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U.S. Department of Health and Human Services
Indian Health Manual

Part 5, Chapter 16: Manual Exhibit 5-16-C

Required Elements of a Corrective Action Plan


__________________________________________________________________
(Management Control Area) 		______________________
(Area Office)
  1. Identify the "problem" or management control deficiency to be corrected.  (What is the problem?)
  2. Describe in detail the corrective action(s) to be taken. NOTE: The corrective action(s) should be achievable.  (What will be done?)
  3. List all responsible parties involved in the corrective action and their specific role in the process.  (Identify each responsible party.  Define their roles.)
  4. Provide a schedule for the completion of the corrective action(s) and/or sub-action(s).  NOTE:  Every effort should be made to complete corrective actions within 1 year of the approved CAP.  (When will it be done?)

Certification Statement

I hereby certify that all information provided in this corrective action plan is accurate, complete, reasonable, achievable, and will mitigate the deficiency to the best of my knowledge.

__________________________________________________________________
(Please type name of person signing here)
Area Director

Note:  A stamped signature of the Area Director will not be accepted.

 ________________________________________
Date
Approval of CAP:_______________________________________________
(Please type name of person signing here)
Headquarters Management Control Area Manager (MCAM)

Note:  A stamped signature of the MCAM will not be accepted.

 ________________________________________
Date

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