Hari/Tgl JENIS PENGENDALIAN UNITSenin/270715DUTY MANAGERUGD & VKOK/ICURawat Inape!inat"#"$i%a&"!at"!i'()a!(a*ien+a,ta!anSatpa(Gi-i"#i.#ini.Ra+i"#"$iC#eanin$ Se!/i0e%"'n+!1Ke'an$an/Ka*i!D!i/e!2i+3 U('(%"$i*ti. & Ke*e.!eta!iatanRe.a( Me+i. & 24SSRS/IA%KEA%A 2AGIANUGD & VKOK/ICURawat Inape!inat"#"$i%a&"!at"!i'()a!(a*ien+a,ta!anSatpa(Gi-i"#i.#ini.Ra+i"#"$iC#eanin$ Se!/i0e%"'n+!1Ke'an$an/Ka*i!D!i/e!2i+3 U('(%"$i*ti. & Ke*e.!eta!iatanRe.a( Me+i. & 24SSRS/IA%SDMUGD & VKOK/ICURawat Inape!inat"#"$i%a&"!at"!i'(Senin/270715SDM)a!(a*ien+a,ta!anSatpa(Gi-i"#i.#ini.Ra+i"#"$iC#eanin$ Se!/i0e%"'n+!1Ke'an$an/Ka*i!D!i/e!2i+3 U('(%"$i*ti. & Ke*e.!eta!iatanRe.a( Me+i. & 24SSRS/IA%K5/SATAMUGD & VKOK/ICURawat Inape!inat"#"$i%a&"!at"!i'()a!(a*ien+a,ta!anSatpa(Gi-i"#i.#ini.Ra+i"#"$iC#eanin$ Se!/i0e%"'n+!1Ke'an$an/Ka*i!D!i/e!2i+3 U('(%"$i*ti. & Ke*e.!eta!iatanRe.a( Me+i. & 24SSRS/IA%KEA%A UNITUGD & VKOK/ICURawat Inape!inat"#"$i%a&"!at"!i'()a!(a*ien+a,ta!anSatpa(Gi-i"#i.#ini.Ra+i"#"$iC#eanin$ Se!/i0e%"'n+!1Ke'an$an/Ka*i!D!i/e!Senin/270715 KEA%A UNIT2i+3 U('(%"$i*ti. & Ke*e.!eta!iatanRe.a( Me+i. & 24SSRS/IA%FORMULIR PENGENDALIAN HARIANASPEK YANG DINILAIi/ShiftKUALITAS PELAYANAN KERAMAHAN KEBERSIHAN Peeliharaa! Sara!aPAGI SORE MALAM PAGI SORE MALAM PAGI SORE MALAM PAGI67 65 67 67 75 62 7068 70 67 67 65 62 6567 70 67 67 65 62 6568 70 67 67 70 62 6568 70 67 67 70 62 6568 70 67 67 70 62 6567 70 67 67 60 62 65 68 70 67 70 6568 70 67 70 6568 70 67 60 6567 70 67 70 6567 70 67 65 6570 67 7067 67 6567 67 6567 67 6562 6565 6562 6262 6161 6565 6767 6562 6062 6062 6062 6560 6165 6760 6261 6080 80 80 85 85 85 80 80 80 8575 80 80 75 85 85 70 85 80 8070 70 70 70 72 72 72 75 75 7080 80 80 80 80 80 80 80 80 7570 75 72 72 71 75 75 70 75 7070 70 70 70 70 70 70 70 70 7075 75 75 70 70 70 75 75 75 7570 65 70 70 70 70 65 65 60 6570 70 70 70 75 75 7070 68 72 70 75 75 7570 75 72 72 71 75 75 70 75 7075 75 80 80 80 80 8075 70 75 75 70 75 7570 70 65 70 65 70 6565 65 65 6570 70 70 7565 70 70 70FORMULIR PENGENDALIAN HARIANASPEK YANG DINILAIi/ShiftPeeliharaa! Sara!a Ke"# Me!$ala!%a! SOP Di&i"li! Pega'aiSORE MALAM PAGI SORE MALAM PAGI SORE MALAM70 65 70 70 6560 65 70 70 6565 65 70 70 6565 65 70 60 6570 65 70 70 6570 65 70 70 6560 65 70 65 6570 70 7070 70 7065 70 7060 70 7070 70 7070 7070707065656565626165606262656065676270/75 65/70 70/7275/75 70/7270/70 70/75 70/7575/75 70/65 75/7570/75 70/70 70/7070/70 70/70 75/7070/70 70/70 70/7570/70 70/7070/70 65/6570/70 70/7570/70 65/7070/70 70/7070/7070/7080 85 80 75 80 85 80 8085 75 80 80 75 75 75 8070 70 70 70 70 75 77 7575 75 80 80 8070 72 70 70 7570 70 65 65 65 70 70 7075 75 75 75 75 75 75 7565 60 70 65 60 70 65 6570 70 70 70 7070 68 65 70 7070 72 70 70 7580 80 8080 75 7565 60 70 70 70657565 70e$awai Yan$ Me#an$$a! Di*ip#inNaa Je!i& Pela!ggara! Ket# Paraf FORMULIR PENGENDALIAN HARIANHari/Tgl JENIS PENGENDALIAN UNITASPEK YANG DINILAIi/ShiftKUALITAS PELAYANANPAGISe#a*a/280715DUTY MANAGERUGD & VKOK/ICURawat Inape!inat"#"$i%a&"!at"!i'()a!