Republic of the Philippines

Department of Education
Region IV - CALABARZON
Schools Division of Lipa
South District
Elementary School
Lipa City

EARLY CHILDHOOD DEVELOPMENT CHECKLIST

2ND ASSESSMENT
Name of Child DOMAINS
Afternoon Session Date of GROSS MOTOR FINE MOTOR SELP HELP RECEPTIVE LANGUAGE EXPRESSIVE LANGUAGE COGNITIVE SOCIAL EMOTIONAL TOTAL
No. Age Interpretation
Birth Raw Scaled Raw Scaled Raw Scaled Raw Scaled Raw Scaled Raw Scaled Raw Scaled Raw Scaled STANDARD
MALE Score Score Score Score Score Score Score Score Score Score Score Score Score Score Score Score SCORE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
FEMALE
1
2
3
4
5
6
7
8
9
10
11
12
13
NOTED:
PREPARED BY:
School Principal Kindergarten Teacher