INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR) PLANNING AND TARGET

SETTING FORM FOR TEACHER I-III

Name of Employee: SACAY, ARLENE R. Name of Rater: CUARESMA, FENELIA M
Position: TEACHER III Position: MASTER TEACHER I
School/Division: MALALAG CENTRAL ELEMENTARY SCHOOL SPED CENTER Date of Review: September 8, 2023
Rating Period: SY: 2023-2024

PERFORMANCE INDICATOR
MFO KRAS OBJECTIVE TARGET QET
Outstanding Very Satisfactory Satisfactory Unsatisfactory Poor
(5) (4) (3) (2) (1)
1: Content 1. Applied To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated
Knowledge knowledge of Level 6 in Objective 1 Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
BASIC EDUCATION SERVICES

and content within as shown in COT Objective 1 as Objective 1 as Objective 1 as Objective 1 as Objective 1 as
Pedagogy and across rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
rating sheets /

Quality
curriculum observer agreement rating sheets / rating sheets / rating sheets / rating sheets /
teaching areas. forms inter-observer inter-observer inter-observer inter-observer inter-observer
agreement forms
(PPST 1.1.2) agreement forms agreement forms agreement forms agreement forms
or
No acceptable
evidence was
shown
Objective was met Objective was No acceptable
Efficiency
within the allotted met but evidence was
time instruction shown
exceeded the
allotted time

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2. Used a range To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated
of teaching Level 6 in Objective Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
strategies that 2 as shown in COT Objective 2 as Objective 2 as Objective 2 as Objective 2 as Objective 2 as
enhance learner rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
achievement in rating sheets /

Quality
observer agreement rating sheets / rating sheets / rating sheets / rating sheets /
literacy and forms inter-observer inter-observer inter-observer inter-observer inter-observer
numeracy skills. agreement forms
agreement forms agreement forms agreement forms agreement forms
(PPST 1.4.2) or
No acceptable
evidence was
shown
Objective was met Objective was No acceptable

Efficiency
within the allotted met but evidence was
time instruction shown
exceeded the
allotted time
3. Applied a To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated
range of teaching Level 6 in Objective Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
strategies to 3 as shown in COT Objective 3 as Objective 3 as Objective 3 as Objective 3 as Objective 3 as
develop critical rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
and creative observer agreement rating sheets / rating sheets / rating sheets / rating sheets / rating sheets /
thinking, as well inter-observer

Quality
forms inter-observer inter-observer inter-observer inter-observer
as other higher- agreement forms
agreement forms agreement forms agreement forms agreement forms
order thinking
skills. or
(PPST 1.5.2)
No acceptable
evidence was
shown
Objective was met Objective was No acceptable
Efficiency

within the allotted met but evidence was

time instruction shown
exceeded the
allotted time

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 4. Displayed To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated
proficient use of Level 6 in Objective 4 Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
Mother Tongue, as shown in COT Objective 4 as Objective 4 as Objective 4 as Objective 4 as Objective 4 as
Filipino and rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
observer agreement rating sheets /

Quality
English to rating sheets / rating sheets / rating sheets / rating sheets /
facilitate forms inter-observer inter-observer inter-observer inter-observer inter-observer
teaching and agreement forms
agreement forms agreement forms agreement forms agreement forms
learning. (PPST or
1.6.2) No acceptable
evidence was
shown
Objective was met Objective was No acceptable
within the allotted met but evidence was

Efficiency
time instruction shown
exceeded the
allotted time

2: Learning 5. Established To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated

Environment safe and secure Level 6 in Objective Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
& Diversity learning 5 as shown in COT Objective 5 as Objective 5 as Objective 5 as Objective 5 as Objective 5 as
of Learners environments to rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
rating sheets /

