ACF Office of Regional Operations Customer Feedback for Learning Experiences

Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

ORO Webinar or Meeting Feedback Survey 1-6-17 clean

ACF Office of Regional Operations Customer Feedback for Learning Experiences

OMB: 0970-0401

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Office of Regional Operations

Webinar/Meeting Event Feedback Survey


For each webinar or meeting event hosted by ORO, a survey will be created in on-line survey software or paper format to gather feedback that can inform project planning. Given the changing nature and context of each webinar and meeting, it is important to be able to get feedback from recipients without creating undue burden by answering excessive questions that only marginally apply. To address this, the survey will be tailored to the unique information needs of each event to ensure low burden while informing high quality service provision. When creating each survey, the Central Office and Regional Offices will use the 6 required questions listed below and choose up to 19 context specific optional questions that can be added to the survey, as needed. This will allow for unique information needs to be met.


It is expected that the brief 5-minute survey would include the 6 required questions. Each tailored survey will have no more than 25 questions, including 6 required questions and a maximum of 10-19 optional questions, with a burden of no more than 15 minutes.


Introductory Text for Survey


The Office of Regional Operations would like your feedback on the webinar/meeting to help inform the planning and improve future webinars/meetings that we host. We invite you to participate in this voluntary feedback survey. The survey should take no more than [5 or 15] minutes and your responses will be kept private to the extent permitted by law.


An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number for this information collection is 0970-0401 and the expiration date is 5/31/2018.


6 Required Questions


Likert Scale Responses:

  1. Strongly Disagree

  2. Disagree

  3. Neutral, neither agree nor disagree

  4. Agree

  5. Strongly Agree


  • The webinar/meeting increased my knowledge and understanding about [add name of specific topic].

  • I intend to apply what I learned in my work.

  • Overall, the presenters enhanced my learning based on the information provided.

  • The webinar/meeting was applicable and relevant to my state and program’s needs.

  • I am satisfied with the overall quality of the webinar/meeting.

  • Please share suggestions for other topics or for improving future webinars/meetings. (open text box)


Optional Questions that may be added:


Likert Scale Responses:

  1. Strongly Disagree

  2. Disagree

  3. Neutral, neither agree nor disagree

  4. Agree

  5. Strongly Agree


  • My understanding of the role of my agency/division/department in addressing the [insert topic] has increased.

  • My understanding of prioritizing the needs of various populations [insert topic] has increased.

  • My understanding of the role and/or activities of philanthropy in efforts to address [insert topic] has increased.

  • I am able to identify at least one new promising practice relevant to addressing [insert topic] in our state.

  • I am able to identify at least one new resource that can help inform efforts to address [insert topic] in our state or community.

  • I am able to identify next steps to advance efforts to [insert topic] in our state or community.

  • I plan to follow-up and explore potential partnerships/collaborations with others that I met today.

  • The [Name of Webinar or Meeting] has increased my practical skills regarding [Topic 1]. (Insert/delete as many topics as necessary)

  • As a result of the [information I learned, knowledge I gained] through the [Name of Webinar or Meeting], I will be a more effective in my work.

  • As a result of my involvement in the [Name of Webinar or Meeting], I have improved my connections with peers/colleagues.

  • As a result of my participation, I am able to [Name of Webinar or Meeting – Goal 1]. (Insert/delete as many objectives/goals as necessary)


Optional Open-ended Questions

  • What aspects of the [Name of Webinar or Meeting] were most useful for your work?

  • Were there ways in which the [Name of Webinar or Meeting] could have been more useful to you? (Yes/No)

    • If yes, please describe how this [Name of Webinar or Meeting] could have been more useful?


Which of the following best describes your position? (Check one)

  • State or local public agency Leadership (Commissioners, Directors, Deputies)

  • Program Managers/ Program Director

  • Supervisors

  • Case Workers/Direct Practice Workers

  • Researcher

  • Policy Maker

  • Technical Assistance/ Consultant

  • Advocacy

  • Other (Please describe)


Which of the following best describes your organizational affiliation? (Check one)

  • State public agency

  • Local or county public agency/organization

  • Federal agency

  • Legislature

  • Non-profit (e.g. community-based organization, faith-based organization)

  • Territory

  • Tribal agency/organization

  • Training and technical assistance provider

  • Philanthropy or foundation

  • Early, Elementary, and Secondary Education

  • Higher Education

  • Other (Please describe)



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMelissa Brodowski
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File Created2021-01-22

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