Republic of the Philippines
DEPARTMENT OF EDUCATION
Region X - Northern Mindanao
DIVISION OF BUKIDNON
PARA SA，
Fortich Street, Sumpong, Malaybalay City
EDUKASYON
DIVISION MEMORANDUM
No. 汹 .s. 2019
To:
Curriculum Implementation Division
School Governance and Operations Division
Public Schools District Supervisors/District-in-charge
Elementary and Secondaiy School Heads
All Others Concerned
From:
MAE L. LIMBACO
/Schools Division Suv^^iteifdent >
/
Subject
INSTRUCTIONAL SUPERVISJON FORMS
D《：
February 4, 2019
1. In line with instructional supervision, the following forms shall be adopted:
1.1.
Classroom Observation
Form
To be accomplished by
Instructional Supervision Form A (ISFA) School Head
Instructional Supervision Form B-l (ISFB- Public
Schools
District
1)
Supervisor
Instructional Supervision Form B-2 (ISFB- Education Program Supervisor
2)
1.2. Utilization of Data/ Monthly Reporting
Form
To be accomplished by
Instructional Supervision Form C (ISFC) School Head
Instructional Supervision Form D-1 (ISFD- Public
Schools
District
1)
Supervisor
Instructional Supervision Form D-2 (ISFD2)
Instructional Supervision Form E-l (ISFE- Education program Supervisor
1)
Instructional Supervision Form E-2 (ISFE2)
2. During classroom observations, Education Program Supervisors or Public Schools
Fortich Street, Sumpong, Malaybalay City [(088) 813-36341 www.depedbukidnon.net.ph | facebook.com/depecfcukidnon.net
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region X - Northern Mindanao
DIVISION OF BUKIDNON
PARA SA，
Fortich Street, Sumpong, Malaybalay City
EDUKASYON
District Supervisors / District In-Charge are directed to sit. with the school head and
provide technical assistance to improve instructional leadership practices.
3. The school heads as instructional leaders shall observe classes to provide technical
assistance to teachers to improve teaching and learning delivery in schools.
4. Quantitative observations shall be backed up with qualitative observation. Hence,
reasons for the rating of 0-2 shall be specified/described under development needs column
while the rating of 3-4 shall be specified/described under strength column.
5. Technical Assistance box shall include recommendations for policy formulation and
decision making to improve both teacher's teaching and learning delivery and school
heads* instructional leadership.
6. Next steps box shall include plans after the conduct of instructional supervision.
7. Submission of reports of the previous month shall be:
a. Every 1st Monday of the succeeding month for the school heads
b. Every 2nd Monday of the succeeding month for the PSDSs and
c. Every 3rd Monday of the succeeding month for the EPSs.
8. The Education Program Supervisors are advised to submit a copy of the approved ISFE
1 and 2 to School Governance and Opei'ations Division (SGOD).
9. SGOD-School Management, Monitoring and Evaluation Unit shall consolidate and
report the highlights of the ISF 1 and 2 for possible technical assistance by this Office.
Data shall be made available as part of the DMEA and RMEA pre-work every quarter and
improvement of curriculum, instruction and assessment.
10. The said forms are part of the means of verification (MOVs) of IPCRF/OPCRF and
accomplishment report and shall also be considered as basis of the schoolbased in-service
trainings.
11. Enclosed are the copies of the Instructional Supervision Forms which can be
downloaded through the link: https://tinyurl.com/depedbukisform
12. For wide dissemination and strict compliance.
CMLL/SAAU0L25.19
Fortich Street, Sumpong, Malaybalay City [(088) 813-36341 www.depedbukidnon.net.ph | facebook.com/depecfcukidnon.net
Instructional Supervision Form A (ISFA)
School Head's Instructional Supervision for Teachers
School ID:
School
District:Year:
Observation: 1
School Name:
Qualitative Observation
Quantitative Observation
Supervisory Concerns/Focus
A
Assistance provided to improve
teachers KSAVs in teaching &
4
3
2
8
1
0
Strengths
Development Needs
c
D
1. Content knowledge and its application
within and across curriculum areas.
2. Research-based knowledge and
principles of teaching and learning.
3. Positive use of ICT.
4. Strategies for promoting literacy and
numeracy.
5. Strategies for developing critical and
creative thinking, as well as other higherorder thinking skills.
6. Mother Tongue, Filipino and English in
teaching.
7. Classroom communication strategies.
8. Learner safety and security.
9. Fair learning environment.
Page 1 of 2
learning delivery
E
Assistance provided to improve
Qualitative Observation
Quantitative Observation
teache" KSAVs in teaching &
Supervisory Concerns/Focus
4
A
3
2
1
0
B
Strengths
Development Needs
learning delivery
c
D
E
10. Management of classroom structure and
activities.
