5S CORRECTIVE ACTION REPORT
Format No.:
STARTING DATE C.A.REPORT.NO.
DETAILS OF CORRECTIVE ACTION LEADERS & TEAM MEMBERS
NON CONFORMITY / AREA - IMPROVEMENT
DETAILS
PRESENT STATUS
TARGET / TARGET DATE
QUESTIONS:
1. Do we have standardized system for this ? Yes / No
2. If Yes Mentioned the system :
3. No the go for Why why Analysis mentioned bellow.
1.
Pareto Analysis results ( if required)
2 5 Why - Why Why analysis
*** You can add questions as your requirements.
ROOT CAUSE (S)
Target date of Actual date of
Corrective action: Responsibility
completion completion
Horizontal Deployment / Preventive Responsibility Target date of Actual date of
Action completion completion
Document change : Responsibility Target date of Actual date of
completion completion
Verification of Evidences Verified By
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