Name of Employee: LUZVIMINDA O. CUIZON Name of Rater: TITA M.

GALAURA
Position: TEACHER - lll Position: MASTER TEACHER - I
Bureau/Center/Service/Division: DepEd- TUBOD NHS Date of review: JUNE 2018-APRIL 2019
Rating Period:jUNE 2018- MARCH 2019

TO BE FILLED OUT DURING PLANNING TO BE FILLED OUT DURING EVALUATION

Performance Indicators
Weight per Very Rating
MFOs KRAs Objectives Timeline Actual Results
Objective QET Outstanding Satisfactory Satisfactory Unsatisfactory Poor
(5) (4) (3) (2) (1) Q E T Average
Basic 1. Content 1. Applied 7.5% Showed Showed Showed Showed No Showed knowledge
Education Knowledge and knowledge of knowledge of knowledge of knowledge of knowledge of acceptable of content and its
Services Pedagogy content within content and its content and its content and its content and its evidence was integration within
(22.5%) and across integration integration integration integration shown and across subject
curriculum within and within and within and within and areas as shown in
teaching areas. across subject across subject across subject across subject MOV 1 with a rating
Quality areas as shown areas as shown areas as shown areas as shown of 6
in MOV 1 with a in MOV 1 with a in MOV 1 with a in MOV 1 with a
rating of 7 rating of 6 rating of 5 rating of 4

4 4 4
Submitted at Submitted at Submitted at Submitted any 1 No Submitted at least 3
least 4 lessons least 3 lessons least 2 lessons of the given acceptable lessons using MOV 1
using MOV 1 using MOV 1 using MOV 1 MOV evidence was and supported by
and supported and supported and supported shown any 1 of the given
Efficiency by any 1 of the by any 1 of the by any 1 of the MOV
given MOV given MOV given MOV

Timeliness
Basic 2. Used a range 7.5% Facilitated using Facilitated using Facilitated using Facilitated using No Facilitated using
Education of teaching different different different different acceptable different teaching
Services strategies that teaching teaching teaching teaching evidence was strategies that
enhance learner strategies that strategies that strategies that strategies that shown promote reading,
achievement in promote promote promote promote writing and/ or
literacy and reading, writing reading, writing reading, writing reading, writing numeracy skills as
numeracy and/ or and/ or and/ or and/ or shown in MOV 1
numeracy skills numeracy skills numeracy skills numeracy skills with a rating of 6
as shown in as shown in as shown in as shown in
Quality MOV 1 with a MOV 1 with a MOV 1 with a MOV 1 with a
rating of 7 rating of 6 rating of 5 rating of 4

4 4 4
 4 4 4
Submitted at Submitted at Submitted at Submitted at No Submitted at least 3
least 4 learner- least 3 learner- least 2 learner- least 1 learner- acceptable learner-centered
centered centered centered centered lessons evidence was lessons as evidently
lessons as lessons as lessons as as evidently shown shown in MOV 1 and
evidently evidently evidently shown in any 1 supported by any 1
shown in MOV shown in MOV shown in MOV of the given of the other MOV
1 and 1 and 1 and MOV given
supported by supported by supported by
Efficiency any 1 of the any 1 of the any 1 of the
other MOV other MOV other MOV
given given given

Timeliness
Basic 3. Applied a 7.5% Use different Use different Use different Use different No Use different
Education range of teaching teaching teaching teaching teaching acceptable teaching strategies
Services strategies to strategies that strategies that strategies that strategies that evidence was that develop critical
develop critical develop critical develop critical develop critical develop critical shown and creative thinking
and creative and creative and creative and creative and creative and/ or other HOTS
thinking, as well thinking and/ or thinking and/ or thinking and/ or thinking and/ or as shown in MOV 1
as other higher- other HOTS as other HOTS as other HOTS as other HOTS as with a rating of 6
order thinking Quality shown in MOV shown in MOV shown in MOV shown in MOV 1
skills 1 with a rating 1 with a rating 1 with a rating with a rating of
of 7 of 6 of 5 4

4 4 4

Submitted at Submitted at Submitted at Submitted at No Submitted at least 3

least 4 lessons least 3 lessons least 2 lessons least 1 lessons acceptable lessons using MOV 1
using MOV 1 using MOV 1 using MOV 1 using MOV 1 evidence was and supported by
and supported and supported and supported and supported shown any 1 of the given
Efficiency by any 1 of the by any 1 of the by any 1 of the by any 1 of the MOV
given MOV given MOV given MOV given MOV

