Individual Learners Profile

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DepEd Order No. 044, s.

2021 Annex 1

Republic of the Philippines


Department of Education
Region VII, Central Visayas
Schools Division of Bohol
District of Talibon II
Talibon II Central Elementary School
_________________________________________________________________________________________

INDIVIDUAL LEARNER’S PROFILE


PART 1
Name: ____________________________________________________ Date of Birth: ______________ Age: ___________
Home Address: ______________________________________________________________________________________
Type of Learner: ____________________________________________ LRN: ____________________________________
School Year: _______________________________________________ Adviser: __________________________________
Principal: ___________________________________________________________________________________________

Record of Assessments
Date Chronological
Type of Assessment Administrator Results’Outcome
Administered Age

Attached Records of Assessment

Interview with Parents/Guardian

Name of Parents/Guardian: _________________________________________________________________________________


Contact Number/s: ______________________________________________ Date of interview: ___________________________

Developmental and Educational History:


___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

Interview with the Learner

Date of Interview: ______________________________________

Interest/Hobbies/Talents:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

DAILY LIVING SKILLS DOMAIN: Present Level of Educational Performance


Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
1
LANGUAGE DEVELOPMENT DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
PSYCHOMOTOR DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
COGNITIVE DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
AESTHETIC AND CREATIVE DOMAIN: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
BEAHVIORAL DEVELOPMENT: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________
ORIENTATION AND MOBILITY: Present Level of Educational Performance
Strength/s: __________________________________________________________________________________________________
Need/s: ____________________________________________________________________________________________________

PART 2

Priority Learning Needs/Interventions:


1. ___________________________________________________________________________________________________
2. ___________________________________________________________________________________________________
3. ___________________________________________________________________________________________________
4. ___________________________________________________________________________________________________
5. ___________________________________________________________________________________________________

Transition Package
1. ___________________________________________________________________________________________________
2. ___________________________________________________________________________________________________
3. ___________________________________________________________________________________________________
4. ___________________________________________________________________________________________________
5. ___________________________________________________________________________________________________

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