FastTrack Submission Form - RHY Regional Meetings

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION: Runaway and Homeless Youth (RHY) Regional Meeting Evaluation

PURPOSE: This tool is used to gather feedback on the extent to which the meeting provided information helpful to grantees in doing their work with runaway and homeless youth in local communities. The tool also provides an opportunity for grantees to provide suggestions on future training and technical assistance needs.

DESCRIPTION OF RESPONDENTS: Attendees of each of the 20 scheduled regional meetings, occurring between March 2020 and July 2021, will be asked to complete the evaluation. These attendees represent Family and Youth Services Bureau funded Runaway and Homeless Youth Program grantees.

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.

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: Christopher Holloway, RHY Program Manager, Family and Youth Services Bureau, Administration for Children and Families

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

Note: Burden includes the estimated number of responses from participants at 20 meetings between March 2020 and July 2021.

Category of Respondent	No. of Respondents	Participation Time	Burden Hours
Individuals	1300	5 minutes	108 hours
Totals	1300	5 minutes	108 hours

FEDERAL COST: The estimated cost is $5,616 contractor burden for development, data collection and analysis.

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? [] Yes [X] 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?

Paper evaluation forms will be distributed to meeting attendees. Participants will self-select whether to complete the anonymous voluntary survey.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[] Web-based or other forms of Social Media

[] Telephone

[X] In-person

[] Mail

[] Other, Explain

2. Will interviewers or facilitators be used? [] Yes [X] No N/A

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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