Business for-not-for-Profit (Respondents)

Appendix I. Observation Checklist

OMB No. 0584-[NEW]

Assessment of Mandatory E&T Programs

Month XX, 2018

Project Officer: Jordan Younes

Office of Policy Support

Food and Nutrition Service

U.S. Department of Agriculture

3101 Park Center Drive

Alexandria, VA 22303

703-305-2935

Jordan.younes@fns.usda.gov

Assessment of Mandatory E&T Programs:
Observation Checklist

Site teams will use this checklist when conducting observations at the local SNAP offices and E&T providers. To the extent possible, teams will observe key steps in the path to SNAP E&T participation and sanctioning: screening and referral, orientation, assessment, compliance determinations, and/or issuing notices of noncompliance or sanctions. Teams should split to achieve the greatest possible number of observations. Ask clarifying questions about the activities being observed. If questions would intrude upon the observed activity, reserve them until the activity ends. If you are unable to observe an activity of interest, you may ask staff to show you how they typically conduct said activity. For instance, if you are observing a screening and the participant is exempt, you may ask staff to show you how they would have referred the client to E&T if the client were mandatory.

Provide a brief introduction to the study prior to conducting your observation. If a client is present and will provide personal information, such as during a screening, obtain permission from the client to conduct the observation and reassure that any information provided will be considered private.

Make a copy of this checklist to use with each observation. Observations will not be recorded, and site teams should expand their notes shortly after conducting each observation.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-xxxx. The time required to complete this information collection is estimated to average 90 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302, ATTN: PRA (0584-xxxx*). Do not return the completed form to this address.

Site visitor: “Thank you for letting me observe your [activity] today. My name is [name], and I’m a researcher at [Insight/Mathematica, working with Insight]. We are trying to better understand how SNAP E&T works in [State], so this will help us see how [pick category that applies to activity: application, E&T intake, sanctioning] works. We may take a few notes, but we will never share this information with anyone outside our study team, and we will not identify you or use your name in our reporting. Do you have any questions?”

State:	Date of observation:
Site location:	Observer:
Activity observed: ______________________________________	Time/duration of activity:

1. Notes

2. Observation Guide

Below is a list of activities you may observe during your visit. Each activity lists questions you are likely to address during the course of your observation. Address these questions to the extent possible, but also expand your notes to include your impressions of the activity and interactions that occurred.

Staff and Documents

[Document for all activities]

1. Job title of staff member(s) observed

2. What guidance is the staff member using to complete the observed activity? Describe and ask for a copy.

3. What documents are given to clients during the observed activity? Describe and ask for a copy.

Screening and Referral

4. Describe the demeanor of the worker, the client/worker interaction, the clarity of the process, etc.

5. Describe the mode of the screening (e.g., online, telephone, mail, in person), location if in person, accessibility, and privacy.

6. How was the screening scheduled? How long did it take to complete?

7. Describe how the screening is conducted. What types of questions are asked? How clear do they appear to be to the client? How does the worker respond to questions?

8. Describe how individual exemptions or deferments are determined and whether all possible exemptions are explored by the eligibility worker.

9. What happens after screening? What information is given to mandatory clients? Are next steps clear?

10. Describe referral to E&T provider. How is the provider selected?

11. How much time is the client given to report?

Orientation

12. Describe the demeanor of the presenter, the clarity of the orientation, the questions clients ask, how the worker responds to questions, etc.

13. Describe the mode of the orientation (e.g., online, in person), location if in person, and accessibility

14. How was the orientation scheduled? How long did it last?

15. Describe the orientation in detail. What information is provided? By whom? In what format?

16. What information is provided about next steps?

17. Describe other activities included in the orientation (e.g., assessment, workfare screening, soft skills instruction).

Assessment

18. Describe the introduction to the assessment, client understanding of its purpose, interaction between workers and clients, etc.

19. Describe the mode of the assessment (e.g., online, telephone, in person), location if in person, accessibility, and privacy.

20. How was the assessment scheduled? How long does it take to complete?

21. Describe the assessment(s): test instrument used (e.g., TABE), work experience, education, career interests, barriers.

22. Describe how the assessment results are used (e.g., exemption, component assignment, support services).

Support Services

[May occur during any number of steps in the intake process]

23. How is eligibility for support services determined? What factors do staff take into consideration when determining the type and amount of support needed?

24. How are supports administered?

25. What is the client’s reaction to the supports provided? Do staff think the supports are sufficient to allow participation in E&T? What do workers think about the type and amount of supports provided?

26. Does the client need other supports that are not covered? What are they? Do staff exempt clients when supports they need are not covered?

Compliance Determination

27. Describe the conciliation process (if applicable) and/or any efforts taken to reengage a client prior to sanction.

28. Describe how good cause is determined. What act of noncompliance is being reviewed? What criteria are used to make the determination? What information does the worker rely on? How much leeway does the worker have in determining good cause?

Issuing NOAAs

29. Describe how the site issues sanctions for failure to meet E&T requirements. How are notices mailed to clients?

30. What information is provided to participants about noncompliance/sanctions?

1. Does the notice specify (1) the act of noncompliance, (2) the proposed sanction period, (3) the steps needed to avoid a sanction, and (4) notice that they can reapply after the sanction period ends?

31. What are the worker’s impressions of the Notice of Adverse Action (NOAA)? Does the worker comment on its clarity? [Collect copies of NOAA if available.]