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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
Unchanged
160
200
0
Other-Survey
Supervisor Survey 12 Month
Unchanged
23
29
0
Other-Survey
Combined Home Visitor - Supervisor Baseline Survey
Unchanged
10
18
0
Other-Survey
Combined Home Visitor-Supervisor 12 Month Survey
Unchanged
10
18
0
Other-Survey
Community Service Provider Survey
Unchanged
510
51
0
Other-Survey
Direct Child Assessments
Unchanged
1445
1156
0
Other-Protocol - Child assessments
Direct parent-child interaction
Unchanged
2890
1734
0
Other-Protocol - parent-child interaction
Family Baseline Survey
Unchanged
1700
1700
0
Other-Survey
Family Screening and Consent
Unchanged
1889
189
0
Other-Screener
Family follow-up survey
Modified
1445
1445
0
Other-Survey
First Round Visits with State Administrators
Unchanged
18
27
0
Other-Site Visits
Home Visitor Group Interview 12 Month
Unchanged
57
86
0
Other-Interview
Home Visitor Individual Interview 12 Month
Unchanged
57
86
0
Other-Interview
Home Visitor Logs
Unchanged
10200
2040
0
Other-Logs
Other-Logs revised
Home Visitor Logs - Past 15 months
Unchanged
8500
765
0
Other-Logs
Home Visitor Survey 12 Month
Unchanged
160
200
0
Other-Survey
Measuring Height and Weight
Unchanged
2890
289
0
Other-Protocol - Child assessments
Other Home Visiting Programs Survey
Unchanged
142
14
0
Other-Survey
Program Manager Group Interview 12 Month
Unchanged
29
44
0
Other-Interview
Program Manager Survey 12 Month
Unchanged
29
58
0
Other-Survey
Program Manager Survey_Part 1 Baseline
Unchanged
29
15
0
Other-Survey
Program Manager Survey_Part 2 Baseline
Unchanged
29
29
0
Other-Survey
Program Manager Survey_Part 3 Baseline
Unchanged
29
29
0
Other-Survey
Second Round Visits with State Administrators
Unchanged
15
23
0
Other-Site Visits
State Administrator Interview 12 Month
Unchanged
8
16
0
Other-Interview
State Administrator Interview Baseline
Unchanged
8
16
0
Other-Interview
Supervisor Group Interview 12 Month
Unchanged
33
50
0
Other-Interview
Supervisor Logs
Unchanged
1980
396
0
Other-Logs
Supervisor Survey Baseline
Unchanged
23
29
0
Other-Survey
Telephone contact with state administrators
Unchanged
49
49
0
Other-Telephone Contact
Visits and Calls with Local Program Directors
Unchanged
120
360
0
Other-Visits and Calls
Total burden requested under this ICR:
34487
11161
0
To view an IC, click on IC Title