ORS 4 COG 1G ORS - Cognitive Elements Test Recording Form

U.S. Department of Labor Bureau of Labor Statistics

Occupational Requirements Survey

State and local government

The BLS publishes statistical tabulations from this survey that may reveal the information reported by individual State and local governments. Upon your request, however, the BLS will hold the information provided on this survey form in confidence.	This report is authorized by law, 31 United States Code §§ 1535/FAR 17.5 of the Economy Act. Your voluntary cooperation is needed to make the results of this survey comprehensive, accurate and timely.	O.M.B. No.: 1220-0189 Expires: 8/31/2018
We estimate that it will take an average of 15 minutes to complete this form, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this information. If you have any comments regarding this estimate or any other aspect of this survey including suggestions for reducing this burden, please send them to the Bureau of Labor Statistics, Office of Compensation and Working Conditions (1220-0189), 2 Massachusetts Avenue N.E., Washington, D.C. 20212. You are not required to respond to the collection of information unless it displays a currently valid OMB control number.

Occupational Requirements Survey – Revised Cognitive Elements Test Recording Form

ORS Schedule # «Sched»			IDC Schedule # (ECI overlaps) «ncs_sched»
Sample Information
Sampled Region «Sample_region»	Sampled Employment «Sample_employment»		Sampled Ownership «Sample_ownership»		Sampled NAICS «Sample_NAICS»
Collection Information
Collection Region «Collection_region»	Reported Employment «reported_employment»		Collected Ownership «collected_ownership»		Collected NAICS «collected_NAICS»
ORS FE «fe_first_name» «fe_last_name»			NCS FE (ECI overlaps) «idc_first_name» «idc_last_name»
Company Information
Company Name «company_name»
Secondary Name «secondary_name»
Street Address «street_address»
City «city»		State «state»		ZIP «zip»
Respondent Information
Respondent Name «respondent_pre» «respondent_pre» «respondent_pre»
Respondent Title “respondent_title”
Respondent Phone “respondent_phone”
Notes:

First Sampled Job
Job Title «job_title_1»	Quote # «Hit_number»
	SOC «soc_code»
«Full_part_time»/«Time_incentive»/«Union_nonunion»	Employment «Occ_employment»
Description: «job_description»
Notes:
Second Sampled Job
Job Title «job_title_2»	Quote # «Hit_number»
	SOC «soc_code»
«Full_part_time»/«Time_incentive»/«Union_nonunion»	Employment «Occ_employment»
Description: «job_description»
Notes:
Work Review		“job_title_1»	“job_title_2»
How frequently is work checked in the occupation?
More than once per day		☐	☐
Once per day		☐	☐
At least once per week, but less than daily		☐	☐
Less than weekly		☐	☐
Are supervisors generally present in the same work area as workers?		Yes☐ No☐	Yes☐ No☐
Control of Work Pace, Workflow & Pause Control		“job_title_1»	“job_title_2»
Which of the following most determines the pace of work? (Select one)
Machinery, equipment, or software controls pace		☐	☐
Numerical performance targets or quotas enforced by company determine pace		☐	☐
Other persons determine pace (e.g., co-workers, supervisors, customers, members of public)		☐	☐
Other external source (specify) _____________________		☐	☐
Self-paced by worker within general performance guidelines		☐	☐
How would you describe the work flow for this job? Would you say that it …
Has few (if any) slack periods		☐	☐
Has few (if any) rush periods (or large build-ups of work)		☐	☐
Varies, with fluctuations or rush periods (or large build-ups of work) and slow periods on a daily or weekly basis		☐	☐
Can workers step away from their work area easily outside of scheduled breaks? (e.g., short bathroom breaks)?		Yes☐ No☐	Yes☐ No☐
Problem Solving		“job_title_1»	“job_title_2»
The next question is about “problem solving” tasks that the worker does in his/her job. Think of “problem solving” as what happens when workers are faced with a new or difficult situation which requires them to think for a while about what to do next. How often is the worker responsible for solving problems that take more than 5 minutes to find a good solution?
More than once per day		☐	☐
Once per day		☐	☐
At least once per week, but not every day		☐	☐
Less than weekly, but at least once per month		☐	☐
Less than monthly, including never		☐	☐
Personal Contacts		“job_title_1»	“job_title_2»
How often does this occupation require verbal, work-related interactions?
Constantly, every few minutes		☐	☐
More than once per hour, but not constantly		☐	☐
More than once per day, but not more than once per hour		☐	☐
No more than once per day, including never		☐	☐
What level of “people skills” does this job require?
Minimal/basic		☐	☐
More than basic		☐	☐
Checklist		“job_title_1»	“job_title_2»
Are workers in this occupation…
Required to work with the general public?		Yes☐ No☐	Yes☐ No☐
Required to work around crowds?		Yes☐ No☐	Yes☐ No☐
Required to supervise others as part of job?		Yes☐ No☐	Yes☐ No☐
Permitted to work from home or telework?		Yes☐ No☐	Yes☐ No☐
Required to work outside?		Yes☐ No☐	Yes☐ No☐

ORS Form 4 COG 1G