Additional Information

OMB0128Additional Information.pdf

Customer Satisfaction Surveys: Fast Track Recall Survey, Ombudsman Survey, State Partner Survey, Hotline Survey, Web Site, and Clearinghouse Survey

Additional Information

OMB: 3041-0128

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OMB Control Number
3041-0128
Expiration date 8/31/2008

Consumer Satisfaction Surveys for 2008-2011

Survey
Clearinghouse
Fast Track
Hotline
Ombudsman
State Partners
Website

Sample
Size
300
150
350
200
54
1,000

Survey
Method
E-mail, Mail
E-mail, Mail
Mail
E-mail, Mail
E-mail, Fax
Web-based

Total Over 3 Years
Total Per Year

Total Respondent Hours per Year
Total Staff Hours per Year

Pre-notice
R

Burden in minutes (R= Respondent, S= Staff)
Thank You /
Survey
Reminder
Follow-up*
R
S
R
S
R
S
4
8
1
1
3
3
4
16
1
1
3
3
4
7
1
1
1
1
4
12
1
1
3
3
4
45
1
1
3
3
3
2
X
X
X
X

GRAND
TOTAL
R
S
9
13
9
21
7
10
9
17
9
50
3
2

1
1
1
1
1
X

1,054

7,216

14,080

1,054

2,462

11,786

18,650

351

2,405

4,693

351

821

3,929

6,217

65
104

*Four of our surveys occasionally receive low response rates due to various factors. To deal with this, a follow-up to the survey is performed when unusually low
response rates appear. The follow-up uses a different survey method (Telephone) to make the survey more accessible to respondents.

OMB Control Number
3041-0128
Expiration Date 8/31/2008

Clearinghouse Survey
Goal
Background

Target Population
Data Source(s)
Sampling Method

Sample Size
Prior Survey
Response Rate
Survey Method

Procedure

Data Quality
Checks

Prior Survey
Performance
Indicator
Data Limitations
Attachments

Strategic/Annual: Sustain the high level of consumer satisfaction with the
Clearinghouse at 90% or better through the year 2010.
The National Injury Information Clearinghouse (Clearinghouse) disseminates statistics
and information related to deaths and injuries associated with the over 15,000 consumer
products under the agency’s jurisdiction. Each year the Commission responds to
requests for information from the American public. The purpose of the survey is to
measure the strategic/annual goal as well as to measure how well the program is
meeting the public’s standards.
Users of the National Injury Information Clearinghouse
Clearinghouse tracking data base
All Clearinghouse users during a 12 week period are included in the survey with the
exception of Freedom of Information Act (FOIA) requests, internal staff requests,
requests from people or entities outside of the U.S., erroneous duplicates of the same
request, follow-up requests, and requests with no return contact information.
300
(Number of Respondents)/(Sample Size)
63%
E-mail and Mail (Phone Follow-up if needed) – All participants who provide an email address will receive the e-mail survey; all other participants will receive the survey
by mail.
Participants will be sent four mailings over several weeks. The first will contain a letter
from the Chairman requesting participation when the survey arrives. One week later, the
questionnaire will be sent out. A follow-up postcard will be mailed one week after the
questionnaire as a reminder. And lastly, five weeks after the follow-up postcard, a
second copy of the survey will be sent to participants. E-mail procedures will be the
same only through e-mails rather then general mailings. NOTE: In the rare case of a
low response rate, the thank you letter will be replaced by a telephone follow-up.
Accuracy: Two survey types will yield similar results to previous surveys with a
standard error of .02
Completeness: Questions cover all appropriate goals and customer service standards.
Consistency: Standardized questionnaire and procedures.
Timeliness: Survey performed in FY09 for FY09 goal.
The proportion of respondents who replied to “In general, how satisfied are you with the
way the Clearinghouse worked?” with either “Very Satisfied” or “Satisfied” was:
93%
Sampling frame restricted to portion of year.
Pre-notice Letter
Mail Survey
Internet Survey

Postcard Reminder
Telephone Follow-up

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
Name
Address
City, State Zip
Within the next few days, you will receive a brief questionnaire asking about your recent request
for information from the U.S. Consumer Product Safety Commission’s National Injury
Information Clearinghouse. The Clearinghouse disseminates statistics and information relating
to deaths and injuries associated with consumer products and works to assist consumers in
reporting product-related incidents. Each year the Clearinghouse responds to over 3000 requests
for information from the public.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The survey should arrive in a few days with OMB control number 3041-0128. If you can not
locate an OMB control number on the survey then it is not an official government survey and
should be disregarded. If you have any questions please contact Employee Name at (301) 504XXXX or via e-mail at Employee@cpsc.gov.
Thank you for your cooperation.
Sincerely,

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

A Message from the Chairman, US Consumer Product Safety Commission
The National Injury Information Clearinghouse disseminates statistics and information related
to deaths and injuries associated with the over 15,000 consumer products under the agency’s
jurisdiction. In order for us to maintain and improve this service to the public, we are conducting a
survey of those who recently used the program.
All responses to our questionnaire are both voluntary and anonymous. The information being collected will
always be presented as a whole, with no individual responses being identified. Completing the survey only takes a
couple of minutes and will help us evaluate how well our services are meeting the public’s needs. The OMB control
number for this particular survey is 3041-0128. You should be able to locate an OMB control number on any official
government survey; otherwise the survey should be disregarded. If you have any questions please contact
Employee Name at (301) 504-XXXX or via e-mail at Employee@cpsc.gov.
Thank you,

Nancy A. Nord
Acting Chairman

Hotline 1-800-638-CPSC
www.cpsc.gov

-----------------------------Detach, fold and return the part below---------------------------------

Your Opinion Counts!
1. The staff person I spoke with was courteous.

[ ] Yes

[ ] No

[ ] Not Applicable

2. I was satisfied with how quickly I received the
information.

[ ] Yes

[ ] No

[ ] Don’t Know

3. I was satisfied with the information I received.

[ ] Yes

[ ] No

[ ] Don’t Know

4. I would use the Clearinghouse again.

[ ] Yes

[ ] No

[ ] Don’t know

5. In general, how satisfied are you with the
Clearinghouse?
[ ] Very Satisfied

[ ] Satisfied

[ ] Dissatisfied

[ ] Very Dissatisfied

Any comments?
_________________________________________________________________________________

Zoomerang

Page 1 of 2

U.S. CONSUMER PRODUCT SAFETY
COMMISSION CLEARINGHOUSE SURVEY 20XX

The National Injury Information Clearinghouse disseminates statistics and
information related to deaths and injuries associated with the over 15,000
consumer products under the agency's jurisdiction. In order for us to maintain
and improve this service to the public, we are conducting a survey of those who
recently used the program. Please take a few moments to answer the following
questions and click the submit button at the end of the survey.
All responses to our questionnaire are both voluntary and anonymous. The
information being collected will always be presented as a whole, with no
individual responses being identified. Completing the survey only takes a couple
of minutes and will help us evaluate how well our services are meeting the
public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be
able to locate an OMB control number on any official government survey;
otherwise the survey should be disregarded. If you have any questions please
contact Employee Name at (301) 504-XXXX or via e-mail at
Employee@cpsc.gov.
Thank you for your cooperation,
Nancy A. Nord
Acting Chairman
OMB Control Number 3041-0128
Expiration Date 8/31/2008

The staff person I spoke with was courteous.
Yes

Not Applicable

I was satisfied with how quickly I received the information.
Yes

Do not know

I was satisfied with the information I received.
Yes

Do not know

http://app.zoomerang.com/Report/print_survey_body.zgi?ID=L23B6E23C3LX

4/4/2008

Zoomerang

Page 2 of 2

I would use the Clearinghouse again.
Yes

Do not know

In general, how satisfied are you with the Clearinghouse?
Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Any comments?

