Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Document Name	Status
Form 1 Child Welfare Program Improvement Plan Pilot Evaluation Form and Instruction	Unchanged
Form 1 2018 ANA Grantee Meeting Survey Form and Instruction	Unchanged
Form 1 Sexual Risk Avoidance (SRA) Social Media Marketing Campaign Form and Instruction	Unchanged
Form 1 Feedback on Strategies Related to Opioid Misuse Form and Instruction	Unchanged
Form 1 Adolescent Pregnancy Preventing Training & Technical Assistance Form and Instruction	Unchanged
Form 36 Course Participant Knowledge Gain Assessment and Instructior and Course Participant Experimental Feedback Form and Instruction	Unchanged
Form 1 Region XII MSHS T/TA Network Technical Assistance Services Delivery Feedback Form and Instruction	Unchanged
Form 1 Sexual Risk Avoidance (SRA) Social Media Marketing Campaign Form and Instruction	Unchanged
Form 1 Audience Research for Sexual Risk Avoidance (SRA) Social Media Marketing Campaign Form and Instruction	Unchanged
Form 1 State Capacity Building Center Tailored TA Feedback Collection for Impact Project Form and Instruction	Unchanged
Form 1 2019 Youth Summit Committe Planning Survey Form and Instruction	Unchanged
Form 1 2018 ANA Grantee Meeting Pre-Survey Form and Instruction	Unchanged
Form 1 HSICC Post Phone Call Survey Form and Instruction	Unchanged
Form 1 TA Assistance Feedback Collection for Webinars Form and Instruction	Unchanged
Form 1 Infant Toddler Specialist Network Training for Trainers (TFT) Form and Instruction	Unchanged
Form 1 Information Architecture Testing of the Early Childhood Learning and Knowledge Center Form and Instruction	Unchanged
Form 1 OFA TANF TA Convening Overall Evaluation Assessment Form and Instruction	Unchanged
Form 1 OFA TANF TA Convening Individual Session Assessment Form and Instruction	Unchanged
Form 1 ANA Youth Summit Survey Form and Instruction	Unchanged
Form 1 Region XII Migrant and Seasonal Head Start T/TA Service Deloivery Feedback Form and Instruction	Unchanged
Form 1 OHS TTA Network Training Feedback Form Form and Instruction	Unchanged
Form 1 Feedback Colection for Peer Leaning Form and Instruction	Unchanged
Form 1 Infant Toddler Specialist Presentation Form and Instruction	Unchanged
Form 1 Infant Toddler Spcialist Infividualized Technical Assistance Form and Instruction	Unchanged
Form 1 ECTTAS Coordination Survey Form and Instruction	Unchanged
Form 1 Communities of Practice Form and Instruction	Unchanged
Form 1 CCDF Administrator Feedback Collection Form and Instruction	Unchanged
Form 1 ACF Office of Regional Operations Curstomers Feedback for Learning Experiences Form and Instruction	Unchanged
Form 1 Regorous Evaluation Technical Assistance (RETA) Feedback Form Form and Instruction	Unchanged
Form 1 Maternal, Infant, and Early Childhood Home Visiting (MEICHV) Continuous Quality Improvement Form and Instruction	Unchanged
Form 1 Maternal, Infant, and Early Childhood Home Visiting (MIECHV) TA Satisfaction Survey Form and Instruction	Unchanged
Form 1 Focus Group with Healthy Marriage and Relationship Education (HMRE) Form and Instruction	Unchanged
Form FRPN Feedback Inst Comment Form: Fatherhood Research and Practice Netrwork Learning Community Form and Instruction	Unchanged
Form 1 Child Welfare Information Gateway's Customer Satisfaction Assessment Form and Instruction	Unchanged
NonSub Change Request - Fast Track Generic Customer Support_0970-0401.docx Justification for No Material/Nonsubstantive Change	2021-05-03
NonSub Change Request-PMFO Conference Feedback Form-7-17-20.docx Justification for No Material/Nonsubstantive Change	2020-07-17
Supporting Statement for Fast Track_Interim Burden Increase.docx Supporting Statement A	2021-05-03
Justification for Increase in Fast Track Burden Ceiling 5-17.docx Justification for No Material/Nonsubstantive Change	2017-05-31
ACF Nonmaterial Nonsubstantive Change Request.docx Justification for No Material/Nonsubstantive Change	2012-11-19

IC Document Collections

IC ID	Document Title	Status
246956	State Capacity Building Center Feedback Collections for Communities of Practice and Peer Learning Groups, Training for Trainers, and Fundamentals of CCDF Administration Other-Survey	Unchanged
246955	State Capacity Building Center Feedback Collection for Individualized Technical Assistance Other-Survey	Unchanged
246954	State Capacity Building Center Feedback Collections for CCDF Administrators and for Technical Assistance Partners Other-Survey - CCDF Administrators	Unchanged
246934	Screenings 2 Services Challenge: Feedback Survey Other-Survey	Unchanged
246914	Sexual Risk Avoidance Education National Evaluation Data Capacity Building Grantee Feedback Other-Survey	Unchanged
246867	nFORM 2.0 Help Desk Customer Service Feedback Surveys Other-Survey	Unchanged
246865	Missing and Murdered American Indian and Alaska Natives Technical Assistance Presentations Pre- and Post-Surveys Other-Pre-Survey	Unchanged
