0920-1352 Capability 1 01MAR2022

Form Approved

OMB Approval No. 0920-1352

Expiration Date: 10/31/2024

Capability 1

Date of the most recently conducted jurisdictional risk assessment (JRA) or equivalent

Hazards identified in the assessment

Process in place for transporting people in an emergency (select lead, support, or no role)

Evidence identifies roles and responsibilities of Equity officer, Disability/Access and Functional Needs (D/AFN) coordinator, or equivalent

Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1352).