DOC.

NO :
CORRECTIVE & PREVENTIVE ACTION
REV. NO :
REPORT
DATE(Rev.) :
8 D No. Issued By Complaint For Sample Received
Supplier Complaint Date Lot Size
Part Name : SRV Rejection Date
Part Number : LINE Rejection M.Doc No.
D-1 C. Team
Name Department Designation Contact No.

D-2 PROBLEM DEFINITION (Attach Photographic details of failure, Attach Trend data, Pareto analysis, Warranty etc) Photo / Sketch ( If Possible)

Process Outline (Highlight The Process in which problem is identified)

D-3 CONTAINMENT ACTION / SHORT TERM ACTION (Within 1 day after receiving part/photos)
Actual Implementation
S. No. Action (s) Responsibility Target Date

D.4-ROOT CAUSE ANALYSIS - WHY ~ WHY .. ANALYSIS (Ishikawa diagram-Cause & Effect) within 2 Days after Containment Action

Man MACHINE

Problem :-

Material Method

S. No. Potential Causes Identified Verification Date Significant Non Significant

S. No. WHY-1 WHY-1 WHY-2 WHY-3 WHY-4 WHY-5

Occurrence

Flow Out

D-5 CORRECTIVE ACTIONS / LONG TERM ACTION (Attach Photographs of actions taken)

S No. Root Cause Identified Corrective Action To be Implemented Responsibility Target Date Impl. On Remarks

D-6 Implement And Validate Corrective Action

S. No. Corrective Actions Implemented Validation Date Remarks

D-7A Action Taken to Prevent Reoccurance & Horizontal Deployment (If Applicable)

S. No. Description Yes No Responsibility Target Date Implemented

1 Poka -Yoke
2 Horizontal Deployment

3 Fixture Modification
4 Any other Engineering Change
AttachEvidence/List if any
7B Standardization of Corrective and preventive Actions Implemented
S. No. QMS Document P if Yes Responsible Planned Date Actual Date Status
1 Control Plan
2 Process check sheet
3 Process Flow Diagram
4 DFMEA/PFMEA/PPAP

8A PROBLEM CLOSURE & SIGN-OFF

SUPPLIER MANAGEMENT VERIFICATION & CLOSURE

Sign

Date

Name

Designation

8B LOT EFFECTIVENESS MONITORING

Lot Date

Lot Status

MANAGEMENT VERIFICATION & CLOSURE WITH ALL SUPPORTING DOCUMENT ATTACHED

Sign

Date

Name

REVIEWED VERIFIED APPROVED