Assessment of Ill Worker Policies Study

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Intervention log - control restaurants	Form and Instruction	New	Available
Resaturant intervention log - control restaurants	Form and Instruction	New	Repair queued
Restaurant intervention log	Form	New	Available
Restaurant intervention log - intervention restaurants	Form	New	Repair queued
Restaurant Environment Observation Form	Form	Removed	Available
Restaurant Environment Observation - Control Visit 3	Form	Removed	Repair queued
Restaurant Environment Observation Form	Form	Removed	Available
Restaurant Environment Observation - Control Visit 2	Form	Removed	Repair queued
Restaurant Environment Observation Form	Form	Removed	Available
Restaurant Environment Observation - Control Visit 1	Form	Removed	Repair queued
Food Worker Consent and Survey	Form	Removed	Repair queued
Food Worker Consent and Survey - Control Visit 3	Form	Removed	Repair queued
Food Worker Consent and Survey	Form	Removed	Available
Food Worker Consent and Survey - Control Visit 2	Form	Removed	Repair queued
Food Worker Consent and Survey	Form	Removed	Available
Food Worker Consent and Survey - Control Visit 1	Form	Removed	Repair queued
Manager Consent and Interview	Form	Removed	Available
Manager Consent and Interview - Control Visit 3	Form	Removed	Repair queued
Manager Consent and Interview	Form	Removed	Available
Manager Consent and Interview - Control Visit 2	Form	Removed	Repair queued
Manager consent and interview	Form and Instruction	Modified	Available
Manager Consent and Interview - control restaurants	Form and Instruction	Modified	Repair queued
Restaurant Environment Observation Form	Form	Removed	Repair queued
Restaurant Environment Observation - Intervention Visit 2	Form	Removed	Repair queued
Restaurant Observation	Form and Instruction	Modified	Available
Restaurant Observation	Form and Instruction	Modified	Repair queued
Food Worker Consent and Survey	Form	Removed	Available
Food Worker Consent and Survey - Intervention Visit 2	Form	Removed	Repair queued
Food Worker Consent and Survey	Form	Removed	Available
Food Worker Consent and Survey - Intervention Visit 1	Form	Removed	Repair queued
Manager Consent and Interview	Form	Removed	Available
Manager Consent and Interview - Intervention Visit 2	Form	Removed	Repair queued
Manager consent and interview	Form and Instruction	Modified	Repair queued
Manager Consent and Interview	Form and Instruction	Modified	Available
Manager recruiting script	Form and Instruction	Modified	Repair queued
Manager Recruiting Script	Form and Instruction	Modified	Repair queued
P_Att 6 Participation Log 201211.xlsx	Supplementary Document	Uploaded 2021-01-13	Repair queued
P_Att 5a Sick Food Worker Toolkit 201211.docx	Supplementary Document	Uploaded 2021-01-13	Repair queued
P_Att 1 Study Advertisement Template 201211.docx	Supplementary Document	Uploaded 2021-01-13	Repair queued
Ill Worker Protocol (body) 201211.docx	Supplementary Document	Uploaded 2021-01-13	Repair queued
App F STARS Determination.pdf	Supplementary Document	Uploaded 2021-01-13	Repair queued
App E Privacy Impact Assessment.pdf	Supplementary Document	Uploaded 2021-01-13	Repair queued
App D EHS-Net Publications.docx	Supplementary Document	Uploaded 2021-01-13	Repair queued
App C EHS-Net Industry Partners.docx	Supplementary Document	Uploaded 2021-01-13	Available
App B 60-day FRN 200914.pdf	Supplementary Document	Uploaded 2021-01-13	Repair queued
App A Authorizing Legislation.pdf	Supplementary Document	Uploaded 2021-01-13	Repair queued
1 - SSB Ass Ill Wrkr Plcy 201211.docx	Supporting Statement B	Uploaded 2021-01-13	Repair queued
1 - SSA Ass Ill Wrkr Plcy 201228.docx	Supporting Statement A	Uploaded 2021-01-13	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
245317	Resaturant intervention log - control restaurants	Form and Instruction	New	Intervention log - control restaurants
245317	Resaturant intervention log - control restaurants	Form and Instruction	New
245315	Restaurant intervention log - intervention restaurants	Form	New	Restaurant intervention log
245315	Restaurant intervention log - intervention restaurants	Form	New
228972	Restaurant Environment Observation - Control Visit 3	Form	Removed	Restaurant Environment Observation Form
228972	Restaurant Environment Observation - Control Visit 3	Form	Removed
228971	Restaurant Environment Observation - Control Visit 2	Form	Removed	Restaurant Environment Observation Form
228971	Restaurant Environment Observation - Control Visit 2	Form	Removed
228970	Restaurant Environment Observation - Control Visit 1	Form	Removed	Restaurant Environment Observation Form
228970	Restaurant Environment Observation - Control Visit 1	Form	Removed
228969	Food Worker Consent and Survey - Control Visit 3	Form	Removed	Food Worker Consent and Survey
228969	Food Worker Consent and Survey - Control Visit 3	Form	Removed
228968	Food Worker Consent and Survey - Control Visit 2	Form	Removed	Food Worker Consent and Survey
228968	Food Worker Consent and Survey - Control Visit 2	Form	Removed
228967	Food Worker Consent and Survey - Control Visit 1	Form	Removed	Food Worker Consent and Survey
228967	Food Worker Consent and Survey - Control Visit 1	Form	Removed
228966	Manager Consent and Interview - Control Visit 3	Form	Removed	Manager Consent and Interview
228966	Manager Consent and Interview - Control Visit 3	Form	Removed
228965	Manager Consent and Interview - Control Visit 2	Form	Removed	Manager Consent and Interview
228965	Manager Consent and Interview - Control Visit 2	Form	Removed
228964	Manager Consent and Interview - control restaurants	Form and Instruction	Modified	Manager consent and interview
228964	Manager Consent and Interview - control restaurants	Form and Instruction	Modified
228963	Restaurant Environment Observation - Intervention Visit 2	Form	Removed	Restaurant Environment Observation Form
228963	Restaurant Environment Observation - Intervention Visit 2	Form	Removed
228962	Restaurant Observation	Form and Instruction	Modified	Restaurant Observation
228962	Restaurant Observation	Form and Instruction	Modified
228961	Food Worker Consent and Survey - Intervention Visit 2	Form	Removed	Food Worker Consent and Survey
228961	Food Worker Consent and Survey - Intervention Visit 2	Form	Removed
228960	Food Worker Consent and Survey - Intervention Visit 1	Form	Removed	Food Worker Consent and Survey
228960	Food Worker Consent and Survey - Intervention Visit 1	Form	Removed
228959	Manager Consent and Interview - Intervention Visit 2	Form	Removed	Manager Consent and Interview
228959	Manager Consent and Interview - Intervention Visit 2	Form	Removed
228958	Manager Consent and Interview	Form and Instruction	Modified	Manager consent and interview
228958	Manager Consent and Interview	Form and Instruction	Modified
228957	Manager Recruiting Script	Form and Instruction	Modified	Manager recruiting script
228957	Manager Recruiting Script	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1227	ICR Reference No: 202101-0920-005
Status: Historical Active	Previous ICR Reference No: 201711-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1227
Title: Assessment of Ill Worker Policies Study
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/15/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/08/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2024	36 Months From Approved	05/31/2021
Responses	820	0	2,127
Time Burden (Hours)	260	0	352
Cost Burden (Dollars)	0	0	0

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Abstract: The Environmental Health Specialists Network (EHS-Net) program, conducts research designed to identify and understand environmental factors associated with foodborne illness and other food safety issues. This study has two goals 1) to assess restaurant ill worker management practices and plans; and 2) examine the effectiveness of an educational intervention for restaurants to develop enhanced ill worker management practices. If the intervention is successful, it will be provided to food safety regulatory agencies as a model practice for working with restaurants to develop ill worker management plans and enhance their practices of keeping ill workers from working with food. Changes have been made based on feedback and response to COVID.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: PHSA
  

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:
	85 FR 56615	09/14/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 8649	02/08/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Food Worker Consent and Survey - Control Visit 1	none	Food Worker Consent and Survey
Food Worker Consent and Survey - Control Visit 2	none	Food Worker Consent and Survey
Food Worker Consent and Survey - Control Visit 3	none	Food Worker Consent and Survey
Food Worker Consent and Survey - Intervention Visit 1	none	Food Worker Consent and Survey
Food Worker Consent and Survey - Intervention Visit 2	none	Food Worker Consent and Survey
Manager Consent and Interview	none	Manager consent and interview
Manager Consent and Interview - Control Visit 2	none	Manager Consent and Interview
Manager Consent and Interview - Control Visit 3	none	Manager Consent and Interview
Manager Consent and Interview - Intervention Visit 2	none	Manager Consent and Interview
Manager Consent and Interview - control restaurants	none	Manager consent and interview
Manager Recruiting Script	none	Manager recruiting script
Resaturant intervention log - control restaurants	none	Intervention log - control restaurants
Restaurant Environment Observation - Control Visit 1	none	Restaurant Environment Observation Form
Restaurant Environment Observation - Control Visit 2	none	Restaurant Environment Observation Form
Restaurant Environment Observation - Control Visit 3	none	Restaurant Environment Observation Form
Restaurant Environment Observation - Intervention Visit 2	none	Restaurant Environment Observation Form
Restaurant Observation	none	Restaurant Observation
Restaurant intervention log - intervention restaurants	none	Restaurant intervention log

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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	820	2,127	0	-1,307	0	0
Annual Time Burden (Hours)	260	352	0	-92	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Revisions have been made in response to feedback from partners and COVID considerations. Burden has been reduced by 91 hours.

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Annual Cost to Federal Government: $119,333

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

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? No

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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: 02/08/2021

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