DOH - SPMS Form 4

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

I, JANE ROSE B. HERNANDEZ, RN, LPT of the Nurse II of Calapan City, commit to deliver and agree to be rated on the attainment of the
following targets in accordance with the indicated measures for the period JANUARY TO JUNE 2023.

Employee: JANE ROSE B HERNANDEZ, RN, LPT

BASILISA M. LLANTO, MD RAYMOND R. GARCIA, RN, MPH, LPT

City Health Officer Name of Supervisor

Output Success Indicators Actual Accomplis

(Target + Measure)
Core Functions:To ensure efficacy on the provision of technical assistance to LGUs and other health partners towards the achievement of UHC.

Conducts home visits to priority households with health problems.

Home-visit logbook with follow-up
Target: 10 HH per month (50)
report/interventions/referral done

Barangay Action Plan Implementation & Monitoring Implement and monitor 1 Barangay Action Plan for Health

Compilation of Individual Treatment Records for Clients Prepares individual treatment record of all walk-in patients in the BHS every 25th day of the
visiting the BHS month (ANA)

Orientations on Health Programs conducted in the 1 Orientation on DOH program conducted monthly in the Barangay (5)
Barangay
Minutes of Barangay Health Board Meeting/ Assembly/
1 Barangay Health Board Meeting /Assembly Meeting /Brgy. Session per quarter (2)
Session

1 BHW report/accomplishment checked monthly (5)

Updated BHW Health Data / Compilation of BHW Monthly
Report
1 Updated Brgy Health data monthly (5)

Participates in the Implementation of health programs of DOH and LGU in the Community
Activity Report for all health related programs or activities
Target: 2
assisted
Programs / month (10)

Copy of Notifiable Disease Reporting Form / Notifiable Assists in the conduct of disease surveillance
Disease Summary Report in BHS Target: ANA

_____ 90% Senior citizen to be fully vaccinated until June 2023

PinasLakas Vaccination Campaign
______ 50% of eligible population for booster dose until June 2023

_____ % 9 - 59 months to be vaccinated until June 15, 2023

MR Supplemental Immunization Activity
______ Catch -up home visitation

Conducts health education / trainings

Health Education / Trainings Conducted
Target : 2x / month (10)
Complete and Updated Target Client List every month: Coordinates with the RHU to ensure timely data collection and reporting every 27th working day of the month

___ pregnant mothers seen and given pre-natal care in 6 months

a. Prenatal Client

b. Postpartum Client ___ post-partum women seen and given post-partum care in 6 months

c. Expanded Program on Immunization ___ infants fully immunized in 6 months

d. Exclusive Breastfeeding ___ infants exclusively breastfeeding

e. Deworming ___ 112-59 months given deworming pills

___ 6 - 11 months infants given Vitamin A

f. Vitamin A
___ 12 - 59 months infants given Vitamin A

Conduct 1 Family Planning Counselling; (Usapan, Pre-marriage Counselling)

Compilation of accomplished M1, Family Planning report ___ Married Couples of Reproductive age monitored in using FP method
submitted on monthly basis
___ individuals with FP unmet needs provided with FP method of choice

Updated Lifestyle-Related Disease Masterlist Assess ___ clients for Lifestyle related diseases

___ Referred for TB Diagnostics

TB Active & Intensive Case Finding ___ Treatment Success Rate (90%)

___ Cure Rate (90%)

Updating of GIDA Profiling Tools 1 Updated GIDA Profiling Tool

Updating of NHFR profile of health facilities 1 Updated NHFR Reistry of facilities

Monthly Journal, DTRs, Itinerary and Locator Matrix submitted to

PDHO Monthly reports submitted to PDOHO every 2nd day of the following month (5)

Average Rating (Core

Support Functions:

Incharge as PHA of the Month _1_ Conduct CHSD inventory of supplies / medicines, submit to PDOHO

Assist in health posts during health emergencies / LGU events / DOH

programs
Provide assistance during the observance or conduct of, e.g. MDA, SBI, Medical Mission

