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Sample Data Gathering Form Lesson 5

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dayana.rosesandoval01
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40 views2 pages

Sample Data Gathering Form Lesson 5

Uploaded by

dayana.rosesandoval01
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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Data Gathering Instrument for Trainee’s Characteristics Please answer the following instrument according to the described below. Encircle the letter of your choice that best describes | learner. Blank spaces are provided for some data that need your response. Name: Danica A. Roma Characteristics of learners language background Ifugao Igorot Your age: __35__ years old Language, literacy Average grade in: Average grade in: and numeracy English Math (LL&N) 95 and above 95 and above 90 a 2 90 a a 85 to 89 to 89 80 to 84 80 to 84 75 to 79 75 to 79 Cultural and Ethnicity/culture: Disabilities(if any) __none_ Existi Health Conditions (Existing illness if any) Anemia Hypertension Diabetes Others(please Previous Work experience related to the qualification Work Duration a. none 1 month-6 months § months ar Previous learning List down trainings/seminar related to Caregiving NCI! experience 4. BLS Training 2. First Aid Training Learning style Please refer to the previous learning style assessment Kinesthetic

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