I, RUDELINE V.

AZARCON, Nurse II of the Department of Education, Tandag City Division, commit to deliver and agree to be rat

DEPARTMENT OF EDUCATION
Location: Purok Narra, Tandurpas, Balilahan, Mabua, Tandag City
Rating Cycle: January 2023 to December 2023
TO BE FILLED DURING PLANNING
PERFORMANCE
WEIGHT PER INDICATORS
KRA 1 OBJECTIVES TIMELINE
KRA

1.1 Achieved
100%
9/9 assigned
coordination with
schools were
schools for the
coordinated for the
provision of AUGUST-
provision of needed
needed health DECEMBER 5%
health facilities,
facilities, 2023
medicines and
medicines and
supplies before the
supplies prior to
opening of classes
the opening of
classes

1.2 Provided JAN-DEC 5% 100% with

Treatment/ First 2023 identified ailments
aid Measure for were
simple and treated/referred to
common improve health
ailments to status
Clienteles as
need arises
 simple and treated/referred to
common improve health
ailments to status
Clienteles as
need arises

1.3 Measured
height and 100% of School
weight of AUGUST- children taken
school children DECEMBER 5% height and weight
and determined 2023 and Nutritional
their Nutritional status determined
Status
 1.4 Conducted
deworming
among
Kindergarten to
85%-90% school
Grade 12 JULY-DEC
5% children were
learners in 2023
dewormed
coordination
with CHO/
Barangay
health workers

1.5 Provided
assistance on Provided
Annual Assistance to 90%
Health Programs Examination of MAY 2023 5% of Teaching/Non-
and Services (65%) Teaching and Teaching
non Teaching personnel
personnel
 31/31 Conducted
1.6 Conduct training and
training and October- capacity
capacity
development for
December 5% development for
WINS 2023 WINS
implementers implementers to
all schools

1.7 Conducted
31/31 Conducted
monitoring/valid
monitoring/validati
ation on OMS JULY-DEC
5% on on OMS
(Online 2023
(Online Monitoring
Monitoring
System)
System)

1.8 Ensured the 9/9 Provided

provision of technical
Technical JAN-DEC assistance to
5%
assistance to 2023 assigned schools
assigned to reach the 3 Star
schools Approach
 provision of technical
Technical JAN-DEC assistance to
5%
assistance to 2023 assigned schools
assigned to reach the 3 Star
schools Approach

JAN-DEC 10% 9/9 conducted

2023 onsite validation/
monitoring of
handwashing
facilities, gender
1.9 Ensured a segregated toilets,
clean, safe menstrual hygiene
school management,
environment sanitation and
and correct waste
hygiene and management
sanitation
practices
among
learners.

1.10 Actual Number of

Conducted Teenage tracked
Monitoring/Trac and referred
king of
Teenage
Pregnancy and
referred for
Antenatal Care JAN-DEC 5%

100% needed
reports are
submitted in
Prepared and conformance to
Submitted the JAN-DEC 5% set standard
needed Reports
KRA 2

2.1 Implemented,
Evaluated and
Monitored 100% of
Sustainable Supplementary
Feeding Program JAN-DEC 10% Feeding Implemented,
to assigned evaluated and
Schools Identified monitored
with Feeding
Beneficiaries

Nutrition 2.2Monitored and

Programs and Evaluated the
Services (20%) Sustainability of
GPP in assigned
Schools, esp.
Schools Identified Monitored the
With SBFP JAN-DEC 10% sustainability of GPP
Benefeciaries in assigned schools

KRA 3

3.1 Sustained and

Sustained and
Strengthened
Linkages (5%) Linkages between strengthened linkages
JAN-DEC 5%
with partners and
education partners
stake holders
and stakeholders
 3.1 Sustained and
Sustained and
Strengthened
Linkages (5%) Linkages between strengthened linkages
JAN-DEC 5%
with partners and
education partners
stake holders
and stakeholders

KRA 4
Participated and
Acted on Activities
on Health and
Other Health
Related Work such
as:

a. Provided
assistance during
the medical/dental
mission at
Mahanon ES and
Telaje ES during
the oral health
month Participated and Acted
Special Services b. on Activities on Health
(10%) Conducted JAN-DEC 10%
and Other Health
assistance on Related Work
medical
examination for
athletes for CRISC,
and other
tournament.
c.
Served as first-
aider during CRISC
2022 and ALS
Sports Fest 2022

d.
Provided
assistance on
Pediatric COVID19
TOTAL SCORE

* To get the score, the rating is

multiplied by the weight assigned by
the weight assigned
 * To get the score, the rating is
multiplied by the weight assigned by
the weight assigned

SUMMARY OF
Weight
RATING:
KRA 1- HEALTH
PROGRAM AND
SERVICES
KRA 2- NUTRITION 65%
PROGRAM AND
SERVICES 20%

KRA 3-LINKAGES 5%

KRA 4- SPECIAL SERVICES 10%

TOTAL 100%

GREGORIO C. LABRADO, EdD.

