Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Expiration Date: 05/2021)
NIMH Employee Engagement Survey 2020
The purpose of this collection is to assess the engagement of all NIMH employees as they telework, and as they transition back to the onsite workplace.
The respondents will include all Federal employees, Contractors, and Fellows, that work at NIMH.
TYPE OF COLLECTION: (Check one)
☐ Customer Comment Card/Complaint Form ☒ Customer Satisfaction Survey
☐ Usability Testing (e.g. Website or Software) ☐ Small Discussion Group
☐ Focus Group ☐ Other: __________________
I certify the following to be true:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
The results are not intended to be disseminated to the public.
Information gathered will not be used for the purpose of substantially informing influential policy decisions.
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 A CHAI_____________________________________________
To assist review, please provide answers to the following questions:
Is personally identifiable information (PII) collected? ☐Yes ☒No
If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? N/A ☐Yes ☐No
If applicable, has a System or Records Notice been published? N/A ☐Yes ☐No
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? ☐Yes ☒No
Category of Respondent |
No. of Respondents |
No. of Responses per Respondent |
Time per Response (in hours) |
Total Burden Hours |
Federal government contractors |
359 |
1 |
4/60 |
24 |
|
|
|
|
|
Total |
|
359 |
|
24 |
Category of Respondent |
Total Burden Hours |
Hourly Wage Rate* |
Total Burden Cost |
Federal government contractors |
24 |
$34.90 |
$837 |
|
|
|
|
Total |
|
|
$837 |
*U.S. Department of Labor, Bureau of Labor Statistics (May 2019) Metropolitan and Nonmetropolitan Area Occupational Employment and Wage Estimates (All Occupations) Washington-Arlington-Alexandria, DC-VA-MD-WV Area - https://www.bls.gov/oes/current/oes_47900.htm#00-0000
FEDERAL COST: The estimated annual cost to the Federal government is: $258
Staff |
Grade/Step |
Salary |
% of Effort |
Fringe (if applicable) |
Total Cost to Gov’t |
Federal Oversight |
|
|
|
|
|
Administrative Officer |
15/1 |
$142,701 |
1 |
|
$143 |
Contractor Cost |
|
|
|
|
|
Management Analyst |
|
$115,000 |
1 |
|
$115 |
Travel |
|
|
|
|
|
Other Cost |
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
|
|
|
|
$258 |
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 ☐ 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?
This is a full population survey of all current NIMH FTE and contract staff.
How will you collect the information? (Check all that apply)
☒ Web-based or other forms of Social Media
☐Telephone
☐In-person
☐Other, Explain
Will interviewers or facilitators be used? ☐Yes ☒No
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Generic Clearance Submission Template |
Subject | Generic Clearance Submission Template |
Author | OD/USER |
File Modified | 0000-00-00 |
File Created | 2021-05-03 |