OMB Control Number: 2506-0212 (Exp. 06/30/2020)
Paperwork Reduction Act Burden: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This collection of information is optional and will assist HUD to improve the quality, relevance, and delivery of technical assistance resources. The total time required to complete this survey is estimated to average 15 minutes including the time to review instructions, gather the data needed, and complete and review the survey. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Housing and Urban Development, Technical Assistance Division, 451 7th Street SW, Room 7218, Washington, D.C. 20410.
Privacy Act Statement: The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in connection with the request for information solicited on this form. Accordingly, pursuant to the requirements of the Act, please be advised:
Authorization: This collection of information is authorized under Sec. 501 of Title V of the Housing and Urban Development Act of 1970, Public Law 91-609, which authorizes the Secretary “to undertake such programs of research, studies, testing, and demonstration relating to the mission and programs of the Department as he determines to be necessary and appropriate.”
Purpose: This collection of information is necessary in order to systematically gather user feedback and outcomes data to evaluate and improve HUD’s deployment and management of its technical assistance resources. This type of information on outcomes has been consistently requested by both OMB and Congressional Appropriations Committee staff.
Uses: This information collection is entirely voluntary. Any information collected may be seen and used by HUD staff that are responsible for analysis of HUD’s technical assistance program. Results of individual surveys will not be shared with TA providers, other TA recipients, or HUD program office staff that have assisted in coordination of the technical assistance engagement. Survey results may be shared in aggregated form with TA providers or HUD program office staff that coordinate technical assistance. Survey results may also be shared in aggregated form with other HUD stakeholders and Congress.
Disclosure: Voluntary. Any information collected in this information collection may be made accessible to the public and shared widely. Please do NOT submit any personally identifiable information as part of this information collection form, defined as any information which can be used to distinguish or trace an individual's identity, such as name, social security number, biometric records, etc. alone, or when combined with other personal or identifying information which is linked or linkable to a specific individual, such as date and place of birth, mother’s maiden name, etc.
HUD
DIRECT TA SURVEY: TA
RECIPIENT VERSION
Your organization, [TA
RECIPIENT], recently received HUD-funded technical assistance led by
[LEAD TA PROVIDER ORGANIZATION]. You may have received assistance
from multiple firms on various topics during this engagement, but
please think about the assistance coordinated through [LEAD TA
PROVIDER ORGANIZATION] as you are completing this survey.
[The following description will be pre-filled for the respondent when they receive the survey.]
TECHNICAL ASSISTANCE ENGAGEMENT DETAILS
LEAD TA PROVIDER ORGANIZATION: ___________________________________________________________________________
PERIOD OF PERFORMANCE: _XX/XX/XXXX – XX/XX/XXXX_
ADDITIONAL TA PROVIDER(S) INVOLVED IN THIS TA ENGAGEMENT: ___________________________________________
TA DESCRIPTION: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
We
would like to ask you a few questions regarding your experience with
this specific engagement and your impression of the effectiveness of
the TA.
Before proceeding, please confirm that you were directly involved in
this TA program and feel qualified to provide general feedback
on the Direct TA engagement, including questions about how well
it met intended outcomes.
Yes,
I was directly involved in this TA program and feel qualified to
answer this survey.
No,
I am not the right person to participate in this survey.
IF RESPONSE = NO, I am not the right person to participate in this survey; Please enter the name and email for an individual who had direct experience with the technical assistance provided to your organization and whom would be qualified to answer questions regarding achievement of intended outcomes and general feedback.
The correct respondent is:
[NAME]________________________________________
___________________________ [EMAIL]________________________________________
Please complete this survey by [DATE].
If you have any questions while taking this survey, please contact [email protected].
Note: Please do not use the "Back" or "Forward" buttons on the top of your browser while in the survey. By doing so, the survey will not work properly, and your responses will not be saved.
