AFRICA Q-HSE DEPARTMENT
Improvement Action Form
QUA-F-0028 Rev 03
Branch: Form Number: Activity:
Identification
Concerned process: Date: Action Type: Origin:
Finding:
Please estimate / Describe the benefits resulting of the resolution of the deficiency (claim, time, avoided mistakes, etc…): In case of a non-conformity, describe the immediate actions taken:
Person in charge: Realization date: Signature of Q-HSE Coordinator:
Cause analysis
Tick the concerned item(s): Cause analysis Proposed actions
Methods N° Proposed solutions Person in charge Deadline
Manpower - Training
Mother Nature - Environment
Machines - Equipment
Materials - Products
Management
Others
Validation
Checker's name: Date and Signature: Efficiency Acceptability criterias
Yes No
Action N°: