FastTrack Generic Submission Form - NCPFCE Resources

OMB Approval Request - Feedback on NCPFCE Resources 12-26-19.docx

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

FastTrack Generic Submission Form - NCPFCE Resources

OMB: 0970-0401

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Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401, Exp. Date: 05/31/2021)

Shape1 TITLE OF INFORMATION COLLECTION: Feedback on National Center on Parent, Family and Community Engagement (NCPFCE) Resources



PURPOSE:

The National Center on Parent, Family and Community Engagement (NCPFCE) resources are designed to help programs learn new ways to connect with families and meet their varying needs. The resources offer suggestions for activities, resources and strategies that programs can use and share with families. This form will gather feedback on the delivery and content of these resources. Feedback will focus attention on areas for improving the future delivery; specifically, information will be requested on how the content supported programs; programs’ satisfaction with the content; and ways in which the content and resource improve to better meet the needs of programs to support families’ financial security.


DESCRIPTION OF RESPONDENTS:

Respondents are directors and family service workers in early childhood programs who have attended NCPFCE webinars on Building Foundations for Economic Mobility or who access and use NCPFCE resources.


TYPE OF COLLECTION: (Check one)


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

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

[ ] 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. 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: Kiersten Beigel, Senior Program Specialist/Federal Program Officer, Office of Head Start


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?

[ ] Yes [X ] No


BURDEN HOURS


Category of Respondent

No. of Respondents

Participation Time

Burden

Early Childhood Education Staff

450

10 minutes

75 hours

Totals

450

10 minutes

75 hours


FEDERAL COST: The estimated annual cost to the Federal government is ____$1500________


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?


The group of respondents are individuals who have attended the webinar series on Building Foundations for Economic Mobility or who have accessed and used NCPFCE resources. Individuals who used multiple resources will only complete the survey once with a focus on a single resource.


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

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



Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

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TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)


PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.


DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.


TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.


CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.


Personally Identifiable Information: Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.


Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.


BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected per row.


No. of Respondents: Provide an estimate of the Number of Respondents.


Participation Time: Provide an estimate of the amount of time (in minutes) required for a respondent to participate (e.g. fill out a survey or participate in a focus group)


Burden: Provide the Annual burden hours: Multiply the Number of Respondents and the Participation Time then divide by 60.


FEDERAL COST: Provide an estimate of the annual cost to the Federal government.


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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.


Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.


Submit all instruments, instructions, and scripts with the request.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleFast Track PRA Submission Short Form
AuthorOMB
File Modified0000-00-00
File Created2021-01-14

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