Annex B

Individual Performance Commitment AND REVIEW (IPCR)

I, Antonio L. dela Cruz Jr., of the Water Resources Generation and Distribution Division of Metropolitan Tuguegarao Water District commit to deliver and agree to be ra
attainment of the following targets in accordance with the indicated measures for the period January 2013 to June 2013

Reviewed by: Date Recommending Approval: Date Approved by: Date

ENGR. MILLER C. TANGUILAN,

ENGR. JANICE R. CARDENAS NINIA P. LUMAUAN C.P.A CESE
OIC-WRGD Division Assisstant General Manager General Manager
Immediate Supervisor Department Manager

Output Success Indicator Actual Accomplishments Rating Remarks

(Target + Measure)
Quantity Quality Time Q1 E2 T3 A4
Strategic Priority No:
1. To conduct chlorine residual test at specified sampling points 257 4 30minutes / water sample 957 5 4 4 4.33
within Tuguegarao.
2. To conduct regular or periodic flushing of blow-off, fire 104 4 1 hour /shift 176 5 4 4 4.33
hydrant and service line to maintain acceptable aesthetic
property of water.
Core Functions:

1. To attend service request on regarding water quality 20 4 2 hours /shift 54 5 4 4 4.33

(murky, sandy, odorous and yellowish) and water
availability.
2. To drive MTWD service vehicle to conduct flushing and to 20 4 4 hours /shift 392 5 4 4 4.33
deliver pump supplies, e.g. Diesel and Chlorine.
3. To collect water samples for microbiological analysis. 36 4 30 minutes /sample 66 5 4 4 4.33

4. To control or adjust gate valves to maintain water 20 4 1 hour/ adjustment 35 5 4 4 4.33

supply within specified areas.
Support Functions:
1. To operate Panacal Pumping Station at assigned schedule 6 4 8 hours /shift 9 5 4 4 4.33
using normal and standby diesel engine as a power source and
record required operational parameters and to operate
chlorinator equipment at all times ,inspect, monitor and adjust
chemical feed rates

Final Average Rating 4.33

Comments and Recommendations for Development Purposes
Needs to under go training to upgrade his knowledge on the new technology in pumps, motors, and controls.

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

ANTONIO L. DELA CRUZ ENGR. JANICE R. CARDENAS NINIA P. LUMAUAN C.P.A.

 Employee Division Manager Assistant General Manager
Legend: 1-Quantity 2-Efficiency 3- Timeliness 4-Average
agree to be rated on the

Date

Remarks

Date
 Individual Performance Commitment AND REVIEW (IPCR)
I, Marvita Q. Domingo , of the Adminstrative Aide III of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2017
MARVITA Q. DOMINGO
Ratee
Date: January 03, 2017
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer

Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Encodes correspondences, PIDSR & FHSIS reports and forms of 5.00
the City Health Office ACTUAL 2 hours/shift No revision 5 5 5 Achieved
2. Assists in the different activities of the City Health Office Accomplishing task in accordance with
ACTUAL Immediately upon request
standard protocol
5 4 4 4.33 Achieved
3. Prepares payroll (permanent & casuals,BHWs) vouchers,per
diem, transportation & other refundable payable expenses. ACTUAL Immediately upon request No revision 5 5 5 5.00 Achieved

4. Attends training/conferences/meetings. Every 2nd Monday of the 4.67

ACTUAL Month/Immediately upon request
100% 5 4 5 Achieved
AVERAGE RATING 4.75 Achieved
Core Functions:
1. Post,sort & Files in-coming & out-going coms. ACTUAL Immediately upon request Accomplishing task in accordance with 5 4 4 4.33 Achieved
standard protocol
2. Prepares death certificates ACTUAL 3 minutes/death cert.form 148 5 4 5 4.67 Achieved
3. Prepares birth certificates ACTUAL 3 minutes/birth cert.form 170 5 5 5 5.00 Achieved
4. Prepares Philhealth Claims (Maternity/IUDPackage) ACTUAL 5 minutes/form 180 5 4 4 4.33 Achieved
AVERAGE RATING 4.58 Achieved
Support Functions:
1. Maintains & checks working condition of the machines
(computer,photocopier,duplo machine,fax machine). ACTUAL Immediately upon request 100% 5 4 4 4.33 Achieved

2.Assist in the drug testing laboratory as specimen collector 4.67

ACTUAL 15 minutesa/client 58 5 5 4 Achieved
AVERAGE RATING 4.50 Achieved
Final Average Rating 4.61 VS
Comments and Recommendations for Development Purposes
Needs to under go training to upgrade his knowledge on the new technology in pumps, motors, and controls.
Discussed With Date Assessed by Date Final Rating by Date
I certify that I discussed my assessment of the
performance with the employee.

3-Jan-17 3-Jan-17 3-Jan-17

MARVITA Q. DOMINGO JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
 Employee Medical Officer V City Health Officer
Individual Performance Commitment AND REVIEW (IPCR)
I, Inocencia C. Serrano , of the Adminstrative Aide III of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2017
INOCENCIA C. SERRANO
Ratee
Date: January 03, 2017
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office

Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
1. Encodes correspondences and forms of the CHO ACTUAL 2 hours/shift No revision 5 5 5 5.00 Achieved
2. Assists in the different activities of the City Health Office ACTUAL Immediately upon request Accomplishing task in accordance with 5 4 4 4.33 Achieved
standard protocol
3. Prepares payroll (permanent & casuals,TEV) & other ACTUAL Immediately upon request No revision 5 4 4 4.33 Achieved
refundable payable expenses
4. Procurement of Medical/Office supplies for the different ACTUAL Immediately upon request Accomplishing task as ordered 5 4 4 4.33 Achieved
programs
5. Attends training/conferences/meetings. ACTUAL Every 2ND Monday of the Month 6 5 4 4 4.33 Achieved
AVERAGE RATING 4.47 Achieved
Core Functions:
1. Post,sort & Files in-coming & out-going communications ACTUAL Twice a week Accomplishing task in accordance with 5 4 4 4.33 Achieved
standard protocol
2. Prepares death certificates ACTUAL 3 minutes/death cert.form 148 5 4 4 4.33 Achieved
3. Prepares Health/Medical certificates ACTUAL 1 minute 150 5 5 5 5.00
4. Follow-up logistics needs of the office ACTUAL Immediately upon request Accomplishing task as ordered 5 4 4 4.33 Achieved
AVERAGE RATING 4.50 Achieved
Support Functions:
1. Maintains & checks working condition of the machines
ACTUAL Immediately upon request 100% 5 4 4 4.33 Achieved
(computer,photocopier,duplo machine,fax machine).
AVERAGE RATING 4.33 Achieved
Final Average Rating 4.43 VS
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

3-Jan-17 3-Jan-17 3-Jan-17

INOCENCIA C. SERRANO JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
 Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, Marie Antoniette R. Pagaddu , of the Adminstrative Aide III of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2017
MARIE ANTONIETTE R. PAGADDU
Ratee
Date:Janaury 03, 2017
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Issues Official Receipt for the payment of health fees
ACTUAL 1 min./client 100% receipted 5 5 5 5.00 Achieved

2. Receipts collections and remits the same to the City

Treasurer's Office ACTUAL Twice a week 100% remitted 5 5 5 5.00 Achieved

AVERAGE RATING 5.00 Achieved

Core Functions:
1. Prepares Medical Certificates (LTO) ACTUAL 2 mins/client Prepared 100% Med. Certs 5 5 5 5.00 Achieved
Accomplishing task in accordance w/
2. Register deaths in the logbook - 30 seconds
standard protocol
5 4 4 4.33 Achieved
AVERAGE RATING 4.67 Achieved
Support Functions:
1. Attends trainings/meetings Every Second Monday of the
6
month
6 5 4 4 4.33 Achieved
AVERAGE RATING 4.33 Achieved
Final Average Rating 4.67 VS
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

3-Jan-17 3-Jan-17 3-Jan-17

MARIE ANTONIETTE R. PAGADDU JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
 Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, Ramon Renato T. Prada , of the Watchman of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2017
RAMON RENATO T. PRADA
Ratee
Date:January 03, 2017
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Oversees the security and safety of the City Health Office Security/safety done in accordance
building and properties after working hours.
E.O June 1 min./client
with standard procedure
5 5 5 5.00 Achieved
2. Attends trainings/meetings
6 Every 2nd Monday of the month 6 5 4 4 4.33 Achieved
4.67 Achieved
Core Functions:
1. Assist the Janitor in cleaning before and after office 2 hours Compliance done in accordance with
hours.
E.O December
standard procedure
5 4 4 4.33 Achieved
Support Functions:
1.Coordinates with the EPI Nurse Coordinator if
electricity in the building stops working for more than two Within 5 days upon reciept
hours to ensure potency of the vaccines being stocked threof
30 mins. Within 3 days upon reciept threof 5 4 4 4.33 Achieved
at the refrigerator.
Final Average Rating 4.44 Achieved
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

3-Jan-17 3-Jan-17 3-Jan-17

 RAMON RENATO T. PRADA JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, ROCEL A. FABRO , of the Medical Officer III of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2017
ROCEL A. FABRO
Ratee
Date:Janaury 03, 2017
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Helps the City Health Officer/Medical Officer V attend to
the administration of health services and supervise Serves as an exemplary model inside
75 1.5 hrs./day
& outside the organization
5 5 5 5.00 Achieved
personnel in the absence of the CHO/MO V
2. Attends trainings/meetings
6 Every 2nd Monday of the month 6 5 4 4 4.33 Achieved
AVERAGE RATING 4.67 Achieved
Core Functions:
1. Serves as clinician in medical consultation, physcial 10 min./patient
examination & counselling
Actual 5 5 5 5.00 Achieved
Serves completely in accordance with
2. Reviews/signs Death/Medical/Health certificates 3 mins./patient standard procedures
Actual 5 5 5 5.00 Achieved
AVERAGE RATING 5.00
Support Functions:
Supervises Medical Interns Conducts case discussion in
Actual January to June 2016
accordance with standard protocol.
5 4 4 4.33 Achieved

Final Average Rating 4.67 VS

Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

3-Jan-17 3-Jan-17 3-Jan-17

 ROCEL A. FABRO, MD. JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer
Individual Performance Commitment AND REVIEW (IPCR)
I, , of the Midwife of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
_________________________
Ratee
Date: January 03, 2017
Reviewed by: Date Recommending Approval: Date Approved by: Date

_____________________________ 7/1/2016 JOSEFINA C. CHUA, MD 7/1/2016 JAMES C. GUZMAN, MD, MHA 7/1/2016
Immediate Supervisor Medical Officer V City Health Officer

Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Deliver/implement the health programs (Maternal,Noenatal,Child
Health Care and Nutrition) in the catchment area. _______ of general population served Achieved

2. Provide family planning information counselling/services _______ eligible Women of Reproductive

Daily Age(WRA),registered & FP service Achieved
rendered
3. Prepare and submit required reports thru FHSIS Submitted in accordance with standard
Monthly/Quarterly Achieved
protocol
4. Attend conferences/trainings/meetings Every 2nd Monday of the
Actual Month/Immediately upon request
Implement current updates Achieved
Total Average Rating
Core Functions:
1. Provide pre-natal care to pregnant mothers 10 min./patient
_______ pregnant mothers given AP care Achieved
2. Handle deliveries and post-prental care On Call _______ deliveries &
_______ post-natal care Achieved
3. Conduct immunization to 0-12 y/o 3 mins./patient _______ were immunized aseptically Achieved
4. Monitors/weighs children 0-71 mos. 3 mins./patient _______ monitored nutritional status Achieved
5. Casefinding of TB symptomatics Follow-up collection done w/in _______ TB pts. Identified with DSSM
___ days _______ pts. Positive Achieved
given treatment
Total Average Rating
Support Functions:
1. Conducts Health Education and acts as Resource
Speaker during Barangay Assembly
1 hour Acted on 100% request on invitation Achieved
Total Average Rating
Final Average Rating
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

 I certify that I discussed my assessment of the
performance with the employee.
3-Jan-17 3-Jan-17 3-Jan-17
JOSEFINA C. CHUA, MD
Employee Nurse /Supervisor Medical Officer V

Individual Performance Commitment AND REVIEW (IPCR)

