Information Collection

Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment

IC 262900 under ICR 202310-2528-003 · OMB 2528-0337.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2528-0337 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Final - Attachment H.1_The Child Assessment_Survey About Child_Baseline.docx	Other-Survey about child (asked of p
Attachment H.1_The Child Assessment_Survey About Child_Baseline.docx	Other-Survey about child (asked of p
Final - Attachment H.2_The Child Assessment_Survey About Child_Follow-up.docx	Other-Survey about child (asked of p
Attachment H.2_The Child Assessment_Survey About Child_Follow-up.docx	Other-Survey about child (asked of p

IC Title:

Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment			Attachment H.1_The Child Assessment_Survey About Child_Baseline.docx		Yes	Yes	Fillable Fileable
Other-Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment			Attachment H.2_The Child Assessment_Survey About Child_Follow-up.docx		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 837

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,674	1,674
Annual IC Time Burden (Hours)	1,256	1,256
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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