246818	Community-Based Child Abuse Prevention (CBCAP) Participant Feedback Survey Other-Survey	Unchanged
246812	Children's Bureau Learning & Coordination Center (CBLCC) Participant Satisfaction Survey - April 2021 Update Other-Survey	Unchanged
246781	Web Meetings of Child Care Policy Research Partnership - Participant Feedback Other-Poll Qs	Unchanged
246763	Community of Practice (CoP) 2021 Virtual Annual Meeting CCDBG Implementation Research and Evaluation Grantee Meeting Evaluation Form Other-Survey	Unchanged
246738	Runaway and Homeless Youth Program Training and Technical Assistance Center (RHYTTAC) Training and Technical Assistance Event Feedback Form Other-survey	Unchanged
246721	State Repatriation Coordinator Feedback Other-Feedback Survey	Unchanged
246649	Regional Partnership Grant (RPG) Meeting Evaluation Feedback Other-Survey	Unchanged
246499	Usability testing for the Pathways to Work Evidence Clearinghouse website Other-Protocol	Unchanged
246401	Center for States Customer Experience Focus Group Guide Other-Focus Group Guide	Unchanged
246282	National Center on Parent, Family and Community Engagement (PFCE) Standard Training/Technical Assistance Customer Feedback Survey Other-Survey	Unchanged
246281	Polling questions for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings Other-Survey	Unchanged
246275	Administration for Native Americans (ANA) Peer Panel Review Surveys Other-Survey	Unchanged
246045	Center for States Live Chat Survey Other-Feedback Survey	Unchanged
246043	Low Income Home Energy Assistance Program (LIHEAP) 2021 Annual Grantee Virtual Training Conference Feedback Form Other-Feedback form	Unchanged
245928	Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Technical Assistance Evaluation (TA) Survey and Immediate Feedback Tool Other-Feedback Form	Unchanged
245919	Maternal, Infant, and Early Childhood Home Visiting (MIECHV) All Grantee Meeting (AGM) & Tribal Regional Meetings Feedback Surveys Other-Survey	Unchanged
245834	Children's Bureau Learning & Coordination Center (CBLCC) Website User Satisfaction Survey Other-Survey	Unchanged
245833	Children's Bureau Learning & Coordination Center (CBLCC) Participant Satisfaction Survey Other-survey	Unchanged
245775	Standard Feedback Survey for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings Other-Survey	Unchanged
245512	2021 Administration for Native Americans (ANA) Virtual Grantee Meeting Survey Other-Survey	Unchanged
245396	Adolescent Pregnancy Prevention Program (APP) Grantee Conference Planning Committee Feedback Other-Discussion Questions	Unchanged
245357	Personal Responsibility Education Program (PREP) Grantee Training and Technical Assistance Feedback Other-Survey	Unchanged
245279	Sexual Risk Avoidance Education (SRAE) Grantee Feedback Survey Other-Survey	Unchanged
245171	Feedback on the Evaluation Goals from the Human Trafficking Youth Prevention Education (HTYPE) Demonstration Program Other-Small Group Discussion Questions	Unchanged
245144	Feedback on the Provision of Technical Assistance for Personal Responsibility Education Innovative Strategies Program (PREIS) and Tribal PREP (TPREP) Grantees Other-Feedback Survey	Unchanged
244859	Tribal Home Visiting Evaluation Institute (TEI) Technical Assistance (TA) Satisfaction Survey Other-Evaluation Survey	Unchanged
244795	Feedback Related to PDG B-5 Technical Assistance Center Communities of Practice and Workgroups Other-Survey	Unchanged
244794	Feedback related to PDG B-5 Technical Assistance Center Tailored Technical Assistance Other-Survey	Unchanged
244793	Feedback Related to PDG B-5 Technical Assistance Center Webinars and Workshops Other-Survey	Unchanged
244792	Scale for Assessing the Attainment of Technical Assistance Outcomes Other-Survey	Unchanged
244768	Office of Refugee Resettlement Unaccompanied Alien Children (UAC) Path Pre Train-the-Trainer 2021 Survey Other-Survey	Unchanged
244574	Feedback related to PDG B-5 TA Center Annual All-Grantee Convening Other-Survey	Unchanged
244482	Feedback Survey for the NS2G Learning Community Calls Other-Feedback Survey	Unchanged
244481	Child Care Policy Research Partnership Community of Practice - Year 1 Customer Comments Other-Evaluation Form	Unchanged
244468	Runaway and Homeless Youth (RHY) Monitoring Site Visit 360 Feedback Forms Other-360 Feedback Form: Peer Monitor	Unchanged
244397	Native American Language Symposium Survey and Sessions Survey Other-Surveys	Unchanged
244393	Panelist and Chair post review surveys for the Family and Youth Services Bureau (FYSB) Discretionary Grant Programs Other-Survey	Unchanged
244378	Human-Centered Design (HCD) Primer Workshop Feedback Forms Other-Surveys	Unchanged
244377	Florida Prototype Project Pilot Feedback Other-Survey	Unchanged
244239	Center for States Internal Evaluation: Interviews with Jurisdictions Other-Interview Guide	Unchanged
244083	Evidence-Building Academy Daily Feedback Forms and Final Evaluation Form Other-Daily Feedback Form	Unchanged
