CLASSROOM EVALUATION SHEET

___Quarter SY 2021 - 2022

Name of Section:_____________________________ 1 st Evaluation Date _________________
Name of Adviser:_____________________________ 2 nd Evaluation Date ________________
A. SAFE AND SECURED 30% 1st Round 2nd Round Average Score
1. Electrical fixtures
2. Door
3. Comfort Room are secured
4. Window
5. Ceiling
6. Table and chairs
7. Survival Kit (First Aid/DRRM/Hygiene) content should be complete
8. With signages and structure for the easy observance of minimum health protocols.
(readable and visible in the most appropriate location
Total x .30
B. SANITARY( Cleanliness) 30% 1st Round 2nd Round Average Score

1. Classroom
a. Floor and CR are clean and free from clutters
b. With available alcohol and hand sanitizer
c. With available Facemask/face shield and other PPE’s
2. With temperature/scanner available
3. With contact tracing forms available
4. With available Trash Bins for different usage
5. WINS Program
a. Drinking materials and potable water
handwashing materials are all available (soap, basin, dipper, etc)
b. Tooth brushing materials are available (toothbrush, toothpaste)
c. Sanitary for Female (sanitary pads etc.)
6. Surrounding area of classroom (front and back) must be clean and dust free
Total x .30
C. SET TO ORDER 20% 1st Round 2nd Round Average Score
1. Surroundings (back & front yard )
2. Class schedules are posted in every classroom
3. Availability of learning materials SLM 1:1,ULAT 1;1
4. The physical arrangement of chairs and other furniture inside the classroom ensures
proper physical distancing (chairs should be 1 to 2 meters apart)
5. The teacher has a Daily Lesson Log/Semi-Detailed Lesson Plan
6. The teacher comprehensively profiled learners who are participating and not in
the Face-to-Face class and their vaccination statu
7. the teacher determines learners exhibiting difficulties in coming to school
8. the teacher monitors the attendance of learners (during the F2F class, parents-during
distribution (Weekly Monitoring Tool)
Total x .20
D. SUSTAINABILITY 20% 1st Round 2nd Round Average Score
1. 4 S (Safety, Security, Sanitary and Set to order) are maintained all the
time
Total x .20
Total Score
Evaluated by: Conforme:

____________________________ ____________________________
Member of Evaluation Committee Class Adviser

Checked by:
______________________________________
Chair/Co Chair Awards Committee
 FACULTY ROOM EVALUATION SHEET
___Quarter SY 2021- 2022

Grade Level :_____________________________ 1 st Evaluation Date _________________

2 nd Evaluation Date ________________
Evaluation Average Score
st
A. SAFE AND SECURED 30% 1 Round 2nd Round Average Score
1. Electrical fixtures
2. Door
3. Comfort Room are secured
4. Window
5. Ceiling
6. Pathways
7. Air passage available
8. Walk flow available
Total x .25
B. SANITARY( Cleanliness )& Orderliness) 30% 1st Round 2nd Round Average Score
1. Available Face Mask and other protective gears
2. Availability of sanitation and disinfection materials inside
3. With temperature/scanner available
4. With contact tracing forms available
5. Trash Bins for different usage
6. Drinking materials (Glasses, dispenser, jug etc)
7. With hand washing facility/area
8. Hand washing materials (soap, basin, etc)
9. Tooth brushing materials (tooth rush, tooth paste)
10. Sanitary for Female (sanitary pads etc.)
Total x .25
C. SET IN ORDER 20% 1st Round 2nd Round Average Score

1. Surroundings (back & front yard )

2. Teachers’ schedules are posted in every classroom
3. Tables and chairs are arrange accordingly
4. Teachers instructional materials are organized
Total x .20
SUSTAINABILITY 20% 1st Round 2nd Round
1. 4 S (Safety, Security, Sanitary and Set to order) are
maintained all the time

Total x .20
Grand Total

Evaluated by: Conforme:

____________________________ ____________________________
Member of Evaluation Committee Grade Level Chair

Checked by:
______________________________________
Chair/Co Chair Awards Committee
 BEST AND ORGANIZED OFFICE EVALUATION SHEET
___Quarter SY 2021 - 2022
Name of Office :_____________________________ 1 st Evaluation Date _________________
2 nd Evaluation Date ________________
Evaluation Average
A. SAFE AND SECURED 40% st
1 Round nd
2 Round Score
1. Electrical fixtures
2. Door
3. Comfort Room is secured
4. Window
5. Ceiling
6. Ceiling
7. Pathways
8. Air passage available
9. Walk flow available
Total x .40
B. SANITARY (Cleanliness) 40% 1st Round 2nd Round Remarks
1. Available Face Mask and other protective gears
2. Availability of sanitation and disinfection materials inside
3. With temperature/scanner available
4. Trash Bins for different usage
5. Drinking materials (Glasses, dispenser, jug etc)
6. With hand washing facility/area
7. Hand washing materials (soap, basin, etc)
8. Tooth brushing materials (tooth rush, tooth paste)
9. Sanitary for Female (sanitary pads etc.)
Total x .40

C. SET IN ORDER AND SUSTAINABILITY 20% 1st Round 2nd Round Remarks
1. Records are intact and organized
2. Used routing slips in transaction
3. Used feedbacking Forms
4. Surroundings (back & front yard )
5. The school has approved alternative work arrangement (AWA)
6. Tables and chairs are arrange accordingly
Total x .20
Grand Total

Evaluated by: Conforme:

____________________________ ____________________________
Member of Evaluation Committee Park In-Charge

Checked by:
______________________________________
Chair/Co Chair Awards Committee
 BEST PARK AND SPOT
___Quarter SY 2021 - 2022

Name of Park/Spot:_____________________________ 1 st Evaluation Date _________________

2 nd Evaluation Date ________________

Evaluation Average
A. SAFE AND SECURED 40% 1st Round 2nd Round Score
1. Free from hazard (i.e. broken glass/bottle/branch of trees)
2. Serve as extension of the indoor learning environment
3. Bench and tables are intact/in good condition
4. Comfortable and convenient for relaxation
Total x .40
B. SANITARY (Cleanliness) 25% 1st Round 2nd Round Remarks
1. Neatness
2. Proper waste disposal
3. Creative landscape
Total x .25
C. SET TO ORDER 25% 1st Round 2nd Round Remarks
1. Plants are healthy, vigorous and hygienic
2. Maintenance of landscape features
3. Eco-friendly park
Total x .25
AND SUSTAINABILITY 10%
4 S (Safety, Security, Sanitary and Set to order) are maintained
all the time
Total x .10
Grand Total

Evaluated by:

____________________________ ____________________________ ____________________________

Member of Evaluation Committee Member of Evaluation Committee Member of Evaluation Committee

Checked by:

______________________________________
Chair Awards Committee