Created by Bangpeg2013

MENU SASARAN KERJA

PEGAWAI NEGERI SIPIL

1. DATA SASARAN KERJA PEGAWAI

2. COVER

3. FORMULIR SKP

4. PENGUKURAN CAPAIAN SKP

5. BUKU CATATAN PERILAKU KERJA PNS

6. PENILAIAN PRESTASI KERJA PNS

KANTOR REGIONAL IIIBADAN KEPEGAWAIAN NEGARA

 DATA SASARAN KERJA PEGAWAI

1 YANG DINILAI

a. Nama : Citra Alfaputri Simbolon, S.K.M.

b. NIP : 19860405 201902 2 004

c. Pangkat/Gol.Ruang : Penata Muda (III /a)

d. Jabatan : Penyuluh KB Ahli Pertama Kabupaten Sambas

: Dinas Pemberdayaan Perempuan, Perlindungan Anak,

e. Unit Kerja Pengendalian Penduduk dan Keluarga Berencana,
Kabupaten Sambas

2 PEJABAT PENILAI

a. Nama : Purtiko Eldiyanto, SH,MH.

b. NIP : 19681006 199503 1 006

c. Pangkat/Gol.Ruang : Pembina ( IV/ a)

d. Jabatan : Kepala Bidang Pengendalian Penduduk

Dinas Pemberdayaan Perempuan, Perlindungan Anak,

e. Unit Kerja : Pengendalian Penduduk dan Keluarga Berencana,
Kabupaten Sambas

3 ATASAN PEJABAT PENILAI

a. Nama : Hendy Wijaya, SKM, MPH

b. NIP : 19690824 198911 1 001

c. Pangkat/Gol.Ruang : Pembina Tingkat I (IV/b)

d. Jabatan : Kepala Dinas

Dinas Pemberdayaan Perempuan, Perlindungan Anak,

e. Unit Kerja : Pengendalian Penduduk dan Keluarga Berencana,
Kabupaten Sambas
 BACK TO
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UTAMA
PENILAIAN PRESTASI KERJA
PEGAWAI NEGERI SIPIL

Jangka Waktu Penilaian

1 Agustus - 31 Desember 2019

Nama Pegawai : Citra Alfaputri Simbolon, S.K.M.

NIP : 19860405 201902 2 004
Pangkat Golongan Ruang : Penata Muda (III /a)
Jabatan : Penyuluh KB Ahli Pertama Kabupaten Sambas
Unit Kerja : Dinas Pemberdayaan Perempuan,
Perlindungan Anak, Pengendalian Penduduk
dan Keluarga Berencana Kabupaten Sambas

DINAS PEMBERDAYAAN PEREMPUAN, PERLINDUNGAN ANAK,

PENGENDALIAN PENDUDUK DAN KELUARGA BERENCANA
KABUPATEN SAMBAS, KALIMANTAN BARAT
TAHUN 2018
BACK TO
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UTAMA
 REKOMENDASI SASARAN KERJA
PENYULUH KELUARGA BERENCANA

NO I. PEJABAT PENILAI NO II. PEGAWAI NEGERI SIPIL YANG DINILAI

1 Nama Purtiko Eldiyanto, SH,MH. 1 Nama Citra Alfaputri Simbolon, S.K.M.

2 NIP 19681006 199503 1 006 2 NIP 19860405 201902 2 004

3 Pangkat/Gol.Ruang Pembina ( IV/ a) 3 Pangkat/Gol.Ruang Penata Muda (III /a)

Penyuluh KB Ahli Pertama Kabupaten

4 Jabatan Kepala Bidang Pengendalian Penduduk 4 Jabatan
Sambas

Dinas Pemberdayaan Perempuan,

Dinas Pemberdayaan Perempuan, Perlindungan Anak, Pengendalian Perlindungan Anak, Pengendalian
5 Unit Kerja 5 Unit Kerja
Penduduk dan Keluarga Berencana, Kabupaten Sambas Penduduk dan Keluarga Berencana,
Kabupaten Sambas

TARGET
NO III. KEGIATAN TUGAS JABATAN AK
KUANT/OUTPUT KUAL/MUTU WAKTU BIAYA

1 Menyusun rencana kerja mingguan program KKBPK di wilayah binaan 0 20 dokumen 100 5 bulan

2 Menyusun rencana kerja bulanan program KKBPK di wilayah binaan 0 5 dokumen 100 5 bulan

3 Mengikuti pendidikan dan pelatihan Prajabatan golongan III 0 1 sertifikat 100 5 bulan
4 Melakukan advokasi ke tokoh formal di tingkat Kecamatan 0 1 laporan 100 5 bulan
5 Melakukan advokasi ke tokoh Informal di tingkat Kecamatan 0 1 laporan 100 5 bulan

Pontianak, 1 Agustus 2019

Pejabat Penilai Pegawai Negeri Sipil Yang Dinilai

Purtiko Eldiyanto, SH.,MH Citra Alfaputri Simbolon, S.K.M.

NIP. 19681006 199503 1 006 NIP. 19860405 201902 2 004
Catatan :
* AK Bagi PNS yang memangku jabatan fungsional tertentu
 REKOMENDASI PENILAIAN CAPAIAN SASARAN KERJA
PENYULUH KELUARGA BERENCANA

Jangka Waktu Penilaian

1 AGUSTUS - 31 DESEMBER 2019
TARGET REALISASI PENGHI
NILAI
Kual
NO I. KEGIATAN TUGAS TAMBAHAN AK Kual/ Biay AK Bia CAPAIAN
Kuant/ Output Waktu Kuant/ Output / Waktu TUNGAN
Mutu a ya SKP
Mutu

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Menyusun rencana kerja mingguan program

1 0 20 dokumen 100 5 bulan 0 20 dokumen 100 5 bulan 276 92.00
KKBPK di wilayah binaan
-
Menyusun rencana kerja bulanan program KKBPK
2 0 5 dokumen 100 5 bulan 0 5 dokumen 100 5 bulan 276 92.00
di wilayah binaan -
Mengikuti pendidikan dan pelatihan Prajabatan
3 0 1 sertifikat 100 5 bulan 0 1 sertifikat 100 3 bulan 260 86.67
golongan III -
Melakukan advokasi dengan tokoh formal di tingkat
4 0 1 laporan 100 5 bulan 0 1 laporan 100 1 bulan 220 73.33
Kecamatan
-
Melakukan advokasi dengan tokoh informal di
5 0 1 laporan 100 5 bulan 0 1 laporan 100 1 bulan 220 73.33
tingkat Kecamatan -

NILAI CAPAIAN SKP 83.47

Baik

Sambas , 31 Desember 2019

Pejabat Penilai,

Purtiko Eldiyanto, SH.,MH

NIP. 19681006 199503 1 006
 BUKU CATATAN PENILAIAN PERILAKU PNS

Nama : Citra Alfaputri Simbolon, S.K.M.

NIP : 19860405 201902 2 004

Nama/NIP dan Paraf

No Tanggal Uraian
Pejabat Penilai
Nama/NIP dan Paraf
1 2 3
Pejabat Penilai

1 1 Agustus - 31 Penilaian SKP sampai dengan akhir Desember 2019=

Desember 2019
83.47 sedangkan penilaian perilaku kerjanya adalah
sebagai berikut :

Orientasi Pelayanan = 81.00 (Baik)

Kepala Bidang Pengendalian

Integritas = 81.00 (Baik) Penduduk
Komitmen = 83.00 (Baik)

Disiplin = 85.00 (Baik)

Kerjasama = 85.00 (Baik) Purtiko Eldiyanto, SH,MH.

19681006 199503 1 006

Jumlah = 415

Nilai Rata-rata = 83.00 (Baik)

BACK TO
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 PENILAIAN PRESTASI KERJA
PEGAWAI NEGERI SIPIL

JANGKA WAKTU PENILAIAN

INSTANSI : DP3AP2KB KABUPATEN SAMBAS 1 Agustus - 31 Desember 2019
1. YANG DINILAI
a. N A M A Citra Alfaputri Simbolon, S.K.M.

b. NIP 19860405 201902 2 004

c. Pangkat, golongan ruang Penata Muda (III /a)

d. Jabatan/Pekerjaan Penyuluh KB Ahli Pertama Kabupaten Sambas

Dinas Pemberdayaan Perempuan, Perlindungan Anak,

e. Unit Organisasi Pengendalian Penduduk dan Keluarga Berencana,
Kabupaten Sambas

2. PEJABAT PENILAI

a. N A M A Purtiko Eldiyanto, SH,MH.

b. NIP 19681006 199503 1 006

c. Pangkat, golongan ruang Pembina ( IV/ a)

d. Jabatan/Pekerjaan Kepala Bidang Pengendalian Penduduk

Dinas Pemberdayaan Perempuan, Perlindungan Anak,

e. Unit Organisasi Pengendalian Penduduk dan Keluarga Berencana,
Kabupaten Sambas

3. ATASAN PEJABAT PENILAI

a. N A M A Hendy Wijaya, SKM, MPH

b. NIP 19690824 198911 1 001

c. Pangkat, golongan ruang Pembina Tingkat I (IV/b)

d. Jabatan/Pekerjaan Kepala Dinas

Dinas Pemberdayaan Perempuan, Perlindungan Anak,

e. Unit Organisasi Pengendalian Penduduk dan Keluarga Berencana,
Kabupaten Sambas
4. UNSUR YANG DINILAI JUMLAH

a. Sasaran Kerja Pegawai (SKP) 83.47 X 60% 50.08

1. Orientasi Pelayanan 81.00 (Baik)

2. Integritas 81.00 (Baik)

3. Komitmen 83.00 (Baik)

Perilaku 4 Disiplin 85.00 (Baik)

b.
Kerja 5. Kerjasama 85.00 (Baik)

Jumlah 415.00

Nilai Rata-rata 83.00 (Baik)

Nilai Perilaku kerja 83.00 X 40% 33.20

83.28
Nilai Prestasi Kerja
(Baik)

5. KEBERATAN DARI PEGAWAI NEGERI SIPIL

YANG DINILAI (APABILA ADA)

Tanggal , 2 Januari 2020

6. TANGGAPAN PEJABAT PENILAI ATAS KEBERATAN

Tanggal , 3 Januari 2020

7. KEPUTUSAN ATASAN PEJABAT PENILAI ATAS

KEBERATAN

Tanggal, 4 Januari 2020

8. REKOMENDASI
 9. DIBUAT TANGGAL, 31 DESEMBER 2019
PEJABAT PENILAI

Purtiko Eldiyanto, SH,MH.

19681006 199503 1 006

10. DITERIMA TANGGAL, 2 JANUARI 2020

PEGAWAI NEGERI SIPIL YANG
DINILAI,

Citra Alfaputri Simbolon, S.K.M.

19860405 201902 2 004

11. DITERIMA TANGGAL, 3 JANUARI 2020

ATASAN PEJABAT YANG MENILAI

Hendy Wijaya, SKM, MPH

19690824 198911 1 001
BACK TO
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Compatibility Report for Form SKP SONI HERMAWAN, SH 2.xls
Run on 1/25/2017 9:38

The following features in this workbook are not supported by earlier versions of
Excel. These features may be lost or degraded when you save this workbook in
an earlier file format.

Significant loss of functionality # of occurrences

Any effects on this object will be removed. Any text that overflows the 13
boundaries of this graphic will appear clipped.
'Menu'!A1
'DATA SKP'!A1:E20

'COVER'!A1:J43
'FORM SKP'!A1:L35

'PENGUKURAN'!A1:AO36

'PERILAKU KERJA'!A1:J35

'PENILAIAN'!A2:J155

One or more functions in this workbook are not available in earlier versions of 36
Excel. When recalculated in earlier versions, these functions will return a
#NAME? error instead of their current results.
'PENGUKURAN'!U9:U17

'PENGUKURAN'!AG9:AG17

'PENGUKURAN'!AM9:AM17

'PENGUKURAN'!AO9:AO17

Minor loss of fidelity

Some formulas in this workbook are linked to other workbooks that are 1
closed. When these formulas are recalculated in earlier versions of Excel
without opening the linked workbooks, characters beyond the 255-character
limit cannot be returned.
'PENGUKURAN'!A5

Some cells or styles in this workbook contain formatting that is not supported 8
by the selected file format. These formats will be converted to the closest
format available.
Compatibility Report for SKP ELLY TERBARU.xls
Run on 3/4/2019 7:19

If the workbook is saved in an earlier file format or opened in an earlier version

of Microsoft Excel, the listed features will not be available.

Significant loss of functionality # of occurrences

Any effects on this object will be removed. Any text that overflows the 20
boundaries of this graphic will appear truncated.
Menu'!A1
DATA SKP'!A1:E20

COVER'!A1:J43
FORM SKP'!A1:L40

PENGUKURAN'!A1:AO32

PERILAKU KERJA'!A1:J35

PENILAIAN'!A2:J154

One or more functions in this workbook are not available in versions prior to 60
Excel 2007. When recalculated in earlier versions, these functions will return a
#NAME? error instead of their current results.
PENGUKURAN'!U9:U23

PENGUKURAN'!AG9:AG23

PENGUKURAN'!AM9:AM23

PENGUKURAN'!AO9:AO23

Minor loss of fidelity

Some cells or styles in this workbook contain formatting that is not supported 8
by the selected file format. These formats will be converted to the closest
format available.
 Version

Excel 97-2003
Excel 97-2003

Excel 97-2003
Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003
Compatibility Report for SKP ELLY TERBARU.xls
Run on 3/4/2019 7:19

If the workbook is saved in an earlier file format or opened in an earlier version

of Microsoft Excel, the listed features will not be available.

Significant loss of functionality # of occurrences

Any effects on this object will be removed. Any text that overflows the 20
boundaries of this graphic will appear truncated.
Menu'!A1
DATA SKP'!A1:E20

COVER'!A1:J43
FORM SKP'!A1:L40

PENGUKURAN'!A1:AO32

PERILAKU KERJA'!A1:J35

PENILAIAN'!A2:J154

One or more functions in this workbook are not available in versions prior to 60
Excel 2007. When recalculated in earlier versions, these functions will return a
#NAME? error instead of their current results.
PENGUKURAN'!U9:U23

PENGUKURAN'!AG9:AG23

PENGUKURAN'!AM9:AM23

PENGUKURAN'!AO9:AO23

Minor loss of fidelity

Some cells or styles in this workbook contain formatting that is not supported 8
by the selected file format. These formats will be converted to the closest
format available.
 Version

Excel 97-2003
Excel 97-2003

Excel 97-2003
Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003
Compatibility Report for SKP ELLY TERBARU.xls
Run on 3/4/2019 7:19

If the workbook is saved in an earlier file format or opened in an earlier version

of Microsoft Excel, the listed features will not be available.

