OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Workplace Violence Prevention Programs In New Jersey Healthcare Facilities

ICR 201808-0920-007 · OMB 0920-0914 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0914 Nursing Home Administrators Committee Chair Interview Form Unchanged Available
Form 0920-0914 Nursing Home Administrators Committee Chair Interview Form Modified Available
Form 0920-0914 Nursing Home Administrators Survey Form Unchanged Repair queued
Request for NonsubstantiveChange 0920-0914.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-08-28 Available
Appendix G.rtf Supplementary Document Uploaded 2018-03-26 Available
Appendix F.pdf Supplementary Document Uploaded 2018-03-26 Available
Appendix E.pdf Supplementary Document Uploaded 2018-02-26 Repair queued
Appendix D.docx Supplementary Document Uploaded 2018-03-26 Available
Appendix B.pdf Supplementary Document Uploaded 2018-02-26 Available
Appendix A.docx Supplementary Document Uploaded 2018-03-26 Available
Supporting Statement B 3.26.18.doc Supporting Statement B Uploaded 2018-03-26 Available
Sup Sta A 0920-0914 3.28.18.docx Supporting Statement A Uploaded 2018-03-28 Available
IC Document Collections
IC IDCollectionTypeStatusForm
205004 Nursing Home Administrators Committee Chair Interview Form Unchanged
205003 Nursing Home Administrators Committee Chair Interview Form Modified
205002 Nursing Home Administrators Survey Form Unchanged
ICR Details
0920-0914 201808-0920-007
Historical Inactive 201802-0920-010
HHS/CDC 0920-0914-18AVI
Workplace Violence Prevention Programs In New Jersey Healthcare Facilities
No material or nonsubstantive change to a currently approved collection   No
Regular
Improperly submitted and continue 10/18/2018
Retrieve Notice of Action (NOA) 09/11/2018
Revised modes of data collection (in this case, switching to an electronic submission system) must be submitted through a revision request. New modes of data collection including changes in methods/platform entail re-review of privacy and IT security issues.
  Inventory as of this Action Requested Previously Approved
05/31/2019 05/31/2019 06/30/2019
60 0 60
60 0 60
0 0 0
This project is an intervention evaluation study, comparing the comprehensiveness of nursing home workplace violence prevention programs in New Jersey (NJ) with the comprehensiveness of programs in Virginia (VA). The purpose of the information collected is to disseminate the information to health departments for potential development of legislation for a workplace violence prevention programs. We are requesting a change to the method of collecting the survey data for one instrument to an online survey due to difficulty recruiting nursing home workplace violence prevention committee chairs to do an in person interview.
PL: Pub.L. 91 - 596 20.a.1 Name of Law: Occupational Safety and Health Act
  
None
Not associated with rulemaking
  82 FR 55611 11/22/2017
83 FR 12764 03/23/2018
Yes
No
No
$0
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Kevin Joyce 404 639-1944 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/11/2018