DOH - SPMS Form 2

DIVISION PERFORMANCE COMMITMENT AND REVIEW (DPCR)

I,___________________________, Division Chief of the ____________________________________, commit to deliver and agree to be rated on the attainment of the following targets in
accordance with the indicated measures for the period _______________ to __________________, 20_____.

Name of Division Chief/Director : Date: ____________

Approved By: Date

Name of Supervisor

5 – Outstanding
4 – Very Satisfactory
3 – Satisfactory
2 - Unsatisfactory
1 - Poor
RATING SCALE

RATING
Major Final Section/Person
Output
SUCCESS INDICATORS Alloted Budget
Accountable
Actual Accomplishment Q E T A Remarks
(1) (2) (3) (4)
Core
Functions

Average Rating
Support
Functions

Average Rating
Strategic
Functions

Average Rating
RATING
Total Overall Rating
Final Average Rating
Final Rating per Function
Average Rating
Function Percentage Distribution (Average Rating x Percentage Remarks
per Function
Distribution)
Core
50%
Functions
Support 10%
Functions
Strategic 40%
Functions
Adjectival Rating
Comments and Recommendation for Development Purposes

Discussed With: Assessed by: Date Final Rating by: Date

I certify that I discussed my assessment of the perfomance
with the employee

Employee Supervisor Next Higher Supervisor

Legend: 1- Quality 2 -Efficiency 3 - Timeliness 4 - Average

 DOH - SPMS Form 3
INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

I, EDWIN E. CASTILLO, JR, of the SLC RFO-V, commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated
measures for the period January to June, 2019.

Name of Emp. Date: _______________

Approved By: Date

JESUSA JOYCE N. CIRUNAY, RPh.
Name of Supervisor

5 – Outstanding
4 – Very Satisfactory
3 – Satisfactory
2 - Unsatisfactory
1 - Poor

RATING
SUCCESS INDICATOR
Output
(Targets + Measure)
Actual Accomplishment Q E T A Remarks
(1) (2) (3) (4)
Core Function
80% of establishments inspected are conducted within
CC (within 10 days after assignment)
Inspections of
Establishments E:5 - 100%; 3 - 80%; 1 - below 80%
T:(5 - within CC; 2 - beyond CC)

46 health establishments, facilities monitored for

continuous compliance to regulatory policies are
achieved.

E: 5 - 60 and above 4 - 53-59 ; 3 - 46-52 ; 2 - 23-45; 1 -

Below 23
PMS
106 health products monitored and evaluated for
continuous compliance to regulatory policies are
achieved.

E: 5 - 138 and above; 4 - 122-137; 3 - 106 - 121;

2 - 54 - 105; 1 - 53 and below
 RATING
SUCCESS INDICATOR
Output
(Targets + Measure)
Actual Accomplishment Q E T A Remarks
(1) (2) (3) (4)

75% of monitored licensed health facilities and

establishments, and products are continously compliant
Compliance to Regulatory
to FDA Standards
standards
Q: 5 - 100%; 4 - 76% - 98%; 3 - 75%; 2 - Below 75%

100% of the required 22 reports are submitted within CC

and no revision (i.e. 6 accomplishment reports - 6,
feedback reports, 6 DTRs,1 SALN, 1, Confidentiality
Report Management Undertaking, 1 Updated PDS,1 Affidavit of Conflict of
Interest)
E:5 - 29 and above; 4 - 26-28; 3 - 22 - 25; 2 - 12-21; 1 - 11
and below

Support Function

85% of the request for TA are acted

Technical Assistance E: 5 - 100%; 3 - 85%; 1 - below 85%
T: 5 - as scheduled; 2 - beyond schedule

85% of the invitations received on related activities for

collaboration are acted and/or participated
Collaborations with local/ E: 5 - 100%; 3 - 85%; 1 - below 85%
international partners T: 5 - as scheduled; 2 - beyond schedule

Note: How about those initiated by inspectors?

Ensure that 100% of complaints received are acted and

referred to the concerned Committee/ Office/ Center
(Contact center ng Bayan, 888 hotline, filed directly to
Complaints
Office, or received thru CSAT)
E: 5 - 100%; 2 - Below 100%
T: 5 - within CC; 2 - beyond CC

RATING
Total Overall Rating
Final Average Rating
Adjectival Rating
Comments and Recommendation for Development Purposes

Discussed With: Assessed by: Date Final Rating by: Date

 RATING
SUCCESS INDICATOR
Output
(Targets + Measure)
Actual Accomplishment Q E T A Remarks
(1) (2) (3) (4)
I certify that I discussed my assessment of
the perfomance with the employee

EDWIN E. CASTILLO, JR. EVANGELINA T. LOZADA JESUSA JOYCE N. CIRUNAY, RPh.

