Information Collection

Tribal Home Visiting Continuous Quality Improvement Collaboratives

IC 280092 under ICR 202508-0970-009 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
THV PDSA Journey Tool.docx	Other-PDSA Journey Tool
THV CQIC FoM Quarterly Reporting Template - CLEAN.docx	Other-CQIC FoM Quarterly Reporting T
THV CQIC FoM Survey Reporting Template - CLEAN.docx	Other-CQIC Survey
Generics Supporting Statement A Tribal MIECHV CQIC_FNL 4.28.26.docx SSA Prog Supp GenIC - Tribal Home Visiting Continuous Quality Improvement Collaboratives	IC Document

IC Title:

Tribal Home Visiting Continuous Quality Improvement Collaboratives

Agency IC Tracking Number:

ECD

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-PDSA Journey Tool	Yes	Yes	Fillable Fileable
Other-CQIC FoM Quarterly Reporting Template	Yes	Yes	Fillable Fileable
Other-CQIC Survey	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 246

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	1,230	1,230
Annual IC Time Burden (Hours)	726	726
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA Prog Supp GenIC - Tribal Home Visiting Continuous Quality Improvement Collaboratives		04/28/2026

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

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