| 1. GRANTEE NAME |
2. GRANT NUMBER |
3. REPORTING PERIOD
From:
To:
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TRAINING SESSIONS
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| 4. DATE |
5. LOCATION |
6. LENGTH
(Hours) |
NUMBER IN ATTENDANCE |
| 7. EMPLOYEES |
8. EMPLOYERS |
9. TOTAL |
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10. TOTAL FROM REPORTING PERIOD |
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| 11. PLAN FOR QUARTER |
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| 12. PERCENTAGE OF PLAN ACCOMPLISHED |
% |
% |
% |
| 13. GRANTEE SIGNATURE |
14. DATE
|
INSTRUCTIONS
Instructions for the Grantee Quarterly Progress Report (OSHA 171 and Narrative
Report) are contained on the reverse of this form.
RETURN THE COMPLETED FORM TO
THE OSHA REGIONAL OFFICE ADMINISTERING YOUR GRANT.
PAPERWORK REDUCTION ACT NOTICE
Form Approved. OMB No. 1218-0100. Expires 10/31/2010.
Persons are not required
to respond to the collection of information unless it displays a currently valid
OMB control number. This information is being collected so that OSHA can monitor
grantee progress in meeting grant workplans, to evaluate the overall
effectiveness of the grant program, and, when applicable, to be used as one
factor in determining continued funding of the grant. The grant program provides
training for employers and employees in the recognition, avoidance, and
prevention of unsafe and unhealthful working conditions in accordance with
Section 21(c) of the Occupational Safety and Health Act. This collection of
information is required to obtain or retain a benefit (29 CFR 95.51 (b) and
(d)). This collection of information is not confidential. We estimate it will
take an average of 12 hours to complete this information collection, including
time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing this burden,
to the Directorate of Training and Education, 2020 S. Arlington Heights Road,
Arlington Heights, IL 60005, and/or to the Department of Labor, Office of IRM
Policy, Room N-1301, 200 Constitution Avenue, NW., Washington, DC 20210.
Previous editions may not be used OSHA 171 Revised 10/07
INSTRUCTIONS FOR PREPARING GRANTEE QUARTERLY PROGRESS REPORTS
I. FREQUENCY OF REPORTING
A Grantee Quarterly Progress Report (OSHA 171 and Narrative Report) is to be
completed for each grant at the end of each Federal fiscal quarter. Federal
fiscal quarters end on December 31, March 31, June 30 and September 30. Two
copies of each report are to be received by the Regional Office administering
the grant no later than the thirtieth of the month following the end of the
Federal fiscal quarter, i.e., January 30, April 30, July 30, and October 30.
II. TIME PERIOD COVERED BY REPORTS
Reports will cover only the activities conducted during the quarter for which
the report is being submitted.
III. RECORDKEEPING REQUIREMENTS
Grantees are required to keep records to support the information contained in
the Grantee Quarterly Progress Report. These records need not be extensive. For
example, a sign-in sheet for participants at a training session that shows
whether the participant is an employee or an employer and notes the date,
location, subject and scheduled beginning and ending time of the session is
sufficient documentation. Records must be kept for three years after grant
closeout or final audit, whichever is later.
IV. METHOD OF REPORTING
Grantees are not required to use form OSHA 171. They may submit the information
in any format so long as the required information is included (i.e., for each
training session the date, location, length, and numbers attending broken out
between employee and employer.) Grantees may also make arrangements with the
Regional Office administering their grant to use electronic means to transmit
the report to OSHA.
V. OSHA FORM 171
A. Identifying Information.
- Item 1. Grantee Name. Enter the name of the grantee organization.
- Item 2. Grant Number. Enter the grant number that appears on the Grant
Agreement face sheet.
- Item 3. Reporting Period. Enter the first and last dates of the quarter
covered by the report, for example, from 4/1/01 to 6/30/01.
B. Training Sessions
A training session is the presentation of occupational safety and health
information to a group of people. Do not count conferences as training sessions.
Use a separate line for each training session. If necessary, continue on another
sheet of paper. Training sessions for the same group of trainees that are
conducted on more than one day are not to be reported until they are completed.
Sessions are to be reported in the quarter in which they end.
- Item 4. Date. Enter the date the training session ended.
- Item 5. Location. Enter the name (or two-letter abbreviation) of the state
where the training session was held.
- Item 6. Length (Hours). Enter the number of hours the training sessions
lasted. Partial hours should be rounded to the nearest half-hour.
- Item 7. Number in Attendance: Employees. Enter the number of employees who
attended the training session. An employee is a
worker who does not meet the definition of an employer. First-line supervisors
are to be included as employees.
- Item 8. Number in Attendance: Employers. Enter the number of employers who
attended the training session. An employer is a person, other than a
first-line supervisor, who is responsible for the work flow of two (2) or more
persons, including responsibility for rating the performance of those persons
working for the employer.
- Item 9. Number in Attendance: Total. Enter the total number who attended
the training session. This will generally be the sum of employees and
employers, but may also include attendees who are neither employees nor
employers.
- Item 10. Total for Reporting Period. Enter the sum of the entries in each
of the columns 4. Employees, 5. Employers, and 6. Total.
- Item 11. Plan for Quarter. Enter the numbers (employees, employers, and
total) planned to be trained during the quarter. This information is to be
obtained from the approved grant application.
- Item 12. Percent of Plan Accomplished. Enter the percent line 10 is of
line 11.
Line 10 x 100 = Percent of Plan Accomplished Line 11.
C. Signature Element.
- Item 13. Grantee Signature. An authorized staff member of the grantee is
to sign the report.
- Item 14. Date. Enter the date the report is signed.
VI. NARRATIVE REPORT
In the narrative report, grantees are to provide descriptive information about
their progress in achieving workplans, any deviations from plans, and important
activities. Reports should follow the format below.
A. Identifying Information. Provide the name of the grantee organization, the
grant number that appears on the Grant Agreement face sheet for the current
grant year, and the reporting period, which is the first and last dates of the
quarter covered by the report, for example, from 4/1/01 to 6/30/01.
B. Training. Describe efforts made to reach the target audience to make them
aware of the training and to enroll them in training. Discuss the training that
has been conducted. Provide a summary of the subject matter, the type of
training (e.g., train-the-trainer, hazard recognition), the results of student
evaluations, and who attended (e.g., employers, building trades workers).
C. Training Materials/Curriculum. Provide information about training materials
in development and any training materials acquired during the quarter. Describe
how completed materials are being used and who is receiving the materials.
Comment on any changes that are being made to improve the materials as a result
of feedback.
D. Other Educational Activities. Discuss any educational activities that are
being conducted other than training or developing training materials. Examples
include assisting an organization in the implementation of a safety program or
operating library services.
E. Planned vs. Actual. Describe progress in meeting plans as contained in the
approved grant. Specify where plans are not being met and discuss the corrective
action that is being taken to meet plans. Where corrective actions have already
been taken, indicate if they were successful. In addition, discuss grant
successes, either where plans were exceeded or where significant accomplishments
were achieved.
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U.S. DEPARTMENT OF LABOR