INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM

Name of Employee: LEILANI R. VERGARA Name of Rater: ORLANDO B. NICOLAS

Position: Guidance Counselor I Position: SECONDARY SCHOOL
PRINCIPAL II
Review Period: JUNE- DECEMBER 2016 Date of Review: DECEMBER, 2016
Bureau/Center/Division: DEPED-NAGUILIAN NATIONAL HIGH SCHOOL
TO BE FILLED IN DURING PLANNING TO BE FILLED DURING
EVALUATION
MODE OF Actual
KRAs OBJECTIVES TIMELIN Weig VERIFICATION Results Rati
MAFO ht
PERFORMANCE Scor
s E per INDICATORS (Actual ng e
KRA( MOVs) (avera
ge)
%) Q E T
1. Guidance and Formulate functional May-June 20% 100% formulated and Copy of 5 5 5 5 0.25
Counselling Guidance and Counselling implemented the Guidance
Program Program to 1304 students Guidance and Program
and 47 teachers.(5%) Counselling Program. Copy of Action
Helps in the Year plan 4 4 4 4 0.20
implementation of the Round Initiated interventions Enrolment lists
Schools Drop-out for SARDOs such as and form
Reduction Program and counselling, PDI
Child Protection Policy. monitoring, parent
(5%) dialogue and home 4 4 4 4 0.20
End of visitation.
Evaluate and improve semester Evaluated the
guidance and counselling Guidance and
activities/services Counselling Services
conducive to learning and through the Guidance 5 5 5 5 0.25
human development.(5%) April & Program.
Novemb
Facilitate enrolment of
er
Grade 7 to Grade 11 (5%) Enrolled 1101 Junior
High School and 91%
of Grade 10 for senior
high school.
2.Administration Administer school based April- 15% Administered Consolidated 5 5 5 5 0.25
of Psychological/ entrance test to 303 June Diagnostic Test for tests results
or Diagnostic Test Grade 7 students and Grade 7 entrants and Consolidated
interpret tests results. interpreted results. NCAE results
 (5%) Certificates 5 5 5 5 0.25
Act as testing coordinator July Assisted in
in administering NAT for administering NAT.
Grade 7 (5%)
Provide solution- Provided individual 5 5 5 5 0.25
focused/counselling October and group career
session to 275 students to counselling.
base on the test results of Novemb
the NCAE.(5%) er
3. Counselling- Provide individual Year 15% Provided individual, Anecdotal 4 4 4 4 0.20
Personal and counselling, small group Round group counselling, Record
Academic counselling and referral and walk in students Pictures/Progra
with personal or academic and those referred by m
problems .(5%) teachers. Intake sheet 5 5 5 5 0.25
Provide career counselling Novemb Career planning and
to 275 Grade 10 students er to counselling to all
in decision making, goal- Decemb Grade 10 students
setting and academic er were initiated.
transition plans.(5%) 4 4 4 4 0.20
Initiate parent- student
conference.(5%) Year Conducted parent-
Round student conference
about school related
problems.
4. Consultant/ Serve as consultant of the Year 10% Implemented Child Consolidated 5 5 5 5 0.20
Resource Speaker CPP, IP, 4Ps and Drop-out Round Protection Policy and data
Reduction Program.(4%) Anti Bullying Policy Certificates
and initiated solution Program
focus intervention in
addressing the needs
and problems of the
Provide Orientation to 47 SARDOs. 5 5 5 5 0.15
teachers on LIS issues and October Conducted lecture
updating the students and orientation to
profile (3%) teachers on LIS.

Provide orientation on 5 5 4 4.67 0.14

Senior High School to 275 October- Conducted the CGAP
Grade 10 students.(3%) Novemb to all Grade 10.
er
5. Career Provide Career Planning/ October 15% Provided career Pictures 5 5 5 5 0.25
Counselling vocational counselling to planning/vocational Program
221 Grade 10 students. counselling to all
(5%) October Grade 10. 5 5 5 5 0.25
Facilitate the conduct of Novemb Conducted the CGAP
guidance week to Grade er to all Grade 10
10 students.(5%) students. 5 5 5 5 0.25
Provide Career Education October-
and Information to 275 Novemb Provided Career
Grade 10 students .(5%) er Planning and oriented
the Grade 10 students
.
6. Research and Assess students needs Year 10% Gathered data and Consolidated 4 4 3 3.67 0.15
Evaluation and problems (SARDO). Round assessed the needs data
(4%) and problems of Home visitation
Student-at-Risk of form
Dropping out and Referral form
initiated intervention. SARDO 4 4 4 4 0.12
Home Visitation- to Year Identified the
identify the needs and Round students needs and
help the students address prevalence of
problems that may be absences through
hindering their academic home visitation. 3 3 3 3 0.03
success.(3%)
Follow-up- to determine Year SARDOs, walk in and
the status of the student Round referred students with
after counselling in terms problems in
of counselees feelings academic/ personal
and opinions.(3%) were followed up after
counselling.
7. Linkages Establish linkages with Year 5% Made referrals and CV- F2 (DSWD 4 4 3 3.67 0.07
PNP/DSWD/Barangay Round dialogues to different Form)
Officials.(2%) agencies and parents LIS
regarding student Consolidated
problems and data
involvements.
Link with the different Follow up and 4 4 4 4 0.06
schools.(1.5%) Year referrals
Referred students with Round
3 3 3 3 0.05
 special needs to Year Made referrals to
specialist/other service Round health care providers
providers.(1.5%) students with health
problems.
8. Plus Factor School Testing 10% NCAE/NAT Certificates 5 5 5 5 0.50
Coordinator administration Program
ICT Coordinator LIS/BEIS
Child Protection CICL/CARL, Child
Committee Vice- Protection Policy
Chairman; DORP, IP, and
4Ps consultant.

Resource Speaker during

the INSET for Teachers-
school-base.
Total 100 OVERALL RATING FOR 4.52
% ACCOMPLISHMENTS
ADJECTIVAL RATING OUTSTANDING

Adjectival Rating Range

Outstanding 4.500- 5.000
Very Satisfactory 3.500- 4.499
Satisfactory 2.500- 3.499
Unsatisfactory 1.500- 2.499
Poor Below 1.999

LEILANI R. VERGARA
Guidance Counselor I/ Ratee

ORLANDO B. NICOLAS
Secondary School Principlal II/ Rater

SUSAN MARIE P. BARTOLOME, Ph.D.

Approving Authorithy