Sample IPCRF

Republic of the Philippines
Department of Education
Region VI
Division of Iloilo
Santa Barbara Central Elementary S
Roosevelt Street, Sanat Barbara, Iloilo
ANNOTATION TEMPLATE
OBJECTIVES Means of Verification Description of the MOV Pres
1. Classroom observation tool (COT) rating
sheet and/or inter-observer agreement
form about knowledge of content within
and across curriculum teaching areas
2. Lesson plans/modified DLLs developed

highlighting integration of content
✘ knowledge within and across subject areas
1. Applied knowledge of
content within and across 3. Instructional materials highlighting
curriculum teaching areas. mastery of content and its integration in
other subject areas
4. Performance tasks/test material(s)

highlighting integration of content
knowledge within and across subject areas
5. Others (Please specify and provide

annotations)

form about teaching strategies that
enhance learner achievement in literacy
and numeracy skills
2. Lesson plans/modified DLLs used in

teaching highlighting learner-centered
2. Used a range of teaching strategies that promote literacy and/or
strategies that enhance numeracy skills
learner achievement in
literacy and numeracy skills. 3. Instructional materials highlighting
learner-centered strategies that promote
literacy and/or numeracy skills
4. Performance tasks/test material(s) used
in teaching
5. Results of assessment used in teaching

annotations)

form about teaching strategies to develop
critical and creative thinking, as well as
other higher-order thinking skills

3. Applied a range of teaching highlighting different teaching
teaching strategies to strategies that develop critical and
develop critical and creative creative thinking and/or other HOTS
thinking, as well as other
higher- order thinking skills. 3. Instructional materials highlighting
different teaching strategies that develop
critical and creative thinking and/or other
HOTS
in demonstration teaching
5. Results of assessment used in teaching

annotations)

4. Managed classroom sheet and/or inter-observer agreement
structure to engage learners, form about managing classroom structure
individually or in groups, in that engages learners in various activities
meaningful exploration,
discovery and hands-on
activities within a range of 2. Lesson plans/modified DLLs highlighting
physical learning various classroom management strategies
environments. that engage learners in activities/tasks in
different physical learning environments
annotations)
Classroom observation tool (COT) rating

form about teacher management of
learner behavior using the following
strategies:
1. Providing motivation d provide
annotations)
5. Managed learner behavior

constructively by applying
positive and non-violent
2. Praising the learners/Giving
5. Managed learner behavior positive feedback
constructively by applying
positive and non-violent 3. Setting house rules/guidelines
discipline to ensure learning- 4. Ensuring learners’ active
focused environments. participation
5. Allowing learners to express
their ideas/opinions
6. Giving equal opportunities to
learners
7. Encouraging learners to ask
questions
8. Others (Please specify and
provide annotations)

form about using differentiated,
developmentally appropriate learning
experiences
2. Lesson plans/modified DLLs developed

6. Used differentiated, highlighting differentiation in content,
product, process, learning environment or
developmentally appropriate others according to learners’ gender,
learning experiences to needs, strengths, interests and
address learners’ gender, experiences
needs, strengths, interests
and experiences.
3. Instructional materials developed
highlighting differentiation in content,
product, process, learning environment or
others according to learners’ gender,
needs, strengths, interests and
experiences
4. Others (Please specify and provide annota

form about using developmentally
sequenced teaching and learning process
7. Planned, managed and
implemented 2. Lesson plans/modified DLLs
developmentally sequenced highlighting developmentally sequenced
teaching and learning instruction that meet curriculum goals and
processes to meet varied teaching contexts
curriculum requirements and
varied teaching contexts.
implemented
developmentally sequenced
teaching and learning
processes to meet
curriculum requirements and 3. Instructional materials used to
varied teaching contexts. implement developmentally sequenced
teaching and learning process to meet
curriculum requirements and varied
teaching contexts.
annotations)
1. Personal notes of teachers on

