The first steps in implementing ISO 9001:2015 in a small to medium enterprise include:

1. Ensuring top management involvement to secure necessary resources for the implementation process.
2. Performing a GAP analysis to determine which requirements are already met and which need to be addressed.
3. Assembling a project team and setting up a project sponsor and project manager.
4. Developing a project plan with defined activities, responsibilities, resources, and deadlines.
5. Providing basic training on ISO 9001 for project team members.
6. Defining the scope of the quality management system (QMS).
7. Mapping processes and determining internal and external context.
8. Determining interested parties and defining quality policy, objectives, and plans to meet them.
9. Identifying risks and opportunities and defining action plans for the most important ones.
10. Documenting processes and starting to measure performance.
11. Performing internal audits and management reviews to decide readiness for certification.