Quality
enhance learning observer agreement rating sheets / rating sheets / rating sheets / rating sheets /
through the forms inter-observer inter-observer inter-observer inter-observer inter-observer
agreement forms
consistent agreement forms agreement forms agreement forms agreement forms
or
implementation
No acceptable
of policies,
evidence was
guidelines and
shown
procedures.
(PPST 2.1.2) Objective was met Objective was No acceptable
Efficiency

within the allotted met but evidence was

time instruction shown
exceeded the
allotted time

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6. Maintained To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated
learning Level 6 in Objective 6 Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
environments as shown in COT Objective 6 as Objective 6 as Objective 6 as Objective 6 as Objective 6 as
that promote rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
observer agreement rating sheets /

Quality
fairness, respect rating sheets / rating sheets / rating sheets / rating sheets /
and care to forms inter-observer inter-observer inter-observer inter-observer inter-observer
agreement forms
encourage agreement forms agreement forms agreement forms agreement forms
or
learning. (PPST
No acceptable
2.2.2)
evidence was
shown
Objective was met Objective was No acceptable
within the allotted met but evidence was

Efficiency
time instruction shown
exceeded the
allotted time

7. Established a To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated

learner-centered Level 6 in Objective 7 Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
culture by using as shown in COT Objective 7 as Objective 7 as Objective 7 as Objective 7 as Objective 7 as
teaching rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
observer agreement rating sheets /

Quality
strategies that rating sheets / rating sheets / rating sheets / rating sheets /
respond to their forms inter-observer inter-observer inter-observer inter-observer inter-observer
agreement forms
linguistic, agreement forms agreement forms agreement forms agreement forms
or
cultural,
No acceptable
socioeconomic
evidence was
and religious
shown
backgrounds.
(PPST 3.2.2) Objective was met Objective was No acceptable
Efficiency

within the allotted met but evidence was

time instruction shown
exceeded the
allotted time

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 8. Adapted and To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated
used culturally Level 6 in Objective 8 Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
appropriate as shown in COT Objective 8 as Objective 8 as Objective 8 as Objective 8 as Objective 8 as
teaching rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
strategies to observer agreement rating sheets / rating sheets / rating sheets / rating sheets / rating sheets /

Quality
address the forms inter-observer inter-observer inter-observer inter-observer inter-observer
needs of learners agreement
agreement forms agreement forms agreement forms agreement forms
from indigenous forms
groups. (PPST or
3.5.2) No acceptable
evidence was
shown
Objective was met Objective was No acceptable

Efficiency
within the allotted met evidence was
time but instruction shown
exceeded the
allotted time

3: 9. Set achievable To set learning Set learning Set learning Set learning Set learning No acceptable
Curriculum and appropriate outcomes were outcomes were outcomes were outcomes were outcomes were evidence was
and Planning learning achievable and achievable and achievable and achievable and not achievable shown
& outcomes that appropriate, and appropriate, and appropriate, and appropriate, and or appropriate,

Quality
Assessment are aligned with contribute to the led to the contributed to the are aligned with and were
and understanding of the attainment of the understanding of the learning partially aligned
learning
Reporting next related next related the next related competencies, as with the learning
competencies.
competency, as competency, as competency, as shown in the competencies, as
(PPST 4.2.2) shown in the shown in the MOV submitted.
shown in the shown in the
MOV submitted MOV submitted. MOV submitted. MOV submitted.
All of the learning Majority of the At least half of Less than half No acceptable
Majority of the outcomes set learning the learning of the learning evidence was
learning outcomes were aligned with outcomes set outcomes set outcomes set
set were aligned with shown
the learning were aligned with were aligned were aligned
the learning
Efficiency

competencies as the learning with the learning with the learning

competencies as shown in the competencies as competencies as competencies as
shown in the MOV submitted shown in the shown in the shown in the
MOV MOV submitted MOV submitted MOV submitted

