COMMISSION ON HIGHER EDUCATION

Regional Office NCR

MONITORING AND EVALUATION INSTRUMENT
Name of HEI : _______________________________ Address: _______________________________ Tel/Fax No. ______________________________
Date Established: ____________________________ Date last monitored: ______________________ Date of Monitoring: ________________________
HEI Head: ____________________________________ Position: ________________________________ E-mail add:______________________________

I. GOVERNANCE AND MANAGEMENT

INSTITUTIONAL PROFILE

VISION- MISSION-GOALS-OBJECTIVES
a. Presence of V-M-G-O (Vision, Mission, Goals, Objectives) _______
b. Displayed in conspicuous places ______
c. Activities conducted along the school’s V-M-G-O __________________________________________

COMPLIED NOT COMPLIED REMARKS

A. VISION- MISSION-GOALS-OBJECTIVES
A.1 Presence of V-M-G-O (Vision, Mission, Goals, Objectives)
A.2 Displayed in conspicuous places ______
A.3 Activities conducted along the school’s V-M-G-O

B. ADMINISTRATORS (PRES, VPS AND OTHER KEY OFFICIALS)

C.ORGANIZATIONAL STRUCTURE/CHART
a. Institutional
b. Department
D.MANUAL / HANDBOOK
a. Faculty/Teaching Personnel
b. Non-Teaching Personnel
c. Student
E. OTHERS (Optional)

ACADEMIC PROGRAMS
Program Offerings Authority No. of No. of Program Offerings Authority No. of No. of
Granted Enrollees Graduates Granted Enrollees Graduates

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 A. Conventional

B. Non- Conventional
Distance Education
Open Learning
E-Learning
ETEEAP
Ladderized Education
Transnational Educ.
Twinning Program
Extension Program/ Classes

Effectivity Reason/s Remarks

List of programs under permit phase/ not 1.
yet recognized 2.
3.
List of programs voluntarily phased-out 1.
by HEIs (include effectivity date) 2.
3.
List of programs phased-out by 1.
CHEDCO/CHEDRO NCR 2.
3
 INSTITUTIONAL DEVELOPMENT PLAN
COMPLIED NOT COMPLIED REMARKS
a. Presence/proof
b. Implementation Status

LIST AND LEVEL OF ACCREDITED PROGRAMS / COE / COD

DISCIPLINE / PROGRAM LEVEL ACCREDITING BODY VALIDITY PERIOD

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 QUALITY ASSURANCE MECHANISM (ISA, ISO, Typology) REMARKS
a. Category
b. Coordinator
c. Status

 AWARDS/RECOGNITION RECEIVED BY THE INSTITUTION

International/ National/ Regional Level/ Local
Instructional Non-Instructional Awarded by: Date
Blood Service Platinum Award Red Cross July 27, 2018

ADMINISTRATION
PROGRAMS Program Dean/Head Experience (No. of Yrs.) Employment Status Teaching Loads
Academe Industry

NON-TEACHING STAFF
Designation Name Highest Educational Attainment Employment Status Contract of Appointment/ Emp.
Registrar -

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 Others: (SPECIFY)
LIBRARIAN

GUIDANCE COUNSELOR Ms. Angel Bautista Master of Arts in Education major in Full time August 1, 2018
Psychology

NSTP COORDINATOR Mr. Argel N. Barrientos Masters in Physical Education Major Full time June 1, 2017
in Sports (Units)
NURSE

MEDICAL

DENTAL

LIAISON OFFICER

RESEARCH DIRECTOR

OSA ( refer to instrument) Mr. Wilson Morano Juris Doctor (JD)/ Masters in Public Regular April 25, 2017
Administration (MPA)

Proof/s of updated benefits remittances YES NO Remarks _____________________________________________________________________________

(SSS, PAG-IBIG, PhilHealth, Retirement/PERAA)

II. QUALITY OF TEACHING AND RESEARCH

FACULTY
A. General Education PROGRAMS
1. No. of Faculty
1.1. Percentage of Master’s Degree holders
1.2. Percentage of Full-time
1.3. Percentage of faculty teaching along area of specialization
1.4. With Contracts/Appointment
1.5. P.E. faculty w/specialization In P.E.

