Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” 1880-0542

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1880-0542)

TITLE OF INFORMATION COLLECTION: Equity Assistance Centers (EAC) Program Annual Client Survey

PURPOSE:

The Office of School Support and Rural Programs (SSRP) administers the Equity Assistance Centers (EAC) program. EACs provide assistance in the areas of race, gender, national origin, and religion to eligible responsible government agencies (i.e., State Education Agencies [SEA], Local Education Agencies [LEA], schools, school boards, and community-based organizations) to improve equal educational opportunities for all students. The EACs are authorized by the 1964 Civil Rights Act, Title IV and Regulations 34 CFR Part 270.

SSRP will collect and use information gathered through this vehicle to identify strengths and weaknesses in capacity building services provided by the EACs and to make improvements that are practical and feasible. Information from these client surveys will be used to plan and redirect resources and efforts to improve or maintain high quality capacity building services to relevant stakeholders.

The purpose of the Annual EAC Client survey is to determine: (1) the type and quality of services provided to clients (2) the extent to which such services resulted in changes to respondents’ awareness, knowledge, and policies and (3) any recommendations on how to improve capacity building services provided by the EAC.

DESCRIPTION OF RESPONDENTS:

Potential respondents include staff from eligible responsible government agencies, including SEAs, LEAs, schools, school boards, and community-based organizations and community members that have received services from the EAC. Participation will be fully voluntary and anonymous.

TYPE OF COLLECTION: (Check one)

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

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

[] 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: Kim Okahara

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 [X ] 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
SEA, LEA, and school staff and community members	200 (estimated)	0.33 (20 min)	66
Totals			66

FEDERAL COST: The estimated annual cost to the Federal government is 0

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? [] Yes [ X] 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?

SSRP will conduct (1) client survey per year and estimates a respondent universe of 200. The estimated number of respondents is based on the number of clients identified in a prior year (school fiscal year 2016) served by the program. The EAC client survey will be distributed via e-mail to all EAC clients in all categories who received services during the budget period.

EACs retain contact information for each client that requested and received capacity building services during the budget period (October 1 – September 30). EACs will provide these client lists to SSRP at the end of the budget period.

Administration of the Instrument

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

[X ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Attachments:

• EAC Client Survey

• Dear Colleague Letter

• Instructions to Identify Clients