Republic of the Philippines

Department of Education
REGION IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA CITY
SAN ROQUE ELEMENTARY SCHOOL
Zamboanga city

LDM FEEDBACK RECORD

Name of Teacher:________________ Grade Level & Section: VI-B

Subject: Science No. of Pupils: Male ____ Female _____ Total _____`
No. of Pupils with feedback: Male __1__ Female __2__Total ___3_ Time: __________ Date:___________

Date/Time Name of Student Type of Issues/ Concern Action Taken Challenges/Problems

October -7-2020 Feedback ( by Teachers ) /Needs
(TI,PI,SI) (Consultation Period)
8:31-8:59 Robin Padilla PI Task/Procedure Activity *simplified/explained /clarified *Difficulty of parents to facilitate
*unclear procedure the procedure learning
9:00-9:20 Joy Wee SI Diagram is unclear Elaborated the meaning of the -unclear printing of diagram
diagram
9:35-9:55 Anna Fox TI Falling below exp. Attempted calls/texts cannot be reached always
Date/ Time - refers to the actual time of engagement between home and school.
Students - refers to the actual students involved during the consultation period. The minimum recommended number of students for consultation per class is 3.
Type of Feedback : Parent Initiated (PI); Teacher initiated (TI), Student Initiated (SI)
Consultation Time : minimum of 3 students per class.
Issues/ Concerns- are items that are raised by the parent/guardian/student or by the teacher which are related to the teaching-learning process.
Action Taken- immediate solution/intervention provided by the teacher in response to the issues/concerns raised.
Challenges/Problems/Needs - are the identified gaps observed in the overall conduct of the consultation period.

CONSOLIDATED FEEDBACK RECORD

San Roque, Zamboanga City

Tel No.: 985-0908
 Republic of the Philippines
Department of Education
REGION IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA CITY
SAN ROQUE ELEMENTARY SCHOOL
Zamboanga city

Grade Level : VI__________________

Subject : Science Date: __________

Name of Teacher No of No. of students Type of No. of students Challenges Priority

Students in with Feedback Feedback with Feedback Level for TA
Class
50-VI-A 3 PI 5- 33% Communication 9/15= 60% HP
Emerald Fernando 50-VI-B 2 TI 10- 66.6% Availability of Capslet 2/15= 13.3 % P2
50-VI-V 5 SI 0- 0% Parents inability to P1
facilitate learning 4/15 = 26.6%

PI-3
Teacher B 50 15 TI-8
SI-4

Teacher C

Feedback - in this form refers to any form of communication that happen between the school and the home.
No of students with feedback- refers to the number of students the teacher was able to communicate at a given period of time (PI, TI, or SI)
Priority Level for TA - refers to the categorization of the importance/impact of the challenge/s based on the report/issues/concerns raised by the
parents/students or as observed by the teacher . The categorization is assigned as HP, P1, P2 etc. High priority (HP) are issues considered critical and
requiring immediate action/intervention/attention; they are considered crucial to the overall flow of the process. Succeeding challenges are
categorized by rank .
Technical Assistance by School Head (TA by SH) column is to be filled up by SH for his/her appropriate provision of technical assistance/intervention.

San Roque, Zamboanga City

Tel No.: 985-0908