Information Collection Request

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

ICR 202402-0920-010 · OMB 0920-1071 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-24DC Excel Tool User Survey for Website Form and Instruction Unchanged Available
Form 0920-24CX Focus Group Moderator Guide Form and Instruction Unchanged Available
Form 0920-24CX Eligible Participant Screener Form and Instruction Unchanged Repair queued
Form 0920-24CX Eligibility Screener Form and Instruction Unchanged Available
Form 0920-24BS Att C - TRAIN Post Training Evaluation Survey Instrument Form and Instruction Unchanged Available
Form 0920-24BS TCEO PFL 3-Week Follow-up Survey Form and Instruction Unchanged Available
Form 0920-24BS Att A - TCEO PFL Post Training Evaluation Survey Instrument Form and Instruction Unchanged Available
Form 0920-1071-24AU TB Care Finder info requested to TB control programs PRA 10.23 Form and Instruction Unchanged Available
NH Survey Form and Instruction Unchanged Available
Form 0920-1071 Nhsn 360 Assessment Facility Survey Form and Instruction Unchanged Available
Form 0920-1071 DFWED Data System User Feedback Survey Form Unchanged Available
External User Satisfaction Survey for HHS Protect Users Form and Instruction Unchanged Available
Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank Form and Instruction Unchanged Available
Topics for Interview and Listening Sessions - Public Health Law Attorneys Form and Instruction Unchanged Available
Topics for Interview and Listening Sessions - Correctional Food Workers, Inspectors, or Trainers Form and Instruction Unchanged Available
Topics for Interview and Listening Sessions - Correctional Partners Form and Instruction Unchanged Available
Form 0920-1071 DCIPHER External User Satisfaction Survey Form and Instruction Unchanged Available
Form 0920-1071 Evaluation of Communication between Immigrant, Refugee Migrant Health Branch at CDC and ARHC partners during responses in 2020-2022 Form Unchanged Available
Form 0920-1071 Interview Consent and Questionnaire Form and Instruction Unchanged Available
BEAM Dashboard Customer Satisfaction Survey Form and Instruction Unchanged Available
Year 7 (2022) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank Form and Instruction Unchanged Available
2022 CDC Science Ambassador Fellowship Summer Course Survey (screenshots, annotated) Form and Instruction Unchanged Available
Form 0920-1070 ARP SHARP Guidance 2021 P1 Activity B1 MDRO Prevention Plan Needs Assessment Form and Instruction Unchanged Available
Form 0920-1071 AR Isolate Bank Customer Satisfaction Survey Form and Instruction Unchanged Available
NSCR 27FEB2024.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-02-27 Available
Published 30dy211071.pdf Supplementary Document Uploaded 2021-02-12 Available
Att. C - Service Delivery Gen-IC Request.docx Supplementary Document Uploaded 2021-02-12 Available
Att. B - 60-Day Published.pdf Supplementary Document Uploaded 2021-02-12 Available
Att. A - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2018-01-04 Available
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 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
265680 [NCEZID] Year 9 (2024) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank Other-WORD New
265560 [NCZEID] SBS Excel Tool for Thematic Analysis Feedback Survey Form and Instruction UnchangedExcel Tool User Survey for Website
265167 [NCZEID] DCIPHER External User Satisfaction Survey Form and Instruction UnchangedFocus Group Moderator Guide
265167 [NCZEID] DCIPHER External User Satisfaction Survey Form and Instruction UnchangedEligible Participant Screener
265167 [NCZEID] DCIPHER External User Satisfaction Survey Form and Instruction UnchangedEligibility Screener
264373 [NCZEID] Project Firstline Training Completion on CDCs TRAINTCEO Systems Form and Instruction UnchangedAtt C - TRAIN Post Training Evaluation Survey Instrument
264373 [NCZEID] Project Firstline Training Completion on CDCs TRAINTCEO Systems Form and Instruction UnchangedTCEO PFL 3-Week Follow-up Survey
264373 [NCZEID] Project Firstline Training Completion on CDCs TRAINTCEO Systems Form and Instruction UnchangedAtt A - TCEO PFL Post Training Evaluation Survey Instrument
263184 [NCZEID]TB Care Finder Form and Instruction UnchangedTB 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 UnchangedNH Survey
262717 [NCEZID] NHSN Facility End User Survey Form and Instruction UnchangedNhsn 360 Assessment Facility Survey
262153 DFWED Data System User Feedback Survey Form UnchangedDFWED Data System User Feedback Survey
261053 [NCEZID] HHS Protect User Satisfaction Survey Form and Instruction UnchangedExternal 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 UnchangedCustomer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank
259021 Understanding Food Safety in Correctional Settings Form and Instruction UnchangedTopics for Interview and Listening Sessions - Public Health Law Attorneys
259021 Understanding Food Safety in Correctional Settings Form and Instruction UnchangedTopics for Interview and Listening Sessions - Correctional Food Workers, Inspectors, or Trainers
259021 Understanding Food Safety in Correctional Settings Form and Instruction UnchangedTopics for Interview and Listening Sessions - Correctional Partners
258886 [NCEZID] DCIPHER External User Satisfaction Survey Form and Instruction UnchangedDCIPHER 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 UnchangedEvaluation 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 UnchangedInterview Consent and Questionnaire
258090 [NCEZID] Evaluation of communication between CDC and Association of Refugee Health Coordinators (ARHC) partners during responses in 2021-2022 Instruction Unchanged
257888 [NCEZID] Improving Traveler Data Exchange Between Health Departments and CDC Division of Global Migration and Quarantine Other-MITRE Project Protocol Unchanged
257756 [NCEZID] BEAM Dashboard User Feedback Survey Form and Instruction UnchangedBEAM Dashboard Customer Satisfaction Survey
256580 Year 7 (2022) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank Form and Instruction UnchangedYear 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 Unchanged2022 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 Unchanged
252302 HAI/AR Program Multi-Drug Resistant Organism (MDRO) Prevention and Response Needs Assessment Survey Form and Instruction UnchangedARP 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 UnchangedAR Isolate Bank Customer Satisfaction Survey

