OSC Technical Assistance Survey

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

2434ss68 OSC Technical Assistance Survey

OSC Technical Assistance Survey

OMB: 2010-0042

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2010-0042 can be found here:

2021-03-31 - Extension without change of a currently approved collection

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DRAFT EPA - OSC Technical Assistance Workshop Surveys

OMB Control No: 2010-0042

EPA ICR No: 2434.68

U.S. Environmental Protection Agency

Office of Sustainable Communities

Technical Assistance Workshop Participant Surveys ICR Request

The U.S. Environmental Protection Agency’s Office of Sustainable Communities (OSC) is will distribute five generic surveys to participants during and after OSC hosted technical assistance workshops. Several OSC programs that host similarly structured technical assistance workshops plan to utilize the surveys. The survey templates below are OSC generic. Individual OSC technical assistance programs would replace the fields below highlighted in yellow [brackets] with individual program names. See Appendix A for a list of OSC technical assistance programs that may choose to use the survey. The set of surveys are designed for three distinct survey groups as listed in the table below. Collectively, the surveys will help OSC gauge immediate and longer-term customer satisfaction with workshop design and outcomes. Survey feedback will help OSC improve measurement of public involvement in OSC technical assistance workshops, better understand customer satisfaction, and help OSC staff make strategic improvements to future workshops.

Survey	Survey Description	Respondents
Workshop – Day 1	Purpose: Collect feedback to measure satisfaction and the level of community engagement at the end of the day 1 workshop; Also, to learn how participants found out about the workshop and why they attended? Findings will inform future workshop design and public outreach. Format: paper-&-pencil at end of workshop; electronic.	Workshop Participants (e.g., community residents; steering committee members; TA point-of-contact; local, state, and federal partners).
Workshop – Day 2	Purpose: To assess participant satisfaction, and better understand participant perceptions on the workshop planning sessions, and which sessions were most useful in achieving stated meeting goals. Format: paper-&-pencil at end of workshop; electronic.	Workshop Participants (e.g., community residents; steering committee members; TA point-of-contact; local, state, and federal partners). Many Day 2 participants are often different from Day 1.
Post-Workshop Surveys	Purpose: evaluate POC and steering committee member perceptions about the OSC workshop effectiveness within the community and post-workshop success. Format: Follow-up electronic questionnaire with the TA local Point-of-Contact: At time of delivery of final TA report. 12 months after workshop. 24 months after the workshop.	Workshop Steering Committee members and applicant point of contact (POC).

[OSC Technical Assistance] Workshop – Day 1

Participant Questionnaire

Thank you for participating in today’s [OSC Technical Assistance] meeting. Your feedback is important and we hope you will take this opportunity to answer the questions below on how we did. This survey is being conducted in accordance with the Federal Paperwork Reduction Act Information Collection Request #2434.68. You will need about 10 minutes to answer the questions.

City/Community: _________________________________

Meeting Event Date ______________________

Day 1 - Meeting Evaluation (Circle the appropriate response below):

Workshop goals & objectives were clearly stated.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The workshop format and design helped us reach the stated goals and objectives.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The public input sessions helped us affirm our common vision and aspirations that shape our [OSC workshop topic] and place-making goals.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
During the workshop, I felt comfortable voicing my opinion, and felt heard.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
After the workshop, I felt energized and more interested in taking on new roles & responsibilities.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The workshop strengthened local partnerships that will benefit our community’s [OSC workshop topic] goals.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The workshop helped me better understand the connections among [OSC workshop topic] issues, community revitalization, improved human health, and environmental protection.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
I am satisfied with the overall outcomes of the workshop.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly

Questions about the meeting event – please write in your responses below:

What did you like most about Day 1 of the workshop? ______________________________

___________________________________________________________________________

What could we do to improve the workshop? ______________________________________

___________________________________________________________________________

What other feedback would you like to share? _____________________________________

___________________________________________________________________________

___________________________________________________________________________

How did you learn about the [OSC] workshop? (Check below all that apply)

_____ Workshop mailings

_____ Newspaper articles

_____ Radio or TV news

_____ Internet web page

_____ Community members/family/friends

_____ Direct communication with a workshop organizer

_____ Store front sign/announcement

_____ Listserve/Facebook/social media announcement

_____ Flyers in store windows/bulletin boards

_____ Other (Please specify):

___________________________________

Demographic Information

Participant Sex (optional) ____M ____F

Participant age group (optional): ____ (18 – 35) ____ (36 – 50) ____ (51 – 64) ___ (65+)

Participant Description (check below how you would describe yourself):

_____ Community Resident

_____ [Workshop topic-specific audience if any]

_____ Business Owner

_____ Community Group/NGO

_____ Local government official

_____ State government official

_____ Federal government official

_____ Other (Please specify):

___________________________________

Thank you for taking the time to share your views with us!

