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Attachment I: Data
Retrieval Call
Form Approved
OMB No. XXXX-XXXX
Exp. Date __xx/xx/20xx
Notice – CDC estimates the average public reporting burden
for this collection of information as 5 minutes per response,
including the time for reviewing instructions, searching existing
data/information sources, gathering and maintaining the
data/information needed, and completing and reviewing the
collection of information. An 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. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions
for reducing this burden to CDC/ATSDR Information Collection
Review Office, 1600 Clifton Road, MS D-74, Atlanta, GA 30333;
ATTN: PRA (0920-XXXX).
Assurance of Confidentiality – We take
your privacy very seriously. All information that relates to or
describes identifiable characteristics of individuals, a practice,
or an establishment will be used only for statistical purposes.
NCHS staff, contractors, and agents will not disclose or release
responses in identifiable form without the consent of the
individual or establishment in accordance with section 308(d) of
the Public Health Service Act (42U.S.C. 242m) and the Confidential
Information Protection and Statistical Efficiency Act (Title III
of the Foundations for Evidence-Based Policymaking Act of 2018
(Pub. L. No. 115-435, 132 Stat. 5529 § 302)). In accordance
with CIPSEA, every NCHS employee, contractor, and agent has taken
an oath and is subject to a jail term of up to five years, a fine
of up to $250,000, or both if he or she willfully discloses ANY
identifiable information about you.
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There
will be data retrieval calls to RCC and ADSC directors when after
receiving the submitted hardcopy mail questionnaires there is missing
information for critical items, such as average daily attendance
(ADSC only), number of licensed beds (RCC only), and current
enrollment/residents.
In
terms of respondent burden, we have assumed that the respondent will
spend on average 5 minutes on the phone during the retrieval call,
and that no more than 5% of cases will require retrieval.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Christine |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |