Corrective and Preventive Action Report (CAPA) Form

 

SEC A-        TO BE FILLED BY THE REPORTING PERSON

Date

Time

Product Name

Batch No

CAPA No

Department

Stage/Process

Reporting Personnel

Designation

Deviation/Non Conformance (Brief Description)

Root Cause Analysis /Investigation

Corrective Action

Responsibility

Target Date of Completion

Actual Date of Completion

Preventive Action

Responsibility

Target Date of Completion

Actual Date of Completion

Document Change

Responsibility

Target Date of Completion

Actual Date of Completion

SEC B-        TO BE FILLED BY QUALITY ASSURANCE DEPARTMENT

Corrective & Preventive Action Review

Corrective Action

Taken

Not Taken

Effective

Not Effective

Preventive Action

Taken

Not Taken

Effective

Not Effective

QA Officer

QA Manager