243863	2020 OPRE Innovative Methods Meeting: Comment Form Other-Comment Form	Unchanged
243757	Administration for Native Americans (ANA) 2021 Grantee Meeting Logistics Survey Other-Pre-Meeting Survey	Unchanged
243722	Family and Youth Services Bureau (FYSB) Grantee COVID Survey Other-Survey	Unchanged
243543	CCDBG Implementation Research and Evaluation Grantee Community of Practice Meeting Evaluation Form Other-Evaluation Form	Unchanged
243212	Evidence-Building Academy Participant Project Update and Data Visualizations Other-Project Update Template	Unchanged
243197	Virtual meeting for soliciting feedback on recruitment and engagement strategies Other-Questions and Mode of Administration (Private Sector - Man	Unchanged
243078	Evidence Building Academy Midpoint Evaluation Form Other-Evaluation Form	Unchanged
242565	Office of Family Assistance PeerTA website Evaluation and Satisfaction Survey Other-Survey	Unchanged
242564	Peer-Based Technical Training and Technical Assistance Feedback Collection Activities Other-Survye	Unchanged
242468	Administration for Native Americans (ANA) 2020 Discretionary Application Process and Peer Panel Review Surveys Other-Survey	Unchanged
242408	Evidence-Building Academy Participant Project Introduction Other-Project Introduction	Unchanged
242233	Administration for Native Americans (ANA) 2020 Initiative for Leadership, Empowerment and Development (I-LEAD) Youth Webinar Series Surveys Other-Survey	Unchanged
241975	Runaway and Homeless Youth (RHY) Program Virtual Town Halls (Interactive Polling Questions) Other-Polling questions	Unchanged
241727	National Responsible Fatherhood Clearinghouse User Feedback and Content Other-	Unchanged
241726	Poll questions for a National Runaway Safeline (NRS) webinar for grantees Other-polling questions	Unchanged
241608	Adolescent Pregnancy Prevention Training & Technical Assistance 2020 Conference Feedback Surveys Other-Survey	Unchanged
241330	Office of Refugee Resettlement (ORR) Refugee Programs Training and Technical Assistance Evaluation Other-Survey	Unchanged
240803	Sexual Risk Avoidance Education (SRAE) Grantee Needs Assessment Other-	Unchanged
240765	Child Welfare Information Gateway Prevention Resource Guide Tip Sheet Feedback Form Other-Feedback Form	Unchanged
240738	Grantee Feedback for the FVPSA Formula Grantee Meeting Planning Other-Discussions	Unchanged
240445	In-Person Convening Child Care Policy Research Partnership – Participant Feedback Other-Survey	Unchanged
240340	Child Care and Development Block Grant (CCDBG) Implementation Research and Evaluation Grantees - Meeting Evaluation Form Other-Survey	Unchanged
240268	Program Management and Fiscal Operations (PMFO) Hurricane Response and Recovery (HRR) Feedback Survey. Other-Survey	Unchanged
240262	ACF State and County Human Services Commissioner Surveys Other-Survey	Unchanged
240138	Center for States 2020 Needs Assessment Survey Other-Survey	Unchanged
240136	Center for States Needs Assessment Focus Group Other-Focus Group Protocol	Unchanged
240130	Child Welfare Information Gateway Needs Assessment Focus Group Guide Other-Focus Group Guide	Unchanged
240123	Feedback on Child Care and Development Fund Plan for States/Territories for FFY 2019–2021 (ACF–118) Other-Focus Group Protocol	Unchanged
240100	2020 ACF Tribal Peer-to-Peer Grantee Meeting Survey Other-Survey	Unchanged
240054	Head Start Management Fellows (HSMF) Program Feedback Surveys Other-Survey	Unchanged
239998	Sexual Risk Avoidance Education (SRAE) Grantee Webinar Satisfaction Survey Other-Survey	Unchanged
239903	Grant Review Panel Chair Development Training Other-Feedback form	Unchanged
239893	Runaway and Homeless Youth (RHY) Regional Meeting Evaluation Other-Survey	Unchanged
239890	Public Assistance Reporting Information System (PARIS) Training Conference Post Event Survey Other-survey	Unchanged
239881	2020 ACF Native American Grantee Meeting Survey Other-Survey	Unchanged
239874	Feedback Survey for capacity building, grantee, training, online sessions hosted by the Family and Youth Services Bureau Other-Survey	Unchanged
239857	Feedback from Child Care and Early Education Policy Research Consortium (CCEEPRC) Members on the CCEEPRC 2020 Annual Meeting Other-Feedback Survey	Unchanged
239447	National Youth in Transition Database (NYTD) Technical Assistance Utilization and Needs Survey Other-Survey	Unchanged
239327	Child Care Development Block Grant (CCDBG) National Webinar Feedback Poll Other-Poll	Unchanged
239307	Grantee Exchange Platform Survey Other-Survey	Unchanged
239275	Feedback Survey for Human Trafficking webinars, online training, online sessions hosted by the Family and Youth Services Bureau Other-Survey	Unchanged
239218	Building Evidence Training (BET) Project Usability Testing Other-Attitude Scale	Unchanged
239176	New Director Mentor Program (NDMP) Feedback Surveys Other-Initial Survey	Unchanged
