LIBHU NATIONAL HIGH SCHOOL

Libhu, Maasin City, Southern Leyte

INDIVIDUAL PERFORMANCE AND COMMITMENT FORM (IPCRF)
Name of Employee: Jonathan J. Palco Name of Rater: CHRISTOPHER D. KUIZON
Position: TEACHER II Position: Principal
Bureau/Center/Service/Division: Maasin City Division Date of Review: March 2017
WEIGH Q PERFORMANCE INDICATORS ACTUAL
RATING SCORE
TIME- T E RESULTS
MFO KRAs OBJECTIVES T
LINESS PER
5 4 3 2 1 Q E T AVE.
KRA
I. BASIC 1.Prepared and
EDUCA- utilized localized Utilized 86% to 99% Utilized 76 to 85% Utilized 60% to 75% Utilized less than
TION Utilized 100% Lesson Plan
and localized and localized and localized and 60% localized and
SERVICES localized and
contextualized contextualized DILP contextualized contextualized DILP contextualized DILP
contextualized DILP Curriculum
lesson plan (LP) June 2016- with complete Ims DILP with complete with complete Ims with complete Ims
with complete Ims
with appropriate March 20% based on Curriculum Ims based on based on Curriculum based on Curriculum Review
based on Curriculum
TEACHING Instructional 2017 Review of Curriculum Review Review of Review of
Review of
Materials (IMs) Competencies which of Competencies Competencies which Competencies which
- every month Q
Competencies which
contributed to 2-3% which contributed contributed to 1- 2% did not contribute to
List of Actual
5 1.00
contributed to 5% or Pictures 1.00
LEARNING which contributed and above increase to 1-2% and above and above increase any increase students
and above increase of
PROCESS to 3% to 4 % students GSA from increase students in students GSA GSA from First Instructional
in students GSA from
(60%) increase in
First Quarter to
First Quarter to GSA from First from First Quarter to Quarter to Second Materials
students GSA Second Quarter and Quarter to Second Second Quarter and Quarter and from
Second Quarter and
from First Quarter from Third Quarter to Quarter and from from Third Quarter to Third Quarter to CD of
from Third Quarter to
to Second Quarter Fourth Quarter Third Quarter to Fourth Quarter. Fourth Quarter presentations
Fourth Quarter.
and Third Quarter Fourth Quarter
to Fourth Quarter
2.Prepared and 50% authentic and 40% authentic and 30% authentic and 20% authentic and 10% authentic and Report on
used 50% traditional 60% traditional 70% traditional 80% traditional 90%traditional Indices of
appropriate assessments based assessments based assessments based assessments based assessments based Mastery
assessment on total count of
on total count of on total count of on total count of on total count of (tables)
tools with 20% recorded
corresponding June 2016- assessments made recorded recorded recorded recorded assessments
assessments made assessments made assessments made used. Authentic 4 0.80 0.80
rubrics for March
learners, 2017 Assessment
E
maintaining Tools
80% of
mastery Activity
indices on
notebook/
quarterly
assessments portfolio of
accomplishm
ents
3.Monitored and Four indicators were Three indicators Two indicators were One indicator was None of the indicators Class
evaluated met. were met. met. met. was met. Records
students progress
quarterly, with
proper supporting Form 138 5 1.00 1.00
June 2016-
documents March 20% T
2017
Indices of
Mastery
 Q PERFORMANCE INDICATORS ACTUAL
WEIGH RATING SCORE
MFO E RESULTS
TIME- T T
KRAs OBJECTIVES
LINESS PER
5 4 3 2 1 Q E T AVE.
KRA

STUDENTS 1. Attained an 9% and above 6% to 8% increase 4 to 5% increase on 2 to 3% e increase 0 to 1% increase on Comparative

LEARNING increase of 5% increase on on students students posttest on students students posttest over Analysis of
OUTCOMES of the Pre- Test students posttest posttest over pre- over pre-test scores posttest over pre- pretest scores Pretest and
(25%)
result on over pretest scores test scores test scores Post test
Achievement Scores
15% T 3 0.45 0.45
Test
Quarterly

2. Attained for 100% 100% of students 95% to 99% of 90% to 95% of 50% to 89% of Less than 50% of SF5
passing rate for passed and attained students passed students passed and students passed students passed and
students on all a GSA of 80% and and attained a attained a GSA of and attained a attained a grade of 75%
subjects above on all subjects GSA of 78% to 79% 77% to 76% on all GSA of 75% on all on all subjects taught
5%
handled at the taught or handled on all subjects subjects taught or subjects taught or and handled.
end of the T taught or handled handled handled 5 0.25 0.25
Quarterly
Second Quarter
and Fourth
Quarter for SY
2016-2017

3. Conducted Quarterly 5% Q Conducted Conducted Conducted Conducted Conducted remediation Plan of 5 0.25
remediation to remediation w/ action remediation w/ remediation w/ action remediation w/ w/ action plan, set of action
poor performing plan, set of activities action plan, set of plan, set of activities action plan, set of activities for
or enrichment for remediation, list activities for for remediation, list activities for remediation, list for Assessment
sessions to for remediation, remediation, list for for remediation, remediation, list for remediation, results. tool
advanced results. remediation, results. remediation,
students with results. results. Activities for
accompanying 4 indicators are met 3 indicators are met 2 indicators are met 1 indicator is met No indicator is met Remediation
proof or
documents List of
Students for
remediation 0.25

Results
 WEIGHT Q PERFORMANCE INDICATORS ACTUAL
TIME- RATING SCORE
OBJECTIVES PER E RESULTS
LINESS
KRA T 5 4 3 2 1 Q E T AVE.
1.Conducted Four _____parents attended _____parents attended _____parents _____parents attended _____parents attended Attendance
PTC meetings and June 3% the 4 PTCs with all the 4 PTCs with all attended the 4 PTCs less than 4 PTCs with less than 4 PTCs with and
sustained 75% 2016- evidences. evidences. with all evidences all evidences. incomplete evidences. Minutes of the
March 0.12
attendance (_____
2017
T Meeting 4 0.12
out of _____) within
the SY 2016-2017 Pictures

Fully accomplished and Fully accomplished 1 Partially accomplished With proposed and No PTA Project Minutes of the
COMMUNIT 2.Accomplished 1 utilized 1 PTA project PTA project with or on-going 1 PTA approved 1 PTA Meeting/ ACR
Y INVO Homeroom PTA June 1% with documentation, documentation, project project.
MFO LVEMENT 2016- E 0.05
( 5% )
project
March
financial reports, etc. financial reports, etc. Pictures 5 0.05
2017

3.Joined in civic Joined in 3 or more Joined in 2 activities Joined in 1 activity Planned but did not join No plan to attend any Attendance
activities such as June 1% activities the activity activity
Alay Lakad, Fun 2016- Picture
March 0.05
Run or as member
in any civic
2017 E 5 0.05
organization

1. Attended June Attended and completed Attended and Attended and Attended and Attended and completed
seminars/works 2016- 176 hours and above in completed 132 hours completed 106 hours completed 88 hours less than 88 hours or had Memorandum
hops and March seminar/workshop and seminars/workshops seminars/workshops seminars/workshops not participated in any
2017
trainings training with and trainings with and trainings with and trainings with seminar at all. Matrix,
(school, district, accompanying proof or accompanying proof or accompanying proof accompanying proof or
division,
3% Q
documents. documents. or documents. documents. Program
5 0.15 0.15
regional,
PROFESSIO- national level) Certificates of
NAL GROWTH Recognition
AND
DEVELOP- 2. Demonstrated 1% E Submitted 100% Submitted 100% Submitted 95% to Submitted 90% to 94% Submitted less than Checklist on
MENT 5 0.05
punctuality in June complete and error-free complete reports/tasks 99% complete and complete and error-free 90% complete or submission of
(5%) 2016-
accomplishing and reports/tasks on or with minimal error time error-free reports / reports / tasks 3-4 days incomplete needed forms
March
submitting report before the due date including all required tasks 1-2 days late late including all reports/tasks 4 or more and school
2017
and in involvement including all required documents/papers for including all required required days late including all documents
0.05
on official school documents/papers for submission documents/papers for documents/papers for required
tasks. submission submission submission documents/papers for
submission
 3. Undertaken 1 Action research Action research was Action research was Action research was No action research Letter
action research and intervention was fully completed but partially completed. proposed and undertaken. Request
its intervention was utilized and presented intervention was approved.
used in the class. 1% E on CDREAMS or in any partially utilized Action
research forum Research

