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Root-Cause Analysis Template

Inspection

Root-Cause Analysis

Issue Details

Date issue reported

Brief description of the issue

Rate the impact to productivity

Possible Root Cause

List potential reasons why the issue happened

CAUSE

Brief description of a cause

Rate probability as the root cause

What is the root cause of the issue?

Categorize the root cause of the issue

Equipment
Process
Organization
Environment
Lack of communication
Incorrect information
Non-conformance
Other

Prevention Strategy

Solution to be implemented

Estimated cost

Are there special considerations?

Are there incidental findings to be reviewed for corrective action?

Completion

Full Name and Signature of RCA Team Leader

List RCA Team Members

MEMBER

Full Name and Signature

Root-cause Analysis Template Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 394

Use this root-cause analysis template to analyze a recurring problem and help eliminate the root causes. Begin by describing the issue and its impact. Next, list potential reasons why the issue happened and identify the root cause and take/attach photo evidence for verification. Provide a prevention strategy and recommend solutions before completing the RCA template with digital signatures.

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