Timeliness
Basic 2. Learning 4. Managed 7.5% Used classroom Used classroom Used classroom Used classroom No Used classroom
Education Environment and classroom management management management management acceptable management
Services Diversity of structure to strategies that strategies that strategies that strategies that evidence was strategies that
Learners (22.5%) engage learners, engage learners engage learners engage learners engage learners shown engage learners in
individually or in in in in in activities/tasks as
groups, in activities/tasks activities/tasks activities/tasks activities/tasks shown in MOV 1
meaningful as shown in as shown in as shown in as shown in with a rating of 7
exploration, Quality MOV 1 with a MOV 1 with a MOV 1 with a MOV 1 with a
discovery and rating of 7 rating of 6 rating of 5 rating of 4
hands-on
activities within
a range of
physical learning 5 5 5
environments.
 exploration,
discovery and
hands-on
activities within
a range of
physical learning 5 5 5
environments.
Submitted at Submitted 3 Submitted 2 Submitted 1 No Submitted at least 4
least 4 lessons lessons using lessons using lesson using acceptable lessons using MOV 1
using MOV 1 MOV 1 and MOV 1 and MOV 1 and evidence was and supported by
and supported supported by supported by supported by shown any 1 of the given
Efficiency by any 1 of the any 1 of the any 1 of the any 1 of the MOV
given MOV given MOV given MOV given MOV

Timeliness
Basic 5. Managed 7.5% Applied teacher Applied teacher Applied teacher Applied teacher No Applied teacher
Education learner behavior management management management management acceptable management
Services constructively by strategies of strategies of strategies of strategies of evidence was strategies of learner
applying positive learner learner learner learner behavior shown behavior that
and non-violent behavior that behavior that behavior that that promote promote positive
discipline to promote promote promote positive and and non-violent
ensure learning- positive and positive and positive and non-violent discipline as shown
focused non-violent non-violent non-violent discipline as in MOV submitted
environments. discipline as discipline as discipline as shown in MOV with a rating of 7
shown in MOV shown in MOV shown in MOV submitted with
Quality submitted with submitted with submitted with a rating of 4
a rating of 7 a rating of 6 a rating of 5

5 5 5

Submitted at Submitted at Submitted at Submitted any 1 No Submitted at least 4

least 4 of the least 4 of the least 4 of the of the given acceptable of the given
given strategies given strategies given strategies strategies as evidence was strategies as
as observed in as observed in as observed in observed in only shown observed in at least 4
Efficiency at least 4 3 leassons 2 lessons 1 lesson leassons
leassons

Timeliness
Basic 6. Used 7.5% Applied Applied Applied Applied No Applied
Education differentiated, differentiated differentiated differentiated differentiated acceptable differentiated
Services developmentally teaching teaching teaching teaching evidence was teaching strategies
appropriate strategies to strategies to strategies to strategies to shown to adress learner
learning adress learner adress learner adress learner adress learner diversity as shown in
experiences to diversity as diversity as diversity as diversity as MOV 1 with a rating
address learners' Quality shown in MOV shown in MOV shown in MOV shown in MOV 1 of 6
gender, needs, 1 with a rating 1 with a rating 1 with a rating with a rating of
strengths, of 7 of 6 of 5 4
interests and
experiences.

Submitted at Submitted 3 Submitted 2 Submitted 1 any No Submitted 3

least 4 differentiated differentiated 1 differentiated acceptable differentiated
differentiated teaching teaching teaching evidence was teaching strategies in
teaching strategies in at strategies in at strategies in at shown at least 2 leassons as 4 4 4
strategies in at least 2 leassons least 2 leassons least 2 leassons evidenced by MOV 1
least 2 leassons as evidenced by as evidenced by as evidenced by and supported by
as evidenced by MOV 1 and MOV 1 and MOV 1 and any 1 of the other
MOV 1 and supported by supported by supported by acceptable MOV
supported by any 1 of the any 1 of the any 1 of the
 strengths,
interests and
experiences.

Submitted at Submitted 3 Submitted 2 Submitted 1 any No Submitted 3

least 4 differentiated differentiated 1 differentiated acceptable differentiated
differentiated teaching teaching teaching evidence was teaching strategies in
teaching strategies in at strategies in at strategies in at shown at least 2 leassons as 4 4 4
strategies in at least 2 leassons least 2 leassons least 2 leassons evidenced by MOV 1
least 2 leassons as evidenced by as evidenced by as evidenced by and supported by
as evidenced by MOV 1 and MOV 1 and MOV 1 and any 1 of the other
MOV 1 and supported by supported by supported by acceptable MOV
supported by any 1 of the any 1 of the any 1 of the
Efficiency any 1 of the other other other
other acceptable acceptable acceptable MOV
acceptable MOV MOV
MOV

