Level 4 Document Title: Corrective Action Form Page: 41 of

49
Doc Ref:
FZL–QMSKBP05F1
Prepared by: PM Revision Date Issued:
No.: 01/06/2022
Approved by: MD 0

NC Raised by:……………………… Department/Process:………………………..

Date Raised:…………………………. NC Ref. No…………………………………….

Please Tick Internal Process or Customer
Appropriate Audit Service/Produc Complain
t t

A.1 Nature of Nonconformity (Give Objective Evidence)

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ISO 9001:2015 Clause/s:…………………………………………….
A.2 Immediate Action (Correction) By:……………………………………
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B.1 The 5 Whys Tool
Adverse effects Reason?
1. Why did the NC occur?

2. Why did this occur?

3. Why did this occur?

4. Why did this occur?

 5. Why did this occur?

B.2 Analysis of Historical Data & Experience

Do You Have Any Previous Experience/s? (If YES GIVE DETAILS) e.g. when it
happened, what was the impact e.g. cost, quantity etc. How was it resolved?
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B.3 Root Cause/s
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C.1 Agreed Corrective/Preventive Action/s
Action/s By Whom By When
1.

2.

C. 2 Checking for Effectiveness of Action/s Taken

Action/s Checked by Date Effective
Yes No

Comment/s (If any)

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Signature:………………………… Date Verified :……………………………………