RIVERSIDE MEDICAL CENTER, INC.

owner and operator of the DR. PABLO O. TORRE MEMORIAL HOSPITAL

PERFORMANCE MANAGEMENT PROGRAM (REVISED AS OF JANUARY 2017)
PERFORMANCE PLANNING FORM

NAME PERIOD COVERED DATE HIRED

JESUS MIGUEL GARGANTIEL JANUARY – DECEMBER 2010/07/07

POSITION DURING PERFORMANCE PERIOD DIVISION SPECIFIC UNIT

Licensing Specialist Total Quality Division Licensing Section

DUTIES AND RESPONSIBILITIES %age STRATEGIC OBJECTIVE TASKS %age

Insure that all permits. Certificates and To initiate and secure licenses/permits
licenses are up to date every month of different service units of new
facilities/buildings.
20.00 50.00

Assists in the preparation of To facilitate the initial application of

documents/data of the completion of specific service areas of the new
application for renewal of permits, building/facilities under Riverside
certificates and licenses that are assigned to 40.00
Medical Center, Inc.
60.00
the section.

Collects a copy of the ipdated PRC Licenses To improve efficiency of the

of concerned employees for the renewal of processeing of the renewal of permits
hospital licenses. and licenses to avail early bird
60.00 70.00
discounts

Submits report (Monthly and Yearly) TO contribute in the cost control of

required by government regualtory agencies waste (Scanning of PRC, PTR, LTOs,
Certificates and etc…)
80.00 80.00

Secures government clearances and permits continuously review processes and

to avail the early bird discounts for business policies to maximize use of resource in
tax the best possible way, maximize
100.00 90.00
outputs, and improve compliance and
to hasten processes.

AGREED MEASURES (WITH RATING INTERPRETATION / RI)

TIMELINESS QUANTITY QUALITY
More than 1 week advanced EXCELLENT: 95.1% - 100% E: 95.1% - 100% E: 95.1% - 100%
1 week ahead VERY SATISFACTORY: 90.1% - 95% VS: 90.1% - 95% VS: 90.1% - 95%
Done ABOVE AVERAGE: 85.1% - 90% AA: 85.1% - 90% AA: 85.1% - 90%
50% Done AVERAGE: 80.1% - 85% A: 80.1% - 85% A: 80.1% - 85%
Started BELOW AVERAGE: 75.1% - 80% BA: 75.1% - 80% BA: 75.1% - 80%
Not Done / Not Started POOR: 75% - below P: 75% - below P: 75% - below

CONFORME

I understand and agree with the Specific Activities, Duties and Responsibilities, and Other Factors that were explained to me by my immediate superior.

Employee's Signature over Printed Name and Date

Immediate Superior's Signature over Printed Name and Date

Next Level Superior's Signature over Printed Name and Date

 RIVERSIDE MEDICAL CENTER, INC.
owner and operator of the DR. PABLO O. TORRE MEMORIAL HOSPITAL
PERFORMANCE MANAGEMENT PROGRAM (REVISED AS OF JANUARY 2017)
PERFORMANCE APPRAISAL FORM

NAME PERIOD COVERED DATE HIRED

JESUS MIGUEL GARGANTIEL JANUARY – JUNE 40366

POSITION DURING PERFORMANCE PERIOD DIVISION SPECIFIC UNIT

Licensing Specialist Total Quality Division Licensing Section

RATING
DUTIES AND RESPONSIBILITIES TIMELINESS QUANTITY QUALITY
TOTAL %AGE
RI RATING RI RATING RI RATING
Insure that all permits. Certificates and licenses are up to
date every month

E 95 E 98 E 98 97 20.00

Assists in the preparation of documents/data of the

completion of application for renewal of permits, certificates
and licenses that are assigned to the section.

E 98 E 100 E 98 98.666667 40.00

Collects a copy of the ipdated PRC Licenses of concerned

employees for the renewal of hospital licenses.

E 95 VS 94 VS 94 94.333333 60.00

Submits report (Monthly and Yearly) required by

government regualtory agencies

VS 94 E 95 VS 94 94.333333 80.00

Secures government clearances and permits to avail the

early bird discounts for business tax

E 97 E 95 E 95 95.666667 100.00

TOTAL 5 96

AGREED MEASURES (WITH RATING INTERPRETATION / RI)

TIMELINESS QUANTITY QUALITY
More than 1 week advanced EXCELLENT: 95.1% - 100% E: 95.1% - 100% E: 95.1% - 100%
1 week ahead VERY SATISFACTORY: 90.1% - 95% VS: 90.1% - 95% VS: 90.1% - 95%
Done ABOVE AVERAGE: 85.1% - 90% AA: 85.1% - 90% AA: 85.1% - 90%
50% Done AVERAGE: 80.1% - 85% A: 80.1% - 85% A: 80.1% - 85%
Started BELOW AVERAGE: 75.1% - 80% BA: 75.1% - 80% BA: 75.1% - 80%
Not Done / Not Started POOR: 75% - below P: 75% - below P: 75% - below

CONFORME

I understand and agree with the results of the mid-year evaluation which were explained to me by my immediate superior.

