Issue date: 20/3/2021
RCA#_02____ Complaint No.
Last update: NA
Doc nr. EA/QA/FMT/014.01 Root-Cause Analysis "RCA" Worksheet Revision: 0
Department: Area: Equipment: Led by : Date initiated: Date closed:
1. Define the problem & Impact (Plan) 4. Implement solutions (Do)
On time
Problem Definition: Problem Impact (KPI's) Corrective Actions By Who Target date Closed on Status completion
(y/n)
2. Analyze the problem (Plan) Preventive action By Who Target date Closed on Status Status
Man Method Machine
5. Evaluate results (Check)
Results:
Validation comments: Designated area for Shift FG storage
6. Learning's & Replication (Act)
Learning's/Opportunities for Replication:
Material Mother Nature Other
3. Determine the root cause (Plan) 7. RCA Closure & Sign-off (Act)
5 whys - Cause 1 5 whys - Cause 2 RCA Team: Sign-off RCA Communication
Production √
Why . . .
Why . . . ? Maintenance
?
QA √
Why . . .
Why . . . ? Warehouse √
?
Store & purchase □
Why . . .
Why . . . ? Area Owner: Nishant Kumar Safety
?
Why . . .
Why . . . ?
Why . . .
Why . . . ?
?
CAPA#_____ Complaint No.
CAPA Format
Doc nr. EA/QA/FMT/014 Rev.00
Department: Area: Equipment:
Team Members:
Problem Definition:
Root Cause:
Responsible
Corrective Action: Target Date
Person
Responsible
Preventive Action: Target Date
Person
Prepared By: Approved By: