Republic of the Philippines

Department of Education
REGION X - NORTHERN MINDANAO
SCHOOLS DIVISION OF MISAMIS ORIENTAL
MEDINA SOUTH DISTRICT

DON GREGORIO PELAEZ NATIONAL HIGH SCHOOL

Grade & Section: _______________________________ Date of Evaluation: _______________

Class Adviser: _________________________________

X – Not Evident
1 – Fair
CRITERIA/BASIS
2 – Moderate
3 – Excellent
1. Handwashing facility is visible outside the classroom
2. At the entrance of the room, a signboard is posted showing the Grade &
Section and the name of the Adviser.
3. A framed copy of the class program is displayed at the door of the
classroom at adult-eye level.
4. Alcohol is visible upon entry of classroom
5. Signages (Health Protocol)
6. The attendance chart and the DepEd forms rack were placed near the
door.
7. On the front wall facing the class, the chalkboard is properly framed and
provided with chalk ledge and curtains installed at a height which is in
accordance with the maximum comfortable reach of the students on top
of the board.
8. Above the chalkboard, a framed portrait of the President of the Philippines
shall be displayed prominently at the center.
9. Above the chalkboard, a framed copy of the National Anthem is displayed
at the upper left-hand corner and on the other side, a framed copy of the
Pledge of Allegiance of the Philippine Flag
10. Flaked at the left side chalkboard level is framed motto for the month or
week.
11. On the right side is a framed picture relevant to the motto.
12. Fourteen (14) pictures framed of the heroes identified is visible
13. The classroom has a Child Protection Policy Information Corner.
14. The classroom has a Child Friendly School System (CFSS) corner.
15. The seats are arranged properly and in order.
16. The bulletin boards (updated) and tack boards as well as charts maybe
placed on the walls at the sides or at the back of the room and shall be
placed at the same height as the chalkboard.
17. Has a subject/learning area or corner.
18. A classroom-based data on the Basic Education Information System
(EBEIS) is displayed on the walls at the side or at the back of the room.
MODULE A – Student’s EIS (Profile of Students)
MODULE B – Teacher’s Profile (Organizational Chart of DepEd Officials,
School Officials, Profile of Adviser and Subject Teacher’s)
MODULE C – Curriculum Development (K-12 Basic Education
Curriculum)
MODULE D- Legislative (Rights of a child, School & Classroom Policies)
MODULE E – Physical Facilities (Inventory of Classroom Property)
MODULE F – Finance (HRPTA) Proposed Projects
MODULE G- Community Involvement (HRPTA Proposed Projects)
MODULE H-Research and Evaluation (Proficiency Level per Subject
Area)
19. The teacher’s table, chair and cabinet are located at the rear of the room
and in order.
20. One corner of the room is set up as a reading corner.
21. Another corner of the room is set up as health corner and provided with
first aid or medicine cabinet with mirror, soap, dish, towel rack and hand
washing and drinking facilities.

1
22. Vision and Mission are visible.
23. Presence of potted plants inside and outside of the classroom.
24. With at least two trash bins with label.
25. Has a functional and well-cleaned toilet.
26. Compilation of Lesson Plans/DLL/Instructional Plan, Instructional
Materials (IM’S) and teacher’s & students’ portfolio, test bank are well-
arranged & neatly placed in a cabinet or rack.
27. Has adequate lighting and proper ventilation.
28. Has a well-cleaned floor and windows.
29. Has compost pit.

CLASSROOM STRUCTURING TOTAL SCORE

_____________________________ _____________________________
Name & Signature of the Ratee Name & Signature of the Rater

___________________________

Secondary School Principal I

2
 Republic of the Philippines
Department of Education
REGION X - NORTHERN MINDANAO
SCHOOLS DIVISION OF MISAMIS ORIENTAL
MEDINA SOUTH DISTRICT

DON GREGORIO PELAEZ NATIONAL HIGH SCHOOL

Grade & Section: _______________________________ Date of Evaluation: _______________

Class Adviser: _________________________________

GARDEN / GULAYAN
X – No Veggies Planted
1 – Fair (1 - 2 kind/s)
CRITERIA/BASIS
2 – Moderate (3 - 4 kinds)
3 – Excellent (5 or more)
Variety of vegetables planted
1. Presence of different kinds of plants

EXAMPLES:
indigenous plants
(kulitis, talinum, sigarilyas, okra, tanglad, sili, langkawas, etc)
legumes / pods
(string beans, kadyos, mung beans, etc)
green leafy vegetables
(kangkong, camote tops, alugbati, pechay, etc.)
vines / gourds
(tomato, upo, squash, cucumber, ampalaya, melon, etc)
X – Not Evident
1 – Fair
CRITERIA/BASIS
2 – Moderate
3 – Excellent
Establishment, Maintenance and Sustainability
2. With garden tools
3. With garden plan (includes cropping pattern, garden layout)
4. With accessible and sufficient water supply
5. With proper labels
6. With fence / trellis
Utilization of Garden Space (JUST PUT A CHECK BASED ON THE % OF SPACE UTILIZED)
75 – 100% was utilized (EXCELLENT)
50 – 74% was utilized (MODERATE)
Less than 50% was utilized (FAIR)
Source of small-scale entrepreneurship and food consumption (documented)
75-100% of the harvest were used as source of small-scale
entrepreneurship and food consumption
50-74% of the harvest were used as source of small-scale
entrepreneurship and food consumption
Less than 50% of the harvest were used as source of small-scale
entrepreneurship and food consumption

GULAYAN / GARDEN TOTAL SCORE

_____________________________ _____________________________
Name & Signature of the Ratee Name & Signature of the Rater

___________________________

3
 Secondary School Principal I

Republic of the Philippines

Department of Education
REGION X - NORTHERN MINDANAO
SCHOOLS DIVISION OF MISAMIS ORIENTAL
MEDINA SOUTH DISTRICT

DON GREGORIO PELAEZ NATIONAL HIGH SCHOOL

Grade & Section: _______________________________ Date of Evaluation: _______________

Class Adviser: _________________________________

LANDSCAPING
X – Not Evident
1 – Fair
CRITERIA/BASIS
2 – Moderate
3 – Excellent
Plant boxes are well painted
Planted with wide variety of ornamental and flowering plants
Structurally safe and sound
Quality or value of landscape as work of art
Thematic interpretation: delivery of landscape based on the theme of the
environment, etc
Dramatic impact: overall impact and attractiveness
Landscape is well sustained

LANDSCAPING TOTAL SCORE

_____________________________ _____________________________
Name & Signature of the Ratee Name & Signature of the Rater

___________________________

Secondary School Principal I