I, JOSEFINA C.CHUA, of the Medical Officer V of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance
indicated measures for the period July to December 2016
JOSEFINA C. CHUA
Ratee
Date:January 5, 2015
Reviewed by: Approved by: Date

JAMES C. GUZMAN, MD, MHA 5-Jan-15 ATTY. ENGELBERT C. CARONAN 5-Jan-15

City Health Officer City Mayor
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Helps the City Health Officer attend to the administration
of health services and supervise personnel in the absence Serves as an exemplary model inside
75 1.5 hr./day
& outside the organization
5 5 5 5.00 Achieved
of the CHO
2. Attendsmeetings,conferences,seminars.
Immediately upon request/
Actual
Every 2nd Monday of the month
100% requests on invitation 5 4 4 4.33 Achieved

Core Functions:
1. Serves as clinician in medical consultation, physcial 10 min./patient
examination & counselling
Actual Serves completely in accordance with 5 5 5 5.00 Achieved
standard procedures
2. Reviews/signs Death/Medical/Health certificates Actual 3 mins./patient 5 5 5 5.00 Achieved
Support Functions:
Conducts case discussion in
1.Supervises Medical Interns Actual Jan-June 2015
accordance with standard protocol.
5 4 4 4.33 Achieved
Final Average Rating 4.73
Comments and Recommendations for Development Purposes
Needs to under go training to upgrade his knowledge on the new technology in pumps, motors, and controls.

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.
 20-Jan-16 20-Jan-16 20-Jan-16
JOSEFINA C. CHUA, MD JAMES C. GUZMAN,MD,MHA ATTY. ENGELBERT C. CARONAN
Employee City Health Officer City Mayor

Individual Performance Commitment AND REVIEW (IPCR)

I, Elsie P. Darauay , of the Nurse III of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
ELSIE P. DARAUAY
Ratee
Date:January 03, 2017
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks
Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Monitor & supervise RHMs in the implementation of diff. 5.00
health programs 7 Monthly 7 RHMs 5 5 5 Achieved

5.00
ACTUAL 1.5 hour every Friday ______ couples 5 5 5 Achieved
2. Conduct pre-marriage orientation to would be couples
3. Review,analyze,record reports thru FSIS 49 Barangays Quarterly 49 Barangays 5 5 5 5.00 Achieved
4. Allocate/distribute drugs & supplies to RHMs 25 RHMs Every First week of the month 25 RHMs 5 5 5 5.00 Achieved
5. Attends monthly staff meeting 6 Every 2nd Monday of the month 6 5 5 5 5.00 Achieved
AVERAGE RATING 5.00 Achieved
Core Functions:
1. Provide Family Planning information/couselling/services
thru:
1.1 Insertion/Removal of Intra-Uterine Device (IUD) 26 IUD inserted/check-up & 10 5 5 5 5.00
ACTUAL 1.5 hour/patient removal in accordance w/ standard Achieved
procedure
1.2 Mgt. of the side effect thru IUD check-up ACTUAL 1.5 hour/patient 13 IUD check-up
1.3Visual Inspection w/ Acetic Acid (VIA) ACTUAL 1.5 hour/patient _ 56 VIA
Support Functions:
1. Acts as a Resource Speaker during Health Events ACTUAL 1 hour Acted 100% request on invitation 4 4 4 4.00 Achieved
Final Average Rating 4.67 VS
Comments and Recommendations for Development Purposes
Discussed With Date Assessed by Date Final Rating by Date
I certify that I discussed my assessment of the
performance with the employee.
 3-Jan-17 3-Jan-17 3-Jan-17
ELSIE P. DARAUAY, RN, MSN JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, Sandra Gay T. Pagulayan , of the Medical Technologist I of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
SANDRA GAY T. PAGULAYAN
Ratee
Date:January 01, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks
Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Conduct Health Educ./ scree EEW's/Vomunteer clients for
Serological examination
-HIV ACTUAL July to December 2016 64 5 6 7 8 Achieved
-Hbsag 37
-Syphilis 332

2. Perform Routine Laboratory services for pregnant mother/patient

2.1 Urinalysis ACTUAL 1,118
2.2 CBC 1 hour/patient 5 5 5 5.00 Achieved
Hgb ACTUAL 1,666
Hct ACTUAL 1,666
WBC ct ACTUAL 252
2.3 Platelet Count ACTUAL 252
3. Attends monthly meeting/trainings Every 2nd Monday of the
ACTUAL Month/Immediately upon request
6 5 5 5 5.00 Achieved
4. Prepares/submit required laboratory reports ACTUAL Quarteryly/Semi-Annual 2 5 5 5 5.00 Achieved
AVERAGE RATE 5.75 Achieved
Core Functions:
1. Perform cervical smear for:
-EEWs ACTUAL 772 5 5 5 5.00 Achieved
-OPD ACTUAL 30 minutes 333
-Pregnant Mothers 271
-Urethral smear for male ACTUAL 69
2. Other Laboratory Services
-Sputum microscopy ACTUAL 10 hours/patient 441
-Malaria microscopy ACTUAL 3 hours/patient 0 5 5 5 5.00 Achieved
-Leprosymicroscopy ACTUAL 3 hours/patient 0
-Stool microscopy ACTUAL 1 hour/patient 0
-Blood typing ACTUAL 30 minutes/patient 293
AVERAGE RATE 5.00
Support Functions:
1. Maintain/equip laboratory equipment (centrifuge 100% Ensure functionality of the LAB
machine,microscope) ACTUAL Once a week
apparatus
5 4 4 4.33 Achieved
Final Average Rating 5.03 VS
Comments and Recommendations for Development Purposes
Discussed With Date Assessed by Date Final Rating by Date
I certify that I discussed my assessment of the
performance with the employee.
3-Jan-17 3-Jan-17 3-Jan-17
SANDRA GAY T. PAGULAYAN JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer
Individual Performance Commitment AND REVIEW (IPCR)
I, Angelie D. Taccad , of the Nurse III of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
ANGELIE D. TACCAD
Ratee
Date:January 01, 2015
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Monitor & supervise RHMs in the implementation of diff. 4.67
health programs
ACTUAL Once a week 7 RHMs 5 4 5 Achieved
3. Consolidates, analyze,record reports thru FHSIS ACTUAL Once a month/RHM 25 RHMs 5 4 4 4.33 Achieved
5. Attend seminars/ trainings/staff meeting Every 2nd Monday of the 4.67
ACTUAL month/immediately upon request
100% attended on invitation 5 4 5 Achieved