LACs/FGDs/meetings with proof of
attendance
8. Participated in collegial
discussions that use teacher
and learner feedback to 2. Minutes of LAC/FGD sessions on use of
enrich teaching practice. teacher and learner feedback to enrich
teaching practice with proof of attendance

annotations)

form about using appropriate teaching
and learning resources, including ICT
Examples:
 Activity sheets/task
sheets/work sheets
9. Selected, developed,  PowerPoint presentations
organized and used
 Video clips
appropriate teaching and
learning resources, including  Module
ICT, to address learning
goals.  SIMs-Strategic Intervention
Materials
 Others
2. Lesson plans/modified DLLs with
appropriate instructional materials
appended

annotations)

form about using diagnostic, formative
and summative assessment strategies
2. Prepared lesson plans/modified DLLs
highlighting appropriate use of formative
assessment strategies
10. Designed, selected,

3. Developed diagnostic tests:
(a) with TOS reviewed by
10. Designed, selected, superior;
organized and used (b) with sample accomplished
diagnostic, formative and questionnaire/answer sheets
summative assessment
strategies consistent with 4. Developed summative tests:
curriculum requirements. (a) with TOS reviewed by
superior;
(b) with sample accomplished
questionnaire/answer sheets
5. Developed performance tasks:
(a) with rubrics reviewed by
superior;
(b) with sample accomplished
rubrics

annotations)
1. Compilation of a learner’s written work

with summary of results and with
signature of parents
2. Formative/summative assessment tools

11. Monitored and evaluated with TOS and frequency of errors with
learner progress and identified least mastered skills
achievement using learner
attainment data. 3. Class records/grading sheets
4. Lesson plans/modified DLLs showing
index of mastery
annotations)
1. At least 3 samples of corrected test

papers of the same 3 learners in the same
learning area with parents’ or guardians’
signature and date of receipt
2. Minutes of PTA meetings or Parent-

Teacher conferences in all quarters with
12. Communicated promptly proof of parents’/guardians’ attendance
and clearly the learners’
needs, progress and 3. Report cards with parent’s or guardian’s
achievement to key signature in all quarters supported by
stakeholders, including minutes of meeting
parents/guardians. 4. Communication with parents/
guardians using various modalities
5. Anecdotal record showing entries per
quarter
6. Other documents showing learners’
needs, progress and achievement
submitted to other stakeholders
1. Certificate of Recognition or
Participation
2. Certificate of Training
3. Certificate of Speakership
4. Committee involvement
13. Performed various 5. Advisorship of Co-curricular activities

related works/activities that
contribute to the teaching- 6. Book or Journal Authorship/
learning process. Coauthorship/Contributorship
7. Coordinatorship/Chairpersons hip
8. Coaching and mentoring learners in

competitions
9. Mentoring pre-service/inservice
teachers
10. Others (Please specify and provide anno

ines Appendix M
tion
ementary School
bara, Iloilo
EMPLATE
n of the MOV Presented Annotations
MT
Region VI
Division of Iloilo
Santa Barbara Central Elementary School
INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM (IPCRF)

Name of Employee: PERLAS M. ACHA
Position: MASTER TEACHER II
Bureau/Center/Service/Division: SALAMAN CENTRAL ELEMENTARY, WEST LEBAK DISTRICT, DIV
Rating Period: SY 2018 - 2019
TO BE FILLED OUT DURING PLANNING
MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

QET Outstanding (5
Basic Educatio1. Content Kn 1. Modeled effeJune 2018 to 0. 075 Quality Modeled effect
Efficiency Submitted at l
Timeliness
QET Outstanding (5
Basic Education Services 2. CollaboratedJune 2018 to 0. 075 Quality Conducted, com
Timeliness Presented the r

QET Outstanding (5
Basic Education Services 3. Developed an
June 2018 to 0. 075 Quality Demonstrated ef
Efficiency Submitted 4 or
Timeliness
Page 13
MT