Employee Supervisor Next Higher Supervisor

Legend: 1- Quality 2 -Efficiency 3 - Timeliness 4 - Average

 DOH - SPMS Form 4

SUCCESS INDICATORS

Organizational
Success Indicator
Major Final Outputs Performance Measures Performance Targets Outcomes/Sectoral
Measures + Targets
Goals
 DOH - SPMS Form - 5
Sample Summary List of Individual Performance Ratings

Office A Performance Assessment: Very Satisfactory

Rating
Division A
Numerical Rating Adjectival Rating
Division A Rating 4 Very Satisfactory

Employee 1 4 Very Satisfactory

Employee 2 5 Outstanding
Employee 3 3 Satisfactory
Employee 4 4 Very Satisfactory
Employee 5 4 Very Satisfactory
No. of Employees (excluding Div. Chief) = 5
Average ratings of staff 20/5 = 4 Very Satisfactory

Rating
Division B
Numerical Rating Adjectival Rating
Division B Rating 3 Satisfactory

Employee 1 3 Satisfactory
Employee 2 4 Very Satisfactory
Employee 3 2 Unsatisfactory
Employee 4 3 Satisfactory
No. of Employees (excluding Div. Chief) = 4
Average ratings of staff 12/4 = 3 Satisfactory

Rating
Division C
Numerical Rating Adjectival Rating
Division C Rating 5 Outstanding

Employee 1 5 Outstanding
Employee 2 4 Very Satisfactory
Employee 3 5 Outstanding
Employee 4 4 Very Satisfactory
No. of Employees = 4 (excluding Div. Chief)
Average ratings of staff 18/4 = 4.5 Outstanding

Summary: Division A 4 Very Satisfactory

Division B 3 Satisfactory
Division C 5 Outstanding
Average 12/3 = 4 Very Satisfactory
 DOH-SPMS Form - 6

Performance Monitoring and Coaching Journal

1st Q
u
2nd a
r
3rd t
e
4th r
Name of Division: _________________________________
Division Chief/Director ______________________________________
Number of Personnel in the Office/Division ________________________

Mechanism/s
Activity Meeting Others
Memo Remarks
(Pls. Specify)
One-in-One Group
Monitoring

Coaching

Please indicate the date in the appropriate box when the monitoring was conducted

Conducted by: Date: Noted by: Date:

Immediate Superior Head of Office

 DOH - SPMS Form - 6A

I. Performance Monitoring and Coaching

(Illustration showing a Sample Tracking Tool for Monitoring Targets)

Task Status
Major Final Assigned
Tasks Duration Remarks
Output to Week 1 Week 2 Week 3 Week 4

Test Item 1.1 Conduct of Test

Item Workshop
1.2 Review of Test
Items
Test Bank 2.1 Encoding of Test
Database Item
2.2 Updating of Test
Item Properties
2.3
Management/Mainte
nance of Test Bank
Database
Exam 3.1 Consultation with
Calendar and CSCRO's
Announceme 3.2 Preparation of
nt Calendar/Announce
ment
3.3 Presentation of
Calendar
/Announcement
Exam 4.1 Constitution of
Conduct Exam Commitees
Action Plan

4.2 Determination of
Testing Centers /Test
Administrators

4.3 Preparation of
Budget Estimate
(Income and
Expenses)
Non- 5.1 Preparation of
Confidential Examiner's Manual
Examination 5.2 Reproduction of
Documents Examination
Documents
5.3 Dissemination of
Examination of
Examination
Documents
Processed 6.1 Review and
Examination Evaluation of
Application Application
6.2 Batching of
Application
 DOH SPMS Form - 6 B

J. Performance Monitoring and Coaching

(Illustration showing a Sample Tracking Tool for Monitoring Assignments)

Performance Monitoring Form

Task ID No. Subject Action Output Date Date Remarks
Officer Assigned Accomplished
Documents No. Subject Area of the Task Date the task Date the Output
or Task No. If or the Signatory of the was assigned was approved by
Taken from Documents and Subject to the draffter the approver
WFP Area
 DOH-SPMS Form - 7

Perfomance Rewarding and Development

(Illustration showing a Professional Development Plan Template)

Professional Development Plan

Date:

Target Date

Review Date

Achieved Date

Aim

Objective

Task Next Step

Commets
Professional Development Plan

Date

Aim

Objective

Target Date

Review Date

Achieved Date

Commets

Task

Outcome

Next Step