Choose Safe Places for Early Care and Education Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
Form 0923-0047 Choose Safe Places for Early Care and Education Survey Form and Instruction
0923-0047 ATSDR Choose Safe Places for Early Care and Education Su AttB CSPECE Survey (scrnshts).docx Form and Instruction
AttA Email Invitation for CSPECE.docx Email Invitation IC Document
NCEH-ATSDR Resrch Dtrm CSPECE-OSSigned.pdf Research Determination IC Document
ATSDR 0923-0047 Choose Safe Places for Early Care and Education Survey-OSSigned.pdf GenIC Request IC Document

Information Collection (IC) Details

IC Title:	Choose Safe Places for Early Care and Education Survey	Agency IC Tracking Number:	0923-0047-18ALZ

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0923-0047	ATSDR Choose Safe Places for Early Care and Education Survey	AttB CSPECE Survey (scrnshts).docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	4	4
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Email Invitation	AttA Email Invitation for CSPECE.docx	06/04/2018
Research Determination	NCEH-ATSDR Resrch Dtrm CSPECE-OSSigned.pdf	06/04/2018
GenIC Request	ATSDR 0923-0047 Choose Safe Places for Early Care and Education Survey-OSSigned.pdf	06/04/2018

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