DOH - SPMS Form 1

OFFICE PERFORMANCE COMMITMENT AND REVIEW (OPCR)

I,___________________________, Head of the ____________________________________, commit to deliver and agree to be rated on the attainment of the following
targets in accordance with the indicated measures for the period _______________ to __________________, 20_____.

Head of Office

Date: _______________

Approved By:

Date

<Name of Agency Head>

Head of Agency

RATING SCALE

Major Final Output

KP
Functional Objectives
THRUST

PERFORMANCE
INDICATORS

Alloted
Budget

RATING
Actual Accomplishment
QTY

QLY
(1)
(2)

(3) A

Remar
ks
(4)

Major Final Output

KP
Functional Objectives
THRUST

PERFORMANCE
INDICATORS

Alloted
Budget

RATING
Actual Accomplishment
QTY

QLY
(1)
(2)

(3) A

Remar
ks
(4)

RATING

Total Overall Rating

Final Average Rating
Adjectival Rating

Comments and Recommendation for Development Purposes

Assessed by:

Final Rating by:

Date

Planning Office
Legend: 1- Quantity

2 -Quality

Date
PMT

3 - Timeliness

Date

4 - Average

Immediate Supervisor

DOH - SPMS Form 1

OFFICE PERFORMANCE COMMITMENT AND REVIEW (OPCR)

I,___________________________, Head of the ____________________________________, commit to deliver and agree to be rated on the attainment of the following
targets in accordance with the indicated measures for the period _______________ to __________________, 20_____.

Head of Office

Date: _______________

Approved By:

Date

Name of Supervisor

RATING SCALE

Major Final Output

Functional Objectives

SUCCESS INDICATORS
(Targets +
Measure)

Alloted
Budget

RATING
Actual Accomplishment

QTY QLY T
A
(1)
(2) (3) (4)

Remarks

RATING
Total Overall Rating
Final Average Rating
Adjectival Rating

Assessed by:

Final Rating by:

Date

Date

Major Final Output

Planning Office
Legend: 1- Quantity

Functional Objectives

SUCCESS INDICATORS
(Targets +
Measure)

Perf. Mgnt. Team

2 -Quality

3 - Timeliness

Alloted
Budget

RATING
Actual Accomplishment

Secretary of Health
4 - Average

QTY QLY T
A
(1)
(2) (3) (4)

Remarks

DOH - SPMS Form 2

DIVISION PERFORMANCE COMMITMENT AND REVIEW (DPCR)

I,___________________________, Division Chief of the ____________________________________, commit to deliver and agree to be rated on the attainment of the following targets in
accordance with the indicated measures for the period _______________ to __________________, 20_____.

Name of Division Chief : ESPERANZA C. CARATING

Approved By:

Date: March 31, 2014

Date
KENNETH G. RONQUILLO, MD, MPH, CESO III

Name of Supervisor
5 Outstanding
4 Very Satisfactory
3 Satisfactory
2 - Unsatisfactory
1 - Poor

RATING SCALE

Major Final Output

Functional Objectives

SUCCESS INDICATORS
(Targets + Measure)

To ensure that employees 100% of hired employees are based

Support to Operations
hired are based on JRRSS on JRRSS within 2 months after
(STO)
process
deadline of posting
To ensure that employees'
Personnel and Welfare and
Benefit transactions are
provided

Employees PWB transactions are

processed upon request based on
deadline set with no error allowed.

To submit statutory reports

to the CSC/DBM/GSIS and
other govt. agencies based
on the deadline set with
100% accuracy

Statutory Reports prepared and

submitted based on deadline with
100% accuracy

To implement SPMS in the

offices under DOH

SPMS implemented starting July 1,

2014

Alloted
Budget

Section/Person
Accountable

RATING
Actual Accomplishment

QTY QLY T
A
(1)
(2) (3) (4)

Remarks

Major Final Output

Functional Objectives

SUCCESS INDICATORS
(Targets + Measure)

Alloted
Budget

Section/Person
Accountable

RATING
Actual Accomplishment

QTY QLY T
A
(1)
(2) (3) (4)

Remarks

Orientation to different CO offices

conducted within April 2014 with 80%
satisfactory rating

To ensure the functionality

Composiition of the different
of the Personnel
Committees are updated by April 15,
Mechanisms in the DOH
2014
Central Office
CO employees are oriented on the
Policies and guidelines on Grievance,
PRAISE and Merit Promotion Plan
by end of April 2014 with 80%
satisfactory rating
To provide updated information to
To ensure implementation of employees through bid bulletin and
the DOH Rationalization
other means of information
Plan
dissemination every first week of the
month

RATING
Total Overall Rating
Final Average Rating
Adjectival Rating

Comments and Recommendation for Development Purposes

Discussed With:

Esperanza C.
Carating

Assessed by:
I certify that I discussed my assessment of the
perfomance with the employee
Kenneth

Employee
Legend: 1- Quantity

Date

2 -Quality

Final Rating by:

G. Ronquillo

JAIME C. LAGAHID, MD, MPH

Supervisor

Next Higher Supervisor

3 - Timeliness

4 - Average

Date

DOH - SPMS Form 2

DIVISION PERFORMANCE COMMITMENT AND REVIEW (DPCR)

I,___________________________, Division Chief of the ____________________________________, commit to deliver and agree to be rated on the attainment of the following
targets in accordance with the indicated measures for the period _______________ to __________________, 20_____.

Name of Division Chief :

Date: ____________

Approved By:

Date

Name of Supervisor
5 Outstanding
4 Very Satisfactory
3 Satisfactory
2 - Unsatisfactory
1 - Poor

RATING SCALE
Major Final
Output

Functional Objectives

PERFORMANCE INDICATORS

Alloted Section/Person
Budget
Accountable

Actual
Accomplishment

RATING
QTY QLY T
A
(1)
(2) (3) (4)

Remarks

RATING
Total Overall Rating
Final Average Rating
Adjectival Rating

Comments and Recommendation for Development Purposes

Discussed With:

Assessed by:
I certify that I discussed my assessment of the
perfomance with the employee

Date

Final Rating by:

Date

I certify that I discussed my assessment of the

perfomance with the employee

Employee
Legend: 1- Quantity

Supervisor
2 -Quality

3 - Timeliness

Next Higher Supervisor

4 - Average

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

I, Yvonne Claire S. Loberas, of the Regional Office VI - DOH assigned at KABANKALAN, Negros Occidental, commit to de
rated on the attainment of the following targets in accordance with the indicated measures for the period Jan to June, 2016.

Yvonne Claire S. Loberas, RN

Approved By:
TERESITA G. MAGBATO, RN
Name of Supervisor

Output

SUCCESS INDICATOR
(Targets + Measure)

Actual Accomplishment

QTY
(1)

6 complete and accurate EPI Reports of

100% of Barangays assigned submitted
every 23rd day of the month.

6 complete and accurate CHT Reports

per household of 100% of Barangays
assigned submitted every 23rd day of
the month.

6 complete and accurate FP Reports of

100% of Barangays assigned submitted
every 8th day of the month

Reports

6 complete and accurate Reports on

Newborns initiated to breastfeeding of
100% of Barangays assigned submitted
every 1st working day of the following
month

RAT

Reports

Output

SUCCESS INDICATOR
(Targets + Measure)

Actual Accomplishment

QTY
(1)

6 complete and accurate Reports on

Exclusive Breastfeeding of 100% of
Barangays assigned every 1st working
day of the following month

Complete and accurate reports on CAS

and NSMP and submitted every 27th
day of the month

6 Complete and accurate reports on

Children initiated to Complimentary
Feeding of 100% of Barangays
assigned every 1st working day of the
following month

Availability of Masterlist

100% of target Clients for MNCHN

Services among NHTS - PR and nonNHTS:Missed Children(MMR/ MCV2),
SWRA with Unmet Needs, Pregnant
Women and their Outcomes, and
Children who are stunted and wasted of
100% of Barangays assigned every 1st
working day of the following month

Inventory of Supplies

Accurate and updated monthly

inventory of 100% of MNCHN logistics
and supplies including Updated
Vaccine/ Syringes Stock Card, FP
Logistics Inventory Card/ Logbook, and
Updated Logbooks on Vit. A, Ferrous
Sulfate, ECCD Card/ Mother and Child
Book of 100% of Barangays assigned
submitted every 8th day of the month.

RAT

Output

SUCCESS INDICATOR
(Targets + Measure)

Actual Accomplishment

QTY
(1)

Profiling

Profiling of 100% of Non-NHTS

Household of assigned Barangay by
end year of 2015

LGU Health Service Assisted

100% of LGU Health Services assisted

in term of client provided services,
improvement of health indicators and
other targets.

CHT

Assist RHM in the creation and

functionalization of barangay CHT and
Management Teams in 100% of
Barangays assigned within the month of
replacement( CHT Partner) and nonfunctionality ( CHT and Management
Team)

FP/MNCHN Implementation

Assist the PHN in the conduct of

inventory of FP logistics and survey on
reasons for non-availment of MNCHN
services in 100% of Barangays
assigned within the quarter prescribed

Conduct of inventory of Personnel Skills

of 100% of Barangays assigned and
submitted every quarter

Assist in the 100% of conducted

preliminary reporting and investigation
of Maternal Death

EPI Implementation

Assist RHM during scheduled

immunization in the assigned Barangay
1 hour upon arrival of the clients.

RAT

Output

SUCCESS INDICATOR
(Targets + Measure)

Actual Accomplishment

QTY

RAT

(1)
Assist in the referral of severly wasted
and stunted pre-school children within
48 hours

Nutrition Program
Implementation

Training of BHW and CHT Partners on

TSISMIS of 100% Barangay Assigned

HI 5
Track MNCHN defaulters such as EPI,
Prenatal and Postnatal clients of 100%
assigned barangay

Attendance in stations as
scheduled

Daily Time Records

Report from 8am to 5pm as scheduled

working stations assigned

Reflected correct and logbook entries of

100% of working days within the month
concerned

RATING
Total Overall Rating

62

Final Average Rating

4.

Adjectival Rating

Comments and Recommendation for Development Purposes

Assessed by:

Discussed With:

Date

Final Rating by:

I certify that I discussed my assessment of the

perfomance with the employee

YVONNE CLAIRE S. LOBERAS

TERESITA G. MAGBATO, RN
Employee
Legend: 1- Quantity

2 -Quality

Supervisor
3 - Timeliness

4 - Average

MILA FE C. DIANALA, BSN-RN, M

Next Higher Supervisor

DOH - SPMS Form 3

(IPCR)

al, commit to deliver and agree to be

n to June, 2016.
Date: _______________

Date

5 Outstanding
4 Very Satisfactory
3 Satisfactory
2 - Unsatisfactory
1 - Poor

RATING

QLY
(2)

Remarks

A
(3)

(4)

RATING

QLY
(2)

Remarks

A
(3)

(4)

RATING

QLY
(2)

Remarks

A
(3)

(4)

RATING

QLY

(2)

(4)

62.2
4.15
VS

g by:

A, BSN-RN, MN

upervisor

Remarks

A
(3)

Date

DOH - SPMS Form 4

SUCCESS INDICATORS
Major Final Outputs

Performance Measures

Performance Targets

Success Indicator
Measures + Targets

Organizational
Outcomes/Sectoral
Goals

DOH - SPMS Form - 5

Sample Summary List of Individual Performance Ratings
Office A

Performance Assessment: Very Satisfactory

Division A

Rating
Numerical Rating

Adjectival Rating

Division A Rating

Very Satisfactory

Employee 1
Employee 2
Employee 3
Employee 4
Employee 5
No. of Employees (excluding Div. Chief) = 5
Average ratings of staff