Timeliness
Basic 3. Curriculum and 7. Planned, 7.5% Planned, Planned, Planned, Planned, No Planned, managed
Education Planning (22.5%) managed and managed and managed and managed and managed and acceptable and implemented
Services implemented implemented implemented implemented implemented evidence was developmen-tally
developmentally developmen- developmen- developmen- developmen- shown sequenced teaching
sequenced tally sequenced tally sequenced tally sequenced tally sequenced and learning
teaching and teaching and teaching and teaching and teaching and processes as shown
learning learning learning learning learning in MOV 1 with a
processes to processes as processes as processes as processes as rating of 6.
meet curriculum Quality shown in MOV shown in MOV shown in MOV shown in MOV 1
requirements 1 with a rating 1 with a rating 1 with a rating with a rating of
and varied of 7. of 6. of 5. 4.
teaching
contexts.

Submitted at Submitted 3 Submitted 2 Submitted 1 No Submitted at least 4

least 4 developmentall developmentall developmentally acceptable developmentally
developmentall y sequenced y sequenced sequenced evidence was sequenced teaching 4 5 4.5
y sequenced teaching and teaching and teaching and shown and learning process
teaching and learning learning learning process as evidently shown
learning process as process as as evidently in MOV 1 and
process as evidently evidently shown in MOV 1 supported by any 1
evidently shown in MOV shown in MOV and supported of the other given
shown in MOV 1 and 1 and by any 1 of the MOV
Efficiency 1 and supported by supported by other given
supported by any 1 of the any 1 of the MOV
any 1 of the other given other given
other given MOV MOV
MOV

Timeliness
Basic 8. Participated in 7.5% Consistently Frequently Occasionally Rarely No Frequently
Education collegial participated in participated in participated in participated in acceptable participated in
Services discussions that LACs/FGDs/ LACs/FGDs/ LACs/FGDs/ LACs/FGDs/ evidence was LACs/FGDs/
use teacher and meetings to meetings to meetings to meetings to shown meetings to discuss
learner feedback discuss discuss discuss discuss teacher/learner
to enrich teacher/learner teacher/learner teacher/learner teacher/learner feedback to enrich
teaching feedback to feedback to feedback to feedback to instructions as
practice. enrich enrich enrich enrich shown in the MOV
Quality instructions as instructions as instructions as instructions as submitted
Basic 8. Participated in 7.5% Consistently Frequently Occasionally Rarely No Frequently
Education collegial participated in participated in participated in participated in acceptable participated in
Services discussions that LACs/FGDs/ LACs/FGDs/ LACs/FGDs/ LACs/FGDs/ evidence was LACs/FGDs/
use teacher and meetings to meetings to meetings to meetings to shown meetings to discuss
learner feedback discuss discuss discuss discuss teacher/learner
to enrich teacher/learner teacher/learner teacher/learner teacher/learner feedback to enrich
teaching feedback to feedback to feedback to feedback to instructions as
practice. enrich enrich enrich enrich shown in the MOV
Quality instructions as instructions as instructions as instructions as submitted
shown in the shown in the shown in the shown in the
MOV submitted MOV submitted MOV submitted MOV submitted

4 4 4

Participated in Participated in 3 Participated in 2 Participated in 1 No Participated in 3

at least 4 LACs/FGDs/ LACs/FGDs/ LACs/FGDs/ acceptable LACs/FGDs/
LACs/FGDs/ meetings as meetings as meetings as evidence was meetings as
meetings as evidently evidently evidently shown shown evidently shown in
evidently shown in any 1 shown in any 1 in any 1 of the any 1 of the given
Efficiency shown in any 1 of the given of the given given MOV MOV
of the given MOV MOV
MOV

Timeliness
Basic 9. Selected, 7.5% Developed and Developed and Developed and Developed and No Developed and used
Education developed, used varied used varied used varied used varied acceptable varied teaching and
Services organized and teaching and teaching and teaching and teaching and evidence was learning resources,
used appropriate learning learning learning learning shown including ICT, to
teaching and resources, resources, resources, resources, address learning
learning including ICT, to including ICT, to including ICT, to including ICT, to goals as shown in
resources, address address address address learning MOV 1 with a rating
including ICT, to learning goals learning goals learning goals goals as shown of 6
address learning as shown in as shown in as shown in in MOV 1 with a
goals. Quality MOV 1 with a MOV 1 with a MOV 1 with a rating of 4
rating of 7 rating of 6 rating of 5

Submitted at Submitted 3 Submitted 2 Submitted any No Submitted 3 varied 4 4 4

least 4 varied varied teaching varied teaching teaching and acceptable teaching and
teaching and and learning and learning learning evidence was learning resources
learning resources resources resources shown including ICT, as
resources including ICT, as including ICT, as including ICT, as evidently shown in
including ICT, as evidently evidently evidently shown MOV 1 and
evidently shown in MOV shown in MOV in MOV 1 and supported by any 1
shown in MOV 1 and 1 and supported by of the acceptable
Efficiency 1 and supported by supported by any 1 of the MOV
supported by any 1 of the any 1 of the acceptable MOV
any 1 of the acceptable acceptable
acceptable MOV MOV
MOV
 shown in MOV 1 and 1 and supported by of the acceptable
Efficiency 1 and supported by supported by any 1 of the MOV
supported by any 1 of the any 1 of the acceptable MOV
any 1 of the acceptable acceptable
acceptable MOV MOV
MOV

Timeliness
Basic 4. Assessment and 10. Designed, 7.5% Designed, Designed, Designed, Designed, No Designed, selected,
Education Reporting selected, selected, selected, selected, selected, acceptable organized and used
Services (22.5%) organized and organized and organized and organized and organized and evidence was diagnostic, formative
used diagnostic, used diagnostic, used diagnostic, used diagnostic, used diagnostic, shown and summative
formative and formative and formative and formative and formative and assessment
summative summative summative summative summative strategies consistent
assessment assessment assessment assessment assessment with curriculum
strategies strategies strategies strategies strategies requirements as
consistent with consistent with consistent with consistent with consistent with shown in MOV 1
curriculum curriculum curriculum curriculum curriculum with a rating of 7
requirements. requirements as requirements as requirements as requirements as
Quality shown in MOV shown in MOV shown in MOV shown in MOV 1
1 with a rating 1 with a rating 1 with a rating with a rating of
of 7 of 6 of 5 4

5 5 5

Submitted at Submitted 3 Submitted 2 Submitted 1 No Submitted at least 4

least 4 varied varied varied assessment acceptable varied assessment
assessment assessment assessment tools as evidence was tools as evidently
tools as tools as tools as evidently shown shown shown by any 1 of
evidently evidently evidently by any 1 of the the acceptable MOV
shown by any 1 shown by any 1 shown by any 1 acceptable MOV
Efficiency of the of the of the
acceptable acceptable acceptable
MOV MOV MOV

Timeliness
Basic 11. Monitored 7.5% Consistently Frequently Occasionally Rarely Consistently
Education and evaluated monitored and monitored and monitored and monitored and monitored and
Services learner progress evaluated evaluated evaluated evaluated evaluated learner
and achievement learner learner learner learner progress progress and
using learner progress and progress and progress and and achievement using
attainment data. achievement achievement achievement achievement learner attainment
using learner using learner using learner using learner No data as shown in the
attainment data attainment data attainment data attainment data acceptable MOV submitted
Quality as shown in the as shown in the as shown in the as shown in the evidence was
MOV submitted MOV submitted MOV submitted MOV submitted shown

5 5 5 5
Submitted a Submitted a Submitted a Submitted 1 No Submitted a
combination of combination of combination of acceptable MOV acceptable combination of at
at least 4 of the 3 of the 2 of the evidence was least 4 of the
acceptable acceptable acceptable shown acceptable MOV
Efficiency MOV MOV MOV
 5 5 5 5
Submitted a Submitted a Submitted a Submitted 1 No Submitted a
combination of combination of combination of acceptable MOV acceptable combination of at
at least 4 of the 3 of the 2 of the evidence was least 4 of the
acceptable acceptable acceptable shown acceptable MOV
Efficiency MOV MOV MOV

Submitted MOV Submitted MOV Submitted MOV Submitted MOV No Submitted MOV
were were were was completed acceptable were distributed
distributed distributed distributed in only 1 quarter evidence was across 4 quarters
Timeliness across 4 across 3 across 2 shown
quarters quarters quarters

Basic 12. 7.5% Consistently Frequently Occasionally Rarely showed No Consistently showed
Education Communicated showed prompt showed prompt showed prompt prompt and acceptable prompt and clear
Services promptly and and clear and clear and clear clear evidence was communication of
clearly the communication communication communication communication shown the learners' needs,
learners' needs, of the learners' of the learners' of the learners' of the learners' progress and
progress and needs, progress needs, progress needs, progress needs, progress achievement to key
achievement to and and and and stakeholders,
key stakeholders, achievement to achievement to achievement to achievement to including
including key key key key parents/guardians as
parents/guardian stakeholders, stakeholders, stakeholders, stakeholders, shown in the MOV
s including including including including submitted
parents/guardia parents/guardia parents/guardia parents/guardia
Quality ns as shown in ns as shown in ns as shown in ns as shown in
the MOV the MOV the the MOV
submitted submitted submitted