239130	Feedback on National Center on Parent, Family and Community Engagement (NCPFCE) Resources Other-Survey	Unchanged
239129	Leadership Initiative Feedback Surveys Other-Midpoint Survey	Unchanged
238866	Child Care and Development Fund (CCDF) Policies Database Pop-Up Survey of Website Users Other-survey	Unchanged
238687	In-Person Convening Child Care Policy Research Partnership - Participant Feedback Other-Survey	Unchanged
238492	Maternal, Infant, and Early Childhood Home Visiting All Grantee & Tribal Regional Meetings Feedback Tools Other-	Unchanged
238491	Tribal Home Visiting Technical Assistance Evaluation Feedback and Immediate Feedback Forms Other-	Unchanged
238489	Coaching Companion Questionnaire Other-Survey	Unchanged
238453	Family Violence Prevention and Services (FVPSA) 2020 Tribal Grantee Meeting Other-Questionnaires	Unchanged
238354	Program Management and Fiscal Operations (PMFO) Consulting Initiative (FCI) Feedback Surveys Other-Survey	Unchanged
238137	Program Management and Fiscal Operations (PMFO) Feedback Survey about the General Business Studies Certificate. Other-Survey	Unchanged
237946	Comment Form: 2019 OPRE Innovative Methods Meeting. Other-	Unchanged
237891	Program Management and Fiscal Operations (PMFO) Feedback Surveys Other-survey	Unchanged
237884	Child Welfare Capacity Building Collaborative Customer Feedback for Webinars and Events Other-Questionnaire	Unchanged
237851	Child Care Development Block Grant (CCDBG) Implementation Research Webinar Feedback Poll Other-poll	Unchanged
237808	2019 National Runaway and Homeless Youth (RHY) Grantees Training Evaluations Other-Feedback Form	Unchanged
237594	Children's Bureau Grantee Connection Survey Other-survey	Unchanged
237590	Personal Responsibility Education Program (PREP) Grantee Training and Technical Assistance Satisfaction and Needs Assessment Other-survey	Unchanged
237543	Community Economic Development (CED) Grantee Training Needs Assessment Other-	Unchanged
237542	Community Economic Development (CED) or Rural Community Development (RCD) Grantee Discussion Groups Other-Discussion Group	Unchanged
237266	Family Violence Prevention and Services (FVPSA) 2019 Tribal Grantee Meeting Other-	Unchanged
237230	National Center on Early Childhood Health and Wellness (NCECHW) Infoline Feedback Form Other-	Unchanged
237166	Children's Bureau Grantee Feedback Survey Other-	Unchanged
237065	FY2019 New Capacity Building Center for States Community of Practice: County Administered State Support Interest Survey Other-Interest Survey	Unchanged
236885	2019 Reader Feedback: Brush Up on Oral Health Other-	Unchanged
236033	Evaluation of Family Violence Prevention and Services Act (FVPSA) Regional Meeting Other-Survey	Unchanged
235817	2019 Low Income Home Energy Assistance Program (LIHEAP) Grantee Conference Feedback Other-	Unchanged
235666	Administration for Native Americans (ANA) Application Submission Process Feedback Survey Other-survey	Unchanged
235646	Administration for Native Americans (ANA) Post Peer Panel Review Survey Other-	Unchanged
235619	Runaway and Homeless Youth (RHY) Regional Meeting Evaluation Other-	Unchanged
235540	Adolescent Pregnancy Prevention Training & Technical Assistance 2019 Conference Feedback Surveys Other-survey	Unchanged
235518	Feedback on Mixed-Delivery System and Service Coordination to Inform Appropriate, Tailored and Timely Technical Assistance Other-Survey	Unchanged
235432	Child Care Development Block Grant (CCDBG) Implementation Research and Evaluation Grantees - Meeting Evaluation Form Other-survey	Unchanged
235384	Feedback from Child Care and Early Education Policy Research Consortium (CCEEPRC) Members on the CCEEPRC 2019 Annual Meeting Other-Survey	Unchanged
235379	Sexual Risk Avoidance Education (SRAE) Grantee Training and Technical Assistance Satisfaction Survey Other-Survey	Unchanged
235370	Usability testing for the "Pathways to Work Evidence Clearinghouse" website Other-Protocol	Unchanged
235313	Child Welfare Information Gateway Subscription Form Other-subscription survey	Unchanged
234989	Feedback Survey for Technical and Training Assistance Activities for Family and Youth Services Bureau/ Runaway and Homeless Youth grantees Other-survey	Unchanged
234917	Listening Session Questions on OHS Training and Technical Assistance System Other-Survey	Unchanged
234737	Center for States Subscription Form Other-Subscription Form	Unchanged
234560	Child Welfare Program Improvement Plan Pilot Evaluation Form and Instruction	Unchanged
234505	Feedback on Webinars for Data Use and General Info for the National Survey of Early Care and Education (NSECE) Other-Registration Questions	Unchanged
234089	2018 ANA Grantee Meeting Survey Form and Instruction	Unchanged
234044	Sexual Risk Avoidance (SRA) Social Media Marketing Campaign Form and Instruction	Unchanged
233914	Feedback on Strategies Related to Opioid Misuse Form and Instruction	Unchanged
