Fast Track GenIC Submission Form - RHYTTAC Training and Technical Assistance Event Feedback Form

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION: Runaway and Homeless Youth Program Training and Technical Assistance Center (RHYTTAC) Training and Technical Assistance Event Feedback Form

PURPOSE: These questions will be asked via a web-based survey form following the delivery of planned training and technical assistance events. The purpose is to assess the quality and value of the Runaway and Homeless Youth Training and Technical Assistance Center (RHYTTAC) training or technical assistance (TTA) events. The information collected will be used to improve future RHYTTAC TTA events to ensure they meet the needs of attendees. A survey link will remain live and participants will have limited time following the event to complete this feedback form.

DESCRIPTION OF RESPONDENTS: Participants in the RHYTTAC training and technical assistance events that target some or all of the Family and Youth Services Bureau (FYSB) Runaway and Homeless Youth (RHY) Program grantees.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. 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 Holloway, RHY Program Manager, Family and Youth Services Bureau, Administration for Children and Families

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

The survey includes the universe of possible questions to be asked at any event but not all questions will be asked at each event. The survey includes 41 items in total and 21 items are common across all TTA event types, which allows for simple aggregation and comparison of data across all TTA event types for those items. We anticipate using these questions at multiple events over the approval period and burden estimates reflect the assumption that an average of 150 people will attend 30 events.

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Participation Time	Burden
Public Sector	150	30	10 minutes	750
Totals	150	30	10 minutes	750

FEDERAL COST: The estimated annual cost to the Federal government is $15,000. Note that this estimate includes costs related to this information collection at about 10 events per year, over a three-year period.

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 [X] 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?

Respondents will be individuals who sign up for and attend training and technical assistance events. They will be asked to complete the surveys upon conclusion of the event.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [X] No

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