View Information Collection (IC)
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
The Home-Based Child Care Toolkit for Nurturing School-Age Children Pilot Study
Agency IC Tracking Number:
OPRE
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Interview Script
Instrument 1. Phase one provider telephone script and recruitment information collection_clean_12-2-22 .docx
Yes
Yes
Fillable Printable
Other-Interview Script
Instrument 2. Phase two provider telephone script and recruitment information collection_clean_12-2-22 .docx
Yes
Yes
Fillable Printable
Other-Questionnaire
Instrument 3. HBCC-NSAC Toolkit Provider Questionnaire_English_clean_12-7-22.docx
Yes
Yes
Fillable Printable
Other-Questionnaire
Instrument 4. HBCC-NSAC Toolkit Family Questionnaire_clean_12-2-22.docx
Yes
Yes
Paper Only
Other-Interview Guide
Instrument 5. Phase one provider cognitive interview guide_clean_12-2-22.docx
Yes
Yes
Fillable Fileable
Other-Interview Guide
Instrument 6. Phase one family cognitive interview guide_clean_12-2-22.docx
Yes
Yes
Fillable Fileable
Other-Logistical Interview
Instrument 7. Family data collection logistics call_clean_12-2-22.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
990
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
50 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
990
0
0
0
0
990
Annual IC Time Burden (Hours)
323
0
0
0
0
323
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix A: Community organization outreach materials
Appendix A Community organization outreach materials_clean_12-2-22.docx
12/14/2022
Appendix A: Community organization outreach materials Spanish
Appendix A Community organization outreach materials_Spanish_12-2-22.docx
12/14/2022
Appendix B: Phase one provider and family recruitment materials
Appendix B Phase one provider and family recruitment materials_clean_12-2-22.docx
12/14/2022
Appendix B: Phase one provider and family recruitment materials Spanish
Appendix B Phase one provider and family recruitment materials_Spanish_12-2-22.docx
12/14/2022
Appendix C: Phase two provider and family recruitment materials
Appendix C Phase two provider and family recruitment materials_clean_12-2-22.docx
12/14/2022
Appendix C: Phase two provider and family recruitment materials Spanish
Appendix C Phase two provider and family recruitment materials_Spanish_12-2-22.docx
12/14/2022
Appendix D: Supplemental provider and family recruitment materials
Appendix D Supplemental provider and family recruitment materials_clean_12-2-22.docx
12/14/2022
Appendix D: Supplemental provider and family recruitment materials Spanish
Appendix D Supplemental provider and family recruitment materials_Spanish_12-2-22.docx
12/14/2022
Appendix E: HBCC-NSAC Toolkit provider questionnaire matrix sampling
Appendix E HBCC-NSAC Toolkit provider questionnaire matrix sampling_clean_12-2-22.docx
12/14/2022
Appendix F: Consent
Appendix F Consent_clean_12-2-22.docx
12/14/2022
Appendix F: Consent Spanish
Appendix F Consent_Spanish_12-2-22.docx
12/14/2022
Appendix G: Sources for HBCC-NSAC Toolkit development
Appendix G Sources for HBCC-NSAC Toolkit development_clean_12-2-22.docx
12/14/2022
Appendix H: HBCC-NSAC Toolkit English version pre-test summary
Appendix H HBCC-NSAC Toolkit English version pre-test summary_clean_12-2-22.docx
12/14/2022
Appendix I: Provider and family invitations
Appendix I Provider and family invitations_clean_12-2-22.docx
12/14/2022
Appendix I: Provider and family invitations Spanish
Appendix I Provider and family invitations_Spanish_12-2-22.docx
12/14/2022
Appendix J: Family data collection instructions
Appendix J Family data collection instructions_clean_12-2-22.docx
12/14/2022
Appendix J: Family data collection instructions Spanish
Appendix J Family data collection instructions_Spanish_12-2-22.docx
12/14/2022
Appendix K: Frequently asked questions
Appendix K Frequently asked questions_clean_12-2-22.docx
12/14/2022
Appendix K: Frequently asked questions Spanish
Appendix K Frequently asked questions_Spanish_12-2-22.docx
12/14/2022
Appendix L: Provider and family thank you letters
Appendix L Provider and family thank you letters_clean_12-2-22.docx
12/14/2022
Appendix L: Provider and family thank you letters Spanish
Appendix L Provider and family thank you letters_Spanish_12-2-22.docx
12/14/2022
Home-Based Child Care Toolkit for Nurturing School-Age Children Pilot Study SSA
HBCCSQ CLIN 7 HBCC-NSAC Toolkit Pilot Study_SSA_clean_12-13-22.docx
12/14/2022
Home-Based Child Care Toolkit for Nurturing School-Age Children Pilot Study SSB
HBCCSQ CLIN 7 HBCC-NSAC Toolkit Pilot Study_SSB_clean_12-2-22.docx
12/14/2022
Instrument 1: Phase one provider telephone script and recruitment information collection Spanish
Instrument 1. Phase one provider telephone script and recruitment information collection_Spanish_12-2-22.docx
12/14/2022
Instrument 2: Phase two provider telephone script and recruitment information collection Spanish
Instrument 2. Phase two provider telephone script and recruitment information collection_Spanish_12-2-22.docx
12/14/2022
Instrument 3: HBCC-NSAC Toolkit provider questionnaire Spanish
Instrument 3. HBCC-NSAC Toolkit Provider Questionnaire_Spanish_clean_12-7-22.docx
12/14/2022
Instrument 4: HBCC-NSAC Toolkit family questionnaire Spanish
Instrument 4. HBCC-NSAC Toolkit Family Questionnaire_Spanish_clean_12-2-22.docx
12/14/2022
Instrument 5: Phase one provider cognitive interview guide Spanish
Instrument 5. Phase one provider cognitive interview guide_Spanish_12-2-22.docx
12/14/2022
Instrument 6: Phase one family cognitive interview guide Spanish
Instrument 6. Phase one family cognitive interview guide_Spanish_12-2-22.docx
12/14/2022
Instrument 7: Family data collection logistics call Spanish
Instrument 7. Family data collection logistics call_Spanish_12-2-22.docx
12/14/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.