Child Welfare Information Gateway

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0970-0303 Appendix B_Customer Survey	Form	Modified	Available
Form 0970-0303 Appendix V_Customer Services Information Questions	Form	New	Available
Form 0970-0303 Appendix U_Customer Services Information Questions	Form	New	Available
Form 0970-0303 Appendix T_Customer Services Information Questions	Form	New	Available
Form 0970-0303 Appendix S_User Needs Assessment Focus Group Guide	Form	New	Available
Form 0970-0303 Appendix R_User Needs Assessment Focus Group Guide	Form	New	Available
Form 0970-0303 Appendix O_Webinar Feedback Survey	Form	New	Available
Form 0970-0303 Appendix N_Webinar Feedback Survey	Form	New	Available
Form 0970-0303 Appendix M_Online Tool / Web Section Survey	Form	New	Available
Form 0970-0303 Appendix L_Online Tool / Web Section Survey	Form	New	Available
Form 0970-0303 Appendix K_Online Tool / Web Section Survey	Form	New	Available
Form 0970-0303 Comment Card_Appendix J	Form	New	Available
Form 0970-0303 Appendix Q_General Focus Group Guide	Form	Modified	Available
Form 0970-0303 Appendix P_General Focus Group Guide	Form	Modified	Available
Form 0970-0303 Appendix I	Form	Modified	Available
Form 0970-0303 Appendix H_Coment Card	Form	Modified	Available
Form 0970-0303 Publication survey	Form	Modified	Available
Form 0970-0303 Publication survey	Form	Modified	Available
Form 0970-0303 Appendix E_Publication Survey	Form	Modified	Available
Form 0970-0303 Appendix D_Customer Survey	Form	Modified	Available
Form 0970-0303 Appendix C_Customer Survey	Form	Modified	Available
Supporting Statement Part B_6-25-10.pdf	Supporting Statement B	Uploaded 2010-06-29	Available
Appendix A_Executive Order.pdf	Supplementary Document	Uploaded 2010-06-29	Available
Supporting Statement Part A_10.12.10.doc	Supporting Statement A	Uploaded 2010-10-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43726	Customer Survey - Ind / Households	Form	Modified	Appendix B_Customer Survey
194058	Customer Services Information Ques - State, Local	Form	New	Appendix V_Customer Services Information Questions
194057	Customer Services Information Ques - Private	Form	New	Appendix U_Customer Services Information Questions
194056	Customer Services Information Ques - Ind / Households	Form	New	Appendix T_Customer Services Information Questions
194055	User Needs Assessment Focus Group - State, Local	Form	New	Appendix S_User Needs Assessment Focus Group Guide
194054	User Needs Assessment Focus Group - Private	Form	New	Appendix R_User Needs Assessment Focus Group Guide
194053	Webinar - Federal	Form	New	Appendix O_Webinar Feedback Survey
194052	Webinar - Private	Form	New	Appendix N_Webinar Feedback Survey
194051	Online tool / Web section survey - State, Local	Form	New	Appendix M_Online Tool / Web Section Survey
194050	Online tool / Web section survey - Private	Form	New	Appendix L_Online Tool / Web Section Survey
194049	Online tool / Web section survey - Ind / households	Form	New	Appendix K_Online Tool / Web Section Survey
194048	Comment Card - Private Sector	Form	New	Comment Card_Appendix J
184345	General Focus Group - State local	Form	Modified	Appendix Q_General Focus Group Guide
184344	General Focus Group - Private Sector	Form	Modified	Appendix P_General Focus Group Guide
184343	Comment Card - State, Local and Tribe	Form	Modified	Appendix I
184342	Comment Card - Ind / Households	Form	Modified	Appendix H_Coment Card
184341	Publication Survey - State, Local	Form	Modified	Publication survey
184340	Publication Survey - Private Sector	Form	Modified	Publication survey
184339	Publication Survey - Ind / Households	Form	Modified	Appendix E_Publication Survey
184338	Customer Survey - State, Local, or Tribal	Form	Modified	Appendix D_Customer Survey
184337	Customer Survey - Private Sector	Form	Modified	Appendix C_Customer Survey

