Ages 3

Gross Motor Raw Fine Motor Self- Help Raw

Scaled Score Scaled Score Scaled Score
Score Raw Score Sore

0 1 0 2 0 1
1 1 1 2 1 1
2 1 2 2 2 1
3 1 3 2 3 1
4 2 4 4 4 1
5 3 5 5 5 1
6 5 6 7 6 1
7 6 7 9 7 1
8 7 8 10 8 1
9 8 9 12 9 1
10 10 10 14 10 2
11 11 11 15 11 3
12 12 12 4
13 14 13 5
14 5
15 6
16 7
17 8
18 9
19 9
20 10
21 11
22 12
23 13
24 13
25 14
26 15
27 16
 Ages 3.1 - 4.0 years
Receptive Language Expressive Language Cognitive Raw
Scaled Score Scaled Score
Raw Score Raw Score Score

0 3 0 1 0
1 3 1 1 1
2 5 2 1 2
3 7 3 3 3
4 10 4 4 4
5 12 5 6 5
6 9 6
7 11 7
8 13 8
9
10
11
12
13
14
15
16
17
18
19
20
21
 Standard Score Equivalent of Sum of Scaled Scores Table

Social Emotional Scaled

Scaled Score Sum of Scaled Scores
Raw Score Score

3 0 1 29
4 1 1 30
5 2 1 31
5 3 1 32
6 4 1 33
7 5 1 34
8 6 1 35
9 7 1 36
10 8 1 37
10 9 1 38
11 10 2 39
12 11 2 40
13 12 3 41
14 13 4 42
14 14 5 43
15 15 6 44
16 16 7 45
17 17 8 46
17 18 8 47
19 19 9 48
19 20 10 49
19 21 11 50
22 12 51
23 13 52
24 14 53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
ent of Sum of Scaled Scores Table Child's Record 2

Standard Scores Interpretation

37 Delay
38 Delay
40 Delay
41 Delay
43 Delay
44 Delay
45 Delay
47 Delay
48 Delay
50 Delay
51 Delay
53 Delay
54 Delay
56 Delay
57 Delay
59 Delay
60 Delay
62 Delay
63 Delay
65 Delay
66 Delay
67 Delay
69 Delay
70 Slight Delay
72 Slight Delay
73 Slight Delay
75 Slight Delay
76 Slight Delay
78 Slight Delay
79 Slight Delay
81 Average
82 Average
84 Average
85 Average
86 Average
88 Average
89 Average
91 Average
92 Average
94 Average
95 Average
97 Average
98 Average
100 Average
101 Average
103 Average
104 Average
105 Average
107 Average
108 Average
110 Average
111 Average
113 Average
114 Average
116 Average
117 Average
119 Average
120 Slight Advanced
122 Slight Advanced
123 Slight Advanced
124 Slight Advanced
126 Slight Advanced
127 Slight Advanced
129 Slight Advanced
130 Highly Advanced
132 Highly Advanced
133 Highly Advanced
135 Highly Advanced
136 Highly Advanced
138 Highly Advanced
Steps in using the “ECCD Checklist Computation using MS Excel with SF5”:
Step 1:
Type the LRN, Name and Birthday of the students or copy it in SF1 and paste in INPUT
DATA Sheet. These data will automatically appear in other sheets.

Step 2:
In INPUT DATE Sheet, type the testing date in the format of MM/DD/YYYY to provide the
age.
Step 3:
Enter the raw score of each domain and it will automatically have the scaled score.
*The scaled score depends on the age of the students. The scaled score table of 3.1-4.0,
4.1 – 5.0 and 5.1 – 5.9 are different to one another.
Step 4:
After entering the raw scores in 7 domains the total scaled score will automatically
computed likewise the standard score and the interpretation of the students.
Step 5:the number of the pupils who got Highly advanced (HA), Slightly Advanced (SA),
Count
Average (A), Slightly Delay (SD), Delay (D) and type it in the lower portion of the sheet.
The results will be reflected in the consolidation report.
Step 6:
The Total Scaled Score and interpretation of the students will be reflected in the new form
of kindergarten, the SF5.

IMPORTANT: DO NOT TYPE IN SF5. THE LRN, NAME OF LEARNER,

STANDARD SCORE, INTERPRETATION, LEVEL OF PROGRESS AND
DEVELOPMENT WILL BE AUTOMATICALLY REFLECTED .

