FastTrack Submission Form_CCPRC 2015 Input

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

T ITLE OF INFORMATION COLLECTION:

Input from Child Care Policy Research Consortium Members for CCPRC 2015 Annual Meeting

PURPOSE:

We are seeking input on programming for the 2015 Annual Meeting of the Child Care Policy Research Consortium (CCPRC). The Annual Meeting brings together researchers, program administrators and policymakers concerned with building the knowledge base and strengthening bridges between research and policies concerning child care subsidies and other initiatives to increase access to high quality early care and education. We have developed an initial list of priority discussion topics and research issues. However, we want the meeting agenda to:

(a) reflect ideas and interests from a wider spectrum of perspectives;

(b) include new research by CCPRC members that is relevant to goals of CCPRC; and

(c) nurture new connections and collaborations among CCPRC members.

A brief web-based survey of CCPRC members will provide a quick and convenient opportunity for CCPRC members to contribute their views, current interests, work and questions to shape the meeting agenda.

DESCRIPTION OF RESPONDENTS:

The survey will be sent to current members of the Child Care Policy Research Consortium (CCPRC), a network of current and former grantees, contractors, and other stakeholders who have received funds from the Administration for Children and Families to conduct research addressing policy questions of relevance to the Child Care Development Fund and related initiatives in the field of early care and education. Currently, the electronic mailing list of the CCPRC includes 275 individuals.

TYPE OF COLLECTION: (Check one)

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

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

[ ] Focus Group [X] Other: _Web-based survey

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:_Ann C. Rivera______________________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [X] Yes [ ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [X ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) 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

Category of Respondent	No. of Respondents	Participation Time	Burden
Individuals	275	5 minutes	23 hours
Totals			23 hours

FEDERAL COST: The estimated annual cost to the Federal government is __$400.00______

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? [X]Yes [ ] 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 have a database of CCPRC members that have elected to continue receiving messages through the CCPRC listserv. We plan to email all current subscribers to the listserv (N=275) to invite them to complete the survey.

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.

2