CFSR
	PIP Pilot: Pre-Onsite Feedback Survey 
	
 
	THE
	PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)   Public reporting
	burden for this collection of information is estimated to average 5
	minutes per response, including the time for reviewing instructions,
	gathering and maintaining the data needed, and reviewing the
	collection of information. An agency may not conduct or sponsor, and
	a person is not required to respond to, a collection of information
	unless it displays a currently valid OMB control number. The control
	number for this project is 0970-0401. The control number expires on
	5/31/2021. 
	
The Capacity Building Collaborative is conducting an evaluation of the Round 3 Child and Family Services Review (CFSR) Program Improvement Plan (PIP) Pilots. Please provide feedback about your experience in preparing for the PIP Pilot on-site meeting. This feedback will be used to inform the onsite meeting and other PIP process improvements. All information you provide is voluntary and anonymous. The survey should take about 5 minutes to complete. If you have any questions, please contact Christine Leicht, Capacity Building Center for States Evaluation Lead at [email protected].
Which of the following best describes your agency role? (Select One)
Public Agency Director/Deputy Director
Public Agency Program/Middle Manager
Public Agency Supervisor
Public Agency Caseworker/Direct Practice Worker/Frontline staff
Family/Youth Partner
Legal/Court Partner
Private Agency Partner
Federal Partner
TA Provider
Other (Please Specify)
Please rate your agreement with the following statements.
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		Strongly Disagree  | 
		Disagree  | 
		Neither Agree nor Disagree  | 
		Agree  | 
		Strongly Agree  | 
	
			
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What could have improved the pre-onsite work?
What suggestions do you have for the PIP Pilot onsite meeting?
  
	
		
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Pochily, Meredith | 
| File Modified | 0000-00-00 | 
| File Created | 2021-05-10 |