DOH - SPMS Form 3

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

I, John Vanne D. Samillano, RMT, of the Regional Office VI - DOH assigned at Maayon, Capiz, commit to
deliver and agree to be rated on the attainment of the following targets in accordance with the indicated
measures for the period January to June 2016.

JOHN VANNE D. SAMILLANO, RMT Date:

Approved By: Date
Joeffry M. Espiritu
Name of Supervisor
5 – Outstanding
4 – Very Satisfactory
3 – Satisfactory
2 - Unsatisfactory
1 - Poor

SUCCESS INDICATOR RATING

Remar
Output (Targets + Actual Accomplishment EFF QLY T
Measure) A (4) ks
(1) (2) (3)

85% of Pregnant women tested for

Hemoglobin and Hematocrit
Determination, Blood Typing,
Urinalysis, Hepatitis B Surface
0.00
Antigen Detection, Test for Syphilis
as ordered by MHO/PHN/RHM for
their Health Assessment. Results
released within 2 hours.

85% of the actual patients tested for

Urinalysis as ordered by the MHO in
the facility for their Health
0.00
Assessment. Results released
within 2 hours upon arrival at the
facility.

85% of the actual patients tested for

Complete Blood Count and Platelet
Performs Count (CBC-APC) as ordered by the
laboratory MHO in the facility for their Health #DIV/0!
examinations Assessment. Results released
within 2 hours upon arrival at the
facility.

85% of the actual patients tested for

Fecalysis as ordered by MHO in the
facility for their Health Assessment. #DIV/0!
Results released within 2 hours
upon arrival at the facility.
 85% of the actual patients tested for
Random/Fasting Blood Sugar
Measurement, Cholesterol
Measurement, Uric Acid #DIV/0!
Measurement as ordered by MHO in
the facility. Results served within 2
hours upon arrival at the facility.

Prepares Narrative Accomplishment Report

analyses and on laboratory examinations done
#DIV/0!
submit every month. Report submitted
reports before the end of the month.

Reflected logbook based entries of

Daily Time
100% of working days within the #DIV/0!
Records
month concerned.

Attendance to Reports to station within 8am-5pm

#DIV/0!
Station as scheduled.

Maintained all laboratory

Maintenance of
equipments in good working
laboratory #DIV/0!
equipment condition, ensured all available
controls are run.

Meeting with (Number) of monthly meetings with

#DIV/0!
DMO/MHO DMO/MHO attended.

Total Overall Rating #DIV/0!

Final Average Rating #DIV/0!

Adjectival Rating

Comments and Recommendation for Development Purposes

Discussed
Assessed by: Date Final Rating by: Date
With:
 I certify that I discussed my
assessment of the
John Vanne perfomance with the
D. Samillano, employee
RMT
Joeffry
M. Espiritu
Employee Supervisor Next Higher Supervisor

Legend: 1- Quantity 2 -Quality 3 - Timeliness 4 - Average