5 HRH meetings / seminars attended as instructed by PDOHO / CHO

Attendance to meetings/seminars for HRH
12 Universal Health Care Implementers Online Course
Assist/Perform other tasks in the City Health and Sanitation Department as assigned.
- LGU/
CHSD activities
- DOH
Assist in performing other tasks in the City Health Office /
program activities and implementation
LGU
- Attendance to regular flag raising ceremonies (16)
-
Uniform Adherence Average Rating (Suppor

Average Rating (Strateg

RATING
Final Rating per
Function Percentage Distribution* Average Rating per Function Function(Average Rating x
Percentage Distribution)
Core Functions: 80%
Support Functions: 20%
Strategic Functions N/A
Comments and Recommendation for Development Purposes:
Discussed with:: Assessed by:
I certify that I discussed assessment of the
performance employee

JANE ROSE B. HERNANDEZ, RN, LPT BASILISA M. LLANTO, MD RAYMOND R. GARCIA, RN, MPH, LPT
Employee CITY HEALTH OFFICER DMO IV /OIC PDOHO
*Legend: 1-Quality 2-Efficiency 3-Timeliness 4-Average; * In the event that there is no strategic output, the percentage distribution is as follows: Core output- 80% and Support output - 20%
 Document Code:
Revision no.:
Effectivity:

Date: MARCH 3, 2023

Date:

Rating
ccomplishments Remarks /
Justification of
Q E T A Unmet Targets
ng (Core Functions)

g (Support Functions)

(Strategic Functions)

Final Average Rating Adjectival Rating Remarks

Date Final Rating by: Date

March 3, 2023 March 3, 2023

RAYMOND R. GARCIA, RN, MPH, LPT

DMO IV /OIC PDOHO
DOH - SPMS Form 4 Document Code:
INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR) Revision no.:
Effectivity:

I, ______________________________, _______________ of __________________ commit to deliver and agree to be rated on the attainment of the
following targets in accordance with the indicated measures for the period JANUARY TO JUNE 2024

Employee: Date: June 16, 2023

Date:

City Health Officer Name of Supervisor

Remarks /
Success Indicators Rating Justification of
Output Actual Accomplishments
(Target + Measure) Q E T A Unmet Targets
Strategic Function: To provide LGUs with competencies and resources for health system strengthening (For UHC IS)
Attendance to seminars and application for Primary Care 12 Universal Health Care Implementers Online Course
Worker certification of HRH Integrated course on Primary Care
Assist LGU staff in attendance to seminars and application 12 Universal Health Care Implementers Online Course
for Primary Care Worker Certification Integrated course on Primary Care
Orientation/advocacy of Universal Health Care on Conduct advocacy session on Universal Health Care to catchment area(s) once per quarter,
catchment area(s) reflected to monthly accomplishment report, and submit post-activity report

Attendance to Health Promotion Playbook Strategy 8 Health Promotion Playbook Modules

Modules through DOH academy
Core Functions:To ensure efficacy on the provision of technical assistance to LGUs and other health partners towards the achievement of UHC.
Home-visit logbook with follow-up Conducts home visits to priority households with health problems.
report/interventions/referral done Target: 10 HH per month (60)
Barangay Action Plan for Health and Barangay Nutrition Implement and monitor 1 Barangay Action Plan for Health
Action Plan Implementation & Monitoring Assist in development of Barangay Nutrition Action Plan for 2024
Nutrition Program MELPI Assist in the monitoring of M&E on Local Program Implementation for Nutrition Target:ANA