ICR Details

OMB Control No: 0970-0303	ICR Reference No: 201008-0970-001
Status: Historical Active	Previous ICR Reference No: 200804-0970-001
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Child Welfare Information Gateway
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/29/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/03/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2013	36 Months From Approved	09/30/2011
Responses	7,650	0	2,153
Time Burden (Hours)	311	0	175
Cost Burden (Dollars)	0	0	0

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Abstract: The National Clearinghouse on Child Abuse and Neglect Information (NCCAN) and the National Adoption Information Clearinghouse (NAIC) received OMB approval to collect data for a customer satisfaction evaluation under OMB control number 0970-0303. On June 20, 2006, NCCAN and NAIC were consolidated into Child Welfare Information Gateway and revisions were made to the Customer Satisfaction Evaluation and approved under OMB control number 0970-0303. This effort is to make further revisions to the Customer Satisfaction Evaluation protocols to collect better information for improving products and services. The Customer Satisfaction Evaluation was initiated in response to Executive Order 12862 issued on September 11, 1993 (Appendix A). The Order calls for putting customers first and striving for a customer-driven government that matches or exceeds the best service available in the private sector. To that end, Child Welfare Information Gateway's evaluation is designed to better understand the kind and quality of services customers want, as well as customers' level of satisfaction with existing services. The proposed data collection activities for the evaluation include customer surveys, customer comment cards, web tool surveys, webinar feedback surveys, selected publication surveys, and focus groups.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Customer Surveys
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 14443	03/25/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 41869	07/19/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 21

table that charts list of burden

IC Title	Form No.	Form Name
Comment Card - Ind / Households	0970-0303	Appendix H_Coment Card
Comment Card - Private Sector	0970-0303	Comment Card_Appendix J
Comment Card - State, Local and Tribe	0970-0303	Appendix I
Customer Services Information Ques - Ind / Households	0970-0303	Appendix T_Customer Services Information Questions
Customer Services Information Ques - Private	0970-0303	Appendix U_Customer Services Information Questions
Customer Services Information Ques - State, Local	0970-0303	Appendix V_Customer Services Information Questions
Customer Survey - Ind / Households	0970-0303	Appendix B_Customer Survey
Customer Survey - Private Sector	0970-0303	Appendix C_Customer Survey
Customer Survey - State, Local, or Tribal	0970-0303	Appendix D_Customer Survey
General Focus Group - Private Sector	0970-0303	Appendix P_General Focus Group Guide
General Focus Group - State local	0970-0303	Appendix Q_General Focus Group Guide
Online tool / Web section survey - Ind / households	0970-0303	Appendix K_Online Tool / Web Section Survey
Online tool / Web section survey - Private	0970-0303	Appendix L_Online Tool / Web Section Survey
Online tool / Web section survey - State, Local	0970-0303	Appendix M_Online Tool / Web Section Survey
Publication Survey - Ind / Households	0970-0303	Appendix E_Publication Survey
Publication Survey - Private Sector	0970-0303	Publication survey
Publication Survey - State, Local	0970-0303	Publication survey
User Needs Assessment Focus Group - Private	0970-0303	Appendix R_User Needs Assessment Focus Group Guide
User Needs Assessment Focus Group - State, Local	0970-0303	Appendix S_User Needs Assessment Focus Group Guide
Webinar - Federal	0970-0303	Appendix O_Webinar Feedback Survey
Webinar - Private	0970-0303	Appendix N_Webinar Feedback Survey

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	7,650	2,153	0	5,497	0	0
Annual Time Burden (Hours)	311	175	0	136	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The proposed OMB estimates 311 hours and 7,650 responses as the reporting burden. Adjusted calculations were based on alterations to survey questions to improve information collected, and additional tools to address key information needs and improve services to customers. Therefore, the increase in burden was the result of a program change.

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Annual Cost to Federal Government: $163,200

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/03/2010

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