HASIL SELF ASSESMENT PUSKESMAS GARUNG

AKREDITASI
BAB PROSENTASE TOTAL DASAR
(minimal)

I 88.98% 88.98% 75%

II 51.72% 51.72% 75%
III 73.44% 73.44% 75%
KIA PROMKES KESLING UKS LANSIA P2P GIZI
IV 45.28% 0 0 0.49057 0 0 21.70% 60%
V 0 28.71% 0 0.32673 0 28.71% 21.29% 60%
VI 0 0 51.72% 0.13793 0 0 6.90% 60%
VII 69.17% 69.17% 20%
VIII 44.32% 44.32% 20%
IV 30.70% 30.70% 20%
 HASIL SELF ASSESMENT PUSKESMAS GARUNG

SELF ASSESMENT ASSESMENT DARI DINAS

BAB JUMLAH NILAI PROSENTASE JUMLAH NILAI ASSESMENT
I 525 590 88.98% 545 590 92.37%
II 450 870 51.72% 550 870 63.22%
III 235 320 73.44% 240 320 75.00%
IV 173.57 530 16.58% 173.57 530 32.75%
V 154.29 1010 11.81% 154.29 1010 15.28%
VI 28.57 290 10.34% 28.57 290 9.85%
VII 920 1330 69.17% 690 1330 51.88%
VIII 585 1320 44.32% 475 1320 35.98%
175 570 30.70% 190 570 33.33%
 HASIL SELF ASSESMENT UPAYA PUSKESMAS GARUNG

BAB IV V VI
PROGRAM JUMLAH NILAI PROSENTASE JUMLAH NILAI PROSENTASE JUMLAH NILAI PROSENTASE
KIA 240 45.28% 0 0 0 0
PROMKES 0 0 0 0 0 0
KESLING 0 0 0 0 150 51.72%
UKS 260 49.06% 330 32.67% 40 13.79%
530 1010 290
LANSIA 0 0 0 0 0 0
P2P 0 0 290 28.71% 0 0
GIZI 115 21.70% 215 21.29% 20 6.90%
Rata-rata 87.86 16.58% 119.29 11.81% 30.00 10.34%

BAB IV V VI
PROGRAM JUMLAH NILAI PROSENTASE JUMLAH NILAI PROSENTASE JUMLAH NILAI PROSENTASE
KIA 235 44.34% 0 0.00% 0 0.00%
PROMKES 70 13.21% 110 10.89% 0 0.00%
KESLING 390 73.58% 190 18.81% 40 13.79%
UKS 260 49.06% 330 32.67% 40 13.79%
530 1010 290
LANSIA 0.00% 0.00% 0.00%
P2P 145 27.36% 235 23.27% 100 34.48%
GIZI 115 21.70% 215 21.29% 20 6.90%
Rata-rata 173.57 32.75% 154.29 15.28% 28.57 9.85%
 HASIL SELF ASSESMENT & ASSESMENT DKK
ADMEN & YANIS PUSKESMAS GARUNG

SELF ASSESMENT ASSESMENT DARI DINAS

BAB KRITERIA SKOR KET
NILAI PROSENTASE NILAI PROSENTASE
I 1.1.1 60 55 91.67% 60 100.00%
1.1.2 30 30 100.00% 30 100.00%
1.1.3 30 10 33.33% 30 100.00%
1.1.4 50 50 100.00% 50 100.00%
1.1.5 40 25 62.50% 30 75.00%
210 170 80.95% 200 95.24%
1.2.1 20 20 100.00% 20 100.00%
1.2.2 20 20 100.00% 10 50.00%
1.2.3 60 55 91.67% 55 91.67%
1.2.4 30 20 66.67% 30 100.00%
1.2.5 110 110 100.00% 110 100.00%
1.2.6 40 40 100.00% 30 75.00%
280 265 94.64% 255 91.07%
1.3.1 50 45 90.00% 30 60.00%
1.3.2 50 45 90.00% 50 100.00%
100 90 90.00% 80 80.00%
TOTAL 590 525 88.98% 535 90.68%
II 2.1.1 30 25 83.33% 30 100.00%
2.1.2 40 20 50.00% 30 75.00%
2.1.3 20 0 0.00% 5 25.00%
2.1.4 60 15 25.00% 25 41.67%
2.1.5 40 25 62.50% 30 75.00%
2.1.6 40 35 87.50% 40 100.00%
2.1.7 40 25 62.50% 30 75.00%
2.1.8 30 30 100.00% 30 100.00%
2.1.9 30 20 66.67% 20 66.67%
2.1.10 50 20 40.00% 30 60.00%
2.1.11 50 0 0.00% 0 0.00%
2.1.12 50 0 0.00% 25 50.00%
2.1.13 30 0 0.00% 15 50.00%
2.1.14 50 25 50.00% 30 60.00%
2.1.15 60 50 83.33% 45 75.00%
2.1.16 50 40 80.00% 40 80.00%
2.1.17 50 35 70.00% 35 70.00%
720 365 50.69% 460 63.89%
2.2.1 30 15 50.00% 30 100.00%
2.2.2 20 10 50.00% 20 100.00%
50 25 50.00% 50 100.00%
2.3.1 0 0 #DIV/0! 0 #DIV/0!
Tidak
2.3.2 0 0 #DIV/0! 0 #DIV/0! Dilakukan
0 0 #DIV/0! 0 #DIV/0!
2.4.1 100 60 60.00% 50 50.00% ,
100 60 60.00% 50 50.00%
TOTAL 870 450 51.72% 560 64.37%
III 3.1.1 50 35 70.00% 50 100.00%
3.1.2 40 15 37.50% 30 75.00%
3.1.3 30 25 83.33% 20 66.67%
3.1.4 50 35 70.00% 50 100.00%
3.1.5 30 30 100.00% 30 100.00%
3.1.6 50 45 90.00% 40 80.00%
III

