DOE F 413.40 Remote Service Provider Implementation Template

OMB Control #: 1910-5184
DOE HQ F 413.40
Exp. Date: 7/31/2023

Home Energy Score
Remote Service Provider Implementation Template
Version: 10/31/2019
This document is intended for organizations seeking to provide Remote Mentoring and/or Desktop
Quality Assurance services to Home Energy Score Partners and Assessors. If also seeking to become
a Partner organization, this may be filled out as an addendum to the Partner Implementation Plan.
Instructions:
1. Be as specific and detailed as possible in your responses.
2. Use this template to describe how you will deliver Home Energy Score services over the next
12- 24 months
3. All fields should be completed.
4. Please refer to the document, “Updated Quality Assurance and Mentoring Protocols for Home
Energy Score” (the “Protocols Document”) for further details on the sections described below.

SERVICE PROVIDER INFORMATION
Name of Organization:

Staff Lead for Home Energy Score: (Name, Organization, City, State, Phone, Email)

Organization type:



Private for-profit organization



Non-profit organization

Expected Clientele: 

Existing Program Partners (list below)



New Program Partners (list type below)



Other:

Provided Services: 

Remote Mentorship/QA



In-field Mentorship/QA



Administrative (list below)



Other:

Part One: Minimum Requirements for Remote Mentors and Desktop QA Auditors
Please describe the compliance path through which your Remote Mentors/Auditors will attain eligibility
(sub section 2 of Part One in the Protocols Document). Will you be using existing HES Assessors or
training new personnel? If training new assessors/mentors/auditors, please explain how you will
onboard them to active Home Energy Score Assessor status.

Part Two: Remote Mentoring Protocol
Using the numbered items in Part Two of the Protocols Document as a guide, please explain the
specific steps of your Remote Mentoring process. Please be specific about the particular technologies
being used for data collection by the Assessor Candidate, and for communication channels between
mentor and mentee and between Service Provider and Home Energy Score.
Provide details of your specific Remote Mentoring process for each of the 9 subsections in Part Two.
Please include any outreach or training materials that you will provide to candidate Assessors to ensure
that they follow the process correctly.
Please include any instances where you have modified or improved upon the process guidance
contained in Part Two. The Home Energy Score team encourages applicants to consider ways to
move beyond this outline to develop innovative and effective practices for mentorship and quality
assurance.

Part Three: Desktop Quality Assurance Protocol
Please include “sandbox”-style login information for your DTQA interface in order than the HES team
can understand from an Assessor’s perspective how your software meets the guidelines in Part 3.
Similarly, please include screen shots from a completed Assessor “packet” that represents the material
that you would be receiving from the Assessors in your system.
Do you intend to follow the photo schedule as presented in the document, or do you see opportunities
to improve upon the schedule in its current state? Please include your reasoning.
Please include any outreach or training materials that you will provide to new Assessors to ensure that
they follow your processes correctly.
What external reference materials to you plan to use during your DTQA sessions in addition to the
“packet” of photos and sketches that is submitted by the Assessor? Please describe the specific
process that your DTQA Auditors will follow when a new packet is being audited, start to finish.
Please describe how you intend to comply with the Corrective Action Procedure in Part Three. Each of
the five items should be addressed separately, with descriptions of the particular processes and
communication media envisioned to serve each function.
Please include a copy of the agreement that you will have as a Service Provider with your Assessor
“clients”, including a description of expected deliverables/actions from the Assessor. Will this
agreement be used, for example, to ensure that Assessors do not deliver any of their first 10 reports to
clients before they have received DTQA, as per the standard?

Part Four: Remote Service Provider requirements
Using the Protocols Document as a guide, please describe how your organization meets each
numbered requirement 1-5, including the sub-sections for item #2. Please be as specific as possible
when describing the technologies and processes envisioned to share necessary information with the
HES team, and when describing your firm’s background in delivering quality assurance and mentorship
services.

Part Five: Dispute Resolution and Appeals Guidelines
Please address the individual guidelines in this section of the Protocols Document by describing your
approach and preparation for these eventualities. Will you have a formal agreement or contract with
the partner in question? If so, will these practices be included in that document?

ADDITIONAL COMMENTS (optional)
Please provide any additional information you think would be useful.

NEXT STEPS: Submit your plan to [email protected] with your company name in the
subject line and file name with the date. E.g. Implementation Plan Missouri West 4-12-12

Paperwork Reduction Act Burden Disclosure Statement
This data is being collected to facilitate participation in U.S. Department of Energy’s Home Energy Score program. The data you supply
will be used for generating and managing Home Energy Scores and the Score’s associated data.
Public reporting burden for this collection of information is estimated to average thirty (30) hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to Office of the Chief Information Officer, Enterprise Policy Development & Implementation Office,
IM-22, Information Collection Management Program (1910-5184), U.S. Department of Energy, 1000 Independence Ave SW,
Washington, DC 20585; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project (1910-5184),
Washington, DC 20503.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for
failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of
information displays a currently valid OMB control number.
Submission of this data is required for applying to become a Home Energy Score Remote Service Provider.