(a*ien+a,ta!anSatpa(Gi-i"#i.#ini.Ra+i"#"$iC#eanin$ Se!/i0e%"'n+!1Ke'an$an/Ka*i!D!i/e!2i+3 U('(%"$i*ti. & Ke*e.!eta!iatanRe.a( Me+i. & 24SSRS/IA%KEA%A 2AGIANUGD & VK 71OK/ICU 71Rawat Inap 70e!inat"#"$i 71%a&"!at"!i'( 70)a!(a*i 70en+a,ta!an 67Satpa(Gi-i 70"#i.#ini. 70Ra+i"#"$i 70C#eanin$ Se!/i0e 70%"'n+!1 70Ke'an$an/Ka*i!D!i/e! 702i+3 U('(%"$i*ti. & Ke*e.!eta!iatan 70Re.a( Me+i. & 24S 70SRS/IA% 70SDMUGD & VK 62OK/ICU 65Se#a*a/280715SDMRawat Inap 62e!inat"#"$i 66%a&"!at"!i'( 60)a!(a*i 62en+a,ta!an 65Satpa(Gi-i 62"#i.#ini. 65Ra+i"#"$i 62C#eanin$ Se!/i0e 60%"'n+!1 65Ke'an$an/Ka*i!D!i/e!2i+3 U('(%"$i*ti. & Ke*e.!eta!iatan 62Re.a( Me+i. & 24S 67SRS/IA% 62K5/SATAMUGD & VKOK/ICURawat Inape!inat"#"$i%a&"!at"!i'()a!(a*ien+a,ta!anSatpa(Gi-i"#i.#ini.Ra+i"#"$iC#eanin$ Se!/i0e%"'n+!1Ke'an$an/Ka*i!D!i/e!2i+3 U('(%"$i*ti. & Ke*e.!eta!iatanRe.a( Me+i. & 24SSRS/IA%KEA%A UNITUGD & VK 85OK/ICU 75Rawat Inap 72e!inat"#"$i 80%a&"!at"!i'( 70)a!(a*i 70en+a,ta!an 70Satpa( 75Gi-i 70Se#a*a/280715 KEA%A UNIT"#i.#ini. 70Ra+i"#"$iC#eanin$ Se!/i0e 75%"'n+!1 75Ke'an$an/Ka*i!D!i/e! 702i+3 U('(%"$i*ti. & Ke*e.!eta!iatan 65Re.a( Me+i. & 24S 70SRS/IA% 65FORMULIR PENGENDALIAN HARIANASPEK YANG DINILAIi/ShiftKUALITAS PELAYANAN KERAMAHAN KEBERSIHANSORE MALAM PAGI SORE MALAM PAGI SORE MALAM65 70 67 75 7570 70 68 65 7570 70 68 70 7570 70 68 60 7570 70 68 60 7570 70 67 70 7570 70 67 65 756770 67 7070 67 6070 67 7070 67 706867676765656265656067626260616062656185 80 85 85 80 80 80 8080 70 70 80 80 80 85 8572 70 75 70 75 72 72 750 80 80 80 80 80 80 8075 72 72 77 72 75 75 7570 70 70 70 70 70 70 7076 76 75 75 75 75 75 7565 60 70 65 60 70 70 7070 72 72 75 7568 72 70 75 7575 75 75 80 8075 80 80 80 7565 70 60 75 7065 6570 7070 65FORMULIR PENGENDALIAN HARIANASPEK YANG DINILAIi/ShiftPeeliharaa! Sara!a Ke"# Me!$ala!%a! SOP Di&i"li! Pega'aiPAGI SORE MALAM PAGI SORE MALAM PAGI SORE66 70 60 70 7067 65 60 70 6567 70 60 70 7067 70 60 70 6567 60 60 70 6567 70 60 70 7067 65 60 70 7067 7067 70 70 7067 65 70 7067 75 70 7067 70 70 7068 7066 7066 7066 7065676266656062616561605961606070/70 68/7070/70 70/6565/70 65/6565/70 70/6570/70 70/7067/69 65/6870/70 69/7568/70 69/6865/65 65/6570/68 65/7067/69 65/6270/70 68/6968/6080 80 80 80 80 85 85 8585 85 85 85 70 80 70 7070 72 70 70 70 70 75 7780 80 80 80 8071 70 70 72 7270 70 70 65 65 65 70 7075 75 75 75 75 75 80 8065 70 70 65 60 60 70 6070 70 72 75 75 7575 75 68 65 70 7080 80 80 8075 80 7575 65 70 70 70 7065 6575 7570 65 70FORMULIR PENGENDALIAN HARIANASPEK YANG DINILAIi/Shift e$awai Yan$ Me#an$$a! Di*ip#inDi&i"li! Pega'aiMALAM Naa Je!i& Pela!ggara!6565656565656565/6570/7062/6065/6862/6065/6770/678080758068S:e##1 ;an+a1ani