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Corrective Action Record (CAR) Form

CAR ID: CAR-[YYYY]-[XXX]
Date Initiated: [YYYY-MM-DD]
Associated Incident / Audit: [Link to INC-XXX or Audit Record]
Responsible Lead: [Name / Role]
Target Resolution Date: [YYYY-MM-DD]
Status: OPEN | IN REMEDIATION | VERIFIED | CLOSED

1. Problem Statement & Deficiency Summary​

Provide a concise description of the observed defect, procedural failure, or compliance deficiency.

2. Root Cause Analysis (5 Whys)​

  1. Why did the issue occur? [Answer]
  2. Why? [Answer]
  3. Why? [Answer]
  4. Why? [Answer]
  5. Why (Root Cause)? [Core systemic failure]

3. Corrective & Preventative Action Plan​

Action ItemAction TypeAssigned OwnerDue DateVerification Evidence
1. Update SOP documentationCorrectiveLead[YYYY-MM-DD]DCR Link
2. Implement automated guardrailPreventativeSystems[YYYY-MM-DD]GitHub PR / Config
3. Retrain team membersPreventativeHR / Ops[YYYY-MM-DD]Training Log

4. Verification of Effectiveness & Closure​

  • Verification Date: [YYYY-MM-DD]
  • Verification Method: [Independent audit, workflow test, or peer review]
  • Effectiveness Confirmed: [ ] Yes [ ] No
  • Approver Signature: ___________________________ • Date: [YYYY-MM-DD]