4
5
3
4
4

Very Satisfactory
Outstanding
Satisfactory
Very Satisfactory
Very Satisfactory

20/5 = 4

Very Satisfactory

Division B
Division B Rating
Employee 1
Employee 2
Employee 3
Employee 4
No. of Employees (excluding Div. Chief) = 4
Average ratings of staff
Division C
Division C Rating
Employee 1
Employee 2
Employee 3
Employee 4
No. of Employees = 4 (excluding Div. Chief)
Average ratings of staff
Summary:

Numerical Rating
3

Rating
Adjectival Rating
Satisfactory

3
4
2
3

Satisfactory
Very Satisfactory
Unsatisfactory
Satisfactory

12/4 = 3

Satisfactory

Numerical Rating
5

Rating
Adjectival Rating
Outstanding

5
4
5
4

Outstanding
Very Satisfactory
Outstanding
Very Satisfactory

18/4 = 4.5

Outstanding

Division A
4
Division B
3
Division C
5
Average 12/3 = 4

Very Satisfactory
Satisfactory
Outstanding
Very Satisfactory

DOH-SPMS Form - 6

Performance Monitoring and Coaching Journal

1st
2nd
3rd
4th

Q
u
a
r
t
e

Name of Division: _________________________________

Division Chief/Director ______________________________________
Number of Personnel in the Office/Division ________________________

Activity

Mechanism/s
Meeting
One-in-One

Memo

Group

Others
(Pls. Specify)

Remarks

Monitoring

Coaching

Please indicate the date in the appropriate box when the monitoring was conducted

Conducted by:

Immediate Superior

Date:

Noted by:

Date:

Head of Office

DOH - SPMS Form - 6A

I. Performance Monitoring and Coaching

(Illustration showing a Sample Tracking Tool for Monitoring Targets)

Major Final
Output

Test Item

Test Bank
Database

Exam
Calendar and
Announceme
nt

Task Status
Tasks

1.1 Conduct of Test

Item Workshop
1.2 Review of Test
Items
2.1 Encoding of Test
Item
2.2 Updating of Test
Item Properties
2.3
Management/Mainten
ance of Test Bank
Database
3.1 Consultation with
CSCRO's
3.2 Preparation of
Calendar/Announce
ment
3.3 Presentation of
Calendar
/Announcement

Exam
4.1 Constitution of
Conduct Exam Commitees
Action Plan
4.2 Determination of
Testing Centers /Test
Administrators
4.3 Preparation of
Budget Estimate
(Income and
Expenses)
NonConfidential
Examination
Documents

5.1 Preparation of
Examiner's Manual
5.2 Reproduction of
Examination
Documents
5.3 Dissemination of
Examination of
Examination
Documents

Processed 6.1 Review and

Examination Evaluation of
Application Application
6.2 Batching of
Application

Assigned

to

Duration

Week 1

Week 2

Week 3

Week 4

Remarks

DOH SPMS Form - 6 B

J. Performance Monitoring and Coaching

(Illustration showing a Sample Tracking Tool for Monitoring Assignments)

Performance Monitoring Form

Task ID No.
Subject
Action
Output Date Assigned
Date
Officer
Accomplished
Documents No. Subject Area of the Task
Date the task Date the Output
or Task No. If or the Signatory of the
was assigned was approved by
Taken from
Documents and Subject
to the draffter the approver
WFP
Area

Remarks

DOH-SPMS Form - 7

Perfomance Rewarding and Development

(Illustration showing a Professional Development Plan Template)

Professional Development Plan

Date:
Target Date
Review Date
Achieved Date

Aim

Objective

Task

Commets

Next Step

Professional Development Plan

Date
Aim

Objective

Target Date
Review Date
Achieved Date
Commets

Task

Outcome

Next Step