QET Outstanding (5
Basic Educatio2. Learning En4. Work with coJune 2018 to 0. 075 Quality Modeled and sha
Timeliness

QET Outstanding (5
Basic Education Services 5. Exibited eff June 2018 to 0. 075 Quality Exibited effect
Efficiency Applied atleast
Timeliness

QET Outstanding (5
Basic Education Services 6. Worked withJune 2018 to 0. 075 Quality Worked with col
Timeliness
Page 14
MT

QET Outstanding (5
Basic Educatio3. Curriculum 7. Develop andJune 2018 to 0. 075 Quality Develop and ap
Timeliness

QET Outstanding (5
Basic Education Services 8. Review with June 2018 to 0. 075 Quality Consistently le
Efficiency Submitted 4 co
Timeliness

QET Outstanding (5
Basic Education Services 9. Advised andJune 2018 to 0. 075 Quality Consistently a
Timeliness
Page 15
MT

QET Outstanding (5
Basic Educatio4. Assessment10. Worked collJune 2018 to 0. 075 Quality Consistently r
Timeliness

QET Outstanding (5
Basic Education Services 11. InterpretedJune 2018 to 0. 075 Quality Consistently co
Efficiency Submitted at le
Timeliness

QET Outstanding (5
Basic Education Services 12. Applied skiJune 2018 to 0. 075 Quality Consistently ap
Efficiency Submitted 4 of
Timeliness
Page 16
MT

QET Outstanding (5
Basic Educatio5. Plus Factor 13. Performed June
various
2018 to 0. 1 Quality Consistently
Efficiency Submitted at
Timeliness
ADJECTIVAL RATING EQUIVALENCES

RANGE ADJECTIVAL RATING
4. 500 -5. 000 Outstanding
3. 500- 4. 499 Very Satisfactory
2. 500 - 3. 499 Satisfactory
1. 500 - 2. 499 Unsatisfactory
Below 1. 499 Poor
PERLAS M. ACHA, MT-II

Rater Ratee
Page 17
MT
Name of Rater: ERLINDA R. GAURANA

Position: PRINCIPAL
NTARY, WEST LEBAK DISTRICT, DIVISION OF SULTAN KUDARAT Date of Review: 43374
TO BE FILLED OUT DURING EVALUATION
Actual Results Rating

Very SatisfactoSatisfactory (3Unsatisfactory Poor Q E
Modeled effectModeled effectModeled effectNo acceptable evidence was 4 4
Submitted 3 leSubmitted 2 leSubmitted 1 le No

Conducted andConducted actiProposed-actioNo acceptable evidence was 4 4
Submitted any Submitted anySubmitted anyNo acceptable evidence was shown
Completed theConducted
r theProposed
r the re
No acceptable evidence was shown

Demonstrated Demonstrated
ef Demonstrated
ef No
ef acceptable evidence was 4 4
Submitted 3 leSubmitted 2 leSubmitted 1 orNo acceptable evidence was shown
Page 18
MT

Modeled and shaModeled and shaModeled and shaNo acceptable evidence was 4 4
Submitted 3 leSubmitted 2 le Submitted 1 No acceptable evidence was shown

Exibited effect Exibited effect Exibited effect No acceptable evidence was 4 4
Applied atleastApplied atleastApplied atleastNo acceptable evidence was shown

Worked with colWorked with colWorked with coNo acceptable evidence was 3 3
Submitted at l Submitted at l Submitted at leNo acceptable evidence was shown
Page 19
MT

Develop and apDevelop and apDevelop and apNo acceptable evidence was 4 4
Submitted 2-3Submitted 1 leSubmitted 1 leNo acceptable evidence was shown

Frequently led Occasionally leRarely led coll No acceptable evidence was 3 3
Submitted 3 coSubmitted 2 coSubmitted 1 coNo acceptable evidence was shown

Frequently advOccasionally Rarely advisedNo acceptable evidence was 4 4
Submitted 3 teSubmitted 2 t Submitted 1 t No acceptable evidence was shown
Page 20
MT

