This is actually in one of the JLP Resource Books, but for those who don't have it they can print a variation here:

http://iteslj.org/t/tmm/ss/021.htm

In the JLP book there's no Korean translation, and I've never used it and wouldn't really want to, but if you want to have a look there's one here: http://iteslj.org/t/tmm/ss/021-korean.htm

I did this activity in part of a class period during my summer school session in July.  The students only evaluated themselves on the first 9 questions, because I knew most students struggled even with those tasks.  But it worked out nice because it's very easy to build lessons around those skills, and on each of the five days we worked on two, and I found games and activities to go along with them. 

If the students were more advanced I would have had them do all 20, and would have used the back 11 as the guide for the week.