FORM 1.

1 SELF-ASSESSMENT CHECK (Sample)

INSTRUCTIONS: This Self-Check Instrument will give the trainer necessary
data or information which is essential in planning training
sessions. Please check the appropriate box of your answer
to the questions below.
CORE COMPETENCIES
CAN I…? YES NO
1. (Insert Competencies Here)
(Insert all LOs here)
( Add additional rows when required)
Example
2. INSTALL AND CONFIGURE COMPUTER SYSTEMS (CSS Core 1)
LO1 Assemble computer hardware (Core 1 Element 1) √
LO2 Prepare installer √
LO3 Install operating system and drivers for √
peripherals/ devices
LO4 Install application software √
LO5 Conduct testing and documentation √
3. SET-UP COMPUTER NETWORKS (CSS Core 2)
LO 1 Install network cables
LO2 Set network configuration
LO3 Set router/Wi-Fi/ wireless access point/
Repeater configuration
LO4 Inspect and test the configured computer
networks

Note: In making the Self-Check for your Qualification, all required competencies
should be specified. It is therefore required of a Trainer to be well- versed
of the CBC or TR of the program qualification he is teaching.

Form 1.2: Evidence of Current Competencies acquired related to

Job/Occupation
Current competencies Proof/Evidence Means of validating
Using the accomplished Write down all proof or Indicate the method/s that
Form 1 as reference, pieces of evidence that you intend to utilize to
copy all competencies / the Trainee can provide validate submitted
LOs that have a “yes” to support what the documents.
check mark trainee has marked
with a “yes” check
mark
Example
INSTALL AND
CONFIGURE
COMPUTER SYSTEMS
LO1 Assemble Certificate of Previous Call previous employer and
computer hardware Employment as check for the authenticity
LO2 Prepare installer Computer Technician and validity of the
submitted document.
LO3 Install operating
system and drivers for
peripherals/ devices
LO4 Install application
software
LO5 Conduct testing
and documentation

Form 1.3 Summary of Current Competencies Versus Required

Competencies (Sample)

Required Units of Current Training

Competency/Learning
 Outcomes based on CBC Competencies Gaps/Requirements
1. INSTALL AND CONFIGURE COMPUTER SYSTEMS
LO1 Assemble computer LO1 Assemble -
hardware computer hardware
LO2 Prepare installer LO2 Prepare installer -
LO3 Install operating LO3 Install operating
system and drivers for system and drivers -
peripherals/ devices for peripherals/
devices
LO4 Install application LO4 Install -
software application software
LO5 Conduct testing and LO5 Conduct testing -
documentation and documentation

Required Units of Current Training

Competency/Learning
Outcomes based on CBC
2. SET-UP COMPUTER NETWORKS
LO 1 Install network cables
LO2 Set network
configuration
LO3 Set router/Wi-Fi/
wireless access point/
Repeater configuration
LO4 Inspect and test the
configured computer
networks
Competencies Gaps/Requirements
- LO 1 Install network
cables
- LO2 Set network
configuration
LO3 Set router/Wi-Fi/
wireless access point/
-
Repeater configuration
- LO4 Inspect and test the
configured computer
networks

Form No. 1.4: Training Needs (Sample)

Training Needs Module Title/Module of
Instruction
(Learning Outcomes)
LO 1 Install network cables SETING-UP COMPUTER
NETWORKS
LO2 Set network configuration
LO3 Set router/Wi-Fi/ wireless access
point/ Repeater configuration
LO4 Inspect and test the configured
computer networks