Republic of the Philippines

Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO ORIENTAL

A. TEACHERS PREPAREDNESS. Check YES if the statement is evident in the school, and NO if it
is not evident in the school operations.

AREAS YES NO REMARKS

1 HEALTH PROTOCOLS
1 Foot Bath
2 Alcohol/Sanitizer
3 Social Distancing (Chair Arrangement)
4 Caution Marks (COVID related)
5 COVID hotline
2. CLASS INFORMATION FEATURES
1 Class Schedule/ Class Program
2. Class list posted outside the door with name of teacher
3. Section nameplate
4. Announcement Board/Paskilan
5. Calendar of Activities (revised)
6. Class Rules/Classroom Child Protection Policy
7. Teacher’s ID (CSC Prescribed)
3. DOCUMENT FEATURES
1. School Forms 1-3
2. Class Record
3. List of enrollments is on file together with the LESF
4. Lesson Plan (WHL/WLL)
5. Simplified MELCS- based Budget of Lesson & Activity Sheets
6. Complete set of printed Modules
 Kindergarten
 Grade 1/7
 Grade 2/8
 Grade 3/9
 Grade 4/10
 Grade 5/11
 Grade 6/12
7. Complete e-file of the SLMs for grade/subject for
grade/subject level assigned from first-fourth quarter.

8. List of the distribution and collection of SLMs

 with parents’ signature & dates
DOCUMENT FEATURES
9. Files checked modules/activity sheets
10. Files checked summative test
11. Form 138
12. Form 137 (Permanent Records) SF
13. ECD Checklist and Progress Report for
Kindergarten
14. PSA/NSO for new entrants’ learners
15. Class Observations by grade level and
subject area
16. Individual Monitoring Plan
17. Remedial Intervention Plan/Program for
SAROF/SARDO
18. List of Least Learned Competencies
19. Learner’s Anecdotal Record
20. Learning Feedback/ Home Visitation Pass
Slip
21. Home Visitation From/ Home Visit Record
22. Student’s Reading Profile
23. CPL by subject area per quarter
24. Individual Weekly Accomplishment Report
25. Teacher’s Portfolio
4. PHYSICAL FACILITIES FEATURES
1. Standard height of chalkboard
2. Enough light and ventilation
3. Functional comfort room with water supply
4. Lavatories/sink with working functional
faucet and soap
5. First Aid Kit
6. Emergency Kit
7. Personal care and grooming area
8. Free form hazard (e.g. door mat, exposed
electrical wires)
9. Segregated garbage bin
10. Divan
11. Teacher’s table with a straight chair
12. Classroom Evaluation Plan
5. LEARNING RESOURSE FEATURES
1 Reading area with enough reading materials
2. Manipulative toys, activity cards, books
3. Multimedia and computer aided materials
4. Instructional Materials/ Teaching Devices by
unit
5. Learner’s Material & Portfolios
REMARKS:

Conformed:

____________________
Name of Teacher

Monitored by:

_________________________ VANESSA T. DUOT

Public Schools District Supervisor
 Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO ORIENTAL
LUPON EAST DISTRICT

B. TEACHER’S PREAREDNESS: Check YES if the statement is evident in the school, and NO if it
is not evident in the school operation.

INDICATORS YES NO MOV’s

1 They are provided with MELCs which are clearly defined by the
Department Heads/School Heads for effective delivery of instruction.
2. Teachers prepared WHL/WLL regularly with complete parts signed by
Department Heads/ School Heads.
3. They have clear plan for the distribution of modules.
4. They have clear plan on the retrieval of learning outputs.
5. They have clear plan on the process of learning assessment.
6. They wear complete and prescribed uniform with IDs.
7. They have enough number of teaching loads and ancillary services.
8. They are reporting to their respective classroom.
9. They prepared master list of students they handled.
10. They ensure cleanliness and orderliness in classroom.
11. They are provided with school supplies.
12. They prepared list of students with failing grades in the previous
grade level.
13. They have a clear understanding of the Alternative Work
Arrangement.
14. They observe proper classroom structuring. (updated posters etc.)
REMARKS:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Conformed:

__________________
Name of Teacher

Monitored by:

RENATO N. ADLAWAN VANESSA T. DUOT

PRINCIPAL - II Public Schools District Supervisor
 Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO ORIENTAL
LUPON EAST DISTRICT

C. TEACHER’S PREPAREDNESS. Check Yes if the statement is evident in the school, and NO it is
not evident in the school operations.

INDICATORS YES NO MOV’s

1 They are provided with CG which are clearly defined by the
Department Heads/ School Heads for effective delivery of instruction.
2. Teachers prepared DLL regularly with complete parts.
3. They wear complete and prescribed uniform with IDs.
4. They have enough number of teaching loads and ancillary services.
5. They are reporting to their respective classroom.
6. They prepared master list of students they handled.
7. They ensure cleanliness and orderliness in classroom.
8. They are provided with school supplies.
9. They prepared list of students with failing grades in the previous
grade level.
10. They observe proper classroom structuring. (updated posters etc.)

REMARKS:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Conformed:

_________________
Name of Teacher

Monitored by:

RENATO N. ADLAWAN VANESSA T. DUOT

PRINCIPAL- II Public Schools District Supervisor