SURIGAO DEL SUR STATE UNIVERSITY

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM

For the Period January to June, 2021

EMPLOYEE JOELINA V. MILLORIN AGENCY:

POSITION CLINIC STAFF UNIT:
Part I
Weight % Output Success Indicator Actual Accomplishment
100% CORE FUNCTIONS
95% inspected the cleanlines and 95% inspected the cleanlines and
Inspect for cleanlines and sanitation of school
30% sanitation of school premises with in 8 sanitation of school premises with in 8
premises hours hours

Monitor vital signs and blood pressure taking to 95% monitored vital signs, and blood 95% monitored vital signs, and blood
30%
faculty, staff and students pressure taking with in 8 hours pressure taking with in 8 hours

Ø Encode and update patients data and individual 90% updated patients data and 95% updated patients data and
20%
records individual records with in 8 hours individual records with in 8 hours

100% assisted thenurse and doctors 95% assisted thenurse and doctors on
10% Ø  Assist nurse and doctor on first aid treatment
on first aid treatment first aid treatment

90% does other heath related services 90% does other heath related services
10% Ø  Does other health related services
with in 8 hours with in 8 hours

Total Equivalent Point Score

Multiplyby Percentage Weight Allocation 70%
Weihted Average Score (WAS)
WE DISCUSS AND AGREE ON THE ABOVE TARGETS Legend PMT ACTION
Q - Quantity
ELDEZINNA C. ONDONA RN,MAN JOELINA V. MILLORIN E - Efficiency FLORIFE O. URBIZTONDO, DPA
RATER RATEE VP for ADMIN & FINANCE
T - Timeliness
A - Average
RM

SURIGAO DEL SUR STATE UNIVERSITY

CLINIC

RATING
Q1 E2 T3 A4

5 4 4 4.3

4 4 4 4.0

5 4 4 4.3

5 4 5 4.7

5 4 4 4.3

4.33
ght Allocation 70%

ZTONDO, DPA NEMESIO G. LOAYON, Ph.D.

& FINANCE Campus Director, Tandag

EMPLOYEE
POSITION
Part II
CRITICAL FACTORS
1. COURTESY
2. HUMAN RELATIONS
3. PUNCTUALITY AND ATTENDANCE
4. INITIATIVE
5. STRESS TOLERANCE
6. READINESS OF SERVICE
7. CLEANLINESS AND ORDERLINESS OF
WORKS AREAS
8. GROOMING AND APPEARANCE
9. OTHERS Professionalism
SURIGAO DEL SUR STATE UNIVERSITY
INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM
For the Period January to June, 2021
JOELINA V. MILLORIN AGENCY:
CLINIC STAFF UNIT:
RATING
SUPERVISOR
Polite, kind thoughtful behavior fowards the public/clientele Rater
manners of speech & Actuation
4
Integrates concern for people at work, office clientele &
Supervisor subordinate relationship into work situations.
Supervisor Rater
4
Observe behavior of coming to office on time or to be present
at work to complete assigned responsibilities. 4
FINAL NUMERICAL PERFORMANCE RATING
Starts Action, projects, and performs assigned tasks without
being told and under minimal supervision 4
Stability of performance under pressure or opposition. 5 EQUIVALENT ADJECTIVAL RATING______________
Is he/ she always at his station: punctual; not engaging in
unofficial matters like chatting, eating telephoning etc. while
the client is waiting or watching. 5
Is his/ her work area cleaned of unsightly items, clean WE DISCUSS AND AGREE ON THE ABOVE RA
organizations or orderly. 4
ELDEZINNA C. ONDONA RN,MAN
Does he/her present a neat and presentable appearance, RATER
swears proper uniform/ attire and ID
5
4 COMMENTS AND RECOMMENDATIONS:
Total Point Scores
divide by# of Entries
Average Point Score 4.33
Muliply by Part II weight (30% )
Weighted Average Score
EW FORM

SURIGAO DEL SUR STATE UNIVERSITY

CLINIC

SUMMARY OF RATINGS
Weighted Ave. Score Over all
Part 1 Part 2 PointScore

4.33 4.33 4.33

ERICAL PERFORMANCE RATING 4.34

ADJECTIVAL RATING__________________________________________

S AND AGREE ON THE ABOVE RATINGS:

A C. ONDONA RN,MAN JOELINA V. MILLORIN

RATEE

AND RECOMMENDATIONS: