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.
CORE COMPETENCIES
CAN I…? YE NO
S
1.

2.

3.

4.

5.

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
Proof/Evidence Means of validating
competencies
 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 Current Training

Competency/Learning Competencies Gaps/Requirement
Outcomes based on CBC s
1.

Required Units of Current Training

Competency/Learning Competencies Gaps/Requirement
Outcomes based on CBC s
2.

3.

4.
 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
Gaps Title/Module of Duration (hours)
Instruction
 TRAINING PLAN

Qualification: ____________________________
Date
Trainees’ Training Training Mode of Facilities/Tools Assessment
Staff Venue and
Requirements Activity/Task Training and Equipment Method
Time

_______________________ ____________________ ______________________

Institution’s Industry Industry Supervisor Trainee
Coordinator
 Instructions:
Technical Education and Skills Development Authority This Trainees’ Record Book (TRB) is intended to serve as
record of all accomplishment/task/activities while undergoing
___(your institution)___
training in the industry. It will eventually become evidence
that can be submitted for portfolio assessment and for
TRAINEE’S RECORD BOOK whatever purpose it will serve you. It is therefore important
that all its contents are viably entered by both the trainees
and instructor.
The Trainees’ Record Book contains all the required
I.D. competencies in your chosen qualification. All you have to do
is to fill in the column “Task Required” and “Date
Accomplished” with all the activities in accordance with the
training program and to be taken up in the school and with
Trainee’s No._______________ the guidance of the instructor. The instructor will likewise
indicate his/her remarks on the “Instructors Remarks”
column regarding the outcome of the task accomplished by
the trainees. Be sure that the trainee will personally
NAME: ___________________________________________________ accomplish the task and confirmed by the instructor.
It is of great importance that the content should be
written legibly on ink. Avoid any corrections or erasures and
QUALIFICATION: PLUMBING NC II_______ maintain the cleanliness of this record.
This will be collected by your trainer and submit the
TRAINING DURATION :____________________________ same to the Vocational Instruction Supervisor (VIS) and shall
form part of the permanent trainee’s document on file.

TRAINER: __________________________________________________
THANK YOU.
NOTES:

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Unit of Competency: 1 PREPARE PIPES FOR INSTALLATION Unit of Competency: 2 PERFORM MINOR CONSTRUCTION
WORKS
NC Level I
Learning Task/Activity Date Instructors NC Level I
Outcome Required Accomplished Remarks Learning Task/Activity Date Instructors
 Lay out Outcome Required Accomplished Remarks
measurements Perform
 Cut pipe piping lay
within the outs
required Cut pipes
length and through
according to walls and
job floors
requirements
 Thread pipes
in accordance ____________________ ______________________
with standard Trainee’s Signature Trainer’s
thread Signature
engagement

__________________ ___________________
Trainee’s Signature Trainer’s Signature
 Unit of Competency: 4 PERFORM SINGLE UNIT PLUMBING
Unit of Competency: 3 MAKE PIPING JOINTS AND INSTALLATION AND ASSEMBLES
CONECTIONS

NC Level I
NC Level I
Learning Task/Activity Date Instructor
Learning Task/Activity Date Instructors Outcome Required Accomplishe s Remarks
Outcome Required Accomplished Remarks d
Fit-up Prepare for
joints and plumbing works
fittings for Install pipe and
PVC pipe fittings
Perform Install hot and
threaded cold water supply
pipe joints Install/assemble
and plumbing fixtures
connections
Caulk
_____________________ ____________________
joints\
_____________________ ______________________ Trainee’s Signature Trainer’s Signature
Trainee’s Signature Trainer’s Signature
 Unit of Competency: 5 PERFORM PLUMBING REPAIR AND
MAINTENANCE WORKS

NC Level I
Learning Task/Activity Date Instructors
Outcome Required Accomplished Remarks
 Clear
clogged
pipes
clear
clogged
fixtures
______________________ ____________________
Trainee’s Signature Trainer’s Signature
 TRAINEE’S PROGRESS SHEET

Name : JUAN DELA CRUZ Trainer :

Nominal
Qualification : Machining NC I :
Duration
Training Training Date Date Trainee’s Supervisor’s
Units of Competency Rating
Activity Duration Started Finished Initial Initial

Total
Note: The trainee and the supervisor must have a copy of this form. The column for rating maybe used either by giving a numerical
rating or simply indicating competent or not yet competent. For purposes of analysis, you may require industry supervisors to give a
numerical rating for the performance of your trainees. Please take note however that in TESDA, we do not us