Compliance Check Procedure Evaluation Form
Use this Compliance Check Procedure Evaluation Form to objectively assess and document the effectiveness of a compliance check procedure. Please complete all sections to ensure a thorough review.
Evaluator Name
*
First Name
Last Name
Date of Evaluation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall rating of the compliance check procedure
*
1
2
3
4
5
Checklist: Which key compliance steps were followed?
*
Documentation reviewed
Procedures adhered to
Corrective actions identified
Records updated
Stakeholders notified
Other
Please rate the following aspects of the compliance check procedure
*
Rows
Poor
Fair
Good
Very Good
Excellent
Clarity of procedure
1
2
3
4
5
Thoroughness of checks
6
7
8
9
10
Timeliness of completion
11
12
13
14
15
Accuracy of documentation
16
17
18
19
20
Communication with stakeholders
21
22
23
24
25
Were any non-compliance issues detected?
*
Yes
No
If yes, briefly describe the non-compliance issue(s)
Actions taken or recommended
Suggestions for improvement
Additional comments
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