I.

SCHOOL PROFILE/DATA -

Instruction: Please input required data/information in unshaded cells. Fill-in only the grade levels that are applicable to yo
community data from different sources. If you find it useful to lift data from other templates and transfer it here, you may
templates to this form.

1. CHILDREN HEALTH AND SAFETY

1.1 Vaccination status
D.4.1 Number of Vaccinated and NonVaccinated Learners for the current SY
VACCINATED
Level 1ST DOSE 2ND DOSE
Total Male Female Total Male Female
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Total
Percent of Total

D.4.2 Projects/interventions implemented in the previous SY causing increased in vaccination (insert new rows if neces
Project/intervention
 ANNEX 1A School-Community Data Template

/DATA - ADDITIONAL DATA

rade levels that are applicable to your school. This template aims to organize existing school and
plates and transfer it here, you may do so. Otherwise, you can just attach the other data

UNVACCINATED
BOOSTER
Total Male Female Total Male Female

accination (insert new rows if necessary)

Number of Children Covered
 II. SITUATION OF CHILDREN / LEARNERS: ACCESS - IN AND O
Instruction: Please input required data/information in unshaded cells. Fill-in only the age groups/grade levels that are app

1. CHILDREN ENROLLED IN SCHOOL [SRC.1.]

1.1. Learners with Special Education Needs (LSENs)
Mainstreamed
Classification/Types of Learners with
Special Educational Needs
Kinder G1 G2 G3 G4 G5 G6

With Diagnosis from Licensed Medical Specialist:

1. Visual Impairment
2. Hearing Impairment
3. Learning Disability
4. Intellectual Disability
5. Autism Spectrum Disorder
6. Emotional-Behavioral Disorder
7. Orthopedic/Physical Handicap
8. Speech/Language Disorder
9. Cerebral Palsy
10 . Special Health Problem / Chronic Disease
11. Multiple Disabilities
With Manifestation
1. Difficulty in Seeing
2. Difficulty in Hearing
3. Difficulty in Applying Knowledge
4. Difficulty in Remembering, Concentrating Paying Attention and Understanding
5. Difficulty in Performing Adaptive Skills
6. Difficulty in Displaying Interpersonal Behavior
7. Difficulty in Mobility (walking, climbing, grasping)
8. Difficulty in Communication
 ANNEX 1A School-Community Data Template

ACCESS - IN AND OUT OF SCHOOL (ADDITIONAL DATA)

grade levels that are applicable to your school.

Mainstreamed
Self- Non- Transition Grand Homebound Hospital Total
Contained Graded Program Total Bound
G7 G8 G9 G10 G11 G12
 III. SITUATION OF CHILDREN / LEARNERS - ADDITIONA
Instruction: Please input required data/information in unshaded cells. Fill-in only the grade levels that are applicable to you

1. LEARNERS NO LONGER PARTICIPATING IN THE LEARNING SESSIONS

1.1 Number of learners no longer participating in the learning sessions for the last three SYs
SY Before Previous SY: 2020-2021 Previous SY: 2021-2022
Level
Total Male Female Total Male
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
TOTAL

1.2 Number of learners no longer participating in the learning sessions by cause (insert new columns if necessary)

Total No. of
Number of Learners No Longer Participating in the Learnin
Level Dropouts
distance from home Other cause: Other cause:
(Current SY) Working
to school _________ _________

Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
TOTAL
Percent of Total

1.3 Projects/interventions implemented for learners no longer participating in the learning sessions

1.3.a Describe the nechanisms used by the school YES NO

- track attendance and identify learners no longer participating in the

learning sessions, and design remedies to keep them attending in the
learning activities?

- track teachers' attendance and ways of ensuring their regular presence

based on CSC policy?

1.4.b What are the interventions implemented for learners no longer participating in the learning sessions? Insert new row
if necessary.
 ANNEX 1A School-Community Data Template

NERS - ADDITIONAL DATA

s that are applicable to your school.

s SY: 2021-2022 Current SY: 2022-2023

Female Total Male Female

umns if necessary)
articipating in the Learning Sessions by Cause (Current SY)
Other cause: Other cause: Other cause: Other cause:
_________ _________ _________ _________
 If YES, please describe the mechanisms used by the school

g sessions? Insert new rows

Number of Children Covered
 IV. SITUATION OF CHILDREN / L
Instruction: Please input required data/information in u

1. GENERAL PERFORMNCE AVERAGE

1.1 Number of Learners achieving at least 80% GPA per subject for the last three SYs
Total SY Before Previous SY: 2020-2021
Level
Enrollment English Filipino Math
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10

Komunikasyon
Total at Pananaliksik
Level Oral Reading and
Enrollment sa Wika at
Communication Writing
Kulturang
Pilipino

Grade 11
SY: 2020-2021
SY: 2021-2022
SY: 2022-2023
Grade 12
SY: 2020-2021
SY: 2021-2022
SY: 2022-2023

1.2 Average GPA per subject for the last three SYs
SY Before Previous SY: 2020-2021
Level
English Filipino Math
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10

Komunikasyon
Level SY Oral Reading and at Pananaliksik
sa Wika at
Communication Writing
Kulturang
Pilipino

