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Annex C

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)


I, GRACIA MINETTE S. AGUADA
of the CSC-ILOCOS SUR FIELD OFFICE of CSC REGIONAL OFFICE NO. I
commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated measures for the period
JULY-DECEMBER 2013.
GRACIA MINETTE S. AGUADA
Ratee
Date : January 27, 2014
Reviewed by :

Date

DIR. NELSON G. SARMIENTO, Acting D-IV


Head of Office

RATING
SCALE

CECILIA R. BARENG, OIC-D II


Immediate Supervisor

Approved by :

MFO/PAP

Success Indicator
Alloted Budget
(Target + Measure)

Division/Individuals
Accountable

Actual
Accomplishments

Provide Excellent HR Processess


Conducted RCS and prepared ROF

Processed Exam. Applications

Conducted Prime HRM assessment

as scheduled;
Questionnaire &

GMSAguada

checklists prepared w/ 95%

w/ 90% acceptability

acceptability
GMSAguada

100% accuracy

accuracy;

processed all applications

1000 applic. Forms

received
GMSAguada

Outstanding
Very Satisfactory
Satisfactory
Unsatisfactory
Poor

Ratings
E
T

Remarks

LandBank, Vigan

GSIS Laoag
4

5 4.6667

5 4.6667 INWD & LGU-Batac

3 mins./appl. With

appl. w/ 100%

as scheduled;

Conducted 2 RCS as
scheduled; questionnaires

Checklist accomplished

4 mins./

5
4
3
2
1

Conducted 2 Prime-HRM

checklists accomplished

assessment as scheduled;

and reports prepared

checklists & reports pre-

with 90% acceptability

pared w/ 95% acceptability

MFO/PAP

Success Indicator

Alloted Budget

Division/Individuals

Ratings

Actual

Remarks

Core Functions:
Prepared RAI Monitoring Reports

90% rcvd., reviewed

GMSAguada

100% rec'd, reviewed

w/in 3 days w/ 90%

w/in 3 days w/ 95%

acceptability

acceptability, when

4 4.3333

4 4.3333

4.67

5 4.6667

in volume w/n 5 days


Processed Appointments

Processed applications under s. Laws

processed

GMSAguada

processed 100% of

90% of all

all appts. rcvd. w/in

appts. received

the day or 2-3 days w/ 95%

w/in 3 days w/
90% accuracy

accuracy.

10 mins

GMSAguada

all applications received

upon rcpt/

6 mins. upon receipt

appl. w/ 90%

with 100% accuracy

accuracy
Rendered Resource Speaking Services

as scheduled

GMSAguada

w/ 80% acceptability

rendered RS on PETSA

4.5

as scheduled with 90%


acceptability

Issued E-Receipts

Prepared Monthly Accomplishment Reports

receipts

GMSAguada

E-receipts issued

issued w/

as required with 100%

100% accuracy

accuracy

Monthly Reports

GMSAguada

Monthly reports

prepared on deadline

prepared on or before the

w/ 100% accuracy

deadline with 100%


accuracy

legal
Rendered Legal Counseling

counseling rendered
to all w/in 15 mins

legal counseling rendered


GMSAguada

to all clients received w/n


10 mins.

Success Indicator

MFO/PAP

Alloted Budget

Division/Individuals

Ratings

Actual

Remarks

Ensure Efficiant Management of Financial Resources


Support Functions:
Encoded exam applications through

5 mins/

EAPS

GMSAguada

appl. w/

3 mins/appl. With

4 DepEd

100% accuracy

100% accuracy
Prepared Post-evaluation reports

1 wk after the

Information sent to customers

GMSAguada

prepared beyond 1 wk

conduct of training

after the conduct of trngs

w/ 100% accuracy

for PETSA with large no. of pax

info. Sent to
customers as requred

GMSAguada

w/ 90% acceptability

by batch

all info. sent to


customers as required/

5 4.6667

instructed w/ 95% acceptability

acceptability
Final Average Rating
Comments and Recommendations for Development Purposes

Average Rating
Category

MFO
3
7
3

Strategic Priority
Core Functions
Support Functions
Total Overall Rating
Final Average Rating
Adjectival Rating

4.778
X.45
4.6428571429 X.45
4.5555555556 X.10

2.150
2.089
0.456

4.695
V.S.

Assessed by:

Date
Head of OPMIS

Discussed with

Rating

Date

Final Rating by:


COMMISSION

Date

Assessed by :

Date

Date

MFO/PAP
GRACIA MINETTE S. AGUADA
Employee

Success Indicator

Division/Individuals
Alloted Budget
CECILIA R. BARENG
Supervisor

Actual

Ratings
NELSON G. SARMIENTO
Head of Office

Remarks

4.778

2.150

4.642857 2.089286

4.555556 0.455556
4.695

Annex C

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)


I, JOHN REMY RAMOS
of the ILOCOS SUR PROVINCIAL HOSPITAL - GABRIELA SILANG
commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated measures for the period
__________________________________________.
Ratee: JOHN REMY RAMOS
Date :
Reviewed by :

