Title Page
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RCA #
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Corrective Action Preventive Action
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Complaint / non-conformity : notice & issue date
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By email
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By phone / chat
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By inspection (FRI / dupro)
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Customer representative
COMPLAINT / NON-CONFORMITY
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SKU#, item code, item type
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Reference : PO/Batch/RPO#, item name-description & quantity
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Discrepancy / non-conformity description
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Defect classification of non-conformity
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Picture & video attachment
CONTAINMENT & CORRECTIVE ACTION
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Where is the non-conformity found? How many quantity?
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Area where defect found :
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What has been put in place to stop the non-conformity?
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PIC & team corrective action
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Timeline (due date) & status
ROOT CAUSE ANALYSIS
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Fishbone diagram :
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As determined 4 factors in fishbone diagram, what is possible cause of non-conformity?
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Man power ?
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Material ?
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Machine ?
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Method ?
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5Why possible main/basic cause :
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As determined by the 5Why, what is the basic root cause of Man power non-conformity?
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Why-1?
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Why-2?
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Why-3?
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Why-4?
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Why-5?
PREVENTIVE ACTION
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Has one point lesson been written ? (Apakah point peringatan sudah dibuat?) If No, What is the other solution? (Jika tidak, Apa solusi lain?)
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PIC & team / time line (due date) / Status
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Has the standard, procedure, work instruction been created, review or updated? (Apakah standard, prosedur, instruksi kerja sudah dibuat, direview atau diperbarui?) If No, What is the other solution? (Jika tidak, Apa solusi lain?)
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PIC & team / time line (due date) / Status
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Have trained, socialization the new or updated standard, SOP, WI? (Apakah sudah ada training, socialization standard, SOP, Instruksi baru?) If No, What is the other solution? (Jika tidak, Apa solusi lain?
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PIC & team / time line (due date) / Status
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Have confirmed to team involved? (Apakah sudah konfirmasi ke team terkait?)
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PIC & team / time line (due date) / Status
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Have the results and improvements been communicated to all affected persons? Apakah hasil dan perbaikan telah dikomunikasikan kepada semua bagian yang terkena dampak?
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PIC & team / time line (due date) / Status
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If the answer is YES and DONE to all of the above in this section, the RCA-CPA is ready to be closed.
COMPLETION & VALIDATION
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Verified QC Manager : ARDHIAN P.
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QA Manager : PRANOWO I.
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Production Manager Unit-1 : M. KARTONO
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Production Manager Unit-2 : AMBANG DJENDRA
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PPIC Manager : M. AGUS
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General Manager : AGUS SANTOSO LAUW
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This report is valid without signed.
