Schlosser Forge - Corrective Action Request Form

Open Date: Response Due Date: Corrective Action Category Finding: Dept: Assigned To: CAR/SCAR# Dept # Cause 'n Correction a Repeat Yes No

ATTACHMENTS: Root Cause Investigation:

Tools required to be used: Immediate Corrective Action:

Tool Used

Fishbone

5-Why's

Yes Containment of Problem Long Term Corrective Action:

No

Other Jobs affected

Yes

No

Mistake Proofing Completed By:

Level 1

Level 2

Level 3

Type 1

Type 2 Date: Date: Y N Accept Reject:

Accept

Review Approved By: (Supervisor/Manager) Supervisor Follow up action complete? (Supervisor Tab)
Proposal Date? Follow-Up Date: Reviewed by: Follow-Up By:

Date:
Date:

Reject:

Follow-Up Results:

Customer Notification Required: Y

Customer Notified Name:

Date:

F14.1 Rev. I

Date Closed

Corrective Action Request Form Instructions

Step 1 Step 2 Review the Finding within the Finding box of the Cause 'n Correction CAR Form Determine Root Cause 2 charts are provided to aid in the investigation of the Root Cause. Fishbone 5 - Why's If SFC deems that the Fishbone or 5 Why chart is required, that particular box will be marked accordingly on the CAR form Charts will be require when the "Tools required to be used" block has: 1. Rejection 2. Repeated 3. Escape 4. Lateness Step 3 Immediate Corrective Action Explain what type of immediate action was taken to correct problem. Was the problem contained Step 4 Long Term Corrective Action Explain what actions were taken to prevent problem coming back into the system. Mistake Proofing (Check the appropriate box) Level 3Prevents Continuance - Good Prevents a defect from going to the next operation or the Customer Warning Devices - Better Detects the error as it is being made - Control Charts, Buzzers, Lights, Alarms that require Human response. Physical Devices - Best Prevents error occurring at the source - Y/N - Y/N Were there any other job with the same problem

Schlosser Forge Company

Level 2-

Level 1-

Any actions that were taken to prevent the problem are to be completed within 30 days Step 5 Step 6 Step 7 Step 8 Step 9 Type in the name of the person completing the CAR, within the "Completed By" box Type in the Date of when the CAR was completed within the Date Box. Supervisor or Manager's name that reviewed the CAR, is required, complete the "Review Approved By" box Type in the Date of when the CAR was reviewed within the Date Box. After the corrective action(s) have been put into place (30 days) the Supervisor is to complete the Supervisor's Follow Up Action Form within 5 days and turn it into Quality

Step 10 Quality will perform a follow up audit for verification of corrective action(s) taken.

Supervisor's Follow Up Actions

Step 1 Step 2
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Supervisor Follow Up Actions form

Complete: Date field, Department field and Supervisor field. Answer questions 1-5, 7,9-12 by providing a Y/N answer within the shaded areas. Provide a brief explanation for questions 6,8, 9 & 13
Instructions

Schlosser Forge Company

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Instructions

Schlosser Forge Company

s form

F14.1 Rev I

Instructions

Schlosser Forge Company

F14.1 Rev I

Instructions

Corrective Action Request

Cause 'n Correction # 70745678.xls.ms_office Date: Department: Supervisor: Root Cause Analysis (RC): Do not accept 'OPERATOR ERROR" as the RC of the problem! Is the RC of the problem Identied? 1 Does the RC statement Identify an element or a process? 2 Is this Non Conformance (NC) a direct result of another quality problem? 3 Could this NC create another problem somewhere else? 4 Correction: Immediate Actions Taken What action will be taken for immediate containment to correct the NC ? 5 6 If product is suspect, what action will be taken?
Describe:

Corrective Action: must be something concrete and not a simple "CAUTION THE OPERATOR" Does correction of the RC identified ensure that the problem will not recur? 7 8 What action is being taken to correct the deficiency which prevented the NC from being
identified? Describe:

What action(s) is planned to correct and prevent recurrence of the RC deficiency? Describe:

Has the implementation of the proposed corrective actions taken place. 10 Was there Training involved? If Yes, provide a copy of the Training 11 Was there Quality Points issued? If Yes, provide a copy of the write up 12 Mistake Proofing 13 What type of mistake proofing was put into effect: Describe:

F14.1 Rev I Supervisors Follow Up Actions

Fishbone Diagram
Methods Materials Other

Cause 'n Correction # 70745678.xls.ms_office

Manpower

Equipment

Environment

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Fishbone Chart

Fishbone Diagram

Cause 'n Correction # 70745678.xls.ms_office

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Fishbone Chart

5 Why Chart
Non Conformance Statement

Cause 'n Correction # 70745678.xls.ms_office

WHY

WHY

WHY

WHY
Root Cause WHY

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5 Why Chart

5 Why Chart

Cause 'n Correction # 70745678.xls.ms_office

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5 Why Chart