Pre-testing of Evaluation Surveys

Forms and Documents

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

IC Document Collections

IC ID	Document Title	Status
212817	Measurement Development: Healthy Marriage and Relationship Education Models and Measures Other-Screener	Modified
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	Unchanged
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: 201411-0970-002
Status: Historical Active	Previous ICR Reference No: 201410-0970-015
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: 12/03/2014
	Date Received in OIRA: 11/20/2014
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
Head Start Family Voices Pilot Study
Permanency Innovations Initiative - LA RISE
Measurement Development: Healthy Marriage and Relationship Education Models and Measures
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
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: 11/20/2014

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