Form OSHA 171 OSHA 171 Grantee Quarterly Progress Report

Grantee Quarterly Progress Report

U.S. DEPARTMENT OF LABOR

Occupational Safety and Health Administration

1. GRANTEE NAME

2. GRANT NUMBER

3. REPORTING PERIOD From: To:

TRAINING SESSIONS

4. DATE	5. LOCATION	NUMBER IN ATTENDANCE			CONTACT HOURS
		6. EMPLOYEES	7. EMPLOYERS	8. TOTAL	9. CLASS LENGTH (in quarter hours)	10. TOTAL
	11. TOTAL FOR REPORTING PERIOD	0	0	0		0.00
	12. PLAN FOR QUARTER
	13. PERCENT OF PLAN ACCOMPLISHED
14. GRANTEE SIGNATURE (Name of the Project Director. Submit via Project Director's email.)					15. DATE

INSTRUCTIONS

Instructions for the Grantee Quarterly Progress Report (OSHA 171 and Narrative Report) are contained on the reverse of this form.

RETURN THE COMPLETED FORM TO THE OSHA REGIONAL OFFICE ADMINISTERING YOUR GRANT.

PAPERWORK REDUCTION ACT NOTICE

Form Approved. OMB No. 1218-0100 Expires 8/31/2017

Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. This information is being collected so that OSHA can monitor grantee progress in meeting grant workplans, to evaluate the overall effectiveness of the grant program, and, when applicable, to be used as one factor in determining continued funding of the grant. The grant program provides training for employers and employees in the recognition, avoidance, and prevention of unsafe and unhealthful working conditions in accordance with Section 21(c) of the Occupational Safety and Health Act. This collection of information is required to obtain or retain a benefit (29 CFR 95.51 (b) and (d)). This collection of information is not confidential. We estimate it will take an average of 14 hours to complete this information collection, including time for reviewing instructions, searching existing data sources, gathering and maintaining 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 the Directorate of Training and Education, 2020 S. Arlington Heights Road, Arlington Heights, IL 60005, and/or to the Department of Labor, Office of IRM Policy, Room N-1301, 100 Constitution Avenue, NW, Washington, DC 20210.

Previous editions may not be used OSHA 171 Revised August 31, 2014

INSTRUCTIONS FOR PREPARING GRANTEE QUARTERLY PROGRESS REPORTS

1. FREQUENCY OF REPORTING

A Grantee Quarterly Progress Report (OSHA 171 and Narrative Report) is to be completed for each grant at the end of each Federal fiscal quarter.

Federal fiscal quarters end on December 31, March 31, June 30, and September 30. An electronic copy of each report is to be received by the Regional Office administering the grant no later than the thirtieth of the month following the end of the Federal fiscal quarter, i.e., January 30, April 30, July 30, and October 30.

2. TIME PERIOD COVERED BY REPORTS

Reports will cover only the activities conducted during the quarter for which the report is being submitted.

3. RECORDKEEPING REQUIREMENTS

Grantees are required to keep records to support the information contained in the Grantee Quarterly Progress Report. For example, a sign-in sheet for participants at a training session that shows whether the participant is an employee or an employer and notes the date, location, training subject, trainer’s name(s) and scheduled beginning and ending time of the session is sufficient documentation. Attendees should include legible first and last names and the sign-in sheet should be signed by the trainer(s) to verify accuracy. Records must be kept for three years after grant closeout or final audit, whichever is later.

4. METHOD OF REPORTING

Grantees are required to submit form OSHA 171 in electronic format to their Regional Office by the end of the fiscal quarter as described in I. FREQUENCY OF REPORTING. All sections for the form must be filled out completely.

5. OSHA FORM 171

1. Identifying Information.

1. Item 1. Grantee Name. Enter the name of the grantee organization.

2. Item 2. Grant Number. Enter the grant number that appears on the Grant Agreement face sheet.

3. Item 3. Reporting Period. Enter the first and last dates of the quarter covered by the report, for example, from 4/1/01 to 6/30/01.

2. Training Sessions

A training session is the presentation of occupational safety and health information to a group of people. Do not count conferences or needs assessments as training sessions. Use a separate line for each training session. If necessary, continue on an additional form. Training sessions for the same group of trainees that are conducted on more than one day are not to be reported until they are completed. Sessions are to be reported in the quarter in which they end. A separate OSHA FORM 171 is required to be submitted for each type (or tier) of training conducted in a quarter.

1. Item 4. Date. Enter the date the training session ended.

2. Item 5. Location. Enter the name (or two-letter abbreviation) of the state where the training session was held.

3. Item 6. Number in Attendance: Employees. Enter the number of employees who attended the training session. An employee is a worker who does not meet the definition of an employer. First-line supervisors are to be included as employees. Attendees not covered under the OSH Act cannot be counted.

4. Item 7. Number in Attendance: Employers. Enter the number of employers who attended the training session. An employer is a person, other than a first-line supervisor, who is responsible for the work flow of two (2) or more persons, including responsibility for rating the performance of those persons working for the employer. Attendees not covered under the OSH Act cannot be counted.

5. Item 8. Number in Attendance: Total. Enter the sum of the entries in each of the columns 6. Employees and 7. Employers. This is calculated automatically in the electronic form once the number of contact hours for the training session is completed for column 9. Class Length.

6. Item 9. Contact Hours: Class Length (in quarter hours). Enter the number of contact hours for each training session. Training less than .5 hours cannot be counted. Partial hours should be rounded to the nearest quarter hour, for example, 1.25, 1.5, or 1.75.

7. Item 10. Contact Hours: Total. Enter the total number of employees and employers who attended the training multiplied by the total number of contact hours for the training session. This is calculated automatically in the electronic form.

8. Item 11. Total for Reporting Period. Enter the sum of the entries in each of the columns 6. Employees, 7. Employers, 8. Total and 10. Total.

This is calculated automatically in the electronic form.

9. Item 12. Plan for Quarter. Enter the total numbers (employees and employers) planned to be trained and the total number of planned contact hours during the quarter. This information is to be obtained from the approved grant application.

10. Item 13. Percent of Plan Accomplished. Enter the percent line 11 is of line 12. This is calculated automatically in the electronic form.

3. Signature Element.

1. Item 14. Grantee Signature. Electronic signature is considered the typed name of an authorized staff member of the grantee and the form forwarded to the Regional office via the authorized staff member’s organizational email address.

2. Item 15. Date. Enter the date the report is signed.

6. NARRATIVE REPORT

In the narrative report, grantees are to provide descriptive information about their progress in achieving work plans, any deviations from plans, and important activities. Reports should follow the format below.

1. Identifying Information. Provide the name of the grantee organization, the grant number that appears on the Grant Agreement face sheet for the current grant year, and the reporting period, which is the first and last dates of the quarter covered by the report, for example, from 4/1/01 to 6/30/01.

2. Capacity Building Activities (Required by Capacity Building Grants only). Describe institutional capacity building activities conducted during the quarter. Compare the timeframe of the activities to those presented in the approved grant application.

3. Needs Assessment (Required by Capacity Building Grants only). Describe the needs assessment process conducted during the quarter, the results of the needs assessment or update, and how the results will be used to develop training materials and training, as applicable.

4. Training. Describe efforts made to reach the target audience, to make them aware of the training, and to enroll them in training. Discuss the training conducted during the quarter. Provide a summary of the subject matter, the type of training (e.g., train-the-trainer, hazard recognition), and who attended (e.g., employers, building trades workers).

5. Training Materials/Curriculum. Provide information about training materials in development and any training or assessment materials acquired during the quarter. Describe how completed materials are being used and who is receiving the materials. Comment on any changes that are being made to improve the materials as a result of feedback.

6. Evaluation Activities. Discuss evaluation activities conducted during the quarter. Describe the results of the Level 1, 2, and 3 evaluations obtained. Only Capacity Building Developmental grants are required to conduct Level 3 evaluations. Results should be summarized in the report.

7. Other Educational Activities. Discuss any educational activities that are being conducted other than training or developing training materials. Examples include on-site consultation, assisting an organization in the implementation of a safety program, or operating library services.

8. Planned vs. Actual. Describe progress in meeting plans as contained in the approved grant. Specify where plans are not being met and discuss the corrective action that is being taken to meet plans. Where corrective actions have already been taken, indicate if they were successful. In addition, discuss grant successes, either where plans were exceeded or where significant accomplishments were achieved.

OMB No. 1218-0100 Previous Editions may not be used OSHA 171 Revised August 31, 2014