Frequently revOccasionally r Rarely revieweNo acceptable evidence was 3 3
Submitted 3 asSubmitted 2 asSubmitted 1 asNo acceptable evidence was shown

Frequently col Occasionally cRarely collabo No acceptable evidence was 4 4
Submitted at l Submitted at l Submitted any No acceptable evidence was shown

Frequently applOccasionally apRarely applied No acceptable evidence was 3 3
Submitted anySubmitted anySubmitted anyNo acceptable evidence was shown
Page 21
MT

Frequently Occasionally Rarely No acceptable evidence was 5 5
Submitted onlySubmitted onlySubmitted any No acceptable evidence was shown
RATING FOR OVERALL ACCOMPLISHMENTS

ADJECTIVAL RATING
PERLAS M. ACHA, MT-II ERLINDA R. GAURANA

Approving Authority
Page 22
MT
ERLINDA R. GAURANA
OUT DURING EVALUATION
Score
T Ave
4 0. 3
Score
T Ave
4 4 0. 3
Score
T Ave
4 0. 3
Page 23
MT
Score
T Ave
4 0. 3
Score
T Ave
4 0. 3
Score
T Ave
3 0. 225
Page 24
MT
Score
T Ave
4 0. 3
Score
T Ave
3 0. 225
Score
T Ave
4 0. 3
Page 25
MT
Score
T Ave
3 0. 225
Score
T Ave
4 0. 3
Score
T Ave
3 0. 225
Page 26
MT
Score
T Ave
5 0. 5
OMPLISHMENTS 3. 8
VERY SATISFACTORY
Page 27
Region VI
Division of Iloilo
ANNOTATION TEMPLATE
OBJECTIVES Means of Verification Description of the MOV Pres

✘
sheet and/or inter-observer agreement form
about effective applications of content
knowledge within and across curriculum
teaching areas

demonstration teaching highlighting
integration of content knowledge within and
across subject areas
3. Instructional materials developed

1. Modeled effective highlighting effective application of content
application of content knowledge within and across subject areas
knowledge within and
across curriculum 4. Performance tasks/test material(s) used
teaching areas. in demonstration teaching highlighting
integration of content knowledge within and
across subject areas
5. Results of assessment used in

demonstration teaching highlighting mastery
of lessons learned

annotations)
1. Copy of the research proposal focused on

enriching knowledge of content and
pedagogy
2. Proof of participation and/or contribution

to a collaborative research (e.g. e-mail,
actual output submitted, terms of reference,
etc.)
2. Collaborated with
colleagues in the conduct
and application of
2. Collaborated with
colleagues in the conduct 3. Certified completed collaborative research
and application of focused on enriching knowledge of content
and pedagogy
research to enrich
knowledge of content and
pedagogy. 4. Proof of dissemination of research
findings with colleagues
5. Proof of utilization of research findings

annotations)

about using effective teaching strategies to
promote critical and creative teaching, as
well as other higher-order thinking skills

demonstration teaching highlighting
different teaching strategies that develop
3. Developed and applied critical and creative thinking and/or other
HOTS
effective teaching
strategies to promote
critical and creative 3. Instructional materials highlighting
thinking, as well as other different teaching strategies that develop
higher- order thinking critical and creative thinking, and/or other
skills. HOTS

in demonstration teaching
5. Results of assessment used in the

demonstration teaching

annotations)

about sharing effective techniques in the
management of classroom structure
4. Work with colleagues
to model and share
effective techniques in the
management of the
classroom structure to
4. Work with colleagues
to model and share
effective techniques in the 2. Lesson plans/modified DLLs used in
management of the demonstration teaching highlighting
effective classroom management strategies
classroom structure to that engage learners in activities/tasks in
engage learners, different physical learning environments
individually or in groups,
in meaningful exploration,
discovery and hands-on 3. Minutes of LAC highlighting the sharing
activities within a range of on effective classroom management
physical learning techniques
environments.
4. Instructional materials used in

