REPORTING: Funded Projects Pilot; Developing Standardized Forms

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Overview

Coversheet
ProduceLandscape
ProgramResource
ProduceResponse

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Sheet 1: Coversheet

	Standard Name		0
	OPEI		0
	Recipent Name (Select)		Select
	State		Select Recipient Name
	Federal Award Identification Number		Select Recipient Name
	Program Path		Select Recipient Name
	Assessment Author (if not PI)
	Date Completed (M/D/YYYY)
	Project Period Start Date		7/1/2021
	Project Period End Date		6/30/2026

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Sheet 2: ProduceLandscape

	Identify covered produce commodities that are common to your jurisdiction:
	Identify common farming conditions and practices in your jurisdiction:
	Identify unique farming conditions and practices in your jurisdiction:
	Review farm inventory estimated data (2017 National Agricultural Statistics Service (NASS) Data or other justified source) and compare it to your jurisdiction’s verified number of farms in inventory. Provide a narrative explanation of the comparison:

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Sheet 3: ProgramResource

	Describe your produce program's organization structure and infrastructure needs to include staffing, facilities, equipment, materials, and supplies - This can be typed, or included as an attachment in the yellow cell below:
	To insert as file in the yellow cell above: 1. Select the yellow cell. 2. From the top menu choose "Insert" and then click on the "Text" drop-down (right hand side of the insert menu in Microsoft Excel 365) 3. Choose "Object" from the drop-down and select the "Create From File" tab in the pop-up window. 4. Browse for the file you'd like to insert and choose "Insert". 5. Click the checkbox to "Display As Icon" and click "OK".
	Identify and describe any unmet organization or infrastructure needs:
	Identify partners and collaborators that support your produce program, such as other regulatory programs, other governmental non-regulatory programs, audit programs, educational programs, industry organizations, commodity groups, and other stakeholders (e.g., coalitions, subject matter experts). Identify potential additional opportunities for collaboration and partnership.
		Partner or Collaborator	Short description of support/potential to support your produce program:	Is this relationship currently active or a potential relationship?
	1			Select
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	15			Select

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Sheet 4: ProduceResponse

	Within your STATE					Within your CAP Produce Program
Event Type (an event that involves your state (e.g. illness or produce traceback))	Does your state have the ability to become aware of event?	Where does the notification come from?	If yes, what state agencies/division(s)/personnel roles are notified in your state?	Would your state be involved in the event response?	If yes, what state agencies/division/personnel roles are involved in the response?	Would your CAP produce program be made aware of event?	Would your CAP produce program be involved in the event response?	(Optional) Provide any additional information as needed	OPEI	Entity Name	Path
Intrastate (local jurisdiction level) foodborne illness outbreak due to human pathogens	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Intrastate (within state) foodborne illness outbreak due to human pathogens	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Interstate foodborne illness outbreak due to human pathogens	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Foodborne illness outbreak due to human pathogens implicating imported produce	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Sample positive for human pathogens	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Voluntary intrastate recall due to human pathogens	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Voluntary interstate recall due to human pathogens	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Natural events that may adulterate produce	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Man-made events that may adulterate produce	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Reportable Food Registry Reports	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Response Capability	Capability exists in your state?	If YES, What level of capability?	If YES, what state agencies/division/personnel roles are involved?	If YES, does the capability exist within your CAP produce program?	If YES, are policies or procedures are in place?	If YES, list any FDA funded programs that are used to implement this capability (e.g. RRT, LFFM, etc.)	(Optional) Provide any additional information as needed	OPEI	Entity Name	Path
Conduct a for-cause inspection or investigation to determine root-cause	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Conduct for-cause product sampling	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Conduct product sample analysis	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Conduct for-cause environmental sampling	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Conduct environmental sample analysis	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Conduct a traceback investigation (to follow the distribution chain)	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Conduct investigations of related operations (compost suppliers, packing sheds) and adjacent land (CAFOs, dairies, livestock farming operations, etc.)	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Publish public communications/consumer advisories	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name
Conduct compliance and enforcement activities at farm level	Select	Select	[Replace bracketed text with your response]	Select	Select	[Replace bracketed text with your response]	[Replace bracketed text with your response]	#N/A	Select	Select Recipient Name