Form 171 Grantee Quarterly Progress Report

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Overview

OSHA QPR FORM 171
OSHA FORM 171 INSTRUCTIONS

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Sheet 1: OSHA QPR FORM 171

Grantee Quarterly Progress Report				U.S. DEPARTMENT OF LABOR
				Occupational Safety and Health Administration
1. GRANTEE NAME				2. GRANT NUMBER		3. REPORTING PERIOD From: To:
TRAINING SESSIONS
4. DATE	5. LOCATION		NUMBER IN ATTENDANCE			CONTACT HOURS AND LANGUAGE
			6. EMPLOYEES	7. EMPLOYERS	8. TOTAL	9. CLASS LENGTH (in quarter hours)	10. LANGUAGE (number crosswalk)	11. TOTAL
	12. TOTAL FOR REPORTING PERIOD
	13. PLAN FOR QUARTER
	14. PERCENT OF PLAN ACCOMPLISHED
15. GRANTEE SIGNATURE						16. DATE
(Name of the Project Director. Submit via Project Director's email.)
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 3/31/2024
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 17 hours to complete this information collection, including time
for reviewing instructions, searching existing datasources, gathering and maintaining 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, 100 Constitution Avenue, NW, Washington, DC 20210.
			Previous editions may not be used					OSHA 171 Revised August 12, 2022

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Sheet 2: OSHA FORM 171 INSTRUCTIONS

INSTRUCTIONS FOR PREPARING GRANTEE QUARTERLY PROGRESS REPORTS
I.  FREQUENCY OF REPORTING		7. Item 10. Contact Hours and Language: Enter the specific language the
		training was conducted in as follows: 1 - Bosnian 2 - Burmese 3 - Cambodian 4 - Chinese 5 - English 6 - Haitian/Creole 7 - Karen Korean 8 - Laotian 9 - Nepali 10 - Portuguese 11 - Russian 12 - Spanish 13 - Tagalog 14 - Vietamese 15 - Other
A Grantee Quarterly Progress Report (OSHA 171 and Narrative Report) is to be		8.        Item 11. Contact Hours: Total. Enter the total number of employees
completed for each grant at the end of each Federal fiscal quarter.		and employers who attended the training multiplied by the total number
Federal fiscal quarters end on December 31, March 31, June 30, and		of contact hours for the training session. This is calculated
September 30. An electronic copy of each report is to be received by the		automatically in the electronic form.
Regional Office administering the grant no later than the thirtieth of the		9.        Item 12. Total for Reporting Period. Enter the sum of the entries in each
month following the end of the Federal fiscal quarter, i.e., January 30, April		of the columns 6. Employees, 7. Employers, 8. Total and 11. Total.
30, July 30, and October 30.		This is calculated automatically in the electronic form.
		10.       Item 13. Plan for Quarter. Enter the total numbers (employees and
II.   TIME PERIOD COVERED BY REPORTS		employers) planned to be trained and the total number of planned
		contact hours during the quarter. This information is to be obtained
Reports will cover only the activities conducted during the quarter for which		from the approved grant application.
the report is being submitted.		11.     Item 14. Percent of Plan Accomplished. Enter the percent line 12 is of
		line 13. This is calculated automatically in the electronic form.
III.   RECORDKEEPING REQUIREMENTS
		C.  Signature Element.
Grantees are required to keep records to support the information contained in
the Grantee Quarterly Progress Report. For example, a sign-in sheet for		1.        Item 15. Grantee Signature. Electronic signature is considered the typed
participants at a training session that shows whether the participant is an		name of an authorized staff member of the grantee and the form
employee or an employer and notes the date, location, training subject,		forwarded to the Regional office via the authorized staff member’s
trainer’s name(s) and scheduled beginning and ending time of the session is		organizational email address.
sufficient documentation. Attendees should include legible first and last		2.        Item 16. Date. Enter the date the report is signed.
names and the sign-in sheet should be signed by the trainer(s) to verify
accuracy. Records must be kept for three years after grant closeout or final		VI.   NARRATIVE REPORT
audit, whichever is later.
		In the narrative report, grantees are to provide descriptive information about
		their progress in achieving work plans, any deviations from plans, and
IV.   METHOD OF REPORTING		important activities. Reports should follow the format below.
Grantees are required to submit form OSHA 171 in electronic format to their		A.       Identifying Information. Provide the name of the grantee organization,
Regional Office by the end of the fiscal quarter as described in I.		the grant number that appears on the Grant Agreement face sheet for
FREQUENCY OF REPORTING. All sections for the form must be filled out		the current grant year, and the reporting period, which is the first and
completely.		last dates of the quarter covered by the report, for example, from 4/1/01
		to 6/30/01.
V.   OSHA FORM 171
		B.       Capacity Building Activities (Required by Capacity Building Grants
A.  Identifying Information.		only). Describe institutional capacity building activities conducted
		during the quarter. Compare the timeframe of the activities to those
1.        Item 1. Grantee Name. Enter the name of the grantee organization.		presented in the approved grant application.
2.        Item 2. Grant Number. Enter the grant number that appears on the
Grant Agreement face sheet.		C.       Needs Assessment (Required by Capacity Building Grants only).
3.        Item 3. Reporting Period. Enter the first and last dates of the quarter		Describe the needs assessment process conducted during the quarter,
covered by the report, for example, from 4/1/01 to 6/30/01.		the results of the needs assessment or update, and how the results will
		be used to develop training materials and training, as applicable.
B.  Training Sessions
		D.       Training. Describe efforts made to reach the target audience, to make
A training session is the presentation of occupational safety and health		them aware of the training, and to enroll them in training. Discuss
information to a group of people. Do not count conferences or needs		the training conducted during the quarter including the language of
assessments as training sessions. Use a separate line for each training		the training session. Provide a summary of the subject
session. If necessary, continue on an additional form. Training sessions for		matter, the type of training (e.g., train-the-trainer, hazard recognition),
the same group of trainees that are conducted on more than one day are not		and who attended (e.g., employers, building trades workers). Provide
to be reported until they are completed. Sessions are to be reported in the		aggreated ethnicity and race data details.
quarter in which they end. A separate OSHA FORM 171 is required to be
submitted for each type (or tier) of training conducted in a quarter.		E.       Training Materials/Curriculum. Provide information about training
		materials in development and any training or assessment materials
1.        Item 4. Date. Enter the date the training session ended.		acquired during the quarter. Describe how completed materials are
2.        Item 5. Location. Enter the name (or two-letter abbreviation) of the		being used and who is receiving the materials. Comment on any
state where the training session was held.		changes that are being made to improve the materials as a result of
3.        Item 6. Number in Attendance: Employees. Enter the number of who		feedback.
employees who attended the training session. An employee is a worker
does not meet the definition of an employer. First-line supervisors		F.       Evaluation Activities. Discuss evaluation activities conducted during the
are to be included as employees. Attendees not covered under the OSH		quarter. Describe the results of the Level 1, 2, and 3 evaluations
Act cannot be counted.		obtained. Only Capacity Building Developmental grants are required to
4.        Item 7. Number in Attendance: Employers. Enter the number of		conduct Level 3 evaluations. Results should be summarized in the
employers who attended the training session. An employer is a person,		report.
other than a first-line supervisor, who is responsible for the work flow
of two (2) or more persons, including responsibility for rating the		G.       Other Educational Activities. Discuss any educational activities that are
performance of those persons working for the employer. Attendees not		being conducted other than training or developing training materials.
covered under the OSH Act cannot be counted.		Examples include on-site consultation, assisting an organization in the
5.        Item 8. Number in Attendance: Total. Enter the sum of the entries in		implementation of a safety program, or operating library services.
each of the columns 6. Employees and 7. Employers. This is calculated
automatically in the electronic form once the number of contact hours		H.       Planned vs. Actual. Describe progress in meeting plans as contained
for the training session is completed for column 9. Class Length.		in the approved grant. Specify where plans are not being met and discuss
6.        Item 9. Contact Hours: Class Length (in quarter hours). Enter the		the corrective action that is being taken to meet plans. Where corrective
number of contact hours for each training session. Training less than .5		actions have already been taken, indicate if they were successful. In
hours cannot be counted. Partial hours should be rounded to the nearest		addition, discuss grant successes, either where plans were exceeded
quarter hour, for example, 1.25, 1.5, or 1.75.		or where significant accomplishments were achieved.
OMB No. 1218-0100 Previous Editions may not be used OSHA 171 Revised June 30 2021