SGOD Chief
RATER
 Republic of the Philippines
Department of Education
Region XIII (Caraga)
City Schools Division of Tandag
City of Tandag

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM (IPCRF)

JANUARY 2023 TO DECEMBER 2023
ision, commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated measures for th

DIMENSION Outstanding Very Satisfactory Satisfactory

(Quality, Efficiency,
Timeliness) 5 4 3

91-100% of schools 71-80%% of schools

81-90%% of schools
were well were well
were well coordinated
coordinated with coordinated with the
QUALITY with the needed health
the needed health needed health
facilities, medicines
facilities, medicines facilities, medicines
and supplies
and supplies and supplies

9 out of 9 assigned 7-8 out of 9 assigned 5-6 out of 9 assigned

EFFICIENCY schools were schools were schools were
coordinated coordinated coordinated

Coordinated with Coordinated with the Coordinated with the

the schools 1 schools 2 weeks schools 1 week
TIMELINESS
month before the before the opening of before the opening
opening of classes classes of classes

91-100% with 81-90% with identified 71-80% with

identified ailments ailments were treated identified ailments
were treated utilizing acceptable were treated utilizing
QUALITY utilizing acceptable treatment acceptable treatment
treatment
 91-100% with 81-90% with identified 71-80% with
identified ailments ailments that require identified ailments
that require medical medical treatment that require medical
treatment were were referred to CHO treatment were
EFFICIENCY referred to CHO or or Hospital referred to CHO or
Hospital Hospital

91-100%Treatment 81-90%Treatment and 71-80%Treatment

and referral to referral to identified and referral to
identified ailments ailments conducted on identified ailments
conducted on the the scheduled date as conducted on the
scheduled date as planned scheduled date as
TIMELINESS planned planned

QUALITY 91-100% of school 81-90% of school 71-80% of school

children weighed children weighed and children weighed
and nutritional nutritional status and nutritional status
status determined determined determined

EFFICIENCY 91-100% 81-90% coordination 71-80% coordination

coordination with with teacher/parents with teacher/parents
teacher/parents and and children was and children was
children was observed during the observed during the
observed during the determination of determination of
determination of nutritional status nutritional status
nutritional status

TIMELINESS 91-100% of school 81-90% of school 71-80% of school

children weighed children weighed and children weighed
and nutritional nutritional status and nutritional status
status determined determined on the determined on the
on the scheduled scheduled date as scheduled date as
date as planned planned planned
 QUALITY/ 91-100% of school 81-90% of school 71-80% of school
EFFICIENCY children dewormed children dewormed children dewormed
with proper with proper with proper
coordination with coordination with coordination with
CHO/Barangay CHO/Barangay Health CHO/Barangay
Health Workers Workers Health Workers

TIMELINESS Conducted Conducted Deworming Conducted

Deworming to 91- to 81-90% of school Deworming to 71-
100% of school children as scheduled 80% of school
children as children as
scheduled scheduled

QUALITY/ Provided Provided assistance to Provided assistance

EFFICIENCY assistance to 91- 81-90% of to 71-80% of
100% of Teaching/Non- Teaching/Non-
Teaching/Non- Teaching personnel Teaching personnel
Teaching personnel and Recorded to Daily and Recorded to
and Recorded to Treatment Record Daily Treatment
Daily Treatment Record
Record

TIMELINESS Provided Provided assistance to Provided assistance

assistance to 91- 81-90% of to 71-80% of
100% of Teaching/Non- Teaching/Non-
Teaching/Non- Teaching personnel as Teaching personnel
Teaching personnel scheduled date as as scheduled date
as scheduled date planned as planned
as planned
 QUALITY/
EFFICIENCY
31/31 Conducted
26-30/31 Conducted 16-25/31 Conducted
training and
training and capacity training and capacity
capacity
development for WINS development for
development for
implementers to WINS implementers
WINS implementers
schools to schools
to schools

TIMELINESS 4 trainings 3 trainings conducted 2 trainings

conducted and and capacity conducted and
capacity development as capacity
development as scheduled date as development as
scheduled date as planned scheduled date as
planned planned

QUALITY/ 31/31 Schools 30 Schools 20 Schools

EFFICIENCY Monitored/validated Monitored/validated Monitored/validated
Online Monitoring Online Monitoring Online Monitoring
System System System

