Annex D

DOH - SPMS Form 4 Document Code:

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR) Revision No:
Effectivity:

I, VANESA A. BALILI, RN of the PDOHO BUKIDNON , commit to deliver and agree to be rated on the attainment of the folllowing of the targets in accordance with the indicated measures for
the period of JANUARY to JUNE, 2022.

Name of Employee: VANESA A. BALILI, RN Date: 7-Dec-21

Approved By: Date:

DALYN T. NERI, RN
DMO IV
5 – Outstanding
RATING
4 – Very Satisfactory
Success Indicator Remarks/Justification of
Output Actual Accomplishment Q E T 3 – Satisfactory
A
(Target + Measure) 2 - Unsatisfactory Unmet Targets
(1) (2) (3)1 - Poor (4)
CORE FUNCTIONS: 80 %
1. Conducted 100% regular visits to Conducts 138 regular visits to priority
priority households with health households with health problems on
problems scheduled date and with excellent results.

2. Prepares 100% health status Prepares and submits 13 signed health status
reports of families/households visited reports of families/households visited on
scheduled date with reports clearly
presented.

3. Plans 100% appropriate Identify health concerns of 13

interventions on the identified health families/households has appropriate planned
concerns of families/households interventions and implemented on scheduled
date with excellent results.

4. Supervise, train, and orient 100% Provides technical assistance 1 LGUs and
the CHT/BHWs and conducts regular other health partners on scheduled date with
monitoring and evaluation of various excellent results.
health programs together with the
MHO, PHN and DMO
5. Monitors 100% adverse events of Monitors and reports 6 adverse events of
vaccines vaccines were monitored and reported within
24 hours without error.

a. Conducts 2 mother's class/purok

household's class/pabasa/fp usapan
series/FDS on scheduled date with excellent
results.
b. Conducts 2 orientation on covid-19
transmission of disease and infection control
on scheduled date with all aspect of work
assignment thoroughly covered .

c. Conducts 2 IEC on HIV/AIDS on

scheduled date with excellent result.

d.Conducts 2 IEC/advocacy on Teenage

6. Conducts 100% health education, Pregnancy on scheduled date and with
advocacies and training on different exellent results.
DOH programs

e. Conducts 2 IEC/advocacy on Blood

Donation on scheduled date and with
excellent results.

f. Conducts 2 IEC/advocacy on Dengue

Awareness on scheduled date and with
excellent results.

g. Conducts 2 IEC/advocacy/activities to
ensure implementation of nutrition Program in
the LGU on scheduled date and with
excellent results.

Submits and recorded 48 reports on

scheduled date with minor error.
7. Prepares 100 % reports of home
visits, follow-up patients, track
referrals and community activities
 Participates during 1 outbreak/epidemiologic
investigations and within 24 hours with all
8. Participates 100% in data gathering
aspects thoroughly covered.
and response during health
emergencies and disasters

a. Give Quality Prenatal Care to 24 Pregnant

Women on scheduled date and with all
aspect of work assignment thoroughly
covered .

b. Follow up and give FP services to 5

women with unmet need daily and with all
aspect of work assignment thoroughly
covered.

c. Track and refer high risk 6 Pregnant

women for hospital delivery as soon as
possible with all aspect of work assignment
thoroughly covered.

d. Monitor 24 0-6 Months Exclusively

9. Participates 100% in the Breastfeeding on specified date accurately
implementation of health programs of with excellent result.
DOH and the LGU in the community
e. Follow up and refer 24 Pregnant women for
FBD on scheduled date and with excellent
result.
f. Give Quality Postpartum Care to 24 Post
Partum Mothers on the scheduled date and
with excellent result.

g. 24 Fully immunize children on scheduled

date and with all aspect of work assignment
thoroughly covered.
h. Monitor 6 "Sabayang 4 o'clock Habit"
monthly on scheduled date with all aspect of
work assignment thoroughly covered.

Maintain and Cover 2 Barangay Health

Station/s daily and with all aspect of work
10.Maintains Barangay Health
assignment thoroughly covered.
Station/s
 Attend 6 Monthly HRH meeting on scheduled
date with 100% attendance and participation
11.Professional/Personal with excellent results.
Development

A. Attend 2 Inter-Agency Meetings on

scheduled date with 100% attendance and
participation with excellent results.

12.Partnership, Collaboration and

B. Attended 1 Online Meetings
Networking Activities
(Webex/Zoom/Google Connect) on scheduled
date with 100% attendance and participation
with excellent results (OPTIONAL).

a. Assess and attend 0 clients at Enhanced

Screening Area within 8 hours with no error

13. HRHDP CITY ISOLATION/TRIAGE b. Assess and monitor 0 patients in Ligtas

Augmentation Covid Center when on duty within 24 hours
with no error

Visits 10 PUM/PUI/LSI/ROF on scheduled

date with all aspect of work assignment
thoroughly covered

Profile, assess and give services (CONTACT

TRACING/ Monitoring and compliance of
Home quarantine) to 80 priority families on
scheduled dates with all aspect of work
14. HRHDP COVID 19 Pandemic assignment thoroughly covered.
Activities
14. HRHDP COVID 19 Pandemic
Activities

Assists in the installation of 2 BIU/MIU based

on guidelines by WHO and DOH on specified
date with all aspect of work assignment
thoroughly covered.

AVERAGE RATING (CORE FUNCTIONS)

SUPPORT FUNCTIONS: 20 %
1. Assists 100% in the preparation of Assists and prepares 2 barangay health
barangay health plans plans on scheduled date clearly presented.

2. Assists 100% the MHO and PHN in Assists the CHO/MHO and PHN during the
the coduct of PIR, MDR and conduct of 0 PIR, MDR and Death/Mortality
Death/Mortality reviews reviews on scheduled date with no error.

3. Attendance to meetings, trainings Attend 6 Monthly HRH meeting on scheduled

in PDOHO / PHO / DOH date with 100% attendance and participation
with excellent results.

4. HRHDP 2020 Daily Monitoring of To Monitor daily 13 HRH Status excellently

Status within 8 hours.

AVERAGE RATING (SUPPORT FUNCTIONS)

RATING

Final Rating per

Final
Average Rating Function (Average
Function Percentage Distribution* Average Adjectival Rating Remarks
per Function Rating x Percentage
Rating
Distribution)
Core Function 80%
Support Function 20%
Comments and Recommendation for Development Purposes:

Discussed With: Assessed by: Date Final Rating By: Date

I certify that I discussed my assessment of
the perfomance with the employee.
 VANESA A. BALILI, RN MARK DELL H. OMPAD, RN, MD DALYN T. NERI, RN

Employee MHO/ CHO/ OIC-MHO DMO IV

Legend: 1 - Quality 2 - Efficiency 3 - Timeliness 4 - Average; *In the event that there is no Strategic Output, the percentage distribution is as follows: Core output-80% and Support output-20%