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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Home Visitor Survey Baseline
Modified
170
213
0
Other-Survey
Supervisor Survey 12 Month
Modified
33
41
0
Other-Survey
Community Service Provider Survey
Modified
510
51
0
Other-Survey
Family Baseline Survey
Modified
1700
1700
0
Other-Survey
Family Screening and Consent
Modified
1889
189
0
Other-Screener
First Round Visits with State Administrators
Modified
18
27
0
Other-Site Visits
Home Visitor Group Interview 12 Month
Modified
57
86
0
Other-Interview
Home Visitor Individual Interview 12 Month
Modified
57
86
0
Other-Interview
Home Visitor Logs
Modified
10200
2040
0
Other-Logs
Home Visitor Survey 12 Month
Modified
170
213
0
Other-Survey
Other Home Visiting Programs Survey
Modified
142
14
0
Other-Survey
Program Manager Group Interview 12 Month
Modified
29
44
0
Other-Interview
Program Manager Survey 12 Month
Modified
29
58
0
Other-Survey
Program Manager Survey_Part 1 Baseline
Modified
29
15
0
Other-Survey
Program Manager Survey_Part 2 Baseline
Modified
29
29
0
Other-Survey
Program Manager Survey_Part 3 Baseline
Modified
29
29
0
Other-Survey
Second Round Visits with State Administrators
Modified
15
23
0
Other-Site Visits
State Administrator Interview 12 Month
Modified
8
16
0
Other-Interview
State Administrator Interview Baseline
Modified
8
16
0
Other-Interview
Supervisor Group Interview 12 Month
Modified
33
50
0
Other-Interview
Supervisor Logs
Modified
1980
396
0
Other-Logs
Supervisor Survey Baseline
Modified
33
41
0
Other-Survey
Telephone contact with state administrators
Modified
49
49
0
Other-Telephone Contact
Visits and Calls with Local Program Directors
Modified
120
360
0
Other-Visits and Calls
Total burden requested under this ICR:
17337
5786
0
To view an IC, click on IC Title