1 2 3 4 5 6

Auditor : Auditor : Auditor : Auditor : Auditor :

III D III D III C POKJA

Drg. Enny Budhi Hastut Dr. Yuswant, MHSc. Dr. A. Tri Yuli Susant Dr. Hert Hermawant Dr. Retno M. MHKes. YANMED
NIP. NIP. 19630730 198911 2 NIP. 19710716 200606 2 NIP.19690711 200212 2 NIP.
002 012 004
Auditor : Auditor : Auditor : Auditor : Auditor :

IV A IV A IV A IV A
POKJA
Rita Utrajani, SKM.MKes. Arfian Nevi, SKM. DEA. Toto Suyoto Ismail, SH. Drg. Roozana Medalia Sri Ratna
ADMEN
NIP. 19680103 199203 2 NIP.19660304 198903 1 MSi NIP.19640108 198910 2 Astut,SKM.MKes
006 014 NIP.19510101 197606 1 001 NIP.19580909 1978 2 001
001
Auditor : Auditor : Auditor : Auditor :

IV A IV A III D IV A
POKJA
Umi Kunart, SKM. MKes. Achmad Yazid, SKM. MKes. Rita Novianingrum, SKM. Effi M. Hafid, SKM.
KIA-KB
NIP.19570428 198012 2 001 NIP.19590501 198603 1 MKes MKes.
018 NIP.19641117 198803 2 NIP.19581220 198302 1
008 006
Auditor : Auditor : Auditor : Auditor :

III D III D III D

POKJA
Endradi, SKM Bambang Supangkat, SKM. Buang Marjuki, SKM. Edi Sukiarko, SKM.
GIZI
NIP.19640325 198703 1 009 MSi. NIP.19610928 198403 1 MKes.
NIP.19630626 198503 1 007 NIP.
010
Auditor : Auditor : Auditor : Auditor :

IV A III D III C POKJA

Wachidaniyah,SKM.MKes. Rinaningsih, SKM. MSi Lisna Ela Riyantna, SKM. PROMKES
NIP.19680426 199202 2 001 NIP.19650707 198512 2 NIP. 19650127 198503 2 NIP.
002 006
Auditor : Auditor : Auditor : Auditor : POKJA
KESLING
III D III C
Binar Rudatn SKM. MKes. Danny Setawan, SKM. Supardi, SKM. MKes. Sit Zulekah, SKM. MKes.
NIP.19610716 198412 2 002 MKes. NIP. NIP.
 NIP.19700610 199501 1
001
Auditor : Auditor : Auditor : Auditor :

IV A III C III D
POKJA P2
Enny Widiastut, SKM. Wahyuni, SKM Rasa Harbakt, SKM. MKes. Listjani S.G. SKM. MKes.
MKes. NIP.19710621 199703 2 NIP.19651215 198903 1 NIP.19651027 198903 2
NIP.19690627 199303 2 007 004 003 007

CATATAN :
1. Personil penilai sesuai Pokja yang diampu (kolom 6),
2. Untuk Auditor yang di arsir/blok, sudah tidak dijadwal (dipakai) lagi.
DAFTAR PENILAI
AKREDITASI PUSKESMAS
DINAS KESEHATAN PROVINSI JAWA TENGAH 2013

1 2 3 4 5 6
Auditor : Auditor : Auditor : Auditor : Auditor :
IV A IV A IV A IV A IV A
Rita Utrajani, SKM.MKes. Arfian Nevi, SKM. DEA. Sri Ratna Astuti,SKM.MKes Susilawati, SH. MKes. R. Wulandari,SKM. POKJA
NIP. 19680103 199203 2 006 NIP.19660304 198903 1 014 NIP.19580909 1978 2 001 NIP.19640108 198910 MKes. ADMEN
2 001 NIP.19640108 198910
2 001
Auditor : Auditor : Auditor : Auditor : Auditor : Auditor : Auditor : Auditor :
IV A III D III D III C
POKJA
Drg. Roozana Medalia Dr. Yuswanti, MHSc. Dr. A. Tri Yuli Susanti Dr. Herti Hermawanti Dr. Retno M. MHKes. Drg.Prima RD, Dr. Nirmala S Dr. Wahyu S.
YANMED
NIP.19640108 198910 2 001 NIP. 19630730 198911 2 002 NIP. 19710716 200606 2 012 NIP.19690711 200212 2 NIP. MKes. NIP. NIP.
004 NIP.
Auditor : Auditor : Auditor : Auditor :
IV A IV A III D
POKJA
Umi Kunarti, SKM. MKes. Achmad Yazid, SKM. MKes. Rita Novianingrum, SKM. Dr. M. Taukhid H.
KIA-KB
NIP.19570428 198012 2 001 NIP.19590501 198603 1 018 MKes NIP.
NIP.19641117 198803 2 008
Auditor : Auditor : Auditor : Auditor :
III D III D III D III D
Endradi, SKM Bambang Supangkat, SKM. Buang Marjuki, SKM. Rinaningsih, SKM. POKJA
NIP.19640325 198703 1 009 MSi. NIP.19610928 198403 1 007 MSi GIZI
NIP.19630626 198503 1 010 NIP.19650707 198512
2 002
Auditor : Auditor : Auditor : Auditor :

IV A IV A III C IV A POKJA
Wachidaniyah,SKM.MKes. Effi M. Hafid, SKM. MKes. Lisna Ela Riyantina, SKM. Handoko, SKM. MKes. PROMKES
NIP.19680426 199202 2 001 NIP.19581220 198302 1 006 NIP. 19650127 198503 2 006 NIP.
Auditor : Auditor : Auditor :

III D III C III D

Binar Rudatin SKM. MKes. Danny Setiawan, SKM. Siti Zulekah, SKM. MKes. POKJA
NIP.19610716 198412 2 002 MKes. NIP. KESLING
NIP.19700610 199501 1 001
Auditor : Auditor : Auditor : Auditor :

IV A III C III D III D

POKJA P2
Enny Widiastuti, SKM. MKes. Wahyuni, SKM Listijani S.G. SKM. MKes. Eni Sih M. SKM.
NIP.19690627 199303 2 007 NIP.19710621 199703 2 004 NIP.19651027 198903 2 007 MKes.
NIP.
KETERANGAN :
1. Kolom yang di BLOK BERWARNA : belum melakukan MAGANG,
2. Penggolongan Penilai pada Pokja masing-masing, berdasar SERTIFIKAT PELATIHAN.

Kepala Seksi UKM

Dinas Kesehatan Provinsi Jawa Tengah

RITA UTRAJANI, SKM. MKes.

NIP. 19680103 199203 2 006