Fast Track Generic Form: CCDBG Grantee Meeting Evaluation Form

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

TITLE OF INFORMATION COLLECTION: CCDBG Implementation Research and Evaluation Grantee Community of Practice Meeting Evaluation Form

PURPOSE: The purpose of this voluntary customer satisfaction survey information collection is to solicit timely feedback from participants after the second session of the Child Care Development Block Grant (CCDBG) Implementation Research and Evaluation Grantee Community of Practice (CoP) two-part virtual annual meeting on September 9 and 30, 2020. This information collection covers both meeting dates and will be administered one time. This feedback will help the government understand the stakeholders’ experiences and preferences and will be used to improve service delivery (i.e., the content and organization of future CoP meetings, ensuring they are useful supports for grantees as they proceed with their cooperative agreements to develop research and evaluation plans).

DESCRIPTION OF RESPONDENTS:

Respondents will be representatives from the six states and tribes with CCDBG Implementation Research and Evaluation Grants who are attending the CoP virtual meeting. Stakeholder respondents will include state and tribal government agency staff and their public university and private sector external research partners.

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: Meryl Barofsky, Senior Social Science Research Analyst, ACF Office of Planning, Research, and Evaluation

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
3 - State/Territory CCDBG Implementation Research Grantee Project Team Members (State, local, or tribal government)	15	5 minutes	1.25 hours
4 - State/Territory CCDBG Implementation Research Grantee Project Team Members (Private sector)	7	5 minutes	.583 hours
Totals	22		1.833 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 universe of potential respondents is the list of state/territory project team members attending the meeting. We will survey the full universe so do not have a sampling plan.

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

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

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

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