DEPARTMENT OF EDUCATION

FRUITS OF FAITH SCHOOL INC.

ECCD / KINDERGARTEN EDUCATION RECORD
SY ____________

NAME OF CHILD: ______________________________ LRN : ________________________

AGE : ______ GENDER: [ ] MALE [ ] FEMALE DATE OF BIRTH: __________________
HANDEDNESS: [ ] RIGHT [ ] LEFT PLACE OF BIRTH : ________________________
D O M A I N
CHILD’S AGE: CHILD’S AGE: CHILD’S AGE:
Expressive domain

Expressive domain

Expressive domain
Socio – Emotional
INTERP
Receptive domain

Receptive domain

Receptive domain
Socio – Emotional

Socio – Emotional
Cognitive domain

Cognitive domain

Cognitive domain
Scaled Score
Scaled Score

Scaled Score
Gross motor

Gross motor

Gross motor
RE
Fine motor

Fine motor

Fine motor
Self - Help

Self - Help

Self - Help
TATIO
domain

domain

domain
N

19 19 19
DEVELOPMENT

18 18 18
17 17 17
ADVANCED

16 16 16
15 15 15
14 14 14
13 13 13
12 12 12
DEVELOPM
AVERAGE

10 11 11
9 10 10
ENT

8 9 9
7 8 8
7 7 7
6 6 6
5 5 5
AFTER 3 -6

4 4 4
3 3 3
2 2 2
1 1 1

DATE OF FIRST ADMINISTRATION: ________________________________ AGE: ______________

DATE OF SECOND ADMINISTRSTION: ________________________________ AGE: ______________
DATE OF THID ADMINISTRATION: _________________________________ AGE: ______________

Interpretation of Scaled Score Interpretation of Scaled Score

Scaled Score Interpretation Scaled Score Interpretation
A 1 -3 Significant Delay A 69& BELOW Significant Delay
B 4–6 Significant Delay B 70 – 80 Significant Delay
C 7 – 13 Average Delay C 81 – 119 Average Delay
D 14 – 16 Slightly Advanced D 120 - 129 Slightly Advanced
E 17 - 19 Highly Advanced E 130 & ABOVE Highly Advanced