READINESS CHECKLIST FOR LEARNERS & PARENTS/GUARDIANS

OF ___________________ ELEMENTARY SCHOOL

This checklist will allow the teacher/School Head to look into factors that might affect the
implementation of Modular Distance Learning. More importantly, it should inform their interventions to
make them more targeted.
Check the space that corresponds to your answer.
Name of Parent/Guardian: __________________________________________________________
Name/s of Child/ren: ________________________________________________________________
FOR THE LEARNERS: Fully Partially Not Yet
Ready Ready Ready

1. Psychosocial preparedness for the opening of classes?

2. Health status?

3. Reading level?

4. Level of learning independence?

5. Learning environment in terms of study space, home

conditions and immediate environment, including
Knowledge Corners with ELLN learning resources for
Kindergarten to Grade 6 and Family TEEPS-SCOPE for
Grades 1-6 and Gulayan sa Tahanan for SBFP recipients
and Grades 4-6?

6. Learning resources including Brigada Pagbasa materials?

Observations/Remarks:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
FOR THE PARENTS: Fully Partially Not Yet
Ready Ready Ready

1. Psychosocial preparedness for the opening of classes?

2. Health status?

3. Confidence level to guide/support the learning of their

child/ward?

4. Time available to guide/support the learning of their

child/ward?

5. Reading level?

6. Learning support resources such as materials, devices,

internet access?

7. Home conditions and immediate environment?

Observations/Remarks:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Verified by:

____________________
Class Teacher-Adviser
Noted:

GEOFFREY T. UNIDA
Head Teacher I