LAPORAN KUNJUNGAN RUMAH
NOMOR :...................
- Identitas
- Klien
Nama siswa :.............................................
Kelas :.............................................
Agama :.............................................
Alamat :............................................. - Orang tua :
Nama Ayah :.............................................
Pekerjaan :.............................................
Alamat :.............................................
Ibu :.............................................
Pekerjaan :.............................................
Alamat :............................................. - Tujuan Home Visit : Mencari dan menggali Informasi yang berhubungan dengan masalah klien.
- Hasil Wawancara :
- Kebiasaan Belajar klien di rumah
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............................................................................................................... - Aktivitas Klien
di rumah :
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Di lingkungan :
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............................................................................................................... - Kedekatan klien dengan anggota keluarga :
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............................................................................................................... - Apakah klien sering terbuka mengemukakan permasalahanya
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............................................................................................................... - Apakah orang tua pernah memeriksa buku catatan/buku tullis
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............................................................................................................... - Kesimpulan
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- ...............................................................................................................
- Catatan
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Mengetahui Guru Pembimbing
Kepala Madrasah/Sekolah
Kepala Madrasah/Sekolah
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ini untuk guru ya mas ?
ReplyDeleteIya mas, betul sekali
Delete