Remy New Pess

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
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
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
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
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
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
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

I, JOHN REMY RAMOS
of the ILOCOS SUR PROVINCIAL HOSPITAL - GABRIELA SILANG
__________________________________________.
Ratee: JOHN REMY RAMOS
Date :
Reviewed by :
Date
Approved by :
DR. TRINA TABBOGA TALAGA
Head of Office
RATING
SCALE
MERILYN GARCIA
Success Indicator
Alloted Budget
(Target + Measure)
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)
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)
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

Average Rating
Category
MFO
2
6
3
Strategic Priority
Core Functions
Support Functions
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)
Accountable
TERESITA AGATEP, RN, MAN

Supervisor
Actual
Accomplishments
Ratings
E
T
DR. TRINA TABBOGA TALAGA

Head of Office
Remarks
Annex C

I,
of the
__________________________________________.
Ratee
Date :
Reviewed by :
Date
Approved by :
Head of Office
RATING
SCALE
MFO/PAP
Strategic Priorities
Success Indicator
(Target + Measure)
Alloted Budget
Accountable
Actual
Accomplishments
5
4
3
2
1
Outstanding
Very Satisfactory
Satisfactory
Unsatisfactory
Poor
Ratings
E
T
Remarks
Core Functions:
Support Functions:

Average Rating
Category
Strategic Priority
Core Functions
Support Functions
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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Annex C

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

DIR. NELSON G. SARMIENTO, Acting D-IV

CECILIA R. BARENG, OIC-D II

Provide Excellent HR Processess

Processed Exam. Applications

Conducted Prime HRM assessment

checklists prepared w/ 95%

processed all applications

1000 applic. Forms

5 4.6667 INWD & LGU-Batac

and reports prepared

checklists & reports pre-

with 90% acceptability

pared w/ 95% acceptability

90% rcvd., reviewed

100% rec'd, reviewed

w/in 3 days w/ 90%

w/in 3 days w/ 95%

in volume w/n 5 days

Processed applications under s. Laws

all appts. rcvd. w/in

the day or 2-3 days w/ 95%

all applications received

6 mins. upon receipt

with 100% accuracy

as scheduled with 90%

Prepared Monthly Accomplishment Reports

as required with 100%

prepared on or before the

deadline with 100%

legal counseling rendered

to all clients received w/n

Ensure Efficiant Management of Financial Resources

Information sent to customers

after the conduct of trngs

for PETSA with large no. of pax

all info. sent to

instructed w/ 95% acceptability

Final Rating by:

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

1. Assisted the nurse and other helath team member

assisted the nurse

during the admission, and transfer of patient.

during the admission

admission of patient with

and transfer of patient

PROVIDE QUALITY NURSING CARE

assisted the nurse during the

with 95% accuracy

with 100% accuracy

logbooks completed with 100%

collected, labelled and forwarded specimen

collected, labelled and

(urine, stool,) at the laboratory

forwarded specimen at the

at the laboratory with

laboratory with 100% accuracy

collected, labelled, and