OMB Control Number 3041-0128
Expires 8/31/08

Survey Page 1

http://app.zoomerang.com/Report/print_survey_body.zgi?ID=L23B6E23C3LX

4/4/2008

U.S. Consumer Product Safety Commission
Bethesda, MD
We recently mailed you a survey (OMB #3041-0128) regarding the CPSC Clearinghouse. If you
have already completed and returned the survey, please accept our sincere thanks. If not, please do
so at your earliest convenience. We are especially grateful for your feedback because we believe
your response will be very useful in understanding how well we are meeting your needs.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs. If you can not locate an OMB control number on the
survey then it is not an official government survey and should be disregarded. If you have any
questions please contact Employee Name at (301) 504-XXXX or via e-mail at
Employee@cpsc.gov.

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

OMB Control #3041-0128
Expires 8/31/08

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Telephone Follow-up Questions
Hello, my name is Employee Name. I am calling on behalf of the U.S. Consumer Product Safety
Commission’s Office of Budget, Planning and Evaluation. We are doing a customer satisfaction
survey about our National Injury Information Clearinghouse. May I ask you a few questions that
will take only a few minutes of your time?
At this time I am required to tell you that the OMB control number for this survey is 3041-0128.
You should be able to locate an OMB control number on any official government survey;
otherwise the survey should be disregarded.
Also, all responses to our questionnaire are both voluntary and anonymous. The information
being collected will always be presented as a whole, with no individual responses being
identified. Completing the survey only takes a couple of minutes and will help us evaluate how
well our services are meeting the public’s needs.
1. The staff person I spoke with was courteous.
Yes
No
Not Applicable
2. I was satisfied with how quickly I received the information.
Yes
No
Do not know
3. I was satisfied with the information I received.
Yes
No
Do not know
4. I would use the Clearinghouse again
Yes
No
Do not know

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
5. In general, how satisfied are you with the Clearinghouse?
Very Satisfied
Satisfied
Dissatisfied
Very Dissatisfied

Comments
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Thank you for your time.

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control Number
3041-0128
Expiration Date 8/31/2008

Fast Track Survey
Goal
Background

Target Population
Data Source(s)
Sampling Method
Sample Size
Prior Survey
Response Rate
Survey Method

Procedure

Data Quality
Checks

Prior Survey
Performance
Indicator
Data Limitations
Attachments

Strategic/Annual: Maintain success with the timeliness and usefulness of the Fast Track
Product Recall programs for industry through 2010.
The U.S. Consumer Product Safety Commission created the Fast Track Recall Program
in 1997 to provide companies with a means to quickly remove hazardous products from
the marketplace. A firm that reports and corrects a problem within 20 business days will
not be subject to a preliminary determination that the product presents a substantial risk
of injury. The purpose of the survey is to measure the strategic/annual goal as well as to
measure how well the program is meeting the firm’s needs.
Any company who recalls a product using the Fast Track Recall Program
Office of Compliance database
During the Fiscal Year of the survey, all companies within the U.S. that recall a product
using the Fast Track Recall Program are included in the survey.
150
(Number of Respondents)/(Sample Size)
74%
E-mail and Mail (Phone Follow-up if needed) – All participants who provide an email address will receive the e-mail survey; all other participants will receive the survey
by mail.
Participants will be sent four mailings over several weeks. The first contains a letter
from the Chairman requesting participation when the survey arrives. One week later, the
questionnaire will be sent out with a cover letter explaining the survey. Another
questionnaire with cover letter will be mailed one week afterwards as a reminder.
Lastly, five weeks after the follow-up letter, a “Thank You” letter will be sent to all
participants. E-mail procedures will be identical only through e-mails rather then
general mailings. NOTE: In the rare case of a low response rate, the “Thank
You/Reminder” letter will be replaced by a telephone follow-up.
Accuracy: All users of the program in a Fiscal Year will be surveyed with a standard
error of .02
Completeness: All appropriate goals and standards measured.
Consistency: Standardized questionnaire and procedures.
Timeliness: Survey completed in FY09 for FY09 goals/standards.
The proportion of respondents who either “strongly agreed” or “agreed” that “The Fast
Track program should be continued” was:
92%
Participant sample comes from previous Fiscal Year.
Pre-notice Letter
Internet Survey
Survey Cover Letter
Thank You Letter
Mail Survey
Telephone Follow-up

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
«TITLE» «FIRST» «LAST»
«Company»
«Street»
«City», «State» «Zip»
«GREETINGLINE»
You recently used our FAST TRACK RECALL PROGRAM. This program is designed
to quickly implement a voluntary consumer-level recall within 20 working days of a
company’s report.
In order for us to assess the effectiveness of the Fast Track program, we will be
conducting a survey of those who recently used the program. We intend to send the
survey out over the next week. When you receive the survey please take a few moments
to answer all of the questions and return it.
All responses to our questionnaire are both voluntary and anonymous. The information
being collected will always be presented as a whole, with no individual responses being
identified. Completing the survey only takes a couple of minutes and will help us
evaluate how well our services are meeting the public’s needs.
The survey should arrive in a few days with OMB control number 3041-0128. If you can
not locate an OMB control number on the survey then it is not an official government
survey and should be disregarded. If you have any questions please contact Employee
Name at (301) 504-XXXX or via e-mail at Employee@cpsc.gov.
Thank you in advance for your cooperation,

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638CPSC (2772) ♦ CPSC’s Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
«TITLE»«FIRST»«LAST»
«Company»
«Street»
«City», «State» «Zip»
«GREETINGLINE»
We are conducting a survey of those who have recently used the FAST TRACK
RECALL PROGRAM. This program is designed to implement a quick voluntary
consumer-level recall within 20 working days of a company’s report.
All responses to our questionnaire are both voluntary and anonymous. The information
being collected will always be presented as a whole, with no individual responses being
identified. Completing the survey only takes a couple of minutes and will help us
evaluate how well our services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able to
locate an OMB control number on any official government survey; otherwise the survey
should be disregarded. If you have any questions please contact Employee Name at (301)
504-XXXX or via e-mail at Employee@cpsc.gov.
Thank you in advance for your cooperation.

