8th Medical Services Corrective Action Request Forms
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Transcript of 8th Medical Services Corrective Action Request Forms
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KPA/MR/FM/008:
CORRECTIVE ACTION REQUEST (CAR) FORM
CAR NO.__ 1____OF__4____
DEPARTMENT:
AUDIT DATE: 22ND MAY, 2012 AUDIT NO: KPA/MR/IA/008
Area under review:
Control of monitoring & measuring
equipment
Clause of normative document:7.6 (a) of ISO 9001:2008
Requirement:The organization shall determine the monitoring and measurement to be taken and the
monitoring and measuring equipment needed to provide evidence of conformity of product/service to determine requirements.
Where necessary to ensure valid results, measuring equipment shall (a) be calibrated or
verified, or both at specified intervals, or prior to use, against measurement standardstraceable to international or national measurement standards.
Nonconformity/evidence:Some of the medical measurement equipment at Bandari Clinic are not being calibrated
Signed: Auditor: _______ _____ Auditee ___ ___ __
Category: MAJOR MINOR
Root Cause: (how/why did this happen?):
Correction (fix now) with completion dates:
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Corrective Action (to prevent recurrence) with completion dates:
Signed: Auditee_____________ Auditor ________________
Date of completion __ _
Follow up (to be completed by the auditor):
Action fully completed
Action partially completedNo action taken
Details:
Signed .
Auditor Name Date
Signed .
Auditee Name Date
Effectiveness of corrective action ( to be completed during the next audit by
auditor):
Was the corrective action taken effective? YES NO
Details:
Signed .
Auditor Name Date
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KPA/MR/FM/008:
CORRECTIVE ACTION REQUEST (CAR) FORM
CAR NO.__ 2____OF__4____
DEPARTMENT:
AUDIT DATE: 22ND MAY, 2012 AUDIT NO: KPA/MR/IA/008
Area under review:
Provision of Resources
Clause of normative document:
6.1 of ISO 9001:2008
Requirement:The Organization shall determine and provide resources needed
a) To implement and maintain the quality management system and continually improve
its effectiveness, and
b) To enhance customer satisfaction by meeting customer requirements
Nonconformity/evidence:The ambulances currently in use are not fully equipped for effective medical emergencies
Signed: Auditor: _______ _____ Auditee ___ ___ __
Category: MAJOR MINOR
Root Cause: (how/why did this happen?):
Correction (fix now) with completion dates:
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Corrective Action (to prevent recurrence) with completion dates:
Signed: Auditee_____________ Auditor ________________
Date of completion __ _
Follow up (to be completed by the auditor):
Action fully completed
Action partially completedNo action taken
Details:
Signed .
Auditor Name Date
Signed .
Auditee Name Date
Effectiveness of corrective action ( to be completed during the next audit by
auditor):
Was the corrective action taken effective? YES NO
Details:
Signed .
Auditor Name Date
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KPA/MR/FM/008:
CORRECTIVE ACTION REQUEST (CAR) FORM
CAR NO.__ 3____OF__4____
DEPARTMENT:
AUDIT DATE: 22ND MAY, 2012 AUDIT NO: KPA/MR/IA/008
Area under review:
Infrastructure
Clause of normative document:
6.3 of ISO 9001:2008
Requirement:The Organization shall determine, provide and maintain the infrastructure needed to achieve
conformity to product / service requirements. Infrastructure includes, as applicable
a) Buildings, workspace and associated utilitiesb) Process equipment (both hardware and software), and
c) Supporting services (such as transport, communication or information systems)
Nonconformity/evidence:The multiple cracks within Kipevu Dispensary are both unsafe and dangerous to staffworking within the building and its environs. The issue was raised in a departmental meetingheld on 14th May, 2012 and has been communicated to the relevant authority time and again
but nothing has been done
Signed: Auditor: _______ _____ Auditee ___ ___ __
Category: MAJOR MINOR
Root Cause: (how/why did this happen?):
Correction (fix now) with completion dates:
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Corrective Action (to prevent recurrence) with completion dates:
Signed: Auditee_____________ Auditor ________________
Date of completion __ _
Follow up (to be completed by the auditor):
Action fully completed
Action partially completedNo action taken
Details:
Signed .
Auditor Name Date
Signed .
Auditee Name Date
Effectiveness of corrective action ( to be completed during the next audit by
auditor):
Was the corrective action taken effective? YES NO
Details:
Signed .
Auditor Name Date
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KPA/MR/FM/008:
CORRECTIVE ACTION REQUEST (CAR) FORM
CAR NO.__ 4____OF__4____
DEPARTMENT:
AUDIT DATE: 22ND MAY, 2012 AUDIT NO: KPA/MR/IA/008
Area under review:
Work Environment
Clause of normative document:
6.4 of ISO 9001:2008
Requirement:The Organization shall determine and manage the work environment needed to achieve
conformity to product / service requirementsNOTE: The term work environment relates to those conditions under which work is
performed including physical, environmental and other factors (such as noise, temperature,
humidity, lighting or weather)
Nonconformity/evidence:The excessive noise within the Kipevu Dispensary and lack of running water for the last onemonth makes it difficult for staff working under these conditions to conform to the provisionof quality medical care services
Signed: Auditor: _______ _____ Auditee ___ ___ __
Category: MAJOR MINOR
Root Cause: (how/why did this happen?):
Correction (fix now) with completion dates:
Corrective Action (to prevent recurrence) with completion dates:
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Signed: Auditee_____________ Auditor ________________
Date of completion __ _
Follow up (to be completed by the auditor):
Action fully completed
Action partially completed
No action taken
Details:
Signed .
Auditor Name Date
Signed .
Auditee Name Date
Effectiveness of corrective action ( to be completed during the next audit by
auditor):
Was the corrective action taken effective? YES NO
Details:
Signed .
Auditor Name Date
