Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN
Lingayen, Pangasinan

Mid-Year Assessment Checklist- Feb. 7, 2023 End Year Assessment:_________

(August 22, 2022- February 3, 2023)
Name of Teacher: __MERNA S. SANCHEZ_________________
Position: _Teacher III_________________________

Evident/
Not
Checklist Evident/No Remarks
t
Concerned
1.Daily Lesson Log (DLL)/Daily Lesson Plan (DLP) Evident
2. Individual Learner’s Monitoring Plan (ILMP) Evident
3.* Learners’ Anecdotal Record Evident
* Learners’ Profile
4. Record of Learners’ Attendance Evident
st
5. List of Instructional Materials prepared during the 1 Evident
& 2nd quarters with presentation of the IMs output
6.Form 138/SF9- Report Card-1st & 2nd grading with Evident
parent’s signature and approved Grading sheets
7.Form 137/SF 10-Permanent Record (properly filed in Evident .
folder with birth certificates)
8. Result of Periodic/Quarter Test- 1st and 2nd quarters Evident
*Test Questions/Items- District & School Initiated
* BOW &Table of Specification- file copy
9. Copy of Class Observations/ Evident
Copy of School Head Monitoring Form (SHMF) with
DLL/DLP, Photo documentation

10. Approved Class & Teachers’ Program Evident

11. *Reading Test Results Evident
*Numeracy Test Results
* Reading and Numeracy Tools used
*Interventions Programs and Activities
*Schedule of Remedial/Enhancement/Enrichment
Programs
12. School -Based Feeding Program (SBFP) Liquidation SBFP Feeding Teacher
Reports
* Records of SBFP distribution of Food Packs
13. School Records duly updated, Records of SF9/Form School Record Officer
137 released
14. Early Childhood Care and Development (ECCD) Kindergarten Teachers
and Birth Certificates
15. WINS/Learners and Teachers’ Vaccination Report School Health Focal
and other Health Reports submitted -School File Copy Person

16. Pantawid Pamilyang Pilipino Program (4 Ps) Report Teacher In-Charge of 4

School File Copy P’s
17. Learning Resources Management and Development School LRMDS Focal
System (LRMDS) Person
 Republic of the Philippines
Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN
Lingayen, Pangasinan

18. School Forms (SF1, SF2, SF3, SF 4) Evident *SF 1, 2 & 3-Advisers
*SF4 per Grade
Consolidation-Grade
Chairman

*Teacher In-Charge of
* *School Form 4 -School Consolidation-(School Consolidation
Receiving Copy)
19. Number and Percentage (%) of Registered Boy and Kid Scout
Girls Scouts. Kab Scout
**Registered Scout Leaders Boy Scout

Age Level -Boys Number and % (per level)

KID Scouts Twinkler
KAB Scouts
Boy Scouts Star Scout
**KID-Kabataang
Imumulat-Diwa (Children Junior Scout
to be introduced to
Virtues)
**KAB-Kabataang Alay
sa Bayan (Children
offered to the Nation)

Age Level- Girls

Twinkler Scouts Note: To be accomplished
Star Scouts by the leaders in-charge
Junior Girl Scouts per age level

**Sample Computation **Sample

# of registered Junior GS
# of registered scouts Grade IV, V & VI= 45
divided by the total divided by total enrolment
numbers of enrollment in of Girls-Grade IV-45
a specific age level Grade V -46
Grade VI-52
Total 143
(* 45/ 143= 31.47%)
What to write in the
above table?

*Junior Girl Scouts 45- 31.47%

**Leaders- 4 teachers

20.School Consolidated Reports School Testing

*Subject Area Coordinator/Focal Person must have a Coordinator
file copy and submit one copy to the School Testing
Coordinator for consolidation
21. DepEd Partnerships Data System (DPDS) School In-charge of
School File copies DPDS
22. School Inventory of Plant, Property and Equipment School Property
(PP & E) & NSBI etc. Custodian
 Republic of the Philippines
Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN
Lingayen, Pangasinan

23. Canteen Report Teacher In-Charge of

Canteen
24. *Signed School DRRM Plan School DRRM Focal
*School Contingency Plan Person
*NSED Quarterly Report
25.*Certificates of Completion for Teachers under
Induction Program for Beginning Teachers (IPBT)/
*Accomplished Coursebooks

Others
*COT 1-3rd quarter
*COT 2-4th quarter

Validated by:

______________CORALIE M. BANIQUED Ed. D_________________

School Head