Compilation of Individual Treatment Records for Clients Consolidate and submit individual treatment record of all walk-in patients in the BHS every
visiting the BHS 25th day of the month (ANA)
Orientations on Health Programs conducted in the 1 Orientation on DOH program conducted monthly in the Barangay (6)
Barangay of BHWs
Advocate/attend Barangay Health Board Meeting/ 1 Barangay Health Board Meeting /Assembly Meeting /BNC/ Brgy. Session per quarter (2)
Barangay Nutrition Council Meeting/ Assembly/ Session/
Update BHW Health Data / Compilation of BHW Monthly 1 BHW report/accomplishment checked monthly (6)
Report 1 Updated Brgy Health Data Board/ Pregnancy Tracking monthly (6)
Activity Report for all health related programs or activities Participates in the Implementation of health programs of DOH and LGU in the Community
assisted Target: 2
Copy of Notifiable Disease Reporting Form / Notifiable Assists MESU in the conduct of mandatory disease surveillance monitoring every monday
Disease Summary Report in BHS
NIP Reports ___ 9-14 years old given HPV vaccine
___ given Influenza vaccine from target population
Health Education during OPD duty and barangay visit Conducts health education / trainings
Target : 2x / month (6)
Complete and Updated Target Client List/M1 every month: Coordinates with the RHU to ensure timely data collection and reporting every 25th working day of the month
a. Prenatal Client pregnant mothers seen and given pre-natal care with 4ANC within 6 months
b. Postpartum Client post-partum women seen and given post-partum care in 6 months
c. Expanded Program on Immunization infants fully immunized in 6 months
d. Exclusive Breastfeeding infants exclusively breastfeeding
e. Deworming 12-59 months given deworming pills
f. Vitamin A 6 - 11 months infants given Vitamin A
12 - 59 months infants given Vitamin A
g. Validate OPT Report 6 - 11 months infants
g. Validate OPT Report
12 - 59 months infants
h. Assistance in the micronutrient supplementation 6 - 11 months infants
12 - 59 months infants
 Conduct __ Family Planning Counselling; (Usapan, Pre-marriage Counselling)
Compilation of accomplished Family Planning report Married Couples of Reproductive age monitored in using FP method
submitted on monthly basis
individuals with FP unmet needs provided with FP method of choice
Updated Lifestyle-Related Disease Masterlist Assess clients for Lifestyle related diseases
Referred for TB Diagnostics (ANA)
TB Active & Intensive Case-Finding
____ of TB Patient in catchment barangay and assisted for treatment
Updated LGU Profile Update LGU profile every every 6 month to be submitted on or before June 30, 2024
Liscence, certification and accreditation of facility Assist in the compliance of requirements for LTO, certification, accreditation of facility
Monthly Journal, DTRs, Itinerary and Locator Matrix Monthly reports submitted to PDOHO every 2nd day of the following month (5)
submitted to PDHO
Average Rating (Core Functions) 0.00
Support Functions:
Incharge as PHA/Leader of the Month 1 Conduct MHO inventory of supplies / medicines and submit other reports to PDOHO
Assist in health posts during health emergencies / LGU Provide assistance during the observance or conduct of, e.g. MDA, SBI, Medical Mission,
events / DOH programs HEMs monitoring, other special evenys/ activities
Attendance to meetings/seminars for HRH 6 HRH meetings / seminars attended as instructed by PDOHO / MHO
Attend trainings/seminars (ANA)
Assist in performing other tasks in the City Health Office / Assist/Perform other tasks in the MHO as assigned.
LGU - LGU activities

- DOH program activities and implementation

- Attendance to regular flag raising

ceremonies (16)
- Uniform Adherence
Act as Resource speaker (ANA) Average Rating (Support Functions) 0.00

Average Rating (Strategic Functions)

RATING
Final Rating per
Function Percentage Distribution* Average Rating per Function Function(Average Rating x Final Average Rating Adjectival Rating Remarks
Percentage Distribution)
Core Functions:
Support Functions:
Strategic Functions
Comments and Recommendation for Development Purposes:
Discussed with:: Assessed by: Date Final Rating by: Date
I certify that I discussed assessment of the
performance employee

