Fast Track GenIC Submission Form - CCWIS Webinar Satisfaction Survey

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

TITLE OF INFORMATION COLLECTION: Comprehensive Child Welfare Information System (CCWIS) Technical Assistance and Webinar Satisfaction Survey

PURPOSE: The Children’s Bureau Division of State Systems (DSS) produces webinars monthly (ranging from 9 to 12 webinars annually). The webinars are intended to provide technical assistance for Child Welfare Information System (CCWIS) related issues such as guidance on developing CCWIS Advance Planning Documents (APD); cost allocation; mobile solutions; cloud computing; data exchanges with the courts, education, health; supporting federal reporting; and CCWIS software design requirements. This proposed survey will gather feedback on the content of a particular webinar, potential improvements to webinars, and ideas for future webinars. The information will help DSS to continuously improve technical assistance and webinar content to support agencies who are building child welfare technology systems.

DESCRIPTION OF RESPONDENTS: States, tribes, vendors, or other participant stakeholders who develop or utilize child welfare information systems.

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: Tresa Young – Children’s Bureau – Administration for Children and Families

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

Burden is estimated for 12 webinars annually, each with about 150-200 attendees. We have estimated 150 responses per webinar. The estimated time to respond to the feedback survey is about 5 minutes.

Information Collection	Category of Respondent	No. of Respondents	No. of Responses per Respondent	Estimated Time per Response	Burden Hours
Webinar satisfaction surveys	States, tribes, vendors	150	12	5 minutes	150
Totals					150

FEDERAL COST: The estimated annual cost to the Federal government is ___$2,205_____

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?

States, tribes and vendors voluntarily sign up to the listserv to receive notifications of webinars. Based on experience, we expect about 150 attendees at each webinar. All attendees will receive a link to the feedback survey. Participants participate at their own discretion.

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

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

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