Information Collection Request

CB Evaluation: Regional Partnership Grants (RPG) National Cross-Site Evaluation and Evaluation Technical Assistance [Implementation/descriptive study and Outcomes/Impact analyses]

ICR 201901-0970-001 · OMB 0970-0527 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
RPG Part_A_Draft_to CB_updated 01092019_CLEAN_v2.docx Supporting Statement A Uploaded 2019-01-09 Available
Appendix I Partner Survey FAQ.docx Supplementary Document Uploaded 2019-01-09 Available
Appendix H_Partner Survey Outreach Emails.docx Supplementary Document Uploaded 2019-01-09 Available
Appendix A_Copy of authorizing legislation.pdf Supplementary Document Uploaded 2019-01-09 Available
RPG Part_B_Draft_to CB_updated 01092019_CLEAN.docx Supporting Statement B Uploaded 2019-01-09 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
234670 Outcomes and impacts data - Standardized instruments: Data entry for comparison study sites (Appendix F) Other-Data Elements New
234669 Outcomes and impacts data - Standardized instruments: Review records and submit (Appendix F) Other-Data Elements New
234668 Outcomes and impacts data - Standardized instruments: Data entry for standardized instruments (Appendix F) Other-Data Elements New
234667 Outcomes and impacts data - Standardized instruments: Review and adopt reporting templates (Appendix F) Other-Data Elements New
234666 Outcomes and impacts data - Administrative data: Report administrative data (Appendix G) Other-Admin Data New
234665 Outcomes and impacts data - Administrative data: Obtain access to administrative data (Appendix G) Other-Admin Data New
234663 Enrollment and services data: Service log entries (Appendix E) Other-Data Elements New
234662 Enrollment and services data: Case closure – prenatal (Appendix E) Other-Data Elements New
234661 Enrollment and services data: Case closure (Appendix E) Other-Data Elements New
234656 Enrollment and services data: Case enrollment data (Appendix E) Other-Data Elements New
234655 Enrollment and services data: Semiannual progress reports (Appendix D) Other-Progress Report New
234654 Site visit and key informant data collection: Partner survey (Appendix C) Other-Survey New
234653 Site visit and key informant data collection: PD/PM phone interview (Appendix B) Other-Interview New
234652 Site visit and key informant data collection: Frontline staff interviews (Appendix B) Other-Interview New
234651 Site visit and key informant data collection: Partner representative interviews (Appendix B) Other-Interview New
234650 Site visit and key informant data collection: Program manager/supervisor individual interviews (Appendix B) Other-Interview New
234648 Site visit and key informant data collection: Program director individual interview (Appendix B) Other-Interview Guide New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2022 36 Months From Approved
386,961 0 0
31,396 0 0
0 0 0





Reginfo record details
17
table that charts list of burden
IC Title Form No. Form Name
Site visit and key informant data collection: Partner survey (Appendix C)
Site visit and key informant data collection: Partner representative interviews (Appendix B)
Enrollment and services data: Case enrollment data (Appendix E)
Enrollment and services data: Case closure (Appendix E)
Enrollment and services data: Service log entries (Appendix E)
Outcomes and impacts data - Administrative data: Report administrative data (Appendix G)
Outcomes and impacts data - Standardized instruments: Review and adopt reporting templates (Appendix F)
Outcomes and impacts data - Standardized instruments: Review records and submit (Appendix F)
Outcomes and impacts data - Standardized instruments: Data entry for comparison study sites (Appendix F)
Site visit and key informant data collection: Program director individual interview (Appendix B)
Site visit and key informant data collection: Program manager/supervisor individual interviews (Appendix B)
Site visit and key informant data collection: Frontline staff interviews (Appendix B)
Site visit and key informant data collection: PD/PM phone interview (Appendix B)
Enrollment and services data: Semiannual progress reports (Appendix D)
Enrollment and services data: Case closure – prenatal (Appendix E)
Outcomes and impacts data - Administrative data: Obtain access to administrative data (Appendix G)
Outcomes and impacts data - Standardized instruments: Data entry for standardized instruments (Appendix F)

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 386,961 0 0 376,372 10,589 0
Annual Time Burden (Hours) 31,396 0 0 26,494 4,902 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No