Senior Corps Focus Groups Submission Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 3045-0137)

TITLE OF INFORMATION COLLECTION: Senior Corps Focus Group Questions and Survey

PURPOSE:

To solicit feedback from Senior Corps project staff to check our understanding of program implementation and opportunities for development as Senior Corps moves into a new administration. Senior Corps will use resulting information to help inform certain policy positions along with feedback received from other stakeholder groups, like Senior Corps Associations, national partners, CNCS field staff, and others. This feedback will also aid in confirming or challenging anecdotal responses to topics presented and may help inform future research into program effectiveness and future investment in innovative applications of Senior Corps program models.

DESCRIPTION OF RESPONDENTS:

Senior Corps project staff from sponsoring organizations

TYPE OF COLLECTION: (Check one)

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

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

[X] 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: Erin McGrath

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

Travel expenses for participants will be paid by Senior Corps. The cost is estimated at an average of $650 per attendee.

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Private Sector (Nonprofit)	50	800 hours	666.7
Public Sector (Government, non-federal)	10	160 hours	26.7
Totals	60	960	693.4

FEDERAL COST: The estimated annual cost to the Federal government is $100,000.

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?

Respondents are selected from the universe of known project staff. Project staff work closely with CNCS field office staff. Field office staff recommend potential respondents based on a number of factors including experience with various aspects of programming and project implementation, geographical representation, and grant award size. Senior Corps HQ selects from the list to ensure that respondents with broad diversity of thought and opinion will be invited to participate.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ ] Telephone

[X] In-person

[ ] Mail

[ ] Other, Explain

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

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

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