3 0.03 0.03

Intervention

Proof of
Achievement

MFO Q PERFORMANCE INDICATORS ACTUAL Score

WEIGHT E RATING
TIME- RESULTS
KRAs OBJECTIVES PER T
LINESS
KRA Ave
5 4 3 2 1 Q E T
OTHER 1. Served with E Served in any 4 or Served in any 3 related Served in any 2 related Served in any 1 related No involvement in any Action Plan or
RELATED evidences in any four more related tasks tasks with the full tasks with the full tasks with the full related task. Work Plan
ACTIVITIES (4) of accomplishments with the full documentation/ artifacts documentation/ artifacts documentation/ artifacts ,
(PLUS on the following: documentation/ , action plan, program , action plan, program action plan, program of Program of
FACTOR) June
a) Committee 2016- artifacts, action plan, of activities and of activities and activities and Activities
(5%) or Program March program of activities, accomplishment accomplishment accomplishment
Chairman 2017 3% and accomplishment report/certification report/certification report/certification Accomplishmen
or report/certification. t Report 4 0.12 0.12
Coordinator
with Certification
project/acc
omplishme
nt like
Gender
and
Developme
nt or Adopt-
A-School
b) District Key
Teacher
c) Facilitator,
Documente
rs in SLAC
or INSET
d) Committee
member
division,
district,
regional
level
e) Guidance
Teacher
f) ICT/LIS
Coordinator
g) Canteen
Manager
h) Clinic
Teacher
 i) Club or
Organizatio
n Adviser
such as
SPA, SSG,
etc.
j) Property
Custodian
k) Librarian
l) Officer in
any
Academic
Organizatio
n
m) Winning
Coach or
Trainer
n) Resource
Person
o) Research
Focal
Person
p) Research
Presenter
q) Demonstrat
ion Teacher
r) Examiner/P
roctor in
any
National
Examinatio
n
s) Corridor
Duty (if
applicable)
t) Other
special task
such as
Curriculum
Writer, Test
Constructor
, MOOE
Assistant,
and
SDRRM

2. Attained zero absent T No unofficial
and zero late from absences or
June 2016 to March tardiness incurred
2017. as reflected in the
2%
CSC Form 48.
Has 1 to 3 absences Has 4 or 5 absences Has 6 to 7 absences (off Has 8 or more 5 Summary of
(off set or not) and (off set) and incurred a set or not) and incurred a absences (off set or Attendance
incurred a total of 10 total of 20 to 30 total of 30 to 40 minutes not) and a total of more Report
minutes late as minutes late. late as reflected in the than 40 minutes or
0.08
reflected in the CSC CSC Form 48. more late as reflected in 4 0.08
Form 48. the CSC Form 48.
OVER - ALL RATING FOR ACCOMPLISHMENT: 4.400 ADJECTIVAL RATING: Very Satisfactory

JONATHAN J. PALCO CHRISTOPHER D. KUIZON RECOMMENDING APPROVAL:

Ratee Rater
ELENA S. DE LUNA, Ph.D.
Assistant Schools Division Superintendent

RANGE ADJECTIVAL RATING

APPROVED:
4.500 5.000 OUTSTANDING
3.500 4.499 VERY SATISFACTORY
2.500 3.499 SATISFACTORY
1.500 2.499 UNSATISFACTORY
MARIZA S. MAGAN, Ed. D., CESO V
BELOW 1.499 POOR
Schools Division Superintendent

PART III: SUMMARY OF RATINGS FOR

DISCUSSION
Final Performance Result Rating Adjectival Rating

Accomplishment of KRAs and Objectives 4.400 Very Satisfactory

RATER- RATEE AGREEMENT

The signatures below confirm that the employee and his/her superior have agreed to the content of this appraisal form and the performance rating.
Name of Employee Name of Superior
JONATHAN J. PALCO CHRISTOPHER D. KUIZON

Signature Signature
Date Date

PART IV: DEVELOPMENT PLANS

Strengths Developmental Needs Action Plan Timeline Resources Needed

Jonathan J. Palco Christopher D. Kuizon MARIZA S. MAGAN, Ed. D., CESO V
Teacher II Principal I Schools Division Superintendent