Information Collection

Tribal Continuous Quality Improvement Collaboratives

IC 245093 under ICR 202104-0970-004 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1 - PDSA Planning Tool Instructions_FINAL 02.06.20.docx	Instruction
Instrument 1 - PDSA Planning Tool_FINAL.docx	Other-Planning Tool
INSTRU~1.XLS	Other-Template
INSTRU~2.XLS	Other-Template
Generics Supporting Statement A - Tribal CQIC Revised. 02-07-20. clean.docx Supporting Statement A - Formative Generic Program Support: Tribal CQIC	IC Document
NOA - Formative Generic Program Support_Tribal CQI Collabs_0970-0531_2.19.20.pdf NOA - Tribal Continuous Quality Improvement Collaboratives	IC Document

IC Title:

Tribal Continuous Quality Improvement Collaboratives

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	Instrument 1 - PDSA Planning Tool Instructions_FINAL 02.06.20.docx	Yes	No	Printable Only
Other-Planning Tool	Instrument 1 - PDSA Planning Tool_FINAL.docx	Yes	Yes	Fillable Fileable
Other-Template	INSTRU~1.XLS	Yes	Yes	Fillable Fileable
Other-Template	INSTRU~2.XLS	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	380	380
Annual IC Time Burden (Hours)	950	950
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A - Formative Generic Program Support: Tribal CQIC	Generics Supporting Statement A - Tribal CQIC Revised. 02-07-20. clean.docx	12/23/2020
NOA - Tribal Continuous Quality Improvement Collaboratives	NOA - Formative Generic Program Support_Tribal CQI Collabs_0970-0531_2.19.20.pdf	12/23/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.