Information Collection Request

Center for States Evaluation Ancillary Data Collection

ICR 202008-0970-004 · OMB 0970-0501 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Annual Assessment Update (8 systematic questions) Form and Instruction Modified Available
CenterforStatesEvaluationAncillaryDataCollection_SSB_Final.docx Supporting Statement B Uploaded 2020-08-07 Available
CenterforStatesEvaluationAncillaryDataCollection_SSA_Final.docx Supporting Statement A Uploaded 2020-08-07 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
226795 Annual Assessment Update (8 systematic questions) Form and Instruction Modified
226794 Assessment and Service Delivery State Lead Interviews-Supplemental Questions Other-Supplemental Questions Modified
226793 Service Delivery and Tracking and Adjustment Observation-Group Debrief Other-Group Debrief Modified
226792 Assessment Observation-Group Debrief Other-Group Debrief Modified
226791 Tailored Services Practice Model Survey Other-Model Survey Modified
226790 Child Welfare Virtual Conference Exit Survey Other-Exit Survey Modified
226788 Child Welfare Virtual Conference Registration Form Other-Registration Form Modified
226787 Child Welfare Virtual Conference Interview Guide Other-Virtual Interview Guide Modified
226786 Child Welfare Virtual Conference Focus Group Guide Other-Focus Group Guide Modified
226785 Child Welfare Virtual Conference Session Surveys Other-Session Surveys Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2023 36 Months From Approved 09/30/2020
4,319 0 7,431
390 0 672
0 0 0





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 4,319 7,431 0 -3,112 0 0
Annual Time Burden (Hours) 390 672 0 -282 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No