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10. Used To demonstrate Demonstrated Demonstrated Demonstrated Demonstrated Demonstrated
strategies for Level 6 in Objective Level 7 in Level 6 in Level 5 in Level 4 in Level 3 in
providing timely, 10 as shown in COT Objective 10 as Objective 10 as Objective 10 as Objective 10 as Objective 10 as
accurate and rating sheets / inter- shown in COT shown in COT shown in COT shown in COT shown in COT
observer agreement rating sheets /

Quality
constructive rating sheets / rating sheets / rating sheets / rating sheets /
feedback to forms inter-observer inter-observer inter-observer inter-observer inter-observer
agreement forms
improve learner agreement forms agreement forms agreement forms agreement forms
or
performance.
No acceptable
(PPST 5.3.2)
evidence was
shown
Objective was met Objective was No acceptable
within the allotted met but evidence was

Efficiency
time instruction shown
exceeded the
allotted time

11. Utilized To develop materials Implemented a Developed Planned for a Analyzed No acceptable
assessment data based on learners’ teaching and materials based on teaching and learners’ evidence was
to inform the assessment data as learning strategy / learners’ learning strategy mastered skills shown
modification of evidenced by a program using assessment data and/or program based on the
teaching and list of identified least / materials based on as evidenced by a based on frequency of
most mastered skills learners’ list of identified learners’ errors and correct

Quality
learning practices
with supporting assessment data least / most assessment data responses as
and programs.
MOV No. 2 as evidenced by a mastered skills with as evidenced by evidenced by a
(PPST 5.5.2) list of identified supporting a list of identified list of identified
least / most MOV No. 2 least / most least / most
mastered skills with mastered skills mastered
To submit MOV/s supporting with supporting skills
showed utilization of MOV No. 1 MOV No. 3
assessment data
across 3 quarters Submitted MOV/s Submitted MOV/s Submitted MOV/s Submitted MOV/s No acceptable
showed utilization showed utilization showed showed evidence was
Timeliness

of assessment data of assessment data utilization of utilization of shown

across 4 across 3 quarters assessment data assessment data
quarters across 2 in only 1 quarter
quarters

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4: Personal 12. Build To sustain Sustained Sustained Secured Communicated No acceptable
Growth and relationships with engagement with engagement engagement with collaboration with and evidence was
Professional parents/ parents/guardians through regular parents/guardians with obtained shown
Development guardians and and/or wider school communication of and/or wider school parents/guardians response from
the wider school community learners’ needs, community and/or wider parents/guardians

Quality
community to to facilitate progress and to facilitate school community and/or wider
facilitate involvement in the achievement to key involvement in the to facilitate school community
involvement in educative process as educative process involvement in to facilitate
stakeholders,
the educative evidenced by 2 or as evidenced by 2 the educative involvement in
including parents/
process. (PPST more of MOV or more of MOV process as the educative
guardians, as evidenced by one process as
6.2.2) no. 1 or 2 no. 1 or 2
shown in the MOV MOV no. 1 or evidenced by
submitted 2 MOV No. 3
To show engagement
with arents/guardians Showed Showed Showed Showed No acceptable
and the wider school engagement with engagement with engagement with engagement with evidence was
community across 3 parents/guardians parents/guardians parents/guardians parents/guardians shown

Timeliness
quarters and the wider and the wider and the wider and the wider
school community school community school community school community
across 4 quarters across 3 quarters across 2 in only 1 quarter
quarters
13. Participated To participate in any Participated in Participated in Participated in Participated in No acceptable
in professional professional any professional any professional any professional any professional evidence was
networks to network/activity that network/activity network/activity network/activity network/activity shown
share requires output* that requires that requires that requires that does not
knowledge and and proof of output* and output* and output* to require output
to enhance implementation** proof of proof of share to share
practice. (PPST within the school to implementation* implementation** knowledge and knowledge and
Quality

7.3.2) share knowledge * within the within the to enhance to enhance

and to enhance school to share department/ practice as practice as
practice across 3 knowledge and to grade level to evidenced by evidenced by
quarters. enhance practice share knowledge the submitted the submitted
as evidenced by and to enhance MOV MOV
the submitted practice as
MOV evidenced by the
submitted MOV

