OSHA 171 Grantee Quarterly Progress Report

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Overview

OSHA QPR FORM 171
OSHA FORM 171 INSTRUCTIONS

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Sheet 1: OSHA QPR FORM 171

Grantee Quarterly Progress Report				U.S. DEPARTMENT OF LABOR
				Occupational Safety and Health Administration
1. GRANTEE NAME				2. GRANT NUMBER
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						15. DATE
(Name of the Project Director. Submit via Project Director's email.)
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 11/30/2020
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 datasources, 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 November 30, 2017

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Sheet 2: OSHA FORM 171 INSTRUCTIONS

INSTRUCTIONS FOR PREPARING GRANTEE QUARTERLY PROGRESS REPORTS
I.  FREQUENCY OF REPORTING		7.        Item 10. Contact Hours: Total. Enter the total number of employees
		and employers who attended the training multiplied by the total number
A Grantee Quarterly Progress Report (OSHA 171 and Narrative Report) is to be		of contact hours for the training session. This is calculated
completed for each grant at the end of each Federal fiscal quarter.		automatically in the electronic form.
Federal fiscal quarters end on December 31, March 31, June 30, and		8.        Item 11. Total for Reporting Period. Enter the sum of the entries in each
September 30. An electronic copy of each report is to be received by the		of the columns 6. Employees, 7. Employers, 8. Total and 10. Total.
Regional Office administering the grant no later than the thirtieth of the		This is calculated automatically in the electronic form.
month following the end of the Federal fiscal quarter, i.e., January 30, April		9.       Item 12. Plan for Quarter. Enter the total numbers (employees and
30, July 30, and October 30.		employers) planned to be trained and the total number of planned
		contact hours during the quarter. This information is to be obtained
II.   TIME PERIOD COVERED BY REPORTS		from the approved grant application.
		10.     Item 13. Percent of Plan Accomplished. Enter the percent line 11 is of
Reports will cover only the activities conducted during the quarter for which		line 12. This is calculated automatically in the electronic form.
the report is being submitted.
		C.  Signature Element.
III.   RECORDKEEPING REQUIREMENTS
		1.        Item 14. Grantee Signature. Electronic signature is considered the typed
Grantees are required to keep records to support the information contained in		name of an authorized staff member of the grantee and the form
the Grantee Quarterly Progress Report. For example, a sign-in sheet for		forwarded to the Regional office via the authorized staff member’s
participants at a training session that shows whether the participant is an		organizational email address.
employee or an employer and notes the date, location, training subject,		2.        Item 15. Date. Enter the date the report is signed.
trainer’s name(s) and scheduled beginning and ending time of the session is
sufficient documentation. Attendees should include legible first and last		VI.   NARRATIVE REPORT
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		In the narrative report, grantees are to provide descriptive information about
audit, whichever is later.		their progress in achieving work plans, any deviations from plans, and
		important activities. Reports should follow the format below.
IV.   METHOD OF REPORTING		A.       Identifying Information. Provide the name of the grantee organization,
		the grant number that appears on the Grant Agreement face sheet for
Grantees are required to submit form OSHA 171 in electronic format to their		the current grant year, and the reporting period, which is the first and
Regional Office by the end of the fiscal quarter as described in I.		last dates of the quarter covered by the report, for example, from 4/1/01
FREQUENCY OF REPORTING. All sections for the form must be filled out		to 6/30/01.
completely.
		B.       Capacity Building Activities (Required by Capacity Building Grants
V.   OSHA FORM 171		only). Describe institutional capacity building activities conducted
		during the quarter. Compare the timeframe of the activities to those
A.  Identifying Information.		presented in the approved grant application.
1.        Item 1. Grantee Name. Enter the name of the grantee organization.		C.       Needs Assessment (Required by Capacity Building Grants only).
2.        Item 2. Grant Number. Enter the grant number that appears on the		Describe the needs assessment process conducted during the quarter,
Grant Agreement face sheet.		the results of the needs assessment or update, and how the results will
3.        Item 3. Reporting Period. Enter the first and last dates of the quarter		be used to develop training materials and training, as applicable.
covered by the report, for example, from 4/1/01 to 6/30/01.
		D.       Training. Describe efforts made to reach the target audience, to make
B.  Training Sessions		them aware of the training, and to enroll them in training. Discuss
		the training conducted during the quarter. Provide a summary of the subject
A training session is the presentation of occupational safety and health		matter, the type of training (e.g., train-the-trainer, hazard recognition),
information to a group of people. Do not count conferences or needs		and who attended (e.g., employers, building trades workers).
assessments as training sessions. Use a separate line for each training
session. If necessary, continue on an additional form. Training sessions for		E.       Training Materials/Curriculum. Provide information about training
the same group of trainees that are conducted on more than one day are not		materials in development and any training or assessment materials
to be reported until they are completed. Sessions are to be reported in the		acquired during the quarter. Describe how completed materials are
quarter in which they end. A separate OSHA FORM 171 is required to be		being used and who is receiving the materials. Comment on any
submitted for each type (or tier) of training conducted in a quarter.		changes that are being made to improve the materials as a result of
		feedback.
1.        Item 4. Date. Enter the date the training session ended.
2.        Item 5. Location. Enter the name (or two-letter abbreviation) of the		F.       Evaluation Activities. Discuss evaluation activities conducted during the
state where the training session was held.		quarter. Describe the results of the Level 1, 2, and 3 evaluations
3.        Item 6. Number in Attendance: Employees. Enter the number of who		obtained. Only Capacity Building Developmental grants are required to
employees who attended the training session. An employee is a worker		conduct Level 3 evaluations. Results should be summarized in the
does not meet the definition of an employer. First-line supervisors		report.
are to be included as employees. Attendees not covered under the OSH
Act cannot be counted.		G.       Other Educational Activities. Discuss any educational activities that are
4.        Item 7. Number in Attendance: Employers. Enter the number of		being conducted other than training or developing training materials.
employers who attended the training session. An employer is a person,		Examples include on-site consultation, assisting an organization in the
other than a first-line supervisor, who is responsible for the work flow		implementation of a safety program, or operating library services.
of two (2) or more persons, including responsibility for rating the
performance of those persons working for the employer. Attendees not		H.       Planned vs. Actual. Describe progress in meeting plans as contained
covered under the OSH Act cannot be counted.		in the approved grant. Specify where plans are not being met and discuss
5.        Item 8. Number in Attendance: Total. Enter the sum of the entries in		the corrective action that is being taken to meet plans. Where corrective
each of the columns 6. Employees and 7. Employers. This is calculated		actions have already been taken, indicate if they were successful. In
automatically in the electronic form once the number of contact hours		addition, discuss grant successes, either where plans were exceeded
for the training session is completed for column 9. Class Length.		or where significant accomplishments were achieved.
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.
OMB No. 1218-0100 Previous Editions may not be used OSHA 171 Revised August 31, 2014