practices
1.3 Monitor infection 1.3 Monitor infection
control performance
control performance
and implement and implement
improvements in improvements in
practices practices
2. RESPOND 2. RESPOND
EFFECTIVELY TO EFFECTIVELY TO
DIFFICULT/ DIFFICULT/
CHALLENGING CHALLENGING
BEHAVIOR BEHAVIOR
2.1 Plan responses 2.1 Plan responses
2.2 Apply response 2.2 Apply response
2.3 Report and review 2.3 Report and review
incidents incidents
3. APPLY BASIC FIRST 3. APPLY BASIC FIRST
AID AID
3.1 Assess the situation
3.1 Assess the
situation

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 3.2 Apply basic first aid 3.2 Apply basic first
techniques aid techniques
3.3 Communicate details 3.3 Communicate
of the incident details of the
incident
4. MAINTAIN HIGH 4. MAINTAIN HIGH
STANDARDS OF STANDARDS OF
PATIENT SERVICES PATIENT SERVICES
4.1 Communicate 4.1 Communicate
appropriately with appropriately with
patients patients
4.2Establish and 4.2Establish and
maintain good maintain good
interpersonal interpersonal
relationship with relationship with
patients patients
4.3 Act in a respectful 4.3 Act in a respectful
manner at all times manner at all times
4.4 Evaluate own work to 4.4 Evaluate own work
maintain a high to maintain a high
standard of patient standard of patient
service service

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 Required Units of Current Training Gaps/
Competency/Learning Competencies Requirements
Outcomes based on CBC

CORE COMPETENCIES
1. PROVIDE CARE AND 1. PROVIDE CARE
SUPPORT TO INFANTS AND SUPPORT TO
AND TODDLERS INFANTS AND
TODDLERS
1.1 Comfort infants and 1.1 Comfort
toddlers infants and
toddlers
1.2 Bathe and dress infants 1.2 Bathe and
and toddlers dress infants
and toddlers
1.3 Feed infants and toddlers 1.3 Feed infants
and toddlers
1.4 Put infants and toddlers 1.4 Put infants
to sleep and toddlers to
sleep
1.5 Enhance social, physical, 1.5 Enhance
intellectual, creative and social,
emotional activities of physical,
infants and toddlers intellectual,
creative and
emotional
activities of
infants and
toddlers
2. PROVIDE CARE AND 2. PROVIDE CARE
SUPPORT TO CHILDREN AND SUPPORT
TO CHILDREN
2.1 Instill personal hygiene 2.1 Instill personal
practices to children hygiene practices
to children

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 2.2 Bathe and dress children 2.2 Bathe and
dress children
2.3 Feed children 2.3 Feed children
3. FOSTER THE SOCIAL, 3. FOSTER THE
INTELLECTUAL, SOCIAL,
CREATIVE AND INTELLECTUAL,
EMOTIONAL CREATIVE AND
DEVELOPMENT OF EMOTIONAL
CHILDREN DEVELOPMENT
OF CHILDREN

3.1. Foster children’s 3.1. Foster

independence and children’s
autonomy independence
and autonomy
3.2 Encourage children 3.2
to express their feelings, Encourage
ideas and needs children to
express their
feelings, ideas
and needs
3.3. Stimulate children’s 3.3. Stimulate
awareness and creativity children’s
awareness and
creativity

3.4 Foster children’s self 3.4 Foster

esteem and development children’s self
of self concept esteem and
development of
self concept
4. FOSTER PHYSICAL 4. FOSTER
DEVELOPMENT OF PHYSICAL
CHILDREN DEVELOPMENT
OF CHILDREN

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 4.1 Enhance physical 4.1 Enhance
activities of children physical activities
of children
4.2 Enhance physical 4.2 Enhance
activities of children physical activities
of children
4.3 Provide experience to 4.3 Provide
support physical development experience to
of children support physical
development of
children

5. PROVIDE CARE AND 5. PROVIDE CARE

SERVICES TO ELDERLY AND SERVICES TO
ELDERLY
5.1 Establish and maintain 5.1 Establish and
an appropriate relationship maintain an
with the elderly appropriate
relationship with
the elderly
5.2 Provide appropriate 5.2 Provide
support to the elderly appropriate
support to the
elderly
5.3 Provide assistance with 5.3 Provide
elderly’s personal care needs assistance with
elderly’s personal
care needs
5.4 Provide assistance with 5.4 Provide
the elderly’s personal care assistance with the
needs elderly’s personal
care needs