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 Participated in Participated in Participated in Participated in No acceptable
professional professional professional professional evidence was
networks to share networks to share networks to networks to shown
knowledge and to knowledge and to share share

Timeliness
enhance practice enhance practice knowledge and knowledge and
across 4 across 3 to enhance to enhance
quarters quarters practice across practice in only
2 quarters 1 quarter
14. Developed a To discuss progress Updated Discussed Set professional Accomplished No acceptable
personal on professional professional progress on development the e-SAT at the evidence was
improvement development goals development professional goals based on beginning of the shown
with the rater during development goals e-SAT results as school year as

Quality
plan based on goals during Phase
reflection of the mid-year review II of the RPMS with the rater evidenced by evidenced by
as evidenced by Cycle as during the mid-year MOV 2 MOV 1
one’s practice
MOV 3 and submit 3 evidenced by review
and ongoing
acceptable MOVs MOV 4 as evidenced by
professional
accomplished within MOV 3
learning. (PPST the prescribed
7.4.2) Submitted 4 Submitted 3 Submitted 2 Submitted 1 No acceptable
RPMS Phase

Efficienc
acceptable MOVs acceptable MOVs acceptable acceptable MOV evidence was
MOVs shown

y
All four (4) Three (3) of the Two (2) of the Only one (1) of No acceptable
submitted MOVs submitted MOVs submitted MOVs the submitted evidence was
were were were MOVs was shown
Timeliness accomplished accomplished accomplished accomplished
within the within the within the within the
prescribed RPMS prescribed RPMS prescribed prescribed
Phase Phase RPMS Phase RPMS Phase

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 Submitted MOVs Submitted MOVs Submitted MOVs Submitted MOV/s No acceptable
were distributed were distributed were distributed was/were evidence was

Timeliness
across 4 quarters across 3 quarters across 2 completed in only shown
quarters 1 quarter

