Supplier Corrective Action Report Form
General Information
Supplier Name & ID Number
Supplier Representative Name & Email Address
Part Name & Number
Quantity Rejected
Description of the Problem
Investigation for Root Cause
Did you go to the place where the work is performed and review the process (gemba)?
Did you review work instructions and procedures?
Did you talk to employees involved with this process?
Is the requirement adequately defined and documented?
Have any changes been implemented around the time of this defect for process(es) related to this defect?
Is tooling & fixtures, process sequencing, and storage/handling of material complete?
Direct Cause
What is the root cause for the technical problem that caused the nonconformity?
Detection Cause
How did the non-conformance escape the process? Why did the quality system fail to detect the non-conformance?
Systemic Cause
How did the product development/production/support processes contribute to the problem?
Has the root cause identified a fundamental breakdown or failure of a process?
Has the element of the process that caused the root cause been corrected?
Permanent Corrective Actions & Recurrence Prevention
Activity Type
Detailed Description of Corrective Action
Name & Title of Person Responsible
Expected Completion Date
Objective Evidence after Completion
Completion
Additional Comments
Quality Manager Name & Signature
