PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
(1) Classroom sampling form from Head Start staff
Unchanged
132
22
0
Other-Sampling Form
(16) Head Start child assessment for plus study (AI/AN FACES)
Unchanged
668
501
0
Other-Assessment
(17) Head Start parent survey for plus study (AI/AN FACES)
Unchanged
273
137
0
Other-Survey
(18) Head Start teacher child report for plus study (AI/AN FACES)
Unchanged
648
110
0
Other-Report
(19) Head Start core parent survey for plus study (AI/AN FACES Spring 2016)
Unchanged
294
147
0
Other-Survey
(2) Child roster form from Head Start staff (AI/AN FACES)
Unchanged
12
4
0
Other-Roster Form
(20) Head Start core teacher survey for plus study (AI/AN FACES)
Unchanged
27
16
0
Other-Survey
(21) Head Start program director core survey for plus study (AI/AN FACES)
Unchanged
7
2
0
Other-Survey
(22) Head Start center director core survey for plus study (AI/AN FACES)
Unchanged
12
4
0
Other-Survey
(K.1) Head Start parent consent form for Plus study (AI/AN FACES)
Unchanged
345
59
0
Other-Consent
Child roster form from Head Start staff
Unchanged
40
13
0
Other-Roster Form
Early care and education providers survey for Plus study (5E-Early Ed pilot)
Unchanged
160
53
0
Other-Survey
Early care and education providers survey for Plus study (FPTRQ)
Unchanged
80
6
0
Other-Survey
Head Start core center director survey
Unchanged
120
50
0
Other-Survey
Head Start core child assessment
Unchanged
1600
1200
0
Other-Child Assessment
Head Start core parent consent form
Unchanged
800
136
0
Other-Consents
Head Start core parent survey
Unchanged
1600
528
0
Other-Survey
Head Start core program director survey
Unchanged
60
30
0
Other-Survey
Head Start core teacher child report
Unchanged
1600
272
0
Other-Child Report
Head Start core teacher survey
Unchanged
240
120
0
Other-Survey
Head Start fall parent supplement survey
Unchanged
800
64
0
Other-Survey
Head Start parent engagement interview consent form (Appendix J-5)
Unchanged
120
20
0
Other-Consent
Head Start parent qualitative interview (Family Engagement)
Unchanged
120
120
0
Other-Interview
Head Start spring parent supplement survey
Unchanged
800
64
0
Other-Survey
Head Start staff (FSS) roster form
Unchanged
20
3
0
Other-Roster Form
Head Start staff engagement interview consent form (Appendix J-7)
Unchanged
60
10
0
Other-Consent
Head Start staff qualitative interview (FSS Engagement)
Unchanged
60
60
0
Other-Interview
Letter for Center Director
Unchanged
308
25
0
Instruction
Telephone script for on-site coordinators
Modified
154
116
0
Other-script
Telephone script for program directors
Modified
154
154
0
Other-script
Total burden requested under this ICR:
11314
4046
0
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