STANDARDIZED SCHOOL-BASED MANAGEMENT SELF-ASSESSMENT TOOL

(Regional Memo 133 & 134 s 2021)

Name of School:

Location: District:
School Type: __ Elementary __ Secondary __ Integrated Sch. Date Established:
School Head:
Last SBM Rating School Year:
Self-Assessment School Year:
Current SBM Rating School Year:

CRITERIA ON THE LEVEL OF PRACTICE

Numerical Description
Rating Scale
0 No Evidence
1 Evidence indicates developing structures and mechanism are in
place to demonstrate ACCESs.
2 Evidence indicates planned practices and procedures are fully
implemented and aligned to ACCES
3 Evidence indicates practices and procedures satisfy quality
standards

I. LEADERSHIP AND GOVERNANCE

STANDARD
MOV/ARTIFACTS
INDICATOR LEVEL OF PRACTICE SCORE REMARKS
(mark / if present and x
if not)
1. In place is The development plan ___Approved School
Development guided by the school’s Improvement
Plan (e.g. SIP vision, mission and goal Plan
developed Level (VMG) is developed ___School
collaboratively 1 through the leadership of Memorandum
by the the school and the ___Letter of Invitation
stakeholders of participation of 50% ___Activity Completion
the school and community stakeholders. Report (ACR)
community The development plan is ___Other supporting
evolved through the documents
Level shared leadership of the (printed/electronic)
2 school and the Approved Office
participation of 51-80% Performance
community stakeholders Commitment and
The development plan is Review
enhanced with the 81- Form
100% community ___School
Level participation in Memorandum
3 performing the leadership ___ Minutes of the
roles with the school Meeting
providing technical ___ACR
support.
2. The The school leads the Approved Annual
development regular review and Implementation Plan
plan (e.g. SIP) is Level improvement of the (AIP)
regularly 1 development plan
reviewed by the The school and 75-80% ___School
school community stakeholders Memorandum
community to Level working as full partners,
keep it up 2 lead the continual review ___Letter of Invitation
responsive and and improvement of the
relevant to development plan. ___Activity Completion
emerging needs, The school and 81-100% Report (ACR)
challenges and of the community
opportunities stakeholders lead the ___Other supporting
regular review and documents
Level improvement process; the (printed/electronic)
3 school stakeholders
facilitate the process
3. The school is The school defines the
organized by a Level organizational structure, School Organizational
clear structure 1 and the roles and Structure
and work responsibilities of the ___Process Flow
arrangements stakeholders. ___Other supporting
that promote The school and 51-80% documents
shared of the community (printed/electronic)
leadership and collaboratively define the
governance and Level structure and the roles and
define roles and 2 responsibilities of
responsibilities stakeholders.
of the The school and 81-100%
stakeholders. of the community
Level collaboratively define the
3 structure and the roles and
responsibilities of
stakeholders.
4. A leadership A network has been Mode of Dissemination:
network collaboratively established
facilitates and is continuously ___School Website
communication improved by the school ___Facebook Account
between and Level community yearly. ___Page/Leaflets/
among school 1 Brochures/
and community The network actively Newsletters
leaders for provides stakeholders ___Transparency/
informed information for making ___Bulletin Board
Level decisions and solving
decision-making ___School Paper
2 learning and
and solving of ___Communication
school- administrative problems Plan, Flow and
community twice a year. System
wide-learning School Based
problems The network allows easy implementing guidelines
exchange and access to on Child Protection
information sources Policy, Anti-Bullying,
beyond the school etc.
Level community every
3 ___ School Memorandum
quarter. ___ Consultation Report
(Attendance and picture)
___Proposed School
Implementing Guidelines
___School Handbook
with dissemination report
(Pictorials and attendance)
___ Intake Sheets
eBEIS – Performance
Indicators
___Gross Enrolment Rate
___ Net Enrolment Rate
___Cohort Survival Rate
___Transition Rate
___School Leaver Rate
___Completion Rate
___ALS Completion Rate
(% of ALS Learners
who completed either
Elementary or
Secondary Level in
accordance with the
requirements)
___ALS A&E Passer
Rate (% of ALS
Learners who passed
the ALS Accreditation
and Equivalency Test)

