Company Name PT.

Nusantara Medika Utama

AUDIT PLAN

Client Number IA113703

Initial Stage Surveillance Recertification Transfer Special

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Type of Audit

Jl. Hayam Wuruk No. 88, Mergelo, Magersari, Kec. Magersari, Kota Mojokerto,
Sites/Locations to be Audited
Jawa Timur 61318
11-13 January 2024 Time Duration 09:00 – 17.00
Planned Audit Dates(s) e.g. 9am – 5pm

Audit Team & Responsibilities Eko Yulianto

To Conduct Initial Stage-2 Audit & Verify Conformity and Effectiveness of ISO
Audit Objectives
9001:2015 Standard
Audit Criteria and Manual, Procedure, Work Instruction, Records & Related Documents
Reference Documents

Audit Scope Provision of Healthcare Management Company

WQA staff and auditors will keep all client information confidential and shall not disclose any such information to a third party, except
Confidentiality required by law or accreditation bodies as part of our accreditation requirements. All staff and auditors have signed independence,
impartiality, conflict of interest and confidentiality statements.

Date : 11 January 2024 Date : 12 January 2024 Date : 13 January 2024

Mr. Eko Yulianto Mr. Eko Yulianto Mr. Eko Yulianto
TIME DAY 1 TIME DAY 2 TIME DAY 3
06.00 Travelling to SBY from 09.00 Corporate Secretary Activities 09.00 Finance Activities
Halim Airport  Legal Compliance - Treasury, Finance & Tax
 BOD-BOC Support & Corporate - Budgeting & Forecasting
Communication - IT
08.00 Travelling to Mojokerto from
Juanda Airport
09.30 Opening Meeting 10.30 Businness Development &
10.00 Top Management Discussion Marketing Activities
10.30 QMR Activities  Business Development &
Investment
 Marketing
12.00 Break Time / Lunch 12.00 Break Time / Lunch 12.00 Break Time / Lunch
13.00 Strategic Operational 13.00 HC & GA Activities
 Operational & Quality  Strategic HR
Assurance  Operational HR
 HSSE & Risk  General Affair
Management
 Pharmacy & Medical
Equipment Support
15.00 Internal Audit Activities 15.00 Procurement Activities
16.00 Report writing 16.00 Report writing 16.00 Closing Meeting
17.00 End of Audit Day-1 17.00 End of Audit Day-2 17.00 End of Audit

Name Eko Yulianto

EKO
Audit Plan Prepared By
Signature

Date 03 January 2024

The audit plan is flexible enough such as to permit any changes that can become necessary as the on-site audit activities progress.
The audit is based upon a representative sampling method therefore there may be non-conformances within the system that have not been identified during
this audit.

Please inform WQA Ltd if you object to the appointment of the auditor or team members stated in this audit plan prior to the audit date.