B E F O R E K A I Z E N
Improvement identified as on:
Responsibility & Target Date:
Name:
Designation:
Sign: Clause Ref:
Clause Title:
Category:
[ ] Major-I
[ ] Minor-II
[ ] Obs-III Department 0 Need for improvement
0 Change/Amendment
0 Disciplinary Action
0 Customer Feedback
0 Machine Maintenance
0 Internal Audit Finding
0 Incident/Accident
0 Risk Anticipation Program
0 Supplier/Sub-Contractor
DESCRIPTION
ROOT CAUSE
Proven Risk:
IMPROVEMENT ACTION AFTER KAIZEN Receiver’s’ Signature:-
CORRECTIVE ACTION
ACTION TO STOP RE-OCCURRENCE PREVENTIVE ACTION
ACTION TO AVOID POTENTIAL OCCURRENCE
Steps Responsibility ETC Steps Responsibility ETC
Follow-up / Remarks on IAR Frequency:
1st Follow-up by:
Scheduled on: 2nd Follow-up by:
Scheduled on: 3rd Follow-up by:
Scheduled on:
Remarks:
Sign:
Remarks:
Sign: Remarks:
Sign:
