TEACHERS CHECKLIST FOR DATA COLLECTION

School-Based Management

Note: Please select and prepare the available documents to be possibly collected by the assigned teachers

ASSIGNED DOCUMENTS TO PREPARED DATE OF SIGNATURE REMARKS

AREA SUBMISSION
TEACHERS
1) List of M& E team, 2) Progress report, 3) Copy of Original SIP, 4) Revised SIP, 5) work plan, 6)
SCHOOL approved project proposal, 7) Minutes/narrative report with Attendance on annual AIP
IMPROVEMENT revision/adjustment, 8)Revision committee for SIP and AIP, 9) Revised SIP included in the barangay
BENES H.
PLAN (SIP) development/ List of copies of work plan implementation, 11) Integration of SIP in the Barangay
DOPITILLO Development Plan, 10) SBM M&E of self-assessment tool
1) Accomplishment Report, 2)deed of donations and acceptance, 3) certificate of recognition given to
VANESSA BRIGADA the stakeholders, 4) attendance, 5) Records of stakeholder support, 6) Financial report, 7)assessment
DELA CRUZ ESKWELA tools/form, 8) Copies of invitation letter for the stakeholder, 9) Copies of letter of confirmation from
stakeholder, 10) Project proposal, 11) Action plan
LEONORA N. 1) Approved Training Design, 2) Matrix of Activities, 3) Narrative Report, 4) Attendance, 5)
PROFESSIONAL
LERIT Memorandum (if any), 6) List of teachers attended National, Regional, Division, District level
DEVELOPMENT Seminar/Workshop/conference, 7) Directory of trainers and consultant,

SCHOOL 1)Proposal , 2) accomplishment reports, 3) Nutritional status of pupils, 4) List of severely wasted
ABEGAIL Z. pupils/students, 5) List of normal weight pupils/students, 6) List of overweight pupils/students, 7)
FEEDING
PEDUCHE List of feeding beneficiaries, 8) List of working committees of school feeding program, 9) attendance
PROGRAM sheet, 10), List of feeding implementation agencies
1) Innovations, 2) action researches, 3) List of localized materials which were formulated and
MARILOU utilized, 4)List of topics integrated in the lesson plan suited to the community, 5) Inventory of
LRC RECORDS
CANADILLA property instructional materials and classroom structuring, 6) Learning environment pictures, 7)
Assessment tool
NORLINDA Approved Training Design, Matrix of Activities, Narrative Report, Attendance, Memorandum,
GAD Action Plan, Post Activity Survey
GARCESA
 PROCUREMENT 1) Copies resolutions, 2) List of BAC Members, 3) List inspectorate team 4) Approved AIP, SOB,
APP, PPMP
NORLINDA PTA FINANCIAL 1) Financial statement (school fund, PTA, IGP, canteen), 2) Copies of annual PTA financial report,
GARCESA REPORT 3) Resolution crafted/made by the PTA and joint resolutions of PTA and Barangay Council
HACHEL TEACHERS 1) Action Plan, 2)Technical assistance needed by teachers, 3) Accomplishment Report of Mentoring
JOY TECHINCAL Program, 4) COT Rating, 5) Copies of ITTPR, STAR, TOGA,
GONZALES ASSISTANCE
LEONORA N. SCHOOL DISASTER RISK
1) Project proposal, 2) Action Plan, 3) Accomplishment Report, 3) Memorandum
REDUCTION
LERIT MANAGEMENT (SDRRM)

DONNA
AWARDS/CERTIFICATION
1) List of awards/certificates received by the school, 2) Certificates, 3) Memorandum,
OF RECOGNATION
CARLOS RECEIVED BY THE
SCHOOL

EDNA 1) Accomplishment Report, 2) Action Plan, 3) Project Proposal

SPG
AMATA
EMELIE PHYSICAL/ 1) School site development plan, 2) School Land Tax Declaration/title, 3) List of school fiscal
committee members, 4) School site development plan, 5) Physical development plan
CABUGWAS FISCAL
,6) Complete record on fiscal management
NORLINDA FINANCIAL 1) Monthly Financial Statement/Financial Report of the School
GARCESA REPORT
ALELI TRANSPARENCY 1) Committee on the school transparency board, 2) Newsletter, 5) Peace advocacy, 6) Posted monthly
PAREL BOARD financial statement signed by the financial management committee on the school transparency board
RHOVILLA ADAPT SCHOOL 1) Accomplishment Report, 2) Action Plan, 3) Project Proposal
V. BOLNEO PROGRAM

ASSESSMENT 1) Copy of test results (periodical rest result, 2) MPS of the NAT, Summative Test and Periodical
AMMIE Test, 3) Comparative graphical; presentation of NAT for 3 consecutive school year, 4) NAT
RESULT preparedness plan/proposal, 5) Phil-IRI, 6) LAPG
GABITANO
ACADEMIC AND 1) Activity Request activities Conducted, Attendance, Narrative reports on academic and
ELIZABETH EXTRACURRICU extracurricular Activities
SAGUBAY LAR ACTIVITIES
COMPILATION OF 1) Copies of updated accomplishment report
CONCEPCION
ACCOMPLISHMEN
MONTERO
T REPORT
MARGIE OTHERS 1) Visitors Log BOOK, 2) Office orders/Job orders, 3) Copies of memorandum of agreement
 BANGIS/ pictorials and documentations, 4) Personnel Handbook, 5) Facebook) Records of Quarterly
LETICIA updated BEIS, 7) Copies of fidelity bond document of school principal
ORTILANO
SHEBA Wash in School 1) Project Proposal, 2) Accomplishment Report, 3) WinS Improvement Plan, 4) WinS Monitoring
CABUYAON WinS Result

HERMINIA GPTA / HRPTA 1) Approved Request for GPTA General Assembly/HRPTA Meeting, 2) Attendance Sheets, 3)
Copies of invitation and confirmation of meetings, 4) minutes/ Narrative Reports, 5) resolutions, 6)
MANATAD MEETING
Post Activity Survey
1) Comparative participation rate, 2) Comparative achievement, 3) Comparative performance
EVONIE indicators, 4) School report card BESRA (participation rate promotion rate, cohort survival rate, drop-
ICT RECORDS
NATIVIDAD out rate, graduate rate, transition rate completion rate, literacy), 5) Comparative NAT results by
subject area for 3 consecutive years, 6) SF1 and 2, 7) , 7) SF 5, Action Plan
BARANGAY 1) Certificates of appearance, 2) certificate of participation, 3) Records of attendance, 4) SCESTA
RHOVILLA officers SCS Constitution & by Laws, 5) Minutes/Narrative Report
MEETING/ASSE
V. BOLNEO
MBLY
EDNA 1) Program Proposal, 2) Action Plan, 3) Accomplishment Report, 4) Attendance, 5) Assessment
INTERVENTION Result or Pupils Anecdotal Record basis for Intervention, 6) Individual Intervention Plan, 7) Progress
TORRECARI
PROGRAM Result
ON
EDNA 1) Program Proposal of remedial reading, 2) Action Plan for reading Intervention, 3) List of Pupils
REMEDIAL According to their Level, 4) List of stakeholders who assisted in review classes and reading
TORRECARI
READING remediation, 5) Reading Assessment Result, 6) Accomplishment Report on remedial reading, 7)
ON Accomplishment report on school reading camp
ELENA SCHOOL GREENING 1)Action Plan, 2) Project Proposal, 3) Accomplishment Report,
PROGRAM/GULAYAN
ESCRUPULO SA PAARALAN