5 5 5 5

Submitted a Submitted a Submitted a Submitted any 1 No Submitted a

combination of combination of combination of of the given acceptable combination of at
at least 4 of the 3 of the 2 of the MOV evidence was least 4 of the
acceptable acceptable acceptable shown acceptable MOV
Efficiency MOV MOV MOV

Submitted MOV Submitted MOV Submitted MOV Submitted MOV No Submitted MOV
were were were was completed acceptable were distributed
distributed distributed distributed in only 1 quarter evidence was across 4 quarters
Timeliness across 4 across 3 across 2 shown
quarters quarters quarters

Basic 5. Plus Factor 13. Performed 10% Consistently Frequently Occasionally Rarely No Consistently
Education (10%) various realted performed performed performed performed acceptable performed various
Services works/ activities various realted various realted various realted various realted evidence was realted works/
that contributes works/ works/ works/ works/ activities shown activities that
to the teaching- activities that activities that activities that that contributes contributes to
learning process. contributes to contributes to contributes to to theteaching- theteaching-learning
theteaching- theteaching- the teaching- learning process process as shown in
learning learning learning as shown in the the MOV submitted.
process as process as process as MOV submitted.
Quality shown in the shown in the shown in the
MOV MOV MOV
submitted. submitted. submitted.
Basic 5. Plus Factor 13. Performed 10% Consistently Frequently Occasionally Rarely No Consistently
Education (10%) various realted performed performed performed performed acceptable performed various
Services works/ activities various realted various realted various realted various realted evidence was realted works/
that contributes works/ works/ works/ works/ activities shown activities that
to the teaching- activities that activities that activities that that contributes contributes to
learning process. contributes to contributes to contributes to to theteaching- theteaching-learning
theteaching- theteaching- the teaching- learning process process as shown in
learning learning learning as shown in the the MOV submitted.
process as process as process as MOV submitted.
Quality shown in the shown in the shown in the
MOV MOV MOV
submitted. submitted. submitted.

5 5 5

Submitted at Submitted 3 Submitted 2 Submitted any 1 No Submitted 3 different

least 4 different different kinds different kinds of the acceptable kinds of acceptable
kinds of of acceptable of acceptable acceptable MOV evidence was MOV
acceptable MOV MOV shown
Efficiency MOV

Timeliness

RATING FOR
OVERALL ACCOM- VERY SATISFACTORY
PLISHMENTS
ON

Score

0.3

0.3
 0.3

0.3

0.375
0.375

0.375

0.3
 0.3

0.337
0.3

0.3
0.375

0.375
0.375

0.375
0.375

4.387
 Republic of the Philippines
Department of Education
Caraga Administrative Region
Division of Surigao del Norte
District of Tubod

TUBOD NATIONAL HIGH SCHOOL

Tubod, Surigao del Norte

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW FORM (IPCRF)

SUMMARY OF RESULTS

Name of Ratee: LUZVIMINDA O. CUIZON Name of Rater: TITA M. GALAURA

Position: Teacher-III Position: Master Teacherl-I
Rating Period: JUNE 2018– APRIL 2019

Weight per Weight per Numerical Ratings

KRA KRA Objectives Objective SCORE
Q E T Average
Objective 1 7.5% 4 4 4 0.3
KRA 1 Objective 2 7.5% 4 4 4 0.3
Objective 3 7.5% 4 4 4 0.3
Objective 4 7.5% 5 5 5 0.375
KRA 2 Objective 5 7.5% 5 5 5 0.375
Objective 6 7.5% 4 4 4 0.3
Objective 7 7.5% 4 5 4.5 0.337
KRA 3 Objective 8 7.5% 4 4 4 0.3
Objective 9 7.5% 4 4 4 0.3
Objective 10 7.5% 5 5 5 0.375
KRA 4 Objective 11 7.5% 5 5 5 5 0.375
Objective 12 7.5% 5 5 5 5 0.375
PLUS
FACTOR Objective 13 10% 5 5 5 0.375
Final Rating 4.387
Adjectival Rating VS

RATER – RATEE AGREEMENT

The signatories below confirm that the employee and his/her supervisor have agreed
on the content of this appraisal form and the performance rating.

Name of Ratee: Name of Rater: Name of Approving Authority:

LUZVIMINDA O. CUIZON TITA M GALAURA CONCORDIO G. CUBELO, JR.

Teacher-III Master Teacher-I Secondary School Principal-I

Date: 4/05/2019 Date: 4/05/2019 Date: 4/22/2019

Name of Approving Authority: