Permanency Innovations Initiative - AZ, CAPP, IL

Pre-testing of Evaluation Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

Documents and Forms

Document Name Document Type
A1-A3 CAPP FAQ, Contact Information Form, Consent Script, Interview.docx Other-CAPP Instruments
B1,2,4,7. ADES Child Assent, Care Provider FAQ, Child-Youth Interview.docx Other-ADES Instruments
C1-7, 9 DCFS Instruments.docx Other-DCFS Instruments
Supporting Statement A_AZ CAPP IL generic_FINAL 1.1.13.docx Supporting Statement A_AZ CAPP IL generic_FINAL 1 IC Document
B3. ADES Care Provider FAQ.docx B3 IC Document
Supporting Statement B_AZ CAPP IL generic_FINAL 1.1.13.docx Supporting Statement B_AZ CAPP IL generic_FINAL 1 IC Document
B5. ADES Caseworker Introduction Email For Prospective-Homes-Found Interview.docx B5 IC Document
B6. ADES Caseworker Introduction Email For Decision-Making Interview.docx B6 IC Document
C8. DCFS CASI-ACASI Measures and Instruction Screens.docx C8 IC Document

Information Collection (IC) Details

IC Title:	Permanency Innovations Initiative - AZ, CAPP, IL	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-CAPP Instruments	A1-A3 CAPP FAQ, Contact Information Form, Consent Script, Interview.docx	Yes	Yes	Fillable Fileable
Other-ADES Instruments	B1,2,4,7. ADES Child Assent, Care Provider FAQ, Child-Youth Interview.docx	Yes	Yes	Fillable Fileable
Other-DCFS Instruments	C1-7, 9 DCFS Instruments.docx	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 954	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	422	422
Annual IC Time Burden (Hours)	521	521
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A_AZ CAPP IL generic_FINAL 1	Supporting Statement A_AZ CAPP IL generic_FINAL 1.1.13.docx	01/02/2013
B3	B3. ADES Care Provider FAQ.docx	01/02/2013
Supporting Statement B_AZ CAPP IL generic_FINAL 1	Supporting Statement B_AZ CAPP IL generic_FINAL 1.1.13.docx	01/02/2013
B5	B5. ADES Caseworker Introduction Email For Prospective-Homes-Found Interview.docx	01/02/2013
B6	B6. ADES Caseworker Introduction Email For Decision-Making Interview.docx	01/02/2013
C8	C8. DCFS CASI-ACASI Measures and Instruction Screens.docx	01/02/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.