Date

Approved by :
DR. TRINA TABBOGA TALAGA
Head of Office

RATING
SCALE

MERILYN GARCIA
Immediate Supervisor

Success Indicator
Alloted Budget
(Target + Measure)

Division/Individuals
Accountable

1. Assisted the nurse and other helath team member

assisted the nurse

J. RAMOS

during the admission, and transfer of patient.

during the admission

admission of patient with

and transfer of patient

100% accuracy

MFO/PAP

Actual
Accomplishments

Strategic Priorities

5
4
3
2
1

Outstanding
Very Satisfactory
Satisfactory
Unsatisfactory
Poor

Ratings
E
T

PROVIDE QUALITY NURSING CARE

assisted the nurse during the


5

4.67

4.67

with 95% accuracy


2. Checked and completed the logbooks (equipment

logbooks completed

linen supplies.

with 100% accuracy

J. RAMOS

logbooks completed with 100%

accuracy

Remarks

Success Indicator
Alloted Budget
(Target + Measure)

Division/Individuals
Accountable

collected, labelled and forwarded specimen

collected, labelled and

J. RAMOS

(urine, stool,) at the laboratory

forwarded specimen

forwarded specimen at the

at the laboratory with

laboratory with 100% accuracy

MFO/PAP

Actual
Accomplishments

Ratings
E
T

Core Functions:

collected, labelled, and


5

4.67

4.67

4.34

4.34

4.34

4.34

95% accuracy
tooked and recorded information of the patient,

took and recorded

J. RAMOS

took and recorded information

vital signs, wieght, and hieght.

information, vital signs,

vital signs ht. And wt. of the

hieght and weight with

patient with 100% accuracy

100% accuracy
Cleaned used instruments and send

cleaning of used

them for sterilization

instruments was done

J. RAMOS

cleaning of used instruments


was done with 100% accuracy

with 90% accuracy


provide a safe and therapeutic environment

providing safe and

J. RAMOS

conducive for healing

therapeutic environment

environment was done with 100%

was done with 95% accuracy

accuracy.

J. RAMOS

providing safe and therapeutic

assisted physician at treatment room for minor

as needed, assisted

as needed, assisted physician

such as: suturing, and Physical Examination

physician for minor

for minor surgery and physical

surgery and physical

examination withyn 100%

examination with

accuracy.

90% accuracy
maintained cleanliness and orderliness of the unit.

cleanliness and
orderliness maintained
with 90% acceptability

J. RAMOS

cleanliness and orderliness


maintain with 95% acceptability.

Remarks

Success Indicator
Alloted Budget
(Target + Measure)

Division/Individuals
Accountable

attended meetings, seminars and

as scheduled

J. RAMOS

conferences

90% of all meetings &

95% o all meetings and

conferences attended

conferences attended.

MFO/PAP

Actual
Accomplishments

Ratings
E
T

Remarks

Support Functions:

Assisted in the implementation of hospital

hospital nursing policies

regulation and policies

implemented with 90%

implemented with 95%

acceptability

acceptability

accomplished and submitted assignment and


accomplishment report

J. RAMOS

as scheduled

submitted assignment
and accomplishment

J RAMOS

report on deadline

4.34

4.34

4.34

hospital nursing policies

submitted assignment and


accomplishment report before
deadline with 100% accuracy

with 100% accuracy


Final Average Rating
Comments and Recommendations for Development Purposes

Average Rating
Category

MFO
2
6
3

Strategic Priority
Core Functions
Support Functions
Total Overall Rating
Final Average Rating
Adjectival Rating

4.67 x .45 - 2.10


4.45 x .45 - 2.0
4.34 x .10 - .43
4.53
VS

Assessed by:

Date
Head of OPMIS

Discussed with

Rating

Date

Final Rating by:


COMMISSION

Date

Assessed by :

Approved by:

Date

MFO/PAP

JOHN REMY RAMOS


Employee

Success Indicator
Alloted Budget
(Target + Measure)

Division/Individuals
Accountable

TERESITA AGATEP, RN, MAN


Supervisor

Actual
Accomplishments

Ratings
E
T

DR. TRINA TABBOGA TALAGA


Head of Office

Remarks

Annex C

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)


I,
of the
commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated measures for the period
__________________________________________.
Ratee
Date :
Reviewed by :

Date

Approved by :

Head of Office

RATING
SCALE

Immediate Supervisor

MFO/PAP
Strategic Priorities

Success Indicator
(Target + Measure)

Alloted Budget

Division/Individuals
Accountable

Actual
Accomplishments

5
4
3
2
1

Outstanding
Very Satisfactory
Satisfactory
Unsatisfactory
Poor

Ratings
E
T

Remarks

Core Functions:

Support Functions:

Final Average Rating


Comments and Recommendations for Development Purposes

Average Rating
Category
Strategic Priority
Core Functions
Support Functions
Total Overall Rating
Final Average Rating
Adjectival Rating

MFO

Rating
X
X
X.

Assessed by:

Date

Final Rating by:


Head of OPMIS

COMMISSION
Date

Discussed with

Employee

Date

Approved by:

Head of Office

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