RAMON C. BOMBAIS, MD, MPH RAMON C. BOMBAIS, MD, MPH

Employee MUNICIPAL HEALTH OFFICER DMO V/ PROVINCIAL DOH OFFICER DMO V /Provincial DOH Officer
*Legend: 1-Quality 2-Efficiency 3-Timeliness 4-Average; * In the event that there is no strategic output, the percentage distribution is as follows: Core output- 80% and Support output - 20%
DOH - SPMS Form 4 Document Code:
INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR) Revision no.:
Effectivity:

I, _ Elesa V. Bernabe, RN of ___San Teodoro_____commit to deliver and agree to be rated on the attainment of the
following targets in accordance with the indicated measures for the period JANUARY to JUNE 2025

Employee: Elesa V. Bernabe, RN Date: July 3, 2025

Mayvelyn R. Aldaba, RN Amanda Daeniele M. Delos Reyes, RN

OIC-Municipal Health Office Name of Supervisor
Success Indicators Rating
Output Actual Accomplishments Remarks / Justification of Unmet Targets
(Target + Measure) Q E T A
Strategic Function: To provide LGUs with competencies and resources for health system strengthening (For UHC IS)
Application for Primary Care
1 Primary care worker Certification for HRH 1 Primary care worker certification accomplished with validity until January 2028 5 5 5
Worker Certification of HRH
Application for primary Care 1 primary care worker Certification for RHU personnel Justine Leonil J. Soriano,
1 Primary care worker Certification for RHU personnel 5 5 5
Worker Certification RN with PCW validity until November 2025
1 Assist in updating the NHWR Update Report No assistance provided Other HRH were incharge to assist other program
National Health Workforce
Registry Inventory 2 Assisted in updating NHWSS inventory quarterly. Accomplished Q1 NHWSS
2 Assist in updating the NHWSS Inventory quarterly 5 5 5
inventory January, 2025 and Q2 NHWSS inventory June,2025
Conducted workshop and selection of (3) Priority Brangays in the LGU. Attended
Implementation of Conduct workshop and selection of (3) Priority Barangays in the MAMAHALIN ORMIN and PuroKalusugan Cascading Activity for Oriental 5 5 5
PuroKalusugan LGU Mindoro PK Teams
Average Rating (Strategic Functions) 5.00
Core Functions:To ensure efficacy on the provision of technical assistance to LGUs and other health partners towards the achievement of UHC.

Conducted 260 priority HH visits: January-10HPN,10sick

Home-visit logbook with follow- Conducts home visits to priority households with health problems. patient,2postpartum February-9HPN,1sick patient,1postpartum
up report/interventions/referral Target: March-10HPN,19sick patient,1postpartum April-10HPN,14sick 5 5 5 5.00
done 10 HH per month (60/60) patient/EPI,2postpartum May-121MDA,10HPN,9sick patient,3postpartum June-
14HPN,3sick patient,8EPI,3postpartum

Barangay Action Plan for Health Implement and monitor 1 Barangay Action Plan for Health 2025 1 Barangay Nutrition Action Plan for 2025 implemented and monitored 5 5 5.00
and Barangay Nutrition Action
Plan Implementation & Assist in Implementation of Barangay Nutrition Action Plan for
Monitoring 1 (100%) Barangay Nutrition Action Plan for 2025 assisted in implementation 5 5 5.00
2025 (100%)

