EMPLOYEE'S OUTPUT RATING

Rating Period: January to June 2020 Date of Evaluation: ______________________________

Name of Employee:
Position:
Points (from the
Output Target Accomplishment/Reported Evaluated
Reference Table)
Quantity Target Actual Points Quantity
Points Quantity Earned

(A)
STRATEGIC PRIORITY
Improve Revenue Generatiion 2 60 60
CORE FUNCTIONS
Nursing Care Supervision 6 96 576

Orientation of new nursing staff, Clinical 6 4

instructor and Nursing Students
24
SUPPORT FUNCTIONS
PGLDN Activities/ events 1.00 2 4
Coordinative Services 0.33 2 0.66
Attendance of learning and
Development Activity 1.00 1 1
TOTAL POINTS - SEMESTER 665.66
Submitted by: Concurred by:

NAME & SIGNATURE OF EMPLOYEE NAME & SIGNATURE OF EMPLOYEE

G

________________________

Evaluated
Total Demerit Total Actual Points Earned
Points
Earned
(B) (C)=(A-B)x2 (D) = B-C

Evaluated by:

Name & signature of Evaluator

 INDIVIDUAL PERFORMANCE COMMITMENT AND

I,______________________ of the KAPATAGAN PROVINCIAL HOSPITAL commit to deliver and agree to be rated on the
measures for the period January to June 2020.

Reviewed by:

VALENTINA I. ANGOD, RN, MN, MPA Date

Acting Chief Nurse

Semestral
MFO/PAP SUCCESS INDICATORS (TARGETS + MEASURES) Target
Points

STRATEGIC PRIORITY

CORE FUNCTIONS
 0.00

SUPPORT FUNCTIONS

0.00
0.00

80% Core Functions, and 20% Support Functions

Category MFO
SP
Core Function
Support Function
Final Average Rating
Adjectival Rating

Comments and Recommendation

for Development Purposes

Discussed with Date

Employee
Reviewed by:
ORMANCE COMMITMENT AND REVIEW (IPCR)

r and agree to be rated on the attainment of the following targets in accordance with the indicated

Ratee Date
Date:

REMEDIOS B. FERNANDEZ,MD Date

Chief of Hospital

5 – Outstanding
4 – Very Satisfactory
RATING
SCALE

3 – Satisfactory
2 - Unsatisfactory
1 - Poor

Semestral
Target Rating
Actual Accomplishments Points Remarks
earned Q E T A
 Average PS for CF >>

Average PS for SF >>

Average
% weight WAPS
PS

Date Final Rating Date

REMEDIOS B. FERNANDEZ
Head of Office
Noted:

EUGENIE P. PUSING
Acting PHRMDO