AVERAGE RATING 4.56

Core Functions:
1. Provide MNCHN information/couselling/health education Every Tuesday/Thursday (10 Acted 100% request on invitation 5 5 5 5.00
ACTUAL
mins./patient)
Achieved
2. Performs cervical smearing to pregnant mothers _____ smeared in accordance with 5 4 4 4.33
ACTUAL 10 mins./patient
standard procedure
Achieved
3. Entertain/Admit patients and identify health histories 100% patients admitted in accordance with 5 4 5 4.67
ACTUAL 10 mins./patient standard procedure Achieved
4. Dispense drugs/medicines to patients 100% dispensed in accordance with 4 5 4 4.33
ACTUAL 3 mins./patient standard procedure Achieved
AVERAGE RATING 4.58
Support Functions:
1. Acts as a Resource Speaker during Health Events ACTUAL 1 hour Acted 100% request on invitation 4 4 4 4.00 Achieved
2. Assist donors during Blood Letting Activity (taking of Vital
signs)
ACTUAL 10 mins./patient Acted 100% request on invitation 5 4 5 4.67 Achieved
AVERAGE RATING 4.33
Final Average Rating 4.49 VS
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

ANGELIE D. TACCAD, RN JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer
Individual Performance Commitment AND REVIEW (IPCR)

I, Erlynne B. Tabarrejo , of the Nurse I of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
ERLYNNE B. TABARREJO,RN
Ratee
Date:Janaury 01, 2015
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks
Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Monitor & supervise RHMs in the implementation of diff. 5.00
health programs
ACTUAL Once a week 7 RHMs 5 5 5 Achieved
2. Conducts Epidemiological Investigation on Notifiable 5.00
Diseases
ACTUAL Once a week 6 Sentinel Sites 5 5 5 Achieved
3. Review, analyze, record reports thru FHSIS ACTUAL Once a month 49 Barangays 5 5 5 5.00 Achieved
4.Allocation /distributes vaccines and other EPI supplies to 5.00
RHMs
ACTUAL Once a month 25 RHMs 5 5 5 Achieved
5. Attend seminars/ trainings/staff meeting Every 2nd Monday of the 5.00
ACTUAL month/immediately upon request
100% attended on invitation 5 5 5 Achieved
AVERAGE RATING 5.00 Achieved
Core Functions:
1. Admit EEWs
1.1. Registration and issuance of Mother & Child Book ACTUAL 2 mins./child 5 4 4 4.33 Achieved
1.2. Height & weight monitoring ACTUAL 3 mins./child 5 5 5 5.00 Achieved
1.3. Conduct of immunization of 0-1 y/o ACTUAL 3 mins./child 5 5 5 5.00 Achieved
100% clients attended in accordance with
1.4. Givng of VAC for 6mos old ACTUAL 2 mins./child
standard procedure 5 5 5 5.00 Achieved
1.5. Giving of EPI/Post Immunization messages ACTUAL 3 mins./child 5 5 5 5.00 Achieved
 1.6. Assess feeding /Breastfeeding and other problems & 5 5 5 5.00
gives appropriate advice ACTUAL 2 mins./child Achieved
AVERAGE RATING 4.89
Support Functions:
1. Acts as a Resource Speaker during Health Events ACTUAL 1 hour Acted 100% request on invitation 4 4 4 4.00 Achieved
Final Average Rating 4.63 VS
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

ERLYNNE B. TABARREJO, RN JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer
Individual Performance Commitment AND REVIEW (IPCR)

I, Sheryll Aleth I. Baccay , of the Medical Technologist I of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
SHERYLL ALET H I. BACCAY
Ratee
Date:January 1, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Verifies & prepares specimen for drug testing ACTUAL 5 mins. 5 5 5 5 Achieved
2. Examines, process & analyzes specimen for drug testing 4.67
ACTUAL 5 mins. 5 4 5 Achieved
4. Attend seminars/ trainings/staff meeting Every 2nd Monday of the 4.67
ACTUAL month/immediately upon request
100% attended on invitation 5 4 5 Achieved
AVERAGE RATING 4.78 Achieved
Core Functions:
1. Encodes clients data for drug testing ACTUAL 15 mins. 5 4 5 4.67
2. Interprets, records, releases and sign outs lab results 5 4 5 4.67
ACTUAL 5 mins. Achieved
AVERAGE RATING 4.67
Support Functions:
1. Acts as a Resource Speaker during Health Events 100% ensure validity of supplies &
ACTUAL Once a week
equip,ent for drug testing
4 4 4 4 Achieved

2. Helps/assist in performing laboratory services

ACTUAL 30 mins./patient 100% performed laboratory services 4 4 4 4 Achieved
AVERAGE RATING 6 6 6 4 Achieved
Final Average Rating 4.48 VS
Comments and Recommendations for Development Purposes
Discussed With Date Assessed by Date Final Rating by Date
I certify that I discussed my assessment of the
performance with the employee.
SHERYLL ALETH I. BACCAY 1-Jul-16 JOSEFINA C. CHUA,MD 1-Jul-16 JAMES C. GUZMAN,MD,MHA 1-Jul-16

Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, CHRISTEL DANIELLE MALANA , of the Dentist I of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
CHRISTEL DANIELLE MALANA
Ratee
Date:January 01, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Formulate/implement health plan for Dental Health 5.00
services
One health plan Whole year plan 95% implemented 5 5 5 Achieved
2. Perform clinical services that are within the scope of the 5.00
service in aacordance with the minimum standard Pregnant mothers, pre- Dental services implemented
schoolers, other adults
Every Tuesday/Thursday
according to standard requirement
5 5 5 Achieved
requirement
3. Prepare/submit required reports 100% accomplished report without 5.00
6 Monthly,Quarterly
revision
5 5 5 Achieved
4. Attend seminars/ trainings/staff meeting ACTUAL 6 100% attended on invitation 5 4 5 4.67 Achieved
AVERAGE RATING 4.92 Achieved
Core Functions:
1. Perform oral examination
-Pregnant mother ACTUAL 5 mins./patient 5 5 5 5.00 Achieved
-Pre-schoolers 1-6 y/o ACTUAL 3 mins./patient 4 5 5 4.67 Achieved
-other adults 10-24 y/o ACTUAL 5 mins./patient 5 5 5 5.00 Achieved
-older person 60 yrs.& above ACTUAL 5 mins./patient 5 4 5 4.67 Achieved
-Oral Prophylaxis ACTUAL 5 mins./patient 5 5 5 5.00 Achieved
-Gum Treatment ACTUAL 5 mins./patient 4 5 4 4.33 Achieved
-Extraction ACTUAL 20 mins./patient 5 5 5 5.00 Achieved
AVERAGE RATING 4.21 Achieved
Support Functions:
1. Act as Resource Speaker during health events ACTUAL 1 hour Acted 100% request on invitation 5 4 5 4.67 Achieved
Final Average Rating 4.60 VS
Discussed With Date Assessed by Date Final Rating by Date
I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

