Fr-Apl-02. Asesmen Mandiri

PEMERINTAH PROVINSI DKI JAKARTA
DINAS KESEHATAN
RUMAH SAKIT UMUM KALIDERES
Jalan Satu Maret No.48 Kel. Pegadungan, Kec. Kalideres, Telp. 021-54390576
Email : rskalideres@gmail.com, rsukalideres@gmail.com
JAKARTA
FR-APL-02 ASESMEN MANDIRI
Nama Peserta : Tanggal/Waktu :
Nama Asesor : Tempat :
Pada bagian ini, anda diminta untuk menilai diri sendiri terhadap unit (unit-unit) kompetensi yang akan diujikan.
1. Pelajari seluruh standar Kriteria Unjuk Kerja (KUK), batasan variabel, panduan penilaian dan aspek kritis serta yakinkan bahwa
anda sudah benar-benar memahami seluruh isinya.
2. Laksanakan penilaian mandiri dengan mempelajari dan menilai kemampuan yang anda miliki secara obyektif terhadap seluruh
daftar pertanyaan yang ada, serta tentukan apakah sudah kompeten (K) atau belum kompeten (BK).
3. Siapkan bukti-bukti yang anda anggap relevan terhadap unit kompetensi, serta ‘matching’-kan setiap bukti yang ada terhadap
setiap elemen/KUK, konteks variable, pengetahuan dan keterampilan yang dipersyaratkan serta aspek kritis
4. Asesor dan asesi menandatangi form asesmen mandiri
Unit Kompetensi :
Nomor : ………………………………………………....
Judul : ...................................................................
Elemen Kompetensi : 1. Menyiapkan alat dan bahan untuk melakukan pengkajian
Daftar Pertanyaan Penilaian Bukti-bukti Pendukung

Komponen Asesmen Mandiri (Asesmen Mandiri/Self Assessment) BK KODE V A C S
K
Kriteria Unjuk Kerja : Indikator Unjuk Kerja
01. Kebutuhan ...1.1.1..................................... .........................................................................

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alat dan bahan
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2
DINAS KESEHATAN
JAKARTA
Elemen Kompetensi : 2. Merumuskan Tujuan & Kriteria Hasil
Penilaian Bukti – Bukti Pendukung

Komponen Asesmen Mandiri
Daftar Pertanyaan
(Asesmen Mandiri atau Self Assessment) BK KODE V A C S
K
Kriteria Unjuk Kerja: Indikator Unjuk
Kerja
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3
DINAS KESEHATAN
JAKARTA
Elemen Kompetensi : 3. Mengembangkan Rencana Strategi Pembelajaran
Penilaian Bukti-bukti Pendukung

Komponen Asesmen Mandiri
Daftar Pertanyaan
(Asesmen Mandiri/Self Assessment) BK KODE V A C S
Kriteria Unjuk Indikator Unjuk Kerja: K
Kerja:
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DINAS KESEHATAN
JAKARTA
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Elemen Kompetensi : 4. Mendokumentasikan Rencana Pembelajaran Ke Dalam Format Yang Ada
Penilaian Bukti-bukti Pendukung

KOMPONEN ASESMEN MANDIRI
Daftar Pertanyaan
(Asesmen Mandiri/Self Assessment) KO
K BK V A C S
Kriteria Unjuk Indikator Unjuk Kerja: DE
Kerja:
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6
DINAS KESEHATAN
JAKARTA
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Rekomendasi Asesor : Peserta :
Nama
Tanda tangan/
Tanggal
Catatan : Asesor :
Nama
No. Reg.
Tanda tangan/
Tanggal
7
DINAS KESEHATAN
JAKARTA

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PEMERINTAH PROVINSI DKI JAKARTA

FR-APL-02 ASESMEN MANDIRI

Nama Peserta : Tanggal/Waktu :

Nama Asesor : Tempat :

Elemen Kompetensi : 1. Menyiapkan alat dan bahan untuk melakukan pengkajian

Daftar Pertanyaan Penilaian Bukti-bukti Pendukung

01. Kebutuhan ...1.1.1..................................... .........................................................................

Elemen Kompetensi : 2. Merumuskan Tujuan & Kriteria Hasil

Penilaian Bukti – Bukti Pendukung

Elemen Kompetensi : 3. Mengembangkan Rencana Strategi Pembelajaran

Penilaian Bukti-bukti Pendukung

Elemen Kompetensi : 4. Mendokumentasikan Rencana Pembelajaran Ke Dalam Format Yang Ada

Penilaian Bukti-bukti Pendukung

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Rekomendasi Asesor : Peserta :

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