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638CPSC (2772) ♦ CPSC’s Web Site: http://www.cpsc.gov

U.S. Consumer Product Safety
Commission Fast Track Survey 2007
Welcome to the CPSC Fast Track Recall Program. Please take a few moments to answer the following questions
and send the survey back using the enclosed envelope. All responses to our questionnaire are both voluntary and anonymous. The information being collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our services are meeting the public’s needs. The OMB control number for this particular survey is 3041-0128. You should be able to locate an OMB control number on any official government survey; otherwise the survey should be disregarded. If you have any questions
please contact Employee Name at (301) 504-XXXX or via e-mail at Employee@cpsc.gov.

1. How did you become aware of the Fast Track Program?
___ Company’s staff attorney
___ CPSC Staff
___ Other, please specify: __________________

___ Attorney outside of the company
___ Other staff from my company
Strongly
Agree

Agree

UnDisagree Strongly
decided
Disagree

2. The CPSC Compliance Officer who worked with you was
knowledgeable about the Fast Track Recall Program.
3. The Compliance Officer was courteous.
4. Did you ask the Compliance Officer for any advice or guidance in
conducting the recall?

___ YES

___ NO If no, skip to question 7.

5. The information provided by the Compliance Officer was clear.
6. The information provided by the Compliance Officer was useful.
7. Did you use Fast Track information materials to develop your recall? ___ YES

___ NO If no, skip to question 10.

8. The information was clear.
9. The information was useful.
10. The time required to implement the recall was adequate.
11. The Fast Track Program should be continued.
12. Please provide suggestions that would allow us to better assist companies who use the Fast Track program.
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
OMB Control Number 3041-0128
Expires 8/31/08

Page 1 of 4

U.S. CONSUMER PRODUCT SAFETY
COMMISSION FAST TRACK SURVEY 20XX

Welcome to the CPSC Fast Track Recall Program Survey. This program is
designed to quickly implement a consumer-level voluntary recall within 20
working days of the company's report. This survey is part of our continuing effort
to provide the best and most efficient service for our customers. Please take a
few moments to answer the following questions and click the submit button at the
end of the survey.
All responses to our questionnaire are both voluntary and anonymous. The
information being collected will always be presented as a whole, with no
individual responses being identified. Completing the survey only takes a couple
of minutes and will help us evaluate how well our services are meeting the
public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be
able to locate an OMB control number on any official government survey;
otherwise the survey should be disregarded. If you have any questions please
contact Employee Name at (301) 504-XXXX or via e-mail at
Employee@cpsc.gov.
Thank you for your cooperation,
Nancy A. Nord
Acting Chairman
OMB Control Number 3041-0128
Expiration Date 8/31/2008

How did you become aware of the Fast Track Program?
Company's staff attorney
Attorney outside of the company
CPSC Staff
Other staff from my company
Other, please specify

The CPSC Compliance Officer who worked with you was
knowledgeable about the Fast Track Recall Program.
Strongly Disagree

Disagree

Undecided

Agree

file://C:\DOCUME~1\dshope\LOCALS~1\Temp\AJNUWVXO.htm

Strongly Agree

4/4/2008

Page 2 of 4

The Compliance Officer was courteous.
Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

Did you ask the Compliance Officer for any advice or guidance in
conducting the recall?

OMB Control Number 3041-0128
Expires 8/31/08

Survey Page 1

U.S. CONSUMER PRODUCT SAFETY
COMMISSION FAST TRACK SURVEY 20XX

The information provided by the Compliance Officer was clear.
Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

The information provided by the Compliance Officer was useful.
Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

OMB Control Number 3041-0128
Expires 8/31/08

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4/4/2008

Page 3 of 4
Survey Page 2

U.S. CONSUMER PRODUCT SAFETY
COMMISSION FAST TRACK SURVEY 20XX

Did you use Fast Track information materials to develop your recall?

OMB Control Number 3041-0128
Expires 8/31/08

Survey Page 3

U.S. CONSUMER PRODUCT SAFETY
COMMISSION FAST TRACK SURVEY 20XX

The information was clear.
Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

Undecided

Agree

Strongly Agree

The information was useful.
Strongly Disagree

Disagree

OMB Control Number 3041-0128
Expires 8/31/08

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4/4/2008

Page 4 of 4

Survey Page 4

U.S. CONSUMER PRODUCT SAFETY
COMMISSION FAST TRACK SURVEY 20XX

10 The time required to implement the recall was adequate.
Strongly Disagree

Disagree

Undecided

Agree

Strongly Agree

Agree

Strongly Agree

11 The Fast Track program should be continued.
Strongly Disagree

Disagree

Undecided

12 Do you have any suggestions that would allow us to better assist
companies who use the Fast Track program?

OMB Control Number 3041-0128
Expires 8/31/08

Survey Page 5

file://C:\DOCUME~1\dshope\LOCALS~1\Temp\AJNUWVXO.htm

4/4/2008

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
«TITLE» «FIRST» «LAST»
«Company»
«Street»
«City», «State» «Zip»
«GREETINGLINE»
We recently mailed you a questionnaire asking about your experience with the FAST
TRACK RECALL PROGRAM. If you already completed and returned the survey to us,
please accept our sincere thanks. If not, please do so at your earliest convenience. We are
especially grateful for your help because we believe your response will be very useful in
understanding how well we are meeting your needs. Even though surveys were sent to
many recent users of the Fast Track Recall Program, it is only by hearing from nearly
every participant that we can be sure that all opinions of the program are represented.
In case you lost or misplaced your survey we have enclosed an additional copy and a
stamped envelope for your use. All responses to our questionnaire are both voluntary and
anonymous. The information being collected will always be presented as a whole, with
no individual responses being identified. Completing the survey only takes a couple of
minutes and will help us evaluate how well our services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able to
locate an OMB control number on any official government survey; otherwise the survey
should be disregarded. If you have any questions please contact Employee Name at (301)
504-XXXX or via e-mail at Employee@cpsc.gov.
Thank you in advance for your cooperation.

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission
CPSC Hotline: 1-800-638CPSC (2772) ♦ CPSC’s Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814

FAST TRACK SURVEY- Phone Interview
Hello, my name is Employee Name. I am calling on behalf of the U.S. Consumer
Product Safety Commission’s Office of Budget, Planning and Evaluation. We are doing a
customer satisfaction survey about our Fast Track Recall Program. May I ask you a few
questions that will take only a few minutes of your time?
At this time I am required to tell you that the OMB control number for this survey is
3041-0128. You should be able to locate an OMB control number on any official
government survey; otherwise the survey should be disregarded.
Also, all responses to our questionnaire are both voluntary and anonymous. The
information being collected will always be presented as a whole, with no individual
responses being identified. Completing the survey only takes a couple of minutes and will
help us evaluate how well our services are meeting the public’s needs.
1. How did you first become aware of the Fast Track Program?
0 Firm’s staff attorney

0 Attorney outside of firm

0 CPSC Staff

0 Other staff from my company

Other____________________________________________________________
Strongly
Agree

2. The Compliance Officer who worked with
you was knowledgeable about the Fast Track
Recall Program.

Agree

Undec.

