Enclosure 1 to Division Memorandum No. 080 s.

2018

CHECKLIST ON THE RESULT OF TECHNICAL ASSISTANCE PROVISION

Name of Monitor:_______________________________ Position:_________________________________

Name of School:________________________________ District:__________________________________
Name of School Head:___________________________ Date of Monitoring:________________________

Has No MOV Has Incomplete Has Complete &

INDICATORS or Outdated MOV Updated MOV
(0) (0.5) (1)
1. Has a copy of Instructional Supervisory Sheet with
Post Observation Conference duly signed by the
observer & conformed by the teacher
2. Has a copy of approved SIP and AIP
3. Has a copy of latest SMEA result
4. Has a copy of ACR on SLAC conducted twice a
month
5. Has a copy of duly signed performance contract
(IPCRF, OPCRF)
6. Has a copy of updated School Report Card
7. Has updated SBM Hub
8. Has a copy of teachers DLL/DLP, CG showing
localized curriculum
9. Has a copy of latest CDR on liquidation of funds
received
10. Has a copy of students’ monthly reading profile
11. Has a copy of Progress Report on Reading
Program implementation
12. Has a copy of approved School Banner Project
13. Has a copy of the Progress Report on School
Banner Project Implementation
14. Has a copy of Students Nutritional Status
15. Has an updated Transparency Board
16. Has copy of Monthly Supervisory Report and
Monthly Accomplishment Report
17. Has a copy of Action Research Conducted
18. Has a copy of Financial Report on Initiated Income
Generating Project
19. Has a copy of Quarterly MPS received by ITO
20. Has a copy of latest SF4, SF7 received by
Planning Office
21. Has a copy of ACR on Social Mobilization /
Partnership Building Activities
22. Has a copy of LIS screen shots for the quarter
23. Has a copy of Downloaded SBM WinS
Assessment Result
24. Has a copy of document/s showing stakeholders
involvement in PAPs
25. Has a copy of Action Plan on the following
programs: GAD, CFSS, DRR, Journalism,
Scouting, Brigada Eskwela, Gulayan sa Paaralan
TOTAL

Rating Scale:
90% to 100% Outstanding
80% to 89% Very Satisfactory
70% to 79% Satisfactory Rating:________
60% to 69% Fair
59% and Below Poor

Monitor: Conforme:

ZALDY A. TABUGOCA _______________________________

District-In-Charge Printed Name Over Signature
School Head