11. Support for learner participation.
12. Promotion of Purposive learning.
13. Management of learner behavior.
14. Learner's gender, needs, strengths,
interests, and experiences.
15. Planning and management of teaching
and learning process.
16. Learning outcomes aligned with learning
competencies.
17. Professional collaboration to enrich
teaching practice.
18. Teaching and learning resources
including ICT.
19. Design, selection, organization and
utilization of assessment strategies.
20. Monitoring and evaluation of learner
progress and achievement.
21. Feedback to improve learning.
Reference: PPST Priority Strands
'
'
Prepared by:
Teacher's Name & Signature
Grade & Learning Area
Observed
Submitted to:
Principal/School Head
CLL/SAU/daweelmac2019
Page 2 of 2
Public Schools District Supervisor/lnCharge
,
,
Legend:
0 - Not Observed
1 _ Below Basic
2 - Basic
3 - Proficient
4- Highly Proficient
Instructional Supervision Form B-1 (ISFB-1)
PSDS'/DICs Instructional Supervision for School Heads
口口0 口
School ID:
School Name:
Qualitative Observation
Quantitative Observation
Supervisory Concerns/Focus
A
Assistance provided to school
heads to improve instructional
4
3
2
B
1
0
Strengths
Development Needs
c
D
1.Instructional Supervisory Plan and
Implementation
2. School Heads Interaction with teacher
teaching the learning area:
2.1. Pre-Observation Conference
2.2. During the classroom observation
2.3. Post classroom Observation
3. Competence in the Instructional Process
3.1. Competence
3.2. Attitude/Attributes
3.3. Abilities and Skills
Page 1 of 2
leadership practices/Remarks
E
Supervisory Concerns/Focus
4
A
2|1|0
3!
Assistance provided to school heads
Qualitative Observation
Quantitative Observation
B
to improve instructional leadership
Strengths
Development Needs
c
D
practices/Remarks
E
4. Learning Environment
4.1. ^earner safety and security
4.2. Fair learning environment
4.3. Management of classroom structure and
activities
4.4. Support for learner participation
4.5. Promotion of purposive learning
4.6. Management of learner behavior
Reference: Regional Memo No. 19,2. 2017 and PPST Domain 2
Submitted to:
Prepared by:
School Head's Name & Signature
CLL/SAU/daweelmac2019
Grade & Learning Area Public Schools District Supervisor/ln- Chief Education Supervisor, Observed
Charge
Curriculum Implementation Division
Date:
Page 2 of 2
Legend:
0 - Not Observed
1 - Below Basic
2 - Basic
3 - Proficient
School ID:
School Name:
Qualitative Observation
Quantitative Observation
Assistance provided to school
heads to improve instructional
Supervisory Concerns/Focus
4
A
3
2
8
1
0
Strengths
Development Needs
c
D
1.Instructional Supervisory Plan and
Implementation
2. School Heads Interaction with teacher
teaching the learning area:
2.1. Pre-Observation Conference
2.2. During the classroom observation
2.3. Post classroom Observation
3. Competence in the Instructional Process
3.1. Competence
3.2. Attitude/Attributes
Page 1 of 2
leadership practices/Remarks
E
Assistance provided to school heads
Qualitative Observation
Quantitative Observation
Supervisory Concerns/Focus
to improve instructional leadership
practices/Remarks
4|3|2|1|0
A
Strengths
c
B
Development Needs
D
E
3.3. Abilities and Skills
4. Learning Environment
4.1.,Learner safety and security
4.2. Fair learning environment
4.3. Management of classroom structure and
activities
4.4. Support for learner participation
4.5. Promotion of purposive learning
4.6. Management of learner behavior
Legend:
0 - Not Observed
Prepared by:
Grade & Learning Area Education Program Supervisor Chief Education Supervisor, Observed
School Head's Name & Signature
CLL/SA U/daweelmac2019
Date:
Reference: Regional Memo No. 29, 2. 2017 and PPST Domain 2
Submitted to:
~
Curriculum Implementation Division
Page 2 of 2
1 - Below Basic
2 - Basic
3 - Proficient
Instructional Supervision Form C (ISFC)
School Head's Instructional Supervision for Teacher Report