Assist 100 % in the monitoring and evaluation on Local Program There was no conduct of M&E on MELLPI from
Nutrition Program MELLPI No assistance provided.
Implementation on Nutrition Target (ANA) January to June 2025
 Consolidated and submitted 515 (100%) individual treatment record of all walk-in
patients in the BHS every 25th day of the month: JANUARY-122 (URTI-
46,COMMON COLDS-3,ATP-5,T/C AGE-10,RASHES-2,BPPV-1,IW-
2,INDIGESTION-1,FP-13,EPI-19,T/C UTI-2,ABD.PAIN-1,PNCU-6,SVI-
8,BODY WEAKNESS-1,B.A.-2) FEB-94 (URTI-24,T/C AGE-2,FP-12,PNCU-
11,ATP-2,IW-4,CMMON COLDS-1,NP-2,HPN-1,SVI-4,T/C PCAP-1,T/C
HFMD-2,EPI-24,ORAL SORE-1,B.A.-1,ABD. PPAIN-1,T/C VIRAL
CONJUNCTIVITIS-1 MARCH-69(LBM-2,ABD.COLIC-2,PNCU-16,FP-4,IW-
1,ATP-3,URTI-16,UTI-4,FEVER-2,SVI-2,TOOTH ABSCESS-1,AGE-2,T/C
MUMPS-1,RASHES-2,MASS-1,EPI-9,COMMON COLDS-1) APRIL-68(URTI-
7,BURN-7,SVI-4,FP-5,HEADACHE-1,POST-NATAL-1,EPI-18,T/C AGE-2,OM-
Compilation of Individual Consolidate and submit individual treatment record of all walk-in
3,ORAL THRUSH-1,ATP-2,PNCU-18,T/C HFMD-1,ABD.PAIN-1,B.A.-1,T/C
Treatment Records for Clients patients in the BHS every 25th day of the month (ANA) 5 5 5.00
UTI-1) MAY-108(URTI-20,SVI-2,PNCU-19,FEVER-1,FP-19,HYPERACIDITY-
visiting the BHS
4,MUSCLE PAIN-2,T/C AGE-9,COMMON COLDS-1,ABD. PAIN-1,T/C
ANEMIA-1,EPI-13,HORDEULOM-1,NP-3,B.A.-2,T/C FUNGAL INFECTION-
1,T/C PARASITISM-1,VA-1,ALLERGY-1,OVERFEEDING-1,OM-1,ABSCESS-
2) JUNE-54(EPI-15,URTI-5,FP-9,PNCU-15,HEAT RASH-1,BURN-1,IW-
2,HEADACHE-2,HYPERACIDITY-1,T/C AGE-2,ATP-1)

12 Orientation on updates on DOH program conducted monthly in the Barangay:

JANUARY-Deworming and Dengue Awareness(1/31/25), FEBRUARY-
PNCU,Deworming,EPI(2/3/25) Dengue Prevention and Control Program(2/24/25)
Family Planning(2/18/25) MARCH-Filaria MDA, Filariasis(3/3/25)
Orientations on the updates of 1 Orientation on updates DOH program conducted monthly in the EPI,Dengue Awareness,Filariasis(3/4/25)
Health Programs conducted in Barangay (6/6) APRIL-HFMD,Handwashing(4/8/25)Immunization and Importance of completing 5 5 5 5.00
the Barangay and BHWs doses(4/10/25) MAY-Imp. of
PNCU,TT,Nutrition and Diet(5/6/25)Teenage Pregnancy,Smoke and
Vape(5/27/25) JUNE-HPN/DM,Glucose
Monitoring(6/17/25) Importance of Hospital Delivery,Exclusively
Breastfeeding,Nutrition and Diet while pregnant(6/16/25)

Advocate/attend Barangay
1 Barangay Health Board Meeting attended (May 5, 2025)
Health Board Meeting/ 1 Barangay Health Board Meeting /Assembly Meeting /BNC/
1 BNC attended (May 5, 2025) 5 5 5.00
Barangay Nutrition Council Brgy. Session per quarter (2/2)
1 Brgy. Session/BHB attended (March 3, 2025)
Meeting/ Assembly/ Session/
Checked 11 BHW reports/accomplishments (January 25,2025, Februaru 25, 2025,
1 BHW report/accomplishment checked monthly (6/6) 5 5 5.00
March 25,2025, April 25,2025, May 25,2025, June 25,2025)

