# Periodic Review Template

Version 1.0 | CSVtoCSA practitioner template | Updated 12 September 2026

## Purpose

Determine whether current operational evidence continues to support the approved intended use and validated state.

## When to use

At the approved review frequency and after significant accumulated change, incident trends, or supplier changes.

## Instructions

- Confirm the current intended use, owner, version, and configuration.
- Review changes, deviations, incidents, access, audit trails, backup/restore, supplier status, and performance.
- Identify stale evidence or changed assumptions.
- Record actions, residual risk, and the validated-state conclusion.

## Blank template

1. System, scope, and review period

   Response: 

2. Current intended use and configuration

   Response: 

3. Changes and releases

   Response: 

4. Incidents, deviations, and CAPA

   Response: 

5. Access and audit-trail review

   Response: 

6. Backup, restore, and continuity

   Response: 

7. Supplier and service performance

   Response: 

8. Open actions and evidence gaps

   Response: 

9. Validated-state conclusion

   Response: 

10. Next review or event trigger

   Response: 

## Completed fictional example

The example below is teaching material, not an executed or approved validation record.

1. System, scope, and review period

   Fictional LIMS interface; October 2025 through September 2026

2. Current intended use and configuration

   Approved-result transfer to ERP; interface version 4.2

3. Changes and releases

   Two mapping additions with approved targeted regression

4. Incidents, deviations, and CAPA

   One delayed message; no incorrect material disposition

5. Access and audit-trail review

   Service accounts and support roles remain approved

6. Backup, restore, and continuity

   Queue recovery and record retrieval tested in May 2026

7. Supplier and service performance

   No material SLA or platform control change

8. Open actions and evidence gaps

   Improve aged-message alert ownership

9. Validated-state conclusion

   Continued use is supported with the open action tracked

10. Next review or event trigger

   September 2027 or earlier schema, mapping, or reconciliation change

## Use and limitations

Adapt this template to the applicable regulation, approved validation procedure, document-control process, risk method, and approval roles. CSVtoCSA does not present this template as a universally required validation record.