Corrective Action Effectiveness Check (Free)

Form – Corrective Action Effectiveness Check

Closing a CAR because the actions are ‘done’ is only half the job. The effectiveness check comes back later and asks: did the problem actually stay fixed? This form structures that second look.

Be specific and honest in every field; vague records help nobody during an investigation. If a field doesn’t apply, write N/A rather than leaving it blank.

1. Document control

1. Reference

• CAR no.: | Original nonconformance: [summary]
• Linked NCR/deviation no.:
• Original root cause (summary):
• Actions taken (summary):
• Date actions completed: [YYYY-MM-DD]
• Effectiveness check due date: [YYYY-MM-DD]

2. Effectiveness check

Leave enough time for the problem to recur if it’s going to – checking the day after the fix proves nothing. Three months of clean data beats three days of good intentions.

• Check method: [Re-audit / record review / data trend / observation]
• Period reviewed: [from] to [to]
• Evidence examined:
• Data sources reviewed:
• Sample size:
• Has the nonconformance recurred? [Y/N – details]
• Have similar issues appeared elsewhere? [Y/N – details]
• Data trend attached? [Y/N – ref]
• Interviews conducted? [Y/N – who]

3. Verdict

• Verdict: [Effective – close CAR / Not effective – continue]
• If not effective: further action required: | New due date:
• Re-check date: [YYYY-MM-DD]
• Reported to management review? [Y/N]
• CAR file location:
• Checked by: [Name / signature / date]
• QA approval: [Name / signature / date]

Approval and control

Keep completed forms for Retain with the linked CAR. at [defined location] – and make sure someone besides you knows where that is.