[OSC Technical Assistance] Workshop – Day 2

Participant Questionnaire

Thank you for participating in the two day [OSC program] planning workshop. We hope you will take this opportunity to provide overall workshop feedback below, including your suggestions for improving future workshops. This survey is being conducted in accordance with the Federal Paperwork Reduction Act Information Collection Request #2434.68. You will need about 10 minutes to answer the questions.

Please provide your rating of the workshop for the following by circling the appropriate rating:

Overall

Day 2 - Please circle the appropriate response below):

Day 2 workshop goals & objectives were clearly stated.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
We achieved Day 2 goals & objectives.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
I was provided adequate opportunity to share my input as we developed specific strategies and actions for our implementation plan.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
Our federal partners provided expertise that was helpful as we developed our implementation plan.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly

Morning session – Please circle your rating for each statement below:

The presentation of other community examples helped me in thinking about my community’s [OSC workshop topic] goals, and strategies on how to achieve them.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The small group exercise was a good approach to exploring how we can better achieve our goals.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly

Afternoon session – Please circle your rating for each session listed below:

The afternoon group exercise was a good approach to identifying implementation actions for each goal.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The afternoon action plan exercise will help us implement workshop goals.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly

How did the workshop benefit from the presence of federal and state agency staff? __________________

_________________________________________________________________________________

What did you like most about the workshop on Day 2?

_________________________________________________________________________________

What can we do to improve Day 2 workshop sessions? ________________________________________

_________________________________________________________________________________

What other feedback would you like to share? ________________________________________

_________________________________________________________________________________

Workshop Logistics

Please provide any feedback you wish to share about the meeting facilities, handouts, other meeting materials and their impact on the workshop. _________________________________________

_________________________________________________________________________________

Demographic Information-

Participant Sex (optional) ____M ____F

Participant age group (optional): ____ (18 – 35) ____ (36 – 50) ____ (51 – 64) ____(65+)

Participant Description (check below how you would describe yourself):

_____ Community Resident

_____ [Workshop Topic-specific Audience if any]

_____ Business Owner

_____ Community Group/NGO

_____ Local government official

_____ State government official

_____ Federal government official

_____ Other (Please specify):

___________________________________

Thank you for taking the time to share your views with us!

[OSC Technical Assistance Program]

Steering Committee Participant Follow-up Questionnaire

(at time of delivery of workshop report)

Workshop Value – Please circle your response for each line below:

Workshop & steering committee meetings achieved what I hoped, and advanced our community [OSC workshop topic] goals.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
Through the workshop we strengthened local partnerships that will help us realize our community [OSC workshop topic] goals.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The workshop energized participants, who have expressed greater interest in taking on new roles & responsibilities.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
Ideas generated during the workshop helped us identify new and better ways to meet our community [OSC workshop topic] goals.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
Overall, I am satisfied with the outcomes of the workshop.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly

Workshop Report – Please circle your response for each line below:

I am satisfied with the final workshop report.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
I feel the final report’s goals & action plan incorporated local community input from the [OSC workshop topic] workshop.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The report clearly explains [OSC workshop topic] issues and impacts on community residents.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
10. The report length is just about right.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly

11. Any other feedback about the workshop or final report you wish to share?

___________________________________________________________________________

12. What community assets are you aware of that were already in place prior to the (OSC program] workshop? Examples of assets include [OSC workshop topic examples].

