Investigation of SARS-CoV-2 transmission in a jail - Louisiana, 2020

Emergency Epidemic Investigation Data Collections - Expedited Reviews (Y3Q4)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1011 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1011 Investigation of SARS-CoV-2 transmission in a jail - Louisiana, 2020 Form and Instruction
0920-1011 Facility Assessment Appendix 1. Facility Survey.docx Form and Instruction
0920-1011 Survey - Day 0 Appendix 2. Survey Day 0.docx Form and Instruction
0920-1011 Survey - Day 3-4 Appendix 3. Survey Day 3.docx Form and Instruction
0920-1011 Survey - Day 14 Appendix 4. Survey Day 14.docx Form and Instruction
0920-1011 Respiratory Testing Form Appendix 5. Lab requisition form cover page.docx Form and Instruction
0920-1011 COVID-19 Test Request Form Appendix 5. COVID-19 Test Request Form.pdf Form and Instruction
2020004-XXX COVID-19 Jail_LA.docx 0920-1011 GenIC Request IC Document
Letter of Invitation.pdf Letter of Invitation IC Document
URGENT 0920-1011 GenIC Request 2020004-XXX COVID-19 Jail_LA.msg Burden Request Memo IC Document

Information Collection (IC) Details

IC Title:	Investigation of SARS-CoV-2 transmission in a jail - Louisiana, 2020	Agency IC Tracking Number:	0920-1011-20OF

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form and Instruction	0920-1011	Facility Assessment	Appendix 1. Facility Survey.docx	NA	No	Paper Only
Form and Instruction	0920-1011	Survey - Day 0	Appendix 2. Survey Day 0.docx	NA	No	Paper Only
Form and Instruction	0920-1011	Survey - Day 3-4	Appendix 3. Survey Day 3.docx	NA	No	Paper Only
Form and Instruction	0920-1011	Survey - Day 14	Appendix 4. Survey Day 14.docx	NA	No	Paper Only
Form and Instruction	0920-1011	Respiratory Testing Form	Appendix 5. Lab requisition form cover page.docx	NA	No	Paper Only
Form and Instruction	0920-1011	COVID-19 Test Request Form	Appendix 5. COVID-19 Test Request Form.pdf	NA	No	Paper Only

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records
Title: Epidemic Investigation Case Records - SORN number 09-20-0113	FR Citation: 51 FR 42466

Number of Respondents: 910	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	910	910
Annual IC Time Burden (Hours)	356	356
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0920-1011 GenIC Request	2020004-XXX COVID-19 Jail_LA.docx	05/07/2020
Letter of Invitation	Letter of Invitation.pdf	05/07/2020
Burden Request Memo	URGENT 0920-1011 GenIC Request 2020004-XXX COVID-19 Jail_LA.msg	05/08/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.