INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

I, RICKY MAGRACIA, ADMINISTRATIVE AIDE II of the TABLAS ISLAND DISTRICT HOSPITAL commit to deliver and agree to be rated on the attainment of the targets
in accordance with the indicated measures for the period of JANUARY TO JUNE 2019.
RICKY MAGRACIA
Ratee
Date: January 4,2019

Reviewed by: Date Approved by: Date

FLORDELIZA M. PALADIN, RN January 4,2019 VENJUNE P. TANSIONGCO, MD. January 4,2019

Immediate Supervisor Head of Office
Success Indicators Actual Accomplishment/ RATING
MFO/PAP (Targets + Measure) Expenses REMARKS
Q E T Ave
.
CORE FUNCTIONS

 Maintain 100% cleanliness of Emergency  Maintained 100% cleanliness of Emergency

Maintain cleanliness of
Room an hour before tour of duty. Room an hour before tour of duty.
Emergency Room

Assists patients upon  Assist 100% of patients during emergency  Assisted 100% of patients during emergency

entrance to ER situation upon arrival in ER. situation upon arrival in ER.

Patient Transport  Transport safety and without delay all  Transported safety and without delay all
patient upon the request of attending MD. patient upon the request of attending MD.

Maintenance of Ambulance  100% maintain cleanliness and replaced  100% maintained cleanliness and replaced
disposal supplies before the end of each disposal supplies before the end of each
shift. shift.

Driver’s License  Comply and updated Driver’s License.  Complied and updated Driver’s License
SUPPORT FUNCTIONS
CSC Compliance  Participate regularly in different hospital  Participated regularly in 90% different
activities and social responsibilities (flag hospital activities and social responsibilities
raising, civic parade, arbor day) (flag raising, civic parade, arbor day)

SUMMARY OF RATING TOTAL FINAL NUMERICAL RATING FINAL ADJECTIVE RATING

Core Functions Formula: (total of all average

ratings/no. of entries) x 90%
Support Functions Formula: (total of all average
ratings/no. of entries) x 10%
Comments and Recommendations for Development Purposes:

Discussed: Date Assessed by: Date: Reviewed: Date: Final Rating by: Date
I certify that I discussed my
assessment of the performance
with the employee.

JULY 4,
RICKY MAGRACIA 2019 FLORDELIZA M. PALADIN, RN VENJUNE P. TANSIONGCO, MD
RATEE SUPERVISOR PMT HEAD OF OFFICE

Legend: Q- Quality E- Efficiency T- Timeliness A- Average