233701	Adolescent Pregnancy Preventing Training & Technical Assistance Form and Instruction	Unchanged
233652	Input on Key Functions of Early Care and Education Research Connections Website Other-Survey	Unchanged
233631	Maternal, Infant, and Early Childhood Home Visiting (MIECHV) AGM 2019 – Peer Sharing Feedback Survey Other-Feedback Form	Unchanged
233584	Course Participant Knowledge Gain Assessment and Instructior and Course Participant Experimental Feedback Form and Instruction	Unchanged
233090	Region XII MSHS T/TA Network Technical Assistance Services Delivery Feedback Form and Instruction	Unchanged
233069	Sexual Risk Avoidance (SRA) Social Media Marketing Campaign Form and Instruction	Unchanged
233068	Audience Research for Sexual Risk Avoidance (SRA) Social Media Marketing Campaign Form and Instruction	Unchanged
233066	State Capacity Building Center Tailored TA Feedback Collection for Impact Project Form and Instruction	Unchanged
233025	2019 Youth Summit Committe Planning Survey Form and Instruction	Unchanged
233024	Maternal, Infant, and Early Childhood Home Visiting (MIECHV) AGM 2019 – Peer Sharing Feedback Survey Other-Feedback Form	Unchanged
232814	2018 ANA Grantee Meeting Pre-Survey Form and Instruction	Unchanged
232746	HSICC Post Phone Call Survey Form and Instruction	Unchanged
232490	TA Assistance Feedback Collection for Webinars Form and Instruction	Unchanged
232488	Infant Toddler Specialist Network Training for Trainers (TFT) Form and Instruction	Unchanged
232184	Information Architecture Testing of the Early Childhood Learning and Knowledge Center Form and Instruction	Unchanged
232147	OFA TANF TA Convening Overall Evaluation Assessment Form and Instruction	Unchanged
232145	OFA TANF TA Convening Individual Session Assessment Form and Instruction	Unchanged
232142	ANA Youth Summit Survey Form and Instruction	Unchanged
232015	Comment Form: 2018 OPRE Innovative Methods Meeting. Other-Meeting Feedback Form	Unchanged
231867	Region XII Migrant and Seasonal Head Start T/TA Service Deloivery Feedback Form and Instruction	Unchanged
231683	OHS TTA Network Training Feedback Form Form and Instruction	Unchanged
231664	Feedback Colection for Peer Leaning Form and Instruction	Unchanged
231663	Infant Toddler Specialist Presentation Form and Instruction	Unchanged
231661	Infant Toddler Spcialist Infividualized Technical Assistance Form and Instruction	Unchanged
231659	ECTTAS Coordination Survey Form and Instruction	Unchanged
231658	Communities of Practice Form and Instruction	Unchanged
231657	CCDF Administrator Feedback Collection Form and Instruction	Unchanged
231551	nFORM Help Desk Customer Service Feedback Surveys Other-Survey	Unchanged
230092	ACF Office of Regional Operations Curstomers Feedback for Learning Experiences Form and Instruction	Unchanged
230091	Regorous Evaluation Technical Assistance (RETA) Feedback Form Form and Instruction	Unchanged
230090	Maternal, Infant, and Early Childhood Home Visiting (MEICHV) Continuous Quality Improvement Form and Instruction	Unchanged
230089	Maternal, Infant, and Early Childhood Home Visiting (MIECHV) TA Satisfaction Survey Form and Instruction	Unchanged
230088	Focus Group with Healthy Marriage and Relationship Education (HMRE) Form and Instruction	Unchanged
230087	Comment Form: Fatherhood Research and Practice Netrwork Learning Community Form and Instruction	Unchanged
230085	Child Welfare Information Gateway's Customer Satisfaction Assessment Form and Instruction	Unchanged

ICR Details

OMB Control No: 0970-0401	ICR Reference No: 202105-0970-001
Status: Received in OIRA	Previous ICR Reference No: 202007-0970-006
Agency/Subagency: HHS/ACF	Agency Tracking No: OPRE
Title: Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/03/2021

	Requested	Previously Approved
Expiration Date	05/31/2021	05/31/2021
Responses	50,124	44,124
Time Burden (Hours)	17,862	17,062
Cost Burden (Dollars)	0	0

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Abstract: Since approval of th Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery., ACF program offices have found the generic to be very useful to collect information on services and to enable ACF to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. Due to the success of this generic mechanism, we have reached the previously estimated burden amounts just prior to the current expiration date of this OMB # (5/31/2021). In anticipation of requesting an extension, ACF began the process to develop a justification package and published a Federal Register Notice to elicit public comment (85 FR 75020) on the request to extend data collection under this umbrella generic. During the 60-day comment period, ACF did not receive any comments. At this time, ACF would like to request a a nonsubstantive change for a minor burden increase. We are requesting an interim increase in burden of 800 hours. This amount is based on ACF’s plans for submissions under this generic clearance prior to May 30, 2021.

