The document is a competency checklist from Zamboanguita Science High School in the Philippines for grade 5 students. It lists the competencies to be mastered in science for the first quarter of the school year. The checklist tracks whether 42 students, 17 male and 25 female, have mastered being able to use properties of materials to determine if they are useful or harmful over the course of one week. It requires signatures from teachers to note students' performance and from school heads and instructional supervisors to provide feedback from classroom visits.

1. RepublicofthePhilippines
DepartmentofEducation
REGION VII, CENTRAL VISAYAS
SCHOOLS DIVISION OF NEGROS ORIENTAL
ZAMBOANGUITA SCIENCE HIGH SCHOOL
DEL PILAR ST., POBLACION, ZAMBOANGUITA, NEGROS ORIENTAL
COMPETENCY CHECKLIST in SCIENCE 5
Grade: ___V____ Section: _________ Enrolment: M__17__ F_25__ T__42__ Attendance: M____ F____ T_____ Quarter: ___1___ Week: ___1____
LIST OF COMPETENCIES DURATION
LEARNERS’ PERFORMANCE REMARKS
Mastered the
competencies
Not Mastered the
competencies
Teachers
(Notes of not achieving the
competency or intervention to address
the least mastered competency)
School Heads & Instructional
Supervisors
(Feedback or agreement during their
classroom visits)
Use properties of materials
whether they are useful or
harmful.
(S5MTIa-b-1 )
WEEK 1 –DAY 1
Prepared by: APRIL LOU Y. DE LA PEÑA
Date Checked: ________________ Date: _______________________

2. Signature: ___________________ Observer: ___________________