CHRISTEL DANIELLE MALANA JOSEFINA C. CHUA, MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, JOSEFINA C. CHUA, of the Medical Officer V of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
JOSEFINA C. CHUA, MD
Ratee
Date:January 01, 2016
Reviewed by: Approved by: Date

JAMES C. GUZMAN, MD, MHA 1-Jul-16 ATTY. ENGELBERT C. CARONAN 1-Jul-16

City Health Officer City Mayor
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Helps the City Health Officer attend to the administration
of health services and supervise personnel in the absence Serves as an exemplary model inside
70 1.5 hrs./day
& outside the organization
5 5 5 5.00 Achieved
of the City Health Officer
2. Attends trainings/seminars/meetings
6 Every 2nd Monday of the month 100% attended to invitations 5 5 5 5.00 Achieved
5.00
Core Functions:
1. Serves as clinician in medical consultation, physcial 10 min./patient
examination & counselling
Actual Serves completely in accordance with 5 4 5 4.67 Achieved
standard procedures
 standard procedures
2. Reviews/signs Death/Medical/Health certificates Actual 3 mins./patient 5 5 5 5.00 Achieved
4.83
Support Functions:
Supervises Medical Interns
Conducts case discussion in
Actual Jan-June 2015
accordance with standard protocol.
5 4 5 4.67 Achieved

Final Average Rating 4.83 VS

Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

JOSEFINA C. CHUA, MD JAMES C. GUZMAN, MD, MHA ATTY. JEFFERSON P. SORIANO
Employee City Health Officer City Mayor
Individual Performance Commitment AND REVIEW (IPCR)
I, Rose-lyn B. Lauron , of the Nurse I of City Health Office(Detailed) commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
ROSE-LYN B. LAURON
Ratee
Date:January 01, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Monitor & supervise RHMs in the implementation of Pregnant mothers, pre- 100% RHMs monitored/supervised done in 4.33
different Health Progs. In assigned catchment are schoolers, other adults
Once a month accordance w/ standard protocol 5 4 4 Achieved

2. Conducts Pre-HIV & Post HIV Voluntary Counselling & 100% done in accordance w/ standard 4.33
Testing to high risk indivíduals on STD/HIV/AIDS. ACTUAL January-June
procedures
5 4 4 Achieved

3. Consolidate/submit STD/HIV report ACTUAL Monthly,Quarterly 100% accomplished report without revision 5 4 4 4.33 Achieved
AVERAGE RATING 4.33 Achieved
Core Functions:
1. Prepare/register/interview EEWs for records/file ACTUAL 10 mins./patient 5 4 5 4.67 Achieved
2. Perform cervical smear to EEWs,hig risk patients on 5 5 5 5.00
STD/HIV/AIDS
ACTUAL 5 mins./patient Achieved
3. Assess/treat clients at Social Hygiene Clinic 95% treated clients w/ standard 5 4 5 4.67
ACTUAL 15 mins./patient Achieved
procedure
4. Entertain/Admit patients and identify health histories ACTUAL 10 mins./patient 100% patients admitted in accordance with 5 5 5 5.00 Achieved
AVERAGE RATING standard procedure
4.83 Achieved
Support Functions:
1. Act as Resource Speaker during health events ACTUAL 1 hour Acted 100% request on invitation 4 4 4 4.00 Achieved
2. Attends meeting/seminar/training Every 2nd Monday of the
ACTUAL month/immediately upon request
Acted 100% request on invitation 5 5 5 5.00

3. Assist in the conduct of Health Education to TB patients 95% patients oriented & implemented in
ACTUAL 3 hours accordance with standard procedure 4 4 4 4.00 Achieved

AVERAGE RATING 4.33 Achieved

Final Average Rating 4.50 VS
Comments and Recommendations for Development Purposes
Discussed With Date Assessed by Date Final Rating by Date
I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

ROSE-LYN B. LAURON JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer
Individual Performance Commitment AND REVIEW (IPCR)

I, Maria Emily C. Ballesteros , of the Nurse Iof City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
MARIA EMILY C. BALLESTEROS
Ratee
Date:January 1, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Monitor & supervise RHMs under mu jurisdiction in the
implementation of different Health Programs/activites 4 Monthly 4 Midwives 5 5 4 4.67 Achieved
2. Allocates/distribute TB drugs & supplies to Midwives 25 Monthly 25 Midwives 5 5 4 4.67 Achieved
3. Consolidate/analyze and submit TB reports 4 Quarterly 4 5 5 4 4.67 Achieved
4. Conduct monthly meeting to Midwives 6 Every 4th Monday of the Month 4 4 5 4 4.33 Achieved
5. Convene the TB Diagnostic Committee Every 2nd & 4th Thursday of the 4.33
12 month
10 4 5 4 Achieved
AVERAGE RATING 4.53 Achieved
Core Functions:
1. Provide TB info./counselling/services thru:
1.1 Interview & register TB patients in TB Case Reg. ACTUAL 2 mins./patient _____ patients 5 5 5 5.00 Achieved
1.2 Initiate/continue TB treatment ACTUAL 2 mins./patient _____ patients 5 4 5 4.67 Achieved
1.3 Observe & report to Physician any adverse reaction ACTUAL 30 mins./patient 100%observed patients 5 5 5 5.00 Achieved
1.4 Prepare and issue NTP I.D card ACTUAL 5 mins./patient _____patients 5 5 5 5.00 Achieved
AVERAGE RATING 4.92 Achieved
Support Functions:
1. Conduct health education to registered TB cases ACTUAL 2 hours 166 patients 4 5 5 4.67 Achieved
2. Attends monthly staff meeting ACTUAL Every 2nd Monday of the Month Acted 100% request on invitation 5 5 5 5.00 Achieved
AVERAGE RATING 4.83 Achieved
Final Average Rating 4.76 VS
Comments and Recommendations for Development Purposes
Discussed With Date Assessed by Date Final Rating by Date
I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

