government employee work performance assessment

Employee Name :

NIP :

Rank/Group :

Position :

Unit :

YEAR 2017

Eryanto Hidayat

197608182014091004

Junior Supervisor, II/a

General Administration

Faculty of Nursing Universitas Indonesia

Assessment Period

January to December, 2017

UNIVERSITAS INDONESIA

GOVERNMENT EMPLOYEEWORK PERFORMANCE ASSESSMENT

Fatimah

Typewritten text

(Supporting Staff Appraisal Form)

1

a. Name : Eryanto Hidayat

b. NIP : 197608182014091004

c. Rank/Group : Junior Supervisor, II/a

d. Position : General Administration

e. Unit : Faculty of Nursing Universitas Indonesia

2

a. Name : Siti Rohaeti, S.Sos., M.Si

b. NIP : 196004201990032002

c. Rank/Group : Administrator, IV/a

d. Position : Evaluation and Reporting Data Processor


3

a. Name : Dr. Rr. Tutik Sri Hariyati, S.Kp., MARS

b. NIP : 197111181999032001

c. Rank/Group : Administrator, IV/a

d. Position : Manager of General Affairs


PERSON ASSESSED

APPRAISAL OFFICER

APPRAISAL OFFICER SUPERVISOR

EMPLOYEE PERFORMANCE TARGET DATA

NO NO

1 Name 1

2 NIP 2

3 Rank/Group 3

4 Position 4

5 Unit 5

QUALITY COST

1 0 7200 documents 100 12 months

2 0 12 proposals 100 12 months

3 0 512 sessions 100 12 months








11 0 12 reports 100 12 months


13 0 100 students 100 12 months

Assist the procurement of goods and services

Assist on plagiarism check of students' research papers

AKTARGET

QUANTITY/OUTPUT

196004201990032002

Administrator, IV/a

Evaluation and Reporting Data Processor

TIME


197608182014091004NIP

Unit

Rank/Group Junior Supervisor, II/a

General AdministrationPosition


GOVERNMENT EMPLOYEE

WORK TARGET FORM

Eryanto Hidayat

I. APPRAISAL OFFICER II. GOVERNMENT EMPLOYEE ASSESSED

NameSiti Rohaeti, S.Sos., M.Si

Government Employee Assessed

Depok, January 5th, 2017

Process incoming mail, outgoing mail, arrange letter archives and serve borrowing

letter archives

Compile a list of needs, supply office stationery, and infrastructure facilities within the

Department

NO

Appraisal Officer

III. OFFICE ASSIGNMENT ACTIVITIES

Facilitate learning and teaching process (BPKM, SAP, Academic staff and students'

attendance)

Prepare materials for Department meetings and distribute the meeting results

Recapitulate lecturer attendance every month within the Department

Assist inventory of facilities and infrastructure maintenance within the Department

Assist administrate lecturers promotion (entries in SIPEG and SIPKD, collecting

physical evidence)

Report (make midterm and annual reports) the implementation of duties to superiors

as accountability

Assist the process of typing quetions for mid and final semester examinations

Assist students' grades processing through the academic.ui.ac.id system and assist

correcting students' mid and final examinations

Assist recapitulate the coaching hours of clinical/community practice and guest

lecturers within the Department

* AK is for Government Employees who hold certain functional position

Siti Rohaeti, S.Sos., M.Si

196004201990032002

Note :

Eryanto Hidayat

197608182014091004

Assessment Period


Quality Cost Quality Cost

1 2 3 5 7 8 10 12 13 14

1Process incoming mail, outgoing mail, arrange letter archives and

serve borrowing letter archives0 7200 documents 100 12 months - 0 5000 documents 90 12 months 235 78.48

2Compile a list of needs, supply office stationery, and infrastructure

facilities within the Department0 12 proposals 100 12 months - 0 8 proposals 90 12 months 233 77.56

3Facilitate learning and teaching process (BPKM, SAP, Academic staff

and students' attendance)0 512 sessions 100 12 months - 0 300 sessions 90 12 months 225 74.86

4Assist the process of typing quetions for mid and final semester

examinations0 168 sessions 100 12 months - 0 140 sessions 90 12 months 249 83.11

5Assist students' grades processing through the academic.ui.ac.id

system and assist correcting students' mid and final examinations0 216 sessions 100 12 months - 0 200 sessions 90 12 months 259 86.20

6Assist recapitulate the coaching hours of clinical/community practice

and guest lecturers within the Department0 15 documents 100 12 months - 0 8 documents 90 12 months 219 73.11

7Assist administrate lecturers promotion (entries in SIPEG and SIPKD,

collecting physical evidence)0 37 documents 100 12 months - 0 30 documents 90 12 months 247 82.36

8Prepare materials for Department meetings and distribute the

meeting results0 22 sessions 100 12 months - 0 20 sessions 90 12 months 257 85.64