5. A long term Developing structures are Training Development

program is in in place and analysis of Plan
operation that the competency and ___Teachers’
addresses the development needs of Development Needs
training and Level leaders is conducted; ___LAC/INSET
development 1 result is used to develop a implementation Plan
needs of school long-term training and (LAC template per
and community development program DepEd/Division
leaders. every year. issuances)
Leaders undertake training ___Project Proposal
modes for 2 quarters that ___School memorandum
are convenient to them ___Technical Working
Level (on-line, off-line, Group
2 modular, group or home- ___ACR with financial
based) and which do not and monitoring report
disrupt their regular ___Sample certification
functions. Leaders and program
monitor and evaluate their ___Technical Assistance
own learning process. Plan (based on
Leaders assume DepEd/Memorandum)
responsibility for their ___Certification of
own training and Attendance to
Level development every trainings/webinars
3 quarter. School (Division/Regional/Nation
community leaders al/International
working individually or in
groups, coach and mentor
one another to achieve
their VMG.
TOTAL
WEIGHTED MEAN (Total Score/5)

FINDINGS: RECOMMENDATIONS:

BEST FEATURES:
Validated By : (affix the Signature)
1. 2.
Designation: Designation:
3 4.
Designation: Designation:
Conformed By:
Designation:

II. CURRICULUM AND INSTRUCTION

STANDARD
INDICATOR LEVEL OF PRACTICE MOV/ARTIFACTS SCORE REMARKS
(mark / if present and x if not)
1. The All types of Learner’s Outcome
curriculum learners of the ( ) Performance Indicator
provides for the school community (Drop-out Rate, Graduation,
development Level are identified, their Cohort-Survival, etc)
needs of all type 1 learning curves ( ) Learner’s Tracking System/
of learners in assessed, Progress Report
the school appropriate ( )Learner’s Profile with their
community programs with its learning needs
support materials ( )Learners’ Portfolio
for each type of ( ) Alternative Delivery Mode
learner are (ADM)
developed 26-50 ( ) Periodic Assessment
% decrease of the Results with Analysis
non-numerates ( ) Summative test Results
and non - literates ( ) Proportion of performing at
Programs are fully proficient level
implemented and A. Numeracy Level
Level closely monitored B. Literacy Level
2 to address
performance In the absence of NAT, the
discrepancies results of the reading test in
benchmark best Filipino and English and
practices coach numeracy test shall be
low performers, considered – with reference to
mentor potential the policy standard set by the
leaders, reward CLMD
high achievements
that makes learning The Percentage weight for the
meaningful and learning outcome shall
enjoyable with 51- 10% - Filipino Reading test
75 % decrease of 10% - English Reading test
the non- 10% Numeracy Test
numerates and
non - literates To determine the improvement
The educational of learning outcomes, the rating
needs of all type of
learners are being
met as shown by
continuous
improvement and
learning outcomes standard below shall be followed
Level and product of
3 learning with 76-
100% or zero
non-reader/non
numerates.
Teachers’ as well
as students’
performance is
motivated by
intrinsic rather than
extrinsic reward.
The school
differentiated
program is
frequently
benchmarked by
other schools.
2. The Local beliefs, ( ) List of Localized,
implemented norms, values, contextualized IMs with
curriculum is Level traditions, sample (Big Books, MTB
localized to 1 folklores, current dictionary, etc.)
make it more events, and ( ) School Initiated SLM/LAS
meaningful to existing (Sample)
the learners technologies are ( ) School Forms
and applicable documented and ( ) Improves/ Localized LMs/
to life in the used to develop a IMs/ DLLs
community lasting curriculum. ( )Instructional Materials
Developed ( ) List of Visual Aids,
localized Digitized, IMs and Quality
curriculum. Assured and accepted localized
Developed LMs
localized
curriculum in 4
learning areas
The localized
curriculum is
Level implemented and
2 monitored closely
to ensure that it
makes learning
more meaningful
and pleasurable,
produced desired
learning outcomes,
and directly
improves
community life.
Ineffective
approaches are
replaced, and
innovative ones are
developed.
Developed
localized
curriculum in 6
learning areas
Best practices in
localizing the
curriculum are
mainstreamed and
Level benchmarked by
3 other schools.
There is marked
increase in number
of projects that use
the community as
learning
laboratory, and the
school as an agent
of change for
improvement of
the community.
Developed
localized
curriculum in ALL
learning areas
3. A A representative Teachers’ Portfolio
representative team of school and ( )RPMS/IPCRF Portfolio
group of school community (proportion of teachers
and community Level stakeholders assess meeting PPST career stage 3
stakeholders 1 content and in all domains (Highly
develop the methods used in Proficient)
methods and teaching creative, ( ) Monthly Supervisory Plan
materials for critical thinking ( ) Classroom Observation Tool
developing and problem ( ) Observation Notes
creative solving. ( ) Class Program
thinking and Assessment results ( ) Sample Lesson Plan
problem solving are used as guide ( ) DepEd emails and FB
to develop accounts
materials in 4 ( ) School Leadership with
learning areas in designation.
all grade levels.
A representative
team of school and
community
Level stakeholders assess
2 content and
methods in
teaching creative,
critical thinking
and problem
solving.
Assessment results
are used as guide
to develop
materials.
Developed learning
materials in 6
learning areas in
all grade levels
Materials and
approaches are
being used in
Level school, in the
3 family and in
community to
develop critical,
creative thinking
and problem-
solving community
of learners and are
producing desired
results. Develop
learning materials
in ALL Learning
areas in all grade
levels.
4. The learning A school – based School Best Practices/
systems are monitoring and Remarkable Accomplishment
regularly and learning system is ( ) School Initiated
collaboratively conducted programs/projects
monitored by Level regularly and ( ) Log sheet/logbook showing
the community 1 cooperatively; and names of visitors who
using feedbacks is shared benchmarked schools-initiated
appropriate with stakeholders. programs
tools to ensure The system uses a ( ) Best practices
the holistic tool that monitors ( ) Innovations
growth and the holistic ( ) Programs for improvement
development of development of of the learning environment and
the learners learner once a increased learning outcomes
and the year. ( ) Continuous Improvement
community. A school – based (CI) Project
monitoring and ( ) Institutionalized programs
learning systems for inclusive education
Level generate feedback ( ) Literary Services
2 that is used for ( ) Guidance Services
making decisions ( ) Guidance Forms
that enhance the ( )Guidance Records and
total development Reports
of learners for 2 ( ) Computer/Science/TLE
quarters. A Laboratory (if any)
committee takes ( ) Learners’ initiated program
care of the ( ) Classroom Structuring
continuous ( ) Reading Centers/ Study
improvement of Sheds (Reading Books)
the tool. Co-curricular activities Report
The monitoring (ex. Scouting, Religious
. system is accepted Instructions, Science Camp,
and regularly used Education Summit, etc.)
for collective
Level decision making
3 every quarter.
The monitoring
tool has been
improved to
provide both
quantitative and
qualitative data.
5. Appropriate The assessment Sample Assessment Tool
assessment Level tools are reviewed ( ) Table of Specification
tools for 1 by the school and ( ) Formative/ Summative
teaching and assessment results Test
learning are are shared with ( ) Periodic Test Questions
continuously school’s ( ) Evaluation Tools
reviewed and stakeholders once ( ) Test/ Item Analysis
improved, and a year ( ) Item Bank per Learning
assessment The assessment Area
results are tools are reviewed ( ) Rubrics Used
contextualized by the school ( ) Enhanced Assessment
to the learner Level community and Tools adopted from partners
and local 2 results are shared
situation and with community
the attainment stakeholders for 2
of relevant life quarters.
skills School assessment
results are used to
develop learning
programs that are
suited to the
Level community, and
3 customized to each
learners’ context,
results of which are
used for
collaborative
decision – making
every quarter.
6. Learning Stakeholders are School Based implementing
managers and Level aware of child/ guidelines on Child Protection
facilitators 1 learner – centered, Policy, Anti-Bullying, etc.
(teachers, right-based, and ( ) School Memorandum
administrators inclusive principle ( ) Consultation Report
and community of education. (Attendance and picture)
members) Learning managers ( ) Proposed School
nurture values and facilitators Implementing Guidelines
and conduct activities ( ) School Handbook with
environments aimed to increase dissemination report (Pictorials
that are 50% of and attendance)
protective of all stakeholder’s ( ) Intake Sheets
children and awareness and
demonstrate commitment to
behaviors fundamental rights
consistent to the of children and the
organization’s basic principle of
Vision, Mission educating them.
and Goals 75 – 80% of
Stakeholders
begin to practice
Level child/learner –
2 centered principles
of education in the
design of support
to education.
Learning managers
and facilitators
apply the principle
in designing
learning materials
Learning
environments,
methods and
resources are
community driven,
Level inclusive and
3 adherent to child’s
rights and
protection
requirements with
81 –100% of
stakeholders’
adherence to
child/Learner
centers principle’s.
Learning managers
and facilitators
observe learners’
rights from
designing the
curriculum to
structuring the
whole learning
environment.
7. Methods and Practices, tools and School Research Outcomes
resources are Level materials for ( ) List of research
learner and 1 developing self- (Proposal and completed)
community – directed learners ( ) Dissemination Plan and
friendly are 100% Report on Research Outcomes
enjoyable, safe, observable in ( ) Innovation/ Interventions.
inclusive, school, but not in Enrichment/ Remediation
accessible and the home or in the Program
aimed at community. ( ) Project Proposal
developing self- Learning programs ( ) ACR
directed are designed and
learners. developed to
Learners are produce learners
equipped with who are
essential responsible and
knowledge, accountable for
skills and their learning.
values to Practices, tools and
assume materials for
responsibility developing self-
and Level directed learners
accountability 2 are observable in
the school and 51-
80% in the
community. The
program is
collaboratively
implemented and
monitored by
teachers and
parents to ensure
that it produces
desired learners
There is a
continuous
exchange of
information,
sharing of
Level expertise and
3 materials among
the schools, home
and community for
the development of
self – directed
learners with 81-
100% are
observable in
school and 81-
100% in the home
and in the
community. The
program is
mainstreamed but
continuously
improved to make
relevant to
emergent demand.
TOTAL
WEIGHTED MEAN (Total Score/7)

