Senior Companion Program Quality of Care Evaluation -- Parts 1-5

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
29271	Senior Companion Program Quality of Care Evaluation -- Parts 1-5	Migrated

ICR Details

OMB Control No: 3045-0057	ICR Reference No: 199906-3045-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: CNCS	Agency Tracking No:
Title: Senior Companion Program Quality of Care Evaluation -- Parts 1-5
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/19/1999
	Date Received in OIRA: 06/14/1999
Terms of Clearance: Approved as amended by and consistent with CNCS' memos and revisions of 8/5/99 and 8/17/99. In addition, the following terms of clearance apply: (1) Because it lacks practical utility and is duplicative with other questions, CNCS will not include the following question in the survey: *During the past week, have you felt that your life was empty?* (2) CNCS will make every effort to maximize the the number of family members/caregivers of clients affiliated with the SCP program. In order to ensure a maximum effective response rate, CNCS will try to contact as close to 100% of the family/caergivers of clients as as possible. (3) Publications issued by CNCS that sites the results of this Evaluation will include a notation that provides the initial sample rate of clients and family/caregivers located and the corresponding response rate for completed interviews.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2002	08/31/2002
Responses	7,800	0	0
Time Burden (Hours)	1,492	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: To complete a congressionally mandated evaluation of programs created under the Domestic Volunteer Service Act, CNCS must assess the impact of senior volunteers on clients, family members/caregivers, and agencies served. The five surveys described here are an essential component of that assessment. The sample includes 1,800 clients, 640 family members/caregivers, and approximately 160 agencies. Results will be reported to Congress and the general public and be used by CNCS for program improvement.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Senior Companion Program Quality of Care Evaluation -- Parts 1-5

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	7,800	0	0	7,800	0	0
Annual Time Burden (Hours)	1,492	0	0	1,492	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/14/1999

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