Republic of the Philippines

Department of Education
Region III- Central Luzon
Schools Division of Bulacan
F. MENDOZA MEMORIAL ELEMENTARY SCHOL

SCHOOL CI PROJECT VALIDATION FORM

School: F. MENDOZA MEMORIAL ELEMENTARY SCHOOL Title of Project: E-CARE 3

School I.D.: 104804
School Head: FILIPINA P. YANGA Date of Validation: MARCH 7, 2017
Stage 1 :ASSESS Points Score
Step 1: Get Organized (10 points)
1.1 The CI Team
1.2 CI Organizational Chart
1.3 Background
1.4 Costumer and Stakeholders
1.5 Objectives of the project (Graph)
Total
Step 2: Talk and Build Relationship with Costumers (10pts)
2.1 Survey/ Question and Answer
2.2 Voice of the customer
2.3 Statements Lifted from the respondents
TOTAL
Step 3: Walk the Process (10pts)
3.1 SIPOC – Learning Process
3.2 Process Details
TOTAL
Step 4: Identify Priority Improvement Area
4.1 Problem Statement
4.2 improvement Area
TOTAL (10 Points)
Total Points for Stage 1
Stage 2 : ANALYZE
Step 5: Do Root Cause Analysis
5.1 Root Cause Analysis (Why-why Diagram)
5.2 Root Cause Validation
5.3 Priority Valid Causes
Total
Step 6: Develop Solutions
6.1. Objective Statement
6.2 Recommended Improvements
6.3 Develop / Pilot Solutions (Materials Used)
6.4 Step by Step Procedure of the Pilot Solution
6.4.1 Planning
6.4.2 Pre-Assessment
6.4.3 Implementation
6.4.4 Post Assessment
6. 5 Future State (SIPOC)
6.5.1 Future State (Process Details)
6.5.2 Future State (Flow Chart)
6.5.3 Comparison of the Current and Future State with
Improvement Highlights
Step 7: Finalize Improvement Plan
7.1 Potential Problem Analysis
7.2 Implementation Plan
Total Points for Stage 2
Stage 3 : ACT
8.1 Problem Analysis
8.2 Implementation Plan
Step 9 : Roll Out Solution (30 Points)
9.1 Scope and Implementation
9.2 Implementation Status
9.3 Stakeholders’ Analysis
Step 10 CHECK PROGRESS
10.1 Check Progress
10.2 Monitoring and Evaluation Report
10.3 Evaluate Progress and Report Based on the
Set
Target
10.4 Interview for the Result
Total Points for Stage 3
School CI Validation Form (Pls. see attached checklist)
1.Basic Background Information
2. CI Implementation Status
3. CI Organization
4. CI Documentation
5. CI Communication
6. CI Project
7. CI Event
8. CI Linkages and Network
9. Type of Validation Test Conducted
10. Result of Validation – Congruency of the CI Results
to the conducted validation
Total Points for School CI Validation
GRAND TOTAL (Stages1,2,3 & CIP Validation Form)

Certified true and Correct:

VALIDATING TEAM

Irene C. San Juan

Chairman

Anita C. Sabino Ma. Lourdes R. Salvador

Member Member
 Republic of the Philippines
Department of Education
Region III- Central Luzon
Schools Division of Bulacan
F. MENDOZA MEMORIAL ELEMENTARY SCHOOL

SCHOOL CI PROJECT VALIDATION FORM

School: ____________________________ Title of Project: ______________________________

School I.D.: _________________________________________________________
School Head: ________________________Date of Validation: ___________________________
Stage 1 :ASSESS Points Score
Step 1: Get Organized (10 points)
1.1 The CI Team 2
1.2 CI Organizational Chart 2
1.3 Background 2
1.4 Costumer and Stakeholders 2
1.5 Objectives of the project (Graph) 2
Total (10 Points)
Step 2: Talk and Build Relationship with Costumers (10pts)
2.1 Survey/ Question and Answer 4
2.2 Voice of the customer 3
2.3 Statements Lifted from the respondents 3
TOTAL (10 Points)
Step 3: Walk the Process (10pts)
3.1 SIPOC – Learning Process 5
3.2 Process Details 5
TOTAL (10 Points)
Step 4: Identify Priority Improvement Area
4.1 Problem Statement 5
4.2 improvement Area 5
TOTAL (10 Points)
Total Points for Stage 1 ( 30 Points)
Stage 2 : ANALYZE
Step 5: Do Root Cause Analysis
5.1 Root Cause Analysis (Why-why Diagram) 4
5.2 Root Cause Validation 3
5.3 Priority Valid Causes 3
Total (10 Points)
Step 6: Develop Solutions
6.1. Objective Statement 1
6.2 Recommended Improvements 1
6.3 Develop / Pilot Solutions (Materials Used) 2
6.4 Step by Step Procedure of the Pilot Solution 4
6.4.1 Planning
6.4.2 Pre-Assessment
6.4.3 Implementation
6.4.4 Post Assessment
6. 5 Future State (SIPOC) 2
6.5.1 Future State (Process Details)
6.5.2 Future State (Flow Chart)
6.5.3 Comparison of the Current and Future State with
Improvement Highlights
Step 7: Finalize Improvement Plan
7.1 Potential Problem Analysis 5
7.2 Implementation Plan 5
Total Points for Stage 2 (30 Points)
Stage 3 : ACT
8.1 Problem Analysis 5
8.2 Implementation Plan 5
Step 9 : Roll Out Solution (30 Points)
9.1 Scope and Implementation 3
9.2 Implementation Status 4
9.3 Stakeholders’ Analysis 3
Step 10 CHECK PROGRESS
10.1 Check Progress 2
10.2 Monitoring and Evaluation Report 2
10.3 Evaluate Progress and Report Based on the 2
Set
Target
10.4 Interview for the Result 4
Total Points for Stage 3 (30 Points)
School CI Validation Form (Pls. see attached checklist)
1.Basic Background Information
2. CI Implementation Status
3. CI Organization
4. CI Documentation
5. CI Communication
6. CI Project
7. CI Event
8. CI Linkages and Network
9. Type of Validation Test Conducted
10. Result of Validation – Congruency of the CI Results
to the conducted validation
Total Points for School CI Validation (10 Points)
GRAND TOTAL (Stages1,2,3 & CIP Validation Form) (100 Points)

Certified true and Correct:

VALIDATING TEAM

Irene C. San Juan

Chairman

Anita C. Sabino Ma. Lourdes R. Salvador

Member Member