REPORTING: Funded Projects Pilot; Developing Standardized Forms

Pilot to Develop Standardized Reporting Forms for Federally Funded Public Health Projects and Agreements

Produce Program Report.xlsx

REPORTING: Funded Projects Pilot; Developing Standardized Forms

OMB: 0910-0909

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Overview

Coversheet
Obj1
Obj2
Obj3
Obj4
Obj5
Obj6
Obj7
Budget
Feedback


Sheet 1: Coversheet

























Standard Name
0




OPEI
0




























































Recipent Name (Select)
Select
State
Select Recipient Name




Federal Award Identification Number
Select Recipient Name




Program Path
Select Recipient Name




Report Frequency
Select




Report Author (if not PI)






Date Completed






















Project Period Start Date
7/1/2021




Project End Date
6/30/2026




Budget Period Start Date
7/1/2022




Budget Period End Date
6/30/2023




















Principal Investigator (PI)

PI Email

PI Phone













Is your contact and admin spreadsheet current in ORAPP?
Select






Sheet 2: Obj1



Assessment and Planning Status Current Status If "not started" or "in progress" explain timeline for completion below

What is the status of your written Assessment? Select


What is the status of your written Project Plan? Select







Does your Written Assessment:

Identify covered produce commodities that are common to your jurisdiction? Select

Identify common farming conditions and practices in your jurisdiction? Select

Identify unique farming conditions and practices in your jurisdiction? Select

Review your farm inventory data? Select

Develop an organizational structure and infrastructure needed to fulfill CAP objectives? Select

Identify partners and collaborators that support your produce program? Select

Assess your state or territories capabilities to respond to produce related events within the jurisdiction? Select

Sheet 3: Obj2



























































a. Are produce program positions filled?
Select









If no, which positions need to be filled and when will you fill the position(s)?































b. Staff training:











b. Training Number of current staff that have completed: Number of current staff awaiting completion of: OPEI Track Obj2 Training Responses






Training Course FD226

#N/A #NAME?







Training Course FD326

#N/A #NAME?







Training Course FD225

#N/A #NAME?




















c. Please share any topics that are needed for your staff to successfully conduct CAP work, but have not been covered in existing courses:





























d. Personnel conducting CAP work (do not include subaward personnel here):







Last Name, First Name Title Primary CAP Role Explain any additional CAP roles and responsibilities Percent of time funded by the CAP OPEI Track




1

Select

#N/A #NAME?




2

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#N/A #NAME?




3

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#N/A #NAME?




4

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5

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6

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7

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8

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9

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10

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11

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#N/A #NAME?




12

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13

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14

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15

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16

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17

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18

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#N/A #NAME?




19

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#N/A #NAME?




20

Select

#N/A #NAME?












f. List key accomplishments of subawards (a subaward is a monetary award for the subrecipient to carry out part of the project).











Subaward Entity Funding Amount Met Expected Deliverables Key Accomplishments Inventory Development Track Obj2 Subaward Responses
1

Select





#N/A #NAME?
2

Select





#N/A #NAME?
3

Select





#N/A #NAME?
4

Select





#N/A #NAME?
5

Select





#N/A #NAME?














If no subwards are listed above, please select a drop down option:

N/A - Subawards are reported above















g. List and describe MOU(s) established:
























MOU Entity Purpose of MOU



1





2





3





4





5





6





7





8





9





10



















If no MOUs listed above, please select a drop down option: N/A - MOUs are listed above




























h. List of contracts established:











A contract is a legal instrument to purchase property or services needed to carry out the project.











Contractor Entity Funding Amount Met Expected Outcomes Property or services purchased OPEI Track Obj2 ContractMOU Responses




1

Select
#N/A #NAME?





2

Select
#N/A #NAME?





3

Select
#N/A #NAME?





4

Select
#N/A #NAME?





5

Select
#N/A #NAME?





6

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#N/A #NAME?





7

Select
#N/A #NAME?





8

Select
#N/A #NAME?





9

Select
#N/A #NAME?





10

Select
#N/A #NAME?



















If no contracts are listed above, please select a drop down option: N/A - Contracts are listed above








Sheet 4: Obj3



a. Describe, list, and quantify your education activities (other than PSA grower trainings) for farms using CAP funds and resources/materials used (examples include trainings, workshops, etc.):











b. Describe, list, and quantify your outreach activities conducted and resources/materials used (examples include mailers, event booths, presentations, advertisements, etc.):











c. Describe, list, and quantify your on farm and/or remote technical assistance activities (other than on farm readiness reviews):











d. Do applicable items include the current Funding Acknowledgement Statement? Select








e. Please share any training/knowledge gaps that you feel exist for produce farms in your jurisdiction:











f. Known number of (non-exempt) covered farms in your jurisdiction that still need Produce Safety Alliance (PSA) Grower Training or equivalent:









How many remaining courses do you estimate needing to host:
















Sheet 5: Obj4



a. What electronic system do you currently use for your farm inventory data:











If this is not your final system, describe the electronic system your jurisdiction plans to use and timeline for
implementation:












b. Based on your efforts to develop your farm inventory to date, how complete and accurate is your
current verified farm inventory:












c. Would you consider your farm inventory to be still in the development phase or in the maintenance phase? Select








If your inventory is in the development phase, when and how will you transition to a maintenance phase?











d. Do you have a written procedure for farm inventory verification? Select








e. Do you have a written procedure for farm inventory maintenance activities? Select








f. Does your inventory system capture all categories of produce farms with produce sales? Select








g. Do you use a registration for inventory purposes? Select








If yes, please explain below:















h. If your inventory development and verification efforts include on farm visits please describe your visits and the resources/materials used:











i. How many inventory verification visits have been conducted this budget period?























Sheet 6: Obj5



a. Number of trained produce inspectors:









b. What is the average number of inspections per each inspector in a CAP year (July 1 - June 30)









c. Do you use the FDA Produce Assignment to guide planning and conducting inspections? Select

If no, explain:















d. Do you use the PDAT for risk based inspection prioritization? Select








e. Do you issue a Notice of Inspection or state equivalent? Select








f. Do you issue the FDA 4056 or a state equivalent at the close of each inspection? Select








g. Are you directly citing 21 CFR 112 citations, when applicable? Select








h. Do you complete the Produce Farm Inspection Summary Report or state equivalent for each inspection? Select








i. Do you have a written process for making a final inspection classification? Select








j. What electronic system do you use to capture inspection data?











k. Number of known (non-exempt) covered farms that have not recieved an initial PSR inspection:









l. After all initial inspections are completed, what is your inspection frequency and prioritization plan?











m. Are you conducting produce safety rule inspections using funds other than CAP funds? Select

If yes, explain:















n. Do you conduct joint sprout inspections with FDA under this CAP? Select








o. Does your state conduct sprout inspections outside of this CAP? Select

If yes, under what regulation do you conduct these sprout inspections?


















Sheet 7: Obj6



a. Select current authority used for enforcement of the Produce Safety Rule: Select








b. Is your authority to conduct PSR inspections and enforcement subject to change? Select

If Yes, please indicate and describe the proposed change and timeline:











c. Do you have internal procedures to conduct the preliminary review of inspection documentation to determine a final inspection classification and deciding next steps for conducting compliance and enforcement action(s) as needed? Select








If no, what is your timeline to develop a procedure?











d. (Path C only) Do you have a framework established for conducting for compliance and enforcement progressive actions? Select








If no, what is your timeline to develop a framework?

























Sheet 8: Obj7



a. Based on your completed Assessment (see Objective 1), does your jurisdiction (e.g. any agency or entity in your state) have the capability to systematically detect, investigate, mitigate, document and analyze produce related incidents to stop, control and prevent hazards that are likely to result in a produce related illness, injury or outbreak. Select








If No, what are the capability gaps?











b. Do you anticipate needing additional funding under this CAP in order to develop and implement produce response capabilities? Select






















Sheet 9: Budget























Expenses Total Budgeted Spent Remaining
1 Total Budget $0 $0 $0
2 Total Salary, Wages, and Fringe Benefits $0 $0 $0
3 Equipment $0 $0 $0
4 Travel $0 $0 $0
5 Materials and Supplies $0 $0 $0
6 Publication Costs $0 $0 $0
7 Consultant Services $0 $0 $0
8 ADP/Computer Services $0 $0 $0
9 Subawards/Contractual Costs $0 $0 $0
10 Equipment/Facility Rental/User Fees $0 $0 $0
11 Federal F&A (Indirect Costs) $0 $0 $0
12 Other 1 [Replace only bracketed text] $0 $0 $0
13 Other 2 [Replace only bracketed text] $0 $0 $0
14 Other 3 [Replace only bracketed text] $0 $0 $0
15 Other 4 [Replace only bracketed text] $0 $0 $0
16 Additional Budget Comments:


Sheet 10: Feedback



Describe any ongoing issues in the implementation of your jurisdiction's produce program:











Describe successes in the implementation of your jurisdiction's produce program:











List additional resources that have been helpful for your program's implementation:











Please share any questions or concerns about the program overall:
























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