Significant loss of functionality # of occurrences

Any effects on this object will be removed. Any text that overflows the 20
boundaries of this graphic will appear truncated.
Menu'!A1
DATA SKP'!A1:E20

COVER'!A1:J43
FORM SKP'!A1:L40

PENGUKURAN'!A1:AO32

PERILAKU KERJA'!A1:J35

PENILAIAN'!A2:J154

One or more functions in this workbook are not available in versions prior to 60
Excel 2007. When recalculated in earlier versions, these functions will return a
#NAME? error instead of their current results.
PENGUKURAN'!U9:U23

PENGUKURAN'!AG9:AG23

PENGUKURAN'!AM9:AM23

PENGUKURAN'!AO9:AO23

Minor loss of fidelity

Some cells or styles in this workbook contain formatting that is not supported 8
by the selected file format. These formats will be converted to the closest
format available.
 Version

Excel 97-2003
Excel 97-2003

Excel 97-2003
Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003
Compatibility Report for SKP ELLY TERBARU.xls
Run on 3/4/2019 7:20

If the workbook is saved in an earlier file format or opened in an earlier version

of Microsoft Excel, the listed features will not be available.

Significant loss of functionality # of occurrences

Any effects on this object will be removed. Any text that overflows the 20
boundaries of this graphic will appear truncated.
Menu'!A1
DATA SKP'!A1:E20

COVER'!A1:J43
FORM SKP'!A1:L40

PENGUKURAN'!A1:AO32

PERILAKU KERJA'!A1:J35

PENILAIAN'!A2:J154

One or more functions in this workbook are not available in versions prior to 60
Excel 2007. When recalculated in earlier versions, these functions will return a
#NAME? error instead of their current results.
PENGUKURAN'!U9:U23

PENGUKURAN'!AG9:AG23

PENGUKURAN'!AM9:AM23

PENGUKURAN'!AO9:AO23

Minor loss of fidelity

Some cells or styles in this workbook contain formatting that is not supported 8
by the selected file format. These formats will be converted to the closest
format available.
 Version

Excel 97-2003
Excel 97-2003

Excel 97-2003
Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003
Compatibility Report for SKP ELLY TERBARU.xls
Run on 3/4/2019 7:20

If the workbook is saved in an earlier file format or opened in an earlier version

of Microsoft Excel, the listed features will not be available.

Significant loss of functionality # of occurrences

Any effects on this object will be removed. Any text that overflows the 20
boundaries of this graphic will appear truncated.
Menu'!A1
DATA SKP'!A1:E20

COVER'!A1:J43
FORM SKP'!A1:L40

PENGUKURAN'!A1:AO32

PERILAKU KERJA'!A1:J35

PENILAIAN'!A2:J154

One or more functions in this workbook are not available in versions prior to 60
Excel 2007. When recalculated in earlier versions, these functions will return a
#NAME? error instead of their current results.
PENGUKURAN'!U9:U23

PENGUKURAN'!AG9:AG23

PENGUKURAN'!AM9:AM23

PENGUKURAN'!AO9:AO23

Minor loss of fidelity

Some cells or styles in this workbook contain formatting that is not supported 8
by the selected file format. These formats will be converted to the closest
format available.
 Version

Excel 97-2003
Excel 97-2003

Excel 97-2003
Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003
Compatibility Report for SKP ELLY TERBARU.xls
Run on 3/4/2019 7:20

If the workbook is saved in an earlier file format or opened in an earlier version

of Microsoft Excel, the listed features will not be available.

Significant loss of functionality # of occurrences

Any effects on this object will be removed. Any text that overflows the 20
boundaries of this graphic will appear truncated.
Menu'!A1
DATA SKP'!A1:E20

COVER'!A1:J43
FORM SKP'!A1:L40

PENGUKURAN'!A1:AO32

PERILAKU KERJA'!A1:J35

PENILAIAN'!A2:J154

One or more functions in this workbook are not available in versions prior to 60
Excel 2007. When recalculated in earlier versions, these functions will return a
#NAME? error instead of their current results.
PENGUKURAN'!U9:U23

PENGUKURAN'!AG9:AG23

PENGUKURAN'!AM9:AM23

PENGUKURAN'!AO9:AO23

Minor loss of fidelity

Some cells or styles in this workbook contain formatting that is not supported 8
by the selected file format. These formats will be converted to the closest
format available.
 Version

Excel 97-2003
Excel 97-2003

Excel 97-2003
Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003

Excel 97-2003