Hope this will help us! :)

JAGILEN M. DELA CRUZ
KINDERGARTEN TEACHER
PIO DEL PILAR ELEMENTARY SCHOOL
SDO - MANILA
IMPORTANT: To prevent #VALUE! Error in the Age cell. Please check your Date and Time S
It should be MM/dd/yyyy. Please refer to the pictures below on how to do it.

2 3

4 5
ck your Date and Time Settings.
 1st session MALE 1st session FEMALE
NAME BIRTH DATE TESTING DATE NAME BIRTH DATE
LRN LRN
(Last Name, First Name, Middle Name) (mm/dd/yyyy) (mm/dd/yyyy) (Last Name, First Name, Middle Name) (mm/dd/yyyy)

AVILA,VICTOR VALENZUELA 1/4/2010 10-27-2020 ALMADOVAR,EIXELL JADE QUIJANO 10/24/2013

BENEDICTO,MHACK DRAE OPIANA 5/10/2013 10-27-2020 CIELO,RIZZA ANGHELA ROBLES 1/12/2013

CRISTOBAL,KRIS AEON NAVA 8/21/2013 10-27-2020 GAA,AYESHA LUMOT 10/1/2011

DE GUZMAN,BERNARDO DIONISIO 9/26/2013 10-27-2020 DIONISIO,EUNICE 12/11/2012

DE GUZMAN,IMMANUEL AMIR SIGUE 11/22/2013 10-27-2020 FORMENTO,SANDARA SANTANDER 9/25/2013

FABREGAS,CARLO PASIIAO 11/9/2013 10-27-2020 MENIANO,MAYAN JEN 2/12/2013

FLORES,NESTOR KENDRICK SALVADOR 8/12/2013 10-27-2020 OSORIO,HANNAH SALUDAGA 5/8/2013

GALANG,ANGELO NEIL MARINAS 12/6/2013 10-27-2020 OSORIO,PRINCESS ELIZE SALUDAGA 9/22/2012

GULLIBAN,EZEQUIEL HERMOGENO 11/9/2013 10-27-2020 PIRIGAO,CRISTINA ANGEL MAGAT 12/25/2013

MORA,KEINT ANDREW RAMA 10/25/2011 10-27-2020 SAYCO,XYRIEL MENDOZA 6/17/2013

MORALES,JOHN RIAN ARIAS 2/9/2011 10-27-2020 TRABALLO,ALIANA ABARIENTOS 8/29/2014

MORILLA,AJ CAJEPE 10/28/2013 10-27-2020

OSONGCO,XIAN LEE ELEZALDE 5/10/2012 10-27-2020

RAMIRO,PRINCE DYLAN RUFIN 2/3/2013 10-27-2020

 2nd session MALE 2nd session FEMALE
TESTING DATE NAME BIRTH DATE TESTING DATE NAME
LRN LRN
(mm/dd/yyyy) (Last Name, First Name, Middle Name) (mm/dd/yyyy) (mm/dd/yyyy) (Last Name, First Name, Middle Name)

10-27-2020

10-27-2020

10-27-2020

10-27-2020

10-27-2020

10-27-2020

10-27-2020

10-27-2020

10-27-2020

10-27-2020

10-27-2020
sion FEMALE
BIRTH DATE TESTING DATE
(mm/dd/yyyy) (mm/dd/yyyy)
 Schools Division Office
MANILA
JACINTO ZAMORA ELEMENTARY SC

Early Childhood Care and Developmen

School Number 136481 School Year 2020-2021
School JACINTO ZAMORA ELEMENTARY SCHOOL Section KCEP

Gross

Motor

Self-
Fine

Help
Motor
Testing

Scaled

Scaled
Score

Score
Birthday Age
No. LRN Name of Pupils Date
(m/d/y) (y.m)
(m/d/y)
0-13 0-11 0-27

