I would ensure the following within my corrective action plan.
• Memorandum format.
• Address each area that fell short of the expected standards.
• Address each area and ways to improve them.
• Address the way each area should be corrected.
• Addressed the timeline and expected outcomes for all corrections to be completed.
As manager I would be disappointed that we did not meet the standards but I would strive for our team to correct our shortcomings and to make improvements needed to be successful. I would stress importance of working together, so this would not happen again.
Ralph,
I agree on working together but also think there needs to be clear ownership for any follow up tasks to ensure accountability and responsibility.
Traci Lee
I think this is a great list, Richard, and also like the fact that you have included a monitoring system to ensure continued compliance.
The corrective action plan should include whether or not the school concurs with the finding and documentation to support their stance or remediation proof the auditors can use to substantiate the finding. I would want to see the department responsible, the reason for the finding, what is being done to fix it, and the number of days needed to fix and how it will be prevented in the future.
Describe what should be included in a corrective action plan submitted by a campus or department in response to audit findings. Include specific topics/items that you would want to see for each finding.
I would like to make sure I knew the date of the visit/audit
Some specifics of the findings
Who was involved such as the name of the student, instructor or staff member mentioned in the citation?
Explanation or reason of to the issue
Suggestions for improvement or if the issue has been resolved and when
Specific policies or processes that will prevent the issue from re-occurring
Contact information for the all involved
Specific area of the audit that was sited
A corrective action plan should include the plan to correct the items that were listed as corrective items. it could be finacial aid refund errors, employee files and students files
A corrective action plan should designate the person or department responsible for the action. I also think its important to involve that person when developing the corrective action plan, so they are not "surprised" by the action they now have to take. The action plan should be reasonable, well thought out, and attainable.
We strongly agree with prior posts. We believe timelines and benchmarks are important in the resolution process of a finding. A plan of correction will also be provided including how we will achieve the goal to meet the standards of the agency.
Items to be included in a corrective action plan should first include a complete description of the problem to be able to break it down into workable parts. A written plan of action, including the amount of time needed to rectify the problem and checks or markers in place to possibly prevent the problem from re-occurring.
Jeanne,
I agree that breaking it down into workable parts is useful to ensure resolution through ownership of the various tasks required.
Traci Lee
Very detailed, I would also add root cause evaluation. Identify the root cause and identify the impact that it may have caused during the process. (Root Cause Anaysis)
Lydell,
The focus on root cause is key to ensure a true "fix" to rectify any problems.
Traci Lee
One of the critical items which should be included in the action plan should be processes to ensure the resolution and prevention of the risk area. Merely correcting the issue is not enough. Further steps should be taken to ensure that the processes are corrected to prevent the issue from happening again. It could also be that during this review process other proactive approaches comes to light and could be implemented. Additionally, the action plan should include dates of when certain tasks will be completed and the individuals responsible for the overall project. This provides a timeline and accountability to oversee that the appropriate actions are carried out. This should also be a time for team building and to include everyone in the department to seek solutions. This way there is ownership in the resolution.
Susan,
Your point on process updates is very valuable as it is true that some focus on fixing the specific item versus the root cause that created the finding. I also like your mention of team building and ownership as this also helps with the long term commitment toward any corrections.
Traci Lee
A corrective action plan should include what caused their to be a finding, identify what needs to be corrected and develop a plan that will prevent the item from being a repeat finding. If the finding was for late refunds I would want to see the current policy the school follows for late refunds, where the area of weakness may be and how they plan to improve the plan to avoid late refunds from happening in the future.
Since repeat findings is part of the top 10 program review and audit findings I would emphasis the importance of implementing the corrective action plan that is created.
Kelly,
Repeat findings are problematic for schools and an effective process with corrective action planning, including subsequent monitoring and validation of problem rectification should mitigate the risk of these recurring problems.
Traci Lee
The plan should include anything that must be done with regard to the specific items identified with a timeline of completion as well as a plan for how to ensure that the process will be modified to prevent future violations. This is what we use to do in our school.
The corrective action plan should include as much detail as possible to support the issue. I had a circumstance where we did not meet the criteria in an audit but we were in compliance. More information in the initial report would have eliminated not being in compliance. I am a minimalist when it comes to writing. My lesson – give them everything I can think of. More is better, sometimes.
Mabel,
I think you are right on the "sometimes" comment as it depends on the circumstance and evaluator. Sometimes more is better but, in some cases, "less is more" as additional detail can further confuse things. With some complexity of processes and methodology, it can be difficult for someone outside the organization to fully understand every situation during an audit. Most auditors provide an opportunity to clarify on items they see as "potential findings" which can help a school determine when more is needed vs. when the initial information provided is sufficient.
Traci Lee
In order to submit a corrective action plan in response to audit findings, I will ask the six investigative elements;the six (w's), What,Where,When,Who,Why and How.I will follow these elements to correct this problem and come up with a plan on how to prevent the finding from occurring again.
