R epublic of the P hilippines

D epartment of Education
REG IO N IV-A CALABARZO N
CITY SCH O O LS D IVISIO N O F TH E CITY O F TAYABAS

ANNEX B

LAC PLAN APPRAISAL TOOL

(For assigned LAC Monitor to accomplish)

Date: __________________________________________________________
Name of School: _________________________________________________
Plan coverage:
Start date: _______________________________________________
End date: ________________________________________________

Scale description:
1 Very Dissatisfied
2 Dissatisfied
3 Neutral
4 Satisfied
5 Very Satisfied

Please indicate whether each description presented in the table below is satisfactory:

Description 1 2 3 4 5 Remarks
1. Relevance – The LAC Plan
presented is relevant on the
current and future needs of
the target group. The Plan
complies to the LAC policy
and theoretical framework.
2. Timeliness – The LAC
Plan addresses key
challenges in a timely
manner.
3. Evidence-based – The
LAC Plan is based on
primary and secondary
data, both qualitative and
quantitative form. Main
reference of the evidence
are needs assessment,
DepEd generated
data/reports, etc.
 Office of the Schools Division Superintendent Page 2 of 6

4. Budget – The LAC Plan

budget is appropriate and
justifiable based on the
approved/agreed activities
and budget and expenditure
guidelines.
5. Strategic – Prioritization of
activities or agenda in the
LAC Plan is strategic.
6. Collaborative – The LAC
Plan is a collaborative plan
created by the core
planning team.
7. Inclusiveness – The LAC
Plan is inclusive and does
not promote any
inconvenience to
marginalized groups.
Moreover, the plan is
gender sensitive.
8. Overall Rating

Recommendations:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Evaluated by:

_________________________________
Signature over printed name
Date:
 R epublic of the P hilippines
D epartment of Education
REG IO N IV-A CALABARZO N
CITY SCH O O LS D IVISIO N O F TH E CITY O F TAYABAS

Annex A

LAC Implementation Plan Template

Learning Goals
(Skills/Competencies)
Learning Group Members

Topic Objectiv Learning Key Material Fund/ Date Time Date Success Means of
es Facilitat Activiti s/ Sourc (Planne (Planne and Indicato Verification
or es Resourc e d d Time rs
es Needs (Actua
l)
 R epublic of the P hilippines
D epartment of Education
REG IO N IV-A CALABARZO N
CITY SCH O O LS D IVISIO N O F TH E CITY O F TAYABAS

ANNEX C

LAC SESSION EVALUATION TOOL

(For LAC Members and School Head to accomplish

Name of Facilitator: _______________________________

Sex: _____________________________________________
Position: _________________________________________
Designation: ______________________________________
Disability: ________________________________________
Ethnic Group: ____________________________________

Scale Description:
1 Observed 0% to 20% of the time;
2 Observed 21% to 40% of the time;
3 Observed 41% to 60% of the time;
4 Observed 61% to 80% of the time;
5 Observed 81% to 100% of the time;
Please indicate whether each description presented in the table below is satisfactory:

Description 1 2 3 4 5 Remarks
1. Introduction procedures
were appropriate
2. Topic was clearly defined
3. Instructions were clear and
appropriate
4. Presentation flow is
chronological and
systematic
5. Effective use of verbal and
non-verbal communication
6. Mastery of content
7. Evidence of ICT integration
8. Established rapport, warm,
and friendly atmosphere
9. Overall Rating
 R epublic of the P hilippines
D epartment of Education
REG IO N IV-A CALABARZO N
CITY SCH O O LS D IVISIO N O F TH E CITY O F TAYABAS

ANNEX D

LAC DOCUMENTATION TOOL

(For the assigned documenter to accomplish)
Date: _________________________________________________
Venue: ________________________________________________
Start time: _____________________________________________
End time: ______________________________________________
Attendees:
Name Designation/Position LAC Role

Objectives:
a.
b.
c.
Topics:
a.
b.
c.

LAC Proper: (Must include agreements from the previous LAC, presentation of monitoring
and evaluation results and areas for plan adjustment)
Topic/Agenda/Major points Discussions/Agreements/Next Steps

Documented by:

_____________________________________
Signature over printed name
Date:
 R epublic of the P hilippines
D epartment of Education
REG IO N IV-A CALABARZO N
CITY SCH O O LS D IVISIO N O F TH E CITY O F TAYABAS

ANNEX E

LAC REFLECTION JOURNAL

Date: _____________________________________________
Name: ____________________________________________
Position: __________________________________________
Designation: _______________________________________
Sex: _____________________
Age: _____________________

Reflections:
Individual Actionable Agreements from Reflection
LAC Session
a. Key Takeaways

b. Challenges

c. Suggestions for Improvement

Overall Impression:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________