100% Check/validate BHW registration and cetification issued by Checked and validated 11 (100%) registered and accredited BHWs certified
Update BHW Health Data / 5 5 5.00
LHB/RAC through LHB Reso No. 2025-0001
Compilation of BHW Monthly
Report
1 Updated Brgy Health Data Board/ Pregnancy Tracking monthly (6/6)
Updated 6 Barangay Health Data Board 5 5 5.00
There was no conduct of BHW Training from January
_100%_ Assist in the conduct of BHW Training (ANA) No assistance provided to June 2025
 Participated and Implemented 32 health programs of DOH and LGU in the
community:January-Garantisadong Pangbata, Vit. A and Deworming (01/30/25)
February-Oral Health Month, DQC(2/24/25)Dengue Awareness
Program(2/24/25) March- Rabies Awareness Month(3/31/25), Womens
Month(3/12/25), TB ACF(3/25/25)NIP training (3/17-21/25) Whole month of
March MDA
Participates in the Implementation of health programs of DOH and
Activity/Narrative Report for all April-Whole month of April Filaria MDA,Tutok Kainan Graduation(4/3/25)
LGU in the Community
health related programs or May- Whole month of May MDA 5 5 5.00
Target: 2 Programs /
activities assisted Filaria, National Election Day(5/12/25) iClinicsys Orientation(5/14-
month (12/12)
15/25),Philhealth KOnsulta(5/23/25),Oplan Tuli sa Barangay(5/18/25)June- IPMR
Orientation(6/2/25),Province Wide Clean Up Drive(6/20/25),MAMAHALIN
Ormin(6/18-20), PK Orientation(6/24-26/25)
Whole 1st Semester-Child Immunization, Prenatal Care, Family
Planning, Services, Post Partum Care, Deworming, Inventory of
Supplies,Medicines and Vaccines, Vitamin A Supplementation, Dengue 5S

100% Assists MESU in the conduct of mandatory disease

Copy of Notifiable Disease
surveillance monitoring every monday and assist in ESR/PIDSR Assisted 28 (100%) MESU in the conduct of mandatory disease surveillance
Reporting Form / Notifiable 5 5 5
reporting forms (ANA) montitoring every Friday and assist in ESR/PIDSR reporting forms
Disease Summary Report in BHS

135 9-14 years old given HPV vaccine 12 (9%) 9-14 years old given HPV vaccine 5 1 2 2.66
Vaccine hesitancy, low parental consents, Competing
NIP Reports
workload of health staff
130 given Influenza vaccine from target population 58(44.6%) were given Influenza vaccine from the target population 5 1 2 2.66

Conducted 21 health education/trainings: JANUARY-Deworming,

OPT,EPI(1/30/25)Deworming and Dengue Awareness(1/31/25),
Deworming,OPT,MNP(1/20/25) FEBRUARY-PNCU,Deworming,EPI(2/3/25)
Dengue Prevention and Control Program(2/24/25) Family Planning(2/18/25)
MARCH-Filaria MDA, Filariasis(3/3/25) EPI,Dengue
Awareness,Filariasis(3/4/25) Breasfeeding and Family Planning(3/10/25)EPI
Vaccines and Its Importance(3/7/25)
Conducts health education / trainings
Health Education during RHU APRIL-HFMD,Handwashing(4/8/25)Immunization and Importance of
Target: 2x / 5 5 5 5.00
OPD duty and barangay visit completing doses(4/10/25)Risk Assessment(4/3/25)Importance of Regular PNCU
month (12/12)
and Warning Signs in Pregnancy(4/14/25) Preventing Intestinal
Parasites,Environmental Cleanliness(4/28/25)
MAY-Imp. of PNCU,TT,Nutrition and Diet(5/6/25)Teenage Pregnancy,Smoke and
Vape(5/27/25) Risk Assessment,Heat-Related Diseases(5/29/25)
JUNE-HPN/DM,Glucose Monitoring(6/17/25)
Importance of Hospital Delivery,Exclusively Breastfeeding,Nutrition and Diet
while pregnant(6/16/25)

Complete and Updated Target Coordinates with the RHU to ensure timely data collection and
Client List/M1 every month: reporting every 25th working day of the month
12 pregnant mothers seen and given pre-natal care with 4ANC Some women only seek check-ups during the later
a. Prenatal Client within 6 months 5 pregnant mothers seen and given pre-natal care with 4ANC within 6 months 5 1 2 2.66 stages of pregnancy

