Information Collection

Early Care and Education (ECE) State Indicator Assessment

IC 218345 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Early Care and Education (ECE) State Indicator Assessment	Form and Instruction
ECE State Indicator Report Att F Instrument Screen Shots _REVISED.docx	Form and Instruction
Att. E Word vers of Instrument Template.docx Instrument Questionnaire - WORD	IC Document
Att. A List of State Health Dept by State.docx List of Health Dept. by State	IC Document
Att. B map of CACFP agency by state.ppt Map of CACFP by State	IC Document
Att. D Figure of CDC spectrum of opportunities.pptx CDC Spectrum of Opportunity	IC Document
Att. G notification email for 1305 ECE coordinator.docx Notification email for 1305 ECE Coordinator	IC Document
Att. H notification email for CACFP director.docx Notification email for CACFP Director	IC Document
Att. I first reminder email for 1305 ECE coordinator.docx First Reminder email for 1305 ECE Coordinator	IC Document
Att. J first reminder to CACFP director.docx First Reminder email for CACFP Director	IC Document
Att. K final reminder email for 1305 ECE coordinator.docx Final Reminder email for 1305 ECE Coordinator	IC Document
Att. L final reminder email for CACFP director.docx Final Reminder email for CACFP Director	IC Document
DNPAO-SIR-SSB.docx Supporting Statement B	IC Document
DNPAO-SIR-SSA_REVISED.docx Supporting Statement A	IC Document

IC Title:

Early Care and Education (ECE) State Indicator Assessment

Agency IC Tracking Number:

15BGR

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	ECE State Indicator Report	Att F Instrument Screen Shots _REVISED.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 102

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	102	102
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Instrument Questionnaire - WORD	Att. E Word vers of Instrument Template.docx	09/25/2015
List of Health Dept. by State	Att. A List of State Health Dept by State.docx	09/25/2015
Map of CACFP by State	Att. B map of CACFP agency by state.ppt	09/25/2015
CDC Spectrum of Opportunity	Att. D Figure of CDC spectrum of opportunities.pptx	09/25/2015
Notification email for 1305 ECE Coordinator	Att. G notification email for 1305 ECE coordinator.docx	09/25/2015
Notification email for CACFP Director	Att. H notification email for CACFP director.docx	09/25/2015
First Reminder email for 1305 ECE Coordinator	Att. I first reminder email for 1305 ECE coordinator.docx	09/25/2015
First Reminder email for CACFP Director	Att. J first reminder to CACFP director.docx	09/25/2015
Final Reminder email for 1305 ECE Coordinator	Att. K final reminder email for 1305 ECE coordinator.docx	09/25/2015
Final Reminder email for CACFP Director	Att. L final reminder email for CACFP director.docx	09/25/2015
Supporting Statement B	DNPAO-SIR-SSB.docx	09/25/2015
Supporting Statement A	DNPAO-SIR-SSA_REVISED.docx	09/28/2015

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