Pre-testing of Evaluation Surveys

Forms and Documents

Document	Type	Status	Availability
Memo to OMB cognitive interview generic clearance FPRQ.DOCX	Justification for No Material/Nonsubstantive Change	Uploaded 2014-02-03	Repair queued
Appendix B3 - Q-DOT Center Director Cover Letter_v2.docx	Supplementary Document	Uploaded 2013-12-17	Repair queued
Appendix A1 - Q-DOT Center Recruitment Letter_v2.docx	Supplementary Document	Uploaded 2013-12-17	Repair queued
Appendix B2 - Q-DOT Teacher Cover Letter.docx	Supplementary Document	Uploaded 2013-12-17	Repair queued
Appendix B1 - Q-DOT FAQs_v2.docx	Supplementary Document	Uploaded 2013-12-17	Repair queued
Q-DOT - Section B_TO OMB_FINAL_v2.docx	Supplementary Document	Uploaded 2013-12-17	Repair queued
Q-DOT - Section A_TO OMB_FINAL_v2.docx	Supplementary Document	Uploaded 2013-12-17	Repair queued
Attachment B.5 SWYC Screens_nov8_(kr-11.13.13).docx	Supplementary Document	Uploaded 2013-11-21	Repair queued
Attachment B.4 SYWC CATI Advance Letter_nov8_(kr-11.13.13).docx	Supplementary Document	Uploaded 2013-11-21	Available
Attachment B.3 SWYC Email Invitation_nov8_(kr-11.13.13).docx	Supplementary Document	Uploaded 2013-11-21	Repair queued
Attachment B.2 Parent Letter and Consent Form_nov8_(kr-11.13.13).docx	Supplementary Document	Uploaded 2013-11-21	Available
Attachment B.1 Program Recruitment Advance Letter_nov8_(kr-11.13.13).docx	Supplementary Document	Uploaded 2013-11-21	Repair queued
FACES_OMB_Part B_11-13-13.docx	Supplementary Document	Uploaded 2013-11-21	Available
FACES_OMB_Part A_11_13_13.docx	Supplementary Document	Uploaded 2013-11-21	Available
FSW recruitment flyer.docx	Supplementary Document	Uploaded 2014-02-03	Repair queued
Email to HS_EHS Directors.docx	Supplementary Document	Uploaded 2014-02-03	Available
Memo to OMB cognitive interview generic clearance FPRQ.DOCX	Supplementary Document	Uploaded 2014-02-03	Repair queued
Memo - FSW Cognitive Interviews 24oct13.doc	Supplementary Document	Uploaded 2013-10-25	Available
Appendix L- Cognitive Interviews - Thank you letter for in-person interviews 24oct13.docx	Supplementary Document	Uploaded 2013-10-25	Repair queued
Appendix K- Cognitive Interviews - Thank you letter for telephone interviews 24oct13.docx	Supplementary Document	Uploaded 2013-10-25	Repair queued
Appendix J - Cognitive Interviews - Script for Program Recruitment 24oct13.docx	Supplementary Document	Uploaded 2013-10-25	Available
Appendix I- Cognitive Interviews - Individual Sign-Up Sheet 24oct13.docx	Supplementary Document	Uploaded 2013-10-25	Available
Appendix H - FPRQ Study Brochure 24oct13.pptx	Supplementary Document	Uploaded 2013-10-25	Repair queued
Appendix G - Cognitive Interviews - Website and newspaper ads 24oct13.docx	Supplementary Document	Uploaded 2013-10-25	Repair queued
Appendix F - Cognitive Interviews - Study Fliers 24oct13.docx	Supplementary Document	Uploaded 2013-10-25	Repair queued
Appendix C - Email & Text Message Reminder of Interview 24oct13.docx	Supplementary Document	Uploaded 2013-10-25	Repair queued
Supporting Statement B-FPRQ FSW Cog interviews-Generic Clearance 24oct13.doc	Supplementary Document	Uploaded 2013-10-25	Available
Supporting Statement A-FPRQ FSW Cog interviews-Generic Clearance 24oct13.doc	Supplementary Document	Uploaded 2013-10-25	Repair queued
B1-B2-B3-C1-combined.docx	Supplementary Document	Uploaded 2013-02-26	Available
Attachments-FINAL.docx	Supplementary Document	Uploaded 2013-02-26	Repair queued
HSFV Supporting Statement B 2-26-13 FINAL.docx	Supplementary Document	Uploaded 2013-02-26	Available
HSFV Supporting Statement A 2-26-13 FINAL.docx	Supplementary Document	Uploaded 2013-02-26	Available
C8. DCFS CASI-ACASI Measures and Instruction Screens.docx	Supplementary Document	Uploaded 2013-01-02	Repair queued
B6. ADES Caseworker Introduction Email For Decision-Making Interview.docx	Supplementary Document	Uploaded 2013-01-02	Repair queued
B5. ADES Caseworker Introduction Email For Prospective-Homes-Found Interview.docx	Supplementary Document	Uploaded 2013-01-02	Available
Supporting Statement B_AZ CAPP IL generic_FINAL 1.1.13.docx	Supplementary Document	Uploaded 2013-01-02	Available
B3. ADES Care Provider FAQ.docx	Supplementary Document	Uploaded 2013-01-02	Available
Supporting Statement A_AZ CAPP IL generic_FINAL 1.1.13.docx	Supplementary Document	Uploaded 2013-01-02	Available
Supporting Statement B RISE generic staff pre-posttest rev_7 25 12.docx	Supplementary Document	Uploaded 2012-08-06	Repair queued
Supporting Statement A RISE generic staff pre-posttest rev_7 25 12.docx	Supplementary Document	Uploaded 2012-08-06	Available
16-Phone Interview Thank you Letter_Clean_June 2013.docx	Supplementary Document	Uploaded 2013-06-28	Repair queued
14-In-person Interview Thank You Letter_Clean_June 2013.docx	Supplementary Document	Uploaded 2013-06-28	Repair queued
12-Revised Provider Consent Form_Clean_June 2013.docx	Supplementary Document	Uploaded 2013-06-28	Repair queued
10-Revised Parent Consent Form_Clean_June 2013.docx	Supplementary Document	Uploaded 2013-06-28	Repair queued
2-Summary Table of Changes to Provider Survey.docx	Supplementary Document	Uploaded 2013-06-28	Repair queued
1-Summary Table of Changes to Parent Survey.docx	Supplementary Document	Uploaded 2013-06-28	Available
OMB Memo - 3rd round of cognitive interviews (generic clearance) 27jun13 (1) (2).doc	Supplementary Document	Uploaded 2013-06-28	Available
Appendix N - FPRQ Study Brochure.pptx	Supplementary Document	Uploaded 2013-05-16	Repair queued
FPRQ Appendices Updated March 2012.docx	Supplementary Document	Uploaded 2013-05-16	Repair queued
FPRQ Cognitive Interviews - Generic Clearance Part A 22March12 track changes.docx	Supplementary Document	Uploaded 2013-05-16	Available
FPRQ Cognitive Interviews - Generic Clearance Part B 22March12.doc	Supplementary Document	Uploaded 2013-05-16	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
212817	Measurement Development: Healthy Marriage and Relationship Education Models and Measures	Other-Screener	New
209922	Q-DOT Pilot Study	Other-Screener	Unchanged
209423	Redesign of the Head Start Family and Child Experiences Survey (FACES 2012)	Other-Selection Form	Unchanged
209100	Measurement Development: Quality of Family-Provider Relationships in Early Care and Education	Other-Interview	Modified
205972	Head Start Family Voices Pilot Study	Other-Script	Unchanged
205269	Permanency Innovations Initiative - AZ, CAPP, IL	Other-CAPP Instruments	Unchanged
203646	Permanency Innovations Initiative - LA RISE	Other-Consents and Survey	Unchanged
201278	Quality of Family-Provider Relationships in Early Care and Education	Other-Interview	Unchanged

