Supervise Work-

Based Learning
FORM 1.1 SELF-ASSESSMENT CHECK

INSTRUCTIONS: This Self-Check Instrument will give the trainer necessary data or information which is essential in planning
training sessions. Please check the appropriate box of your answer to the questions below.
Can I? YES NO
Basic Competencies
1. Participate in workplace communication
1.1. Obtain and convey workplace information 
1.2. Complete relevant work-related document 
1.3. Participate in workplace meeting and discussion 
2. Work in a team environment
2.1. Describe and identify team role and responsibility 
2.2. Describe work as a team member 
3. Practice career professionalism
3.1. Integrate personal objectives with organizational goals 
3.2. Set and meet work priorities. 
3.3. Maintain professional growth and development. 
4. Practice occupational health and safety procedures
4.1. Identify hazards and risks. 
4.2. Evaluate hazards and risks. 
4.3. Control hazards and risks. 
4.4. Maintain occupational health and safety awareness. 

Can I? YES NO
Common Competencies
1. Apply quality standards
1.1 Assess quality of received materials 
1.2 Assess own work 
1.3 Engage in quality improvement 
2. Perform computer operations
2.1. Plan and prepare for tasks to be undertaken 
2.2. Input data into computer 
 2.3. Access information using computer 
2.4. Produce output/data using computer system 
2.5. Use basic functions of a web browser to locate

information
2.6. Maintain computer equipment and systems 
3. Perform mensuration and calculation
3.1. Select measuring instruments 
3.2. Carry out measurements and calculation 
3.3. Maintain measuring instruments 
4. Prepare and interpret technical drawing
4.1. Identify different kinds of technical drawings 
4.2. Interpret technical drawing 
4.3. pare/make changes on electrical/electronic

schematics and drawings
5. Use hand tools
5.1. Plan and prepare for tasks to be undertaken 
5.2. Prepare hand tools 
5.3. Use appropriate hand tools and test equipment 
5.4. Maintain hand tools 
6. Terminate and connect electrical wiring and
electronic circuits
6.1. Plan and prepare for termination/connection of

electrical wiring/electronics
6.2. Terminate/connect wiring/electronic circuits 
6.3. Test termination/connections of electrical

wiring/electronics circuits

Core Competencies
1. Install and configure computer systems
1.1. Assemble computer hardware 
1.2. Install operating system and drivers for peripherals/

devices
1.3. Install the computer application software 
1.4. Conduct testing and documentation 
2. Set-up computer networks
 2.1. Install network cables 
2.2. Set network configuration 
2.3. Set router/Wi-Fi/ wireless access point/repeater

configuration
2.4. Inspect and test the configured computer networks 
3. Set-up Computer Servers
3.1. Set-up user access 
3.2. Configure network services 
3.3. Perform testing, documentation and pre-deployment

practices
4. Maintain and repair computer systems and networks
4.1. Plan and prepare for diagnosis of faults of computer

systems
4.2. Maintain computer systems and networks 
4.3. Diagnose faults of computer systems 
4.4. Rectify/correct defects in computer systems 
4.5. Inspect and test the computer systems and networks 

Note: In making the Self-Check for your Qualification, all required competencies
should be specified. It is therefore required of a Trainer to be well- versed
of the CBC or TR of the program qualification he is teaching.
Evidences/Proof of Current Competencies (Sample)

Form 1.2: Evidence of Current Competencies acquired related to Job/Occupation

Current competencies Proof/Evidence Means of validating
Basic Competency
1. Communicate information about workplace processes
1.1. Obtain and convey workplace information TOR/Cert. of Employment • Oral interview
• written test
1.2. Complete relevant work-related document TOR/Cert. of Employment • Oral interview
• written test
1.3. Participate in workplace meeting and TOR/Cert. of Employment • Oral interview
discussion • written test
2. Working in a Team Environment
2.1. Describe and identify team role and • Oral interview
responsibility Cert. of Employment • written test
2.2. Describe work as a team member • Oral interview
Cert. of Employment • written test
3. Practice career professionalism
3.1. Integrate personal objectives with • Interview
organizational goals Cert. of Employment • Written examination
3.2. Set and meet work priorities. • Interview
Cert. of Employment • Written examination
3.3. Maintain professional growth and • Interview
development. Cert. of Employment • Written examination
4. Practice occupational health and safety procedures
4.1. Identify hazards and risks. • Interview
Cert. of Employment • Written examination
4.2. Evaluate hazards and risks. • Interview
Cert. of Employment • Written examination
4.3. Control hazards and risks. • Interview
Cert. of Employment • Written examination
4.4. Maintain occupational health and safety • Interview
Cert. of Employment
awareness. • Written examination

Current competencies Proof/Evidence Means of validating

Common Competency
1. Apply quality standards
1.1. Assess quality of received materials • Interview
Cert. of Employment
• Written examination
1.2. Assess own work • Interview
Cert. of Employment
• Written examination
1.3. Engage in quality improvement • Interview
Cert. of Employment
• Written examination
2. Perform computer operations
2.1. Plan and prepare for tasks to be • Interview
Cert. of Employment
undertaken • Written examination
2.2. Input data into computer • Interview
Cert. of Employment
• Written examination
2.3. Access information using computer • Interview
Cert. of Employment
• Written examination
2.4. Produce output/data using computer • Interview
Cert. of Employment
system • Written examination
2.5. Use basic functions of a web browser to • Interview
Cert. of Employment
locate information • Written examination
2.6. Maintain computer equipment and • Interview
Cert. of Employment
systems • Written examination
3. Perform mensuration and calculation
3.1. Select measuring instruments • Interview
Cert. of Employment
• Written examination
3.2. Carry out measurements and calculation • Interview
Cert. of Employment
• Written examination
3.3. Maintain measuring instruments • Interview
Cert. of Employment
• Written examination
4. Prepare and interpret technical drawing
4.1. Identify different kinds of technical • Interview
Cert. of Employment
drawings • Written examination
4.2. Interpret technical drawing • Interview
Cert. of Employment
• Written examination
4.3. Pare/make changes on • Interview
electrical/electronic schematics and Cert. of Employment • Written examination
drawings
5. Use hand tools
5.1. Plan and prepare for tasks to be • Interview
Cert. of Employment
undertaken • Written examination
5.2. Prepare hand tools Cert. of Employment • Interview
• Written examination
5.3. Use appropriate hand tools and test Cert. of Employment • Interview
equipment • Written examination
5.4. Maintain hand tools Cert. of Employment • Interview
• Written examination
6. Terminate and connect electrical wiring and electronic circuits
6.1. Plan and prepare for Cert. of Employment • Interview
termination/connection of electrical • Written examination
wiring/electronics
6.2. Terminate/connect wiring/electronic Cert. of Employment • Interview
circuits • Written examination
6.3. Test termination / connections of Cert. of Employment • Interview
electrical wiring / electronics circuits • Written examination
 Identifying Training Gaps
From the accomplished Self-Assessment Check (Form 1.1) and the evidences of current competencies (Form 1.2), the Trainer
will be able to identify what the training needs of the prospective trainee are.

Form 1.3 Summary of Current Competencies versus Required Competencies (Sample)

Required Units of Competency/Learning
Current Competencies Training Gaps/Requirements
Outcomes based on CBC
Basic Competencies
1. Participate in workplace communication
1.1. Obtain and convey workplace Obtaining and conveying workplace
information information
Completing relevant work-related
1.2. Complete relevant work-related document
document
1.3. Participate in workplace meeting and Participating in workplace meeting and
discussion discussion
2. Work in a team environment
2.2. Describe and identify team role and Describing and identifying team role and
responsibility responsibility
2.3. Describe work as a team member Describing work as a team member
3. Practice career professionalism
3.1. Integrate personal objectives with Integrating personal objectives with
organizational goals organizational goals
3.2. Set and meet work priorities. Setting and meeting work priorities.
3.3. Maintain professional growth and Maintaining professional growth and
development. development.
4. Practice occupational health and safety procedures
4.1. Identify hazards and risks. Identifying hazards and risks.
4.2. Evaluate hazards and risks. Evaluating hazards and risks.
4.3. Control hazards and risks. Controlling hazards and risks.
4.4. Maintain occupational health and safety Maintaining occupational health and
awareness. safety awareness.

Required Units of Competency/Learning Current Competencies Training Gaps/Requirements

Outcomes based on CBC
Common Competencies
1. Apply quality standards
1.1. Assess quality of received materials Assessing quality of received materials
1.2. Assess own work Assessing own work
1.3. Engage in quality improvement
Engaging in quality improvement
2. Perform computer operations
2.1. Plan and prepare for tasks to be undertaken Planning and preparing for tasks to be
undertaken
2.2. Input data into computer Inputting data into computer
2.3. Access information using computer Accessing information using computer
2.4. Produce output/data using computer system Producing output/data using
computer system
2.5. Use basic functions of a web browser to Using basic functions of a web
locate information browser to locate information
2.6. Maintain computer equipment and systems Maintain computer equipment and
systems
3. Perform mensuration and calculation
3.1. Select measuring instruments Selecting measuring instruments
3.2. Carry out measurements and calculation Carrying out measurements and
calculation
3.3. Maintain measuring instruments Maintaining measuring instruments
4. Prepare and interpret technical drawing
4.1. Identify different kinds of technical drawings Identifying different kinds of technical
drawings
4.2. Identify different kinds of technical drawings Identifying different kinds of technical
drawings
4.3. pare/make changes on electrical/electronic paring/making changes on
schematics and drawings electrical/electronic schematics and
drawings
5. Use hand tools
5.1. Plan and prepare for tasks to be undertaken Planning and preparing for tasks to be
Prepare undertaken Prepare
5.2. hand tools handling tools
 5.3. Use appropriate hand tools and test Using appropriate hand tools and test
equipment equipment
5.4. Maintain hand tools Maintaining hand tools
6. Terminate and connect electrical wiring and electronic circuits
6.1. Plan and prepare for termination/connection Planning and preparing for
of electrical wiring/electronics termination/connection of electrical
wiring/electronics
6.2. Test circuits Testing circuits
6.3. Terminate/connect wiring/electronic circuits Terminating/connecting
wiring/electronic circuits
6.4. Test termination/connections of electrical Testing termination/connections of
wiring/electronics circuits electrical wiring/electronics circuits

Using Form No.1.4, convert the Training Gaps into a Training Needs/ Requirements. Refer to the CBC in identifying the Module
Title or Unit of Competency of the training needs identified.

Form No. 1.4: Training Needs (Sample)

Module Title/Module of
Gaps Duration (hours)
Instruction
Basic Competencies
1. Participate in  Participating in
workplace workplace
communication communication
2. Work in a team  Working in a team
environment environment
3. Practice career  Practicing career
professionalism professionalism
4. Practice occupational  Practicing occupational
health and safety health and safety
procedures procedure
Common Competencies
1. Apply quality  Applying quality standards
standards
2. Perform computer  Performing computer
operations operations
3. Perform mensuration  Performing mensuration
and calculation and calculation
4. Prepare and interpret  Preparing and interpreting
technical drawing technical drawing
5. Use hand tools  Using hand tools
6. Terminate and connect  Terminating and connect
electrical wiring and electrical wiring electronics
elecs circuit circuit