9 Recapitulate lecturer attendance every month within the Department 0 22 documents 100 12 months - 0 20 documents 90 12 months 257 85.64

10Assist inventory of facilities and infrastructure maintenance within

the Department0 12 sessions 100 12 months - 0 2 sessions 90 12 months 183 60.89

11Report (make midterm and annual reports) the implementation of

duties to superiors as accountability 0 12 reports 100 12 months - 0 12 reports 90 12 months 266 88.67

12 Assist the procurement of goods and services 0 15 sessions 101 12 months - 0 8 sessions 90 12 months 218 72.81

13 Assist on plagiarism check of students' research papers 0 100 students 102 12 months - 0 90 students 90 12 months 254 84.75

1 (additional duty)

(additional duty)

2 (creativity)

(creativity)

79.54

(Good)

GOVERNMENT EMPLOYEE

PERFORMANCE TARGET ASSESSMENT

Depok, 29 Desember 2017Appraisal Officer,

SKP Achievement

Score

REALISATIONNO I. ADDITIONAL ASSIGNMENT ACTIVITIES AK AK

SKP Achievement Score

11

Period

Siti Rohaeti, S.Sos., M.Si196004201990032002

QuantitiyQuantity/Output

CALCULA

TION

TARGET

4 6

II. ADDITIONAL DUTY AND CREATIVITY :

Period

9

Name : Eryanto Hidayat

NIP : 197608182014091004

NoName/NIP and Sign

Appraisal Officer

1 4

1 SKP assessment score until the end of December, 2017 =

80.56 while the assessment of work behavior is

as follow :

Service Orientation = 85.00 (Good)

Integrity = 84.50 (Good)

Commitment = 85.00 (Good)

Discipline = 84.50 (Good)

Teamwork = 84.50 (Good) Siti Rohaeti, S.Sos., M.Si

Leadership = 196004201990032002

Total = 423.5

Average = 84.70 (Good)

RECORD OF GOVERNMENT EMPLOYEE BEHAVIOR ASSESSMENT

Evaluation and Reporting Data

Processor

Date

2

Description

3

January to

December, 2017

ASSESSMENT PERIOD

UNIVERSITAS INDONESIA

1.

a.

b.

c.

d.

e.

2.

a.

b.

c.

d.

e.

3.

a.

b.

c.

d.

e.

GOVERNMENT EMPLOYEE

WORK PERFORMANCE ASSESSMENT

Name


PERSON ASSESSED

NIP

Rank, Group

Position

Organizational Unit

Manager of General Affairs


Name

NIP

Rank, Group

Position

Organizational Unit

Name

NIP

Rank, Group

Position

Organizational Unit

Dr. Rr. Tutik Sri Hariyati, S.Kp., MARS

197111181999032001

Administrator, IV/a

APPRAISAL OFFICER

SUPERVISOR OF APPRAISAL OFFICER

Administrator, IV/a

Evaluation and Reporting Data Processor


Eryanto Hidayat

197608182014091004

Junior Supervisor, II/a


196004201990032002


General Administration

4. TOTAL

1. Service Orientation 85.00 (Good)

2. 84.50 (Good)

3. 85.00 (Good)

4 84.50 (Good)

5. 84.50 (Good)

6. 0.00

423.50

84.70 (Good)

Work Behavior Score 84.70 X 40% 33.88

82.22

(Good)

5. OBJECTION FROM UNIVERSITAS INDONESIA GOVERNMENT EMPLOYEE

ASSESSED (IF THERE IS)

Date ...........................................

80.56 X 60% 48.34a. Employee Performance Target (SKP )

Leadership

ELEMENTS ASSESSED

Integrity

Commitment

Disciplinary

Teamwork

Average

b.

Work Performance Score

Total

Work Behavior

6. APPRAISAL OFFICER RESPONSE

TO OBJECTION

Date ...........................................

7. DECISION OF APPRAISAL OFFICER SUPERVISOR

ON OBJECTION

Date ...........................................

8. RECOMMENDATION

9 CREATED ON JANUARY 5th, 2018

10.

11. RECEIVED ON JANUARY 9th, 2018

197111181999032001

APPRAISAL OFFICER


196004201990032002

RECEIVED ON JANUARY 8th, 2018

GOVERNMENT EMPLOYEE ASSESSED,

Eryanto Hidayat

197608182014091004

APPRAISAL OFFICER SUPERVISOR

Dr. Rr. Tutik Sri Hariyati, S.Kp., MARS

lanek. W.ktu Penllrlin)anuarrr/d D*.nber20r7

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UiIIVERSITAS INDONESIATAHUN 2017

Fatimah

Typewritten text

(Supporting Staff Appraisal Report)

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government employee work performance assessment

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