LEMBAR MONITORING

UJIAN SEKOLAH BERSTANDAR NASIONAL, UJIAN AKHIR MADRASAH BERSAMA DAERAH, DAN
UJIAN MADRASAH
(USBN/UAMBD/UM)
MADRASAH IBTIDAIYAH (MI)
TAHUN PELAJARAN 2018/2019

Nama Madrasah :………………….………………………………………………………….…………

Alamat Madrasah :………………..….……………………………………………………..…………..
Nama Kepala Madrasah :…………..………………………………………………….………………………..

NO URAIAN KETERANGAN

1. Program Kerja Ujian (USBN/UAMBD/UM) Ada Tidak Ada

2. SK Pengangkatan Panitia Ujian Ada Tidak Ada
3. Agenda Kegiatan Ujian Ada Tidak Ada
4. Jadwal TO/USBN/UAMBD/UM Tulis Ada Tidak Ada
5. Jadwal TO/USBN/UAMBD/UM Praktik Ada Tidak Ada
6. Waktu Pelaksanaan Pagi Siang Pagi & Siang
Tertulis/Seharusnya Yang hadir
Peserta
L P L+P L P L+P
Kelas VI MI .............................................
MI .............................................
7. Jumlah
Daftar Peserta /Ruangan Ada Tidak Ada
Kartu Peserta Ada Tidak Ada
Daftar Hadir Peserta dari Panitia Ada Tidak Ada
NONO URAIAN
URAIAN KETERANGAN
KETERANGAN
Denah Tempat
Daftar Duduk
Peserta yang tidak hadir AdaAda Tidak AdaAda
Tidak
Nomor Meja/Kursi
Tata Tertib Peserta AdaAda Tidak AdaAda
Tidak
Nomor Ruangan
Naskah Soal Ada Tidak Ada
Pemeriksaan
Jenis Soal Tulis Lisan Praktik
Tempat
Bentuk Soal Di Sekolah
PG Uraian Di Luar Sek
Lainnya …………..
Tanggal
Dibuat sendiri Ya Bergabung
11.
8 Daftar Pemeriksa AdaAda Tidak AdaAda
Kisi-kisi Tidak
Pemeriksa per Lembar Jawab untuk setiap Mata Pelajaran
Kunci Jawaban 1 Orang
Ada 2 Orang
Tidak Ada
Sumber BiayaSkoring/Penilaian
Pedoman Rp Ada Tidak Ada
BOSBerita Acara Rp Ada Tidak Ada
Komite Sekolah
Daftar Hadir Peserta (dalam sampul naskah) Rp Ada Tidak Ada
12.
Iuran Khusus
Daftar Nilai Rp Ada Tidak Ada
Yayasan/Sumber lain
Pengawas Ruangan Rp
Jumlah
Jadwal Pengawasan Rp Ada Tidak Ada
9. Pelaporan
Tata Tertib Pengawas Waktu
Ada / Tanggal Tidak Ada Bentuk
13. Kepada Pengawas
Daftar Bina dan Kemenag cq. Seksi Pendidikan Madrsh
Hadir Pengawas Ada Tidak Ada
Daftar Serah Terima Naskah, Lembar Jawab, dll Ada Tidak Ada
Ruangan
Ruang Panitia Ada Tidak Ada
10.
Ruang Pengawas Ada Tidak Ada
Denah Ruangan Ada Tidak Ada

3
Temuan
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Kesimpulan
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Sukabumi, April 2019

Kepala Madrasah, Pengawas Madrasah,

DIDIN SA’DILLAH, S.Pd.I. E. SURYANI S, S.Pd.I.

NUPTK. 4438753655200013 NIP. 196905632005012002