(受控编号)
CORRECTIVE
CORRECTIVE
CORRECTIVE & & & & PREVENTIVE
PREVENTIVE
PREVENTIVE
ACTION
ACTION
REQUEST
REQUEST
FORM
FORM
(CAPA)
(CAPA)
CORRECTIVE
PREVENTIVE ACTION
ACTION REQUEST
REQUEST FORM
FORM (CAPA)
(CAPA)
CAPA Number
Responsible
Issued Date
Person
Responsible Dept/
Action Team
Office
Issue Severity:
Major
Major
Major
Major
Minor
Minor
Minor
Minor
Observation
Observation
Observation
Observation
Part
Part
Part
Part A:
A: A:
A: Description
Description
Description
Description of of of of Issue
Issue
Issue
Issue
Prepared By
Prepare Date
Client
Received Date
Clarify with client:
Part
Part
Part
Part B:
B: B:
B: Immediate
Immediate
Immediate
Immediate Action
Action
Action
Action
Reference
sample analysis
Shipment/defect
sample analysis
Inspection
report analysis
Factory's
information
Inspector's self-
explanation
Approved By:
Approval Date:
Part
Part
Part
Part C:
C: C:
C: Define
Define
Define
Define and
and
and
and Verify
Verify
Verify
Verify Root
Root
Root
Root Cause
Cause
Cause
Cause ( ( ( ( Office
Office
Office
Office investigation
investigation
investigation
investigation and
and
and
and analysis
analysis
analysis
analysis) ) ) )
Prepared By
Prepare Date
Approved By
Approval Date
Part
Part
Part D: D: D: D: Action
Action
Action
Action to to to to Be
Be
Be
Taken
Taken
(how
(how
(how to to to to reply
reply
reply
client)
client)
Part
Be Taken
Taken (how
reply client)
client)
Prepared By
Prepare Date
Approved By
Approval Date
Responsible By:
Target Date of Completion:
Part
Part
Part
Part E: E: E: E: Corrective
Corrective
Corrective
Corrective Actions
Actions
Actions
Actions and
and
and
and Preventive
Preventive
Preventive
Preventive Action
Action
Action
Action
Prepared By
Prepare Date
Approved By
Approval Date
CCIC
CCIC
CCIC
CCIC Shenzhen
Shenzhen
Shenzhen
Shenzhen Office,
Office,
Office,
Office, 9/F Anlian Building, No.4018 Jintian Road, Futian District, Shenzhen, China Tel: 0755-88286188
Fax: 0755-88286111
-
DO NOT DISCLOSE THIS DOCUMENT OUTSIDE YOUR ORGANISATION WITHOUT CCIC PRIOR WRITTEN CONSENT".