FastTrack GenIC Submission Form - National Adoption Month Website Survey

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

FastTrack GenIC Submission Form - National Adoption Month Website Survey

OMB: 0970-0401

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

Shape1 TITLE OF INFORMATION COLLECTION: National Adoption Month Website Survey


PURPOSE: Child Welfare Information Gateway (Information Gateway) is a service of the Children’s Bureau (CB), a component within the Administration for Children and Families (ACF), and is dedicated to the mission of connecting professionals and concerned citizens to information on programs, research, legislation, and statistics regarding the safety, permanency, and well-being of children and families.


The Information Gateway oversees the National Adoption Month website (https://www.childwelfare.gov/topics/adoption/nam/) which is an initiative of the Children's Bureau with the goal to increase national awareness of the need for permanent families for children and youth in the U.S. foster care system. The proposed feedback survey is designed to collect input from visitors to the 2021 National Adoption Month website to ensure that the site meets their needs. The survey will measure customer type and satisfaction as well as how they intend to use the information provided. The ACF Information Gateway will use the information collected in the survey to enhance future National Adoption Month campaign websites and resources.


DESCRIPTION OF RESPONDENTS: Respondents will be visitors to the National Adoption Month website including child welfare professionals, students, and personal customers.



TYPE OF COLLECTION:


[ ] 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 primary purpose of the results is not for public dissemination.

  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 and affiliation: Beth Claxon, Child Welfare Program Specialist, ACF Administration on Children, Youth and Families (ACYF)_


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




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


Information Collection

Category of Respondent

No. of Respondents

No. of Responses per Respondent

Estimated Time per Response

Burden Hours

National Adoption Month Website Survey

Individuals

200

1

.08

16

Totals




16


FEDERAL COST: The estimated annual cost to the Federal government is _$843__


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?


Visitors to the National Adoption Month website will be invited to complete the survey via a pop-up window after they have visited three separate pages on the site. Responses will be collected from September 15 through December 31, 2021.


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


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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleDOCUMENTATION FOR THE GENERIC CLEARANCE
Author558022
File Modified0000-00-00
File Created2022-01-14

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