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Republic of the Philippines

Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF BAIS CITY

DIVISION MID-YEAR EVALUATION FOR SY 2022-2023


(SCHOOL VISIT CHECKLIST)

I. School Information
Name of School: _________________________________________________________
Name of School Head/Principal: _________________________________________________________
Category (ES, HS, Integrated): _________________________________________________________
Cluster: __________________________________________________________
Name of Monitoring Official/s: ________________________________________________________
Date Monitored: __________________________________________________________
II. School Governance and Operation
Yes No List of MOVs / Remarks
PARTICULAR (√) (√)
1. SBM SY 2021 – 2022 Report (accomplished offline To be follow up by: JAT
tool)
2. First Quarter SMEA Conference Report, SY 2022 – To be follow up by: JAT
2023
3. Available Data for School Improvement Plan (SIP) To be follow up by: JAT
4. Establishment of Functional SGC To be follow up by: JAT
5. List of Utilization of Donations Received To be follow up by: JAT
6. List of Partners supporting the school with To be follow up by: JAT
documents
7. List of SHS work immersion partners with To be follow up by: JAT
documents, if applicable
8. Action Plans (BE, ASP & PTA) To be follow up by: JAT
9. DRRM Contingency Plan To be follow up by: JAT
10.Record of conducted declogging To be follow up by: JAT
11. Visible DRRM Signages To be follow up by: JAT
12.Orientation on DO 37, s. 2022 (title) to Parents and To be follow up by: HCJ
Learners
13.SBFP Liquidation Report To be follow up by: HCJ
14.Compiled copies of MOVs on school health-related To be follow up by: HCJ
activities
15.Functional Handwashing Facility To be follow up by: HCJ
16.Functional learners’ Toilet & water supply To be follow up by: HCJ
17.Provision of Drinking Water To be follow up by: HCJ
18.Presence of washstand inside the classroom (Elem) To be follow up by: HCJ
19. Health Profiling Forms for Learners & personnel To be follow up by: HCJ
20. Compiled copies of school monitoring/observation To be follow up by: HCJ
tool on the implementation of DM No. 061, s. 2023
titled Guidelines on the operations of school
canteen & DO No. 013, s. 2017 titled Policy &
Guidelines on Healthy Food and Beverages Choices
in Schools & in DepEd Offices
21. NGP/GPP Accomplishment 2022 To be follow up by: HCJ
22. Updated School Site Documents (in preparation To be follow up by: HCJ

Address: Laurel St., Bais City


Telephone Nos.: (035) 402-3172; 522-1907
Email Address: bais.city@deped.gov.ph Page 1 of 4
for school site titling)
23. Drawn to Scale School Site Dev’t Plan reflecting To be follow up by: WBJ
the specific type of the proposed building for
construction on buildable space
24. GAD Plan & Budget FY 2023 To be follow up by: WBJ
25. GAD Accomplishment Report FY 2022 To be follow up by: WBJ
26. Establishment of Child Protection Committee To be follow up by: WBJ
(CPC) based on DO 40 s. 2012
27. Compiled Approved Basic/Action Researches but To be follow up by: WBJ
not limited to BERF
28.Accomplished Report on Beginning of the SY Child- To be follow up by: WBJ
Friendly School Survey
29. All learners with IDs and whistle To be follow up by: WBJ
30. School with perimeter fence To be follow up by: WBJ
31. No stray dogs inside the school premises To be follow up by: WBJ
32.Supplies, materials, plant & equipment are To be follow up by: WBJ
properly recorded, stocked/stored
33. DepEd’s Mission, Vision, Core Values, Quality To be follow up by: WBJ
Policy Statement, and Citizen Charter were
prominently posted (for official design, look for Mr.
Cadimas for official design)
34.Offices, rooms & classrooms are compliant with 5S To be follow up by: WBJ
35.Designated school coordinators in Brigada Eskwela To be follow up by: EEG
and Adopt-a-School
36.Updates on Status of BOSY Encoding To be follow up by: EEG
37.School profile on Government Elementary School To be follow up by: EEG
Profile (GESP), GJHSP and GSHSP
38.Status update of Brigada Pagbasa Implementation To be follow up by: EEG
39.Part IV IPCRF / IDP for the SY To be follow up by: EEG
40.Consolidated Development Plans To be follow up by: EEG
41.Consolidated Training Needs Analysis for School To be follow up by: EEG
Heads & Teachers
42.School Professional Development Plan/School L & To be follow up by: EEG
D Plan for the SY
43.School-Based Calendar of Activities for the SY To be follow up by: EEG
44.School L & D Accomplishment Report To be follow up by: EEG
45.Approved Training Program Design with Session To be follow up by: EEG
Guides for each Training
46.Documentation of Trainings such as pictures, To be follow up by: EPT
facilitator evaluation, debriefing/ feedbacking docs
47.Training Evaluation Reports with Very Satisfactory To be follow up by: EPT
Rating
48.List of Approved School-Based Trainings for the SY To be follow up by: EPT
49.Training Completion Reports received by the To be follow up by: EPT
Division HRD Section
50.Updated Training Passbooks for Teachers, NTPs & To be follow up by: EPT
SHs
51.Inventory / List of Trainings participated by the To be follow up by: EPT
Teachers, School Head & NTPs
52.Copy of Certificate of Participation / Completion / To be follow up by: EPT
Attendance, Memorandum & Travel Order of the
Trainings attended

