Document Code

DILG REGION 10 – Northern Mindanao FM-SP-R10-04-01

CORRECTIVE ACTION REPORT Rev. No. Eff. Date Page
01 06.10.17 1 of 3

CAR NO: DATE OF ISSUANCE: July 26, 2019

PROCESS: Procurement of Goods,
OFFICE/DIVISION: DILG-Bukidnon Provincial Office Infrastructure and Consulting Services (QP-
R10-FAD-33)
A. BASIS: (Please check (√) the appropriate box)
NON-AUDIT-RELATED :
Unmet target / objective Others
AUDIT-RELATED:
Nonconformity (NC)
B. STATEMENT OF NONCONFORMITY:

Deviation from the written procedure as against the actual relevant key activities and practices.
Steps 1, 4 and 5 are not totally followed in the conduct of procurement. (Clause 4.4)

ISSUED BY: REVIEWED BY: ACCEPTED BY:

REZZA MAE B. TOLINERO MARIA PAMELA D. BENITEZ CARMELO ENRIQUE B. LIBOT, CESO V
Signature over Printed Name of QMS Head
Signature over Printed Name of QMS Head Signature over Printed Name of concerned
Secretariat/Deputy QMS Secretariat Leader
Secretariat Team Leader/Deputy QMS Deputy QMR/OIC Head of Office (OHOO)
for Non-audit Related or RIQA Head/Team
Secretariat Member for Non-audit Related Date
Leader for Audit Related/ Date
or IQ Auditor for Audit Related/ Date
C. CORRECTION/IMMEDIATE ACTION (C/IA): (Items C and D must be accomplished and submitted by the Process Owner to
the Deputy QMR/OHOO, 3 days upon receipt; CAR must only stay with the Deputy QMR/OHOO for 3 days, for confirmation)

D. Potential/Actual Consequence(s), if any Planned Action (PA), if necessary: (CAR must be forwarded by
the concerned Deputy QMR/OHOO to Process Owner within 3 days upon
receipt)

Prepared By: Confirmed By:

/ _______________________________/_______
Signature over Printed Name of Process Owner/ Date Signature over Printed Name of concerned Deputy QMR/OHOO / Date

CORRECTIVE ACTION REPORT

DILG REGIONAL OFFICE ______
 Document Code
DILG REGION 10 – Northern Mindanao FM-SP-R10-04-01
CORRECTIVE ACTION REPORT Rev. No. Eff. Date Page
01 06.10.17 2 of 3

D. ROOT-CAUSE ANALYSIS: (Use 5-Why Analysis or Fishbone Diagram) (Items D and E to be submitted by Process Owner to
concerned Deputy QMR/OHOO, within 10 days upon receipt)
For Audit-Related: Deputy QMR must submit the CARs to the RIQA Head/Team Leader thru the RIQA Secretariat
For Non Audit: Deputy QMR must submit CARs to QMS Head Secretariat/Deputy QMS Secretariat Member

E. CORRECTIVE ACTION PLAN (CAP):

TIMELINE
ACTIVITY RESPONSIBLE PERSON
START END

Prepared by: Approved by: Accepted by:

/ /
Signature over Printed Name of Deputy
Signature over Printed Name of Process
QMR/OHOO / Date
Owner/ Date
/
Signature over Printed Name of
RIQA Head/Team Leader/QMS Head
Secretariat/Deputy QMS Head Secretariat
Team Leader Date

CORRECTIVE ACTION REPORT

DILG REGIONAL OFFICE ______
 Document Code
DILG REGION 10 – Northern Mindanao FM-SP-R10-04-01
CORRECTIVE ACTION REPORT Rev. No. Eff. Date Page
01 06.10.17 3 of 3

F. VERIFICATION OF CAP IMPLEMENTATION: (at least 2 months after the full implementation )

CAP ACTIVITY STATUS AND REMARKS / Verified by / Date

G. VERIFICATION OF CAP EFFECTIVENESS: (For non-audit related, at least 2 months after full implementation of the CAP
and non-recurrence of the identified root-cause/s. For audit related, the effectiveness of the CAP will be verified in the next audit).
Verified By Approved by
Signature over Printed Signature over Printed
Results of CAP verification/ Name of QMS Head Name of QMS Head
Status Secretariat Team Secretariat/Deputy QMS
Date REMARKS
(Open / Closed) Leader/Deputy QMS Secretariat Leader for
(Effective / Not Effective) Secretariat Member for Non-Audit or RIQA
Non-Audit or IQ Auditor Head/Team Leader /
for Audit Related/ Date Date
(1)

(2)

(3)

Note: (2) and (3) verification is necessary if the CAP cannot be closed after the (1st) first verification.

Prepared By Reviewed By Approved By

CORAZON S. VICENTE YVETTE C. TOLENTINO-SUNGA, CESO V ARNEL M. AGABE, CESO IV

Regional Quality Management
QMS Head Secretariat Regional Director
Representative

CORRECTIVE ACTION REPORT

DILG REGIONAL OFFICE ______