School Form 5 Report on Promotion and Level of Proficiency For Kinder (SF5-K)

End of School Year Kindergarten Appraisal Report

School Name Concepcion ES District Manay Division Davao Oriental Region Region XI

School ID 129345 Section JOSE RIZAL School Year 2021-2022

SUMMARY TABLE
Summative Appraised (Grade One
LEARNER'S NAME
NO LRN Assesment Interpretation Ready or needs
(Last Name, First Name, Middle Name) Standard Score Further Intervention STATUS MALE FEMALE TOTAL

MALE GRADE ONE READY 2 3 5

1 129345210001 BANTAYAN,GERALD JAMES DANDOY 104 AD GRADE ONE READY

Needs Further Intervention 0 0 0
2 129345210002 DAGANSILONG,TERENCE BABAO 103 AD GRADE ONE READY

2 <=== TOTAL MALE LEVEL OF PROFICIENCY

Descriptor & Grading

Summative Appraised (Grade One MALE FEMALE TOTAL
LEARNER'S NAME Scale
NO LRN Assesment Interpretation Ready or needs
(Last Name, First Name, Middle Name) Standard Score Further Intervention Suggest Highly Advanced
Development - SHAD (130 0 0 0
and above)

FEMALE Suggest Slight Advanced

Development - SSAD (120- 0 1 1
129)
3 129345210003 MAMONTAYAO,KRYSTEL QUEEN BANTAYAN 123 SSAD GRADE ONE READY

Average Development - AD
4 129345210005 PUGO,ELROSE - 111 AD GRADE ONE READY (80-119) 2 2 4

5 129345210004 SAGUIDAN,JESSA MAMONTAYAO 94 AD GRADE ONE READY Suggest Slight Delay in

Overall Development - 0 0 0
SSIDOD (70-79)
3 <=== TOTAL FEMALE
Suggest Significant Delay in
5 <=== COMBINED Overall Development - 0 0 0
SSDOD (69 and below)

INSTRUCTIONS:
 1. The SCC shall conduct checking in their own school, no
swapping of SCC from one school to another is permitted.
2. The name of SCC members shall be printed and put their
signature on top (additional space may be added)
3. The school head is accountable and liable for any wrongful entry
on the forms (Deped Order 4, 2014 par.5) therefore, the DCC is not
required to put their names and signatures in SF 5
4. Only LIS generated SF5 shall be recognized (DO 11, 2018, page
7)
5. This form shall be submitted to the DCC together with the
accomplished SFCR1 - SCC- (Deped Order 11, 2018, page 11)

PREPARED BY:

MARY DAVE BANTAYAN SUMAMBOT

Class Adviser
(Name and Signature)

CERTIFIED CORRECT & SUBMITTED BY:

WALTER PUGO CASUMPO

School Head & SCC Chair
(Name and Signature)

REVIEWED BY: SCC Members

Signature over Printed Name

Signature over Printed Name

Signature over Printed Name

Generated thru LIS (SCC CO-Chair)