DAILY INDIVIDUAL PERFORMANCE MANAGEMENT CHECKLIST

For the Month of __________________

DATE
DAY

OUTPUT WEEK 1 WEEK 2 WEEK 3 WEEK 4 WEEK 5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

Prepared by: Noted by:

522077575.xlsx
Signature Over Printed Name of Staff Signature Over Printed Name of Immediate Supervisor

522077575.xlsx
D
A
T REMARKS 16 OFF DUTY - SATURDAY
E

1 HOLIDAY - New Years Day 17 OFF DUTY - SUNDAY

OPD DUTY - Daily OPD rounds done. Area supervised. Area concern addressed. Facilitate crowd control. Webinar Certificates
2 OFF DUTY - SATURDAY 18
and PPDP facilitated. COVID-19 Vaccination Program Module prepared. Updated IPCR attachments.

3 OFF DUTY - SUNDAY 19 OFFICIAL TIME - CONDUCTED TRAINING FOR COVID-19 VACCINE IMMUNIZATION PROGRAM - WEBINAR VIA ZOOM

OPD DUTY - PMR and COVID-19 Vaccination Committee Meeting attended. Daily OPD rounds done. Area supervised. Area
4 OPD DUTY - Area supervised. DTR submitted. ABTC & ISO report submitted to PHO and DOH RO2 20
concern addressed.

OPD DUTY - OPD Meeting, orientation and re-orientation conducted. Daily OPD rounds done. Area supervised. ISO DCO
5 21 OFFICIAL TIME - CONDUCTED TRAINING FOR COVID-19 VACCINE IMMUNIZATION PROGRAM - WEBINAR VIA ZOOM
endorsed to Dr. Reyes. SALN and PPDP facilitated. Area concern addressed. Facilitate crowd control.

OPD DUTY - OPD Meeting, orientation and re-orientation conducted. Daily OPD rounds done. Area supervised. Area concern
OPD DUTY - Daily OPD rounds done. Area supervised. Area concern addressed. Facilitate crowd control. Physicians
6 addressed. Follow up webinar certificates. 2021 R2TMC calendar distributed. Communication regarding IM forwarded to 22
graduation covered.
CMPS.

OPD DUTY - OPD Meeting, orientation and re-orientation conducted. Daily OPD rounds done. Area supervised. Area concern
7 23 OFF DUTY - SATURDAY
addressed. Follow up webinar certificates. 2021 R2TMC calendar distributed. Consolidated webinar certificate submitted.

DM CONSULT DUTY - 2 DM pateints catered, all Health record retured to HIMD. OPD Meeting, orientation and re-orientation
8 24 OFF DUTY - SUNDAY
conducted. Daily OPD rounds done. Area supervised. Area concern addressed.

OPD DUTY - Daily OPD rounds done. Area supervised. Area concern addressed. Facilitate crowd control. PPDP facilitated.
9 OFF DUTY - SATURDAY 25
Updated IPCR attachments. OPD duty schedule submitted.

OPD DUTY - Daily OPD rounds done. Area supervised. Area concern addressed. Facilitate crowd control. ITR complied and
10 OFF DUTY - SUNDAY 26
submitted.

OPD DUTY - Daily OPD rounds done. Area supervised. Area concern addressed. Medical and office supples for DCC OPD DUTY - Daily OPD rounds done. Area supervised. Area concern addressed. Facilitate crowd control. COVID forms drafted
11 27
requested to CSSU, Housekeeping, Linen and Supply Office. IPCR attachement updated. and presented to COVID-19 Vaccination Committee.

OPD DUTY - Daily OPD rounds done. Area supervised. Area concern addressed. Facilitate crowd control. COVID forms
12 OFFICIAL TIME - TRAINING OF TRAINERS OF COVID-19 VACCINE IMMUNIZATION PROGRAM - WEBINAR VIA ZOOM 28
presented to COVID-19 Vaccination Committee meeting. Attended virtual orientation & Microplanning For COVID-19 Vaccine

DM CONSULT DUTY - Daily OPD rounds done. Area supervised. Area concern addressed. Facilitate crowd control. COVID
13 OFFICIAL TIME - TRAINING OF TRAINERS OF COVID-19 VACCINE IMMUNIZATION PROGRAM - WEBINAR VIA ZOOM 29
forms duly accompleshed and submitted. ABTC monthly report submmited to PHO via email.

OPD DUTY - OPD Meeting, orientation and re-orientation conducted. Daily OPD rounds done. Area supervised. Area concern
14 30 OFF DUTY - SATURDAY
addressed. PPDP on TOT submitted to NTO and PETU. Review COVID Vaccine Phamplet. Meeting PETU on Training Plan.

522077575.xlsx
 OPD DUTY - OPD Meeting, orientation and re-orientation conducted. Daily OPD rounds done. Area supervised. Area concern
15 31 OFF DUTY - SUNDAY
addressed. COVID-19 Vaccination Committee meeting attended.

522077575.xlsx