FINDINGS: RECOMMENDATIONS:

BEST FEATURES:

Validated By : (affix the Signature)

1. 2.
Designation: Designation:
Conformed By:
Designation:

III. ACCOUNTABILITY AND CONTINOUS IMPROVEMENT

LEVEL OF STANDARD MOV/ARTIFACTS
INDICATOR SCORE REMARKS
PRACTICE (mark / if present and x if not)
1. Roles and There is an School Organizational Structure
responsibilities active party that ( ) Functional organizations/ teams/
of accountable initiates committees
person/s and Level clarification of ( ) MPTA (DO 54, s. 2009, DO )
collective 1 the roles and ( ) SGC
body/ies are responsibilities ( ) SSG/SPG (DM 4 s. 2012)
clearly defined in education ( ) Finance Team
and agreed delivery with ( ) SPT (School Planning Team)
upon by 50% of ( ) SMEA Team
community stakeholders’ ( ) Grievance Committee
stakeholders. participation. ( ) Faculty Club
There is 51- ( ) HR PTA
80% ( ) SBM Team
Level stakeholders’ ( ) CPP Committee
2 engagement in ( ) QA Team for School LRMD
clarifying and ( ) Organized school Quality
defining their Management System
specific roles ( ) WinS TWG
and ( ) Others
responsibilities.
Shared and Attachments are but not limited to:
participatory ( ) Structures/Charts
Level processes with ( ) Constitutions and By-Laws
3 81-100% ( ) Terms of Reference (TOR)
stakeholders’ Roles and Responsibilities
engagement in ( ) Designation/ Appointment
determining ( ) Oath of Office
roles, ( ) Invitation Letter
responsibilities, ( ) School Memorandum
and ( ) Minutes of the Meeting
accountabilities ( ) List of Project Proposals (from
of stakeholders Principle 1)
in managing and ( ) ACR
supporting ( ) Enhanced School Process (QMS)
education. like in enrolment, module distribution
and retrieval (process flow)
2. Performance School Monitoring Evaluation &
Achievement accountability is Adjustment (SMEA)
of goals is Level practiced at the ( ) SMEA Committee
recognized 1 school level ( ) SMEA meetings with School
based on a with 50% gaps Memorandum
collaboratively addressed. ( ) Minutes of the meeting
developed A community- ( ) ACR
performance level ( ) SMEA Plan with:
accountability Level accountability ( ) Quarterly/Semestral SMEA
system; gaps 2 system is Results
are addressed evolving from ( ) Report on Midyear assessment
through school-led and Year End Performance
appropriate initiatives with
action. 51-80% gaps
addressed.
A community-
accepted
performance
accountability,
Level recognition and
3 incentive system
being practiced
with 81-100%
gaps
addressed.
3. The The school School Performance and
accountability articulates the Accomplishments
system is accountability
owned by the Level assessment ( ) School Report Card (SRC)
community 1 framework with ( ) State of the School Address
and is basic (SOSA)
continuously components,
enhanced to including
ensure that implementation,
management guidelines to the
structures and 50% of
mechanisms stakeholders.
are responsive 51-80% of
to emerging Stakeholders
learning needs are engaged in
and demands Level the development
of the 2 and operation of
community. an appropriate
accountability
assessment
system.
81-100% of
School
community
Level stakeholders
3 continuously
and
collaboratively
review and
enhance
accountability
systems’
processes,
mechanism and
tools.
4. The school, with Feedback Mechanism
Accountability the participation ( ) Feedback from Stakeholders
assessment of 50% regarding school policies
criteria and stakeholders, ( ) Feedback tools
