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Instrumen Supervisi Sarana Dan Prasarana

Instrumen Supervisi Sarana Dan Prasarana

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Dipublikasikan oleh Agus Rubiyanto
FORMAT INSTRUMEN SUPERVISI

SARANA DAN PRASARANA
1. 2. 3. 4.
NO

Nama Madrasah Kecamatan Kabupaten/Kota Hari, tanggal

: : : :

................................................................................................... ................................................................................................... CILACAP ................
FORMAT INSTRUMEN SUPERVISI

SARANA DAN PRASARANA
1. 2. 3. 4.
NO

Nama Madrasah Kecamatan Kabupaten/Kota Hari, tanggal

: : : :

................................................................................................... ................................................................................................... CILACAP ................

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Published by: Agus Rubiyanto on Mar 14, 2011
Hak Cipta:Attribution Non-commercial

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04/17/2013

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KEMENTERIAN AGAMA

KELOMPOK KERJA PENGAWAS PAI (POKJAWAS PAI)
KANTOR KABUPATEN CILACAP
Alamat : Jalan DI. Panjaitan No.44 Telp. (0282)531155 Cilacap
FORMAT INSTRUMEN SUPERVISI
SARANA DAN PRASARANA
1. Nama Madrasah : ...................................................................................................
2. Kecamatan : ...................................................................................................
3. Kabupaten/Kota : CILACAP
4. Har! tan""a# : ...................................................................................................
NO ASPEK KEGIATAN / KONDISI
Tdk (
tdk
ada)
Ya ( ada)
SKOR KET
1 2 3
$nda% #an&ut terhadap saran 'an" dber%an
A
KEPEMILIKAN
1. $anah m#% sendr dbu%t%an den"an sert(%at tanah
2. )edun" m#% sendr
3. $anah dan "edun" semua dman(aatan untu% madrasah
B
RUANG BELAJAR
1. *um#ah ruan" be#a&ar cu%up untu% semua rombon"an be#a&ar
*m# +uan"
2. Luas setap ruan" be#a&ar sesua den"an raso %e#as
+ombe# : .
3. Konds ruan" teran"! bersh! n'aman dan tera,at
*m#
+ombe# :..
4. Ke#en"%apan perabot ba% dan tera,at
C
RUANG DAN SARANA PENUNJANG
1. +uan" #aboratorum - .s%a! Kma! /o#o"! /ahasa!
Komputer! IP0 1 'an" ber"un"s.
2. +uan" perpusta%aan 'an" dda'a"una%an
3. +uan" Kep. 0e% dan ruan" 2a%# Kep. 0e% bersh dan tera,at
4. +uan" admnstras/$3 #en"%ap den"an prabot %omputer dan
per#en"%apan serta bersh dan tera,at
4. +uan" "uru cu%up #uas! d#en"%ap den"an me&a %er&a dan
#oc%er untu% semua "uru! bersh dan tera,at
5. +uan" /K den"an per#en"%apan memada! bersh dan tera,at
6. +uan" Ibadah den"an per#en"%apann'a
7. +uan" 80I0 den"an perabot bersh dan tera,at
9. +uan" 3K0 den"an perabot bersh dan tera,at
1:.Au#a / ruan" serba "una
11.Lapan"an uoacara! #apan"an 8#ah ra"a 'an" memada
12. 0arana / pera#atan o#ah ra"a dan sen buda'a
13.Meda pembe#a&aran memada
D
SARANA LAIN
1. Insta#as ar bersh dan ain!an li"ti#
2. *arn"an te#epon dan nternet
3. Kantn bersh dan d#en"%ap tempat pembun"an sampah
4. $o#et / MC &um#ahn'a cu%up! bersh dan tera,at
JUMLA! SKOR / NILAI
MASALA! / KENDALA "
................................................................................................................................................................................
................................................................................................................................................................................
SARAN PEMBINAAN "
................................................................................................................................................................................
................................................................................................................................................................................
Kepa#a Madrasah! 75 ; 1:: < A C#acap! ...........................................
61 = 74 < / Pen"a,as !
45 = 6: < C
> 45 < ?
-................................................1 ...................................................
NIP.

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