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RY.FR.002 - RİSK ANALİZİ DÜZELTİCİ ÖNLEYİCİ FAALİYET RAPORU FORMU

Doküman Kodu: RY.FR.002
Yayın Tarihi: 20.06.2017
Revizyon Tarihi: 02.04.2022
Revizyon No: 1

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Demo Hastanesi (Prokalite.Com) RİSK ANALİZİ DÜZELTİCİ ÖNLEYİCİ FAALİYET RAPORU FORMU

Doküman Kodu: RY.FR.002

Yayın Tarihi: 20.06.2017

Revizyon Tarihi: 02.04.2022

Revizyon No: 1

Sayfa: Otomatik

FAALİYET RAPOR NUMARASI:. ........................................ RAPOR TARİHİ: ....................................
TESPİT EDİLEN TEHLİKENİN ANALİZİ
TANIMI:
TESPİT EDİLME ZAMANI:
BULUNDUĞU YERLER: …......................................................................................................................... …......................................................................................................................... ….........................................................................................................................		SÜRE:…....................................... …................................................ …................................................ …................................................
SEBEBİ: () Kişi () Tesis () Kurum () Teknik () Eğitim () Yazılım () Diğer Açıklama: ................................................................................................................................................................. .................................................................................................................................................................................... .................................................................................................................................................................................... ....................................................................................................................................................................................
SEBEP OLACAĞI RİSKLER 1. .............................................................................................................. 2. ............................................................................................................... 3. ............................................................................................................... 4. ............................................................................................................... 5. ............................................................................................................... 6. ............................................................................................................... 7. ............................................................................................................... 8. ...............................................................................................................		RİSKTEN ETKİLENENLER ..................................................... ..................................................... ..................................................... ...................................................... ...................................................... ...................................................... .................................................... .................................................... ......................................................

PLANLANAN DÜZELTİCİ ÖNLEYİCİ FAALİYETLER	TERMİN/GÜN	SORUMLULAR

DÜZELTİCİ ÖNLEYİCİ FAALİYET
() YAPILDI Açıklama:…....................................................................... …...................................................................................... …...................................................................................... …...................................................................................... …...................................................................................... …...................................................................................... …......................................................................................	TARİH: …......................... …......................... …......................... …......................... …......................... …......................... ….........................	AD SOYAD İMZA …......................... …......................... …......................... …......................... …......................... …......................... ….........................
() YAPILMADI Açıklama (Gerekçe):…....................................................... …...................................................................................... …...................................................................................... …...................................................................................... …...................................................................................... …...................................................................................... …......................................................................................	TARİH: …......................... …......................... …......................... …......................... …......................... …......................... ….........................	EK SÜRE TALEBİ …......................... …......................... …......................... …......................... …......................... …......................... ….........................
DİĞER ÇÖZÜM ÖNERİLERİ / GÖRÜŞ: …......................................................................................................................................................................................................................... …......................................................................................................................................................................................................................... …......................................................................................................................................................................................................................... ….........................................................................................................................................................................................................................
DÖF: KAPATILDI () KAPANMA TARİHİ:…/….../…........ KAPATILMADI () () () () () () () () () () ()

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<table style="border-collapse: collapse; width: 882px;" class=" cke_show_border" cellspacing="0"><tbody><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:29px; text-align:center; vertical-align:bottom; width:739px"><span style="font-size:15px"><span style="color:black">FAALİYET RAPOR NUMARASI:. ........................................ RAPOR TARİHİ: ....................................</span></span></td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:34px; text-align:center; vertical-align:bottom"><span style="font-size:15px"><span style="color:black">TESPİT EDİLEN TEHLİKENİN ANALİZİ</span></span></td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:79px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">TANIMI:</span></span><br></td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:33px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">TESPİT EDİLME ZAMANI:</span></span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:107px; text-align:left; vertical-align:top; width:517px"><span style="font-size:15px"><span style="color:black">BULUNDUĞU YERLER:<br>….........................................................................................................................<br>….........................................................................................................................<br>….........................................................................................................................</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:222px"><span style="font-size:15px"><span style="color:black">SÜRE:….......................................<br>…................................................<br>…................................................<br>…................................................</span></span></td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:114px; text-align:left; vertical-align:top; width:739px"><span style="font-size:15px"><span style="color:black">SEBEBİ: () Kişi () Tesis () Kurum () Teknik () Eğitim () Yazılım () Diğer<br>Açıklama: .................................................................................................................................................................<br>....................................................................................................................................................................................<br>....................................................................................................................................................................................<br>....................................................................................................................................................................................</span></span></td></tr><tr><td colspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:215px; text-align:left; vertical-align:top; width:517px"><span style="font-size:15px"><span style="color:black">SEBEP OLACAĞI RİSKLER<br>1. ..............................................................................................................<br>2. ...............................................................................................................<br>3. ...............................................................................................................<br>4. ...............................................................................................................<br>5. ...............................................................................................................<br>6. ...............................................................................................................<br>7. ...............................................................................................................<br>8. ...............................................................................................................</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:222px"><span style="font-size:15px"><span style="color:black">RİSKTEN ETKİLENENLER<br>.....................................................<br>.....................................................<br>.....................................................<br>......................................................<br>......................................................<br>......................................................<br>....................................................<br>....................................................<br>......................................................</span></span></td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:33px; text-align:center; vertical-align:top"><span style="font-size:15px"><span style="color:black">PLANLANAN DÜZELTİCİ ÖNLEYİCİ FAALİYETLER</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:top"><span style="font-size:15px"><span style="color:black">TERMİN/GÜN</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:top"><span style="font-size:15px"><span style="color:black">SORUMLULAR</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"><br></td></tr></tbody></table><div style="page-break-after:always"><br></div><table style="border-collapse: collapse; width: 882px;" class=" cke_show_border" cellspacing="0"><tbody><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:31px; text-align:center; vertical-align:middle; width:990px"><span style="font-size:15px"><span style="color:black">DÜZELTİCİ ÖNLEYİCİ FAALİYET</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:210px; text-align:center; vertical-align:top; width:511px"><span style="font-size:15px"><span style="color:black">() YAPILDI<br>Açıklama:….......................................................................<br>…......................................................................................<br>…......................................................................................<br>…......................................................................................<br>…......................................................................................<br>…......................................................................................<br>…......................................................................................</span></span><br></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:top; width:186px"><span style="font-size:15px"><span style="color:black">TARİH:<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:top; width:293px"><span style="font-size:15px"><span style="color:black">AD SOYAD İMZA<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:160px; text-align:center; vertical-align:top; width:511px"><p><span style="font-size:15px"><span style="color:black">() YAPILMADI<br>Açıklama (Gerekçe):….......................................................<br>…......................................................................................<br>…......................................................................................<br>…......................................................................................<br>…......................................................................................<br>…......................................................................................<br>…......................................................................................</span></span></p><p><br></p></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:top; width:186px"><p><span style="font-size:15px"><span style="color:black">TARİH:<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................</span></span></p></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:top; width:293px"><p><span style="font-size:15px"><span style="color:black">EK SÜRE TALEBİ<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................<br>….........................</span></span></p></td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:117px; text-align:left; vertical-align:top; width:990px"><p><span style="font-size:15px"><span style="color:black">DİĞER ÇÖZÜM ÖNERİLERİ / GÖRÜŞ:</span></span></p><p><br><span style="font-size:15px"><span style="color:black">….........................................................................................................................................................................................................................</span></span><br><span style="font-size:15px"><span style="color:black">….........................................................................................................................................................................................................................<br>….........................................................................................................................................................................................................................<br>….........................................................................................................................................................................................................................</span></span></p><p><br></p></td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:82px; text-align:left; vertical-align:top; width:990px"><p><span style="font-size:15px"><span style="color:black">DÖF: </span></span></p><p><br><span style="font-size:15px"><span style="color:black">KAPATILDI () KAPANMA TARİHİ:…/….../…........<br><br>KAPATILMADI () () () () () () () () () () () </span></span></p><p><br></p></td></tr></tbody></table>