tools, feedback Level articulates an ( ) Suggestion Box, Clients’
mechanisms, 1 accountability Satisfaction Survey, Checklist
and assessment Form, Survey Questionnaire,
information framework with Tracer Study Tool, Text Brigade
collection and basic ( ) Summary of Suggestions and
validation components, actions taken
techniques and including ( ) Survey Results, analysis, and
process are implementation interventions
inclusive and guidelines.
collaboratively 51-80%
developed and Stakeholders
agreed. are engaged in
Level the development
2 and operation of
an appropriate
accountability
assessment
system
81-100%
. Stakeholders
continuously
and
Level collaboratively
3 review and
enhance
accountability
systems;
processes,
mechanisms and
tools.
5. School initiates Stakeholders’ Recognition
Participatory Level periodic ( ) Institutionalized School
assessment of 1 performance Recognition and Incentive
performance is assessments System on:
done regularly with the Internal stakeholders
with the participation of LEARNERS/ TEACHERS/
community. the 50% PARENTS
Assessment stakeholders. ( ) Criteria
results and Collaborative ( ) School Memorandum
lessons learned conduct of ( ) Quarterly Learners Teachers/
serve a basis performance Parents Recognition
for feedback, Level assessment ( ) List of Awardees
technical 2 informs ( ) Sample Certificates
assistance, planning, plan ( ) Pictorials
recognition adjustments and ( ) ACR on the Awarding Activity
and plan requirements for External Stakeholders
adjustment. technical ( ) ACR on stakeholders’
assistance with Convergence
51-80% ( ) List of awardees
stakeholders’ ( ) Sample Certificate
participation. ( ) Pictorials
School ( ) Rubric/ Criteria Awards
community received by students/pupils and
developed School across governance levels
performance (Division/Region/National/International)
assessment is ( ) List of Awards
Level practiced and is ( ) Sample Certificates
3 the basis for ( ) Pictorials
improving
monitoring and
evaluation
systems,
providing
technical
assistance, and
recognizing and
refining plans
with 81-100%
stakeholders
participation.
TOTAL
WEIGHTED MEAN (Total Score/5)

FINDINGS: RECOMMENDATIONS:

BEST FEATURES:

Validated By : (affix the Signature)

1. 2.
Designation: Designation:
Conformed By:
Designation:

IV. MANAGEMENT OF RESOURCES

STANDARD
MOV/ARTIFACTS
INDICATOR LEVEL OF PRACTICE SCORE REMARKS
(mark / if present and x
if not)
1. Regular 50 % of stakeholders School Inventory
resource are aware that a Resources
inventory is regular resource
collaboratively Level inventory is available ( ) Human Resources
undertaken by 1 and is used as basis for ( ) Pupil/students
learning resource allocation and Classroom Ratio
managers, mobilization. ( ) Teacher-Learner
learning Resource inventory is Ratio
facilitators, and characterized by
community Level regularity, with 51- ( ) School Facilities
stakeholders as 2 80% of participation ( ) Seat-Learner
basis for of stakeholders, and Ratio
resource communicated to the ( ) Functional
allocation and community as the Library
mobilization. basis for resource ( ) Rooms
allocation and ( ) Furniture
mobilization. ( ) Equipment
Resource inventories
are systematically ( )Technological
developed and with Resources
81-100% ( ) ICT Package/e-
stakeholders’ classroom package
Level engagement in a (Functional/not
3 collaborative process Functional computers
to make decision on ( ) Internet Access
resource allocation and
mobilization. ( ) Electricity
connection