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2024 05/31/2024 05/31/2024
5,800 0 5,800
3,975 0 3,850
0 0 0





Reginfo record details
19
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 ,   ,  
DFWED Data System User Feedback Survey 0920-1071
HAI/AR Program Multi-Drug Resistant Organism (MDRO) Prevention and Response Needs Assessment Survey 0920-1070
Understanding Food Safety in Correctional Settings n/a, n/a, n/a ,   ,  
Year 6 (2021) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank 0920-1071
Year 7 (2022) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank None
[2022] The Science Ambassador Fellowship Summer Course Satisfaction Survey [CSELS] None
[NCEZID] BEAM Dashboard User Feedback Survey None
[NCEZID] DCIPHER External User Satisfaction Survey 0920-1071
[NCEZID] Evaluation of communication between CDC and Association of Refugee Health Coordinators (ARHC) partners during responses in 2021-2022 0920-1071, 0920-1071 ,  
[NCEZID] HHS Protect User Satisfaction Survey n/a
[NCEZID] Improving Traveler Data Exchange Between Health Departments and CDC Division of Global Migration and Quarantine
[NCEZID] NHSN Facility End User Survey 0920-1071
[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
[NCEZID] Year 8 (2023) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank n/a
[NCEZID] Year 9 (2024) Customer Satisfaction Survey for the CDC Antibiotic Resistance (AR) Isolate Bank
[NCZEID] DCIPHER External User Satisfaction Survey 0920-24CX, 0920-24CX, 0920-24CX ,   ,  
[NCZEID] SBS Excel Tool for Thematic Analysis Feedback Survey 0920-24DC
[NCZEID]TB Care Finder 0920-1071-24AU

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) 3,975 3,850 0 125 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No