TIMELINESS 91-100% Schools 81-90% Schools 71-80% Schools

monitored as monitored as monitored as
scheduled scheduled scheduled

QUALITY/ 9 schools provided 8 schools provided 6-7 schools provided

EFFICIENCY technical technical assistance to technical assistance
assistance to assigned schools to to assigned schools
assigned schools to reach the 3 Star to reach the 3 Star
reach the 3 Star Approach Approach
Approach
TIMELINESS 91-100% Schools 81-90%% Schools 71-80% Schools
provided technical provided technical provided technical
assistance as assistance as assistance as
scheduled scheduled scheduled

QUALITY/ 8/9 assigned 6-7/9 assigned 4-5/9 assigned

EFFICIENCY schools monitored schools monitored and schools monitored
and visited for the visited for the proper and visited for the
proper implementation of proper
implementation of WinS Program implementation of
WinS Program WinS Program

TIMELINESS Assigned schools Assigned schools Assigned schools

monitored and monitored and visited monitored and
visited monthly every 2 months visited quarterly

QUALITY/ 91-100% Teenage 81-90% Teenage 71-80% Teenage

EFFICIENCY pregnant tracked pregnant tracked and pregnant tracked
and referred for referred for Antenatal and referred for
Antenatal Care Care Antenatal Care

TIMELINESS 100% Teenage 81-90% Teenage pregnant 71-80% Teenage

pregnant referred for referred for Antenatal Care pregnant referred for
Antenatal Care on the on the set schedule Antenatal Care on the set
set schedule schedule

QUALITY/ 91-100% of reports 81%-90% of reports are 71-80% of reports are

EFFICIENCY are submitted submitted submitted

TIMELINESS Submitted report 3 days Submitted report on the Submitted report 1 day
before deadline date of deadline after deadline
 QUALITY/ 91-100% of 81-90% of Supplementary 71-80%% of
EFFICIENCY Supplementary Feeding Feeding Implemented, Supplementary Feeding
Implemented, evaluated evaluated and monitored Implemented, evaluated
and monitored and monitored

TIMELINESS 100% Supplementary 90%-99%% Supplementary 80%-89%%

Feeding implemented, Feeding implemented, Supplementary Feeding
evaluated and evaluated and monitored on implemented, evaluated
monitored on the the scheduled date as and monitored on the
scheduled date as planned scheduled date as
planned planned

QUALITY/ 9 schools monitored/ 7-8 schools monitored/ 5-6 schools monitored/

EFFICIENCY evaluated ands evaluated ands sustained evaluated ands sustained
sustained the Gulayan the Gulayan sa Paaralan the Gulayan sa Paaralan
sa Paaralan

TIMELINESS 9 schools monitored 7-8 schools monitored and 5-6 schools monitored
and evaluated on the evaluated on the scheduled and evaluated on the
scheduled date as date as planned scheduled date as
planned planned

QUALITY/ established 91-100% of established 81-90% of an established 71-80% of an

EFFICIENCY an active partnership active partnership among active partnership among
among the PTA's, the PTA's, LGU's and other the PTA's, LGU's and
LGU's and other stakeholders to initiate other stakeholders to
stakeholders to initiate projects to sustain health initiate projects to sustain
projects to sustain programs health programs
health programs
TIMELINESS 91-100% of Partners 81-90% of Partners and 71-80% of Partners and
and other stakeholders other stakeholders initiated other stakeholders
initiated projects on the projects on the scheduled initiated projects on the
scheduled date as date as planned scheduled date as
planned planned

QUALITY/
EFFICIENCY
91-100%Participated
and Acted on Other
Health related Activities
81-90%Participated and 71-80%Participated and
Acted on Other Health Acted on Other Health
related Activities related Activities

4-5 health related

3 health related activities 2 health related activities
TIMELINESS activities participated
participated and acted participated and acted
and acted
Actual Results RANGE

4.50 - 5.00

3.50- 4.49

2.50-3.49

1.50-2.49

Below 1.49

RUDELINE V. AZARCON, RN
Nurse
NURSE II II
RATEE
IEW FORM (IPCRF)

e with the indicated measures for the period of January 1, 2022 to DECEMBER 31, 2022

Rater: Gregorio C. Labrado EdD

Date Prepared: August 7, 2023

TO BE FILLED DURING EVALUATION

Unsatisfactory Poor Actual
2 1 Results QUALITY EFFICIENCY TIMELINESS

Below 60% of
61-70% of schools
schools were
were well
well coordinated
coordinated with
with the needed
the needed health
health facilities,
facilities, medicines
medicines and
and supplies
supplies

0-2out of 9
3-4 out of 9
assigned
assigned schools
schools were
were coordinated
coordinated

Coordinated
Coordinated with
with the schools
the schools 4 days
on the day of
before the opening
opening of
of classes
classes
61-70% with Below 60% with
identified ailments identified
were treated ailments were
utilizing acceptable treated utilizing
treatment acceptable
treatment
61-70% with Below 60% with
identified ailments identified
that require medical ailments that
treatment were require medical
referred to CHO or treatment were
Hospital referred to CHO
or Hospital

61-70%Treatment Below 60%

and referral to Treatment and
identified ailments referral to
conducted on the identified
scheduled date as ailments
planned conducted on
the scheduled
date as planned

61-70% of school Below 60% of

children weighed school children
and nutritional weighed and
status determined nutritional status
determined

61-70% Below 60%

coordination with coordination
teacher/parents with
and children was teacher/parents
observed during the and children
determination of was observed
nutritional status during the
determination of
nutritional status

61-70% of school Below 60%of

children weighed school children
and nutritional weighed and
status determined nutritional status
on the scheduled determined on
date as planned the scheduled
date as planned
 61-70% of school Below 60% of
children dewormed school children
with proper dewormed with
coordination with proper
CHO/Barangay coordination
Health Workers with
CHO/Barangay
Health Workers

Conducted Conducted
Deworming to 61- Deworming to
70% of school 60% below of
children as school children
scheduled as scheduled

Provided Provided
assistance to 61- assistance to
70% of 60% below of
Teaching/Non- Teaching/Non-
Teaching personnel Teaching
and Recorded to personnel and
Daily Treatment Recorded to
Record Daily Treatment
Record

Provided Provided
assistance to 61- assistance to
70% of 60% below of
Teaching/Non- Teaching/Non-
Teaching personnel Teaching
as scheduled date personnel as
as planned scheduled date
as planned
 6-15/31 Conducted 5/31 Conducted
training and training and
capacity capacity
development for development for
WINS WINS
implementers to implementers to
schools schools

1 training no training
conducted and conducted and
capacity capacity
development as development as
scheduled date as scheduled date
planned as planned

15 Schools 5 Schools
Monitored/validated Monitored/valida
Online Monitoring ted Online
System Monitoring
System

61-70% Schools 60% below

monitored as Schools
scheduled monitored as
scheduled

3-5 schools 1-2 schools

provided technical provided
assistance to technical
assigned schools to assistance to
reach the 3 Star assigned
Approach schools to reach
the 3 Star
Approach
61-70% Schools 60% Schools
provided technical provided
assistance as technical
scheduled assistance as
scheduled
2-3/9 assigned 0-1/9 assigned
schools monitored schools
and visited for the monitored and
proper visited for the
implementation of proper
WinS Program implementation
of WinS
Program

Assigned schools Assigned

monitored and schools
visited every 6 monitored and
months visited annually

61-70% Teenage Below 60%

pregnant tracked Teenage
and referred for pregnant
Antenatal Care tracked and
referred for
Antenatal Care

61-70% Teenage Below 60%

pregnant referred for Teenage pregnant
Antenatal Care on the referred for
set schedule Antenatal Care on
the set schedule

61-70% of reports are Below 60% of

submitted reports are
submitted

Submitted report 2 days Submitted report 3

after deadline or more days after
deadline
61-70% of Below 60% of
Supplementary Feeding Supplementary
Implemented, evaluated Feeding
and monitored Implemented,
evaluated and
monitored

70%-79%% 69% below

Supplementary Feeding Supplementary
implemented, evaluated Feeding
and monitored on the implemented,
scheduled date as evaluated and
planned monitored on the
scheduled date as
planned

3-4 schools monitored/ 0-2 schools

evaluated ands monitored/
sustained the Gulayan evaluated ands
sa Paaralan sustained the
Gulayan sa
Paaralan

3-4 schools monitored 0-2 schools

and evaluated on the monitored and
scheduled date as evaluated on the
planned scheduled date as
planned

established 61-70% of established below

an active partnership 61% of an active
among the PTA's, partnership among
LGU's and other the PTA's, LGU's
stakeholders to initiate and other
projects to sustain stakeholders to
health programs initiate projects to
sustain health
programs
61-70% of Partners and 60% below of
other stakeholders Partners and other
initiated projects on the stakeholders
scheduled date as initiated projects on
planned the scheduled date
as planned

61% below
61-70%Participated and Participated and
Acted on Other Health Acted on Other
related Activities Health related
Activities

no health related
1 health related
activities
activities participated
participated and
and acted
acted

TOTAL SCORE
 OVERALL
RATING FOR
ACCOMPLISHMENTS

ADJECTIVAL RATING

ADJECTIVAL RATING

Outstanding

Very Satisfactory

Satisfactory

Unsatisfactory

Poor

ROEL T. DIAMANTE, PhD, CESE

OIC-ASSISTANT SCHOOLS DIVISION SUPERINTENDE
APPROVING AUTHORITY
ING EVALUATION

AVERAGE SCORE
AL RATING

anding

isfactory

actory

factory

or

NTE, PhD, CESE

DIVISION SUPERINTENDENT
G AUTHORITY