Disagree Strongly
Disagree

CPSC Hotline: 1-800-638CPSC (2772) ♦ CPSC’s Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Strongly
Agree

3. The Compliance Officer was courteous.

Agree

Undec.

Disagree Strongly
Disagree

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4. Did you ask the Compliance officer for any advice or guidance in conducting the
recall? Yes [ ]
No [ ] If no, skip to 7.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
5. The information provided by the
Compliance Officer was clear.
5
4
3
2
1
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
6. The information provided by the
Compliance Officer was useful.
5
4
3
2
1
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
7. Did you use the Fast Track information materials to develop your recall?
Yes [ ]
No [ ] If no, skip to 10.
8. The information was clear.
5
4
3
2
1
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

CPSC Hotline: 1-800-638CPSC (2772) ♦ CPSC’s Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/2008

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Strongly
Agree

Agree

Undec.

Disagree Strongly
Disagree

9. The information was useful.
5
4
3
2
1
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
10. The time required by CPSC to implement the
recall (typically 20 business days) was
adequate.
5
4
3
2
1
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
11. The Fast Track program should be
continued.
5
4
3
2
1
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

I just have one final question.
12. Do you have any suggestions that would allow us to better assist firms who use the
Fast Track program?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Thank you for your time.

CPSC Hotline: 1-800-638CPSC (2772) ♦ CPSC’s Web Site: http://www.cpsc.gov

OMB Control Number
3041-0128
Expiration Date 8/31/2008

Hotline Survey
Goal
Background

Target Population
Data Source(s)
Sampling Method
Sample Size

Strategic/Annual: Sustain the high level of consumer satisfaction with the hotline at
90% or better through the year 2010.
The Hotline is a toll-free service that allows consumers to report product complaints or
product-related injuries, learn about recalls and safety hazards, and obtain safety
publications 24 hours a day, 7 days a week. The Hotline has published customer service
standards. The purpose of the survey is to measure the strategic/annual goal as well as to
measure how well the program is meeting the public’s needs.
Anyone who calls the Hotline.
Hotline callers who provided their names and addresses to CPSC staff to file a statement
about a potentially hazardous product, request information, or be put on a mailing list.
All callers in a 7-week period who spoke with a Hotline representative and agreed to
give their name and address are included in the survey.
350

Prior Survey
Response Rate
Survey Method
Procedure

(Number of Respondents)/(Sample Size)
65%
Mail survey
Participants will be sent four mailings over several weeks. The first contains a letter
from the Chairman requesting participation when the survey arrives. One week later, the
questionnaire will be sent out with a cover letter signed by the Chairman and a small
incentive. A follow-up postcard will be mailed one week after the questionnaire as a
reminder. And lastly, five weeks after the follow-up postcard, a second copy of the
survey, with cover letter, will be sent to participants.

Data Quality
Checks

Accuracy: A standard error of .02
Completeness: Questions covered all appropriate goals and customer service standards.
Consistency: Standardized questionnaire.
Timeliness: Survey done in FY2011 for FY2011 goal.
The proportion of respondents who replied to “In general, how satisfied are you with the
way the Hotline worked?” with either “Very Satisfied” or “Satisfied” was:

Prior Survey
Performance
Indicator
Data Limitations

Attachments

91%
Inability to include callers who do not speak to hotline staff
Inability to include callers who do not provide a mailing address.
Sampling restricted to 7-week time period.
Pre-notice Letter
Reminder Postcard
Survey Cover Letter
Thank You Letter
Mail Survey

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
Name
Address 1
City, State Zip
Within the next few days you will receive a request to fill out a brief customer satisfaction
survey regarding the Consumer Product Safety Commission Hotline. The Hotline is a toll-free
service that allows consumers to report product complaints or product-related injuries, learn
about recalls and safety hazards, and obtain safety publications 24 hours a day, 7 days a week.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The survey should arrive in a few days with OMB control number 3041-0128. If you can not
locate an OMB control number on the survey then it is not an official government survey and
should be disregarded. If you have any questions please contact Employee Name at (301) 504XXXX or via e-mail at Employee@cpsc.gov.
Thank you very much for your cooperation.
Sincerely,

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
Name
Address
City, State Zip
I am writing to ask for your opinion of the CPSC Hotline. The Hotline is a toll-free service that
allows consumers to report product complaints or product-related injuries, learn about recalls and
safety hazards, and obtain safety publications 24 hours a day, 7 days a week. This survey is part
of our continuing effort to provide the best and most efficient service to consumers. We are very
interested in how you rate the program and what suggestions you have to improve the services
provided by the Hotline.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able to locate
an OMB control number on any official government survey; otherwise the survey should be
disregarded. If you have any questions please contact Employee Name at (301) 504-XXXX or
via e-mail at Employee@cpsc.gov.
Thank you very much for your cooperation.
Sincerely,

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

U.S. Consumer Product Safety Commission
Hotline Survey 20XX
Welcome to the CPSC Hotline Survey. Please take a few moments to answer the following questions and send the
survey back using the enclosed envelope. All responses to our questionnaire are both voluntary and anonymous. The information being collected will always be presented as a whole, with no individual responses being identified. Completing the
survey only takes a couple of minutes and will help us evaluate how well our services are meeting the public’s needs. The
OMB control number for this particular survey is 3041-0128. You should be able to locate an OMB control number on any
official government survey; otherwise the survey should be disregarded. If you have any questions please contact Employee
Name at (301) 504-XXXX or via e-mail at Employee@cpsc.gov.
1. For your most recent call to the Hotline, did you… (check all that apply)
___ File a complaint about an unsafe product
___ Get product safety or recall information
___ Get a referral to another agency

___ Request a publication
___ Request to be put on the mailing list
___ Other, please specify: __________________

2. Was this the first time you ever used the Hotline?
___ Yes

___ No

___ I don’t remember

3. Did you get a busy signal when you first dialed the Hotline?
___ Yes

___ No

___ I don’t remember

Strongly
Agree

Agree

Strongly
Neutral Disagree Disagree

4. The instructions on how to use the Hotline were easy to follow.
5. Did you get safety information from a recorded message?

___ Yes

___ No If no, skip to question 8.

6. The recorded safety information was easy to find.
7. The recorded safety information was easy to understand.
8. The Hotline operator was courteous.
9. The information received from the operator was easy to understand.
10. In general, I am satisfied with the way the Hotline worked.
11. Would you use the Hotline again?
___ Yes

___ No

12. Why or why not?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

13. What did you like about the CPSC Hotline? What needs improvement?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

Thank you for taking the time to give us your feedback.

