Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Instrument 10: Parent–child interaction Modified 537 92 0 Other-Parent-Child Interaction (2020 and 2021)
Instrument 1: Classroom/ home visitor sampling form (from EHS staff) Modified 262 45 0 Other-Sampling Form (2021)
Other-Sampling Form (2020)
Instrument 2: Child roster form (from EHS staff) Modified 175 59 0 Other-Roster Form (2021)
Other-Roster Form (2020)
Instrument 3: Parent consent form Modified 1617 276 0 Other-Consent (2021)
Other-Consent (2020)
Instrument 4: Parent survey Modified 1042 553 0 Other-Survey (2021)
Instrument 5: Parent Child Report Modified 1209 400 0 Other-Child Report (2020)
Other-Child Report (2021)
Instrument 6: Staff survey (Teacher survey and Home Visitor survey) Modified 761 381 0 Other-Survey (2020)
Other-Survey (2020)
Other-Survey (2021)
Other-Survey (2021)
Instrument 7: Staff Child Report Modified 1331 333 0 Other-Child Report (2020)
Other-Child Report (2020)
Other-Child Report (2021)
Other-Child Report (2021)
Instrument 8: Program director survey Modified 65 33 0 Other-Survey (2020)
Other-Survey (2021)
Instrument 9: Center director survey Modified 168 85 0 Other-Survey (2020)
Other-Survey (2021)
Total burden requested under this ICR: 7167 2257 0  
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