FastTrack GenIC - PDG-5 TA Feedback Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION: Preschool Development Grant Birth through Five (PDG B-5) Technical Assistance (TA) Feedback Form

PURPOSE AND USE: The Administration for Children and Families (ACF) Office of Early Childhood Development Preschool Development Grant Birth through Five (PDG B-5) Program collects feedback from grant recipients about their satisfaction to inform the planning of training and TA delivered through webinars, peer calls, workshops, community of learnings, and similar events. The information is intended for internal use and planning to help ensure that ACF provides PDG B-5 grant recipients with effective and efficient support.

DESCRIPTION OF RESPONDENTS: The PDG B-5 program provides grants to states and territories to strengthen early childhood systems to prepare low-income and disadvantaged children to enter kindergarten. Grantee team members such as directors, partners, and evaluators participate in universal and targeted TA opportunities and receive individualized TA from TA Specialists.

TYPE OF COLLECTION:

[ ] Customer Comment Card/Complaint Form [X ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The primary purpose of the results is not for public dissemination.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name and affiliation: Anne Bergan, Senior Policy Analyst, Office of Early Childhood Development

To assist review, please provide answers to the following questions:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Tokens of Appreciation or Honoraria:

Will a token of appreciation or honoraria be provided to participants? [ ] Yes [ X ] No

BURDEN HOURS

Information Collection	Category of Respondent	No. of Respondents	No. of Responses per Respondent	Estimated Time per Response	Burden Hours
PDG B-5 Training and Technical Assistance Feedback Form	Private Sector	30	1	2 minutes	1 hour

FEDERAL COST: The estimated annual cost to the Federal government is $ 150.00_based on labor hours by the contractor to collect and analyze submissions.

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X ] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Participants of training and TA events are current PDG B-5 grant recipients. Grantee project directors will be invited to provide feedback on the quality of the TA received.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ X ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ X ] No

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