Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2018 ANA Grantee Meeting Pre-Survey New 188 47 0 Form and Instruction 1 Grantee Meeting Pre-Survey
2018 ANA Grantee Meeting Survey New 940 47 0 Form and Instruction 1 ANA GM - Blank Survey Form
2019 Low Income Home Energy Assistance Program (LIHEAP) Grantee Conference Feedback New 150 15 0 Other-
Other-
Other-
2019 National Runaway and Homeless Youth (RHY) Grantees Training Evaluations New 1750 93 0 Other-Feedback Form
Other-Feedback Form
Other-Feedback Form
2019 Reader Feedback: Brush Up on Oral Health New 325 27 0 Other-
2019 Youth Summit Committe Planning Survey New 26 7 0 Form and Instruction 1 ILIAD 2019 Youth Summit Planning Committee Survey
2020 ACF Native American Grantee Meeting Survey New 400 67 0 Other-Survey
2020 ACF Tribal Peer-to-Peer Grantee Meeting Survey New 250 21 0 Other-Survey
ACF Office of Regional Operations Curstomers Feedback for Learning Experiences New 7100 1588 0 Form and Instruction 1 ORO Webinar or Meeting Feedback Survey
ACF State and County Human Services Commissioner Surveys New 125 63 0 Other-Survey
Other-Survey
ANA Youth Summit Survey New 100 33 0 Form and Instruction 1 2018 I-LEAD Youth Summiot Survey
Administration for Native Americans (ANA) 2020 Discretionary Application Process and Peer Panel Review Surveys New 500 83 0 Other-Survey
Other-Survey
Administration for Native Americans (ANA) 2020 Initiative for Leadership, Empowerment and Development (I-LEAD) Youth Webinar Series Surveys New 120 30 0 Other-Survey
Other-Survey
Administration for Native Americans (ANA) Application Submission Process Feedback Survey New 300 50 0 Other-survey
Administration for Native Americans (ANA) Post Peer Panel Review Survey New 100 17 0 Other-
Adolescent Pregnancy Preventing Training & Technical Assistance New 100 33 0 Form and Instruction 1 Attachment 1-Survey
Adolescent Pregnancy Prevention Training & Technical Assistance 2019 Conference Feedback Surveys New 1925 201 0 Other-survey
Other-survey
Adolescent Pregnancy Prevention Training & Technical Assistance 2020 Conference Feedback Surveys New 2200 200 0 Other-Survey
Other-Survey
Other-Survey
Audience Research for Sexual Risk Avoidance (SRA) Social Media Marketing Campaign New 100 150 0 Form and Instruction 1 Attachment 1
Form and Instruction 1 CTK Parent Consent Form
Form and Instruction 1 CTK Youth Assent Form
Building Evidence Training (BET) Project Usability Testing New 43 98 0 Other-Attitude Scale
Other-Post Test
Other-Pre-Post Test
Other-Pre-Post Test
Other-Pre-Post Test
Other-Pre-Post Test
Other-Pre-Post Test
Other-Knowledge Checks
Other-Survey
Other-survey
Other-Survey
CCDF Administrator Feedback Collection New 65 11 0 Form and Instruction 1 CCDF Administrators
Center for States 2020 Needs Assessment Survey New 200 33 0 Other-Survey
Center for States Needs Assessment Focus Group New 30 30 0 Other-Focus Group Protocol
Center for States Subscription Form New 1223 61 0 Other-Subscription Form
Child Care Development Block Grant (CCDBG) Implementation Research Webinar Feedback Poll New 200 7 0 Other-poll
Child Care Development Block Grant (CCDBG) Implementation Research and Evaluation Grantees - Meeting Evaluation Form New 27 2 0 Other-survey
Child Care Development Block Grant (CCDBG) National Webinar Feedback Poll New 100 2 0 Other-Poll
Child Care and Development Block Grant (CCDBG) Implementation Research and Evaluation Grantees - Meeting Evaluation Form New 22 2 0 Other-Survey
Child Care and Development Fund (CCDF) Policies Database Pop-Up Survey of Website Users New 500 25 0 Other-survey
Child Welfare Capacity Building Collaborative Customer Feedback for Webinars and Events New 53 27 0 Other-Questionnaire
Child Welfare Information Gateway Needs Assessment Focus Group Guide New 32 48 0 Other-Focus Group Guide
Child Welfare Information Gateway Prevention Resource Guide Tip Sheet Feedback Form New 35 6 0 Other-Feedback Form
Child Welfare Information Gateway Subscription Form New 24888 1244 0 Other-subscription survey
Child Welfare Information Gateway's Customer Satisfaction Assessment New 8150 423 0 Form and Instruction 1 CWIG Customer Satisfaction Assessment Data Collection Instruments
Child Welfare Program Improvement Plan Pilot Evaluation New 336 154 0 Form and Instruction 1 PIPPilot
Form and Instruction 1 PIPPilot
Form and Instruction 1 PIPPilot Onsite Feedback Survey
Form and Instruction 1 PIPPilot PreonsiteFeedbackSurvey
Children's Bureau Grantee Connection Survey New 112 9 0 Other-survey
Children's Bureau Grantee Feedback Survey New 140 12 0 Other-
Coaching Companion Questionnaire New 350 41 0 Other-Survey
Comment Form: Fatherhood Research and Practice Netrwork Learning Community New 40 3 0 Form and Instruction FRPN Feedback Instrument FRPN Feedback Instrument
Comment Form: 2018 OPRE Innovative Methods Meeting. New 100 8 0 Other-Meeting Feedback Form
Comment Form: 2019 OPRE Innovative Methods Meeting. New 125 21 0 Other-
Communities of Practice New 60 8 0 Form and Instruction 1 Communities of Practice
Community Economic Development (CED) Grantee Training Needs Assessment New 164 41 0 Other-
Community Economic Development (CED) or Rural Community Development (RCD) Grantee Discussion Groups New 90 90 0 Other-Discussion Group
Course Participant Knowledge Gain Assessment and Instructior and Course Participant Experimental Feedback New 145 145 0 Form and Instruction 36 EBPAS-36
Form and Instruction 1 Instructior Experience Survey Final
Form and Instruction 1 Instructor Unit Survey Final
Form and Instruction 1 Participant Experience Survey Final
Form and Instruction 1 Unit 1 Post Test Final
Form and Instruction 1 Unit 2 Post-Test Final
Form and Instruction 1 Unit 2 Pre-Test Final
Form and Instruction 1 Unit 3 Post-Test Final
Form and Instruction 1 Unit 3 Pre-Test Final
Form and Instruction 1 Unit 4 Post-Test Final
Form and Instruction 1 Unit 4 Pre--Test Final
Form and Instruction 1 Unit 5 Post-Test Final
Form and Instruction 1 Unit 5 Pre-Test Final
Form and Instruction 1 Unit 6 Post-Test Final
Form and Instruction 1 Unit 6 Pre-Test Final
ECTTAS Coordination Survey New 60 6 0 Form and Instruction 1 ECTTAS Coordination Survey
Evaluation of Family Violence Prevention and Services Act (FVPSA) Regional Meeting New 250 63 0 Other-Survey
Evidence-Building Academy Participant Project Introduction New 100 72 0 Other-Project Introduction
FY2019 New Capacity Building Center for States Community of Practice: County Administered State Support Interest Survey New 45 4 0 Other-Interest Survey
Family Violence Prevention and Services (FVPSA) 2019 Tribal Grantee Meeting New 253 21 0 Other-
Family Violence Prevention and Services (FVPSA) 2020 Tribal Grantee Meeting New 65 5 0 Other-Questionnaires
Feedback Colection for Peer Leaning New 100 13 0 Form and Instruction 1 Peer Learning
Feedback Survey for Human Trafficking webinars, online training, online sessions hosted by the Family and Youth Services Bureau New 500 83 0 Other-Survey
Feedback Survey for Technical and Training Assistance Activities for Family and Youth Services Bureau/ Runaway and Homeless Youth grantees New 80 13 0 Other-survey
Feedback Survey for capacity building, grantee, training, online sessions hosted by the Family and Youth Services Bureau New 500 83 0 Other-Survey
Feedback from Child Care and Early Education Policy Research Consortium (CCEEPRC) Members on the CCEEPRC 2019 Annual Meeting New 200 27 0 Other-Survey
Feedback from Child Care and Early Education Policy Research Consortium (CCEEPRC) Members on the CCEEPRC 2020 Annual Meeting New 150 25 0 Other-Feedback Survey
Feedback on Child Care and Development Fund Plan for States/Territories for FFY 2019–2021 (ACF–118) New 56 84 0 Other-Focus Group Protocol
Feedback on Mixed-Delivery System and Service Coordination to Inform Appropriate, Tailored and Timely Technical Assistance New 46 4 0 Other-Survey
Feedback on National Center on Parent, Family and Community Engagement (NCPFCE) Resources New 450 75 0 Other-Survey
Feedback on Strategies Related to Opioid Misuse New 1574 131 0 Form and Instruction 1 Feedback Form on Strategies Related to Opioid Misuse
Feedback on Webinars for Data Use and General Info for the National Survey of Early Care and Education (NSECE) New 600 32 0 Other-Registration Questions
Other-Post-webinar questions
Focus Group with Healthy Marriage and Relationship Education (HMRE) New 40 53 0 Form and Instruction 1 SARHM generic OMB
Grant Review Panel Chair Development Training New 30 3 0 Other-Feedback form
Grantee Exchange Platform Survey New 52 4 0 Other-Survey
Grantee Feedback for the FVPSA Formula Grantee Meeting Planning New 100 100 0 Other-Discussions
HSICC Post Phone Call Survey New 300 15 0 Form and Instruction 1 Post Phone Calll Survey
Head Start Management Fellows (HSMF) Program Feedback Surveys New 270 53 0 Other-Survey
Other-Survey
Other-Survey
In-Person Convening Child Care Policy Research Partnership - Participant Feedback New 28 5 0 Other-Survey
Other-Group Questions
In-Person Convening Child Care Policy Research Partnership – Participant Feedback New 38 3 0 Other-Survey
Infant Toddler Spcialist Infividualized Technical Assistance New 9 1 0 Form and Instruction 1 Infant Toddler Specialist Individualized Technical Assistance
Infant Toddler Specialist Network Training for Trainers (TFT) New 180 35 0 Form and Instruction 1 Traininging for Training
Infant Toddler Specialist Presentation New 135 18 0 Form and Instruction 1 Infant Toddler Specialist Presentations
Information Architecture Testing of the Early Childhood Learning and Knowledge Center New 192 16 0 Form and Instruction 1 ECLKC-tree-jack survey instrument
Input on Key Functions of Early Care and Education Research Connections Website New 250 21 0 Other-Survey
Leadership Initiative Feedback Surveys New 70 14 0 Other-Midpoint Survey
Other-Final Event Survey
Listening Session Questions on OHS Training and Technical Assistance System New 80 20 0 Other-Survey
Maternal, Infant, and Early Childhood Home Visiting (MEICHV) Continuous Quality Improvement New 65 22 0 Form and Instruction 1 MIECHV
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) AGM 2019 – Peer Sharing Feedback Survey New 350 29 0 Other-Feedback Form
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) AGM 2019 – Peer Sharing Feedback Survey New 350 29 0 Other-Feedback Form
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) TA Satisfaction Survey New 150 25 0 Form and Instruction 1 DOHVE 2
Maternal, Infant, and Early Childhood Home Visiting All Grantee & Tribal Regional Meetings Feedback Tools New 1450 145 0 Other-
Other-
National Center on Early Childhood Health and Wellness (NCECHW) Infoline Feedback Form New 360 30 0 Other-
National Responsible Fatherhood Clearinghouse User Feedback and Content New 1125 94 0 Other-
National Youth in Transition Database (NYTD) Technical Assistance Utilization and Needs Survey New 291 24 0 Other-Survey
New Director Mentor Program (NDMP) Feedback Surveys New 63 21 0 Other-Initial Survey
Other-90 Day Check-in Survey
Other-2/3 Check-In Survey
Other-Final Check-In Survey
OFA TANF TA Convening Individual Session Assessment New 350 29 0 Form and Instruction 1 OFA Convening Individual Assessment
