TITLE
OF INFORMATION COLLECTION: Feedback USA Button –
Department of Homeland Security (DHS)/U.S. Citizenship and
Immigration Services (USCIS) Pilot Survey
PURPOSE: This is an OMB sponsored project managed by the General Services Administration (GSA). OMB and GSA are looking for partner agencies to pilot the Feedback USA Button– a simple tool to collect customer feedback and:
Provide agencies with information needed to improve program delivery;
Provide the Executive Branch with insight into best practices and areas to improve; and
Provide the public with transparency around the quality of services provided.
We purpose to engage the public for feedback on their experience on services provided at 8 of our USCIS field offices.
For this survey, we have identified 8 field offices to house 2 kiosks each. We will ask only one question at each kiosk. The kiosk is a simple electronic device with one question listed at the top of its screen. The respondent’s response is a series of four smiley-face emoticons.
Survey Details
Who will conduct the survey? USCIS is working with GSA.
Where will we conduct the survey? We will conduct the survey at 8 field offices. We purpose to install 2 kiosks at each field office. When a customer visits the participating field office for the purpose of seeking information or for an immigration adjudication interview. At the conclusion of the customer’s appointment, an employee who interacts directly with the customer to provide information or adjudication services\ will inform the customer of the option of providing feedback on his or her experience. The customer can voluntarily enter feedback by using the onsite kiosk to answer the question with the additional option to provide free-form text on the website.
When will we conduct the survey? For two months beginning in May 2016.
DESCRIPTION OF RESPONDENTS: The respondents are members of the public who come to USCIS field office to obtain information or receive immigration services.
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:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
The results are not intended to be disseminated to the public.
Information gathered will not be used for the purpose of substantially informing influential policy decisions.
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: Michael Biggs, Special Assistant, District 22, Field Operations Directorate, U.S. Citizenship and Immigration Services
To assist review, please provide answers to the following question:
Personally Identifiable Information:
Is personally identifiable information (PII) collected? [ ] Yes [X ] No
If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No
If Applicable, has a System or Records Notice been published? [ ] Yes [ ] 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 (per month)
Category of Respondent |
No. of Respondents |
Participation Time (Minutes) |
Burden (hours) |
Kiosk |
4900 |
1 |
98 |
Totals |
4900 |
1 |
98 |
FEDERAL COST: The estimated annual cost to the Federal government is ____$960________
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
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?
We plan to inform customers who come to a field office that they have the option to answer a one-question customer satisfaction survey via a kiosk in reference to their experience with the field office.
Administration of the Instrument
How will you collect the information? (Check all that apply)
[ ] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ X ] Other: Self standing kiosk
Will interviewers or facilitators be used? [ ] Yes [ X ] No
Please make sure that all instruments, instructions, and scripts are submitted with the request.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | DOCUMENTATION FOR THE GENERIC CLEARANCE |
Author | 558022 |
File Modified | 0000-00-00 |
File Created | 2021-01-26 |