Information Collection

National and State Survey of Child and Adolescent Well-Being (NSSCAW): Informing Site Selection and Recruitment Processes

IC 278292 under ICR 202504-0970-028 · OMB 0970-0356.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1 - Site Survey 11.24.25.docx	Other-Instrument 1: Site Survey
Instrument 2 - Site Survey Discussion Guide 11.24.25.docx	Other-Instrument 2: Site Survey Disc
Instrument 3 - Site Agreement Template and Discussion Guide 11.24.25.docx	Other-Instrument 3: Site Agreement T
Instrument 4 - Sampling Approach Discussion Guide 11.24.25.docx	Other-Instrument 4: Sampling Approac
SSA_NSSCAW Site Selection and Recruitment Processes 12-2-25 - clean.docx SSA Formative Research GenIC: NSSCAW: Informing Site Selection and Recruitment Processes	IC Document
SSB_NSSCAW Site Selection and Recruitment Processes 11.24.25 - clean.docx SSB Formative Research GenIC: NSSCAW: Informing Site Selection and Recruitment Processes	IC Document
Appendix A - Site Outreach Materials 11.24.25.docx Appendix A - Site Outreach Materials	IC Document
Appendix B - Introductory Letter from ACF 11.24.25.docx Appendix B - Introductory Letter from ACF	IC Document

IC Title:

Agency IC Tracking Number:

OPRE

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Instrument 1: Site Survey	Yes	Yes	Fillable Fileable
Other-Instrument 2: Site Survey Discussion Guide	Yes	Yes	Printable Only
Other-Instrument 3: Site Agreement Template and Discussion Guide	Yes	Yes	Printable Only
Other-Instrument 4: Sampling Approach Discussion Guide	Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 234

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	78	78
Annual IC Time Burden (Hours)	97	97
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA Formative Research GenIC: NSSCAW: Informing Site Selection and Recruitment Processes		12/03/2025
SSB Formative Research GenIC: NSSCAW: Informing Site Selection and Recruitment Processes		12/03/2025
Appendix A - Site Outreach Materials		12/03/2025
Appendix B - Introductory Letter from ACF		12/03/2025

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

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