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53.Copy of Job-Embedded Learning (JEL) To be follow up by: EPT
54.Copy of Re-entry Action Plan (REAP) To be follow up by: EPT
Implementation / JEL Completion Report
55.Training / Program Completion Report completed To be follow up by: EPT
and submitted
56.Reflective Journals of SH, Teachers & NTPs with To be follow up by: EPT
entries
57.Signed Individual Performance and Commitment To be follow up by: AAB
Review Form before the start of the SY
58.Accomplished Performance Monitoring & Coaching To be follow up by: AAB
Form (PMCF) for each personnel
59.Accomplished Mid-Year Performance Review Forms To be follow up by: AAB
for SH, Teachers and NTPs by Midyear INSET
60. Consolidated IPCRF ratings of Teaching and NTPs To be follow up by: AAB
61.Teachers’ Portfolios To be follow up by: AAB
62. School Level Criteria for Selection of Outstanding To be follow up by: AAB
Personnel (Teaching & Non-Teaching)
63.School Memorandum on designation of School To be follow up by: AAB
PRAISE for the SY with external stakeholders as
members
64.Score Sheets / Rating Sheets of Nominees for To be follow up by: AAB
Awardees for the SY
65.List of School Awardees in School, Cluster-Based, To be follow up by: AAB
Division, Regional and/or National Levels for the
SY
66.Activity Design for School-Based Recognition / To be follow up by: AAB
Awarding Ceremonies for Teaching, NTP and other
stakeholders for the SY
67.School Memorandum of the School-Based To be follow up by: AAB
Recognition / Awarding for the SY
68.R&R Completion Report with pictures and other To be follow up by: DAS
MOVs
69. Designation of School Grievance Committee for To be follow up by: DAS
Teaching and NTP for the SY
70.Designation of Student Discipline Committee for To be follow up by: DAS
the SY
71.Record book / log of school / work-related To be follow up by: DAS
complaints / grievance / issues and concerns
among teaching, NTP, learners, parents,
community acted upon and resolved at the school
level
72.DepEd Orders for the SY, Division Memorandum To be follow up by: DAS
relative on Rules and Regulations (i.e. uniform,
DTR submission, pass slips, travel authority,
submission of leave forms, etc.) & School
Memorandum of dissemination
73.School Memorandum on Coordinatorship / To be follow up by: DAS
Chairmanship designation of School Personnel for
the SY 2022 - 2023 submitted to SDO thru HRD
Section
74.Record book/log of investigations and resolutions To be follow up by: DAS
of cases at the school level
75.SY Report on Percentage of issues / cases / To be follow up by: DAS

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complaints / grievance resolved by the end of SY
76.School LAC Plan To be follow up by: DAS
77.LAC Activity Designs with session guides, if To be follow up by: DAS
applicable
78.LAC Minutes of the Meeting with MOVs To be follow up by: DAS
79.Midyear / Year-End Inventory of LAC Sessions To be follow up by: DAS
80.National Drug Education Program (NDEP) Plan To be follow up by: DAS
81.Midyear & Year-End NDEP Accomplishment Report To be follow up by: DAS
with MOVs
III. Concerns, Issues, Gaps and Problems (CIGPs) / Interventions
CIGPs Interventions/Preventive Measures

IV. Recommendations

Conforme:

______________________________________________
Name and Signature of School Head /Principal

Noted:

_____________________________
Name and Signature of Monitor

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