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6. PROVIDE CARE AND 6. PROVIDE CARE
SUPPORT TO PEOPLE WITH AND SUPPORT TO
SPECIAL NEEDS PEOPLE WITH
SPECIAL NEEDS
6.1 Establish and maintain 6.1 Establish and
appropriate relationship with maintain
people with special needs appropriate
relationship with
people with special
needs
6.2 Provide appropriate 6.2 Provide
support to people with special appropriate
needs support to people
with special needs
6.3 Assist in maintaining well 6.3 Assist in
being of people with special maintaining well
needs being of people
with special needs
6.4 Assist people with special 6.4 Assist people
needs to identify and meet with special needs
their needs to identify and
meet their needs
6.5 Assist people with special 6.5 Assist people
needs in maintaining an with special needs
environment that enables in maintaining an
maximum independent living environment that
enables maximum
independent living
7. MAINTAIN A HEALTHY 7. MAINTAIN A
AND SAFE ENVIRONMENT HEALTHY AND
SAFE
ENVIRONMENT
7.1 Maintain a clean and 7.1 Maintain a
hygienic environment clean and

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 hygienic
environment
7.2 Provide a safe 7.2 Provide a safe
environment environment
7.3 Supervise the safety of 7.3 Supervise the
clients safety of clients
8. RESPOND TO EMERGENCY 8. RESPOND TO
EMERGENCY
8.1 Implement procedures for 8.1 Implement
infection control and procedures for
prevention infection control
and prevention
8.2 Recognize and respond to 8.2 Recognize and
signs of potential illness respond to signs
of potential
illness
8.3 Respond to emergencies 8.3 Respond to
and accidents emergencies and
accidents
8.4 Administer medication 8.4 Administer
within guidelines medication
within
guidelines
8.5 Respond to threats and 8.5 Respond to
situations of danger threats and
situations of
danger

9. CLEAN LIVING ROOM, 9. CLEAN LIVING

DINING ROOM, ROOM, DINING
ROOM,
BEDROOMS,
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 BEDROOMS, TOILETS, TOILETS,
BATHROOM AND KITCHEN BATHROOM AND
KITCHEN

9.1 Clean surfaces and floors 9.1 Clean surfaces

and floors
9.2 Clean furnishing and 9.2 Clean
fixtures furnishing and
fixtures
9.3 Make up beds and cots 9.3 Make up beds
and cots
9.4 Clean toilet and bathroom 9.4 Clean toilet and
bathroom

9.5 Sanitize rooms 9.5 Sanitize rooms

9.6 Maintain clean room 9.6 Maintain clean
environment room environment
9.7 Clean kitchen 9.7 Clean kitchen
10. WASH AND IRON 10. WASH AND
CLOTHES, LINEN AND IRON CLOTHES,
FABRIC LINEN AND FABRIC
10.1 Check and sort clothes, 10.1 Check and
linens and fabrics sort clothes, linens
and fabrics
10.2 Remove stains 10.2 Remove stains
10.3 Prepare washing 10.3 Prepare
equipment and supplies washing equipment
and supplies
10.4 Perform laundry 10.4 Perform
laundry
10.5 Dry clothes, linen and 10.5 Dry clothes,
fabric linen and fabric

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10.6 Iron clothes, linens and 10.6 Iron clothes,
fabrics linens and fabrics

11. PREPARE HOT AND 11. PREPARE HOT

COLD MEALS/FOOD AND COLD
MEALS/FOOD
11.1 Prepare ingredients 11.1 Prepare
according to recipes ingredients
according to
recipes

11.2 Cook meals and dishes 11.2 Cook meals

according to recipes and dishes
according to
recipes

11.3 Present cooked dishes 11.3 Present

cooked dishes

11.4 Prepare sauces, 11.4 Prepare

dressings and garnishes sauces,
dressings and
garnishes

11.5 Prepare Appetizers 11.5 Prepare

Appetizers

11.6 Prepare desserts and 11.6 Prepare

salads desserts and
salads

11.7 Prepare sandwiches 11.7 Prepare

sandwiches

11.8 Store excess foods and 11.8 Store excess

ingredients foods and
ingredients

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 Caregiving Document No.
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 Using Form No.1.4, convert the Training Gaps into a Training
Needs/ Requirements. Refer to the CBC in identifying the Module Title or
Unit of Competency of the training needs identified.

Form No. 1.4: Training Needs

Module Title/Module of Duration

Gaps
Instruction (hours)

1.1 Comfort infants

and toddlers 12 hours
PROVIDE CARE AND
SUPPORT TO INFANTS
1.2 Bathe and AND TODDLERS
dress infants 17 hours
and toddlers

1.3 Feed infants

and toddlers 13 hours

1.4 Put infants and

toddlers to sleep 12 hours

1.5 Enhance social,

physical,
intellectual, 14 hours
creative and
emotional
activities of
infants and
toddlers

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 TRAINING PLAN

Qualification: PROVIDE CARE AND SUPPORT TO INFANTS AND TODDLERS

Trainees’ Facilities/To
Training Mode of Assessment Date and
Training Staff ols and Venue
Activity/Task Training Method Time
Requirements Equipment
 Submitting the
Training Plan to Training
Coordinator/ Asilo de
Submit training the Industry August
Supervisor Training Plan la
plan to industry Partner in
Milagrosa
accordance with Trainer
the MOA.
 Orienting and
Training
introducing the August,
Coordinator/ Asilo de la
Orientation company’s OJT Training Plan 2019
Supervisor Milagrosa
background,
management and Trainer (2 hours)
operations, work
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 ethics and
standards.
 Sending the
trainees to the Training
actual workplace. Coordinator/ Asilo de la AUGUST
Site Visit OJT Supervisor Training Plan
 Giving them a tour Milagrosa ( 2 hours)
of the actual Trainer
workplace.
LO1. Comfort 1. Preparing tools and OJT Supervisor Manuals Asilo de la  Demonstrati August
infants and equipment according Milagrosa on with
Trainer Checklist 6:00 am-
toddlers to the need of the questioning 2:00 pm
infant/toddler Staff Caregiving  Direct
paraphernalia observation
PPE  Written

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2. Responding OJT Supervisor Manuals Asilo de la  Demonstrati August
distressed infants and Milagrosa on
Trainer Caregiving 6:00 am-
toddlers based on  Direct
paraphernalia 2:00 pm
appropriate methods, Staff observation
activity and non- PPE
 Written
verbal cues. exam

3. Picking up and OJT Supervisor Manuals Asilo de la  Demonstrati AUgust

cuddling infants and Milagrosa on with
Trainer Checklist 6:00 am-
toddlers according to questioning 2:00 pm
procedure Staff Caregiving  Interview
paraphernalia
 Direct
PPE observation

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LO2. Bathe and 1. Checking infants OJT Supervisor Manuals Asilo de la  Demonstrati August
dress infants and toddlers' vital Milagrosa on with
Trainer Checklist 6:00 am-
and toddlers signs based on questioning 2:00 pm
procedure. Staff Chart note  Written
Caregiving exam
paraphernalia  Direct
PPE observation

2. Checking water OJT Supervisor Chart note Asilo de la  Demonstrati August,

quantity and Milagrosa on with 2018
Trainer Bath
temperature as per questioning
thermometer 6:00 am-
requirement. Staff  Interview 2:00 pm
Bath tub
 Direct
Hot and cold observation
water

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Technical Education and Skills Development Authority
USJR
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 TRAINEE’S RECORD BOOK

Trainee's no: 14344

I.D.
NAME: SARAH T. ABING

QUALIFICATION: CAREGIVING NC II

TRAINING DURATION : 68 HOURS

TRAINER: MARY JANE A. TULABING

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 Instructions:
This Trainees’ Record Book (TRB) is intended to serve as record of all accomplishment/task/activities while undergoing
training in the industry. It will eventually become evidence that can be submitted for portfolio assessment and for whatever purpose
it will serve you. It is therefore important that all its contents are viably entered by both the trainees and instructor.
The Trainees’ Record Book contains all the required competencies in your chosen qualification. All you have to do is to fill in
the column “Task Required” and “Date Accomplished” with all the activities in accordance with the training program and to be taken
up in the school and with the guidance of the instructor. The instructor will likewise indicate his/her remarks on the “Instructors
Remarks” column regarding the outcome of the task accomplished by the trainees. Be sure that the trainee will personally accomplish
the task and confirmed by the instructor.
It is of great importance that the content should be written legibly on ink. Avoid any corrections or erasures and maintain the
cleanliness of this record.
This will be collected by your trainer and submit the same to the Vocational Instruction Supervisor (VIS) and shall form part
of the permanent trainee’s document on file.

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 THANK YOU.

_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
NOTES:
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_____________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________

Unit of Competency 1: PROVIDE CARE AND SUPPORT TO INFANTS AND TODDLERS

NC Level II

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 Learning Outcome Task/Activity Required Date Instructors
Accomplished Remarks
LO1. Comfort infants and 1. Preparing tools and equipment according to the need of March 10, 2016 Competent
toddlers the infant/toddler.
2. Responding distressed infants and toddlers based on March 10, 2016 Competent
appropriate methods, activity and non-verbal cues.
3. Picking up and cuddling infants and toddlers according March 10, 2016 Competent
to procedure.
LO2. Bathe and dress 1. Checking infants and toddlers' vital signs based on March 16, 2016 Competent
infants and toddlers procedure.
2. Checking water quantity and temperature as per March 16, 2016 Competent
requirement.
3. Bathing infants and toddlers according to procedure. March 16, 2016 Competent
LO3. Feed infants and 1. Cleaning and sterilizing infants and toddlers' bottles as March 18, 2016 Competent
toddlers needed.
2. Preparing milk formula as prescribed. March 18, 2016 Competent
LO4. Put infants and 1. Preparing infants and toddlers' crib based on procedure. March 22, 2016 Competent
toddlers to sleep 2. Putting infants and toddlers' to sleep based on March 22, 2016 Competent
procedure.

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LO5. Enhance social, 1. Exposing infants and toddlers to family members, March 29, 2016 Competent
physical, intellectual, relatives and playmates for communication and
creative and emotional interaction purposes.
activities of infants and 2. Providing infant /toddlers with manipulative or creative March 29, 2016 Competent
toddlers toys and games as needed.
3. Giving infants/toddlers with exercise activities as March 29, 2016 Competent
required.

__________________ ___________________
Trainee’s Signature Trainer’s Signature

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 TRAINEE'S PROGRESS SHEET

Name : LEIRA T. ABING Trainer : RITZCHEL T. ABING

Nominal
Qualification : CAREGIVING NC II : 68 HOURS
Duration
Training Date Date Trainee’s Supervisor’s
Units of Competency Training Activity Rating
Duration Started Finished Initial Initial

PROVIDE CARE AND SUPPORT TO INFANT AND TODDLER

LO1. Comfort 1. Prepared tools and
infants and equipment according to the
toddlers need of the infant/toddler. March 9, March Competent LA RA
2016 10, 2016
12
2. Responded distressed hours
infants and toddlers based
on appropriate methods, March 9, March Competent LA RA
activity and non-verbal 2016 10, 2016
cues.

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 3. Picked up and cuddling March 9, March Competent LA RA
infants and toddlers 2016 10, 2016
according to procedure.
LO2. Bathe and 1. Checked infants and March March Competent LA RA
dress infants toddlers' vital signs based 14, 2016 16, 2016
and toddlers on procedure. 17
hours
2. Checked water quantity March March Competent LA RA
and temperature as per 14, 2016 16, 2016
requirement.
3. Bathing infants and March March Competent LA RA
toddlers according to 14, 2016 16, 2016
procedure.
LO3. Feed 1. Cleaned and sterilizing March March Competent
infants and infants and toddlers' 17, 2016 18, 2016
toddlers bottles as needed. 13 LA RA
hours
2. Prepared milk formula as March March Competent LA RA
prescribed. 17, 2016 18, 2016

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LO4. Put infants 1. Prepared infants and 12 March March Competent LA RA
and toddlers to toddlers' crib based on hours 21, 2016 22, 2016
sleep procedure.
2. Putting infants and March March Competent LA RA
toddlers' to sleep based on 21, 2016 22, 2016
procedure.
LO5. Enhance 1. Exposed infants and
social, physical, toddlersto family members,
intellectual, relatives and playmates for 14 March March Competent LA RA
creative and communication and hours 28, 2016 29, 2016
emotional interaction purposes.
activities of
infants and 2. Provided infant / toddlers
toddlers with manipulative or
creative toys and games as March March Competent LA RA
needed. 28, 2016 29, 2016

3. Gave infants/toddlers with March March Competent LA RA

exercise activities as 28, 2016 29, 2016
required.

