Republic of the Philippines

Department of Education
REGION VIII – EASTERN VISAYAS
Division of Leyte
LIM-AO NATIONAL HIGH SCHOOL
Kananga, Leyte

Name of the Trainee: Immersion Coordinator:

Work Immersion Cooperating Industry: Immersion Supervisor:

WORK IMMERSION EVALUATION FORM SY 2023-2024

Directions: Kindly rate the Work Immersion Trainee/Student’s performance according to the rating scale
below. Please put a check (/) mark on the space that corresponds to your given rating.

5 Outstanding (O) Trainee/Student’s performance was impressive and 90-100

outstanding. It exceeded that performance on
the trainee/student on the tasks and/or activities
assigned to him/her
4 Very Trainee/Student’s performance satisfied the expectations of the 85-89
Satisfactory industry supervisor concerning the tasks/activities assigned to
(VS) him/her
3 Satisfactory (S) Trainees/Student’s performance satisfied the expectations of 80-84
the industry supervisor
concerning the tasks/activities assigned to him/her. But, one or
two areas still had to be improved.
2 Fairly Work performance was okay, but there were lots of areas that 75-79
Satisfactory (FS) have to be given attention to at least satisfy the target
competencies.
1 Failed (F) Did not Meet Expectations 74 below

Work Habit Formation 5 4 3 2 1

1 Always come on time
2 Comes to work regularly and religiously
3 Show passion, commitment and dedication
4 Performs tasks/activities independently
5 Demonstrates self-discipline, self-accountability and flexibility
6 Observes appropriate ethical behavior and/or attitude
7 Prioritizes and observes safety-conscious actions
8 Demonstrates honesty and dependability
Score
The work immersion trainee/student…
Work Skills and Competence 5 4 3 2 1
1 Handles details of the given tasks/activities
2 Provides relevant feedback to the management or supervisor
3 Performs the tasks based on the job/work description
4 Suggest solutions to problems
5 Can troubleshoot immediate concerns and issues by providing solutions to
problem
6 Can manipulate the tools and/or equipment in the workplace concerning
the assigned tasks recorded to his/her specialization.

Interpersonal and Human Relations Skills 5 4 3 2 1

1 Show respect in dealing with clients and industry supervisor
2 In properly groomed and well-poised
3 Accepts suggestions from industry supervisor, co-workers and co-trainee
in improving work performance
4 Demonstrates appropriate eye contact, gestures and language in dealing

Brgy. Lim-ao, Kananga, Leyte / email add: 303395@deped.gov.ph

LIM-AO NATIONAL HIGH SCHOOL OFFICIAL FACEBOOK PAGE
 with others in various situations
5 Demonstrates emotional maturity and stability.
Score

Personality 5 4 3 2 1
1 Reports to work in proper attire and follows proper personal hygiene
2 Exercise self-confidence and comfortable in airing his/her problems and
difficulties with his/her superior
3 Is flexible in work and in dealing with people
4 Accepts miscellaneous jobs and tasks with proper attitude without
complaining
5 Shows interest and pride with the task assign to him/her
Score

Rating
Total Rating (Academic Performance)

Describe the learner’s strong points.

Describe the learner’s areas that need improvement

This report has been discussed with the learner.

Comments:

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Signature overprinted name of WI Supervisor Date

Brgy. Lim-ao, Kananga, Leyte / email add: 303395@deped.gov.ph

LIM-AO NATIONAL HIGH SCHOOL OFFICIAL FACEBOOK PAGE