SCHOOL 1) Project Proposal, 2) Accomplishment Reports on SGC Activities Conducted, 3) Attendance Sheets,
HARRIETE 4) Resolutions, 5) List of records of barangay donations, 6) List of SGC officers and members with
GOVERNANCE
JAYD defined functions, 7) List of SGC officers & appearance in barangay meetings, 8) Minutes during
COUNCIL Barangay Meeting with SGC officers
SIMBRE
ORGANIZATION 1) Updated organizational chart, 2) List of created school committee to M & E on resource
AL STRUCTURE Management, 3) List of planning team organized, 4)Curriculum and learning Planning team, 5) List
LYDIA of different organizational structures in school (parents, teachers and pupils), 6) List of officials of
& LIST OF
CAGULADA SGC/GPTA/SPG teaching force organization, different school clubs, Barangay council, SIP & AIP
COMMITTEE
Revision) with their correspondence roles.
TEAM
ELLEN FAITH FAMILY 1) Family Mapping Report and other data
SEGOVIA MAPPING

TEACHERS 1) Teachers Portfolio, 2) , 4) Copies of appointment of teachers, 5) Copies of the plantilla of teachers,
LYN ANN 6) Records of updated personnel profile, 7) IPCRF, 8) Class record, 9) Classroom program, 10, List
DATA of Teachers graduate MA/PHD, 11) Action Plan
BUENO
1) FORM, 137 A-E, 2) List of 4ps beneficiaries, 3) List of school age pupils in the community, 5)
AMMIE PUPILS DATA Copies of school report card, 6) Revised Philippine ECD Checklist, 7) Pupils anecdotal records
GABITANO
EZRHA 1) List of formulated accountability systems process mechanisms and tools (school climate survey,
RUELLA SURVEY opinion survey, students’ pupils’ opinion survey etc)
BALIBAGOSO
BENES H. SPECIAL 1) IEP, 2) Self-Learning Modules, 3) List of SPED Learners, 4) Innovation, etc.
DOPITILLO EDUCATION
BENES H. SCHOOL SCHOOL PUBLICATION THAT PUBLISHED INDICATORS, NAT RESULT (COMPARATIVE
DOPITILLO PUBLICATION DATA)
COMPILATION COMPILATION OF DEPED ORDERS, ADVISORIES AND MEMORANDA ( DIVISION,
EMMAVILL OF DEPED LOCAL, NON-DEPED REGIONAL AND NATIONAL), SCHOOL CALENDAR OF
A AZUELO ORDERS ACTIVITIES/MONTHLY PROGRAM
LEARNING 1) Copy of School BE-LCP, 2) Accomplishment Report of the Implementation of BE-LCP, 3)
DISTANCE Accomplished Project Proposal, 4) Narrative report of strategies/activities, 5) MELC, 6)WHLP,
JOVANE D. MODALITY 7)ILP, 8)School Monitoring Evaluation and Plan Adjustment, 9) Communication Mechanisms on the
Implementation of the school LDM, 10) Innovative Teaching Strategies,11) Leaners Assessment
LEGAPI SIGNIFICANT
Result/Progress in the LDM, 12) self-learning Module in Print,
ACCOMPLISHME
NTS
LEARNING DISTANCE
1) Programs/Projects/ Health protocols initiated for a safe Learning Environment for Learners, 2)
MODALITY
RIZEL LURA PROVISION OF LEARNING Parents and Stakeholders, 3) Management and Improvement of Classroom Facilities
ENVIRONMENT

1) Professional development/training participated in the implementation of Alternative learning

LEARNING DISTANCE MODALITY
PROFESSIONAL

LEONORA N.
DEVELOPMENT/TRAININGS
PARTICIPATED IN THE modalities, 2) Technical Assistance Provided to Teachers and Stakeholders
IMPLEMENTATION OF ALTERNATIVE
LERIT MODALITIES

LEARNING DISTANCE
1) Stakeholders Participation and Involvement, 2) Parents Willingness to Co-Supervise and –monitor
HAZEL MODALITY
the Progress of their Children learning
PARENTS INVOLVEMENT
MAGHINAY AND COMMUNITY
PARTNESHIP
.
Prepared by:

BENES H. DOPITILLO
SBM Coordinator

APPROVED:

MERLIE S. ABECIA
Elementary School Principal II