For the Month of:______
A
District:
School Name:
School Year:
No. of IS Conducted with
Date of Classroom
Observation
School ID:
Teacher
the Teacher Identified in
Grade Level
Learning Area
Observed
Observed
Column B
B
D
c
E
Strengths
Development Needs
Assistance provided to improve
teacher's KSAVs in teaching &
learning delivery
Refer to IS FA Column C
Refer to ISFA Column D
Refer to ISFA Column E
F
G
H
Teacher
TECHNICAL ASSISTANCE NEE DS
NEXT STEPS
Prepared by:
Public Schools District Supervisor/ln-
Signature of
Submitted to:
Charge
School Head
CLL/SA U/daweelmac2019
Page 1 of 1
/
Instructional Supervision Form D-1 (ISFD-1)
District Instructional Supervision for Teachers Report
For the Month of: __________________________
"任吧 School Name:
District:
School Year:
School Head:
Date of Visit
Learning Area
Observed
A
B
Grade Level
Observed
C
Strengths
Development Needs
Assistance provided to improve teacher*s
KSAVs in teaching & learning delivery
Refer to ISFC Column F
Refer to ISFC Column G
Refer to ISFC Column H
D
E
F
Signature of School
Head
No. of IS Conducted with the
School Head Identified in
Column G
G
H
English
Science
Mathematics
Filipino
Araling
Panlipunan
MAPEH
EsP
MTB
Inclusive Ed:
SPED, ALIVE,
IPEd, ALS
Others
NEXT STEPS
TECHNICAL ASSISTANCE NEEDS
Submitted to:
Prepared by:
Public Schools District Supervisor/ln-Charge
Chief Education Supervisor, Curriculum Implementation
Division
CLL/SA U/davi/eelmac2019
Page 1 of 1
Instructional Supervision Form D-2 (ISFD-2)
District Instructional Supervision for School Heads Report
School Name:
District:
School Head:
School Year:
Date of Visit
Learning Area
Observed
Grade Level
Observed
A
B
C
Strengths
Development Needs
Assistance provided to school heads to
improve instructional leadership
practices/Remarks
Refer to ISFB-1 Column C
Refer to ISFB-1 Column D
Refer to ISFB-1 Column £
D
E
F
English
Science
Mathematics
Filipino
Araling
Panlipunan
MAPEH
EsP
MTB
Inclusive Ed:
SPED, ALIVE,
IPEd, ALS
Others
For the Month of:_________________________
Prepared by:
Chief
Education
Submitted to:
Public Schools District
Supervisor, Curriculum Implementation Division
Supervisor/ln-Charge
CLL/SA U/daweelmac2019
TECHNICAL ASSISTANCE NEEDS
Page 1 of 1
NEXT STEPS
Signature of School
Head
No. of IS Conducted with
the School Head
Identified in Column G
G
H
Instructional Supervision Form E-1 (ISFE-1)
For the Month of:
Division Instructional Supervision for Teachers Report
Learning Area:
District/School Name:
Recommeding Approval:
Noted:
Prepared by:
Chief Education Supervisor, Curriculum
Education Program Supervisor
Assistant Schools Division Superintendent
Implementation Division
PSDS/School Head:
Findings/Observations
Date of Visit
Grade Level
Observed
Strengths
Development Needs
Refer to ISFB-2 Column C & ISFD-1 Column D
A
B
Signature of
PSDS/SH
No. of IS Conducted with the
PSDS/SH Identified in Column
F
E
F
G
Refer to ISFB-2 Column D & ISFD-1 Column E
C
D
NEXT STEPS
TECHNICAL ASSISTANCE NEEDS
Approved:
CLL/SA U/daweelmac2019
Assistance provided to improve teacher's KSAVs
in teaching & learning delivery
Schools Division Superintendent
Page 1 of 1
Instructional Supervision Form E-2 (ISFE-2)
Division Instructional Supervision for School Heads Report
For the Month of: Learning Area:
District/School Name:
PSDS/School Head:
Findings/Observations
Date of Visit
A
Grade Level
Observed
B
Strengths
Development Needs
Refer to ISFB-2 Column C & ISFD-2 Column D
Refer to ISFB-2 Column D & ISFD-2 Column E
C
D
Noted:
No. of IS Conducted with the
PSDS/SH Identified in Column F
E
F
G
Recommeding Approval:
Chief Education Supervisor, Curriculum
Education Program Supervisor
Implementation Division
Approved:
CLL/SAU/daweelmac20i9
Signature of
PSDS/SH
NEXT STEPS
TECHNICAL ASSISTANCE NEEDS
Prepared by:
Assistance provided to improve teacher's KSAVs in
teaching & learning delivery
Schools Division Superintendent
Page 1 of 1
Assistant Schools Division Superintendent