SELF ASSESMENT ASSESMENT DARI DINAS

BAB KRITERIA SKOR KET
NILAI PROSENTASE NILAI PROSENTASE
3.1.7 70 50 71.43% 20 28.57%
320 235 73.44% 240 75.00%
TOTAL 320 235 73.44% 240 75.00%
VII 7.1.1 70 70 100.00% 45 64.29%
7.1.2 60 55 91.67% 40 66.67%
7.1.3 80 55 68.75% 20 25.00%
7.1.4 40 30 75.00% 20 50.00%
7.1.5 30 5 16.67% 0 0.00%
280 215 76.79% 125 44.64%
7.2.1 40 35 87.50% 20 50.00%
7.2.2 30 20 66.67% 20 66.67%
7.2.3 40 20 50.00% 5 12.50%
110 75 68.18% 45 40.91%
7.3.1 40 30 75.00% 10 25.00%
7.3.2 30 30 100.00% 10 33.33%
70 60 85.71% 20 28.57%
7.4.1 50 15 30.00% 10 20.00%
7.4.2 40 35 87.50% 0 0.00%
7.4.3 70 55 78.57% 30 42.86%
7.4.4 50 40 80.00% 35 70.00%
210 145 69.05% 75 35.71%
7.5.1 40 35 87.50% 15 37.50%
7.5.2 30 25 83.33% 0 0.00%
7.5.3 40 40 100.00% 40 100.00%
7.5.4 20 15 75.00% 15 75.00%
130 115 88.46% 70 53.85%
7.6.1 80 75 93.75% 75 93.75%
7.6.2 50 40 80.00% 30 60.00%
7.6.3 0 0 #DIV/0! 0 #DIV/0! Tidak Dilakukan
7.6.4 50 5 10.00% 0 0.00%
7.6.5 40 40 100.00% 30 75.00%
7.6.6 30 15 50.00% 15 50.00%
7.6.7 40 10 25.00% 15 37.50%
290 185 63.79% 165 56.90%
7.7.1 50 20 40.00% 20 40.00%
7.7.2 70 40 57.14% 40 57.14% Tidak Dilakukan
120 60 50.00% 60 50.00%
7.8.1 40 25 62.50% 5 12.50%
40 25 62.50% 5 12.50%
7.9.1 0 0 #DIV/0! 0 #DIV/0!
Tidak Dilakukan
7.9.2 0 0 #DIV/0! 0 #DIV/0!
7.9.3 40 20 50.00% 20 50.00%
40 20 50.00% 20 50.00%
7.10.1 0 0 #DIV/0! 0 #DIV/0!
Tidak Dilakukan
7.10.2 0 0 #DIV/0! 0 #DIV/0!
7.10.3 40 20 50.00% 20 50.00%
40 20 50.00% 20 50.00%
TOTAL 1330 920 69.17% 605 45.49%
VIII 8.1.1 40 30 75.00% 10 25.00%
8.1.2 110 85 77.27% 40 36.36%
8.1.3 30 20 66.67% 10 33.33%
8.1.4 50 15 30.00% 15 30.00%
8.1.5 50 20 40.00% 5 10.00%
VIII

