Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Polling Questions	Form and Instruction	New	Repair queued
Form 1 Survey	Form and Instruction	New	Available
Form 1 Questions for Professionals	Form	Unchanged	Available
Form 1 Questions for Students	Form	Unchanged	Available
Form 1 Individuals/Households	Form	Unchanged	Available
Fous Group Template	Form and Instruction	Unchanged	Repair queued
Focus Group Template	Form and Instruction	Unchanged	Available
This is a nonmaterial no substantive change.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2012-06-13	Repair queued
HSContinBlueprintv5AFinlo.pdf	Supplementary Document	Uploaded 2012-03-14	Repair queued
HS Description and Process.docx	Supplementary Document	Uploaded 2012-03-14	Available
HS Partnerships PILOT Focus Group Template.docx	Supplementary Document	Uploaded 2012-03-14	Available
HS GUIDE CLEARANCE - Request for Approval.doc	Supplementary Document	Uploaded 2012-02-27	Available
HS Partnerships Guide CLEARANCE doc 1 31 12.docx	Supplementary Document	Uploaded 2012-02-27	Available
HSContinBlueprintv5AFinlo.pdf	Supplementary Document	Uploaded 2012-02-27	Available
HS GUIDE CLEARANCE - Request for Approval.doc	Supplementary Document	Uploaded 2012-02-27	Available
HS Partnerships Guide CLEARANCE doc 1 31 12.docx	Supplementary Document	Uploaded 2012-02-27	Available
HSContinBlueprintv5AFinlo.pdf	Supplementary Document	Uploaded 2012-02-27	Repair queued
HS GUIDE CLEARANCE - Request for Approval.doc	Supplementary Document	Uploaded 2012-02-27	Available
HS Partnerships Guide CLEARANCE doc 1 31 12.docx	Supplementary Document	Uploaded 2012-02-27	Available
HSContinBlueprintv5AFinlo.pdf	Supplementary Document	Uploaded 2012-02-27	Available
HS GUIDE CLEARANCE - Request for Approval.doc	Supplementary Document	Uploaded 2012-02-27	Available
HS Partnerships Guide CLEARANCE doc 1 31 12.docx	Supplementary Document	Uploaded 2012-02-27	Available
HSContinBlueprintv5AFinlo.pdf	Supplementary Document	Uploaded 2012-02-27	Available
HS GUIDE CLEARANCE - Request for Approval.doc	Supplementary Document	Uploaded 2012-02-27	Available
HS Partnerships Guide CLEARANCE doc 1 31 12.docx	Supplementary Document	Uploaded 2012-02-27	Available
HSContinBlueprintv5AFinlo.pdf	Supplementary Document	Uploaded 2012-02-27	Repair queued
HSContinBlueprintv5AFinlo.pdf	Supplementary Document	Uploaded 2012-02-27	Available
HS GUIDE CLEARANCE - Request for Approval.doc	Supplementary Document	Uploaded 2012-02-27	Available
HS Partnerships Guide CLEARANCE doc 1 31 12.docx	Supplementary Document	Uploaded 2012-02-27	Available
HS GUIDE CLEARANCE - Request for Approval.doc	Supporting Statement A	Uploaded 2012-03-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
204008	Polling Questions for CWIG	Form and Instruction	New	Polling Questions
203655	Survey	Form and Instruction	New	Survey
203548	OPRE Research Dissemination Project	Other-Interview	New
202699	Satisfaction Survey for Child Welfare Information Gateway	Form	Unchanged	Questions for Professionals
202699	Satisfaction Survey for Child Welfare Information Gateway	Form	Unchanged	Questions for Students
202699	Satisfaction Survey for Child Welfare Information Gateway	Form	Unchanged	Individuals/Households
201591	Partnerships for Sustained Learning: A Guide to Creating Head Start-School Partnerships - State	Form and Instruction	Unchanged	Fous Group Template
201591	Partnerships for Sustained Learning: A Guide to Creating Head Start-School Partnerships - State	Instruction	Unchanged
201590	Partnerships for Sustained Learning: A Guide to Creating Head Start-School Partnerships - Private	Form and Instruction	Unchanged	Focus Group Template
201590	Partnerships for Sustained Learning: A Guide to Creating Head Start-School Partnerships - Private	Instruction	Unchanged

ICR Details

OMB Control No: 0970-0401	ICR Reference No: 201207-0970-001
Status: Historical Active	Previous ICR Reference No: 201206-0970-007
Agency/Subagency: HHS/ACF	Agency Tracking No: 16797
Title: Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/05/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/03/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2015	04/30/2015	04/30/2015
Responses	7,090	0	3,090
Time Burden (Hours)	4,062	0	2,062
Cost Burden (Dollars)	0	0	0

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Abstract: This is a generic request to seek feedback from the public on service delivery. This is in accordance with the Administrations's commitment to improving service delivery.

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Authorizing Statute(s): PL: Pub.L. 110 - 134 125 Name of Law: Head Start Act of 2007
  

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 80542	12/22/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 70460	11/14/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
OPRE Research Dissemination Project
Partnerships for Sustained Learning: A Guide to Creating Head Start-School Partnerships - Private	none	Focus Group Template
Partnerships for Sustained Learning: A Guide to Creating Head Start-School Partnerships - State	none	Fous Group Template
Polling Questions for CWIG	1	Polling Questions
Satisfaction Survey for Child Welfare Information Gateway	1, 1, 1	Individuals/Households ,   Questions for Students ,   Questions for Professionals
Survey	1	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	7,090	3,090	0	0	4,000	0
Annual Time Burden (Hours)	4,062	2,062	0	0	2,000	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $1,000

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 07/03/2012

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