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 68
Total:
hours

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 SUPERVISED INDUSTRY TRAINING
EVALUATION / ON-THE-JOB
TRAINING EVALUATION FORM

Note: The following questionnaire is designed to evaluate the

effectiveness of the Supervised Industry Training (SIT) or On The Job
Training (OJT) you had with the Industry Partners of USJR. Please
check the appropriate box corresponding to your rating for each
question asked. The results of this evaluation shall serve as basis for
improving the design and management of the SIT in USJR to maximize
the benefits of the said program. Thank you for your cooperation.

LEGEND:
5 – Outstanding
4 – Very Good / Very Satisfactory
3 – Good / Adequate
2 – Fair / Satisfactory
1 – Poor / Unsatisfactory
NA – Not Applicable
INSTITUTION EVALUATION: Rating:
Item Question 1 2 3 4 5 NA
No.
1 Did USJR conduct an /
orientation about the SIT/OJT
program, the requirements and
preparation needed, and its
expectations?
2 Did USJR provide the necessary /
assistance such as referrals or
recommendations in finding the
company for your OJT?

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 3 Did USJR show coordination /
with the Industry partner in the
design and supervision of your
SIT/OJT?
4 Is your in-school training /
adequate to undertake Industry
partner assignment and its
challenges?
5 Has USJR monitored your /
progress in the industry?
6 Has the supervision been /
effective in achieving your OJT
objectives and providing
feedbacks when necessary?
7 Did USJR conduct an /
assessment of your SIT/OJT
program upon completion?
8 Were you provided with the /
results of the Industry and
USJR’s assessment of your
OJT?
Comments/Suggestions:
_______________________________________________________________________
_______________________________________________________________________

_______________________
Trainee’s Signature

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 Printed Name: SARAH T. ABING

Qualification: CAREGIVING NC - II

Host Industry Partner: ASILO DE LA MILAGROSA

Industry Supervisor: ARIEL B. ABING

Duration of Training: 68 HRS.

Training Instructor: MARY JANE A. TULABING

INDUSTRY PARTNER EVALUATION: Rating:

Item Question 1 2 3 4 5 NA
No.
1 Was the industry partner /
appropriate for your type of
training required and/or
desired?
2 Has the industry partner /
designated the training to meet
your objectives and
expectations?
3 Has the industry partner showed /
coordination with UCTC in the
design and supervision of the
SIT/OJT?
4 Has the Industry Partner and its /
staff welcomed you and treated
you with respect and
understanding?
5 Has the industry partner /
facilitated the training, including
the provision of the necessary
resources such as facilities and

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 equipment needed to achieve
your OJT objectives?
6 Has the Industry Partner /
assigned a supervisor to oversee
your work or training?
7 Was the supervisor effective in /
supervising you through regular
meetings, consultations and
advise?
8 Has the training provided you /
with the necessary technical and
administrative exposure of real
world problems and practices?
9 Has the training program allowed /
you to develop self-confidence,
self motivation and positive
attitude towards work?
10 Has the experience improved /
your personal skills and human
relations?
11 Are you satisfied with your /
training in the Industry?
Comments/Suggestions:
_______________________________________________________________________
_______________________________________________________________________

_______________________
Trainee’s Signature

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 SUMMARY EVALUATION SHEET
INSTITUTIONAL EVALUATION

RATER Rating Rating Rating Rating Rating Rating Rating Rating

Item 1 Item 2 Item 3 Item 4 Item 5 Item 6 Item 7 Item 8
Rater A 4 4 5 4 5 5 4 5
Rater B 4 5 5 4 4 5 5 4
Rater C 4 4 4 5 4 4 5 4
Rater D 5 4 5 5 5 4 5 5
Rater E 4 5 4 4 4 5 4 4
Total 21 22 23 22 22 23 23 22
Average 4.2 4.4 4.6 4.4 4.4 4.6 4.6 4.4

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 SUMMARY EVALUATION SHEET
INDUSTRY EVALUATION

Item Item Item Item Item Item Item Item Item Item Item
Rater
1 2 3 4 5 6 7 8 9 10 11

Rater A 4 4 4 5 4 4 4 4 4 4 4
Rater B 4 5 4 4 5 4 5 4 4 5 5
Rater C 4 5 5 5 4 5 5 4 5 4 4
Rater D 4 5 4 4 5 5 4 5 4 5 5
Rater E 5 4 5 5 4 4 5 4 5 4 4
Total 21 23 22 23 22 22 23 21 22 22 22
Average 4.2 4.6 4.4 4.6 4.4 4.4 4.6 4.2 4.4 4.4 4.4

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Printed Name: SARAH T. ABING
Qualification: CAREGIVING NC - II
Host Industry Partner: ASILO DE LA MILAGROSA
Industry Supervisor: JOSE NINO P. MENDOZA
Duration of Training: 68 HRS.
Training Instructor: MARY JANE A. TULABING

RATER A

PREPARATION 1 2 3 4 5

1. Workshop layout conforms with the x

components of a CBT workshop
2. Number of CBLM is sufficient x

3. Objectives of every training session x

is well explained

4. Expected activities/outputs are x

clarified

RATER B

PREPARATION 1 2 3 4 5

1. Workshop layout conforms with the x

components of a CBT workshop
2. Number of CBLM is sufficient x

3. Objectives of every training session x

is well explained

4. Expected activities/outputs are x

clarified

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RATER C

PREPARATION 1 2 3 4 5

1. Workshop layout conforms with the x

components of a CBT workshop
2. Number of CBLM is sufficient x

3. Objectives of every training session x

is well explained

4. Expected activities/outputs are x

clarified

RATER D

PREPARATION 1 2 3 4 5

1. Workshop layout conforms with the x

components of a CBT workshop
2. Number of CBLM is sufficient x

3. Objectives of every training session x

is well explained

4. Expected activities/outputs are x

clarified

RATER E

PREPARATION 1 2 3 4 5

1. Workshop layout conforms with the x

components of a CBT workshop

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2. Number of CBLM is sufficient x

3. Objectives of every training session x

is well explained

4. Expected activities/outputs are x

clarified

AVERAGE RATING

PREPARATION Average
1. Workshop layout
conforms with the 3.2
components of a CBT
workshop
2. Number of CBLM is
sufficient 4.2
3. Objectives of every
training session is well 4.4
explained
4. Expected
activities/outputs are
3.4
clarified
General Average 3.04

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General Interpretation:

Based on the gathered data on the Summary for Institutional

Evaluation Sheet, all item numbers have a very satisfactory results with
the average rating from 4.2 to 4.6 from the selected respondents. This
shows that the institution is effective in providing necessary assistance to
trainees like giving orientation about the Supervised Industry Program or
On the Job, preparing the requirements needed and expectations,
monitoring the progress of trainees in the industry and giving immediate
feedbacks and assessment. The trainees are well satisfied in their in-
school training in preparing them for this SIT/OJT program.

Based on the quantitative data on the Summary for Industry

Evaluation Sheet, all item numbers have a very good results with the
average rating from 4.2 to 4.6 from the selected respondents. The data
shows that the trainees are very satisfied in their industry training. The
evaluation result shows that the industry is appropriate for their desired
training and meeting their objectives and expectations. The industry
shows coordination with the institution in supervising the trainees such
as providing the necessary facilities and equipment to achieve the
SIT/OJT objectives, exposing the trainees into real world problems and
improving their personal skills and positive attitude towards work.

According to the data gathered in the preparation, the result from

the evaluation on the effectiveness of the Supervised Industry Training
(SIT)/ On the Job Training (OJT) with the Industry partner in Asilo de la
Milagrosa results under the range of "Good/Satisfactory" with the average
rating of 3.04 from the selected respondents. This shows that the
SIT/OJT is effective towards delivering actual or practical training to the
trainees.

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 Based on the gathered data in the preparation, the workshop layout
conforms with the components of a CBT workshop has an average of 3.2
under the range of good/satisfactory. The number of CBLM has the
average of 4.2 under the range of very satisfactory. The objectives of every
training session has the average of 4.4 under the range of very
satisfactory. The expected activities/outputs has the average of 3.4 under
the range of good/satisfactory.

Recommendations:

Therefore, it is recommended that the workshop layout should

conforms with the components of a CBT by revising and reviewing the
training plan for the next implementation. The results of the program
evaluation should be one of the basis if there is a need for changes in the
training plan. The objectives of every training and expected
activities/outputs should also be clearly discussed to avoid
misinterpretation and confusion to trainees.

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 Caregiving Document No.
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