Workplace Violence Prevention Programs In New Jersey Healthcare Facilities

ICR 201206-0920-003

OMB: 0920-0914

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Form
Modified
Form
Modified
Form
Modified
Justification for No Material/Nonsubstantive Change
2012-06-12
Supplementary Document
2012-06-12
Supplementary Document
2012-06-12
Supplementary Document
2012-06-12
Supplementary Document
2011-10-13
IC Document Collections
IC ID
Document
Title
Status
199796 Modified
199795 Modified
199794 Modified
199793 Modified
ICR Details
0920-0914 201206-0920-003
Historical Active 201206-0920-001
HHS/CDC
Workplace Violence Prevention Programs In New Jersey Healthcare Facilities
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/15/2012
Retrieve Notice of Action (NOA) 06/15/2012
  Inventory as of this Action Requested Previously Approved
01/31/2015 01/31/2015 01/31/2015
4,150 0 4,150
1,483 0 1,483
0 0 0

CDC's National Institute for Occupational Safety and Health (NIOSH) seeks clearance to conduct research on the prevention of workplace violence in the healthcare industry. The objective of this project is to evaluate the impact of the New Jersey Violence Prevention in Health Care Facilities Act.

PL: Pub.L. 91 - 596 20.a.1 Name of Law: Occupational Safety and Health Act
  
None

Not associated with rulemaking

Yes

4
IC Title Form No. Form Name
Evaluation Form - Administrators none Evaluation Form
Interview - Committee Chair none Interview
Incident Information none Incident Information
Nurse Survey none Nurse Survey

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 4,150 4,150 0 0 0 0
Annual Time Burden (Hours) 1,483 1,483 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$831,088
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Carol Walker 4046394773

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/15/2012


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