annotations)
Classroom observation tool (COT) rating

about effective teacher management of
learner behavior using the following
strategies:
1. Providing motivation
2. Praising the learners/Giving

positive feedback
5. Exibited effective and
constructive behavior
management skills by 3. Setting house rules/guidelines
applying positive and
non-violent discipline to
ensure learning- focused 4. Ensuring learners’ active
participation
environments.
5. Allowing learners to express their
ideas/opinions
6. Giving equal opportunities to

learners
7. Encouraging learners to ask

questions
8. Others (Please specify and

provide annotations)
1. Minutes of LAC session/s, highlighting
one’s sharing of strategies on differentiated
and developmentally appropriate
opportunities to address learners’
differences
6. Worked with
colleagues to share 2. Lesson plans/modified DLLs highlighting
differentiated, strategies on differentiated and
developmentally-appropriate opportunities
developmentally to address learners’ differences
appropriate learning
experiences to address
learners’ gender, needs,
strengths, interests and ✘
3. Corresponding instructional materials
experiences. showing differentiated and developmentally-
appropriate opportunities to address
learners’ differences
4. Others (e.g. testimonial, write-up from

colleagues of the lessons/insights gained
from the Master Teacher's sharing)

about using effective strategies in
implementing developmentally sequenced
teaching and learning process
2. Results of learners’ assessment during

7. Develop and applied the actual teaching
effective strategies in the
planning and 3. Lesson plans/modified DLLs used in
management of demonstration teaching highlighting
developmentally developmentally sequenced teaching-
learning process
sequenced teaching and
learning processes to
meet curriculum
4. Instructional materials showing effective
requirements and varied strategies in developmentally sequenced
teaching contexts. teaching and learning process
5. Performance tasks/test material(s) used in


annotations)
1. Implemented LAC/FGD Plan
8. Review with
colleagues, teacher and 2. Minutes of LAC/FGD sessions on use of
learner feedback to plan, teacher and learner feedback to enrich
facilitate and enrich teaching practice with proof of attendance
teaching practice.
annotations)
1. Teaching and learning resources

developed by colleagues and critiqued on
their alignment to learning goals
9. Advised and guided
colleagues in the
selection, organization, 2. Lesson plans by colleagues critiqued in
development and use of ✘ terms of the alignment of the teaching and
appropriate teaching and learning resources to the indicated learning
goals and appropriateness to the target
learning resources, learners
including ICT, to address
specific learning goals.
annotations)
1. Any proof of collaborative review if the

test is designed based on its purpose (e.g.
diagnostic, formative and summative)
2. Any proof of collaborative review of the

10. Worked alignment of the test with the curriculum
collaboratively with
colleagues to review the
design, selection,
organization and use of a 2.1. formative test attached to a
range of effective lesson plan
diagnostic, formative and
summative assessment
strategies consistent with 2.2. summative assessment with
curriculum requirements. TOS
2.3. diagnostic test with its TOS

annotations)
1. Collaborative interpretation of the index
of mastery obtained from 1 class
11. Interpreted
collaboratively monitoring
and evaluation strategies
of attainment data to
support learner progress
11. Interpreted 2. Collaborative interpretation of item
collaboratively monitoring analysis of quarterly examinations
and evaluation strategies
of attainment data to 3. Collaborative interpretation of results of
support learner progress performance assessment
and achievement.
annotations)
1. Sample agreement for learners at risk

signed by parents and corresponding
evidence of improvement
2. Record of dialogue and/or parent-teacher

conferences and corresponding evidence of
improvement
3. Anecdotal record communicated to and

signed by the learners and/or parents with
corresponding evidence of improvement
4. Sample of learners' test results signed by