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B. Professional Subjects
1. Total No. of Faculty
- Baccalaureate degree holders
- W/ Master’s units
- Master’s degree holders
- W/ Doctoral units
- Doctoral degree holders
2. Percentage of:
- Master’s degree holders
- Full-time
- Faculty teaching along area of specialization
3. W/ Contracts/Appointment
4. Experience in Academe/Industry
C. Assignment/Teaching Load (per unit per term)
1. Full-time faculty (max. 24 units, 4 preps per term)
2. Part-time faculty (max. 15 units)

COMPLIED NOT COMPLIED REMARKS

D. Faculty/Staff Development Program- ( at least 5 years)
a. Proof/s of trainings, scholarships and graduate studies
b. HEI’s assistance
E. Faculty Assessment
a. Evaluation Instrument
b. Periodic Evaluation
F. Faculty Involvement (linkages)
Date of Engagement Extent of Linkages
1.
2.
3.
TWINNING LINKAGES
International
Faculty
Students
Others

OJT/PRACTICUM
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 Presence of OJT/Practicum Manual June 26, 2018
Program Coordinator Ms. Riza Lea Mateo
and Mr. Julius Battung
International Ms. Riza Lea Mateo
National Ms. Riza Lea Mateo
and Mr. Julius Battung
Local or Regional Ms. Riza Lea Mateo
and Mr. Julius Battung

III. CURRICULUM
COMPLIED NOT COMPLIED REMARKS
- Curriculum noted by CHEDRO (by program)
NATIONAL SERVICE TRAINING PROGRAM
a. Component (ROTC/CWTS/LTS) X
b. NSTP Office X Under Renovation

c. Director/Coordinator X
d. Masterlist of enrollees/semester X
e. Masterlist of graduates (end of AY)/ Request for Serial No. of Grad. X
f. Accredited Provider (School/NGOs) X
g. Notarized MOA (w/ NGO) X
h. Syllabi X
i. Modules X
j. Insurance provider X
l. Fee (Based on RA 9163, NSTP Law) X
m. Report on the utilization of NSTP Funds X
RESEARCH CAPABILITIES
a. Research Center/Office
b. Research Director or Coordinator
c. Research Agenda
d. Institutional Research
e. Research budget

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 f. Involvement of Faculty/ Research Staff
g. Research output/s
h. Inventions (Patented and Commercialized)
i. Research Journal (refereed)
j. Research Journal (locally published)
k. Research Manual
l. Institutional Research Applied/ Implemented

LIBRARY
a. Qualified Librarian
b. Library Assistants
c. Total Library Holdings (total accessioned books)
D. Library Development Plan
e. Seating Capacity

IV. STUDENT SERVICES

COMPLIED NOT COMPLIED REMARKS
1. Dean/Coordinator for Student Services X
2. Admission/Retention Policies X Indicated in Student Handbook
3. Masterlist of Enrollees of foreign students
3.1 Foreign Student Unit Coordinator (L.O.)
4. BID permit
5. STUFAP
5.1 CHED Program
5.2 Compliance GASTPE (5%)
5.3 Others
6. Guidance Services X
6.1 Qualified guidance counselor/s X
6.2 Psychological Testing materials (original)/Standardized Teacher X
made testing materials
6.3 Guidance office with counseling area (w/ one way mirror) X

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 6.4 Conduct of aptitude test X
6.5 Career Guidance Activities X Employment Preparation Seminar, Job Fair, ICARES
(Graduate Placement Activities/Job Fair/Graduate Tracer Studies)
7. Student Assistance and Services
7.1 School Paper X
7.2 Campus Journalism X
- Campus Publication X
- Activities
7.3 Student Council/Government X
7.4. Student Crime Prevention Council X CSG Police
7.5. Implementation of RA 9165 (Dangerous Drug Act 2002) X
7.6 Implementation of RA 7877 “Anti- Sexual Harassment Act of 1995” X
7.7 Implementation of RA 9211 “Tobacco Regulation Act of 2003” X
7.8 Implementation of RA 8049 “Anti-hazing law” X
7.9. Extra-curricular activities X Sportsfest, Zumba Party, Gardening
-Sports activities
- Religious/Spiritual
-Cultural
- Health /Environmental activities
7.10 Academic Activities X DENR Quiz Bee
-Quiz Bee
-Essay contests and related activities
-Remedial /Enrichment Classes
7.11 Search for Outstanding Student Leader X

IV.COMMUNITY EXTENSION/OUTREACH (separate from NSTP)

COMPLIED NOT COMPLIED REMARKS
1. Community Extension/Outreach Area/Office X
2. Community Extension/Outreach Coordinator X Mr. Argel N. Barrientos
3. Programs and Projects X “A December to Remember” Bgy. Sto Cristo, Quezon City

4. Linkages with Industry/GOs/NGOs/ NETWORKING X Haribon Foundation, Philippine National Red Cross

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5. Involvement of Faculty, Staff and Students X
6. Sustainability of the project X
7. Extension Manual X
8. Adopted Community / Forest X