MARIA EMILY C. BALLESTEROS JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, James C. Guzman, of the City Health Officer of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
Date:January 01, 2016
Ratee: Approved by: Date

JAMES C. GUZMAN, MD, MHA 1-Jul-16 ATTY. ENGELBERT C. CARONAN 1-Jul-16

City Health Officer City Mayor
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Attends to the administration of health services &
supervise personnel
75 1.5 hrs./day 100% areas covered 5 5 5 5.00 Achieved
2. Monitors & evaluates the implementation of the different
programs & projects
22 1 hr./day 100% areas covered 5 5 5 5.00 Achieved
3. Conducts monthly meetings with the City Health
personnel
6 2 hours 6 5 5 5 5.00 Achieved
AVERAGE RATING 5.00 Achieved
Core Functions:
1. Consult patients referred by MO,Interns & other health 10 min./patient
personnel
As need arises VS feedback 5 5 5 5.00 Achieved
2. Review/signs documents Actual 2 mins. 100% without revision 5 5 5 5.00 Achieved
3. Endorses communications to higher authorities/offices 1 day upon receipt
and other offices
As need arises 100% without revision 5 5 5 5.00 Achieved
AVERAGE RATING 5.00 Achieved
Support Functions:
1.Supervises Medical Interns Conducts case discussion in accordance
Actual July-December 2016 with standard protocol. 5 5 5 5.00 Achieved
2.Conduct post-mortem examination Actual 30 mins./examination 100% examined with VS feedback 5 5 5 5.00 Achieved
3.Acts as Resource Speaker during health events 1 hour Acted 100% request on invitation 5 5 5 5.00 Achieved
AVERAGE RATING 5.00 Achieved
Final Average Rating 5.00 E
Comments and Recommendations for Development Purposes

Discussed With Date Final Rating by Date

1-Jul-16 1-Jul-16
JAMES C. GUZMAN, MD, MHA ATTY. JEFFERSON P. SORIANO
Employee City Mayor
Individual Performance Commitment AND REVIEW (IPCR)

I, Lovely Regina Isabel G. Mabborang , of the Admin. Aide III of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
LOVELY REGINA ISABEL G. MABBORANG
Ratee
Date:January 5, 2015
Reviewed by: Approved by: Date

AMALIA A. CALUBAQUIB 5-Jan-15 JAMES C. GUZMAN, MD, MHA 5-Jan-15

Nutritionist Dietitian III City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Encodes correspondences and forms of theNutrition & ACTUAL Immediately upon request No revision 5 5 5 5.00 Achieved
Population program
2. Sort/Files/deliver incoming and outgoing Immediately upon request No revision 5 4 5 4.67 Achieved
communications and reports of Nutrition & Population prog. ACTUAL

Core Functions:
1 Assist in the conduct of pre-marriage couseling to would 445 couples 5 4 5 4.67
be couples.
ACTUAL Every Friday Achieved
3. Assist in the distribution of Vitamins/Feo4 tabs/syrup to Immediately upon request 25 RHMs 5 4 5 4.67
RHMs ACTUAL Achieved

Support Functions:
1. Assist in the preparation of Nutrition Month Celebration
ACTUAL January-June 2015 100% 4 4 4 4.00 Achieved
2. Attends monthly staff meeting 6 Every 2nd Monday of the Month 6 5 5 5 5.00 Achieved
Final Average Rating 4.67 VS
Comments and Recommendations for Development Purposes
Discussed With Date Assessed by Date Final Rating by Date
I certify that I discussed my assessment of the
performance with the employee.

6-Jul-15 6-Jul-15 6-Jul-15

LOVELY REGINA ISABEL G. MABBORANG AMALIA A. CALUBAQUIB, RND JAMES C. GUZMAN,MD,MHA
Employee Nutritionist Dietitian III City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, GILBERT T. CLAVERIA , of the Nurse I of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
GILBERT T. CLAVERIA
Ratee
Date:January 01, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Assist in the implementation of diff. health programs 4.67
ACTUAL Daily 7 RHMs 5 4 5 Achieved
2. Carrying out doctors'order, e.g drug dispensing,
administration of injections, wound care and numerous
other personalized interventions
Core Functions:
1. Entertains/Admit patients and identify health histories: 100% patients admitted in accordance with 5 5 5 5.00
general data gathering, taking and recording of vital signs, standard procedure
ACTUAL 10 mins./patient Achieved
assisting during physical examination

2. Provide health promotion, counseling and education ACTUAL Every Tuesday & Thursday 100% 5 4 5 4.67 Achieved
3. Attend trainings/seminars ACTUAL Mar-15 100% efficient 5 5 5 5.00 Achieved
4. Conducts Blood Letting Activity Quarterly Every after 3 mos. _____ Donors 5 4 4 4.33 Achieved
AVERAGE RATING 4.75 Achieved
Support Functions:
1. Acts as a Resource Speaker during Health Events ACTUAL 1 hour Acted 100% request on invitation 5 5 4 4.67 Achieved
Final Average Rating 4.69 VS
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

GILBERT T. CLAVERIA JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, MAGNOLIA L. FUGGAN, of the Nurse I of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
MAGNOLIA L. FUGGAN
Ratee
Date: January 01, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Assist in the implementation of diff. health programs 4.67
ACTUAL Monthly 7 RHMs 5 4 5 Achieved
2. Consolidate/analyze and submit Morbidity/Mortality 4.67
report
ACTUAL Once a week 4 5 5 4 Achieved
Core Functions:
1. Entertains/Admit patients and identify health histories: 98% efficient 5 5 5 5.00
general data gathering, taking and recording of vital signs, ACTUAL 10 mins./patient Achieved
assisting during physical examination
100% efficient 5 4 5 4.67
3. Provide health promotion, counseling and education
ACTUAL 15 mins./patient Achieved
4. Carrying out doctors'order, e.g administration of 98% efficient 5 5 4 4.67
injections, wound care and numerous other personalized ACTUAL 2 mins./patient Achieved
interventions
Support Functions:
1. Acts as a Resource Speaker during Health Events ACTUAL 1 hour Acted 100% request on invitation 5 5 4 4.67 Achieved
2. Attend trainings/seminars ACTUAL 6 100% efficient 5 5 5 5.00 Achieved
Final Average Rating 4.76 VS
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

MAGNOLIA FUGGAN JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, GILBERT C. PAÑO , of the Utility Worker of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
GILBERT I. PAÑO
Ratee
Date:January 5, 2015
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 5-Jan-15 JAMES C. GUZMAN, MD, MHA 5-Jan-15

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1.Clean and maintain the health care facilities/premises
Actual Daiy 95% efficient 5 5 4 4.67 Achieved
Core Functions:
1. Maintain adequate house keeping supplies/equipment Daiy 95% efficient
Actual 5 5 4 4.67 Achieved
Support Functions:
1. Dispose/handle medical waste 98% efficient
Actual Daiy 5 4 4 4.33 Achieved
(sharps-syringes/needle)
1.Coordinates with the EPI Nurse Coordinator if 100% efficient
electricity in the building stops working for more than two
hours to ensure potency of the vaccines being stocked Actual As need arises 5 4 4 4.33 Achieved
at the refrigerator.

2. Clean compressor of the freezers. Actual Every Friday 98% efficient 5 5 4 4.67 Achieved
Every second Monday of the 100% efficient
3. Attend staff meeting 6
Month
5 4 4 4.33 Achieved
Final Average Rating 4.50
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

6-Jul-15 6-Jul-15 6-Jul-15

GILBERT C. PAÑO JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, ROCEL A. FABRO , of the Medical Officer III of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
ROCEL A. FABRO
Ratee
Date:January 01, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks

Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Helps the City Health Officer/Medical Officer V attend to
the administration of health services and supervise Serves as an exemplary model inside
70 1.5 hrs./day
& outside the organization
5 5 5 5.00 Achieved
personnel in the absence of the CHO/MO V
2. Attends trainings/meetings
6 Every 2nd Monday of the month 6 5 4 4 4.33 Achieved
Core Functions:
1. Serves as clinician in medical consultation, physcial 10 min./patient
examination & counselling
Actual Serves completely in accordance with 5 5 5 5.00 Achieved
standard procedures
2. Reviews/signs Death/Medical/Health certificates Actual 3 mins./patient 5 5 5 5.00 Achieved
Support Functions:
Conducts case discussion in
Supervises Medical Interns Actual Jan-June 2015
accordance with standard protocol.
5 4 4 4.33 Achieved
Final Average Rating 4.73
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

ROCEL A. FABRO, MD. JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, ROSE-LYN B. LAURON, of the Nurse I of City Health Office commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period July to December 2016
ROSE-LYN B. LAURON
Ratee
Date:January 1, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 5-Jan-15 JAMES C. GUZMAN, MD, MHA 5-Jan-15

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks
 Target Measure Q1 E2 T3 A4
Strategic Priority No:
1. Assist in the implementation of diff. health programs 4.67
ACTUAL Daily 7 RHMs 5 4 5 Achieved
Core Functions:
1. Entertains/Admit patients and identify health histories: 100% patients admitted in accordance with 5 5 5 5.00
general data gathering, taking and recording of vital signs, standard procedure
assisting during physical examination ACTUAL 10 mins./patient Achieved

100% 5 4 5 4.67
3. Provide health promotion, counseling and education
ACTUAL Every Tuesday & Thursday Achieved
4. Carrying out doctors'order, e.g administration of 100% dispensed in accordance with 5 5 4 4.67
injections, wound care and numerous other personalized ACTUAL 2 mins./patient standard procedure Achieved
interventions
Support Functions:
1. Acts as a Resource Speaker during Health Events ACTUAL 1 hour Acted 100% request on invitation 5 5 4 4.67 Achieved
2. Performs cervical smearing to pregnant mothers and 100% smeared in accordance with 5 4 4 4.33
EEW's ACTUAL 10 mins./patient standard procedure Achieved

Final Average Rating 4.67 VS

Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

ROSE-LYN B. LAURON JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer

Individual Performance Commitment AND REVIEW (IPCR)

I, GERONIMO S. ADDATU , of the Local Government of Tuguegarao City of the City Health Office commit to deliver and agree to be rated on the attainment of the following targets
indicated measures for the period July to December 2016
GERONIMO S. ADDATU
Ratee
Date:January 01, 2016
Reviewed by: Approved by: Date

JOSEFINA C. CHUA, MD. 1-Jul-16 JAMES C. GUZMAN, MD, MHA 1-Jul-16

Medical Officer V City Health Officer
Immediate Supervisor Head of Office
Output Success Indicator Actual Accomplishments Rating Remarks
 Target Measure Q1 E2 T3 A4
Strategic Priority No:
1.Drive ambulance in transporting pregnant/sick/
emergency cases to hospitals/birthing facilities.
Actual Daiy 100% Accomplished 5 5 5 5.00 Achieved
Core Functions:
1. Maintain adequate house keeping supplies/equipment Daiy
Actual 100% Accomplished 5 5 4 4.67 Achieved
Support Functions:
1.Coordinates with the City Health Officer r if electricity
in the building stops working for more than two hours to
ensure potency of the vaccines being stocked at the Actual As need arises 100% Accomplished 5 5 5 5.00 Achieved
refrigerator.
Every second Monday of the
2. Attend staff meeting 6
Month
100% Accomplished 5 5 4 4.67 Achieved
4.83 Achieved
Final Average Rating 4.83 VS
Comments and Recommendations for Development Purposes

Discussed With Date Assessed by Date Final Rating by Date

I certify that I discussed my assessment of the
performance with the employee.

1-Jul-16 1-Jul-16 1-Jul-16

GERNIMO S. ADDATU JOSEFINA C. CHUA,MD JAMES C. GUZMAN,MD,MHA
Employee Medical Officer V City Health Officer
 OFFICE PERFORMANCE COMMITMENT AND REVIEW (OPCR)
I, DR. JOSEFINA C. CHUA, Head of the City Health Office, commit to deliver and agree to be rated on the attainment of the following targets in accordance with the following targets in accordance with the indicated measures for the
period January to December 2024.
_______________________
Ratee
Date:January 02, 20
Approved by

JOSEFINA C. CHUA, MD, MPH

City Health Officer

Major Final Output/PAP Success Indicator Division/indivuduals Actual Accomplishments Rating

Target Measure ALLOTED BUDGET Accountable Q1 E2

STRATEGIC PRIORITY
To ensure the health and well-being of the
community
Core Functions: through comprehensive healthcare
services and disease prevention programs.
Delivery of Quality Health Services
Medical Consultations/Check-ups
Maintained a patient satisfaction rating
Achieve a 95% patient satisfaction rating for medical
of 96%, reflecting the quality of care
consultations/check-ups.
and service delivery.

Immunization:
Achieved 98% coverage of essential
Attain 100% coverage of target populations for essential vaccines among target populations,
vaccines. contributing to herd immunity and disease
prevention.

Prenatal/Post-partum Care Achieved a prenatal/post-partum care

Ensure 90% attendance rate for prenatal/post-partum care appointment attendance rate of 92%,
appointments. ensuring comprehensive maternal
healthcare.

Achieved a contraceptive prevalence rate of

Achieve a contraceptive prevalence rate of 50% among
55%, empowering individuals to make
eligible individuals. informed choices about family planning.
Family Planning
Nutrition
Successfully reduced malnutrition rates by
Reduce malnutrition rates by 10% compared to the previous
12% through nutrition education programs
year. and access to nutritional supplements.

Laboratory Services
Achieved a turnaround time of 20 hours for
EMaintain a turnaround time of 24 hours for laboratory test
laboratory test results, enhancing efficiency
results. and timely diagnosis.

Dental Services
Provided dental care to 98% of registered
Provide dental care to 95% of registered patients. patients, promoting oral health and hygiene.
Premarital Counselling
Conduct premarital counselling sessions for 100% of couples.
Adolescent and Youth Health
Engage 80% of adolescents and youth in health education
programs.
Reproductive Health and Wellness (STI, HIV and Aids)
Increase awareness of STI, HIV, and AIDS prevention by
20%.
Ensure 100% compliance with treatment protocols for TB and
leprosy cases.
Infectious Diseases Services (TB/Leprosy):
Counseling and Referral
Provide counselling and referral services to 100% of clients in
need.
Tropical Diseases (Dengue, Malaria, Schistosomiasis): Reduce the incidence of tropical diseases by 15% compared
to the previous year.
Health and Sanitation
Issue sanitary permits to 100% of compliant establishments.
Cardiovascular Diseases:
Reduce mortality rates from cardiovascular diseases by 10%.
Non-Communicable Diseases (Prevention of Blindness,
Hearing, Mental Health, PWDs, Senior Citizens): Provide preventive services to 90% of individuals at risk for
non-communicable diseases.
Birthing Center
Provide safe and comprehensive delivery services to 100% of
expectant mothers.
Issuance of Health Certificates and Medical Certificates:
Issue health certificates and medical certificates within 24
hours of application.
Review of Death Certificates
Review all death certificates within 48 hours of receipt.
Issuance of Permits (Transfer, Cremation):
Provide medico-legal services to 100% of cases requiring
documentation.
SUPPORT FUNCTIONS
Conducted premarital counselling sessions
for all registered couples, promoting healthy
relationships and family planning.
Engaged 85% of adolescents and youth in
health education programs, addressing
issues such as reproductive health and
substance abuse.
Increased awareness of STI, HIV, and AIDS
prevention by 25% through educational
campaigns and outreach programs.
Achieved 100% compliance with treatment
protocols for TB and leprosy cases,
promoting successful treatment outcomes
and disease control.
Provided counselling and referral services
to all clients in need, ensuring access to
appropriate healthcare resources.
Achieved a contraceptive prevalence rate of
55%, empowering individuals to make
informed choices about family planning.
Issued sanitary permits to all compliant
establishments, promoting public health and
safety.
Reduced mortality rates from
cardiovascular diseases by 12% through
early detection and intervention programs.
Provided preventive services to 92% of
individuals at risk for non-communicable
diseases, promoting overall health and well-
being.
Provided safe and comprehensive delivery
services to all expectant mothers, ensuring
maternal and newborn health.
Issued health certificates and medical
certificates within 12 hours of application,
ensuring timely access to healthcare
documentation.
Reviewed all death certificates within 24
hours of receipt, facilitating accurate
reporting and data collection.
Provided medico-legal services to all cases
requiring documentation, supporting legal
proceedings and investigations.
Infrastructure and Facility Maintenance
Maintenance completion rate for health facilities and
equipment.
Achieved a 95% completion rate for
scheduled maintenance, ensuring
uninterrupted service delivery and
optimal functioning of health facilities
and equipment.

2.Human Resource Management Maintained a staff satisfaction rate of

85% and a staff retention rate of 92%
by addressing staff concerns,
Staff satisfaction and retention rate. providing professional development
opportunities, and fostering a
supportive work environment.

3.Procurement and Inventory Management Procurement processes were

completed within the designated
timelines, with 97% of purchases
made within 30 days. Inventory
Timeliness of procurement process and inventory accuracy. accuracy was maintained with a
variance of less than 3%.

4.Information Management and Reporting Submitted all reports accurately and

on time, achieving a 100% accuracy
Accuracy and timeliness of reports submitted. rate and meeting all deadlines set by
relevant authorities.

Community Engagement and Advocacy Increased community participation in

health programs by 25% through a
combination of outreach activities,
Level of community participation and awareness. awareness campaigns, and
participatory decision-making
processes, fostering a sense of
ownership and engagement among

Average Rating

Assessed by: Final Rating by:

Date Date

Planning Office PMT Head of Agency

Legend: 1-Quantity 2-Efficiency 3-Timeliness 4-Average
with the indicated measures for the

_______________________________
Ratee
Date:January 02, 2024

2-Jan-24
Date

Rating Remarks
T3 A4
 Date

2-Jan-24
241140
24114
36300
40190
5000
346744