FSMS CORRECTIVE ACTION REQUEST

COMPANY NAME: PT PERKEBUNAN NUSANTARA VIII – MALABAR FACTORY DATES OF AUDIT: 04 April 2019

COMPANY REPRESENTATIVE: Mr. Dodi Kusumah LEAD AUDITOR: Khairil Anwar

(khairil.anwar@sgs.com)

Minor Non-conformities

Date to Complete
Number Clause Details of Non- Conformance Cause Planned Actions / Corrective Action
Action
1. 8.4.3 Evaluation of verification analysis for
control measure was not effectively
controlled, since it has observed that
several record was not fully completed to
ensure an effective operation of food
safety management system, e.g. - Inconsistency in - Holding up training for ‘petugas
- Type and interval of pesticide usage April 5th 2019
checking ‘SP timbang’ in order to increase the
was not properly recorded during Pucuk’, awareness of controlling CCP I
incoming of tea from afdeling Malabar especially in recorded in ‘SP Pucuk’.
Selatan, i.e. block 07 (puncak mala) checking CCP I
incoming date on 26/2/2019, block 9 (pesticide used)
(Gambung) incoming date on by ‘petugas
9/1/2019, timbang’.

- Record of inlet drying temperature - Lack of precision

was not recorded as actual process, - Reinputting data properly and holding April 5th 2019
from Mandor up enlightenment for Mandor
i.e. During audit (04/05/2019), there Pengeringan in
was found no monitoring record for Pengeringan and also verifying data
filling ‘monitoring by Asisten Pengolahan.
temperature and drying time of VFBD pengeringan’ in
02 while production was begin in 2 inputting data for
am (4/4/2019) and it also found that column. The data
no drying time for TSD 03 should have
Note: moisture content test result was been written in
periodically performed and still found column VFBD
standard range (max. 3%) 02, but in
‘monitoring drier’
it is written in
TSD 03 which is
not used.
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2. 7.2.3 During audit, PRP implementation was

not effectively controlled, e.g.
- Found no water supply for hand - Found blockage - Taking off the blockage in water - April 4th 2019
washing station before entering which causes instalation
production area. water supply
stopped
- Cleaning tools was temporary stored - Lack of discipline - Holding up englightenment about the - April 5th 2019
inside of product contact container by workers in danger of contamination to all
(bolotong) anticipating workers in order to increase the
danger of awareness and discipline in handling
contamination cleaning activity.
from the cleaning
tools used.

Major Non-conformities

Cause Detail of action

Number Clause Details of Non- Conformance Planned Action Date Reviewed
completed/evidence reviewed
N/A

Critical Non-conformities

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 FSMS CORRECTIVE ACTION REQUEST

Cause Detail of action

Number Clause Details of Non- Conformance Planned Action Date Reviewed
completed/evidence reviewed
N/A

CLIENT ACCEPTANCE OF NON-CONFORMITIES

NAME:Mr. Dodi Kusumah POSITION: ADM SIGNED: DK DATE: 05/04/2019

AUDITOR CONFIRMATION THAT NON-CONFORMANCES NAME: Khairil Anwar SIGNED: KHA DATE: 05/04/2019
DISCUSSED AND ISSUED AT THE CLOSING MEETING

CORRECTIVE ACTION PLAN REVIEWED AND ACCEPTED BY: NAME: Khairil Anwar SIGNED: KHA DATE:

NOTES
Nonconformities detailed here shall be addressed through the organization’s corrective action process, in accordance with the relevant corrective action requirements of the
audit standard, including actions to analyse the cause of the nonconformity and prevent recurrence, and complete records maintained.

Corrective action plans for closure of the non-conformities shall be provided within 14 days of the audit.
All timings for corrective action plans, evidence and site visits are given in calendar days from the last day of the audit.

The following action is applicable to the non-conformances detailed in the table:-

CRITICAL at initial: Certification shall not be granted until a full re-audit is completed
CRITICAL at any other audit: Certification shall be suspended until a full re-audit is completed
MAJOR at initial/renewal: Certification/recertification shall not be granted until evidence of corrective action taken has been verified as effective.
MAJOR at all other audits: The Auditor shall decide whether documentary evidence is adequate to demonstrate if the Major has been closed or if an on-site visit is required.
A corrective action plan shall be provided within 14 days. The evidence of closure or site visit will be made within a further 14 days. Majors that are not closed within 28 days
will be escalated to Criticals and certification shall be suspended.
MINOR: A corrective action plan shall be submitted to the auditor within 14 days. If the actions are acceptable they will be verified as effective at the next scheduled visit

THE AUDITOR MUST INFORM THE CERTIFYING OFFICE OF ALL CRITICAL NON-CONFORMITIES WITHIN 24 HOURS OF THE AUDIT

DETAILS OF THE NON-CONFORMITY: i.e. what was found that concluded a non-compliance with a clause of the standard. (To be completed by the auditor in
English or audit language with English translation) Objective evidence of the non-conformity must be provided e.g. document name, visual evidence
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CAUSE OF NON-CONFORMITY i.e. determining the cause of the non-conformityTo be completed by the client (in English or audit language with English translation)
CORRECTIVE ACTION PLAN i.e. to propose appropriate corrective action toclose the non-conformityTo be completed by the client (in English or audit language
with English)
For re-certification audits the time scales indicated may need to be reduced in order to ensure re-certification prior to expiry of current certification.
At the next scheduled audit visit, the SGS audit team will follow up on all identified nonconformities to confirm the effectiveness of the corrective actions taken

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