fast track for DERT Director survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Exp. date: 06/31/2024)

TITLE OF INFORMATION COLLECTION: DERT Director Candidate Feedback (NIEHS)

PURPOSE:

The purpose of this survey is to collect anonymous feedback on the DERT Director candidates’ seminars, on 10/11/22 and 10/13/22. The survey will ask attendees to rate the candidates’ seminar performance across several key metrics, including how well they described their qualifications, commitment to DEIA principles, vision for supporting the NIEHS strategic plan, and understanding of NIEHS scientific culture.

DESCRIPTION OF RESPONDENTS:

The respondents will be attendees of the candidate seminars on Zoom, who voluntarily click the link provided in the chat to anonymously provide their feedback.

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:___Spencer Smith_____________________________________________

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

3. If Applicable, has a System or Records Notice 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

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Individuals	50	2	5/60	8
Totals	50	100		8

COST TO RESPONDENT

Category of Respondent	Total Burden Hours	Hourly Wage Rate*	Total Burden Cost
Individuals	8	45.09	$360.72
Totals			$360.72

*Cite source per bls.gov if applicable (all occupations) http://www.bls.gov/oes/current/naics4_541700.htm

FEDERAL COST: The estimated annual cost to the Federal government is _$90.86__

Staff	Grade/Step	Salary*	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
GS-301 Program Specialist (RTP, NC)	12/4	90,862	0.1%		$90.86
Contractor Cost
Travel
Other Cost
Total					$90.86

*the Salary in table above is cited from https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2022/RA.pdf

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? [X] Yes [ ] 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?

Attendees of DERT Director candidate seminars. Link will be sent through the Zoom chat feature to only attendees.

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

5