National Irrigation Administration

Quality Management System

RFA No. _______
REQUEST FOR ACTION
This section to be accomplished by the IQA Auditor or Initiator

ISSUED TO: (Office/Department/Division/Section/Unit) OFFICE ADDRESS: ISSUANCE DATE:

SHADE THE APPROPRIATE OVAL

NATURE OF RFA: RFA ISSUED AS A RESULT OF:
NC (Nonconformity – Non-fulfilment of a Internal Quality Audit Follow-up Audit
requirement.)
Service Provision Service Realization
OFI (Opportunity for Improvement – Statement of
fact or condition that does not signify a failure in the Customer Feedback Customer Satisfaction Survey
system but needs to be addressed.) Others (please specify) ________________________________________________________
REQUIREMENT: (customer; legal including government rules; ISO 9001 clauses; policies, procedures, manuals, project contracts, etc. Put specific clause or
reference number, as applicable) Section 5 of EO No. 6, stating that “a citizen’s concern lodged through any of the communication channels shall have a
concrete and specific action within 72 hours from the receipt of the concern by proper agency or instrumentality

DESCRIPTION OF THE NONCONFORMITY/OFI: SOURCE OF INFORMATION:

Interview
Observation of activities
Documented Information
External sources (e.g. customer feedback, survey measurements)
Databases and websites
Simulation and modelling
INITIATED BY: VERIFIED BY: ACKNOWLEDGED BY:
(the one who issued the RFA) (IQA Team Leader/Immediate Superior) (Head of the Office/Department/Division/Section/Unit of Auditee)
Accept
Does not accept. RATIONALE: __________________________

Signature over Printed Name/ Signature over Printed Name/ Signature over Printed Name/
Date signed Date signed Date signed
This section to be accomplished by the Auditee once the RFA has been accepted.
ROOT CAUSE ANALYSIS:

NIA-QPR-Form10 Rev.02
 MANPOWER
(i.e. competency, availability
health and or behavior of
personnel, employee or
outsourced service provider)
MACHINE MATERIALS METHOD ENVIRONMENT
(i.e. availability and suitability of (i.e. availability and suitability of (i.e. efficiency, effectiveness, (i.e. suitability of human,
equipment including hardware raw materials, indirect availability, suitability including physical, social and
and software, parts, accessories, materials) approval of procedures, policies) psychological factors)
transportation resources,
information and communication
technology, infrastructure)

AGREED ACTION/S:
Immediate Correction/s: (Band-aid solution or short-term action/s to be taken immediately to eliminate detected NCs/OFIs) Target Implementation
Date: (When will you take
action?

Corrective Action/s: (Long-term action/s that will address all root causes of NCs/OFIs. This will ensure the non-recurrence or Target Implementation
non-occurrence of NCs/OFIs) Date: (When will you take
action?

Prepared by: Approved by:

Signature over Printed Name / Date signed Signature over Printed Name / Date signed

This section to be accomplished by the IQA Auditor or Initiator

EVALUATION OF EFFECTIVENESS OF THE CORRECTIVE ACTION TAKEN

Corrected CLOSED Date CLOSED-OUT:

Not corrected OPEN Date EVALUATED:

Follow-up comments: Date EVALUATED:

NOTE: *Please accomplish the RFA completely within ten (10) working days upon receipt.

NIA-QPR-Form10 Rev.02
NIA-QPR-Form10 Rev.02