Generic Template for SSS TA Center Focus Groups

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1880-0524)

T ITLE OF INFORMATION COLLECTION:

Safe and Supportive Schools Technical Assistance (SSS TA) Center Focus Groups

PURPOSE:

SSS TA believes that it is important to determine the level of satisfaction of its delivery of technical assistance and supports to grantees. The data collected regarding the performance and effectiveness of how these technical assistance activities, events and publications are meeting customers’ needs will provide data for the SSS TA overall annual evaluation plan as well as the center’s continuous quality improvement process. As a result, the Department wishes to solicit input from current ED grantees to determine whether they have been satisfied with the services and products provided or whether other services or products would better meet their needs.

DESCRIPTION OF RESPONDENTS:

Audiences are comprised of from 1-25 people who represent the grantees who are implementing the Safe and Supportive Schools Initiative. Each will be given the opportunity to participate in focus groups. These focus groups are a deliverable included in the contract as part of the annual evaluation of the center’s activities.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[X] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Sandra Keenan or Rita Foy-Moss

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Focus Group	25	1 hour	25
Totals	25	1 hour	25

FEDERAL COST: The estimated annual cost to the Federal government is $10,000 covers cost in contract to provide evaluation activities related to focus groups.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

The 11 state SSS grantees are the primary audience for the focus group. We have defined lists for grantee project directors and staff.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

] Web-based or other forms of Social Media

[ ] Telephone

[ X] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ X ] Yes [] No

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