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Root Cause Analysis (RCA) Document
Root Cause Analysis (RCA) Document
Document Statistics
Title
Document Version
Last Date Document was Updated
Document Owner
Document Author
Document Reviewer(s)
Problem Assigned
Problem Assigned to RCA Completed By:
Team
Incident Number:
Incident Start Incident Resolution
Incident Priority
Date & Time: Date & Time:
Section Two
Incident Summary
Incident Description / Impact / Symptoms:
Description –
Impact –
Symptoms –
Impacted Locations:
CI details:
Host Name :
CI:
Was this a result of a (failed) change? If Change caused the incident – enter Change #
Section Three
Section Five
Contributing Factors
1.
Section Six
1.
2.
Note - Add additional rows for action items as required
Section Seven
No Lesson Learned