Inspection

Corrective Action Report

Principal Investigator

Details of Non-Conformity Identified

Add photo evidence of deficiency if applicable

Reference

Response to deficiency

Corrective Action Plan

Describe corrective action

Risk Matrix Reference

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Consequences

Likelihood

Risk Rating

Additional comments

Timeline of Implementation

Signature of Auditor
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.