Information Collection Request

The Evaluation of the Pathway Home Grant Program (Pathway Home Evaluation)

ICR 202203-1290-001 · OMB unassigned · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
PHE_OMB1_Attach H_Pre-Release Focus Group Consent Form_08312021_toDOL.docx Supplementary Document Uploaded 2022-03-25 Repair queued
PHE_OMB1_Attach G_Baseline Consent Form_08312021_toDOL.docx Supplementary Document Uploaded 2022-03-25 Repair queued
PRA Signature Form_Pathway Home_(2022_0217).pdf Supplementary Document Uploaded 2022-03-25 Repair queued
T3-086_PHE_OMB1_Supporting Statement Part B_with QED_clean.docx Supporting Statement B Uploaded 2022-07-08 Repair queued
Pathway Home Grant Evaluation_OMB1_Supporting Statement Part A.docx Supporting Statement A Uploaded 2022-07-20 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
253081 Post-Release Interview Topic Guide Other-Information form New
253080 Pre-Release Focus Group Topic Guide Other-Information form New
253079 Staff Interview Topic Guide - Frontline staff Other-Information form New
253078 Staff Interview Topic Guide - Partner staff administrators Other-Information form New
253077 Staff Interview Topic Guide - Grant administrators Other-Information form New
253076 Facility Survey Other-Survey New
253075 Grantee Survey Other-Survey New
252823 Baseline Information Form Other-Information form New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
1,138 0
512 0
0 0





table that charts list 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 1,138 0 0 1,138 0 0
Annual Time Burden (Hours) 512 0 0 512 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No