Root Cause Analysis (RCA) Checklist

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This Template was installed 4 times.

Problem Definition & Data Gathering

1 of 8

Focuses on clearly defining the problem, identifying symptoms, and collecting relevant data to understand the situation.

Detailed Problem Description

Quantity of Affected Units/Batches

Date Problem First Noticed

Time Problem First Noticed

Observed Symptoms and Impacts

Affected Processes/Departments

Relevant Photos/Videos of the Problem

Description of the environment when the problem was observed (temperature, humidity, etc.)

Team Formation & Roles

2 of 8

Ensures the RCA team has the right expertise and defined responsibilities for thorough investigation.

Team Lead Assigned?

Team Lead Name

Key Functional Areas Represented (Select all that apply)

Team Member 1 Name & Role

Team Member 2 Name & Role

Number of Team Members

Brief Description of Team Member Roles & Responsibilities

Has the Team Received RCA Training?

5 Whys & Cause-Effect Diagram (Fishbone)

3 of 8

Utilizes common RCA techniques to explore potential causes and their relationships to the problem.

Describe the Problem Statement in Detail (as understood so far)

Number of 'Whys' Asked for the Initial Problem

Record the First 'Why' and the Answer

Record the Second 'Why' and the Answer

Record the Third 'Why' and the Answer

Record the Fourth 'Why' and the Answer

Record the Fifth 'Why' (or subsequent 'Whys' if needed) and the Answer

Potential Categories for Fishbone Diagram (e.g., Man, Machine, Method, Material, Measurement, Environment)

List Potential Causes within Each Category of the Fishbone Diagram

Data Analysis & Verification

4 of 8

Involves analyzing gathered data, testing hypotheses, and verifying potential root causes.

Statistical Process Control (SPC) Data Points Analyzed

Description of Statistical Analysis Performed (e.g., Regression Analysis, Hypothesis Testing)

Control Chart Type Used (if applicable)

Summary of Data Trends & Anomalies Observed

Data Sources Verified for Consistency

Hypothesis Testing Outcome (If Applicable)

Supporting Data Files (e.g., Excel Spreadsheets, Charts)

Description of how data was verified and cross-referenced

Root Cause Identification & Validation

5 of 8

Definitively identifies the root cause(s) and validates this determination through evidence.

Describe the identified root cause(s) in detail. Provide supporting evidence and data.

Which of the following categories best describes the root cause?

Assign a risk score (1-10, 10 being highest) to the likelihood of the identified root cause recurring if no corrective action is taken.

Upload any supporting documents, charts, or graphs that validate the identified root cause(s).

Explain the methodology used to validate the identified root cause(s). (e.g., statistical analysis, simulation, observation, experimentation)

Is the identified root cause validated by the team?

If the root cause is not validated, explain why and what further investigation is needed.

Corrective Actions & Implementation Plan

6 of 8

Develops and documents specific corrective actions to address the root cause and prevent recurrence.

Detailed Description of Corrective Action(s)

Estimated Cost of Implementation

Planned Start Date of Implementation

Planned Completion Date of Implementation

Responsible Department/Team

Implementation Priority (High, Medium, Low)

Resources Required (Check all that apply)

Potential Risks/Challenges in Implementation

Verification & Monitoring

7 of 8

Establishes a process to verify the effectiveness of corrective actions and monitor for long-term stability.

Baseline Performance Metric Value (Before Action)

Target Performance Metric Value (After Action)

Actual Performance Metric Value (Post-Implementation)

Date of First Verification Measurement

Frequency of Verification Measurements (e.g., weekly, monthly)

Verification Measurement Status

Notes on Verification Measurement (e.g., deviations, anomalies)

Date of Next Scheduled Verification

Documentation & Lessons Learned

8 of 8

Records the entire RCA process, findings, and corrective actions for future reference and continuous improvement.

Summary of RCA Process & Findings

Detailed Description of Corrective Actions Implemented

Estimated Cost of Corrective Actions

Date of RCA Completion

Lessons Learned & Recommendations for Future RCAs

Categories of System/Process Impacted by the Root Cause?

Contact Person for Follow-up & Verification

Supporting Documentation (e.g., data reports, diagrams)

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