1 AVILA,VICTOR VALENZUELA 01-04-2010 10-27-2020 10.9 13 11 11 12 27

2 BENEDICTO,MHACK DRAE OPIANA 05-10-2013 10-27-2020 7.5 13 11 11 12 27
3 CRISTOBAL,KRIS AEON NAVA 8/21/2013 10-27-2020 7.2 13 11 11 12 27
4 DE GUZMAN,BERNARDO DIONISIO 9/26/2013 10-27-2020 7.1 13 11 11 12 27
5 DE GUZMAN,IMMANUEL AMIR SIGUE 11/22/2013 10-27-2020 6.11 13 11 11 12 27
6 FABREGAS,CARLO PASIIAO 11-09-2013 10-27-2020 6.11 13 11 11 12 27
7 FLORES,NESTOR KENDRICK SALVADOR 08-12-2013 10-27-2020 7.2 13 11 11 12 27
8 GALANG,ANGELO NEIL MARINAS 12-06-2013 10-27-2020 6.10 13 11 11 12 27
9 GULLIBAN,EZEQUIEL HERMOGENO 11-09-2013 10-27-2020 6.11 13 11 11 12 27
10 MORA,KEINT ANDREW RAMA 10/25/2011 10-27-2020 9.0 13 11 11 12 27
11 MORALES,JOHN RIAN ARIAS 02-09-2011 10-27-2020 9.8 13 11 11 12 27
12 MORILLA,AJ CAJEPE 10/28/2013 10-27-2020 6.11 13 11 11 12 27
13 OSONGCO,XIAN LEE ELEZALDE 05-10-2012 10-27-2020 8.5 13 11 11 12 27
14 RAMIRO,PRINCE DYLAN RUFIN 02-03-2013 10-27-2020 7.8 13 11 11 12 27
15
16
17
18
19
20
21
22
23
24
25

Interpretation HA SA A SD D

Results 0 0 14 0 0
sion Office
LA
EMENTARY SCHOOL

velopment Checklist Report

20-2021 Testing Date October 27,2020
KCEP Teacher MS. RENEE LYN MARQUICIAS
Receptive

Expressive

Cognitive

Total Scaled
Language

Emotional
Language

Social

Scores
Scaled

Scaled

Scaled

Scaled

Scaled
Score

Score

Score

Score

Score

Standard
Score
Interpretation

0-5 0-8 0-21 0-24

13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
 Schools Division Office
MANILA
JACINTO ZAMORA ELEMENTARY SC

Early Childhood Care and Developmen

School Number 136481 School Year 2020-2021
School JACINTO ZAMORA ELEMENTARY SCHOOL Section KCEP

Gross
Testing

Motor

Self-
Fine

Help
Motor
Birthday

Scaled

Scaled
Score

Score
Date Age
No. LRN Name of Pupils (d/m/y)
(d/m/y) (y.m)
(m/d/y)
(m/d/y) 0-13 0-11 0-27

1 ALMADOVAR,EIXELL JADE QUIJANO 10/24/2013 10-27-2020 7.0 13 11 11 12 27

2 CIELO,RIZZA ANGHELA ROBLES 01-12-2013 10-27-2020 7.9 13 11 11 12 27
3 GAA,AYESHA LUMOT 10-01-2011 10-27-2020 9.0 13 11 11 12 27
4 DIONISIO,EUNICE 12-11-2012 10-27-2020 7.10 13 11 11 12 27
5 FORMENTO,SANDARA SANTANDER 9/25/2013 10-27-2020 7.1 13 11 11 12 27
6 MENIANO,MAYAN JEN 02-12-2013 10-27-2020 7.8 13 11 11 12 27
7 OSORIO,HANNAH SALUDAGA 05-08-2013 10-27-2020 7.5 13 11 11 12 27
8 OSORIO,PRINCESS ELIZE SALUDAGA 9/22/2012 10-27-2020 8.1 13 11 11 12 27
9 PIRIGAO,CRISTINA ANGEL MAGAT 12/25/2013 10-27-2020 6.10 13 11 11 12 27
10 SAYCO,XYRIEL MENDOZA 6/17/2013 10-27-2020 7.4 13 11 11 12 27
11 TRABALLO,ALIANA ABARIENTOS 8/29/2014 10-27-2020 6.1 13 11 11 12 27
12
13
14
15
16
17
18
19
20
21
22
23
24
25

Interpretation HA SA A SD D

Results 0 0 11 0 0
sion Office
LA
EMENTARY SCHOOL

velopment Checklist Report

20-2021 Testing Date October 27,2020
KCEP Teacher MS. RENEE LYN MARQUICIAS
Receptive

Expressive

Cognitive

Total Scaled
Language

Emotional
Language

Social

Scores
Scaled

Scaled

Scaled

Scaled

Scaled
Score

Score

Score

Score

Score

Standard
Score
Interpretation

0-5 0-8 0-21 0-24

13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
13 5 11 8 11 21 13 24 13 84 117 Average
 Schools Division Office
MANILA
JACINTO ZAMORA ELEMENTARY SC

