| ( Observasi Dokumen Perangkat Pembelajaran ) |
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| Nama Guru | : …………………………………………………………… |
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| NIP |
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| Nama Sekolah | : …………………………………………………………… |
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| Guru Mata pelajaran | : …………………………………………………………… |
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| No. | Jenis Dokumen | Nilai *) | catatan |
| 4 | 3 | 2 | 1 | 0 |
| 1 . | Standar Isi dan SKL | | | | | | | |
| 2 . | Kalender Pendidikan |
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| 3 . | Analisis pekan- Hari efektif | | | | | | |
| 4 . | Program Tahunan |
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| 5 . | Program Semester | | | | | | | |
| 6 . | Silabus |
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| 7 . | Rencana Pelaksanaan Pembelajaran ( RPP ) | | | | | | |
| 8 . | Bahan Ajar |
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| 9 . | Lembar Kerja Siswa | | | | | | | |
| 10 . | Jadwal Mengajar |
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| 11 . | Agenda Guru ( Pelaksanaan Pembelajaran ) | | | | | | |
| 12 . | Buku Daftar Hadir Siswa |
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| 13 . | Analisis Penetapan KKM | | | | | | | |
| 14 . | Kisi-kisi Soal Ulangan |
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| 15 . | Istrument Penilaian ( Soal Ulangan ) | | | | | | |
| 16 . | Buku Daftar Nilai Siswa |
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| 17 . | Analisis Hasil Evaluasi Hasil Belajar Siswa | | | | | | |
| 18 . | Program Tindak Lanjut (Remidial dan Pengayaan ) | | | | | | |
| 19 . | Program dan Jadwal Kegiatan Eskul ( Mapel ) | | | | | | |
| 20 . | Buku catatan Supervisi | | | | | | | |
| | JUMLAH SKOR | | | | | | | |
| | N I L A I | | | |
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| *Kriteria Nilai : 4 : Amat Baik, 3 : Baik , 2 : Sedang, 1 : Kurang, 0 : Kosong |
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| A | 91 - 100 Amat Baik |
| Jakarta, …………………………… |
| B | 76 - 90 Baik |
| Penilai |
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| C | 61 - 75 Cukup |
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| D | 51 - 60 Sedang |
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| E | > 50 |
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| ……………………………………………………. |
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| NIP. |
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