FORM. PENILAIAN AKREDITASI AKREDITASI PUSKESMAS TAHUN 2017
NO
URAIAN
AD A
1.
SK PELAKSANA( UKM, M,UKP)
2.
RENCANAUSULANKERJ A( RUK)
3.
RENCANAPELAKSANAAN KERJ A( RPK)
4.
URAI AN TUGAS
5.
BUKU P EDOMAN
6.
P ANDUAN
7.
KERANGKA ACUAN KERJ A( KAK)
8.
ST ANDAROPRASI ONALPROSEDUR UR( SOP)
9.
RENCANAKEGI ATAN
10. KALENDER KEGI ATAN 11. BUKU KEGI ATAN 12. HASI LKEGI AT AN ( LAPORAN) 13. ANALI SI SMA MASALAH 14. PET A MA MASALAH 15. RENCANA TI NDAKLANJUT( RTL ) 16. MONI TORI NG HASI LTI NDAKLANJUT 17. NO OT TULEN RAPAT( BO OL LEH GABUNG DIBK KEGI GI AT AN) 18 . TAM MP PI LAN DATA ( P APAN DATA) 19 . EVALUASI( HASI LDI BANDI DI NG GK KAN DENGAN TARGET) + ANALI SI S 20. DOKUMENTASIHASI L( LAP ORAN KEGI ATAN:SRTTGS, HASI LL ENGKAPANALI SI SDENGAN RTLNYA,DH, FOTO BI LAPERLU)
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4. Pemeriksaan Gula Darah
3. Pemeriksaan Golongan Darah
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FORM. PENILAIAN AKREDITASI PUSKESMAS TAHUN 20 PUSKESMAS : ……………………………………………………………………. PROGRAM : ……………………………………………………………………... NAMA PETUGAS PUSKESMAS : ……………………………………………………………………. NAMA PENILAI KABUPATEN : ……………………………………………………………………. TANGGAL : ……………………………………………………………………... NILAI : ……………………………………………………………………… NO
URAIAN 0
1.
SK PELAKSANA UKM
2.
URAIAN TUGAS
3.
ANALISIS MASALAH
4.
RENCANA USULAN KERJA (RUK)
5.
KALENDER KEGIATAN
6.
RENCANA PELAKSANAAN KERJA (RPK)
7.
STANDAR OPRASIONAL PROSEDUR (SOP)
8.
BUKU PEDOMAN
.
KERANGKA ACUAN KERJA (KAK)
1!.
BUKU KEGIATAN (BUKU LAPANGAN)
11.
NOTULEN RAPAT
12.
HASIL KEGIATAN (P"S)
13.
E#ALUASI (HASIL DIBANDINGKAN DENGAN TARGET)
14.
TAMPILAN DATA (PAPAN DATA)
15.
PETA MASALAH
16.
RENCANA TINDAK LANJUT (RTL)
17.
MONITORING HASIL TINDAK LANJUT
18.
DOKUMENTASI HASIL
NILAI 5
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KETERANGAN : Nilai 0 = i!a" a!a !aa Nilai 5 = Daa a!a# i!a" l$%&"a' Nilai 10 = Daa l$%&"a'
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4. Pemeriksaan Gula Darah
3. Pemeriksaan Golongan Darah
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