Pregnant women in GIDA areas have limited access to

b. Facility-Based Delivery 100% of pregnant mothers assisted to facility-based delivery 11 (62.5%) of pregnant mothers assisted to facility-based delivery 5 2 2 3.00 Health facilities

12 post-partum women seen and given post-partum care in 6

c. Postpartum Client 17 post-partum women seen and given post-partum care in 6 months 5 5 5 5.00
months
 There is only 71% coverage rate due to
1. 1 child migarted to Manila
d. Expanded Program on 2. Missed scheduled immunization due to sickness
34 infants fully immunized in 6 months 8 infants fully immunized in 6 months 5 1 2 2.66
Immunization 3. Vaccine hecitancy and fear of immunization after
effect on their children like fever and children getting
irritable

e. Exclusive Breastfeeding 5 infants exclusively breastfeeding 11 infants exclusively breastfeeding 5 5 5 5.00

f. Deworming 200 12-59 months given deworming pills 210 12-59 months given deworming pills 5 3 5 4.30

32 6 - 11 months infants given Vitamin A 35 6-11 months infants given vitamin A 5 3 5 4.30
g. Vitamin A GP
200 12 - 59 months infants given Vitamin A 210 12-59 months infants given vitamin A 5 3 5 4.30

32 6 - 11 months infants 35 6-11 months infant validated 5 3 5 4.30

h. Validate OPT Report

200 12 - 59 months infants 210 12-59 months infants validated 5 3 5 4.30

32 6 - 11 months infants 35 6-11 months infants given MNP supplementations 5 3 5 4.30

I. Assistance in the
micronutrient supplementation
200 12 - 59 months infants 210 12-59 months infants given MNP supplementation 5 3 5 4.30

Some children had underlying infections e.g.

Improve nutritional status of 21 SAM children to MAM Improved nutritional status of 12 SAM Children 5 2 2 3.00 diarrhea,parsitism that delayed weight gain
Improve Nutritional Status of
Malnourished children Some children had underlying infections e.g.
Improve nutritional status of 19 MAM children to normal Improved nutritional status of 9 MAM Children 5 2 2 3.00 diarrhea,parsitism that delayed weight gain

Conduct 2 Family Planning Counselling; (Usapan, Pre-marriage

Compilation of accomplished Conducted (25) Family Planning Counselling sessions 5 5 5 5.00
Counselling)
Family Planning report 187 Married Couples of Reproductive age monitored in using FP
submitted on monthly basis method 192 Married Couples of Reproductive age monitored using FP method 5 3 5 4.30

