Evaluation of the Older Adults Home Modification Grant Program

ICR 202409-2528-002

OMB: 2528-0335

Federal Form Document

Forms and Documents

Document Name	Status
Appendix I. Grantee Process Evaluation Survey_EOAHMP-C2.DRAFT(clean).docx Supplementary Document	2024-10-15
Appendix H. Completed Work Documentation_EOAHMP-C2.DRAFT(clean).docx Supplementary Document	2024-10-15
Appendix G. Lost-to-Project_EOAHMP-C2.DRAFT(clean).docx Supplementary Document	2024-10-15
Appendix F. Client Impact Evaluation Interview_EOAHMP-C2.DRAFT (clean).docx Supplementary Document	2024-10-15
Appendix E. Informed Consent_EOAHMP-C2.DRAFT(clean).docx Supplementary Document	2024-10-15
Appendix D. Home Hazard Checklist_EOAHMP-C2.DRAFT(clean).docx Supplementary Document	2024-10-15
Appendix C. Client Program Questionnaire_EOAHMP-C2.DRAFT (clean).docx Supplementary Document	2024-10-15
Appendix B. Client Eligibility _EOAHMP-C2.DRAFT (clean).docx Supplementary Document	2024-10-15
83c_Older_Adult_Home_Modification.docx Justification for No Material/Nonsubstantive Change	2024-10-15
omb83-c. 2528-0335.pdf Justification for No Material/Nonsubstantive Change	2022-07-20
Final- EOAHMO ICR Supporting Statement_PDR.Final_PART_A.docx Supporting Statement A	2022-01-03
Appendix A. 12 U.S. Code § 1701z6_OAHM_Final.docx Supplementary Document	2021-12-16
30-Day Notice Evaluation of the Older Adults Home Modification Grant Program.pdf Supplementary Document	2021-12-16
60-Day Notice Evaluation of the Older Adults Home Modification Grant Program.pdf Supplementary Document	2021-12-16
Final - EOAHMO ICR Supporting Statement_PDR.Final_PART.B.docx Supporting Statement B	2021-12-16

IC Document Collections

IC ID	Document Title	Status
254748	Grantee Site Visit Interview Guide Other-Grantee Site Visit Interview Guide	Unchanged
254747	Grantee Process Evaluation Online Survey Year 1 Other-Grantee Process Evaluation Online Survey Year 1	Modified
254746	OAHM Program Documentation of Work Completed Form Other-OAHM Program Documentation of Work Completed Form	Modified
254745	Lost-to-Project Form Other-Lost-to-Project Form	Modified
254744	Client Eligibility Documentation Form Other-Client Eligibility Documentation Form	Modified
250824	Client Process Evaluation Interview Other-Client Process Evaluation Interview	Unchanged
250823	Script to Schedule Client Process Evaluation Interview Other-Script to Schedule Client Process Evaluation Interview	Unchanged
250822	OAHM Client Impact Evaluation Interview (Post-modification) Other-OAHM Client Impact Evaluation Interview (Post-modification	Modified
250821	OAHM Client Impact Evaluation Interview (Baseline) Other-OAHM Client Impact Evaluation Interview (Baseline)	Modified
250820	Home Hazard Checklist (Post-modification) Other-Home Hazard Checklist (Post-modification)	Modified
250819	Home Hazard Checklist (Baseline) Other-Home Hazard Checklist (Baseline)	Modified
250817	OAHM Program Evaluation Informed Consent Other-OAHM Program Evaluation Informed Consent	Modified
250816	OAHM Client Program Questionnaire (Post-modification) Other-OAHM Client Program Questionnaire (Post-modification)	Modified
250815	OAHM Client Program Questionnaire (Baseline) Other-OAHM Client Program Questionnaire (Baseline)	Modified