Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-24DC Excel Tool User Survey for Website	Form and Instruction	New	Repair queued
Form 0920-24CX Focus Group Moderator Guide	Form and Instruction	New	Repair queued
Form 0920-24CX Eligible Participant Screener	Form and Instruction	New	Repair queued
Form 0920-24CX Eligibility Screener	Form and Instruction	New	Repair queued
Form 0920-24BS Att C - TRAIN Post Training Evaluation Survey Instrument	Form and Instruction	New	Repair queued
Form 0920-24BS TCEO PFL 3-Week Follow-up Survey	Form and Instruction	New	Repair queued
Form 0920-24BS Att A - TCEO PFL Post Training Evaluation Survey Instrument	Form and Instruction	New	Repair queued
Form 0920-1071-24AU TB Care Finder info requested to TB control programs PRA 10.23	Form and Instruction	New	Repair queued
NH Survey	Form and Instruction	New	Repair queued
Form 0920-1071 Nhsn 360 Assessment Facility Survey	Form and Instruction	New	Repair queued
Form 0920-1071 DFWED Data System User Feedback Survey	Form	New	Repair queued
External User Satisfaction Survey for HHS Protect Users	Form and Instruction	New	Repair queued
Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank	Form and Instruction	New	Repair queued
Topics for Interview and Listening Sessions - Public Health Law Attorneys	Form and Instruction	New	Repair queued
Topics for Interview and Listening Sessions - Correctional Food Workers, Inspectors, or Trainers	Form and Instruction	New	Repair queued
Topics for Interview and Listening Sessions - Correctional Partners	Form and Instruction	New	Repair queued
Form 0920-1071 DCIPHER External User Satisfaction Survey	Form and Instruction	New	Repair queued
Form 0920-1071 Evaluation of Communication between Immigrant, Refugee Migrant Health Branch at CDC and ARHC partners during responses in 2020-2022	Form	New	Repair queued
Form 0920-1071 Interview Consent and Questionnaire	Form and Instruction	New	Repair queued
BEAM Dashboard Customer Satisfaction Survey	Form and Instruction	New	Repair queued
Year 7 (2022) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank	Form and Instruction	New	Repair queued
2022 CDC Science Ambassador Fellowship Summer Course Survey (screenshots, annotated)	Form and Instruction	New	Repair queued
Form 0920-1070 ARP SHARP Guidance 2021 P1 Activity B1 MDRO Prevention Plan Needs Assessment	Form and Instruction	New	Repair queued
Form 0920-1071 AR Isolate Bank Customer Satisfaction Survey	Form and Instruction	New	Available
Published 30dy211071.pdf	Supplementary Document	Uploaded 2021-02-12	Repair queued
Att. C - Service Delivery Gen-IC Request.docx	Supplementary Document	Uploaded 2021-02-12	Repair queued
Att. B - 60-Day Published.pdf	Supplementary Document	Uploaded 2021-02-12	Repair queued
Att. A - Section 301 of the Public Health Service Act (42 USC 241).pdf	Supplementary Document	Uploaded 2018-01-04	Repair queued
SSB_0920-1071_Extension_2020.docx	Supporting Statement B	Uploaded 2021-02-12	Available
SSA_0920-1071_Extension_020121_v2.docx	Supporting Statement A	Uploaded 2021-02-12	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
265560	[NCZEID] SBS Excel Tool for Thematic Analysis Feedback Survey	Form and Instruction	New	Excel Tool User Survey for Website
265167	[NCZEID] DCIPHER External User Satisfaction Survey	Form and Instruction	New	Focus Group Moderator Guide
265167	[NCZEID] DCIPHER External User Satisfaction Survey	Form and Instruction	New	Eligible Participant Screener
265167	[NCZEID] DCIPHER External User Satisfaction Survey	Form and Instruction	New	Eligibility Screener
264373	[NCZEID] Project Firstline Training Completion on CDCs TRAINTCEO Systems	Form and Instruction	New	Att C - TRAIN Post Training Evaluation Survey Instrument
264373	[NCZEID] Project Firstline Training Completion on CDCs TRAINTCEO Systems	Form and Instruction	New	TCEO PFL 3-Week Follow-up Survey
264373	[NCZEID] Project Firstline Training Completion on CDCs TRAINTCEO Systems	Form and Instruction	New	Att A - TCEO PFL Post Training Evaluation Survey Instrument
263184	[NCZEID]TB Care Finder	Form and Instruction	New	TB Care Finder info requested to TB control programs PRA 10.23
263139	[NCEZID] Survey of Nursing Homes to Support a Pilot Test of a National Healthcare Safety Network (NHSN) Electronic Health Record (EHR) Implementation Guide (IG)	Form and Instruction	New	NH Survey
262717	[NCEZID] NHSN Facility End User Survey	Form and Instruction	New	Nhsn 360 Assessment Facility Survey
262153	DFWED Data System User Feedback Survey	Form	New	DFWED Data System User Feedback Survey
261053	[NCEZID] HHS Protect User Satisfaction Survey	Form and Instruction	New	External User Satisfaction Survey for HHS Protect Users
261000	[NCEZID] Year 8 (2023) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank	Form and Instruction	New	Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank
259021	Understanding Food Safety in Correctional Settings	Form and Instruction	New	Topics for Interview and Listening Sessions - Public Health Law Attorneys
259021	Understanding Food Safety in Correctional Settings	Form and Instruction	New	Topics for Interview and Listening Sessions - Correctional Food Workers, Inspectors, or Trainers
259021	Understanding Food Safety in Correctional Settings	Form and Instruction	New	Topics for Interview and Listening Sessions - Correctional Partners
258886	[NCEZID] DCIPHER External User Satisfaction Survey	Form and Instruction	New	DCIPHER External User Satisfaction Survey
258090	[NCEZID] Evaluation of communication between CDC and Association of Refugee Health Coordinators (ARHC) partners during responses in 2021-2022	Form	New	Evaluation of Communication between Immigrant, Refugee Migrant Health Branch at CDC and ARHC partners during responses in 2020-2022
258090	[NCEZID] Evaluation of communication between CDC and Association of Refugee Health Coordinators (ARHC) partners during responses in 2021-2022	Form and Instruction	New	Interview Consent and Questionnaire
258090	[NCEZID] Evaluation of communication between CDC and Association of Refugee Health Coordinators (ARHC) partners during responses in 2021-2022	Instruction	New
257888	[NCEZID] Improving Traveler Data Exchange Between Health Departments and CDC Division of Global Migration and Quarantine	Other-MITRE Project Protocol	New
257756	[NCEZID] BEAM Dashboard User Feedback Survey	Form and Instruction	New	BEAM Dashboard Customer Satisfaction Survey
256580	Year 7 (2022) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank	Form and Instruction	New	Year 7 (2022) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank
254358	[2022] The Science Ambassador Fellowship Summer Course Satisfaction Survey [CSELS]	Form and Instruction	New	2022 CDC Science Ambassador Fellowship Summer Course Survey (screenshots, annotated)
254358	[2022] The Science Ambassador Fellowship Summer Course Satisfaction Survey [CSELS]	Other-WORD document to facilitate review of survey content	New
252302	HAI/AR Program Multi-Drug Resistant Organism (MDRO) Prevention and Response Needs Assessment Survey	Form and Instruction	New	ARP SHARP Guidance 2021 P1 Activity B1 MDRO Prevention Plan Needs Assessment
247834	Year 6 (2021) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank	Form and Instruction	New	AR Isolate Bank Customer Satisfaction Survey

ICR Details

OMB Control No: 0920-1071	ICR Reference No: 202101-0920-020
Status: Historical Active	Previous ICR Reference No: 201711-0920-019
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1071
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/10/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/16/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2024	36 Months From Approved	05/31/2021
Responses	5,800	0	5,800
Time Burden (Hours)	3,850	0	3,850
Cost Burden (Dollars)	0	0	0

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Abstract: This is a generic ICR. The collection of this information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
   US Code: 42 USC 241 Name of Law: The Public Health and Welfare
  

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 66985	10/21/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 9342	02/12/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 18

table that charts list of burden

IC Title	Form No.	Form Name
[NCZEID] Project Firstline Training Completion on CDCs TRAINTCEO Systems	0920-24BS, 0920-24BS, 0920-24BS	Att A - TCEO PFL Post Training Evaluation Survey Instrument ,   TCEO PFL 3-Week Follow-up Survey ,   Att C - TRAIN Post Training Evaluation Survey Instrument
DFWED Data System User Feedback Survey	0920-1071	DFWED Data System User Feedback Survey
HAI/AR Program Multi-Drug Resistant Organism (MDRO) Prevention and Response Needs Assessment Survey	0920-1070	ARP SHARP Guidance 2021 P1 Activity B1 MDRO Prevention Plan Needs Assessment
Understanding Food Safety in Correctional Settings	n/a, n/a, n/a	Topics for Interview and Listening Sessions - Correctional Partners ,   Topics for Interview and Listening Sessions - Correctional Food Workers, Inspectors, or Trainers ,   Topics for Interview and Listening Sessions - Public Health Law Attorneys
Year 6 (2021) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank	0920-1071	AR Isolate Bank Customer Satisfaction Survey
Year 7 (2022) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank	None	Year 7 (2022) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank
[2022] The Science Ambassador Fellowship Summer Course Satisfaction Survey [CSELS]	None	2022 CDC Science Ambassador Fellowship Summer Course Survey (screenshots, annotated)
[NCEZID] BEAM Dashboard User Feedback Survey	None	BEAM Dashboard Customer Satisfaction Survey
[NCEZID] DCIPHER External User Satisfaction Survey	0920-1071	DCIPHER External User Satisfaction Survey
[NCEZID] Evaluation of communication between CDC and Association of Refugee Health Coordinators (ARHC) partners during responses in 2021-2022	0920-1071, 0920-1071	Interview Consent and Questionnaire ,   Evaluation of Communication between Immigrant, Refugee Migrant Health Branch at CDC and ARHC partners during responses in 2020-2022
[NCEZID] HHS Protect User Satisfaction Survey	n/a	External User Satisfaction Survey for HHS Protect Users
[NCEZID] Improving Traveler Data Exchange Between Health Departments and CDC Division of Global Migration and Quarantine
[NCEZID] NHSN Facility End User Survey	0920-1071	Nhsn 360 Assessment Facility Survey
[NCEZID] Survey of Nursing Homes to Support a Pilot Test of a National Healthcare Safety Network (NHSN) Electronic Health Record (EHR) Implementation Guide (IG)	n/a	NH Survey
[NCEZID] Year 8 (2023) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank	n/a	Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank
[NCZEID] DCIPHER External User Satisfaction Survey	0920-24CX, 0920-24CX, 0920-24CX	Eligibility Screener ,   Eligible Participant Screener ,   Focus Group Moderator Guide
[NCZEID] SBS Excel Tool for Thematic Analysis Feedback Survey	0920-24DC	Excel Tool User Survey for Website
[NCZEID]TB Care Finder	0920-1071-24AU	TB Care Finder info requested to TB control programs PRA 10.23

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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	5,800	5,800	0	0	0	0
Annual Time Burden (Hours)	3,850	3,850	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $50,000

Does this IC contain surveys, censuses, or employ statistical methods? No

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.     Yes

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: 02/16/2021

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