Evaluation of Outreach Efforts Related to NRC's Safety Culture Policy Statement - State, Local, or Tribal Gov't

Survey Instructions

Thank you for taking the time to complete this survey. You have received this survey because you are a licensee of the Nuclear Regulatory Commission (NRC) or one of its Agreement State partners. This survey is voluntary and will be used to support the evaluation of the effectiveness of the NRC’s and Agreement States’ communications and outreach about Safety Culture and the Safety Culture Policy Statement. Your answers will be confidential and will not be attributed to or used to identify your organization or you personally.

This survey should take no longer than 20 minutes of your time.

If you have any questions about the survey instrument, please contact Eric Cross at LinkVisum Consulting Group (ecross@linkvisum.com or 703.442.4573). If you have any questions regarding the survey content, please contact Stephanie Morrow, Safety Culture Program Manager, at the Nuclear Regulatory Commission (stephanie.morrow@nrc.gov

or 301-415-1986).

Please note that a government agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Burden is estimated to average 20 minutes per response. Please send comments regarding this burden estimate or any other aspect of this collection for information, including suggestions for reducing the burden to: Records and FOIA/Privacy Services Branch (T-5 F52), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by e-mail to Infocollects.Resource@NRC.gov.

OMB Control Number: 3150-XXXX

Expiration: XX/XX/XXXX

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Topic Area	Question	Type of question
Demographics	Licensee of: Nuclear Regulatory Commission (NRC) Illinois (IEMA) Minnesota North Carolina Ohio Rhode Island Virginia Washington Wisconsin	Drop-Down Menu (Select one)
	Your Position (please select the most relevant position title): Owner or Executive Management Safety Officer or Compliance Officer Technical staff Administrative staff Other: Please Specify (free text)	Checkbox (Select one)
	Type of License: Portable Gauge License Fixed Gauge License Industrial Radiography License Irradiator License Master Materials License Medical Use License Broad Scope License Research & Development, Gas Chromatographs, and X-Ray Fluorescence Analyzers Exempt Distribution License Possession License for Manufacturing and Distribution Commercial Radiopharmacy License Well Logging, Tracer, and Field Flood Study License License Authorizing Distribution to General Licensees Service Provider License (e.g., leak test, instrument calibration, decontamination) Possession License for Production of Radioactive Material Using an Accelerator Decommissioning Facility Uranium Recovery License Waste Disposal License License for Special Nuclear Material of Less than Critical Mass License for Special Nuclear Material of Greater than Critical Mass (Including Universities and Research Centers) Spent Fuel Storage License Fuel Transportation License Fuel Cycle Facility (Conversion/De-Conversion, Enrichment and Fuel Fabrication) Other: Please Specify (free text)	Drop-Down Menu (Select one)

Awareness	Based on your knowledge and experience within your organization, please respond to the following questions to the best of your ability. I am aware of the NRC’s or my State regulator’s policy on Safety Culture (e.g., the Safety Culture Policy Statement).	Yes or No
	In general, management in my organization is aware of the NRC’s or my State regulator’s policy on Safety Culture (e.g., the Safety Culture Policy Statement). In general, staff in my organization is aware of the NRC’s or my State regulator’s policy on Safety Culture (e.g., the Safety Culture Policy Statement).	Most: 81%- 100%; Many: 61% - 80%; About Half: 41% - 60%; Some: 21% - 40%; Few: 0% - 20% Don’t Know
Distribution	Based on your knowledge and experience within your organization, please respond to the following questions to the best of your ability. My organization has received information on Safety Culture from (select all that apply): Inspections Presentations (meetings, conferences, etc.) Correspondence (letters, email, etc.) The NRC’s Safety Culture website My State regulator’s website Other (free text)	Checkbox (select all that apply)
	It is easy and convenient to access information about Safety Culture from the NRC or my State regulator. The information my organization has received about Safety Culture is useful.	Likert Scale (Strongly Agree to Strongly Disagree)
	Please provide examples of why your organization has or has not found information about Safety Culture to be useful.	Free Text
Products	The following set of questions asks for feedback on the NRC’s Safety Culture website (http://www.nrc.gov/about-nrc/regulatory/enforcement/safety-culture.html), and products available on the website such as the Safety Culture Case Studies and Safety Culture Brochure. Please indicate the products you are familiar with to provide feedback about those products. If applicable, select option “d” to provide feedback about safety culture information and materials on your State regulator’s website. Which of the following Safety Culture products are you familiar with? (select all that apply): The NRC’s Safety Culture website. The NRC’s Safety Culture brochure. The NRC’s Safety Culture case studies. Information about Safety Culture on my State regulator’s website.	Qs 12, 13, 14, and 15 will only be asked if respondent indicates they are familiar with the products (Q11). Checkbox (select all that apply)
Products	The NRC’s Safety Culture website is: User friendly Easy to find Up-to-date Informative Please provide any additional feedback about the NRC’s Safety Culture website. (free text) The NRC’s Safety Culture brochure is: Clear, logical, and easy to follow Easy to find Informative Appropriately detailed Engaging Helpful in increasing my organization’s knowledge and understanding of safety culture Please provide any additional feedback about the Safety Culture brochure. (free text) The NRC’s Safety Culture case studies are: Clear, logical, and easy to follow Easy to find Informative Appropriately detailed Engaging Practical Helpful in increasing my organization’s knowledge and understanding of safety culture Please provide any additional feedback about the Safety Culture brochure. (free text) The Safety Culture information on my State regulator’s website is: User friendly Easy to find Up-to-date Please provide any additional feedback about the safety culture information on your State regulator’s website. (free text)	Likert Scale (Strongly Agree to Strongly Disagree)
	Have you received or accessed any other Safety Culture products? If so, please list. (free text) Do you have suggestions for additional Safety Culture products or resources? (free text)	Free text
Support	Overall, my organization is satisfied with the level of communications we have received about Safety Culture and the Safety Culture Policy Statement. Overall, my organization is satisfied with the quality of communications we have received about Safety Culture and the Safety Culture Policy Statement.	Likert Scale (Strongly Agree to Strongly Disagree)
	How can the NRC or your State regulator continue to improve its communications about Safety Culture and the Safety Culture Policy Statement?	Free text

Survey Thank You Page

Thank you for completing this survey on the communications and outreach about Safety Culture and the Safety Culture Policy Statement. We know you are busy and appreciate the time you have taken to complete the survey. Your feedback is invaluable to continuously improving the NRC’s and your State regulator’s communications about safety culture. If you seek additional information on safety culture, please visit the NRC’s safety culture webpage at the following link:

http://www.nrc.gov/about-nrc/regulatory/enforcement/safety-culture.html

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