DOH - SPMS Form 3

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)
I,BERNARDO MACARUBBO, of the CAGAYAN VALLEY MEDICAL CENTER, 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, 2018
Name of Employee: BERNARDO MACARUBBO Date: 7/5/2018

Approved By: ROCHELLE C. NARAG,RN,MSN Date: 7/5/2018

 Name of Supervisor    
  5 – Outstanding
4 – Very Satisfactory
3 – Satisfactory
2 - Unsatisfactory
1 - Poor

Success indicator RATING

Output Actual Accomplishment Q E T A Remarks
(Target + Measure)
(1) (2) (3) (4)

95% of planned activities are efficiently and effectively

implemented within the allotted time
CORE

100% excellently supervises nursing staff in performing

quality nursing care regularly CORE

Better Health Outcomes 100% availability of medical/ surgical supplies and equipment
in the clinical area are efficiently and effectively facilitated
CORE

All required Nursing Reports are completely and accurately

accomplished and submitted on scheduled time
CORE

100% efficiently and effectively performs other functions as

directed
SUPPORT
95% of recommended / trained nursing staff re-echoes and
applies comprehensively and effectively the trainings
attended CORE
Human Resource Training &
Development Services All general assemblies, unit meetings , seminars, trainings
and other hospital activities were attended with no tardiness CORE
recorded
RATING
Total Overall Rating              
Final Average Rating                    
Adjectival Rating                       
Comments and Recommendation for Development Purposes
Discussed With: Assessed by: Date Final Rating by: Date
I certify that I discussed my assessment of the performance with the
employee
BASILISA M. HAMLIG, RN, MSN
BERNARDO MACARUBBO
ROCHELLE C. NARAG, RN,MSN

Employee Supervisor Next Higher Supervisor

Legend: 1- Quality 2 -Efficiency 3 - Timeliness 4 - Average
                      DOH - SPMS Form 3
INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)
I,VICTORINO CONSTANTINO, of the CAGAYAN VALLEY MEDICAL CENTER, 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, 2018
Name of Employee: VICTORINO CONSTANTINO Date: 7/5/2018

Approved By: ROCHELLE C. NARAG,RN,MSN Date: 7/5/2018

 Name of Supervisor    
  5 – Outstanding
4 – Very Satisfactory
3 – Satisfactory
2 - Unsatisfactory
1 - Poor

Success indicator RATING

Output Actual Accomplishment Q E T A Remarks
(Target + Measure)
(1) (2) (3) (4)

95% of planned activities are efficiently and effectively

implemented within the allotted time
CORE

100% excellently supervises nursing staff in performing

quality nursing care regularly CORE

Better Health Outcomes 100% availability of medical/ surgical supplies and equipment
in the clinical area are efficiently and effectively facilitated
CORE

All required Nursing Reports are completely and accurately

accomplished and submitted on scheduled time
CORE

100% efficiently and effectively performs other functions as

directed
SUPPORT
95% of recommended / trained nursing staff re-echoes and
applies comprehensively and effectively the trainings
attended CORE
Human Resource Training &
Development Services All general assemblies, unit meetings , seminars, trainings
and other hospital activities were attended with no tardiness CORE
recorded
RATING
Total Overall Rating              
Final Average Rating                    
Adjectival Rating                       
Comments and Recommendation for Development Purposes
Discussed With: Assessed by: Date Final Rating by: Date
I certify that I discussed my assessment of the performance with the
employee
BASILISA M. HAMLIG, RN, MSN
VICTORINO COSTANTINO
ROCHELLE C. NARAG, RN,MSN

Employee Supervisor Next Higher Supervisor

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