Information Collection

HAI/AR Program Multi-Drug Resistant Organism (MDRO) Prevention and Response Needs Assessment Survey

IC 252302 under ICR 202403-0920-013 · OMB 0920-1071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1070 HAI/AR Program Multi-Drug Resistant Organism (MDRO) Prevention and Response Needs Assessment Survey	Form and Instruction
Form 0920-1070 HAI/AR Program Multi-Drug Resistant Organism (MDRO) Prevention and Response Needs Assessment Survey	Form and Instruction
0920-1070 ARP SHARP Guidance 2021 P1 Activity B1 MDRO Prevention P MDRO Prevention - Health Department Needs and Resource Availability Assessment_FINAL.pdf	Form and Instruction
0920-1070 ARP SHARP Guidance 2021 P1 Activity B1 MDRO Prevention P MDRO Prevention - Health Department Needs and Resource Availability Assessment_FINAL.pdf	Form and Instruction
Service Delivery Fast Track_MDROPreventionNeedsAssessmt.docx Request for Approval under the “Generic Clearance	IC Document
Service Delivery Fast Track_MDROPreventionNeedsAssessmt.docx Request for Approval under the “Generic Clearance	IC Document
HumanSubjectsDetermination_MDROPreventionNeedsAssessment.pdf Determination of Non-applicability of Human Subjects	IC Document
HumanSubjectsDetermination_MDROPreventionNeedsAssessment.pdf Determination of Non-applicability of Human Subjects	IC Document

IC Title:

HAI/AR Program Multi-Drug Resistant Organism (MDRO) Prevention and Response Needs Assessment Survey

Agency IC Tracking Number:

0920-1071-22DP

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1070	ARP SHARP Guidance 2021 P1 Activity B1 MDRO Prevention Plan Needs Assessment	MDRO Prevention - Health Department Needs and Resource Availability Assessment_FINAL.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 64

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	96	96
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval under the âGeneric Clearance	Service Delivery Fast Track_MDROPreventionNeedsAssessmt.docx	03/21/2022
Determination of Non-applicability of Human Subjects	HumanSubjectsDetermination_MDROPreventionNeedsAssessment.pdf	03/21/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.