OFA TANF TA Convening Overall Evaluation Assessment New 400 33 0 Form and Instruction 1 OFA Convening Overall Assessment
OHS TTA Network Training Feedback Form New 1200 100 0 Form and Instruction 1 TTA Network Training Feedback
Office of Family Assistance PeerTA website Evaluation and Satisfaction Survey New 500 83 0 Other-Survey
Office of Refugee Resettlement (ORR) Refugee Programs Training and Technical Assistance Evaluation New 714 119 0 Other-Survey
Peer-Based Technical Training and Technical Assistance Feedback Collection Activities New 348 29 0 Other-Survye
Personal Responsibility Education Program (PREP) Grantee Training and Technical Assistance Satisfaction and Needs Assessment New 85 35 0 Other-survey
Poll questions for a National Runaway Safeline (NRS) webinar for grantees New 150 13 0 Other-polling questions
Program Management and Fiscal Operations (PMFO) Consulting Initiative (FCI) Feedback Surveys New 180 15 0 Other-Survey
Other-Survey
Other-Survey
Program Management and Fiscal Operations (PMFO) Feedback Survey about the General Business Studies Certificate. New 16 3 0 Other-Survey
Program Management and Fiscal Operations (PMFO) Feedback Surveys New 1875 196 0 Other-survey
Other-survey
Other-survey
Other-survey
Other-survey
Program Management and Fiscal Operations (PMFO) Hurricane Response and Recovery (HRR) Feedback Survey. New 24 4 0 Other-Survey
Public Assistance Reporting Information System (PARIS) Training Conference Post Event Survey New 240 20 0 Other-survey
Region XII MSHS T/TA Network Technical Assistance Services Delivery Feedback New 300 50 0 Form and Instruction 1 Region-XII-TTA Feedback Form
Region XII Migrant and Seasonal Head Start T/TA Service Deloivery Feedback New 40 10 0 Form and Instruction 1 Service Delivery Feedback Form OHS Region 12
Regorous Evaluation Technical Assistance (RETA) Feedback Form New 126 42 0 Form and Instruction 1 RETA-Feedback Form
Runaway and Homeless Youth (RHY) Program Virtual Town Halls (Interactive Polling Questions) New 650 11 0 Other-Polling questions
Runaway and Homeless Youth (RHY) Regional Meeting Evaluation New 450 38 0 Other-
Runaway and Homeless Youth (RHY) Regional Meeting Evaluation New 1300 108 0 Other-Survey
Sexual Risk Avoidance (SRA) Social Media Marketing Campaign New 400 33 0 Form and Instruction 1 Social Norms Quiz
Sexual Risk Avoidance (SRA) Social Media Marketing Campaign New 280 70 0 Form and Instruction 1 Attachment 1 Discussion Prompts
Form and Instruction 1 CTK Parent Consent Form
Form and Instruction 1 CTK Youth Assent Form
Form and Instruction 1 Display
Form and Instruction 1 Youth Assent Form The Hive
Sexual Risk Avoidance Education (SRAE) Grantee Needs Assessment New 126 32 0 Other-
Sexual Risk Avoidance Education (SRAE) Grantee Training and Technical Assistance Satisfaction Survey New 108 45 0 Other-Survey
Sexual Risk Avoidance Education (SRAE) Grantee Webinar Satisfaction Survey New 200 83 0 Other-Survey
State Capacity Building Center Tailored TA Feedback Collection for Impact Project New 18 5 0 Form and Instruction 1 OCC OMB SCBC Task 4 Impact Instrument
TA Assistance Feedback Collection for Webinars New 300 25 0 Form and Instruction 1 Task 3 Webinars
Tribal Home Visiting Technical Assistance Evaluation Feedback and Immediate Feedback Forms New 115 17 0 Other-
Other-
Usability testing for the "Pathways to Work Evidence Clearinghouse" website New 29 29 0 Other-Protocol
nFORM Help Desk Customer Service Feedback Surveys New 688 57 0 Other-Survey
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 76148 8178 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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