SY: 2020-2021
Grade 11 SY: 2021-2022
SY: 2022-2023
SY: 2020-2021
Grade 12 SY: 2021-2022
SY: 2022-2023

1.3 Projects/interventions implemented to improve academic performances of the learners (insert new rows if necessary)

2. Early Grade Reading Assessment (EGRA)

2.1 Number of Learners according to reading level during PRETEST
EGRA READING LEVEL
Total No. What Reading Level the learner belongs based on his/ results
Grade Level of
Learners NEEDS
VERY GOOD GOOD NEEDS PRACTICE
IMPROVEMENT

Grade 1
Grade 2
2.2 Number of Learners according to reading level during POST TEST
EGRA READING LEVEL
Total No. What Reading Level the learner belongs based on his/ results
Grade Level of
Learners NEEDS
VERY GOOD GOOD NEEDS PRACTICE
IMPROVEMENT

Grade 1
Grade 2

2.3 Projects/interventions implemented to improve reading skills of Grades 1 and 2 learners (insert new rows if necessary)

3. Early Childhood Care and Development (ECCD) Scaled Scores

3.1 Number of Kinder Learners according to scaled score during PRETEST

Total No. of Learners Total No. of Actual Takers

Domain

Male Female Total Male Female

Gross Motor
Fine Motor
Self-help
Receptive Language
Expressive Language
Cognitive
Socio-emotional
Total

3.2 Number of Kinder Learners according to scaled score during POST TEST
 Total No. of Learners Total No. of Actual Takers
Domain

Male Female Total Male Female

Gross Motor
Fine Motor
Self-help
Receptive Language
Expressive Language
Cognitive
Socio-emotional
Total

3.3 Projects/interventions implemented to kinder learners in the development of the different domains (insert new rows if
 ANNEX 1A

TION OF CHILDREN / LEARNERS: QUALITY - ADDITIONAL DATA

required data/information in unshaded cells. Fill-in only the grade levels that are applicable to your school.

ous SY: 2020-2021 Previous SY: 2021-2022

Science HEKASI English Filipino Math Science HEKASI

SENIOR HIGH SCHOOL CORE CURRICULUM SUBJECTS

Pagbasa at 21st Century

Pagsusuri ng Literature Contemporar Media and
Statistics Earth and
Iba’t-Ibang from the y Philippine Information General Math and Life
Teksto Tungo Philippines Arts from the
Literacy Probability Science
sa and the Regions
Pananaliksik World

ous SY: 2020-2021 Previous SY: 2021-2022

Science HEKASI English Filipino Math Science HEKASI
 SENIOR HIGH SCHOOL CORE CURRICULUM SUBJECTS

Pagbasa at 21st Century

Pagsusuri ng Literature Contemporar
Iba’t-Ibang from the y Philippine Media and Statistics Earth and
Information General Math and Life
Teksto Tungo Philippines Arts from the
Literacy Probability Science
sa and the Regions
Pananaliksik World

s (insert new rows if necessary)

Mode Of Conduct SLM/LAS Performan

What Performance did the learner show base
A B C D
TOTAL TOTAL
Face to Face Online/Media GPA Module VERY
Performance GOOD
 Mode Of Conduct SLM/LAS Performan
What Performance did the learner show base
A B C D
TOTAL TOTAL LAS outputs

Face to Face Online/Media GPA Module VERY

Performance GOOD

rs (insert new rows if necessary)

1-3 Suggest Significant delay in overall 4-6 Suggest slight delay in overall
of Actual Takers development in the domain must be development Domain in the domain
monitored after 3 months must be monitored after 6 months

Total Male Female Total Male Female Total

 1-3 Suggest Significant delay in overall 4-6 Suggest slight delay in overall
of Actual Takers development in the domain must be development Domain in the domain
monitored after 3 months must be monitored after 6 months

Total Male Female Total Male Female Total

rent domains (insert new rows if necessary)

 ANNEX 1A School-Community Data Template

school.

Current SY: 2022-2023

English Filipino Math Science HEKASI

Introduction
to the Physical
Physical Philosophy Education Personal
Science of the and Development
Human Health
Person

Current SY: 2022-2023

English Filipino Math Science HEKASI
 Introduction
to the Physical
Physical Philosophy Education Personal
Science of the and Development
Human Health
Person

SLM/LAS Performance
What Performance did the learner show based on his/her SLM/ GPA Profiling (MTB)
LAS outputs
NEEDS
TOTAL
NEEDS
GOOD PRACTICE
IMPROVEM 74 below 75-79 80-84 85-89 90-100
ENT
 SLM/LAS Performance
What Performance did the learner show based on his/her SLM/ GPA Profiling (MTB)
LAS outputs TOTAL
NEEDS NEEDS
GOOD PRACTICE
IMPROVEM 74 below 75-79 80-84 85-89 90-100
ENT

14 - 16 Suggest Slightly Advanced Suggest highly Advanced

7 - 13 Average overall development
development development

Male Female Total Male Female Total Male Female Total

 14 - 16 Suggest Slightly Advanced Suggest highly Advanced
7 - 13 Average overall development
development development

Male Female Total Male Female Total Male Female Total

TOTAL
TOTAL