SELF ASSESMENT ASSESMENT DARI DINAS

BAB KRITERIA SKOR KET
NILAI PROSENTASE NILAI PROSENTASE
8.1.6 40 25 62.50% 10 25.00%
8.1.7 70 30 42.86% 10 14.29%
8.1.8 70 10 14.29% 15 21.43%
460 235 51.09% 115 25.00%
8.2.1 80 35 43.75% 35 43.75%
8.2.2 90 35 38.89% 45 50.00%
8.2.3 80 45 56.25% 30 37.50%
8.2.4 40 20 50.00% 15 37.50%
8.2.5 40 15 37.50% 70 175.00%
8.2.6 30 15 50.00% 15 50.00%
360 165 45.83% 210 58.33%
8.3 0 0 #DIV/0! 0 #DIV/0! Tidak Dilakukan
8.4.1 30 20 66.67% 15 50.00%
8.4.2 40 30 75.00% 5 12.50%
8.4.3 30 15 50.00% 15 50.00%
8.4.4 30 15 50.00% 15 50.00%
130 80 61.54% 50 38.46%
8.5.1 60 30 50.00% 25 41.67%
8.5.2 40 20 50.00% 20 50.00%
8.5.3 40 5 12.50% 5 12.50%
140 55 39.29% 50 35.71%
8.6.1 40 15 37.50% 20 50.00%
8.6.2 40 20 50.00% 10 25.00%
80 35 43.75% 30 37.50%
8.7.1 40 15 37.50% 25 62.50%
8.7.2 30 0 0.00% 10 33.33%
8.7.3 40 0 0.00% 25 62.50%
8.7.4 40 0 0.00% 20 50.00%
150 15 10.00% 80 53.33%
TOTAL 1320 585 44.32% 535 40.53%
IX 9.1.1 100 60 60.00% 60 60.00%
9.1.2 30 20 66.67% 20 66.67%
9.1.3 30 0 0.00% 5 16.67%
160 80 50.00% 85 53.13%
9.2.1 60 0 0.00% 0 0.00%
9.2.2 50 40 80.00% 40 80.00%
110 40 36.36% 40 36.36%
9.3.1 40 20 50.00% 20 50.00%
9.3.2 30 0 0.00% 0 0.00%
9.3.3 30 0 0.00% 0 0.00%
100 20 20.00% 20 20.00%
9.4.1 40 15 37.50% 15 37.50%
9.4.2 80 20 25.00% 20 25.00%
9.4.3 40 0 0.00% 0 0.00%
9.4.4 40 0 0.00% 10 25.00%
200 35 17.50% 45 22.50%
TOTAL 570 175 30.70% 190 33.33%

Kepala Puskesmas Garung Ketua Akreditasi

 SELF ASSESMENT ASSESMENT DARI DINAS
BAB KRITERIA SKOR KET
NILAI PROSENTASE NILAI PROSENTASE
dr. Isni Nur Harjanto drg. Irma Puspitasari
NIP. 19710607 200212 1 003 NIP. 19840625 2011 01 2 009
 HASIL SELF ASSESMENT & ASSESMENT DKK
UPAYA PUSKESMAS GARUNG

KIA PROMKES P2 KESLING GIZI

BAB KRITERIA SKOR SA SA SA SA SA
NILAI % NILAI % NILAI % NILAI % NILAI %
IV 4.1.1 70 30 42.86% 0 0.00% 0 0.00% 0 0.00% 20 28.57%
4.1.2 50 30 60.00% 15 30.00% 15 30.00% 15 50.00% 15 30.00%
4.1.3 50 25 50.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00%
170 85 50.00% 15 8.82% 15 8.82% 15 17.65% 35 20.59%
4.2.1 50 30 60.00% 20 40.00% 0 0.00% 0 0.00% 0 0.00%
4.2.2 50 25 50.00% 20 40.00% 20 40.00% 20 80.00% 20 40.00%
4.2.3 60 20 33.33% 5 8.33% 5 8.33% 5 25.00% 5 8.33%
4.2.4 50 35 70.00% 30 60.00% 30 60.00% 30 85.71% 30 60.00%
4.2.5 50 20 40.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00%
4.2.6 50 25 50.00% 25 50.00% 25 50.00% 25 100.00% 25 50.00%
310 155 50.00% 100 32.26% 80 25.81% 80 51.61% 80 25.81%
4.3.1 50 30 60.00% 10 20.00% 10 20.00% 10 33.33% 10 20.00%
50 30 60.00% 10 20.00% 10 20.00% 10 33.33% 10 20.00%
TOTAL 530 270 50.94% 125 23.58% 105 19.81% 105 19.81% 125 23.58%