Early Childhood Care and Developmen

School Number 136481 School Year 2020-2021
School JACINTO ZAMORA ELEMENTARY SCHOOL Section WISE

Gross
Testing

Motor

Self-
Fine

Help
Motor
Birthday

Scaled

Scaled
Score

Score
Date Age
No. LRN Name of Pupils (d/m/y)
(d/m/y) (y.m)
(m/d/y)
(m/d/y) 0-13 0-11 0-27

1 13 Err:502 11 Err:502 24
2 13 Err:502 11 Err:502 27
3 8 Err:502 8 Err:502 17
4 13 Err:502 11 Err:502 22
5 13 Err:502 10 Err:502 12
6 13 Err:502 11 Err:502 25
7 13 Err:502 10 Err:502 27
8 13 Err:502 11 Err:502 26
9 13 Err:502 11 Err:502 21
10 9 Err:502 5 Err:502 23
11 12 Err:502 11 Err:502 22
12 13 Err:502 11 Err:502 27
13 13 Err:502 11 Err:502 19
14
15
16
17
18
19
20
21
22
23
24
25

Interpretation HA SA A SD D

Results 0 0 0 0 0
sion Office
LA
EMENTARY SCHOOL

velopment Checklist Report

20-2021 Testing Date October 27,2020
WISE Teacher MS. JAGILEN M. DELA CRUZ
Receptive

Expressive

Cognitive

Total Scaled
Language

Emotional
Language

Social

Scores
Scaled

Scaled

Scaled

Scaled

Scaled
Score

Score

Score

Score

Score

Standard
Score
Interpretation

0-5 0-8 0-21 0-24

Err:502 5 Err:502 8 Err:502 20 Err:502 20 Err:502

Err:502 5 Err:502 8 Err:502 21 Err:502 24 Err:502
Err:502 5 Err:502 6 Err:502 19 Err:502 16 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 22 Err:502
Err:502 5 Err:502 6 Err:502 20 Err:502 17 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 13 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 24 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 23 Err:502
Err:502 5 Err:502 5 Err:502 20 Err:502 17 Err:502
Err:502 5 Err:502 8 Err:502 19 Err:502 12 Err:502
Err:502 5 Err:502 8 Err:502 20 Err:502 21 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 24 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 24 Err:502
 Schools Division Office
MANILA
JACINTO ZAMORA ELEMENTARY SC

Early Childhood Care and Developmen

School Number 136481 School Year 2020-2021
School JACINTO ZAMORA ELEMENTARY SCHOOL Section WISE

Gross
Testing

Motor

Self-
Fine

Help
Motor
Birthday

Scaled

Scaled
Score

Score
Date Age
No. LRN Name of Pupils (d/m/y)
(d/m/y) (y.m)
(m/d/y)
(m/d/y) 0-13 0-11 0-27

1 13 Err:502 9 Err:502 18
2 10 Err:502 11 Err:502 19
3 13 Err:502 11 Err:502 27
4 13 Err:502 11 Err:502 27
5 13 Err:502 10 Err:502 19
6 10 Err:502 7 Err:502 21
7 13 Err:502 11 Err:502 27
8 10 Err:502 7 Err:502 21
9 13 Err:502 11 Err:502 18
10 11 Err:502 11 Err:502 25
11 13 Err:502 10 Err:502 19
12 13 Err:502 10 Err:502 25
13
14
15
16
17
18
19
20
21
22
23
24
25

Interpretation HA SA A SD D

Results 0 0 0 0 0
sion Office
LA
EMENTARY SCHOOL

velopment Checklist Report

20-2021 Testing Date October 27,2020
WISE Teacher MS. JAGILEN M. DELA CRUZ
Receptive

Expressive

Cognitive

Total Scaled
Language

Emotional
Language

Social

Scores
Scaled

Scaled

Scaled

Scaled

Scaled
Score

Score

Score

Score

Score

Standard
Score
Interpretation

0-5 0-8 0-21 0-24

Err:502 5 Err:502 8 Err:502 20 Err:502 24 Err:502

Err:502 5 Err:502 6 Err:502 21 Err:502 19 Err:502
Err:502 5 Err:502 7 Err:502 21 Err:502 20 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 17 Err:502
Err:502 5 Err:502 8 Err:502 20 Err:502 20 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 16 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 21 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 16 Err:502
Err:502 5 Err:502 8 Err:502 20 Err:502 17 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 19 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 17 Err:502
Err:502 5 Err:502 8 Err:502 21 Err:502 21 Err:502
 Schools Division Office
MANILA
JACINTO ZAMORA ELEMENTARY SCHOOL

Early Childhood Care and Development Checklist Report

School Number 136481 School Year 2020-2021 Testing Date October 27,2020
School JACINTO ZAMORA ELEMENTARY SCHOOL Teacher MS. RENEE LYN MARQUICIAS

MALE FEMALE TOTAL

Delay (D) 0 Delay (D) 0 Delay (D) 0

KCEP

Slight delay (SD) 0 Slight delay (SD) 0 Slight delay (SD) 0

Average (A) 14 Average (A) 11 Average (A) 25
Slightly advanced (SA) 0 Slightly advanced (SA) 0 Slightly advanced (SA) 0
Highly advanced (HA) 0 Highly advanced (HA) 0 Highly advanced (HA) 0
Total Number of Pupils: 14 Total Number of Pupils: 11 Total Number of Pupils: 25

MALE FEMALE TOTAL

Delay (D) 0 Delay (D) 0 Delay (D) 0

Slight delay (SD) 0 Slight delay (SD) 0 Slight delay (SD) 0
Average (A) 0 Average (A) 0 Average (A) 0
Slightly advanced (SA) 0 Slightly advanced (SA) 0 Slightly advanced (SA) 0
Highly advanced (HA) 0 Highly advanced (HA) 0 Highly advanced (HA) 0
Total Number of Pupils: 0 Total Number of Pupils: 0 Total Number of Pupils: 0
 School Form 5 Report on Promotion & Level of Proficiency For Kinder (SF5-K)
End of School Year Kindergarten Appraisal Report
School Name JACINTO ZAMORA ELEMENTARY SCHOOL District Division Region

School ID 136481 Section KCEP School Year 2020-2021

SUMMARY TABLE
SUMMATIVE APPRAISED
NAME OF LEARNER
No. LRN ASSESSMENT INTERPRETATION (Grade One Ready or Needs STATUS MALE FEMALE TOTAL
(Last Name, First Name, Name Extension, Middle Name)
STANDARD SCORE Further Intervention)

GRADE ONE (1) READY

MALE NEEDS FURTHER
1 AVILA,VICTOR VALENZUELA 117 Average INTERVENTION

2 BENEDICTO,MHACK DRAE OPIANA 117 Average

3 CRISTOBAL,KRIS AEON NAVA 117 Average
4 DE GUZMAN,BERNARDO DIONISIO 117 Average LEVEL OF PROGRESS AND ACHIEVEMENT
5 DE GUZMAN,IMMANUEL AMIR SIGUE 117 Average
INTERPRETATION MALE FEMALE TOTAL
6 FABREGAS,CARLO PASIIAO 117 Average
7 FLORES,NESTOR KENDRICK SALVADOR 117 Average Suggest Highly Advanced Development -
0 0 0
S.H.A.D. (130 and above)
8 GALANG,ANGELO NEIL MARINAS 117 Average
9 GULLIBAN,EZEQUIEL HERMOGENO 117 Average Suggest Slight Advanced Development
0 0 0
- S.S.A.D. (120-129)
10 MORA,KEINT ANDREW RAMA 117 Average
11 MORALES,JOHN RIAN ARIAS 117 Average
Average Development - A.D. (80-119) 14 11 25
12 MORILLA,AJ CAJEPE 117 Average
13 OSONGCO,XIAN LEE ELEZALDE 117 Average
Suggest Slight Delay in Overall Development -
14 RAMIRO,PRINCE DYLAN RUFIN 117 Average S.Sl.D.O.D (70-79) 0 0 0

15
Suggest Significant Delay in Overall
16 Development - 0 0 0
S.S.D.O.D (69 and below)
17
14 11
18 TOTAL BY GENDER

19
20
21
22
23
24
25
26
27
28
14 <=== TOTAL MALE
 LEARNER'S NAME
No. LRN (Last Name, First Name, Name Extension, Middle Name)
SUMMATIVE ASSESSMENT STANDARD SCORE INTERPRETATION ACTION TAKEN (Grade One Ready or Needs Further Intervention)

FEMALE
1 ALMADOVAR,EIXELL JADE QUIJANO 117 Average Prepared By:
2 CIELO,RIZZA ANGHELA ROBLES 117 Average
3 GAA,AYESHA LUMOT 117 Average MS. RENEE LYN MARQUICIAS
4 DIONISIO,EUNICE 117 Average Signature of Class Adviser over Printed Name

5 FORMENTO,SANDARA SANTANDER 117 Average

6 MENIANO,MAYAN JEN 117 Average Certified Correct & Submitted By:

7 OSORIO,HANNAH SALUDAGA 117 Average

8 OSORIO,PRINCESS ELIZE SALUDAGA 117 Average Signature of School Head over Printed Name

9 PIRIGAO,CRISTINA ANGEL MAGAT 117 Average

10 SAYCO,XYRIEL MENDOZA 117 Average Reviewed By:
11 TRABALLO,ALIANA ABARIENTOS 117 Average
12 Signature of Public Schools District
Supervisor/Representative over Printed Name
13
14 Checked & Validated By:

15
16 Signature of Division Representative over Printed Name

17
18 GUIDELINES:

19 1. Do not include Dropouts and Transferred Out (DO 4, s.

2014)
20 2. This should be prepared by the Adviser. Post Test Standard
Score should be taken from the record submitted to the
21 Division Office.
22 3. The summary table should reflect the total number of
learners. For GRADE ONE READY, Summative Assessment
23 Standard Score must be 80 and above, while NEEDS
24 FURTHER INTERVENTION must be 79 and below.

11 <=== TOTAL FEMALE

25 <=== COMBINED
SFRT 2017
 School Form 5 Report on Promotion & Level of Proficiency For Kinder (SF5-K)
End of School Year Kindergarten Appraisal Report
School Name JACINTO ZAMORA ELEMENTARY SCHOOL District Division Region

School ID 136481 Section 0 School Year 2020-2021

SUMMARY TABLE
SUMMATIVE APPRAISED
NAME OF LEARNER
No. LRN ASSESSMENT INTERPRETATION (Grade One Ready or Needs STATUS MALE FEMALE TOTAL
(Last Name, First Name, Name Extension, Middle Name)
STANDARD SCORE Further Intervention)

GRADE ONE (1) READY

MALE NEEDS FURTHER
1 INTERVENTION

2
3
4 LEVEL OF PROGRESS AND ACHIEVEMENT
5
INTERPRETATION MALE FEMALE TOTAL
6
7 Suggest Highly Advanced Development -
0 0 0
S.H.A.D. (130 and above)
8
9 Suggest Slight Advanced Development
0 0 0
- S.S.A.D. (120-129)
10
11
Average Development - A.D. (80-119) 0 0 0
12
13
Suggest Slight Delay in Overall Development -
14 S.Sl.D.O.D (70-79) 0 0 0

15
Suggest Significant Delay in Overall
16 Development - 0 0 0
S.S.D.O.D (69 and below)
17
0 0
18 TOTAL BY GENDER

19
20
21
22
23
24
25
26
27
28
0 <=== TOTAL MALE
 SUMMATIVE
LEARNER'S NAME ACTION TAKEN (Grade One Ready
No. LRN ASSESSMENT INTERPRETATION
(Last Name, First Name, Name Extension, Middle Name) STANDARD SCORE
or Needs Further Intervention)

FEMALE
1 Prepared By:
2
3 MS. RENEE LYN MARQUICIAS
4 Signature of Class Adviser over Printed Name

5
6 Certified Correct & Submitted By:

7
8 Signature of School Head over Printed Name

9
10 Reviewed By:
11
12 Signature of Public Schools District
Supervisor/Representative over Printed Name
13
14 Checked & Validated By:

15
16 Signature of Division Representative over Printed Name

17
18 GUIDELINES:

19 1. Do not include Dropouts and Transferred Out (DO 4, s.

2014)
20 2. This should be prepared by the Adviser. Post Test Standard
Score should be taken from the record submitted to the
21 Division Office.
22 3. The summary table should reflect the total number of
learners. For GRADE ONE READY, Summative Assessment
23 Standard Score must be 80 and above, while NEEDS
24 FURTHER INTERVENTION must be 79 and below.

0 <=== TOTAL FEMALE

0 <=== COMBINED
SFRT 2017