V. PHYSICAL FACILITIES
COMPLIED NOT COMPLIED REMARKS
A. Site/Location
- Area
- Owned/Leased in the name of the school
- Free from disturbances, noise and places with undesirable influences
B. Classrooms WITH WITHOUT
1. No. of classrooms
2. Area per classroom (1 sq.m. per student)/ seating capacity)
3. State of the art facilities in every classroom
4. Area for indoor P.E. /NSTP
C. Science Laboratories
1. Chemistry Lab is provided with sufficient hose or devices for the exit of irritating or
poisonous gases (Fumehood)
2. Area per Laboratory (1.5 sq.m. per student)
3. Fire extinguisher/bucket of sand/fire blanket
5. Shower room/lavatories
4. Gas appliance vented to the outside or to a suitable stack
6. Poisonous chemicals and materials are kept in appropriate & secured areas & disposed of
properly
7. Waste disposal facility/system
8. With 2 doors each opening out (if one door at least 2 meters wide)
9. Well-ventilated
10. Adequately illuminated
11. Clean and properly maintained
12. Essential features needed in the laboratories are present
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 13. Sufficient/functional equipment, supplies and tools
14. With first aid kit
D. LABORATORY FOR PROFESSIONAL SUBJECTS (SEPARATE SHEET)
SPECIFIC REQUIREMENTS PER PROGRAM
For Education:
1. For Practice Teaching: Approval and MOA both with public and private schools
2. Presence of a Laboratory / Cooperating School
On-Campus – the facility is administered by the institution and its faculty
Off-Campus – there is a long term memorandum with a cooperating school or
with a cluster of cooperating schools.
3. Laboratory Requirements: there are appropriate laboratory facilities for
programs offering specializations in the science and technology fields.
4. Educational Technology Laboratory which have the appropriate computer
equipment and software. It allows preparation, presentation and viewing of
audio-visual materials to support instruction.
5. Admission and Retention Policies
For AB Psychology
1. Psychology laboratory that contains the following:
a. Three (3) computers with Internet access for use of faculty and students
b. Original Testing materials
c. Counselling room with one-way mirror (one side is for the observer and
one side is for the student being observed).
For AB Journalism
1. Computer laboratory – 1:1 ratio and with printer.
2. Photography Laboratory – dark room with 1:2 computer to student ratio and
with printer.
3. Newspaper production laboratory
4. Newsroom with 1:2 computer to student ration and with printer
For AB Communication program
1. Computer laboratory
2. Photography laboratory
3. Broadcast equipment/facilities
For AB Broadcasting
1. 1:1 computer to student ratio for the computer laboratory
2. For radio, sufficiently equipped audio production and post production
facilities shld be reasonable and adequate for effective undergraduate work.
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 3. For Television, a sufficiently equipped studio, electronic news gathering
(ENG), Electronic Field Production (EFP) and post production equipment
should be reasonable and adequate for effective undergraduate work.
4. Technical Support: a qualified technician with adequate training and
experience inn radio and television operation and maintenance.
For AB Performing Arts
A. Dance Program: Dance studio ( 8m x 8m x 3.5m) ideally safe with floor,
mirrors and barres with provisions for music and video playback for classes.
B. Theatre Program: Black box theater or any equivalent space for classes,
rehearsals and performances.
C. Technical Theater: Scene shop or any equivalent space.
Note: General Facilities
Music and video recorders and players for dance and theater tracks.
Software for dance notation for dance track
Basic lighting equipment ( lights, boards, par lights, wires and gels) for dance
and theatre tracks
Storage room or space for costumes and set pieces.
For Information Technology Education/ BS Computer Engineering
1. 2 Computer Laboratories with 15/LAB Capacity (Minimum) 20% should be
latest model.
2. Current License of the Operating System and Office.
It should be one (1) license per computer unit.
If Academic License, check the number of units covered and it should be
named after the school being monitored.
For BS Hospitality Management/ BS Hotel and Restaurant Management/ BS
Tourism Management
1. Kitchen Laboratories ( Separate Hot and Cold Kitchens, Baking Kitchen)
2. General Storeroom with Inventory System
3. Dining Area
4. Commercial Kitchen for Quantity Food Production
5. Bar-Set up for instructional purposes
6. For Hotel operations: Mock Hotel ( reception area outside mock hotel room),
mock hotel room set-up with full bathroom
7. For Travel Management: Mock-up Travel
For BS Accountancy/ BS Accounting Technology
1. Computers with Accounting Information Systems Software
For BS in Office Administration
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 1. Education Technology Centers – facilities to allow preparation, presentation
and viewing of audio-visual materials to support instruction.
For BS Entrepreneurship
1. Incubator room with complete/adequate facilities (machines: photocopying,
facsimile, computer, printer; internet connection, chairs, tables, whiteboard for
meetings, warehouse/storage space)
For BS in Criminology ( Police Science Laboratory)
1. Gymnasium or facility for defensive tactics
2. Interrogation room with one-way mirror for criminal interrogation
3. Crime Laboratory for question documents and ballistics
4. An Observation room
5. Permanent crime scene room and other instructional rooms
6. Target range
7. Swimming pool
For Dentistry Program
1. Basic Medical laboratory ( Biochemistry, General Physioogy, Pharmacology,
Microscopic Anatomy, General Pathology and Microbiology)
2. Basic Dental Subject Laboratory ( Restorative Dentistry, Endodontics,
Prosthodontics, Orthodontics and Pedodontics)
3. Pre-Clinical Laboratory with the following facilities:
One mannequin or phantom head per student
10 simulators per class
One articulated metal or acrylic per student
2 sets of adjustable anatomic articulator with accessories for demonstration
purposes
Dental surveyor set 8 pcs. for a class of 40-50 students
2 pieces curing unit /class
Cast trimmer, centrifugal casting machine, furnace, acethylene torch and tank,
lathe machine, spot welder.
Dental chair ( 1: 4 students)
4. Radiology laboratory (must be located in close proximity to clinic) with: x-ray
machine, periapical x-ray machine, panoramic/cephalometric x-ray machine
5. Licensed /registered radiologic technician
6. Sterilizing room
7. Personnel trained in infection control
For Medicine Program