☐ Very Satisfied
☐ Satisfied
☐ Dissatisfied
☐ Very Dissatisfied
☐ I don’t know
Direct TA Elements |
Very Dissatisfied |
Dissatisfied |
Satisfied |
Very Satisfied |
I don’t know |
Provider knowledge and skills |
☐ |
☐ |
☐ |
☐ |
☐ |
Provider organization and management of the work |
☐ |
☐ |
☐ |
☐ |
☐ |
Provider communication |
☐ |
☐ |
☐ |
☐ |
☐ |
Provider follow-through |
☐ |
☐ |
☐ |
☐ |
☐ |
Length of TA Engagement |
☐ |
☐ |
☐ |
☐ |
☐ |
Level of TA Support Provided |
☐ |
☐ |
☐ |
☐ |
☐ |
Focus of the TA Engagement |
☐ |
☐ |
☐ |
☐ |
☐ |
Coordination among parties, including the TA recipient(s), TA provider(s), and HUD/Field Office staff |
☐ |
☐ |
☐ |
☐ |
☐ |
Other, please specify: ___________________________________________________________________________________________________ |
☐ |
☐ |
☐ |
☐ |
☐ |
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
[This section comes pre-filled for the survey respondent; Questions 2-5 will be asked for each Outcome]
[List HUD Outcomes and TA provider-supplied outcome descriptions in table format]
○ 100%-Outcome fully achieved ○ 80% ○ 60% ○ 40% ○ 20% ○ 0%-Outcome was not achieved ○ I don’t know
[Note: This is a skip pattern question (dependent on score of 20-100% on Question 2)]
☐ Guidance or support provided by the TA provider
☐ Guidance or support provided directly by HUD
☐ Increase in funding or revenue dedicated to the area
☐ Increase in number of staff assigned to work in that area
☐ New organizational structure or new/increased leadership support for the area
☐ New political leadership
☐ Improvement in local economy or other external factors
☐ Other, please specify: ________________________________________________________________________________________
☐ I don’t know
☐ Very Likely
☐ Likely
☐ Unlikely
☐ Very Unlikely
☐ I don’t know/ Not applicable
[Note: This is a skip pattern question (dependent on score of 0-80% on Question 2)]
☐ Assistance from the TA Provider was not adequate (please explain specific concern in the comments section)
☐ Guidance provided directly by HUD was not adequate (please explain specific concern in the comments section)
☐ Level of engagement of our organization’s staff was not adequate
☐ Turnover in our organization’s staff or leadership
☐ Insufficient number of available staff at our organization
☐ Inadequate support from our organization’s leadership/management
☐ Decrease in or insufficient political support
☐ Decrease in funding or revenue dedicated to this area
☐ Decline in economy or other external factors
☐ Other, please specify: _______________________________________________________________________________________
☐ I don’t know
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
☐ Yes
☐ No
☐ I don’t know
Please explain your response: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please provide any recommendations for ways to improve HUD’s technical assistance program: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Outcome
Outcome
Description
Improved capacity
to design system-wide strategies that address community needs
(e.g., designed
innovative multi-disciplinary strategies, designed coordinated
place-based development to leverage neighborhood impacts)
Provide Technical
Assistance and Capacity Building to the Puerto Rico Public
Housing Administration and the Puerto Rico Department of Housing
to include: preparation of a redevelopment/Repositioning Plan for
the 9 priority sites identified by PRPHA and HUD and to provide
recommendations for prioritizing modernization and development
projects.
☐ 100% -Outcome was fully
achieved ☐ 80% ☐ 60 % ☐ 40% ☐ 20% ☐ 0%-Outcome was not achieved ☐ I don’t know
Outcome
Outcome
Description
Improved coordination and alignment with
other community or regional plans
(e.g., HUD plans aligned with plans of
other HUD or federal programs, local and regional government
agencies, service providers, or nonprofit organizations)
Provide Technical Assistance and Capacity
Building to the Puerto Rico Public Housing Administration and the
Puerto Rico Department of Housing to include: recommendations
regarding PRPHA's Five (5) Year Plan, including alignment with
the strategic plan from regional advisory board and the city’s
Five (5) Year Plan.
☐ 100%-Outcome was fully
achieved ☐ 80% ☐ 60% ☐ 40% ☐ 20% ☐ 0%-Outcome was not achieved ☐ I don’t know
EXAMPLE SURVEY QUESTION 2 –
TA RECIPIENT RESPONDENT VIEW
SURVEY QUESTION 2: PROGRESS TOWARD ACHIEVING
SELECTED OUTCOME(S)
To what extent has your organization [improved
capacity to design system-wide strategies that address community
needs]?
To what extent has your organization [improved
coordination and alignment with other community or regional plans]?
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Steven Shepherd |
File Modified | 0000-00-00 |
File Created | 2021-01-14 |