Assess 379 clients for Lifestyle related diseases risk assessment Target clients did not visit health center for routine
Updated Lifestyle-Related check-up due to busy work
tool Assessed 135 clients for Lifestyle related diseases using risk assessment tool 5 2 2 3.00
Disease Masterlist
Target: 15% of 20-59 years old & 15% of 60 years old and above
Referred 100% for TB Diagnostics (ANA) (Dssm, Xray,
No TB patient referred. No detected TB patient from January to June 2025
TB Active & Intensive Case- Genexpert)
Finding 100% of TB Patient in catchment barangay and assisted for 6 (100%) of TB Patient in catchment barangay and assisted for treatment 2 are
5 5 5 5.00
treatment completed
Environmental Health and Assist RSI in monitoring 100% Environmental Health and No EHS activities conducted/ instructed from January
No assistance provided.
Sanitation Sanitation activities (ANA) to June 2025
Maternal Death Prevention and 100% Assist in the conduct of community maternal death review No maternal deaths reported from January to June
No assistance provided.
Monitoring (ANA)
Assist in updating 1 LGU profile every 6 month to be submitted on Other HRH were incharge to assist other program
No assistance provided.
or before June, 2025
Assist in the submission of 1 Primary Care Facility Client Other HRH were in-charge of the accomplishment
Updated LGU Profile No assistance provided.
Experience Survey (PCF-CES) Tool, NHFR (ANA) of the survey
Update GIDA profile of 1 Barangays (Bigaan) using the 2024 data, encoded in
Update 1 GIDA profile using the 2024 data by June 2025 BHW Connect on (June 30,2025) 5 5 5 5.00
License, certification and 100% Assist in the compliance of requirements/policies for LTO, 100% Assisted in ABTC Certification, issued March 10, 2025, valid until March
5 5 5 5.00
accreditation of facility certification, accreditation of facility (ANA) 10, 2027. Certification No. 2025-MIMAROPA-0067
Monthly Journal, DTRs,
Monthly reports submitted to PDOHO every 2nd day of the
Itinerary and Locator Matrix 6/6 monthly report submitted to PDOHO every 2nd day of the following month 5 5 5.00
following month (6/6)
submitted to PDHO
Average Rating (Core Functions) 4.34
Support Functions:
1 Conduct MHO inventory of supplies / medicines and submit other Conducted 1 (May,2025) MHO inventory of supplies/ medicines and submitted
Incharge as PHA/Leader of the Mreports other reports to PDOHO 5 5 5.00
to PDOHO

Provided (100%) assistance during the observance or conduct of the following:

Assist in health posts during Provide 100% assistance during the observance or conduct of, e.g.
1. MDA - March, April and May, 2025
health emergencies / LGU events MDA, SBI, Medical Mission, HEMs monitoring, Road 5 5 5.00
2. HEMs Monitoring - Every Saturday of the whole 1st semester
/ DOH programs accidents/other special evenys/ activities
3. Assisted on Election Day as Emergency Responder -May 12,2025

Attended 9 meetings as instructed.

6 HRH meetings / seminars attended as instructed by PDOHO /
January 3,2025, January 21,2025, February 28,2025, July 3,2025, July 11,2025, 5 5 5.00
MHO
Attendance to meetings/seminars Janury 7,2025, February 27,2025, March 21,2025, July 7,2025
for HRH
100% Assist/Perform other tasks in the MHO as assigned. Attended 100% Trainings as instructed: (specify dates)
Attend 100% trainings/seminars/webinars (ANA) NIP Training, MAMAHALIN OrMin, PK Cascading Teams 5 5 5.00
- LGU activities

- DOH
program activities and implementation
Assist in performing other tasks Provided 100% assistance/compliance to assigned tasks in MHO:
in the City Health Office / LGU HEMS reporting, Health emergency Response Team, Health emergency Response 5 5 5.00
-
Team, Launching of Tutok Kainan, Dengue 5 S Campaine, OPD / RHU Duty
Attendance to regular flag raising ceremonies (16)

- Uniform
Average Rating (Support Functions) 5.00
Adherence
RATING
-updating of IP GIDA data/profile tool per catchment barangay
Act as Resource speaker (ANA)

Function Percentage Distribution* Average Rating per Function Final Rating per Final Average Rating Adjectival Rating Remarks
Function(Average Rating x
Percentage Distribution)
Core Functions: 50% 4.3 2.15
Support Functions: 10% 5 0.50 4.65 Very Satisfactory
Strategic Functions 40% 5 2.00
Comments and Recommendation for Development Purposes:
Discussed with: Assessed by: Date Final Rating by: Date
I certify that I discussed assessment of the
performance employee

July 3, 2025

ELESA V. BERNABE, RN MAYVELYN R. ALDABA, RN AMANDA DANIELE M. DELOS REYES, RN RAMON C. BOMBAIS, MD, MPH
Employee OIC-MUNICIPAL HEALTH OFFICE NURSE II/ DOH REPRESENTATIVE DMO V /Provincial DOH Officer
*Legend: 1-Quality 2-Efficiency 3-Timeliness 4-Average; * In the event that there is no strategic output, the percentage distribution is as follows: Core output- 80% and Support output -