___________________________________________________________________________

13. Describe how you think the workshop and final report will benefit your community?

___________________________________________________________________________

[OSC Technical Assistance Program]

Steering Committee Participant Follow-up Questionnaire

(12 months out)

Progress 12 months after the [OSC program] workshop - Please circle your response for each line below:


After 12 months, our community [OSC workshop topic] work is still active.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
Our community has used the [OSC workshop topic] workshop report as a guiding document.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
We have succeeded in reaching the goals we listed in our [OSC workshop topic] action plan.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
The [OSC workshop topic] process helped lead us to additional financial resources over the last year to support our efforts.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
We have shared with other communities what we learned through the [OSC workshop topic] process.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
A year after the [OSC workshop topic] workshop, our partnerships in our community have:	Grown Significantly	Grown	Remained the Same	Declined	Declined Significantly
Engagement with community residents has:	Grown Significantly	Grown	Remained the Same	Declined	Declined Significantly

If you have not reached your [OSC workshop topic] goals, what percentage of completion would you assign toward reaching your goals? (e.g., 50%, 70%, 100 % complete)? _______%

What are the most significant successes you achieved to date?

___________________________________________________________________________

What challenges or barriers have you encountered?

___________________________________________________________________________

What community assets are you aware of that were started or enhanced since the [OSC workshop topic] workshop? Examples of assets include [OSC program examples].

___________________________________________________________________________

Any other feedback you wish to share a year after the workshop?

___________________________________________________________________________

If you have not yet realized your [OSC workshop topic] goals, do you still expect to do so in the future?

___________________________________________________________________________

[OSC Technical Assistance Program]

Steering Committee Participant Follow-up Questionnaire

(24 months out)

Progress 24 months after the [OSC program] workshop - Please circle your response for each line below:


After 2 years, our [OSC workshop topic] efforts are still active.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
In the last 12 months, our community continues to use the [OSC workshop topic] workshop report as a guiding document.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
In the last 12 months we have succeeded in reaching the goals we listed in our [OSC workshop topic] action plan.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
In the last 12 months [OSC workshop topic] continued to lead us to new financial resources to support our efforts.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
Other communities have borrowed some of our [OSC workshop topic] ideas for their own use.	Disagree Strongly	Disagree	Neutral	Agree	Agree Strongly
Partnerships in our community continue to:	Grow Significantly	Grow	Remain the Same	Decline	Decline Significantly
Engagement with community residents continues to:	Grow Significantly	Grow	Remain the Same	Decline	Decline Significantly

What percentage would you assign to having completed the goals listed in your [OSC workshop topic] action plan (e.g., 50%, 70%, 100 % complete)? _______%

What barriers did you encounter in attempting to complete your goals?

___________________________________________________________________________

What community assets are you aware of that were already in place prior to the [OSC workshop topic] workshop? Examples of assets include [OSC program examples]. ___________________________________________________________________________

___________________________________________________________________________

Any other feedback you wish to share two years after the workshop? ___________________________________________________________________________

___________________________________________________________________________

APPENDIX A

EPA Office of Sustainable Communities Technical Assistance Programs

The following Office of Sustainable Community technical assistance programs may utilize the customer service satisfaction survey instrument:

Local Foods, Local Places (LFLP) - Helps communities develop and implement action plans that promote local foods and downtown revitalization. Representatives of communities anywhere in the United States are eligible to apply. This program builds on the Livable Communities in Appalachia Program, which offered technical assistance to help small towns and rural communities in Appalachia revitalize their traditional downtowns to boost the local economy and improve quality of life.

Healthy Places for Healthy People - Helps communities create walkable, healthy, economically vibrant places by engaging with their health care facility partners such as community health centers (including Federally Qualified Health Centers), nonprofit hospitals, and other health care facilities. Eligible applicants include local government representatives, health care facilities, local health departments, nonprofit organizations, tribes, and others proposing to work in a neighborhood, town, or city anywhere in the United States.

Building Blocks for Sustainable Communities - One- to two-day, targeted technical assistance to give communities tools to implement smart growth development approaches. Eligible applicants are tribal, county, and local governments, and nonprofit organizations that have the support of the local government on whose behalf they are applying.

Cool & Connected - Helps rural communities use broadband service to revitalize main streets and promote economic development. Any community representative can apply.

Greening America’s Communities - Helps selected cities and towns envision and implement design strategies for more sustainable communities. Formerly called Greening America's Capitals.

Smart Growth Implementation Assistance - Works with public-sector entities that want to incorporate smart growth techniques into their development. As of 2015, EPA's regional staff identifies and selects communities to assist. Summaries and reports from past SGIA projects can be helpful to communities facing similar issues

Special Smart Growth Technical Assistance Projects - Additional technical assistance projects done in partnership with other entities.

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File Title	OMB Control No: xxxx-xxxx
Author	Chris Rossomando
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File Created	2021-01-21