Form 1 TTA Activity Survey Introduction

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Training and Technical Assistance (T/TA) Activity Survey - Introduction
Expiration Date: 06/30/2013

OMB NO.: 0970-0377
Training and Technical Assistance (T/TA) Activity Survey

Welcome to the Child Welfare Training and Technical Assistance Evaluation (T/TA) weblink for completing a survey on your experience with
providers of the Children's Bureau's T/TA Network.
Based on your participation in T/TA from Western and Pacific CW Implementation Center (WPIC), you have been randomly selected to assist in
an independent cross-site evaluation of the Children's Bureau's National Resource Centers (NRCs) and Implementation Centers (ICs). Your
participation is a critical component of this evaluation and is vital to providing important information to the Children's Bureau about the
effectiveness of T/TA.
This cross-site evaluation addresses the role of T/TA services in helping states and tribes improve their child welfare systems. We are
interested in learning more about your experiences with a particular T/TA activity that was provided to American Samoa. The questions in this
survey will focus on the selected activity described below.
For purposes of this evaluation, we define the child welfare system to include the child welfare agency, the courts and legal system, social
service agencies, and other child-serving providers. Some respondents to this survey may be counties, territories, or local jurisdictions, but for
the purposes of a common language, we use the generic term of "State or Tribe" in this survey.
It takes about 15 minutes to answer the questions. Your privacy is very important to us. Your responses will be combined with the answers
from agencies across the country and individual answers will not be associated with organizations or respondents. If you should have any
questions about the survey, please contact Dr. James DeSantis at JBA via email at desantis@jbassoc.com or via phone at 800-546-3230.
The questions for this survey pertain to the following T/TA activity:
State/Tribe: American Samoa
T/TA Recipient Lead:
Lead T/TA Provider: Western and Pacific CW Implementation Center (WPIC)
Lead T/TA Provider Point of Contact: Joel, jeiholzer@icfi.com, 540-230-6237
Other T/TA Providers involved in T/TA, if applicable: NRC for Adoption (NRCA)
Primary Mode of Contact: Teleconference/telephone calls
Primary Type of T/TA:
Date(s) of T/TA Activity: 04/18/2011
Description: This is my description
Contact Hours: 6.0
This survey should be completed by the State/Tribal T/TA Liaison or the person most knowledgeable of the aforementioned T/TA activity. Are
you the appropriate person to respond to this T/TA survey?
Yes, begin survey
No, Stop. You do not need to continue with this survey. Please indicate the name, title, and email of the person in your
agency/organization most knowledgeable of this T/TA Activity:
Name:

(required)

Title:
Email:

(required)

Phone:

(XXX-XXX-XXXX)

Phone Ext:

This evaluation is being conducted by James Bell Associates and its subcontractor, ICF International, and is funded by the Children's Bureau

5/12/2011 9:33 AM