Generic Clearance Template Small and Very Small Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0583-0151)

TITLE OF INFORMATION COLLECTION:

VOLUNTARY CUSTOMER FEEDBACK SURVEY: GENERAL INFORMATION AND OUTREACH NEEDS OF SMALL AND VERY SMALL ESTABLISHMENTS

The Small Plant Help Desk is one of the valuable resources OOEET’s Outreach and Partnership Division offers to the small and very small meat and poultry producers in the US. As a result of the 2008 Farm Bill, the Small Plant Help Desk provides assistance to these plant owners and operators so they can achieve and maintain regulatory compliance.

FSIS believes there is a need for specific direct information and training delivered in a way that will reach small and very small livestock and poultry slaughter and processing plants with impact. Before Agency resources are devoted to this project, FSIS needs to determine the current level of understanding at the plant management level, the specific information and training needed to improve understanding of agency guidelines and policy and to determine what additional training may be needed, and the best delivery method for this outreach, in order to ensure regulatory compliance is maintained and improved.

DESCRIPTION OF RESPONDENTS:

Small and very small slaughter plant owners – by definition, small establishments have less than 500 employees and very small establishments have less than 10 employees.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[] Focus Group [X] Other: _Voluntary customer feedback survey_____________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:________________________________Gerri French________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X ] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ X ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No

BURDEN HOURS

There are a total of 46 questions in the survey. The majority (approximately 94%) of establishments will receive the survey online. However, the number of questions that establishments would complete will depend on their inspection activities so most will only see a subset of these questions. The range of questions to be answered may be as little as 21 with a maximum of 46. We estimate that 3 questions can be completed in 1 minute. We will be submitting the survey to a total of 4824 establishments. Through our online survey software, we will give establishments an option of deciding whether they would like to proceed with completing the survey in English or receive the survey in one of four different languages: Spanish, Chinese, Arabic, or Vietnamese. Only the introduction and request for a survey in one of these languages have been translated. At this time, we do not know whether we will receive requests for translations of the entire survey and, because of costs associated with translating the entire survey, will wait until we receive a request. We will submit an update to this request to OMB in the event we do receive a request for the entire survey to be translated in one of the above four languages so that OMB can review the entire translated survey prior to administration.

Category of Respondent	No. of Respondents	Participation Time	Burden
Small and Very Small Establishments – maximum estimated time burden	4824	11 min.	884 hrs
Total Estimated Time Burden	4824		884 hours

FEDERAL COST: The estimated annual cost to the Federal government is approximately $750 (for mailing and other associated costs, as needed.)_________

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X ] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Information and characteristics of all federally regulated establishments are included in FSIS’ Public Health Information System (PHIS). We have downloaded from PHIS a listing of all small and very small establishments along with the specific inspection activities and products they produce. This listing is being used to determine the overall burden hours. We will be requesting that one employee/survey be completed for each small and very small establishment. Because we anticipate submitting the survey to the entire population, we do not have a sampling plan. Approximately 94% of establishments have an email address so they will receive the survey electronically. Approximately 6% do not have an email address—these establishments will receive a mail version to complete and return.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ X ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[X ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ X ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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