parents and corresponding evidence of
improvement
12. Applied skills in the
effective communication
of learner needs, 5. Sample of accomplished rubrics given for
progress and performance task and corresponding
achievement to key
stakeholders, including
parents/guardians. 6. Attendance sheet/minutes of parent-
teacher conference
7. Signed report cards of students at risk

with corresponding evidence of
improvement
8. Correspondence notebook/letters/proof
of communication using other modalities
(e.g. email, SMS, etc.) and corresponding
9. Learners’ performance record

annotations)
1. Served as reliever of classes in the

absence of teachers
2. Served as OIC in the absence of the
principal
3. Represented the principal in meetings and

conferences
4. Observed classes of Teachers I-III
5. Assisted the school selection committee in

the evaluation of credentials when hiring or
promoting teachers
6. Certificate of Recognition or Participation
7. Certificate of Training
13. Performed various
related works/activities
that contribute to the 8. Certificate of Speakership
teaching-learning
process.
9. Committee involvement
10. Advisorship of Co-curricular activities
11. Book or Journal

Authorship/Coauthorship/Contributorship
12. Coordinatorship/Chairpersonship
13. Coaching and mentoring learners in

competitions
14. Mentoring pre-service/in-service

teachers

annotations)
ppines Appendix M
cation
o
lementary School
arbara, Iloilo
EMPLATE
n of the MOV Presented Annotations
Region VI
Division of Iloilo
PART IV: DEVELOPMENT PLANS OF THE IPCRF (IP

Action Plan (Recommended Devel
Strengths Development Needs
Intervention)
A. Teaching Competencies (PPST)
B. Core Behavioral Competencies (DepEd)
Feedback:
RATEE
ublic of the Philippines
partment of Education
Region VI
Division of Iloilo
entral Elementary School
Street, Sanat Barbara, Iloilo
T PLANS OF THE IPCRF (IPCRF-DP)

Action Plan (Recommended Developmental
Timeline Resources Needed
Intervention)
RATER APPROVING AUTHORITY

Region VI
Division of Iloilo
PERFORMANCE MONITORING AND COACHING

DATE CRITICAL INCIDENCE DESCRIPTION OUTPUT
RATEE RATER
ippines
ucation
lo
Elementary School
Barbara, Iloilo
AND COACHING FORM

SIGNATURE
T IMPACT ON JOB/ACTION PLAN
(RATER/RATEE)
RATER APPROVING AUTHORITY

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Republic of the Philippines

2. Lesson plans/modified DLLs developed

4. Performance tasks/test material(s)

5. Others (Please specify and provide

1. Classroom observation tool (COT) rating

2. Lesson plans/modified DLLs used in

6. Others (Please specify and provide

1. Classroom observation tool (COT) rating

2. Lesson plans/modified DLLs used in

6. Others (Please specify and provide

1. Classroom observation tool (COT) rating

Classroom observation tool (COT) rating

5. Managed learner behavior

1. Classroom observation tool (COT) rating

2. Lesson plans/modified DLLs developed

4. Others (Please specify and provide annota

1. Classroom observation tool (COT) rating

1. Personal notes of teachers on

3. Others (Please specify and provide

1. Classroom observation tool (COT) rating

3. Others (Please specify and provide

1. Classroom observation tool (COT) rating

10. Designed, selected,

6. Others (Please specify and provide

1. Compilation of a learner’s written work

2. Formative/summative assessment tools

1. At least 3 samples of corrected test

2. Minutes of PTA meetings or Parent-

13. Performed various 5. Advisorship of Co-curricular activities

8. Coaching and mentoring learners in

10. Others (Please specify and provide anno

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM (IPCRF)

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

MFOs KRAs Objectives Timeline Weight per KRPerformance Indicators

ADJECTIVAL RATING EQUIVALENCES

PERLAS M. ACHA, MT-II

Name of Rater: ERLINDA R. GAURANA

TO BE FILLED OUT DURING EVALUATION

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

Actual Results Rating

RATING FOR OVERALL ACCOMPLISHMENTS