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Sample - Corrective Action Request Form

This document is a corrective action request (CAR) from an audit that found issues with a company's products, processes, or systems. The CAR describes the non-conformity in detail, including the quality or food safety standards violated. It requires the company to provide immediate corrections, a root cause analysis, and a long-term action plan to prevent recurrence. The auditor will follow up to ensure the actions were effective at resolving the problem. If not, the company must revisit the root cause analysis and enhance their corrective actions until compliance is achieved.

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boyet
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© © All Rights Reserved
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Download as XLSX, PDF, TXT or read online on Scribd
3K views

Sample - Corrective Action Request Form

This document is a corrective action request (CAR) from an audit that found issues with a company's products, processes, or systems. The CAR describes the non-conformity in detail, including the quality or food safety standards violated. It requires the company to provide immediate corrections, a root cause analysis, and a long-term action plan to prevent recurrence. The auditor will follow up to ensure the actions were effective at resolving the problem. If not, the company must revisit the root cause analysis and enhance their corrective actions until compliance is achieved.

Uploaded by

boyet
Copyright
© © All Rights Reserved
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
You are on page 1/ 4

HMA Corporation

1234, Whereroad, Whereplace, Neverland

CORRECTIVE ACTION REQUEST (CAR)


Doc No: __________
Rev 0, Issue 1

CAR Control No. Type of Non-conforminty (please mark):


Date Product
Initiated by Process
Section/ Department Audit (internal)
Record path Audit (customer)

Return to initiator on: Audit (third party)

I. Description of Deficiency: Minor Major Serious


Non-conformance Statement (Overview of the finding and evidences seen):

Violated Quality and Food Safety Standard(s): Legal, Customer, ISO, BRC, IFS, etc.

Corrections for the obvious cause (Immediacte actions to regain control and containment to eliminate the detected non-conformity). Root
cause not needed.

Corrections/ Containment plan Responsible Time Frame

Root Cause Analysis (to be accomplished by the auditee): Method:


Element Root Cause(s) Prioritization

Man
Method
Machine
Material
Environment
Time
Others
If applicable: Potential Effect of Deficiency (Other problems that may happen as a result of the existing NC)

Auditee: Auditor:
II. Action Required to correct the problem and/ or prevent its recurrence (to be completed by auditee or process owner):
Implementation
Countermeasures (CM)/ Corrective Action Responsible
Date

Page 1 of 4
Date Completed: Auditee: Auditor:
III. Follow-up required to confirm that action has been taken and is effective:
Monitoring of effectiveness
Months of Quantifiable Improvement
Monitoring recurrences Rate
Remarks (Is the desired improvement and effectiveness indicator achived?)

Date finalized : Signed (Auditor):


Signed (Auditor):
CAR Closed on:_________________________ Management Review/ Verification (Remarks, if
(can only be closed if the applicable):
desired effectiveness level is achieved. If effectiveness level is not achieved, revisit and enhance
the root-cause and corrective actions. Summarize the enhancements made below.):

Corrective Action Enhancements (date: ____________)

(Applicable only if the result of the review revealed that the effectiveness level is not achieved)
Element Root Cause(s) Prioritization

Man
Method
Machine
Material
Environment
Time
Others
Implementation
Countermeasures (CM)/ Corrective Action Responsible
Date

Signed (Auditor):
CAR Closed on:_________________________ Management Review/ Verification (Remarks, if
(can only be closed if the applicable):
desired effectiveness level is achieved. If effectiveness level is not achieved, revisit and enhance
the root-cause and corrective actions. Summarize the enhancements made below.):

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ease mark):
Legal
Customer
KPI
Design (R&D)
Others
Critical

ed non-conformity). Root

Implementation
verification

Approved by
Management?

f the existing NC)

cess owner):
Effectiveness
Indicator

Page 3 of 4
ndicator achived?)

Verification (Remarks, if

eved)
Approved by
Management?

Effectiveness
Indicator

Verification (Remarks, if

Page 4 of 4

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