Employee's Signature over Printed Name and Date

Immediate Superior's Signature over Printed Name and Date

Next Level Superior's Signature over Printed Name and Date

 RIVERSIDE MEDICAL CENTER, INC.
owner and operator of the DR. PABLO O. TORRE MEMORIAL HOSPITAL
PERFORMANCE MANAGEMENT PROGRAM (REVISED AS OF JANUARY 2017)
PERFORMANCE APPRAISAL FORM

NAME PERIOD COVERED DATE HIRED

JESUS MIGUEL GARGANTIEL JULY – DECEMBER 40366

POSITION DURING PERFORMANCE PERIOD DIVISION SPECIFIC UNIT

Licensing Specialist Total Quality Division Licensing Section

RATING
DUTIES AND RESPONSIBILITIES TIMELINESS QUANTITY QUALITY
TOTAL %AGE
RI RATING RI RATING RI RATING
Insure that all permits. Certificates and licenses are up to
date every month

E 98 E 98 E 95 97 20.00

Assists in the preparation of documents/data of the

completion of application for renewal of permits, certificates
and licenses that are assigned to the section.

E 97 E 97 E 97 97 40.00

Collects a copy of the ipdated PRC Licenses of concerned

employees for the renewal of hospital licenses.

E 96 VS 94 VS 94 94.666667 60.00

Submits report (Monthly and Yearly) required by

government regualtory agencies

E 95 VS 94 VS 94 94.333333 80.00

Secures government clearances and permits to avail the

early bird discounts for business tax

E 96 E 95 E 95 95.333333 100.00

TOTAL 5 95.666667

AGREED MEASURES (WITH RATING INTERPRETATION / RI)

TIMELINESS QUANTITY QUALITY
More than 1 week advanced EXCELLENT: 95.1% - 100% E: 95.1% - 100% E: 95.1% - 100%
1 week ahead VERY SATISFACTORY: 90.1% - 95% VS: 90.1% - 95% VS: 90.1% - 95%
Done ABOVE AVERAGE: 85.1% - 90% AA: 85.1% - 90% AA: 85.1% - 90%
50% Done AVERAGE: 80.1% - 85% A: 80.1% - 85% A: 80.1% - 85%
Started BELOW AVERAGE: 75.1% - 80% BA: 75.1% - 80% BA: 75.1% - 80%
Not Done / Not Started POOR: 75% - below P: 75% - below P: 75% - below
 RIVERSIDE MEDICAL CENTER, INC.
owner and operator of the DR. PABLO O. TORRE MEMORIAL HOSPITAL
PERFORMANCE MANAGEMENT PROGRAM (REVISED AS OF JANUARY 2017)
PERFORMANCE APPRAISAL FORM

PERIOD COVERED

JANUARY – DECEMBER

RATING
STRATEGIC OBJECTIVES TASKS TIMELINESS QUANTITY QUALITY
TOTAL %AGE
RI RATING RI RATING RI RATING
To initiate and secure licenses/permits of different service
units of new facilities/buildings.

E 95 E 95 E 95 95 20.00

To facilitate the initial application of specific service areas of

the new building/facilities under Riverside Medical Center,
Inc.

E 96 E 95 VS 94 95 40.00

To improve efficiency of the processeing of the renewal of

permits and licenses to avail early bird discounts

E 96 E 95 E 95 95.333333 60.00

TO contribute in the cost control of waste (Scanning of PRC,

PTR, LTOs, Certificates and etc…)

E 96 VS 94 E 95 95 80.00

continuously review processes and policies to maximize use

of resource in the best possible way, maximize outputs, and
improve compliance and to hasten processes.

VS 94 VS 94 VS 94 94 90.00

TOTAL 5 85.38

AGREED MEASURES (WITH RATING INTERPRETATION)

TIMELINESS QUANTITY QUALITY
More than 1 week advanced EXCELLENT: 95.1% - 100% E: 95.1% - 100% E: 95.1% - 100%
1 week ahead VERY SATISFACTORY: 90.1% - 95% VS: 90.1% - 95% VS: 90.1% - 95%
Done ABOVE AVERAGE: 85.1% - 90% AA: 85.1% - 90% AA: 85.1% - 90%
50% Done AVERAGE: 80.1% - 85% A: 80.1% - 85% A: 80.1% - 85%
Started BELOW AVERAGE: 75.1% - 80% BA: 75.1% - 80% BA: 75.1% - 80%
Not Done / Not Started POOR: 75% - below P: 75% - below P: 75% - below
 RIVERSIDE MEDICAL CENTER, INC.
owner and operator of the DR. PABLO O. TORRE MEMORIAL HOSPITAL
PERFORMANCE MANAGEMENT PROGRAM (REVISED AS OF JANUARY 2017)
PERFORMANCE APPRAISAL FORM

PERIOD COVERED

JANUARY – DECEMBER

COMPANY EVENTS / ACTIVITIES ATTENDED SUBTOTAL 25

Major (please refer to Table 1.0) = 4 points | Minor (not indicated in Table 1.0) = 2 points | Corporate Mass = 1 point
ACTIVITY DATE POINTS
Quality Week Celebration 11/6,7 & 8/2019 4
Aguinaldo Mass 12/20/19 1
Employee’s Christmas Party 12/05/19 4
Handwashing Day Desktop Background Making Contest 10/16/19 4
Feast Day of Mt. Carmel 6/16/2019 1
Founder’s Day Fun Walk & Fun Run 06/29/19 4
White Mass 01/15/19 1
Continous Quality Improvement 01/11-13/2019 2
Learning from the Best 11/28/19 2
Ancillary Week Opening 10/01/19 2

COMMITTEE INVOLVEMENT SUBTOTAL 6

Chairperson = 5 points | Co-Chairperson = 3 points | Active Member = 2 points | Emcee/Performer = 3 points

ACTIVITY DATE POINTS
Quality Week Celebration 11/6,7 & 8/2019 2
Handwashing Day 10/16/19 2
ACI Committee 2
 COMMENDATION OR AWARD SUBTOTAL 10

With written document |President = 20 points | MANCOM = 10 | Division = 5

ACTIVITY DATE POINTS
0
Best Dept. in Customer Service September 2019 5
Best Dept. in Customer Service November 2019 5

TRAININGS SUBTOTAL 10

Please refer to Table 2.0 for the point system

ACTIVITY DATE POINTS
Accreditation Canada International Seminar/Training/Orientation01/10-11/2019 2
Accreditation Canada International Seminar/Training/Orientation 02/06/19 2
Accreditation Canada International Seminar/Training/Orientation 2/20/2019 2
Accreditation Canada International Seminar/Training/Orientation 02/27/19 2
Accreditation Canada International Seminar/Training/Orientation 3/1/2019 2

PUNCTUALITY SUBTOTAL 6

Please see attached Attendance Matrix

INFRACTION SUBTOTAL 10

None = 10 points | Employees with infraction will be rated one (1) scale lower in the final grade

OTHER FACTORS TOTAL POINTS (MAXIMUM OF 100) 67

 RIVERSIDE MEDICAL CENTER, INC.
owner and operator of the DR. PABLO O. TORRE MEMORIAL HOSPITAL
PERFORMANCE MANAGEMENT PROGRAM (REVISED AS OF JANUARY 2017)
PERFORMANCE APPRAISAL FORM
RANK-AND-FILE
PERFORMANCE FACTOR (80%)
MID-YEAR YEAR-END AVERAGE PF WEIGHT SUBTOTAL
Duties and Responsibilities 96 95.66666667 95.83333333 0.80 76.66666667
Strategic Objectives 85.38 0.20 17.076
TOTAL 93.74266667
OTHER FACTORS (20%)
TOTAL 67
360-DEGREE FEEDBACK (N/A)
TOTAL

OVERALL RATING
RATING WEIGHT RATING x WEIGHT
Performance Factor 93.74266667 0.80 74.9941333333334
Other Factors 67 0.2 13.4
360-Degree Feedback
SUBTOTAL 88.3941333333334
INFRACTION (DEDUCTION OF 7.5 POINTS) 0
TOTAL PMP RATING 88.3941333333334
TOTAL PMP RATING INTERPRETATION VERY SATISFACTORY

IMMEDIATE SUPERIOR'S COMMENTS

Key Strengths

Areas for Development

Recommended Trainings

CONFORME

I understand and agree with the results of the mid-year evaluation which were explained to me by my immediate superior.

Employee's Signature over Printed Name and Date

Immediate Superior's Signature over Printed Name and Date

Next Level Superior's Signature over Printed Name and Date

TOTAL PMP RATING INTERPRETATION

Excellent 92.50% - 98.00%
Very Satisfactory 85.00% - 92.49%
Above Average 77.50% - 84.99%
Average 70.00% - 77.49%
Below Average 66.50% - 69.99%
Poor Below – 66.49%