RATA - RATA SA 27.55%

V 5.1.1 40 15 37.50% 15 37.50% 15 37.50% 15 37.50% 15 37.50%

5.1.2 40 15 37.50% 15 37.50% 15 37.50% 15 37.50% 15 37.50%
5.1.3 30 0 0.00% 0 0.00% 5 16.67% 0 0.00% 0 0.00%
5.1.4 70 15 21.43% 15 21.43% 25 35.71% 15 21.43% 20 28.57%
5.1.5 60 0 0.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00%
5.1.6 50 30 60.00% 30 60.00% 30 60.00% 30 60.00% 30 60.00%
290 75 25.86% 75 25.86% 90 31.03% 75 25.86% 80 27.59%
V

KIA PROMKES P2 KESLING GIZI

BAB KRITERIA SKOR SA SA SA SA SA
NILAI % NILAI % NILAI % NILAI % NILAI %
5.2.1 50 0 0.00% 0 0.00% 30 60.00% 0 0.00% 0 0.00%
5.2.2 50 10 20.00% 10 20.00% 10 20.00% 10 20.00% 10 20.00%
5.2.3 70 20 28.57% 20 28.57% 20 28.57% 20 28.57% 20 28.57%
170 30 0.485714 30 0.485714 60 1.085714 30 17.65% 30 17.65%
5.3.1 70 0 0.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00%
5.3.2 40 0 0.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00%
5.3.3 40 10 25.00% 10 25.00% 10 25.00% 10 25.00% 10 25.00%
150 10 0.25 10 0.25 10 0.25 10 6.67% 10 6.67%
5.4.1 50 0 0.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00%
5.4.2 40 10 25.00% 10 25.00% 10 25.00% 10 25.00% 10 25.00%
90 10 0.25 10 0.25 10 0.25 10 11.11% 10 11.11%
5.5.1 40 25 62.50% 25 62.50% 30 75.00% 25 62.50% 25 62.50%
5.5.2 50 15 30.00% 15 30.00% 25 50.00% 15 30.00% 15 30.00%
5.5.3 50 25 50.00% 25 50.00% 25 50.00% 25 50.00% 25 50.00%
140 65 1.425 65 1.425 80 1.75 65 46.43% 65 46.43%
5.6.1 30 10 33.33% 10 33.33% 10 33.33% 10 33.33% 10 33.33%
5.6.2 50 10 20.00% 10 20.00% 10 20.00% 10 20.00% 10 20.00%
5.6.3 30 5 16.67% 5 16.67% 10 33.33% 5 16.67% 5 16.67%
110 25 0.7 25 0.7 30 0.866667 25 22.73% 25 22.73%
5.7.1 20 20 100.00% 20 100.00% 20 100.00% 20 100.00% 20 100.00%
5.7.2 40 10 25.00% 10 25.00% 10 25.00% 10 25.00% 10 25.00%
60 30 125% 30 125.00% 30 1.25 30 50.00% 30 50.00%
TOTAL 1010 245 24% 245 24.26% 310 30.69% 245 24.26% 250 24.75%
RATA-RATA SA 25.64%
 KIA PROMKES P2 KESLING GIZI
BAB KRITERIA SKOR SA SA SA SA SA
NILAI % NILAI % NILAI % NILAI % NILAI %
VI 6.1.1 60 20 33.33% 20 33.33% 20 33.33% 50 83.33% 20 33.33%
6.1.2 50 0 0.00% 0 0.00% 0 0.00% 20 40.00% 0 0.00%
6.1.3 40 0 0.00% 0 0.00% 0 0.00% 20 50.00% 0 0.00%
6.1.4 40 0 0.00% 0 0.00% 0 0.00% 40 100.00% 0 0.00%
6.1.5 30 10 33.33% 10 33.33% 10 33.33% 20 66.67% 10 33.33%
6.1.6 70 0 0.00% 0 0.00% 0 0.00% 0 0.00% 0 0.00%
6.1.7 60 0.00% 0.00% 0.00% 0.00% 0.00%
6.1.8 90 0.00% 0.00% 0.00% 0.00% 0.00%
6.1.9 50 0.00% 0.00% 20 40.00% 0.00% 0.00%
6.1.10 60 0.00% 0.00% 10 16.67% 0.00% 0.00%
290 30 10.34% 30 10.34% 60 15.00% 150 51.72% 30 10.34%
400
TOTAL 290 30 10.34% 30 10.34% 60 15.00% 150 51.72% 30 10.34%
RATA-RATA SA 19.55%

Kepala Puskesmas Garung Ketua Akreditasi

dr. Isni Nur Harjanto drg. Irma Puspitasari

NIP. 19710607 200212 1 003 NIP. 19840625 2011 01 2 009