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Authorizing Statute(s): PL: Pub.L. 110 - 134 125 Name of Law: Head Start Act of 2007
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 54345	11/17/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 6025	02/12/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 170

IC Title	Form No.	Form Name
2018 ANA Grantee Meeting Pre-Survey	1	Grantee Meeting Pre-Survey
2018 ANA Grantee Meeting Survey	1	ANA GM - Blank Survey Form
2019 Low Income Home Energy Assistance Program (LIHEAP) Grantee Conference Feedback
2019 National Runaway and Homeless Youth (RHY) Grantees Training Evaluations
2019 Reader Feedback: Brush Up on Oral Health
2019 Youth Summit Committe Planning Survey	1	ILIAD 2019 Youth Summit Planning Committee Survey
2020 ACF Native American Grantee Meeting Survey
2020 ACF Tribal Peer-to-Peer Grantee Meeting Survey
2020 OPRE Innovative Methods Meeting: Comment Form
2021 Administration for Native Americans (ANA) Virtual Grantee Meeting Survey
ACF Office of Regional Operations Curstomers Feedback for Learning Experiences	1	ORO Webinar or Meeting Feedback Survey
ACF State and County Human Services Commissioner Surveys
ANA Youth Summit Survey	1	2018 I-LEAD Youth Summiot Survey
Administration for Native Americans (ANA) 2020 Discretionary Application Process and Peer Panel Review Surveys
Administration for Native Americans (ANA) 2020 Initiative for Leadership, Empowerment and Development (I-LEAD) Youth Webinar Series Surveys
Administration for Native Americans (ANA) 2021 Grantee Meeting Logistics Survey
Administration for Native Americans (ANA) Application Submission Process Feedback Survey
Administration for Native Americans (ANA) Peer Panel Review Surveys
Administration for Native Americans (ANA) Post Peer Panel Review Survey
Adolescent Pregnancy Preventing Training & Technical Assistance	1	Attachment 1-Survey
Adolescent Pregnancy Prevention Program (APP) Grantee Conference Planning Committee Feedback
Adolescent Pregnancy Prevention Training & Technical Assistance 2019 Conference Feedback Surveys
Adolescent Pregnancy Prevention Training & Technical Assistance 2020 Conference Feedback Surveys
Audience Research for Sexual Risk Avoidance (SRA) Social Media Marketing Campaign	1, 1, 1	Attachment 1 ,   CTK Parent Consent Form ,   CTK Youth Assent Form
Building Evidence Training (BET) Project Usability Testing
CCDBG Implementation Research and Evaluation Grantee Community of Practice Meeting Evaluation Form
CCDF Administrator Feedback Collection	1	CCDF Administrators
Center for States 2020 Needs Assessment Survey
Center for States Customer Experience Focus Group Guide
Center for States Internal Evaluation: Interviews with Jurisdictions
Center for States Live Chat Survey
Center for States Needs Assessment Focus Group
Center for States Subscription Form
Child Care Development Block Grant (CCDBG) Implementation Research Webinar Feedback Poll
Child Care Development Block Grant (CCDBG) Implementation Research and Evaluation Grantees - Meeting Evaluation Form
Child Care Development Block Grant (CCDBG) National Webinar Feedback Poll
Child Care Policy Research Partnership Community of Practice - Year 1 Customer Comments
Child Care and Development Block Grant (CCDBG) Implementation Research and Evaluation Grantees - Meeting Evaluation Form
Child Care and Development Fund (CCDF) Policies Database Pop-Up Survey of Website Users
Child Welfare Capacity Building Collaborative Customer Feedback for Webinars and Events
Child Welfare Information Gateway Needs Assessment Focus Group Guide
Child Welfare Information Gateway Prevention Resource Guide Tip Sheet Feedback Form
Child Welfare Information Gateway Subscription Form
Child Welfare Information Gateway's Customer Satisfaction Assessment	1	CWIG Customer Satisfaction Assessment Data Collection Instruments
Child Welfare Program Improvement Plan Pilot Evaluation	1, 1, 1, 1	PIPPilot ,   PIPPilot ,   PIPPilot Onsite Feedback Survey ,   PIPPilot PreonsiteFeedbackSurvey
Children's Bureau Grantee Connection Survey
Children's Bureau Grantee Feedback Survey
Children's Bureau Learning & Coordination Center (CBLCC) Participant Satisfaction Survey
Children's Bureau Learning & Coordination Center (CBLCC) Participant Satisfaction Survey - April 2021 Update
Children's Bureau Learning & Coordination Center (CBLCC) Website User Satisfaction Survey
Coaching Companion Questionnaire
Comment Form: Fatherhood Research and Practice Netrwork Learning Community	FRPN Feedback Instrument	FRPN Feedback Instrument
Comment Form: 2018 OPRE Innovative Methods Meeting.
Comment Form: 2019 OPRE Innovative Methods Meeting.