( ) WinS Assessment
(STAR)
( ) Hand washing
facilities
( )Toilet M/F
2. A regular 50% stakeholders’ Approved Work and
dialogue for participation in the Financial Plan
planning and Level development of ( ) School
resource 1 educational plan in Memorandum
programming, resource ( ) Minutes of the
that is programming, and in meeting
accessible and the implementation of ( ) Attendance
inclusive, educational plan. ( ) Pictures
continuously 51-80% stakeholders
engage are regularly engaged School Plan and
stakeholders Level in the planning and Resources
and support 2 resource programming ( ) Annual Procurement
implementation and support Plan
of community continuously ( ) Human Resource
education plans. implementation of the Development Plan
educational plan. ( ) Financial
81-100% Management
stakeholders Development Plan
collaborate to ensure ( ) Technology
timely and need-based Resource
Level planning and resource Improvement Plan
3 programming and ( ) School Physical
support continuously Development Plan
implementation of the ( ) Physical Facilities
educational plan. Improvement of School
( ) IGP Sustainability
Plan
( ) Resource Allocation
and Mobilization Plan
( ) School Site Titling

3. In place is a 50% of stakeholders ( ) Approved School

community- support judicious, Operating Budget(SOB)
developed appropriate, and ( ) School
resource Level effective use of Memorandum
management 1 resources. ( ) Minutes of the
system that 51-80% of meeting
drives stakeholders are ( ) Attendance
appropriate engaged and share ( ) Pictures
behaviors of the Level expertise in the
stakeholders to 2 collaborative
ensure development of
judicious, resource management
appropriate, system.
and effective 81-100% of
use of resources. stakeholders sustain
the implementation
Level and improvement of a
3 collaboratively
developed,
constituent-focused
resource management
system.
4. Regular 50% of stakeholders School Finance
Monitoring. are invited to ( ) Liquidation Report
Evaluation, and participate in the ( ) Income Generating
reporting development and Project
process of Level implementation of ( ) Canteen report
resource 1 monitoring, ( ) No Adverse COA
management evaluation, and findings on MOOE
are reporting processes on Liquidation
collaboratively resource management.
developed and
implemented by 51-100% of
the learning stakeholders
managers, collaboratively
facilitators, and Level participate in the
community 2 development and
stakeholders. implementation of
monitoring, evaluation
and reporting for
resource management.
81-100% of
. stakeholders are
engaged, held
accountable and
Level implement a
3 collaboratively
developed system of
monitoring, evaluation
and reporting for
resource management.
5. There is a An engagement Social Mobilization and
system that Level procedure to identify Networking System
manages the 1 and utilize ( ) Brigada Eskwela
network and partnerships with 50% Report
linkages which stakeholders for (Acknowledgement
strengthen and improving resource Receipt, Delivery
sustain management evident. Receipt, Pledges,
partnership for 51-80% stakeholders Deed of donations,
improving support a system of MOA/MOUs
resource partnerships for ( ) Records of
management. Level improving resource donations with
2 management. pictures
An established system ( ) Inventory of
of partnership is projects given by
managed and sustained stakeholders
by 81-100% ( ) Percentage of
stakeholders for financial
Level continuous contribution from
3 improvement of stakeholders and
resource management. other partners
( ) Financial report of
School PPAs
( ) Barangay IRA
( ) Report on the
Barangay
Assistance to
schools
( ) Innovations for the
collective and
judicious utilization
and transparent,
effective, and
efficient resources
and management
system.
TOTAL
WEIGHTED MEAN (Total Score/5)

FINDINGS: RECOMMENDATIONS:

BEST FEATURES:

Validated By : (affix the Signature)

1. 2.
Designation: Designation:
Conformed By:
Designation:

SUMMARY

Name of School:

Location: District:
School Type: __ Elementary __ Secondary __ Integrated Sch. Date Established:
School Head:
Last SBM Rating School Year:
Self-Assessment School Year:
Current SBM Rating School Year:

PRINCIPLE WEIGHT AVE.RATING X WEIGHTED RATING

WEIGHT
1 30% ___ x 0.3
2 30% ___ x 0.3
3 25% ___ x 0.25
4 15% ___ x 0.15
TOTAL 100%

SBM SCORE: ____________

Legend:

Level I – Developing 0.5 - 1.49

Level II- Maturing 1.50 – 2.49
Level III- Advance 2.50 – 3.0

Validated By : (affix the Signature)

1. 2.
Designation: Designation:
3 4.
Designation: Designation:
Conformed By:
Designation: