Adoption of FDA Model Food Code by Local, State and Tribal Governments

FDA FOOD CODE ADOPTION SURVEY		Form Approval: OMB No. 0910-0448 Expiration Date: 06/30/2010 See Reverse /Side 2 for OMB Statement FOR CONTRACT USE ONLY SURVEY NUMBER RECEIVED DATE ______/________/______
PARTICIPANT INFORMATION
Agency Name:		Survey response date:
Agency Address: (Number, Street)		Respondent Name:
City and State:		Zip Code: Mail Code:
Telephone (include area code):	Facsimile (FAX) NO. (include area code)	E-mail:
Is your current retail/foodservice regulation modeled after a version of the FDA Model Food Code? If so, which version? (This does not mean that you necessarily adopted every provision of the Model Food Code, but that it served as the pattern for your regulations.) Please check one: ___ 1993 ___ 1995 ___ 1997 ___ 1999 ___ 2001 2005 ___ 2009 ___ 2013
If your regulation is modeled after one of the above versions, did you encounter any obstacles or objections during the rulemaking or legislative process? Name the top 3 obstacles you encountered from elected officials, board of health members, local health agencies, industry stakeholders, trade associations, or consumer advocates, etc., and how those were resolved.
Does your current regulation lack elements of the FDA Model Food Code that should have been included? If so, briefly describe them.
Are you in the rulemaking or legislative process to revise your retail/foodservice regulations? ___ Yes. Estimated target date for completion: ____________________________________ ___ No If yes, please check one of the following: ___ We plan to adopt the 2009 Model Food Code in its entirety, or substantially so. ___We plan to adopt most of the 2009 Model Food Code, but not the following provisions: __________________________________________________________________________ ___ We plan to adopt only selected provisions of the 2009 Model Food Code and incorporate them into our existing state agency regulations. Please list those provisions: _________________________________________________________________________ ___ We plan to adopt the 2005 Model Food Code in its entirety, or substantially so. ___ We plan to adopt most of the 2005 Model Food Code, but not the following provisions: _________________________________________________________________________ ___ We plan to adopt only selected provisions of the 2005 Model Food Code and incorporate them into our existing state agency regulations. Please list those provisions: _______________________________________________________________________________ Page 1 of 2 Please check the following, if applicable: ___We plan to adopt certain CFP recommendations and incorporate them into our existing state agency regulations. Please list those CFP recommendations: ___Other – please describe: _______________________________________________________
What assistance could the FDA provide that would improve or make the adoption process easier in terms of technical assistance, financial assistance, or advocacy?
Has your agency enrolled in the Voluntary National Retail Food Regulatory Program Standards (Program Standards)? Yes _____ If Yes, what is the date of enrollment? ________/_________/_________ NO _____
If enrolled in the Program Standards, has your agency completed a self-assessment to determine conformance with Program Standard #1, Regulatory Foundation? If Yes, did the self-assessment indicate that your agency meets Program Standard #1? YES __ NO __ Uncertain __
Paperwork Reduction Act of 1995 Public reporting burden for this collection of information is estimated to average one hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Food and Drug Administration CFSAN (HFS-320) 5100 Paint Branch Parkway College Park, MD 20740 An Agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number.
Page 2 of 2

8. Are you in the rulemaking or legislative process to revise your retail/foodservice regulations?

___ Yes. Estimated target date for completion: ____________________________________

___ No

If yes, please check one of the following:

___ We plan to adopt the 2009 Model Food Code in its entirety, or substantially so.

___We plan to adopt most of the 2009 Model Food Code, but not the following provisions:

__________________________________________________________________________

___ We plan to adopt only selected provisions of the 2009 Model Food Code and incorporate them into our existing state agency regulations. Please list those provisions:

_________________________________________________________________________

___ We plan to adopt the 2005 Model Food Code in its entirety, or substantially so.

___ We plan to adopt most of the 2005 Model Food Code, but not the following provisions: _________________________________________________________________________

___ We plan to adopt only selected provisions of the 2005 Model Food Code and incorporate them into our existing state agency regulations. Please list those provisions:

_______________________________________________________________________________

Page 1 of 2

Please check the following, if applicable:

___We plan to adopt certain CFP recommendations and incorporate them into our existing state agency regulations. Please list those CFP recommendations:

___Other – please describe: _______________________________________________________

9. What assistance could the FDA provide that would improve or make the adoption process easier in terms of technical assistance, financial assistance, or advocacy?

10. Has your agency enrolled in the Voluntary National Retail Food Regulatory Program Standards (Program Standards)?

Yes _____ If Yes, what is the date of enrollment? ________/_________/_________

NO _____

11. If enrolled in the Program Standards, has your agency completed a self-assessment to determine conformance with Program Standard #1, Regulatory Foundation?

If Yes, did the self-assessment indicate that your agency meets Program Standard #1?

YES __ NO __ Uncertain __

Paperwork Reduction Act of 1995

Public reporting burden for this collection of information is estimated to average one hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to:

Food and Drug Administration

CFSAN (HFS-320)

5100 Paint Branch Parkway

College Park, MD 20740

An Agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB number.