SAN JOSE ELEMENTARY SCHOOL

San Miguel, Iloilo

Name of Teacher: ____________________________________ Date: ____________________________

I. Instructional Supervision
__________1. I am included in the supervisory plan of the school.
__________2. I have been observed using COT.
__________3. I have submitted COT forms.
__________4. I belong to proficient teacher.
__________5. I have my portfolio in RPMS.
__________6. I have my portfolio for promotion.
__________7. I have attended LAC session.
__________8. I was mentored and coached in content and pedagogy on Information Literacy (IL).
__________9. I was mentored and coached in content and pedagogy on Critical Thinking (CT).
__________10. I was mentored and coached in content and pedagogy on Problem Solving (PS).
__________11. I was mentored and coached in Strategies of Teaching on Information Literacy (IL).
__________12. I was mentored and coached in Strategies of Teaching on Critical Thinking (CT).
__________13. I was mentored and coached in Strategies of Teaching on Problem Solving (PS).
__________14. I was mentored and coached in Assessment on Information Literacy (IL).
__________15. I was mentored and coached in Assessment on Critical Thinking (CT).
__________16. I was mentored and coached in Assessment on Problem Solving (PS).
__________17. I managed my classroom properly.
__________18. I used localization and contextualization in my lesson.
__________19. I applied the enhanced Bloom’s Taxonomy (Krathwohl and Anderson)
__________20. I used appropriate instructional materials.
__________21. I conducted intervention to improve my learners’ performance.
__________22. I was trained about Embedded Learning.
__________23. I practice Peer Teaching with my co-teachers.
__________24. I practice Walkthrough.
__________25. I have undergone mentoring with my co-teachers.
__________26. I joined school conferencing.
__________27. I joined the school LAC Sessions.
__________28. I joined the Study Group.
__________29. I have done an Action Research.
__________30. I have done a case study.
__________31. I have compiled my DLL.
__________32. The number of DLL that I have taught is _________________.
__________33. The number of my DLL that was checked is_______________.
__________34. The number of DLL that I was delivered as scheduled is_________.
__________35. I have instructional material in a form of worksheet/workbook.
__________36. I have instructional material in a form of Video clips.
__________37. I have instructional material in a form of Power point presentation.
__________38. I have instructional material in a form of Documentary films.
__________39. I provide handouts/Syllabi to my learners.
__________40. I have learners’ materials in my classroom.
__________41. I have teacher’s guide of the subjects I taught in my possession.
__________42. I used supplementary materials such as Reference books, Dictionaries, Encyclopedia, Atlas, etc.
__________43. I have an assessment tool with TOS.
__________44. I have conducted pre-assessment test and recorded the result.
__________45. I have conducted post-assessment test and compared the results with the pre-assessment.
__________46. I have a compilation of summative test.
__________47. I have a compilation of Periodical Tests with TOS.
__________48. I have accomplished my DLL Reflections.
__________49. I have contextualized my lesson plans per learning area and per Grade Level.
__________50. The number of my contextualized lesson plan is ________________.
__________51. I have contextualized my instructional materials.
__________52. The number of my contextualized instructional materials is___________.
__________53. I contextualized my assessment tool.
__________54. The number of my contextualized assessment tool is__________.
__________55. I have my formative test notebook.
__________56. I have summative test with TOS in all of my learning areas I taught.
__________57. I have my quarterly assessment with TOS in all of the learning areas I taught.
__________58. I have a separate class record for formative and summative assessment.
__________59. I submitted grading sheets quarterly to the school principal.
__________60. I have the result of Item analysis of quarterly exam submitted to the school principal.
__________61. I have identified the least mastered skills of quarterly exams in learning areas I thought.
__________62. I have compilation of appropriate assessment tool to address least mastered skills in all learning areas.
__________63. I have List of recipient learners for remediation per learning area per grade level.
__________64. I have quarterly progress report of recipient learners for remediation.
__________65. I have conducted school research which improve learners’ performance.
__________66. The number of school research which improve the learners’ performance I conducted is___________.
__________67. I have replicated, utilized, adopted school research.
__________68. The number of school research I replicated, utilized and adopted is____________
__________69. I have implemented action research per learning area.
__________70. The number of action research I implemented is____________.

Scored by:_______________________________ NOTED: __________________________________