Republic of the Philippines Document Code: SDO-BUL-QF-CID -002

Department of Education
Region III – Central Luzon Revision: 03
SCHOOLS DIVISION OF BULACAN
Capitol Compound, City of Malolos Effectivity date: 12-17-2018

Monitoring and Evaluation Name of Office: CID

Elementary

MONITORING AND EVALUATION TOOL FOR INSTRUCTIONAL SUPERVISION (ELEMENTARY)

Name of Supervisor who monitored: ___________________________ Date of Visit: __________________

School: ____________________________________________ District: _________________________
Name of School Head: _________________________________
Type of School: [ ] Small [ ] Medium [ ] Large [ ] Central [ ] Multigrade

√ - if evident
Indicator Remarks
× - if not evident
1. Class Program in every level √
2. Teacher’s Program √
3. List of Students at the door √
4. School Directory √
5. School Policy/ Manual of Regulation √
6. Lesson Plan / DLL √
7. Curriculum Guide √
8. Budget of Work √
9. School Form 1 (SF 1) √
10. Class Record √
11. Attendance Chart √

12. Grade Level Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Total
No. of Classrooms 0 3 3 4 4 4
No. of Classrooms under construction: _________

13. Number of Available Learners’ Materials

Level MTB English Filipino Math Science AP MAPEH EsP EPP
Kinder
Grade 1 195 196 197 195 195
Grade 2 105 113 111 109 105 89 111
Grade 3 299 298 285 298 304 163 318 160
Grade 4 139 143 140 136 135 280 132 145
Grade 5 178 191 187 190 188 372 188 182
Grade 6 159 177 166 180
Total 599 728 926 1090 630 786 1236 952 507

a. Are LMs/Textbooks distributed to students? Yes √ No ____ : Why? ___________________

b. Students to Textbooks ratio: _________________
Remarks: _____________________________________________________________________________
Recommendations: _____________________________________________________________________

14. Mode of Classes

a. Regular Classes: Start: 7:15 End: __________
b. Shifting of Classes
Shift Start End
First Shift 6:00 11:30
Second Shift 12:00 5:00
Third Shift (if necessary)
Remarks: _____________________________________________________________________________
Recommendations: _____________________________________________________________________

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 Republic of the Philippines
Department of Education
Region III – Central Luzon
SCHOOLS DIVISION OF BULACAN
Capitol Compound, City of Malolos
Document Code: SDO-BUL-QF-CID -002
Revision: 03
Effectivity date: 12-17-2018

Monitoring and Evaluation Name of Office: CID

Elementary

15. Inventory of Seats, Teachers Tables & Blackboards

Teacher’s Arm Teacher’s Arm
Level Blackboards Level Blackboards
Table Chairs Table Chairs
Kinder 2 2 Grade 4 3 140 4
Grade 1 4 5 Grade 5 6 140 4
Grade 2 4 3 Grade 6 5 180 4
Grade 3 4 40 4 Total 28 500 26
Remarks: _____________________________________________________________________________
Recommendations: _____________________________________________________________________

16. Loads of Teachers

Date of No. of No. of
Grade Original Other
Name of Teachers Position Classes Subjects
Level Appointment Assignments
Handled Taught
1
2
Kinder
3
4
1
2
Grade
3
1
4
5
1
Grade 2
2 3
4
1
Grade 2
3 3
4
1
Grade 2
4 3
4
1
Grade 2
5 3
4
1
Grade 2
6 3
4
(Add space if needed)
Remarks: _____________________________________________________________________________
Recommendations: _____________________________________________________________________

17. Other Issues/ Concerns: __________________________________________________________________________

__________________________________________________________________________________________________

Monitored by: Conferred with:

_________________________________ ________________________________
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 Republic of the Philippines
Department of Education
Region III – Central Luzon
SCHOOLS DIVISION OF BULACAN
Capitol Compound, City of Malolos
Document Code: SDO-BUL-QF-CID -002
Revision: 03
Effectivity date: 12-17-2018

Monitoring and Evaluation Name of Office: CID

Elementary

EPS / PSDS School Head

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