Communities of Practice	1	Communities of Practice
Community Economic Development (CED) Grantee Training Needs Assessment
Community Economic Development (CED) or Rural Community Development (RCD) Grantee Discussion Groups
Community of Practice (CoP) 2021 Virtual Annual Meeting CCDBG Implementation Research and Evaluation Grantee Meeting Evaluation Form
Community-Based Child Abuse Prevention (CBCAP) Participant Feedback Survey
Course Participant Knowledge Gain Assessment and Instructior and Course Participant Experimental Feedback	36, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1	EBPAS-36 ,   Instructior Experience Survey Final ,   Instructor Unit Survey Final ,   Participant Experience Survey Final ,   Unit 1 Post Test Final ,   Unit 2 Post-Test Final ,   Unit 2 Pre-Test Final ,   Unit 3 Post-Test Final ,   Unit 3 Pre-Test Final ,   Unit 4 Post-Test Final ,   Unit 4 Pre--Test Final ,   Unit 5 Post-Test Final ,   Unit 5 Pre-Test Final ,   Unit 6 Post-Test Final ,   Unit 6 Pre-Test Final
ECTTAS Coordination Survey	1	ECTTAS Coordination Survey
Evaluation of Family Violence Prevention and Services Act (FVPSA) Regional Meeting
Evidence Building Academy Midpoint Evaluation Form
Evidence-Building Academy Daily Feedback Forms and Final Evaluation Form
Evidence-Building Academy Participant Project Introduction
Evidence-Building Academy Participant Project Update and Data Visualizations
FY2019 New Capacity Building Center for States Community of Practice: County Administered State Support Interest Survey
Family Violence Prevention and Services (FVPSA) 2019 Tribal Grantee Meeting
Family Violence Prevention and Services (FVPSA) 2020 Tribal Grantee Meeting
Family and Youth Services Bureau (FYSB) Grantee COVID Survey
Feedback Colection for Peer Leaning	1	Peer Learning
Feedback Related to PDG B-5 Technical Assistance Center Communities of Practice and Workgroups
Feedback Related to PDG B-5 Technical Assistance Center Webinars and Workshops
Feedback Survey for Human Trafficking webinars, online training, online sessions hosted by the Family and Youth Services Bureau
Feedback Survey for Technical and Training Assistance Activities for Family and Youth Services Bureau/ Runaway and Homeless Youth grantees
Feedback Survey for capacity building, grantee, training, online sessions hosted by the Family and Youth Services Bureau
Feedback Survey for the NS2G Learning Community Calls
Feedback from Child Care and Early Education Policy Research Consortium (CCEEPRC) Members on the CCEEPRC 2019 Annual Meeting
Feedback from Child Care and Early Education Policy Research Consortium (CCEEPRC) Members on the CCEEPRC 2020 Annual Meeting
Feedback on Child Care and Development Fund Plan for States/Territories for FFY 2019–2021 (ACF–118)
Feedback on Mixed-Delivery System and Service Coordination to Inform Appropriate, Tailored and Timely Technical Assistance
Feedback on National Center on Parent, Family and Community Engagement (NCPFCE) Resources
Feedback on Strategies Related to Opioid Misuse	1	Feedback Form on Strategies Related to Opioid Misuse
Feedback on Webinars for Data Use and General Info for the National Survey of Early Care and Education (NSECE)
Feedback on the Evaluation Goals from the Human Trafficking Youth Prevention Education (HTYPE) Demonstration Program
Feedback on the Provision of Technical Assistance for Personal Responsibility Education Innovative Strategies Program (PREIS) and Tribal PREP (TPREP) Grantees
Feedback related to PDG B-5 TA Center Annual All-Grantee Convening
Feedback related to PDG B-5 Technical Assistance Center Tailored Technical Assistance
Florida Prototype Project Pilot Feedback
Focus Group with Healthy Marriage and Relationship Education (HMRE)	1	SARHM generic OMB
Grant Review Panel Chair Development Training
Grantee Exchange Platform Survey
Grantee Feedback for the FVPSA Formula Grantee Meeting Planning
HSICC Post Phone Call Survey	1	Post Phone Calll Survey
Head Start Management Fellows (HSMF) Program Feedback Surveys
Human-Centered Design (HCD) Primer Workshop Feedback Forms
In-Person Convening Child Care Policy Research Partnership - Participant Feedback
In-Person Convening Child Care Policy Research Partnership – Participant Feedback
Infant Toddler Spcialist Infividualized Technical Assistance	1	Infant Toddler Specialist Individualized Technical Assistance
Infant Toddler Specialist Network Training for Trainers (TFT)	1	Traininging for Training
Infant Toddler Specialist Presentation	1	Infant Toddler Specialist Presentations
Information Architecture Testing of the Early Childhood Learning and Knowledge Center	1	ECLKC-tree-jack survey instrument
Input on Key Functions of Early Care and Education Research Connections Website
Leadership Initiative Feedback Surveys
Listening Session Questions on OHS Training and Technical Assistance System
Low Income Home Energy Assistance Program (LIHEAP) 2021 Annual Grantee Virtual Training Conference Feedback Form
Maternal, Infant, and Early Childhood Home Visiting (MEICHV) Continuous Quality Improvement	1	MIECHV
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) AGM 2019 – Peer Sharing Feedback Survey
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) AGM 2019 – Peer Sharing Feedback Survey
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) All Grantee Meeting (AGM) & Tribal Regional Meetings Feedback Surveys
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) TA Satisfaction Survey	1	DOHVE 2
Maternal, Infant, and Early Childhood Home Visiting All Grantee & Tribal Regional Meetings Feedback Tools
Missing and Murdered American Indian and Alaska Natives Technical Assistance Presentations Pre- and Post-Surveys
National Center on Early Childhood Health and Wellness (NCECHW) Infoline Feedback Form
National Center on Parent, Family and Community Engagement (PFCE) Standard Training/Technical Assistance Customer Feedback Survey
National Responsible Fatherhood Clearinghouse User Feedback and Content
National Youth in Transition Database (NYTD) Technical Assistance Utilization and Needs Survey
Native American Language Symposium Survey and Sessions Survey
New Director Mentor Program (NDMP) Feedback Surveys
OFA TANF TA Convening Individual Session Assessment	1	OFA Convening Individual Assessment
OFA TANF TA Convening Overall Evaluation Assessment	1	OFA Convening Overall Assessment
OHS TTA Network Training Feedback Form	1	TTA Network Training Feedback
Office of Family Assistance PeerTA website Evaluation and Satisfaction Survey
Office of Refugee Resettlement (ORR) Refugee Programs Training and Technical Assistance Evaluation
Office of Refugee Resettlement Unaccompanied Alien Children (UAC) Path Pre Train-the-Trainer 2021 Survey
Panelist and Chair post review surveys for the Family and Youth Services Bureau (FYSB) Discretionary Grant Programs
Peer-Based Technical Training and Technical Assistance Feedback Collection Activities
Personal Responsibility Education Program (PREP) Grantee Training and Technical Assistance Feedback
Personal Responsibility Education Program (PREP) Grantee Training and Technical Assistance Satisfaction and Needs Assessment
Poll questions for a National Runaway Safeline (NRS) webinar for grantees
Polling questions for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings
Program Management and Fiscal Operations (PMFO) Consulting Initiative (FCI) Feedback Surveys
Program Management and Fiscal Operations (PMFO) Feedback Survey about the General Business Studies Certificate.