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 1. Skills laboratory with facilities which represent similar settings to the actual
place of medical practice including community, ambulatory care facilities and
in-patient care facilities.
2. Base Hospital with at least DOH level III hospital with accredited residency
training program in medicine, surgery, pediatrics and OB-GYNE located within
the same region.
3. Audio-Visual Equipment – films, slide and overhead projectors, tapes and CDs,
charts, pictures and models.
For Medical Technology:
Presence of a Medical Technology Laboratory
1. Must be distinct from the clinical facilities of the hospital
2. Shall provide requirements for the following laboratories:
 Biological Sciences
 Clinical Chemistry
 Immunology and Serology
 Blood Banking
 Hematology
 Microbiology
 Clinical Microscopy
 Parasitology
 Histopathology
 Toxicology
3. With Medical Laboratory Science/Medical Technology (MLS/MT) Training Laboratory
– a tertiary category hospital-based and/or institution-based clinical laboratory duly
licensed to operate by the Bureau of Health Facilities and Services (BHFS) of the
Department of Health (DOH) to be the training facility for Medical Laboratory
Science/Medical Technology interns.
4. MOA with an accredited affiliation center
For Nursing:
Presence of Nursing Skills Laboratory
 Well-lighted and well-ventilated with at least 8m x 112 sq.m for return demonstration
and practice area
 Simulated major and special areas in hospital setting equipped with basic instruments,
equipment and supplies
 Amphitheater style demo room that can accommodate a maximum of 50 students

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 Ratio of bed to practicing students is 1:2 at a time
 With at least 2 doors serving as entrance and exit
 With at least 1 fire extinguisher placed outside the door in each science lab/nursing
skills lab. Fire extinguisher attached with record of refill and expiry date (Fire Safety Code)
 Presence of the following basic demonstration models & equipment and evidence of
utilization:
a. Birthing Model
b. Newborn Model
c. Adult Bisexual
1. DOH certification of the institution’s 100-bed capacity/80% occupancy base hospital
within the region or MOA w/ the hospital
2. Updated Contracts of Affiliation
3. Actual Master Rotation Plan for RLE –
For Pharmacy:
1. Presence of separate laboratory for physical, biological, pharmaceutical sciences and
research
2. Presence of Botanical Garden
3. Separate well maintained animal house
For Physical Therapy/Occupational Therapy (PT/OT):
1. Presence of PT/OT Laboratory with equipment inventory
2. MOA with an accredited affiliation center
For Radiologic Technology
1. Presence of Radiologic Technology Laboratory
- with inventory of laboratory facilities and laboratory supplies
- must be distinct from the clinical facilities of the hospital
2. Laboratory with Certification from Bureau of Health Devices and Technology (BHDT)
of the Department of Health (DOH) as proof of compliance with the basic standards as
well as safety requirements
3. MOA with hospital/clinic affiliation
For Repiratory Therapy:
1. Presence of Respiratory Therapy Laboratory with inventory of equipments and
supplies
2. MOA with hospital/clinic affiliation
1. Full time dentist
2. Full time nurse
3. Periodic Medical/Dental Check-up

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 4. Lavatory or hand washing facility with potable water supply
5. Basic medical and dental equipment & supplies(first aid kits, stretcher, portable
oxygen tank,)
6. Clinic beds (separate male and female with privacy)
7. Dental chair
8. Comfort Room
10. Involvement in the health programs/activities of the school i.e. medical mission

GENERAL FINDINGS/OBSERVATIONS:
____________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________

Monitoring Team: ______________________________ ________________________________ __________________________

Education Supervisor II Education Supervisor II Team Member

Conforme: ____________________________________ Date;_________________

School Official / Designation
(Signature over Printed Name)

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