OMB Control 3041-0128
Expires 8/31/2008

U.S. Consumer Product Safety Commission
Bethesda, MD
We recently mailed you a survey (OMB #3041-0128) regarding the CPSC Hotline. If you have
already completed and returned the survey, please accept our sincere thanks. If not, please do so at
your earliest convenience. We are especially grateful for your feedback because we believe your
response will be very useful in understanding how well we are meeting your needs.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs. If you can not locate an OMB control number on the
survey then it is not an official government survey and should be disregarded. If you have any
questions please contact Employee Name at (301) 504-XXXX or via e-mail at
Employee@cpsc.gov.

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
Name
Address
City, State Zip
We recently mailed you a survey asking about your experience using the CPSC Hotline. If you
already completed and returned the survey to us, please accept our sincere thanks. If not, please
complete the survey and return it to us at your earliest convenience. We are especially grateful
for your help because it is only by receiving feedback from people like you that we can evaluate
how well the Hotline works.
In case you lost or misplaced your survey, we have enclosed an additional copy and a stamped
envelope for your use. If you already responded, please disregard this request.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able to locate
an OMB control number on any official government survey; otherwise the survey should be
disregarded. If you have any questions please contact Employee Name at (301) 504-XXXX or
via e-mail at Employee@cpsc.gov.
Thank you very much for your cooperation.
Sincerely,

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control Number
3041-0128
Expiration Date 8/31/2008

Small Business Ombudsman Survey
Goal
Background

Target Population
Data Source(s)
Sampling Method
Sample Size
Prior Survey
Response Rate
Survey Method

Procedure

Data Quality
Checks

Prior Survey
Performance
Indicator
Data Limitations
Attachments

Strategic/Annual: Maintain success with the timeliness and usefulness of the Small
Business Ombudsman programs for industry through 2010.
The Small Business Ombudsman Program helps small businesses comply more easily
with product safety guidelines and manufacture safer products. The program provides
firms with a single point of contact that expedites a clearly understandable response
from the CPSC technical staff. The purpose of the survey is to measure the
strategic/annual goal as well as to measure how well the program is meeting the needs
of small businesses.
Small businesses that contact the Ombudsman Program
Small Business Ombudsman database
All small businesses that contacted the Ombudsman during an 8-month period are
included in the survey.
200
(Number of Respondents)/(Sample Size)
74%
E-mail and Mail (Phone Follow-up if needed) – All participants who provide an email address will receive the e-mail survey; all other participants will receive the survey
by mail.
Participants will be sent four mailings over several weeks. The first contains a letter
from the Chairman requesting participation when the survey arrives. One week later, the
questionnaire will be sent out with a cover letter explaining the survey. A follow-up
letter and questionnaire will be mailed one week after the questionnaire as a reminder.
Lastly, five weeks after the follow-up letter, a “Thank You/Reminder” letter will be sent
to all participants. E-mail procedures will be identical only through e-mails rather then
general mailings. NOTE: In the rare case of a low response rate, the “Thank
You/Reminder” letter will be replaced by a telephone follow-up.
Accuracy: A standard error of .02
Completeness: All appropriate goals and standards measured.
Consistency: Standardized questionnaire and procedures.
Timeliness: Survey completed in FY09 for FY09 goal.
The proportion of respondents who either “strongly agreed” or “agreed” that “The
Ombudsman program should be continued” was:
92%
Sampling restricted to portion of fiscal year.
Pre-notice Letter
Internet Survey
Survey Cover Letter
Reminder / Thank You Letter
Mail Survey
Telephone Follow-up

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
Name
Address
City, State Zip
Greeting Line
The Consumer Product Safety Commission’s (CPSC) Small Business Ombudsman program
(SBO) helps small businesses comply more easily with product safety guidelines by responding
to their inquiries clearly and quickly. Over the next few weeks, the CPSC will be conducting a
survey of recent SBO users in an effort to rate the program.
Since you contacted us recently, we would like to hear about your experience. When the survey
arrives, simply fill out the short questionnaire and return it using the prepaid return envelope.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The survey should arrive in a few days with OMB control number 3041-0128. If you can not
locate an OMB control number on the survey then it is not an official government survey and
should be disregarded. If you have any questions please contact Employee Name at (301) 504XXXX or via e-mail at Employee@cpsc.gov.

Thank you in advance for your cooperation,

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
Name
Address
City, State Zip
Greeting Line
The Consumer Product Safety Commission’s (CPSC) Small Business Ombudsman program
(SBO) helps small businesses comply more easily with product safety guidelines by responding
to their inquiries clearly and quickly. Over the next few weeks, the CPSC will be conducting a
survey of recent SBO users in an effort to rate the program.
Since you contacted us recently, we would like to hear about your experience. Please fill out the
enclosed questionnaire and return it using the prepaid return envelope.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able to locate
an OMB control number on any official government survey; otherwise the survey should be
disregarded. If you have any questions please contact Employee Name at (301) 504-XXXX or
via e-mail at Employee@cpsc.gov.

Thank you in advance for your cooperation,

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

U.S. Consumer Product Safety Commission
Small Business Ombudsman Survey 20XX
Welcome to the CPSC Small Business Ombudsman Survey. Please take a few moments to answer the following
questions and send the survey back using the enclosed envelope. All responses to our questionnaire are both voluntary and
anonymous. The information being collected will always be presented as a whole, with no individual responses being identified. Completing the survey only takes a couple of minutes and will help us evaluate how well our services are meeting
the public’s needs. The OMB control number for this particular survey is 3041-0128. You should be able to locate an
OMB control number on any official government survey; otherwise the survey should be disregarded. If you have any
questions please contact Employee Name at (301) 504-XXXX or via e-mail at Employee@cpsc.gov.
1. Was your inquiry responded to in a timely manner?

___ YES

___NO

2. Was the information clear?

___YES

___NO

3. Was the information supplied useful?
Comments__________________________________

___YES

___NO

Comments___________________________________
___________________________________

Strongly
Agree

___________________________________

Agree

UnDisagree Strongly
decided
Disagree

4. The Product Safety Expert who contacted you was knowledgeable.
5. The Product Safety Expert who contacted you was courteous.
6. The time to receive a response was adequate.
7. How satisfied are you with your experience?
8. How did you contact the CPSC?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

9. Was this the first time you contacted the CPSC?

___YES

___NO

10. Was your inquiry related to a small business?

___ YES

___NO

11. About how many employees work in your organization?

________________

___Do not know

12. What term would best describe your organization?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________

13. Do you have any comments that would allow us to better assist firms who use the Ombudsman program?
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
OMB Control Number 3041-0128
Expires 8/31/08

Page 1 of 3

U.S. CONSUMER PRODUCT SAFETY
COMMISSION SMALL BUSINESS OMBUDSMAN
SURVEY 20XX

Welcome to the CPSC Small Business Ombudsman Survey. The SBO program
is designed to help small businesses comply more easily with product safety
guidelines by responding to their inquiries clearly and quickly. This survey is part
of our continuing effort to provide the best and most efficient service for our
customers. Please take a few moments to answer the following questions and
click the submit button at the end of the survey.
All responses to our questionnaire are both voluntary and anonymous. The
information being collected will always be presented as a whole, with no
individual responses being identified. Completing the survey only takes a couple
of minutes and will help us evaluate how well our services are meeting the
public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be
able to locate an OMB control number on any official government survey;
otherwise the survey should be disregarded. If you have any questions please
contact Employee Name at (301) 504-XXXX or via e-mail at
Employee@cpsc.gov.
Thank you for your cooperation,
Nancy A. Nord
Acting Chairman
OMB Control Number 3041-0128
Expiration Date 8/31/2008

Was your inquiry responded to in a timely manner?

Additional Comment

Was the information clear?

Was the information supplied useful?

Additional Comment

file://C:\DOCUME~1\dshope\LOCALS~1\Temp\D1ZLVA50.htm

5/15/2008

Page 2 of 3

The Product Safety Expert who contacted you was knowledgeable.
Strongly Disagree

Agree

Strongly Agree

Disagree

Undecided

Agree

Strongly Agree

Agree

Strongly Agree

Agree

Strongly Agree

The time to receive a response was adequate.
Strongly Disagree

Undecided

The Product Safety Expert who contacted you was courteous.
Strongly Disagree

Disagree

Undecided

How satisfied are you with your experience?
Strongly Disagree

Disagree

Undecided

How did you contact the Consumer Product Safety Commission?

Was this the first time you contacted the Consumer Product Safety
Commission?

10 Was your inquiry related to a small business?
Yes

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Do not know

5/15/2008

Page 3 of 3
11 About how many employees work in your organization?

12 What term would best describe your organization?

13 Do you have any comments that would allow us to better assist firms
who use the Ombudsman program?

OMB Control Number 3041-0128 Expires 8/31/08

Survey Page 1

file://C:\DOCUME~1\dshope\LOCALS~1\Temp\D1ZLVA50.htm

5/15/2008

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Date
Name
Address
City, State Zip
Greeting Line
You recently received a survey concerning the Small Business Ombudsman program (SBO).
Over the past few weeks, the Consumer Product Safety Commission (CPSC) has been
conducting a survey of recent SBO users in an effort to rate the program. If you have already
filled out and returned the survey we thank you for your time and input. If you have not done so,
we ask that you take a few moments to complete the survey now.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able to locate
an OMB control number on any official government survey; otherwise the survey should be
disregarded. If you have any questions please contact Employee Name at (301) 504-XXXX or
via e-mail at Employee@cpsc.gov.

Thank you in advance for your cooperation,

NANCY A. NORD
Acting Chairman
U.S. Consumer Product Safety Commission

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
Small Business Ombudsman Telephone Survey
Hello, my name is Employee Name. I am calling on behalf of the U.S. Consumer Product
Safety Commission’s Office of Budget, Planning and Evaluation. We are doing a customer
satisfaction survey about our Small Business Ombudsman. May I ask you a few questions that
will take only a few minutes of your time?
At this time I am required to tell you that the OMB control number for this survey is 30410128. You should be able to locate an OMB control number on any official government survey;
otherwise the survey should be disregarded.
Also, all responses to our questionnaire are both voluntary and anonymous. The information
being collected will always be presented as a whole, with no individual responses being
identified. Completing the survey only takes a couple of minutes and will help us evaluate how
well our services are meeting the public’s needs.
1. Was your inquiry responded to in a timely manner?
_ Yes
_ No
2. Was the information clear?
_ Yes
_ No
3. Was the information supplied useful?
_ Yes
_ No
4. The Product Safety Expert who contacted you was knowledgeable.
_ Strongly Agree
_ Agree
_ Undecided
_ Disagree
_ Strongly Disagree

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
5. The product safety expert who contacted you was courteous.
_ Strongly Agree
_ Agree
_ Undecided
_ Disagree
_ Strongly Disagree
6. The time to receive a response was adequate.
_ Strongly Agree
_ Agree
_ Undecided
_ Disagree
_ Strongly Disagree
7. How satisfied are you with your experience?
_ Very Satisfied
_ Satisfied
_ Somewhat Satisfied
_ Not Satisfied
8. How did you contact the Consumer Product Safety Commission?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
9. Was this the first time you contacted the Consumer Product Safety Commission?
_ Yes
_ No

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control #3041-0128
Expires 8/31/08

U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 EAST WEST HIGHWAY
BETHESDA, MD 20814
10. Was your Inquiry related to a small business?
_ Yes
_ No
_ Do not know
11. About how many employees work in your organization?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
12. What term would best describe your organization?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
13. Do you have any comments that would allow us to better assist firms who use the
Ombudsman program?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Thank you very much for your help. We appreciate you time.

CPSC Hotline: 1-800-638-CPSC (2772) CPSC's Web Site: http://www.cpsc.gov

OMB Control Number
3041-0128
Expiration Date 8/31/2008

State Partners Survey
Goal
Background

Target Population
Data Source(s)
Sampling Method
Sample Size
Prior Survey
Response Rate
Survey Method
Procedure

Data Quality
Checks

Prior Survey
Performance
Indicator
Data Limitations

Attachments

Strategic/Annual: Sustain the high level of consumer satisfaction with the State Partners
Program at 90% or better through the year 2010.
The State Partners program was established to promote Federal-State cooperation for
the purpose of carrying out the Consumer Product Safety Act. Using CPSC funds and
resources the program brings product safety services to consumers through cooperative
programs with state and local governments and territories. The purpose of the survey is
to measure the strategic/annual goal as well as to measure how well the program is
meeting state and local needs.
All state, district and territorial contacts.
A list of all state, district and territorial contacts provided by our Field Office.
All state, district and territorial contacts are included in the survey.
54
(Number of Respondents)/(Sample Size)
85%
E-mail and Fax (Phone Follow-up as needed)
Participants will be contacted up to four times within several weeks. The first contact
will be by e-mail and contain an opening remark from the Chairman requesting
participation when the survey arrives. One week later, the questionnaire will be sent out
in e-mail form. Ten days latter a reminder fax will be sent to all participants who have
not completed the survey. Ten days after the reminder fax a Thank You e-mail will go
out to all participants. NOTE: In the rare case of a low response rate, the “Thank
You/Reminder” letter will be replaced by a telephone follow-up.
Accuracy: A standard error of .02
Completeness: All appropriate goals and standards were measured.
Consistency: Standardized questionnaire and procedures.
Timeliness: Survey done in FY09 for FY09 goal.
The proportion of respondents who replied to “In general, how satisfied are you with the
way the State Partners program works?” with either “Very Satisfied” or “Satisfied” was:
88%
List of contacts not standardized; some states have one state designee who is appointed
by the governor while others states have various contacts working separately or
collectively.
Pre-notice e-mail
Fax Reminder
E-mail containing survey link
Thank You e-mail
Internet Survey
Telephone Follow-up

OMB Control #3041-0128
Expires 8/31/08

Pre-notice E-mail
Hello! My name is Employee Name from the U.S. Consumer Product Safety Commission. The
U.S. Consumer Product Safety Commission is committed to our state and local Partners in
Safety. In the next few days I will be sending you a survey about our State Partners service. We
are asking for your help to understand how well our State Partners service is meeting your needs.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The survey should arrive in a few days with OMB control number 3041-0128. If you can not
locate an OMB control number on the survey then it is not an official government survey and
should be disregarded. If you have any questions please contact me, Employee Name, at (301)
504-XXXX or via e-mail at Employee@cpsc.gov.
Sincerely,
Employee Name
Office of Planning, Budget and Evaluation
U.S. Consumer Product Safety Commission
(301) 504-XXXX
Employee@cpsc.gov

OMB Control # 3041-0128
Expires 08/31/2008

OMB Control #3041-0128
Expires 8/31/08

E-mail Containing Survey
Hello! My name is Employee Name from the U.S. Consumer Product Safety Commission. We
are conducting a survey about our State and Local program. Your help will help us to understand
how well our State Partners service is meeting your needs.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able to locate
an OMB control number on any official government survey; otherwise the survey should be
disregarded. If you have any questions please contact me, Employee Name, at (301) 504-XXXX
or via e-mail at Employee@cpsc.gov.

Sincerely,
Employee Name
Division of Planning, Budget and Evaluation
U.S. Consumer Product Safety Commission
Employee@cpsc.gov

OMB Control # 3041-0128
Expires 08/31/2008

Page 1 of 4

U.S. CONSUMER PRODUCT SAFETY
COMMISSION STATE PARTNERS SURVEY
20XX

Welcome to the CPSC State Partners Program Survey. This survey is part of our
continuing effort to provide the best and most efficient service for our customers.
Please take a few moments to answer the following questions and click the
submit button at the end of the survey.
All responses to our questionnaire are both voluntary and anonymous. The
information being collected will always be presented as a whole, with no
individual responses being identified. Completing the survey only takes a couple
of minutes and will help us evaluate how well our services are meeting the
public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be
able to locate an OMB control number on any official government survey;
otherwise the survey should be disregarded. If you have any questions please
contact Employee Name at (301) 504-XXXX or via e-mail at
Employee@cpsc.gov.
Thank you for your cooperation,
Nancy A. Nord
Acting Chairman
OMB Control Number 3041-0128
Expiration Date 8/31/2008

Does your State participate in CPSC's State & Local Program?

OMB Control Number 3041-0128 Expires 8/31/08

Survey Page 1

U.S. CONSUMER PRODUCT SAFETY
COMMISSION STATE PARTNERS SURVEY
20XX

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2

Which programs do you participate in below?
Recall Effectiveness Checks
In-depth investigations
Poison Prevention Packaging Act Program
Home/ Senior Safety Consultations
Child Care Safety Consultations
Fire Data Collection
Recall Round-Up
Resale Round Up Campaigns
State & Local Workshops and Conferences
Information and Education initiatives
Other

When requested, does CPSC assist you to promote product safety
initiatives in your State?
Yes
No
Do not know

Have you found that having a local CPSC contact is helpful in
accomplishing State consumer product safety objectives?
Very Helpful

Neutral

Not very helpful

Not helpful

Do you feel that your partnership with CPSC helps to eliminate
duplication of effort involving product safety activities? (i.e. product
safety investigations, recall checks, and product safety news release,
other activities)
Strongly Agree

Helpful

Agree

Neutral

Disagree

Strongly Disagree

Is your local CPSC contact responsive to your requests for product
recall notices and education materials?
All the time

Most of the time

Neutral

Some of the time None of the time

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7

Are you satisfied with the information you receive from CPSC such as
State & Local list serve messages and the Neighborhood Safety
Network?
Very Satisfied

Satisfied

Undecided

Dissatisfied

Very Dissatisfied

Are you satisfied with the number of joint activities CPSC initiates?
Very Satisfied

Satisfied

Undecided

Dissatisfied

Very Dissatisfied

OMB Control Number 3041-0128
Expires 8/31/08

Survey Page 2

U.S. CONSUMER PRODUCT SAFETY
COMMISSION STATE PARTNERS SURVEY
20XX

Overall, how satisfied are you with the relationship between CPSC and
your State/Territory?
Very Satisfied

Satisfied

Neutral

Dissatisfied

Very Dissatisfied

10 Have can CPSC better assist your State in promoting consumer product
safety?

OMB Control Number 3041-0128
Expires 8/31/08

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5/15/2008

OMB Control #3041-0128
Expires 8/31/08

fax

t r a n s m i t t a l

EMPLOYEE NAME
OFFICE OF PLANNING, BUDGET AND EVALUATION
U.S. CONSUMER PRODUCT SAFETY COMMISSION
4330 East West Highway
Bethesda, MD 20814-4408
tel (301) 504-XXXX
fax (301) 713-XXXX
email: employee@cpsc.gov
to:
fax #:
date:
re:

State-Partners Survey

pages:

including this cover sheet

The U.S. Consumer Product Safety Commission is conducting a customer satisfaction
survey about our State Partners program. Your responses will be used to help us
understand how well our services are meeting your needs.
All responses to our questionnaire are both voluntary and anonymous. The
information being collected will always be presented as a whole, with no individual
responses being identified. Completing the survey only takes a couple of minutes
and will help us evaluate how well our services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able
to locate an OMB control number on any official government survey; otherwise the
survey should be disregarded. If you have any questions please contact Employee
Name at (301) 504-XXXX or via e-mail at Employee@cpsc.gov.
Thank you for your help.
Nancy A. Nord
Acting Chairman
U.S. Consumer Product Safety Commission

OMB Control #3041-0128
Expires 8/31/08

Thank You E-mail
A few weeks ago we e-mailed you a questionnaire seeking your opinion about our State Partners
service. If you have already completed the survey, thank you for your time and input. If you have
not completed the questionnaire, please do so today. We are especially grateful for your help
because we believe that your response will be very useful in understanding how well we are
meeting your needs.
All responses to our questionnaire are both voluntary and anonymous. The information being
collected will always be presented as a whole, with no individual responses being identified.
Completing the survey only takes a couple of minutes and will help us evaluate how well our
services are meeting the public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be able to locate
an OMB control number on any official government survey; otherwise the survey should be
disregarded. If you have any questions please contact me, Employee Name, at (301) 504-XXXX
or via e-mail at Employee@cpsc.gov.

Sincerely,
Employee Name
Division of Planning, Budget and Evaluation
U.S. Consumer Product Safety Commission
Employee@cpsc.gov

OMB Control # 3041-0128
Expires 08/31/2008

OMB Control #3041-0128
Expires 8/31/08

STATE PARTNERS TELEPHONE SURVEY
Hello, my name is Employee Name. I am calling on behalf of the U.S. Consumer Product
Safety Commission’s Office of Budget, Planning and Evaluation. We are doing a customer
satisfaction survey about our State Partners Program. May I ask you a few questions that will
take only a few minutes of your time?
At this time I am required to tell you that the OMB control number for this survey is
3041-0128. You should be able to locate an OMB control number on any official government
survey; otherwise the survey should be disregarded.
Also, all responses to our questionnaire are both voluntary and anonymous. The information
being collected will always be presented as a whole, with no individual responses being
identified. Completing the survey only takes a couple of minutes and will help us evaluate how
well our services are meeting the public’s needs.
1. Does your State participate in CPSC’s State & Local Program?
_ Yes
_ No, skip to Question 9
2. Which programs do you participate in below?
_ Recall Effectiveness Checks
_ In-depth investigations
_ Poison Prevention Packaging
Act Program
_ Home/ Senior Safety
Consultations
_ Child Care Safety
Consultations
_ Fire Data Collection
_ Recall Round-Up
_ Resale Round Up Campaigns
_ State & Local Workshops
and Conferences
_ Information and Education
initiatives
_ Other

OMB Control #3041-0128
Expires 8/31/08

3. When requested, does CPSC assist you to promote product safety initiatives in your State?
_ Yes
_ No
_ Do not know
4. Have you found that having a local CPSC contact is helpful in accomplishing State
consumer product safety objectives?
_ Very Helpful
_ Helpful
_ Neutral
_ Not very helpful
_ Not helpful

5. Do you feel that your partnership with CPSC helps to eliminate duplication of effort
involving product safety activities? (i.e. product safety investigations, recall checks, and
product safety news release, other activities)
_ Strongly Agree
_ Agree
_ Neutral
_ Disagree
_ Strongly Disagree
6. Is your local CPSC contact responsive to your requests for product recall notices and
education materials?
_ All the time
_ Most of the time
_ Neutral
_ Some of the time
_ None of the time
7. Are you satisfied with the information you receive from CPSC such as State & Local list
serve messages and the Neighborhood Safety Network?
_ Very Satisfied
_ Satisfied
_ Undecided
_ Dissatisfied
_ Very Dissatisfied

OMB Control #3041-0128
Expires 8/31/08

8. Are you satisfied with the number of joint activities CPSC initiates?
_ Very Satisfied
_ Satisfied
_ Undecided
_ Dissatisfied
_ Very Dissatisfied
9. Overall, how satisfied are you with the relationship between CPSC and your
State/Territory?
_ Very Satisfied
_ Satisfied
_ Neutral
_ Dissatisfied
_ Very Dissatisfied

10. How can CPSC better assist your State in promoting consumer product safety?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Thank you very much for your help. We appreciate you time.

OMB Control Number
3041-0128
Expiration Date 8/31/2008

Web Site Survey
Goal
Background

Target Population
Data Source(s)
Sampling Method
Sample Size
Prior Survey
Response Rate
Survey Method
Procedure
Data Quality
Checks

Prior Survey
Performance
Indicator
Data Limitations
Attachments

Strategic/Annual: Sustain the high level of consumer satisfaction with the Web site at
90% or better through the year 2010.
The CPSC Web site is a critical source for the public to view information about recalled
products, report unsafe products, request and download information and submit
inquiries to CPSC professional staff in a timely manner. With the maturity and
significant increase in the use of the internet as a communications tool, customer
satisfaction with the CPSC Web site is one of the organization’s service quality and
satisfaction goals cited in the CPSC Strategic Plan. The purpose of the survey is to
measure the strategic/annual goal as well as to measure how well the Web site is
fulfilling its potential.
All CPSC Web site users
Everyone who contacts the Web Site during the survey.
A ten week period in which all Web site users are included in the survey.
1,000
(Number of Respondents)/(Sample Size)
69%
Web-based
Upon visiting the CPSC Web site, all visitors are prompted about the opportunity to
voluntarily participate in an on-line survey about the Web site.
Accuracy: A standard error of .02
Completeness: Questions covered all appropriate goals and customer service standards.
Consistency: Standardized questionnaire and procedures.
Timeliness: Survey completed in FY09 for FY09 goals/standards.
The proportion of respondents who indicated either “satisfied” or “very satisfied” when
asked “How Satisfied were you with the CPSC Web site?” was:
94%
Sampling restricted to portion of fiscal year.
Internet Survey

Page 1 of 3

U.S. CONSUMER PRODUCT SAFETY
COMMISSION WEB SITE SURVEY 20XX

Welcome to the CPSC Web site Survey. This survey is part of our continuing
effort to provide the best and most efficient service for our customers. Please
take a few moments to answer the following questions and click the submit
button at the end of the survey.
All responses to our questionnaire are both voluntary and anonymous. The
information being collected will always be presented as a whole, with no
individual responses being identified. Completing the survey only takes a couple
of minutes and will help us evaluate how well our services are meeting the
public’s needs.
The OMB control number for this particular survey is 3041-0128. You should be
able to locate an OMB control number on any official government survey;
otherwise the survey should be disregarded. If you have any questions please
contact Employee Name at (301) 504-XXXX or via e-mail at
Employee@cpsc.gov.
Thank you for your cooperation,
Nancy A. Nord
Acting Chairman
OMB Control Number 3041-0128
Expiration Date 8/31/2008

How did you hear about the CPSC Web site? (Check all that apply)
Television
Radio
Newspaper
Publication
Web search
Link from another site
Other, please specify

How frequently do you access the CPSC Web site?
First time
Rarely
Sometimes (monthly to yearly)
Often (daily to weekly)

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How do you typically access the Internet?
Dial-up modem
Direct Connection (TI, cable modem, DSL, etc.)
Other- Don't know

For your most recent visit to the CPSC Web site did you... (Check all
that apply)
Get product safety or recall information
Report an injury, death or unsafe product
Ask to be put on an e-mail subscription list
Apply for a job
Other (Please specify)

OMB Control Number 3041-0128 Expires 8/31/08

Survey Page 1

U.S. CONSUMER PRODUCT SAFETY
COMMISSION WEB SITE SURVEY 20XX

Ability to find what you were looking for.
Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Dissatisfied

Very Dissatisfied

Ability to navigate around the web site.
Very Satisfied

Satisfied

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Web page load time.
Very Satisfied

Dissatisfied

Very Dissatisfied

Satisfied

Dissatisfied

Very Dissatisfied

Dissatisfied

Very Dissatisfied

Web site design/layout
Very Satisfied

Satisfied

Usefulness of the information
Very Satisfied

Satisfied

10 Overall how satisfied were you with the CPSC Web site?
Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

11 Do you have any comments related to your responses above or is there
anything you would like to tell us about the CPSC Web site?

OMB Control Number 3041-0128 Expires 8/31/08

Survey Page 2

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File Type	application/pdf
File Title	Consumer Satisfaction Surveys for 2008-2011
Author	dshope
File Modified	2008-08-01
File Created	2008-04-09