Information Collection Request

Assessment of Ill Worker Policies Study

ICR 202101-0920-005 · OMB 0920-1227 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Resaturant intervention log - control restaurants Form and Instruction New Missing upstream
Restaurant intervention log - intervention restaurants Form New Missing upstream
Restaurant Environment Observation - Control Visit 3 Form Removed Repair queued
Restaurant Environment Observation - Control Visit 2 Form Removed Repair queued
Restaurant Environment Observation - Control Visit 1 Form Removed Repair queued
Food Worker Consent and Survey - Control Visit 3 Form Removed Missing upstream
Food Worker Consent and Survey - Control Visit 2 Form Removed Repair queued
Food Worker Consent and Survey - Control Visit 1 Form Removed Missing upstream
Manager Consent and Interview - Control Visit 3 Form Removed Repair queued
Manager Consent and Interview - Control Visit 2 Form Removed Missing upstream
Manager Consent and Interview - control restaurants Form and Instruction Modified Missing upstream
Restaurant Environment Observation - Intervention Visit 2 Form Removed Repair queued
Restaurant Observation Form and Instruction Modified Repair queued
Food Worker Consent and Survey - Intervention Visit 2 Form Removed Repair queued
Food Worker Consent and Survey - Intervention Visit 1 Form Removed Repair queued
Manager Consent and Interview - Intervention Visit 2 Form Removed Repair queued
Manager Consent and Interview Form and Instruction Modified Available
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 Missing upstream
App F STARS Determination.pdf Supplementary Document Uploaded 2021-01-13 Missing upstream
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 Missing upstream
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 Missing upstream
1 - SSB Ass Ill Wrkr Plcy 201211.docx Supporting Statement B Uploaded 2021-01-13 Missing upstream
1 - SSA Ass Ill Wrkr Plcy 201228.docx Supporting Statement A Uploaded 2021-01-13 Repair queued

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 05/31/2021
820 2,127
260 352
0 0





Reginfo record details
6
table that charts list of burden
IC Title Form No. Form Name
Manager Recruiting Script none Manager recruiting script
Manager Consent and Interview - Control Visit 2 none Manager Consent and Interview
Manager Consent and Interview - control restaurants none Manager consent and interview
Manager Consent and Interview none Manager consent and interview
Manager Consent and Interview - Control Visit 3 none Manager Consent and Interview
Food Worker Consent and Survey - Control Visit 3 none Food Worker Consent and Survey
Restaurant Environment Observation - Control Visit 3 none Restaurant Environment Observation Form
Restaurant Environment Observation - Control Visit 1 none Restaurant Environment Observation Form
Resaturant intervention log - control restaurants none Intervention log - control restaurants
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
Restaurant Environment Observation - Control Visit 2 none Restaurant Environment Observation Form
Restaurant Observation none Restaurant Observation
Manager Consent and Interview - Intervention Visit 2 none Manager Consent and Interview
Food Worker Consent and Survey - Intervention Visit 2 none Food Worker Consent and Survey
Food Worker Consent and Survey - Intervention Visit 1 none Food Worker Consent and Survey
Restaurant intervention log - intervention restaurants none Restaurant intervention log
Restaurant Environment Observation - Intervention Visit 2 none Restaurant Environment Observation Form

table that charts list of burden
  Total Request 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


Reginfo record details
  No