SACAY, ARLENE R. CUARESMA, FENELIA M. ERIEL L. NAPILA, P-1

Ratee Rater Approving Authority

PART II: COMPETENCIES

CORE BEHAVIORAL COMPETENCIES CORE SKILLS

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Self-Management
1 Sets personal goals and direction, needs and development.
2 Undertakes personal actions and behaviors that are clear and
purposive and takes into account personal goals and values
congruent to that of the organization.
3 Displays emotional maturity and enthusiasm for and is challenged by
higher goals.
4 Prioritizes work tasks and schedules (through Gantt charts,
checklists, etc.) to achieve goals.
5
Sets high quality, challenging, realistic goals for self and others.
Professionalism and Ethics
1 Demonstrates the values and behavior enshrined in the Norms of
Conduct and Ethical Standards for public officials and employees
(RA 6713).
2 Practices ethical and professional behavior and conduct taking into
account the impact of his/her actions and decisions.
3 Maintains a professional image: being trustworthy, regularity of
attendance and punctuality, good grooming and communication.
4 Makes personal sacrifices to meet organization’s needs.
5 Acts with a sense of urgency and responsibility to meet
organization’s needs, improve systems and help others improve their
effectiveness.
Result Focus
Achieves results with optimal use of time and resources most of the
1 solutions. Fosters new ideas, processes, and suggests better ways
time.
2 Avoids rework, mistakes and wastage through effective work
methods by placing organizational needs before personal needs.
3 Delivers error-free outputs most of the time by conforming to
standard operating procedures correctly and consistently. Able to
produce very satisfactory quality of work in terms of
usefulness/acceptability and completeness with no supervision
required.
4 Expresses a desire to do better and may express frustration at waste
or inefficiency. May focus on new or more precise ways of meeting
goals set.
5 Makes specific changes in the system or in own work methods to
improve performance. Examples may include doing something
better, faster, at a lower cost, more efficiently, or improving quality,
customer satisfaction, morale, without setting any specific goal.
Teamwork
1 Willingly does his/her share of responsibility.
Promotes collaboration and removes barriers to teamwork and
2 goal accomplishment across the organization.
3 Applies negotiation principles in arriving at win-win agreements.
4 Drives consensus and team ownership of decisions.
5 Works constructively and collaboratively with others and across
organizations to accomplish organizational goals and objectives.
Service
Orientation
Can explain and articulate organizational directions, issues and
1 Knows the different written business communication formats used in DepEd.
problems.
2 Takes personal responsibility for dealing with and/or correcting
customer service issues and concerns.
3 Initiates activities that promotes advocacy for men and women
empowerment.
4 Participates in updating of office vision, mission, mandates and
strategies based on DepEd strategies and directions.
5 Develops and adopts service improvement programs through
simplified procedures that will further enhance service delivery.
Innovation
1 Computer/ICT Skills
Examines the root cause of problems and suggests effective
to do things (cost and/or operational efficiency).
2
Demonstrates an ability to think “beyond the box”. Continuously
focuses on improving personal productivity to create higher value
and results.
3
Promotes a creative climate and inspires co-workers to develop
original ideas or solutions.
4 productivity, assists in conducting research and communicate through local and
Translates creative thinking into tangible changes and solutions
that improve the work unit and organization.
5 5
Uses ingenious methods to accomplish responsibilities.
Demonstrates resourcefulness and the ability to succeed with
minimal resources.
Oral Communication
1 Follows instruction accurately.
2 Expresses self clearly, fluently and accurately.
3 Uses appropriate medium for the message
4 Adjust communication styles to others.
5 Guides discussions between and among peers to meet an objective.
Written Communication
1
2
Writes routine correspondence/communications, narrative and descriptive repor
based on readily available information data with minimal spelling or grammatica
errors (e.g. memos, minutes, etc.)
3 Secures information from required references (i.e., Directories, schedules,
notices, instructions) for specific purposes.
4
Self-edits words, numbers, phonethic notation and content, if necessary.
5 Demonstrates clarity, fluency, impact, conciseness and effectiveness in his/her
written communications.
1
Prepares basic compositions (e.g., letters, reports, spreadsheets and graphics
presentation using Word Processing and Excel).
2
Identifies different computer parts, turns the computer on/off, and work on a
given task with acceptable speed and accuracy and connects computer
peripherals (e.g. printers, modems, multimedia projectors, etc.)
3 Prepares simple presentation using Powerpoint.
4
Utilizes technologies to: access information to enhance professional
global professional networks.
Recommends appropriate and updated technology to enhance productivity and
professional practice.
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 PART III: SUMMARY OF RATINGS FOR DISCUSSION
Final Performance Results Rating Adjectival Rating

Accomplishment of KRAs and Objectives

Rater-Ratee Agreement

The signatures below confirm that the employee and his/her superior have agreed on the contents of this appraisal form and the performance rating.

Name of Employee Name of Superior

Signature Signature

Date

PERFORMANCE MONITORING AND COACHING FORM

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 Critical Incidence
Impact on Job Action Plan
Description Output Signature of
Date
(Situation, Task &
(Result) (Outcome)
Action) (Reinforce/ Redirect) Ratee Rater

Prepared by : ______________________________

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 Resources Needed
Action Plan
Strengths Development Needs Timeline
(Recommended Developmental Intervention)

Feedback:
EMPLOYEE FEEDBACK FORM

Page 13 of 14
 PART IV: DEVELOPMENT PLANS
I, ARLENE R. SACAY, Teacher III, commit to deliver and agree to the rater on the attainment of the following Action Plan to address my development

needs in accordance with the indicated measures for the period August 2022-July 2023.

Action Plan
Strengths Development Needs (Recommended Developmental Timeline Resources Needed
Intervention)

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