Instrument 18: Administrative Data Survey

The Paperwork Reduction Act of 1995 (Pub. L. 104-13) Statement: This collection of information is voluntary and will be used to assess the feasibility of implementing continuous quality improvement methods in ECE programs and systems to support the use and sustainability of evidence-based practices. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number and expiration date for this collection are OMB #: 0970-0605, Exp: 03/31/2026. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Kathryn Tout, ktout@childtrends.org or Child Trends, 708 N 1^st Suite #333 Minneapolis, MN 55401 Attention: Kathryn Tout

Instrument 18: Administrative Data Survey

Culture of Continuous Learning Project: A Breakthrough Series Collaborative for Improving Child Care and Head Start Quality

Respondents	Time of Data Collection
Center Administrators	Baseline (T1) Mid-Point (T2) Post-Test (T3) Follow-Up (T4)

Please share your most up to date staff roster with us.

Please include all center staff who have been at your center for at least 3 weeks and who work at least 10 hours a week.

You can upload a file in any format (Word, Excel, .pdf) or enter the list into the fields below.

1. Upload

2. Fields: name, role, work e-mail address, Core BSC Team Member (yes/no)

Who is the parent who will be on your Core BSC Team?

Name

E-mail address

Phone number