Teacher’s Name: Time/Day: Room:

Subject: AY: Semester:

Direction: The statements below are designed to find out about your class and teacher. This is not a test. DO NOT PUT
YOUR NAME ON THIS PAPER. Rate your teacher’s performance on the following items.
5 = Almost Always; 4= Usually; 3=Sometimes; 2= Not Often; 1= Never
Domain 1. Content Knowledge and Pedagogy 5 4 3 2 1
1 My teacher explains the content of the lesson and its relevance to other subjects or areas of
discipline.
2 My teacher demonstrates understanding of a scientific process in a particular lesson and how this
process can enhance my knowledge of the lesson.
3 My teacher knows how to make use of television, LCD projector, and/or other ICT learning
materials in conducting the lesson.
4 My teacher knows teaching strategies that enable me to develop my literacy and numeracy skills.
5 My teacher uses teaching strategies that enable us to think critically and creatively and/or develop
our higher order thinking skills.
6 My teacher has the ability to teach the lesson using Mother Tongue, Filipino and English as the
medium of instruction.
7 My teacher produces the sounds and pronounces the words correctly and uses appropriate
gestures that help me understand, participate, and engage in the lesson as well as achieve the
learning outcomes set.
Domain 2. Learning Environment
1 My teacher shows understanding of his/her responsibility to provide a safe and secure learning
environment for us (students).
2 My teacher cares, respects and treats us fairly.
3 My teacher knows that our classroom should be a venue for individual and group engagement
activities, meaningful exploration, discovery and hands-on learning.
4 My teacher makes me feel nurtured and inspired to participate during the lesson.
5 My teacher knows that he/she has to involve us in making classroom policies, rules, and guidelines
as well as setting the parameters for class discussions and activities.
6 My teacher shows knowledge of positive and non-violent disciplinary measures in managing us.
Domain 3. Diversity of learners
1 My teacher knows that he/she needs to design lessons in such a way that our individual
differences in terms of gender, needs, strengths, interests and experiences are addressed.
2 My teacher uses teaching strategies that suit my linguistic, cultural, socio-economic and religious
backgrounds.
3 My teacher utilizes strategies that enable learners with disabilities, giftedness and talents learn
based on their pace.
4 My teacher demonstrates understanding of our special educational needs in times of difficult
situations including geographical isolation, chronic illness, displacement due to armed conflict,
urban resettlement or disasters, child abuse and child labor practices.
5 My teacher demonstrates knowledge of teaching strategies that are fair to all of us including our
indigenous classmates.
 Domain 4. Curriculum and Planning 5 4 3 2 1
1 My teacher develops an instructional plan based on the school and curricular goals.
2 My teacher develops an instructional plan that matches/aligns learning outcomes/objectives,
strategies, assessment and my needs at the appropriate level of difficulty.
3 My teacher develops an instructional plan that is relevant and responsive to the real life situation.
4 My teacher consults other teachers regarding the strategies that can enrich his/her teaching
practice.
5 My teacher knows how to select appropriate teaching and learning resources including ICT to
achieve the learning goals.
Domain 5. Assessment and Reporting
1 My teacher conducts appropriate assessments that can identify my strengths and weaknesses,
determine which level of learning I belong, and assess my performance before, during and after the
lesson.
2 My teacher monitors and evaluates my learning progress and achievement based on the results of
my assessments.
3 My teacher provides me appropriate, accurate, and constructive descriptive feedback to improve my
performance.
4 My teacher conducts various ways such as individual student consultation to communicate to us
regarding our performance progress and achievement.
5 My teacher bases his/her instructional decisions on the results of assessment he/she conducted.
Domain 6. Community Linkages and Professional Engagement
1 My teacher has the ability to creatively make our classroom as venue for simulation activities that
enable us to apply our learning to real life situations.
2 My teacher seeks advice on what to do to build relationships with parents/guardians and the other
members of the community.
3 My teacher is aware of the existing laws and regulations that apply to the teaching profession and
knows what he/she should and/or should not do as a teacher.
4 My teacher knows and understands the school policies and procedures that enable him/her to foster
harmonious relationship with the other members of the community.
Domain 7. Personal Growth and Professional Development
1 My teacher’s philosophy of teaching is centered to us, learners.
2 My teacher projects a caring attitude, respect, and honesty towards his/her students.
3 My teacher attends to seminars, workshops and conferences.
4 My teacher applies the strategies he/she learns from seminars, workshops and conferences.