LAPORAN TAKING OWNERSHIP

PENDIDIKAN DAN PELATIHAN KEPEMIMPINAN TINGKAT IV

ANGKATAN XXXII

TOPIK AREA PERUBAHAN

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OLEH :
……………………………………………. NAMA
NIP . …………………………………….
NDH : ………. (Nomor Daftar Hadir)

BADAN PENGEMBANGAN SUMBER DAYA MANUSIA DAERAH

PEMERINTAH PROVINSI KALIMANTAN SELATAN
BANJARBARU
2018
 LEMBAR KERJA ISU AKTUAL
PESERTA PENDIDIKAN DAN PELATIHAN KEPEMIMPINAN TINGKAT IV
ANGKATAN XXXII BPSDMD PROVINSI KALIMANTAN SELATAN

NAMA : …………………………………………………………………………………………….. ……….. ……….

NIP : …………………………………………………………………………………………….. ……….. ……….
JABATAN : …………………………………………………………………………………………….. ……….. ……….
UNIT KERJA : …………………………………………………………………………………………….. ……….. ……….
DIKLATPIM TK. : ………..
ANGKATAN : ………..
TUPOKSI : 1. …………………………………………………………………………………………….. ………..
2. …………………………………………………………………………………………….. ………..
3. …………………………………………………………………………………………….. ………..

FUNGSI
1. Deskripsi singkat Tugas Pokok dan Fungsi
(Tupoksi lampirkan)

2. Permasalahan Organisasi
Lima isu aktual menggunakan metode analisis APKL
a. ………………………………………………………………………………………………………………………………………………..
b. ………………………………………………………………………………………………………………………………………………..
c. ………………………………………………………………………………………………………………………………………………..
d. ………………………………………………………………………………………………………………………………………………..
e. ………………………………………………………………………………………………………………………………………………..

3. Isu Prioritas Organisasi

Tiga isu prioritas menggunakan metode analisis USG
a. ………………………………………………………………………………………………………………………………………………..
b. ………………………………………………………………………………………………………………………………………………..
c. ………………………………………………………………………………………………………………………………………………..

4. Isu Prioritas Terpilih

Isu prioritas berkemungkinan menjadi topik proyek perubahan (judul)
…………………………………………………………………………………………………………………………………………………….

Banjarbaru, ……………………………… 2018

Peserta, Mentor/Atasan Langsung,

(……………………………..) (……………………………..)
 TABEL AKPL
(AKTUAL, KEKHALAYAKAN, PROBLEMATIK,LAYAK)

No Isu Aktual A K P L Jumlah Rangking

1

Keterangan :
A : Aktual
P : Kekhalayakan
K : Problematika
L : Layak

Skala Nilai :
1 : Sangat kurang
2 : Kurang
3 : Sedang
4 : Besar
5 : Sangat besar
 TABEL USG
(URGENCY, SERIOUSNESS, GROWTH)

No Isu Aktual U S G Jumlah Rangking

1

Keterangan :
U : Urgency
S : Seriousness
G : Growth

Skala Nilai :
1 : Sangat kurang
2 : Kurang
3 : Sedang
4 : Besar
5 : Sangat besar

ISU PRIORITAS TERPILIH (JUDUL)

…………………………… ……………………………………………………………………………………… (kalimat positif)

 FORMULIR BAGI ATASAN LANGSUNG PADA TAHAP TAKING OWNERSHIP

1. Nama Peserta :

2. Instansi :

3. Topik Proyek Perubahan :

Catatan terhadap Rencana Aksi perubahan yang disiapkan peserta

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Rekomendasi

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Banjarbaru, tanggal, bulan dan tahun

Atasan Langsung,

(………………………………)
 FORMULIR BAGI COACH PADA TAHAP TAKING OWNERSHIP

1. Nama Peserta :

2. Instansi :

3. Topik Proyek :
Perubahan

Catatan terhadap Rencana Proyek Perubahan yang disiapkan peserta

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Rekomendasi

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Banjarbaru, ……………………………….2018

Coach,

(………………………………)
 KESEPAKATAN AREA PERUBAHAN
PESERTA PENDIDIKAN DAN PELATIHAN KEPEMIMPINAN TINGKAT IV
ANGKATAN XXXII

1. Deskripsi Singkat Tugas dan Fungsi Unit Kerja

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2. Area Organisasi yang Bermasalah

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3. Area Organisasi yang Menjadi Area Perubahan

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Banjarbaru, ………………………. 2018

Atasan Langsung Peserta Diklat, Peserta Diklat,

(………………………………………………………….) (………………………………………………………….)
 FORMULIR KEGIATAN PESERTA DIKLAT PIM IV ANGKATAN XXXII
PADA TAHAP TAKING OWNERSHIP/MEMBANGUN KOMITMEN BERSAMA

1. Nama Peserta : ........................................................................

2. Instansi : ........................................................................
3. Rencana Area : ........................................................................
Perubahan ..........................................................................................................................
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No Hari/Tgl Kegiatan Output Dinfokan ke Coach Paraf

Tanggal Mentor

………...............................2018

PESERTA DIKLAT PIM TK. IV

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