Program Management and Fiscal Operations (PMFO) Feedback Surveys
Program Management and Fiscal Operations (PMFO) Hurricane Response and Recovery (HRR) Feedback Survey.
Public Assistance Reporting Information System (PARIS) Training Conference Post Event Survey
Region XII MSHS T/TA Network Technical Assistance Services Delivery Feedback	1	Region-XII-TTA Feedback Form
Region XII Migrant and Seasonal Head Start T/TA Service Deloivery Feedback	1	Service Delivery Feedback Form OHS Region 12
Regional Partnership Grant (RPG) Meeting Evaluation Feedback
Regorous Evaluation Technical Assistance (RETA) Feedback Form	1	RETA-Feedback Form
Runaway and Homeless Youth (RHY) Monitoring Site Visit 360 Feedback Forms
Runaway and Homeless Youth (RHY) Program Virtual Town Halls (Interactive Polling Questions)
Runaway and Homeless Youth (RHY) Regional Meeting Evaluation
Runaway and Homeless Youth (RHY) Regional Meeting Evaluation
Runaway and Homeless Youth Program Training and Technical Assistance Center (RHYTTAC) Training and Technical Assistance Event Feedback Form
Scale for Assessing the Attainment of Technical Assistance Outcomes
Screenings 2 Services Challenge: Feedback Survey
Sexual Risk Avoidance (SRA) Social Media Marketing Campaign	1	Social Norms Quiz
Sexual Risk Avoidance (SRA) Social Media Marketing Campaign	1, 1, 1, 1, 1	Attachment 1 Discussion Prompts ,   CTK Parent Consent Form ,   CTK Youth Assent Form ,   Display ,   Youth Assent Form The Hive
Sexual Risk Avoidance Education (SRAE) Grantee Feedback Survey
Sexual Risk Avoidance Education (SRAE) Grantee Needs Assessment
Sexual Risk Avoidance Education (SRAE) Grantee Training and Technical Assistance Satisfaction Survey
Sexual Risk Avoidance Education (SRAE) Grantee Webinar Satisfaction Survey
Sexual Risk Avoidance Education National Evaluation Data Capacity Building Grantee Feedback
Standard Feedback Survey for the National Center for Health, Behavioral Health, and Safety's Training and Technical Assistance Offerings
State Capacity Building Center Feedback Collection for Individualized Technical Assistance
State Capacity Building Center Feedback Collections for CCDF Administrators and for Technical Assistance Partners
State Capacity Building Center Feedback Collections for Communities of Practice and Peer Learning Groups, Training for Trainers, and Fundamentals of CCDF Administration
State Capacity Building Center Tailored TA Feedback Collection for Impact Project	1	OCC OMB SCBC Task 4 Impact Instrument
State Repatriation Coordinator Feedback
TA Assistance Feedback Collection for Webinars	1	Task 3 Webinars
Tribal Home Visiting Evaluation Institute (TEI) Technical Assistance (TA) Satisfaction Survey
Tribal Home Visiting Technical Assistance Evaluation Feedback and Immediate Feedback Forms
Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Technical Assistance Evaluation (TA) Survey and Immediate Feedback Tool
Usability testing for the "Pathways to Work Evidence Clearinghouse" website
Usability testing for the Pathways to Work Evidence Clearinghouse website
Virtual meeting for soliciting feedback on recruitment and engagement strategies
Web Meetings of Child Care Policy Research Partnership - Participant Feedback
nFORM 2.0 Help Desk Customer Service Feedback Surveys
nFORM Help Desk Customer Service Feedback Surveys

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ICR Summary of Burden

	Total Request	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	50,124	44,124	0	0	6,000	0
Annual Time Burden (Hours)	17,862	17,062	0	0	800	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Due to the success of this generic mechanism, ACF reached the previously estimated burden amounts just prior to the current expiration date of overarching generic (5/31/2021). Since we will be unable to submit and individual requests under this umbrella generic while the extension request is submitted, we would like the opportunity to submit a few final generic information collections that were already in development. These requests would be submitted immediately, prior to the current expiration date. At this time, ACF would like to request a a nonsubstantive change for a minor burden increase of 800 hours.

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Annual Cost to Federal Government: $1,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/03/2021

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