Tribal Home Visiting Continuous Quality Improvement Collaboratives

Formative Data Collections for ACF Program Support

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Document Name Document Type
Post collab PDSA PT template_for OMB.xlsx Other-template
Post collab PDSA PT template_for OMB.xlsx Other-template
Generics Supporting Statement A - Tribal CQIC_final clean.docx SSA - THV CQI Collaboratives GenIC IC Document
Generics Supporting Statement A - Tribal CQIC_final clean.docx SSA - THV CQI Collaboratives GenIC IC Document
Generics Supporting Statement B - Tribal CQIC _final clean.docx SSB - THV CQI Collaboratives GenIC IC Document
Generics Supporting Statement B - Tribal CQIC _final clean.docx SSB - THV CQI Collaboratives GenIC IC Document
NOA_OCC THV CQI_Form Prog Supp_0970-0531_6.14.22.pdf NOA - THV CQI Collaboratives GenIC IC Document
NOA_OCC THV CQI_Form Prog Supp_0970-0531_6.14.22.pdf NOA - THV CQI Collaboratives GenIC IC Document

Information Collection (IC) Details

IC Title:	Tribal Home Visiting Continuous Quality Improvement Collaboratives	Agency IC Tracking Number:	OCC

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-template			Post collab PDSA PT template_for OMB.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 23	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	138	138
Annual IC Time Burden (Hours)	138	138
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SSA - THV CQI Collaboratives GenIC	Generics Supporting Statement A - Tribal CQIC_final clean.docx	07/11/2022
SSB - THV CQI Collaboratives GenIC	Generics Supporting Statement B - Tribal CQIC _final clean.docx	07/11/2022
NOA - THV CQI Collaboratives GenIC	NOA_OCC THV CQI_Form Prog Supp_0970-0531_6.14.22.pdf	07/11/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.