Republic of the Philippines

Region VII
Schools Division of Negros Oriental

NEGROS ORIENTAL HIGH SCHOOL

Kagawasan Avenue, Daro, Dumaguete City

WORK IMMERSION PERFORMANCE APPRAISAL

STUDENT’S NAME: TANGCALAGAN, KIMBERLY MAXINNE STRAND: HUMSS

Partner Institution: PHILIPPINE NATIONAL POLICE-SIBULAN
Address: BOLOCBOLOC, SIBULAN NEGROS ORIENTAL Contact No.: 09362992203
Work Immersion Supervisor: _________________________ Position: WORK IMMERSION STUDENT
Training Period: ______________ to________________ Total No. of Hours Rendered: ___________

Directions. For each behavioral item listed within the competency bands, with 5 being the most
and 1 is the least, please select the evaluation most suited.

5 Outstanding Performance exceeds the required standard.

4 Very Satisfactory Performance fully met job requirements. Was able to perform
what was expected of a person in his/her position.
3 Satisfactory Performance has met the required standard. Can perform
duties with minimal supervision.
2 Fair Performance partially meets the required standard. Less than
satisfactory could be doing better.
1 Needs Improvement Performance does not meet the required standard. Major
Improvements needed.
NA Not Applicable Performance indicator is nor relevant to the job.

COMPETENCIES 5 4 3 2 1
TEAM WORK
1. Consistently works with others to accomplish goals and tasks.
2. Treats all team members in a respectful courteous manner.
3. Actively participates in activities and assigned task required.
4. Willing to work with team members to improve team
collaboration on a continuous basis.
5. Considers the feedback and views of team members when
completing an assigned task.
TEAM WORK Total Score

COMMUNICATION 5 4 3 2 1
1. Actively listens to supervisor and/or co-workers.

2. Comprehends written and oral information.

3. Consistently delivers accurate information both written and oral.

4. Reliably provides feedback as required, both internally and

externally.

COMMUNICATION Total Score

 COMPETENCIES 5 4 3 2 1
ATTENDANCE AND PUNCTUALITY
1. Is punctual on a regular basis.
2. Maintains good attendance.
3. Informs supervisor in a timely manner when absenteeism and
tardiness may occur.
ATTENDANCE AND PUNCTUALITY Total Score
PRODUCTIVITY/ RESILIENCE 5 4 3 2 1
1. Consistently produces quality results.
2. Meets deadlines and manages time well.
3. Can do multitasking.
4. Can work under pressure and delivers the required tasks.
5. Effective and efficient in time management.
6. Efficiently informs supervisor of any challenge or hindrance related to
given task or assignment.
PRODUCTIVITY/ RESILIENCE Total Score
INITIATIVE/PROACTIVE 5 4 3 2 1
1. Completes assignments with minimum supervision.
2. Completes tasks independently and consistently.
3. Seeks support as need arises.
4. Recognizes and takes immediate action to effectively address
problems and opportunities.
5. Engages in continuous learning.
6. Contributes new ideas and shares skills to improve the department/
organization.
INITIATIVE/PROACTIVE Total Score
JUDGEMENT/ DECISION MAKING 5 4 3 2 1
1. Analyzes problem effectively.
2. Has the ability to make creative and effective solutions to problems.
3. Demonstrates food judgement in handling routine problems.
JUDGEMENT/ DECISION MAKING Total Score
DEPENDABILITY/ REABILITY 5 4 3 2 1
1. Has the ability to follow through and meet deadlines.
2. Has commitment for his/her action.
3. Can adjust easily to changes in workplace.
4. Display high level of performance at all times.
DEPENDABILITY/ REABILITY Total Score
ATTITUDE 5 4 3 2 1
1. Offers assistance willingly.
2. Shows a positive work attitude.
3. Shows sensitivity to and consideration for other’s feelings.
4. Accepts criticism positively.
5. Shows pride in work.
ATTITUDE Total Score
PROFESSIONALISM 5 4 3 2 1
1. Respects persons in authority.
2. Uses all tools, equipment and facilities responsibly.
3. Follows all policies and procedures when issues and conflict arises.
4. Physical appearance conforms to the workplace and placement rules.
PROFESSIONALISM Total Score

OVER ALL RATING Weighted

Average
 Republic of the Philippines
Region VII
Schools Division of Negros Oriental
WORK IMMERSION PERFORMANCE APPRAISAL

SUMMARY OF SCORES

CRITERIA WEIGHTED AVERAGE

TEAM WORK
COMMUNICATION
ATTENDANCE & PUNCTUALITY
PRODUCTIVITY/RESILIENCE
INITIATIVE/PROACTIVITY
JUDGEMENT/DECISION MAKING
DEPENDABILITY/RELIABILITY
ATTITUDE
PROFESSIONALISM
Over-All Weighted Average
Equivalent Grade

REMARKS: (Comments/Suggestions)

Student’s Signature: _______________________________________ Date: _______________________

Work Immersion Supervisor’s Signature Over Printed Name _______________________________

Transmutation Table

Computed Weighted Equivalent Grade

Average
4.20- 5.00 100
3.40- 4.19 95
2.60- 3.39 90
1.80- 2.59 85
1.0- 1.79 80