ICR Details

OMB Control No: 0970-0355	ICR Reference No: 201404-0970-002
Status: Historical Active	Previous ICR Reference No: 201402-0970-001
Agency/Subagency: HHS/ACF	Agency Tracking No: 21397
Title: Pre-testing of Evaluation Surveys
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: 05/16/2014
	Date Received in OIRA: 04/29/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2015	01/31/2015	01/31/2015
Responses	4,000	0	4,000
Time Burden (Hours)	2,000	0	2,000
Cost Burden (Dollars)	0	0	0

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Abstract: To date the Administration for Children and Families (ACF), Office of Planning Research and Evaluation (OPRE), has relied on small field tests (involving fewer than ten respondents) in developing questionnaires. However, these small tests are limited in their ability to detect and diagnose problems with the instruments and the procedures being tested. In response to this problem, we request a generic survey development clearance to allow us to use larger samples in applying methods useful for identifying questionnaire and procedural problems, suggesting solutions, and measuring the relative effectiveness of alternative solutions.

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Authorizing Statute(s): US Code: 42 USC 1310 Name of Law: Social Security Act
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
Measurement Development: Quality of Family-Provider Relationships in Early Care and Education
Quality of Family-Provider Relationships in Early Care and Education
Q-DOT Pilot Study
Head Start Family Voices Pilot Study
Permanency Innovations Initiative - LA RISE
Measurement Development: Healthy Marriage and Relationship Education Models and Measures
Permanency Innovations Initiative - AZ, CAPP, IL
Redesign of the Head Start Family and Child Experiences Survey (FACES 2012)

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ICR Summary 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	4,000	4,000	0	0	0	0
Annual Time Burden (Hours)	2,000	2,000	0	0	0	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: $120,000

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: 04/29/2014

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