Republic of the Philippines
DEPARTMENT OF EDUCATION
Division of Northern Samar
Region VIII
ST. FRANCIS COLLEGE – ALLEN
Pascual B. Gutay St., Sabang 2,
Allen, Northern Samar 6405
WORK IMMERSION PERFORMANCE APPRAISAL
Student’s Name : ______________________________ Strand :
_________________________
Partner Institution :
___________________________________________________________________
Address : ______________________________ Contact No. : ___________________
Work Immersion Supervisor : ________________________ Position :
___________________
Immersion Period : _______________ to ____________ Total No. of Hours Rendered :
_______
Directions: For each behavioral item listed within the competency bands, with 5
being the most and 1 is the least, please select rating most suited.
5 Outstanding Performance exceeds the required standard.
4 Very Satisfactory Performance fully met the required standard.
Was able to perform what is expected from
him/her.
3 Satisfactory Performance gas met the required standard.
Can perform duties with minimal supervision.
2 Fair Performance partially met the required
standard. Can perform duties with full
supervision.
1 Needs Improvement Performance does not meet the required
standard. Major improvement needed.
NA Not Applicable Performance indicator is nor relevant to the
job.
COMPETENCIES
TEAMWORK 5 4 3 2 1
1. Consistently works with other to accomplish goals and
tasks.
2. Treats all team members in a respectful courteous
manner.
3. Actively participates in activities and assigned tasks
required
4. Is willing to work with team members to improve team
collaboration on a continuous basis
5. Considers the feedback and views of team members
when completing an assigned task.
Total Score/5
COMMUNICATION 5 4 3 2 1
1. Actively listen to supervisor and/or co-workers
2. Comprehends written and oral information
3. Consistently delivers accurate information both written
and oral.
4. Reliably provides feedback as required, both internally
and externally.
Total Score/4
ATTENDANCE AND PUNCTUALITY 5 4 3 2 1
1. Is punctual on a regular basis.
2. Maintains good attendance
3. Informs supervisor in a timely manner when
absenteeism and tardiness may occur.
Total Score/3
PRODUCTIVITY/RESILIENCY 5 4 3 2 1
1. Consistent produces quality results.
2. Meets deadlines and manages time well.
3. Can do multitasking
4. Can work under pressure and delivers the required
tasks.
5. Is effective and efficient in time management
6. Efficiently informs supervisor of any challenge or
hindrance related to given task or assignment.
Total Score/6
INITIATIVE/PROACTIVITY 5 4 3 2 1
1. Completes assignments with minimum supervision
2. Completes tasks independently and consistently
3. Seeks support as need arises
4. Recognizes and takes immediate action to effectively
address problems and opportunities.
5. Engages in continuous learning
6. Contributes new ideas and shares skills to improve the
department/organization.
Total Score/6
JUDGEMENT/DECISION MAKING 5 4 3 2 1
1. Analyzes problems effectively
2. Has the ability to make creative and effective solutions
to problems.
3. Demonstrates good judgement in handling routine
problems.
Total Score/3
DEPENDABILITY/RELIABILITY 5 4 3 2 1
1. Has the ability to follow through and meet deadlines
2. Has commitment for his/her action
3. Can adjust easily to changes in workplace
4. Displays high level of performance at all times
Total Score/4
ATTITUDE 5 4 3 2 1
1. Offers assistance willingly
2. Shows a positive work attitude.
3. Shows sensitivity to and consideration for other’s
feelings.
4. Accepts criticism positively.
5. Shows pride in work.
Total Score/5
PROFESSIONALISM 5 4 3 2 1
1. Respects persons authority
2. Uses all tools, equipment and facilities responsibly.
3. Follows all policies and procedures when issues and
conflict arise.
4. Physical appearance conforms with the workplace and
placement rules
Total Score/4
Weighte
Equivale
d
nt Grade
Average
OVERALL RATING
SUMMARY OF SCORES
CRITERIA WEIGHTED
AVERAGE
Teamwork
Communication
Attendance and Punctuality
Productivity/Resilience
Initiative/Proactivity
Judgment/Decision Making
Dependability/Reliability
Attitude
Professionalism
Over-All Weighted Average
Equivalent Grade
REMARKS: (Comments and Suggestions)
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Student’s Signature : _______________________________ Date :
____________________
Work Immersion Supervisor’s Signature Over Printed Name: Date :
________________________________________________ ___________________________
Transmutation Table
Computed Weighted Equivalent Grade
Average
4.20 – 5.00 100
3.40 – 4.19 95
2.60 – 3.39 90
1.80 – 2.59 85
1.00 – 1.79 80