Survey of Food Safety Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Att11_SurveyFSP_ Follow-up 3 Reminder Telephone_Clean.doc	Supplementary Document	Uploaded 2014-06-12	Available
Att10_SurveyFSP_ Follow-up 2 Reminder Email__Clean..doc	Supplementary Document	Uploaded 2014-06-12	Available
Att9 _SurveyFSP_Follow-up 1 Reminder Email__Clean.doc	Supplementary Document	Uploaded 2014-06-12	Repair queued
Att8 _SurveyFSP_Telephone Script for Recruitment of Health Department Script _Clean..docx	Supplementary Document	Uploaded 2014-06-12	Available
Att 7 Survey of Food Safety Program Fact Sheet_Clean.docx	Supplementary Document	Uploaded 2014-06-12	Available
Att6 _SurveyFSP_ Participation Request Email__Clean.docx	Supplementary Document	Uploaded 2014-06-12	Available
Survey FSPs_Supporting Statement B _Clean.docx	Supporting Statement B	Uploaded 2014-06-12	Available
Att 5 EFSPs_IRB3.pdf	Supplementary Document	Uploaded 2014-01-16	Available
Att 2 EFSPs_ 60Day_FRN_.pdf	Supplementary Document	Uploaded 2014-01-16	Available
Att 1 EFSPs_ AuthLeg.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 9a EFSPs_Cover Correspondence_PaperSurvey.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 10 EFSPs _Telephone Script for Recruitment of Health Department.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 13 EFSPs_ Follow-up 3 Reminder Telephone Call.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 12 EFSPs_ Follow-up 2 Reminder Email.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 11 EFSPs Follow-up 1 Reminder Email.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 8 EFSPs_ Informed Consent Info Sheet.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 6 EFSPs_ Participation Request Email.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 7 EFSPs_Fact Sheet.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 9b EFSPs_Cover Correspondence_ElectronicSurvey.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 10 EFSPs _Telephone Script for Recruitment of Health Department.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 13 EFSPs_ Follow-up 3 Reminder Telephone Call.doc	Supplementary Document	Uploaded 2014-01-16	Repair queued
Att 12 EFSPs_ Follow-up 2 Reminder Email.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 11 EFSPs Follow-up 1 Reminder Email.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 8 EFSPs_ Informed Consent Info Sheet.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 6 EFSPs_ Participation Request Email.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 7 EFSPs_Fact Sheet.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 9b EFSPs_Cover Correspondence_ElectronicSurvey.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 10 EFSPs _Telephone Script for Recruitment of Health Department.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 13 EFSPs_ Follow-up 3 Reminder Telephone Call.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 12 EFSPs_ Follow-up 2 Reminder Email.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 11 EFSPs Follow-up 1 Reminder Email.doc	Supplementary Document	Uploaded 2014-01-16	Repair queued
Att 8 EFSPs_ Informed Consent Info Sheet.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 7 EFSPs_Fact Sheet.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 6 EFSPs_ Participation Request Email.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 10 EFSPs _Telephone Script for Recruitment of Health Department.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 13 EFSPs_ Follow-up 3 Reminder Telephone Call.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 12 EFSPs_ Follow-up 2 Reminder Email.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 11 EFSPs Follow-up 1 Reminder Email.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 9a EFSPs_Cover Correspondence_PaperSurvey.doc	Supplementary Document	Uploaded 2014-01-16	Available
Att 8 EFSPs_ Informed Consent Info Sheet.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 6 EFSPs_ Participation Request Email.docx	Supplementary Document	Uploaded 2014-01-16	Available
Att 7 EFSPs_Fact Sheet.docx	Supplementary Document	Uploaded 2014-01-16	Available
SurveyofFSPs_Supporting Statement A_Clean.doc	Supporting Statement A	Uploaded 2014-06-12	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
210106	Survey of Food Safety Program (paper) State Health Departments	Other-WORD	New
210105	Survey of Food Safety Program (electronic) State Health Departments	Other-WORD	New
210104	Survey of Food Safety Program (electronic) Local Health Departments	Other-WORD	New
210103	Survey of Food Safety Programs Survey (paper) Local Health Departments	Other-WORD	New

ICR Details

OMB Control No: 0920-1021	ICR Reference No: 201401-0920-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 21325
Title: Survey of Food Safety Programs
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/13/2014
	Date Received in OIRA: 01/22/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2016	24 Months From Approved
Responses	190	0	0
Time Burden (Hours)	380	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Local and state food safety programs (FSPs) are on the frontline of foodborne disease prevention in the U.S. However, in the current economic milieu, these programs along with other public health programs are being eliminated due to funding reductions. The purpose of this study is to 1) describe the current status and activities of local and state FSPs; 2) describe changes in status and activities that occurred within FSPs from 2007-2012; and to 3) determine if there is a relationship between different levels of FSP funding and FSP status and activities. This survey will involve state and local health departments implementing food safety programs in the United States. Data collected will help us better understand the relationship between different levels of funding and FSP activities.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 54652	09/05/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 3206	01/17/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Survey of Food Safety Programs Survey (paper) Local Health Departments
Survey of Food Safety Program (electronic) Local Health Departments
Survey of Food Safety Program (electronic) State Health Departments
Survey of Food Safety Program (paper) State Health Departments

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ICR Summary of Burden

table that charts list of burden

	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	190	0	0	190	0	0
Annual Time Burden (Hours)	380	0	0	380	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new data collection request.

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Annual Cost to Federal Government: $15,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 01/22/2014

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