National Center on Early Childhood Health and Wellness (NCECHW) Infoline Feedback Form

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

Infoline-NCECHW-Feedback-Form-8-1-19

National Center on Early Childhood Health and Wellness (NCECHW) Infoline Feedback Form

OMB: 0970-0401

Document [docx]
Download: docx | pdf

O MB #: 0970-0401

Expiration Date: 5/31/2021


NCECHW INFOLINE EVALUATION



You sent an inquiry that was responded to by the National Center on Early Childhood Health and Wellness. We are always striving to improve our programs and services. Please take a moment to tell us how we did by completing the survey below.

  1. Your organization (please check all that apply):

Child Care

Head Start

Community Partner

Other (specify)


  1. Your role (please check all that apply):

Parent/Caregiver/Guardian

Family Child Care Specialist/ Provider

Home Visitor

Teacher/ Teacher's Aide/Assistant/ Educator / EHS Caregiver

Health Manager/ Coordinator/ Specialist

Child Care Health Consultant

Mental Health Content Manager/Coordinator

Mental Health Consultant

Nutrition/Food Services Content Manager/Coordinator

Disabilities Manager/ Coordinator/ Specialist

Education Content Manager/Coordinator

Family Services Manager / Coordinator/ Advocate

Center Director/ Supervisor/ Manager/ Coordinator

Governing Body/Board Member/Policy Council

Technical Assistance Staff

Federal Staff

Child Care Partner

Community Partner

Dental Hygienist Liaison

Head Start Collaboration Office

Licenser

Health Care Provider

Other (specify)


  1. Years in your current role


  1. What type of information were you requesting in your Infoline inquiry? (please check all that apply)

Webinar

Training

Materials/Resources

Other (specify)









  1. The response to my inquiry met or exceeded my expectations.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

  1. I was satisfied with the quality of the response.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

  1. I was satisfied with the timeliness of the response.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

  1. The responder was knowledgeable in the content area.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

  1. The responder was responsive to my questions and need for information.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

  1. The content of the response was relevant to my work.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

  1. Please let us know whether you found the content in the response to be too simple, too advanced, or just about right.

1

Far too advanced

2

A bit too advanced

3

About right

4

A bit too simple

5

Far too simple

  1. The response deepened my knowledge of the topic presented.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

I plan to use information I learned from the response to…

  1. Create practice or policy changes in my organization.

1

Strongly Disagree

2

Disagree

3
Agree

4

Strongly Agree

5

N/A

  1. Build collaborations with others.

1

Strongly Disagree

2

Disagree

3
Agree

4

Strongly Agree

5

N/A

  1. Make changes to improve my practice.

1

Strongly Disagree

2

Disagree

3
Agree

4

Strongly Agree

5

N/A

  1. I learned something from the response that I plan to use in my work.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

  1. I plan to share the information from the response with others.

1

Strongly Disagree

2

Disagree

3

Agree

4

Strongly Agree

  1. How likely would you be to use the Infoline again?

1

Extremely Likely

2

Likely

3

Unlikely

4

Extremely Unlikely

5

N/A



  1. Please provide an example of how the Infoline response made a difference for your program.



  1. Which type(s) of information could the Infoline provide that would help you improve your practice?


Thank you for your participation and feedback.

Paperwork Reduction Act Burden Statement: This collection of information is voluntary. Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. 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.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorHeidi
File Modified0000-00-00
File Created2021-01-13

© 2024 OMB.report | Privacy Policy